Courtesy of the West Hudson Psychiatric Society newsletter, eSynapse, April 3023 edition
Article by Bro. Ulrick Vieux DO, MS, DFAPA
Director of Child and Adolescent Psychiatry Education at Hackensack University Medical Center & private practice in Pomona, NY
On February 12, 2023, I lost my cousin and god-brother, David Jolicoeur. David’s death follows the death of his younger brother, Michael Jolicoeur a year and a half before.
The loss of a cousin is a sobering reminder of the frailty of life. It is a reminder that we will all taste death, and at the end, we may ask ourselves and wonder what is the purpose of life? David’s death also presented a unique challenge to our family, in our bereavement, since David was a celebrity. He was the founding member of the legendary, ground-breaking group, De La Soul. The success of this group, from an artistic perspective, and equally important, as a business has been a source of inspiration for so many artists. Many contemporary artists have acknowledged being influenced by the music of De La Soul. Artists from Kanye West to Kendrick Lamar have been inspired by David’s genius.
A moment that really exemplified the influence of De La Soul in contemporary music for me was a couple of years ago when I was chair of the department of psychiatry at Garnet during the Covid pandemic; I saw an older white female wearing a De La Soul T-shirt. Intrigued, I introduced myself to this woman and expressed interest in her T-shirt. She mentioned how De La Soul was her favorite group and how she had been following them since the late 80’s. I asked her if I could take a picture of her, so I can send the pic to David. She was simply awestruck and this reaction really resonated with me.
Michael’s career was also inspirational. Michael was a tour manager and his artists have included Common and A Tribe Called Quest, among many other groups. I was amazed at how difficult of a job it is to be a tour manager. I remember a conversation I had with Michael about how he was so excited to have met one of his role models, who had been the tour manager of the Rolling Stones. I was fortunate to catch the Rolling Stones show at MetLife prior to the Covid pandemic. I believe that this show was one of the last shows that legendary drummer, Charlie Watts played in New York. Based on my conversation with Michael, I was able to appreciate the brilliance of the Rolling Stones show. Listening to Michael speaking of the intricacies of his craft was simply inspiring and has been a template on how I have pursued my career.
Hence, the loss of loved ones is very painful. The grieving process is a personal process and many people will eventually move forward with their lives. However, some people will find the death so debilitating that it will be difficult to move forward with their own life. This is known as complicated grief or persistent complex bereavement disorder. The pattern that is experienced following the loss is listed below. 1
- Accepting the reality of your loss
- Allowing yourself to experience the pain of your loss
- Adjusting to a new reality in which the deceased is no longer present
- Having other relationships
When grieving does not subside and remains intense, persistent and debilitating beyond 12 months, then the diagnosis of complicated grief is applicable. The symptoms of complicated grief are similar to major depression, but the distinctions are important in order to provide appropriate therapy. The mainstay for therapy of complicated grief is complicated grief therapy, which utilizes techniques used for depression and PTSD. However, with complicated grief treatment, the emphasis is the following. 1
- Learn about complicated grief and how it’s treated
- Explore such topics as grief reactions, complicated grief symptoms, adjusting to your loss and redefining your life goals
- Hold imagined conversations with your loved one and retell the circumstances of the death to help you become less distressed by images and thoughts of your loved one
- Explore and process thoughts and emotions
- Improve coping skills
- Reduce feelings of blame and guilt
- Other types of psychotherapy can help you address other mental health conditions, such as depression or PTSD, which can occur along with complicated grief.
Medications, specifically SSRIs have a role, as it relates to possible overlap with major depressive disorder. Death is a reality and it is important that we prepare for this and provide support for our loved ones and patients during this challenging period of the shared human experience.