Overcome by or Overcoming Loss: A Call for the Development of Therapy for Individuals Mourning Vocational Loss in Schizophrenia

People with schizophrenia are often unable to realize vocational expectations because of schizophrenia-related functional impairments. This is particularly acute in those individuals from advantaged sociocultural backgrounds of whom much is expected. We present the case history of an acclaimed woman artist who lost artistic productivity with the advent of severe and persistent psychotic symptoms. We suggest that “loss of vocational potential” is a major loss worthy of grief work. Introduction and rationale are presented, followed by a case presentation that aims to illustrate the psychological effects of intangible loss for individuals suffering from serious mental illness. Three approaches to grief work are reviewed. The notion of incorporating grief work into the treatment of persons with schizophrenia is introduced. The authors call for increased attention to and study of the symbolic and emotional impact of the interpersonal and vocational losses that accompany schizophrenia. A carefully structured grief work intervention needs to be developed that maximizes adaptation and minimizes risk for suicide and that should be coupled with clinical indicators and validated outcome measures.