When Grief After a Loss Is Long-Lasting

More from our inbox:

• The Value of Oral Exams for Undergraduates
• The Risks if U.S. Foreign Policy Turns Inward

To the Editor:

Re “Grief Is a Forever Thing,” by Jill Bialosky (Opinion guest essay, Dec. 4):

I agree with Ms. Bialosky that “prolonged grief,” a new entry in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, may be problematic. Characterizing prolonged grief (lasting more than a year, according to the D.S.M.-5) as pathological reflects our cultural unease in the face of bereavement, especially after a suicide, and the expectation that one should “get over it.”

When my mother ended her life 42 years ago, it took me totally by surprise. She was stoical in all things, including and especially her inner turmoil. For years, I tried to understand why she had made such a desperate choice for herself, but the answer eluded me; my mother had taken it with her when she ended her life.

Suicide remains a mystery to those of us who do not make that choice. And the mystery is one reason grief after suicide is a forever thing. We can never fully know why, but we can come to accept that mystery and integrate it, along with the person we’ve lost, into our ongoing lives.

Victoria Alexander
Bath, Maine
The writer is the author of “In the Wake of Suicide: Stories of the People Left Behind.”

To the Editor:

The inclusion of prolonged grief in the D.S.M.-5 does not at all deny the integrity and poignancy of lifelong reactions to events like suicides. It merely allows a diagnosis — to enable insurance payments to cover the treatment for times when suffering people cannot function as they wish or need to.

Far from injurious or stigmatizing, this can be lifesaving.

Deborah Fried
New Haven, Conn.
The writer is an associate clinical professor of psychiatry at Yale University.

To the Editor:

Jill Bialosky does her best to suggest that grief that goes on forever is neither pathological nor necessarily a bad thing. Grief, she says, is evidence that you loved, missed and cherished someone who has died too early, from suicide in her sister’s case, but presumably from other causes as well.

The manual of psychiatric disorders disagrees. And so do I. Grief that prevents one from engaging in one’s own life can be debilitating and, God forbid, lead to one’s own early demise by suicide. Getting rid of endless grief is not the same as devaluing the one who has died.

I know, because six people in my family died by suicide. I am lucky: Through powerful therapies I have learned how to put the PTSD behind me.

Christopher Lukas
Sparkill, N.Y.
The writer is the co-author of “Silent Grief: Living in the Wake of Suicide.”

To the Editor:

From 1991 to 1995, I lost four siblings and in-laws, ages 27 to 41, to suicide, murder and AIDS. Life is split between Before and After.

I have gotten used to the reality. The shock and searing pain have subsided, but I remember my lost loved ones with sadness every day.

If psychiatrists and psychologists want to call my lasting grief a mental disorder, so be it. Try going through what I’ve experienced, and see if you come out differently.

Mary van Valkenburg
Hobart, N.Y.

The Value of Oral Exams for Undergraduates

To the Editor:

Re “Bring Back the Oral Exam,” by Molly Worthen (Opinion guest essay, Dec. 4):

Dr. Worthen’s thoughtful essay praising the value of oral exams for undergraduate students does not mention an important added use for such exams. As an adjunct professor at Northeastern University in the fields of psychology and project management, I sometimes offer oral exams to students who qualify for physical or psychological accommodations.

Both the students and I enjoy the back-and-forth discussion of the course material in a setting that allows them to express their knowledge without feeling anxious about time limitations, filling in answer sheet bubbles, etc.

Peter Lifton
Lexington, Mass.

To the Editor:

As Molly Worthen described, after decades of teaching college biology, I find I can’t remember much of what even the best students wrote on exams. But I will never forget the student who came into my office so terrified of our oral exam that she had to put her head between her knees before we began.

As we talked about cell migration, the color came back to her face and her voice steadied. Soon her answers soared, and she explained mouse lung development with nuance and enthusiasm.

As we finished, she asked why I tested this way, and I told her that I failed my oral qualifying exam in graduate school. I was sitting there as her professor only because I learned not to be intimidated by more experienced scholars.

I thanked her for showing me just how brave a student could be, and hope I convinced her that her ideas were very worth sharing.

Rachel Fink
South Hadley, Mass.
The writer is a professor of biological sciences at Mount Holyoke College.

To the Editor:

A semester abroad at Oxford was exhilarating for combining the oral with the written. Every week I researched and wrote an essay, which I then read aloud to my professor in his chambers over a glass of sherry. The remainder of the hour was a freewheeling discussion of the topic at hand.

The rest of the day was laced with the thrill of walking on air, alive to a new scary challenge, hoping that next week’s meeting would again open my mind like a parachute and set me down safely.

Jefferson Eliot
Venice, Calif.

The Risks if U.S. Foreign Policy Turns Inward

To the Editor:

Re “Can America Envision World War III?,” by Stephen Wertheim (Opinion guest essay, Dec. 4):

Mr. Wertheim is certainly correct: Americans have lost touch with the potential costs of a great-power military conflict involving the United States, and should be made aware of the risks associated with continued U.S. global military leadership.

But they should also be made aware of the risks associated with a world in which the United States deems those risks to be too great, and chooses a more inward and aloof foreign policy.

Mr. Wertheim points to the post-Cuban missile crisis era, when the risks of “a third and total” world war impelled the United States and the Soviet Union toward détente.

In the 1970s, however, the Soviets used the guise of détente — and an America weary from the Vietnam War debacle — to advance its nuclear-war-fighting capabilities and help topple governments in Africa, Central Asia, the Middle East and Central America.

In the 1980s, President Reagan confronted Soviet militarism and expansionism with a huge military buildup, and a strong public argument defending it. He won a landslide re-election in 1984.

Since 1945, the American people have recognized that U.S. power and global engagement have played a decisive role in sustaining peace and reducing the chances of war. Those stakes have not changed simply because some of the actors have.

Stuart Gottlieb
New York
The writer teaches American foreign policy and international security at Columbia University.