Over the past century, grief has been transformed from a communal, emotional experience into a pathologised condition subject to psychiatric intervention. In her incisive article, D. Grace Smith (2024) challenges conventional timelines that place the medicalisation of grief in the 21st century, particularly with the DSM-5-TR’s introduction of Prolonged Grief Disorder. Instead, Smith situates the critical shift between 1975 and 1995, a period marked by the growing dominance of psy-disciplines—psychology, psychiatry, and related human sciences—and the rising influence of neoliberal ideology.
Drawing on 70 peer-reviewed articles published in leading U.S. psy-discipline journals, Smith employs critical discourse analysis to reveal how grief was subtly but systematically reframed. First, psy-experts redefined grief as a domain requiring their exclusive authority, marginalising religious, cultural, and communal frameworks. Over time, non-psy figures such as clergy and morticians were erased from the academic narrative, while intervention by trained therapists became a presumed necessity.
Second, the approach to studying grief became more “scientific,” privileging quantitative methodologies and multidimensional models. Grief was fragmented into symptom clusters, timelines, and correlates, creating space for predictive models and clinical tools. Qualitative approaches, although still present, were increasingly justified defensively, revealing a growing bias toward empirical, scalable knowledge production.
Finally, the meaning of grief itself was redefined. Earlier conceptualisations based on psychoanalytic traditions were gradually displaced by frameworks rooted in medicalised symptomatology and functional performance. Normal grief came to include feelings like guilt and behavioural symptoms previously seen as pathological. Health, in turn, was reinterpreted as a return to productivity, echoing neoliberal values that equate wellness with work-readiness and social contribution.
Smith argues that these transformations were neither accidental nor merely semantic. They reflect the active exertion of power by medical institutions and epistemic authorities. The article makes clear that medicalisation is not a neutral process—it shifts the site of care from society to the clinic, frames grief as dysfunction, and delegates interpretive authority away from individuals to professionals. Importantly, the article invites sociologists to revisit not just when grief was medicalised, but how and why this process unfolded in step with broader political and cultural changes.
This article offers a powerful framework for examining other instances where human emotion is medicalised, refracted through the lens of institutional authority, and reshaped by underlying economic logics. It is essential reading for anyone interested in the sociology of health, medical authority, or the political underpinnings of psychological diagnosis.
Reference
Smith, D. G. (2024). Proposing a new history of grief’s medicalisation: A critical discourse analysis. Sociology of Health & Illness, 46(7), 1306–1326. https://doi.org/10.1111/1467-9566.13770
