The medicalised context of bereavement
The medicalised context of bereavement

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The medicalised context of bereavement

2 Efforts to measure the effects of grief

2.1 Introduction

A rapidly growing branch of medical science has begun to try to measure the physiological impact of grief. Incorporated into this study are the ways in which bodily functions change in response to emotional stimuli. This new area of scientific research has been called ‘psychoneuroimmunology’ and is the study of how different feelings and stresses lead to changes in hormone levels and other metabolic functions within the body. These can often be quantified through blood tests and other physiological measurements, an example of which has come from Dutch clinical psychologist Ellen Beem and colleagues (Beem et al., 1999), who attempted to catalogue measurable physiological changes when people were bereaved.

In another area of scientific study, an argument is growing that there is a complex interaction between the brain and the immune system in emotional states such as depression and grief. American psychoneuroimmunologists Michael Irwin and Andrew Miller (2007) have proposed a model to demonstrate the way in which immunological responses are brought about by the emotions associated with bereavement (or depression). In their model, not only do emotional responses have an impact on the immune system: immunological changes in themselves go on to affect the way the brain works and emotions are experienced. They argue that these adverse circular actions and re-actions cause potentially serious medical and psychological effects that may lead to an increased susceptibility to many short-term conditions, such as infections, and a wide range of longer-term health problems, such as arthritis, ischaemic heart disease and cancer.

The precise mechanisms through which these adverse health effects are brought about are still being determined, but it has been suggested that people experiencing grief have some of their immunological responses stimulated while other ‘protective responses’ seem to be suppressed. In lay terms, the protective responses that may be damaged or reduced when someone experiences grief include the way in which immune cells, such as T cells and lymphocytes, work to control infections in the body and possibly even ingest or ‘mop up’ early cancer cells. At the same time, other components of the immune response are activated, such as inflammatory enzymes. The release of these substances and their subsequent effects on other organs may have relevance for the development of ischaemic heart disease and auto-immune disorders. Irwin and Miller argue that some of these adverse physiological effects can be controlled and reversed by factors such as physical exercise and sleep.

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