Grief as a Border Diagnosis

Grief is sometimes poetically described as the price of love: An inescapable existential condition of human life. However, throughout the 20th century, grief has increasingly come to be understood as a pathological condition that requires psychological and/or medical intervention. With the release of Diagnostic and Statistical Manual of Mental Disorders (5th ed., DSM-5; American Psychiatric Association, 2013), grief came close to being included as a separate mental disorder. However, the diagnostic revisions concerning bereavement have been met with criticism of medicalizing grief and of exceeding the territory of psychiatry beyond its legitimate borders. On this basis, I argue that grief is currently a border diagnosis, that is, a condition whose meanings are informed in heterogeneous ways by medical, psychiatric, and psychological understandings yet constantly challenged by alternative, nonmedicalizing discourses. Drawing on empirical findings from an ongoing interview study with bereaved parents after infant loss, I analyze and discuss 4 different accounts concerning the question of diagnosing grief: (a) diagnosis as a legitimating and normalizing practice, (b) diagnosis as a demarcation practice, (c) diagnosis as pathologization, and (d) diagnosis as a normative ideal. Through the examples, I attempt to demonstrate how bereaved individuals do not merely passively adopt but reflectively use these kinds of understandings to deal with their grief.