Narrative reconstruction therapy for prolonged grief disorder: Basic interventions and mechanisms of change

Abstract

Narrative reconstruction is a time-limited integrative therapy, originally developed in the context of post-traumatic stress disorder and adjusted for the treatment of prolonged grief disorder (PGD). It consists of exposure to the loss memory and narrating a detailed written reconstruction of it. In this paper, we describe narrative reconstruction interventions and modifications for the treatment of PGD as well as the underlying mechanisms of change including integration of the loss episode into the life narrative. A case demonstration of narrative reconstruction with a patient with PGD presented for illustration and the integrative nature of narrative reconstruction for PGD is discussed.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Referred to Freud’s paper Mourning and melancholia.

2 Sarah gave her consent to publish a report about her therapy. Significant personal details were changed to protect her identity. Sarah read a final draft of this report and approved its publication.

3 At various points during the therapy, the therapist suggested that Sarah write a letter to Mickey, but the idea seemed impossible to her. However, a week after she talked about her husband, she came with a letter for him (Session 10). This was the first time that Sarah talked about herself and Mickey with compassion. The therapist interpreted Sarah's decision to write a letter to her husband as the beginning of some inner movement, and as a brave, though terrifying, attempt to touch upon the past. It seemed that Sarah was adapting her movements to her evolving capabilities. It seemed that bringing her husband into the story had facilitated a different narrative about their shared parenting experiences, thus allowing her to treat herself with compassion as a human being and as a mother, and to feel remorse as opposed to endless guilt.

4 Analogical listening (Neimeyer, 2012b) represents a means of becoming deeply oriented to clients’ emotional symptoms of grief.

5 RCI was calculated according to Jacobson and Truax (1991) using the formula of Bauer et al. (2004). Both post-treatment and follow-up RCIs were computed to represent the change from pre-treatment. Values larger than 1.96 (in absolute value) are considered significant.

Additional information

Funding

This study was supported by the Danielle Sonnenfed Foundation in Israel.