Grief: Lessons from the past, visions for the future

Over the last millennium, patterns of mortality have changed and have determined who grieves and how. At all times grief has been recognized as a threat to physical and mental health. More recently the scientific study of bereavement has enabled us to quantify such effects and to develop theoretical explanations for them. This article reviews our evolving understanding of grief, focusing especially on the developments in research, theory, and practice that have come about in the last century. Wars and similar conflicts are associated with repression of grief, but methods of helping by facilitating its expression that developed during the 2 World Wars are less needed and effective at other times. In recent years more attention has been paid to the social context in which grief arises and, particularly, to the nature of the attachments that precede and influence the reaction to bereavement and to other traumatic life events. At the same time a range of caring resources has become available and acceptable to bereaved people and the results of scientific evaluation of these gives promise that we are moving toward an era in which more sensitive and appropriate care will be provided to the bereaved by both voluntary and professional caregivers.