Studies Suggest Theories on Grief : Years Later, the Loss of One's Parents Can Lead to Stress

The Washington Post

Eileen Simpson is a New York psychotherapist and author of such diverse books as "Reversals," about her own dyslexia; "Poets in Their Youth," about her first husband, poet John Berryman, and his circle of brilliant but troubled poets; and a novel, "The Maze," at least in part based on her doomed marriage to Berryman.

Simpson was an orphan, but until very recently she did not realize that that was probably the most compelling aspect of her life. She was never permitted to understand or properly mourn the death of her parents.

She was not even 1 year old when her mother died, and not yet 7 when her father followed. Nonetheless, the indelibility of the separation would shadow her life until, in middle age, following the death of her second husband of 20 years, the unassimilated grief, the never-completed mourning for parents she barely knew, burst upon her, compounding and prolonging the grief of her more recent loss.

In her just published book, "Orphans, Real and Imagined," she writes of her feelings months after her husband's death: "The black ink of anxiety spilled and spread, saturating the fabric of my life. The anguish I felt was greater than any I had known in mourning . . . for the first time in my life I felt profoundly orphaned."

"In some ways," says Dr. Alan Breier, a psychiatrist at the National Institute of Mental Health, "I think that losing a parent might be the most profound life experience of all. It is an experience that is with people every day of their lives."

Breier and his colleagues at the Clinical Neuroscience Branch of the institute have completed a study of 90 adult volunteers who responded to a newspaper advertisement for "adults who experienced separation from a parent during childhood."

Breier interviewed each of the volunteers and was struck, he said, by the fact that in almost every case, when he would say "tell me about the loss of your parent," there would be tears.

"In essence," he said, "it was extraordinarily profound, uncontrolled stress." One hypothesis suggests that such a loss induces the kind of learned helplessness seen in laboratory animals subjected to unavoidable stresses, such as electric shocks.

Based on earlier data on animals as well as on people, the institute's scientists were not surprised to discover that a high percentage of their volunteers had experienced psychological problems in adulthood. Of the 90, 69 (or 77%) had undergone a major psychiatric disorder. Most of these were depressions, with anxiety disorders second and alcoholism third.

Breier notes that the sample was self-selected, rather than a true random sampling of people who had lost parents in their youth.

But neither were the subjects mentally ill at the time. Only four of the volunteers were experiencing any signs of depression. "These are not people who are in treatment for anything," Breier said. "They're out there living in the community, not on any medication, not drinking alcohol or taking drugs. In fact, the socio-demographic profile of our group is that they are very high functioning."

The study was designed to try to identify those childhood experiences that might predict later psychiatric difficulties, as well as to determine if any biological signs of stress were evident in the people who had problems in later life.

The researchers also wondered what aspects of a childhood might prevent such a reaction.

By computer and elaborate statistical analysis of information obtained through interviews with the 90 subjects and a control group, the researchers found that "by far, the single most powerful predictor of adult psychopathology was the quality of home life and personal adaptation during childhood. In fact, that variable alone predicted 80% of all people who had a mood disorder."

Moreover, they found high levels of the stress hormones cortisol and ACTH in the blood of those who had had psychiatric problems. These higher levels also correlated with poorer home situations at the time of the parental loss.

The Breier study, which has been presented at two psychiatric conferences, now needs confirmation by prospective studies--following children through time after the loss of a parent. Several are currently under way, Breier said, "but our study would suggest that attending to a child's emotional needs is extremely important, and not attending to them could have long-term negative consequences.

"Understandably, the surviving parent is undergoing an enormous amount of pain," Breier said, "and it can be hard to look beyond his own pain to help the child grieve as well, but it might be important for other family members or mental health professionals to be attuned to these things."

Recalling the death of her second husband, the event that made her deal with her orphanhood, Eileen Simpson said: "What the crisis did was to blast through the powerful defense I'd built up of the lucky orphan. I had to believe that my losses had not been devastating . . . the intense anxiety and depression I suffered in the recent period of profound orphanhood had nothing to do with the present. They were holdovers from the past."

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