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Community Ment Health J. 1990 Feb;26(1):27-48.

Loss, stress, and mental health.

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Jerusalem Institute for the Study of Psychological Stress.


1. The loss of an attachment to a loved person or of some other significant attachment leads to a prolonged period of distress and disability. 2. The upset feelings are usually associated with reduction in cognitive effectiveness and problem-solving capacity, the magnitude of which is dependent on the intensity and duration of emotional arousal. There is a reduced capacity for collecting and processing information and for access to relevant memories that associate significant meaning to perceptions. There is also a deterioration in the clarity of the person's self-concept and in his capacity to assess his ability to persevere in the face of discomfort, which weakens his will to struggle. 3. The disability following loss of an attachment is the product of three interlocking factors: (a) the pain of the rupture in the bond and the agony of coming to terms with this reality, (b) the handicapping privation of the missing assets previously derived from the lost person or resource, and (c) the cognitive erosion and reduction in problem-solving capacities and of the will to persevere. 4. These factors may lead to poor mental health in the form of an acute adjustment disorder, or else of chronic psychopathology if the individual uses maladaptive ways of trying to escape his burdens through alienation from reality or through the irrational mechanisms of psychoneurotic symptoms, or if prolonged emotional tension leads to malfunctioning of a bodily system. On the other hand, if the individual masters his problems by working out ways of effective coping, he may emerge from the experience with increased competence and resilience. 5. Eventual mastery of the burdensome experience involves reorganization of the individual's "assumptive world," namely of his intrapsychic maps of external reality and his internal system for guiding and motivating his behavior, which have been disorganized by the loss of their anchorage in the ruptured attachment. 6. This reorganization is helped by the following: a. The maintenance of hope of eventual personal mastery that provides a basis for continued striving. b. Regular activity through adhering to a daily schedule of work and social interaction, even though this initially provides little emotional satisfaction and seems empty and meaningless. c. Seeking support from other people in compensating for current deficits and in helping lower the intensity of emotional arousal. d. Repeatedly remembering the values and guidance the person used to derive from the old attachments.(ABSTRACT TRUNCATED AT 400 WORDS).

[Indexed for MEDLINE]

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