Anniversary Reaction Phenomenon

The evolution of the notion of an anniversary phenomenon related to both bereavement and death is interesting from both a definitional as well as a historical perspective. One of the earliest mentions of the anniversary reaction phenomenon can be traced to the late 1950s at which time the concept was defined as the tendency to relive a childhood trauma at a specific time. Usually this is the date of a parent's death. This description emerged out of a study of hospitalized patients who had suffered parental losses. In later studies, however, the same phenomenon was found in a sample of nonhospitalized population.

In 1972, the termanniversary reaction was used to describe the emotional response of widows and widowers on the anniversary of a spouse's death. Based on research on the bereavement of 92 widowed persons, 30#x0025; had only a minimal reaction to the first anniversary of the spouse's death, 67#x0025; described a mild or severe reaction; for 3#x0025; of the cases, the response was unknown. Because the mild or severe reaction was significantly associated with the presence of clinical depression, it was proposed that the anniversary reaction phenomenon would be useful to primary care physicians as a simple diagnostic tool to evaluate the patient's distress without resorting to a lengthy psychiatric intake evaluation.

A decade later, the notion of an anniversary reaction phenomenon was established firmly in the bereavement literature and now included any [Page 58]bereaved person and any anniversary related to the death that “reawakened bereavement or morbidity” in the bereaved. Two decades after the introduction of the concept, anniversary reactions were considered a normal if not essential component of the mourning process.

Also in 1972, this same concept, anniversary reaction, was used to refer to the tendency of some individuals to die on a particular date, such as a birth date or death date that had particular significance. The data used to substantiate this esoteric view have been questioned. In standard death education textbooks, an anniversary reaction refers to an increase in intensity of pain on any date associated with the deceased person.

As interesting as the definitional evolution of this concept may be, the historical context within which this concept evolved is perhaps even more interesting. To understand this context, it is necessary to return to the definition of grief as defined originally by Sigmund Freud. In his work, “Mourning and Melancholia,” Freud characterized grief as painful but normal. The return to the emotional state preceding the death, however, requires work on the part of the bereaved and compels the bereaved, that is, the ego, to relinquish all energy directed toward the deceased. This argument suggests a linear process in which the intensity of the pain gradually decreases over time and eventually ceases altogether.

The notion that grief is a natural human response to a bereavement or loss and that some effort on the part of the bereaved person is required is generally accepted in the bereavement literature. The delineation between normal grief and abnormal or pathological grief, however, is probably one of the least resolved issues. Two critical issues refer to the degree of intensity and the longevity of the phenomenon.

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