Prolonged mourning has been recorded as a precipitant life event in RA and other autoimmune disorders, but other events such as retirement, redundancy and injury have also been identified. The author’s submission is that pathological mourning is present in all patients with AI disease, and that other events such as those mentioned are only precipitant because they uncover mourning until then kept in check by occupation and use of work as a drug. When time for reflection and loneliness allows long suppressed ambivalent feelings, guilt and bitterness to surface, remorse over ‘unfinished business’ increasingly dominates the patient’s thoughts. Children and young people rarely have the opportunity to mourn, thus early loss is often paramount and is awakened from the unconscious years later when further losses of key figures or surrogates, including pets, occur or are anticipated. Psychotherapy involves helping patients resolve their pathological mourning.