Grief revisited.

The article serves to examine the cultural influences on attitudes towards the deceased and bereaved, as well as on the practice of mourning, and to revisit normal and pathological variants of grief. Grief is a subjective state of psychological and physiological reaction to the loss of a loved one. Reaction to the loss is experienced internally in a uniform manner across cultures. However, mourning, the voluntary social expression of the loss, varies from culture to culture. Rituals provide a standardised mode of behaviour, which helps to relieve the sense of uncertainty or loss. There were reports of ghost sightings involving foreign tourists in the 6 worst-hit southern provinces in Thailand following the tsunami tragedy. This phenomenon of "mass hallucinations" is understandable from the cultural perspective. New models of grief have been developed to account for the individuality and diversity of grief and to encompass the social, behavioural and spiritual dimensions of loss as well as those of the psychological and physical. Clinically, the duration of grief reactions varies widely, depending on the nature of the loss and the connection to the deceased. In the case of the tsunami tragedy, with relatives missing, homes swept away and familiar neighbourhoods turned into wastelands, many victims are likely to have complicated grief. Traumatic grief, which includes a prominent component of separation distress characterised by yearning and searching and frequent "bittersweet" recollections of the deceased, has been associated with long-term dysfunction. Grief work utilising the traumatic grief treatment protocol appears to be a promising intervention.