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Disenfranchised Grief: The Concept and Impact on Health

Medicine focuses on life and death issues, but less time is spent exploring the effects of living health losses with patients. A patient's illness is filled with overwhelming sadness, uncertainty, and grief. When health losses experienced by a patient are ignored, it can be detrimental to their mental and physical health. The videos below will explore the foundation work of Dr. Doka's theory on disenfranchised grief and the impact of disenfranchised grief on one's health. 

​Disenfranchised Grief-Video highlights: 

  • Doka defines disenfranchised grief as "Grief that is not openly acknowledged, socially validated, or publicly supported." (Doka, 2002)  

  • Doka identified five types of disenfranchised grief:

1) Unacknowledged Relationship.

2) Unrecognized Grief.

3) Unacknowledged Griever.

4) Stigmatized Grief.

5) Unsanctioned Griever.

Based on my clinical experience with patients, I have expanded upon Dr. Doka's work to identify six types of living health losses-what I call Underdiagnosed Grief. 


 Impact of Disenfranchised Grief-Video       highlights:

  • Within healthcare, the language of loss is not used when speaking about living health losses.

  • Treatment teams don't recognize the living health losses of our patients.

  • Health social workers cannot provide the patients with appropriate support when we don't acknowledge these losses. 

Disenfranchised Grief in Illness-Video highlights:

  • Unprocessed losses can compromise a patient's mental and physical health. 

  • Patients may become stuck and controlled by their health losses.

  • Once patients have processed their health losses, patients can:

    • Create meaning. 

    • Better understand of their diagnosis.

    • Better manage their medical treatment. 

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