A man was brought to the emergency room for treatment of minor injuries after an accident in which his life partner, a transvestite, was killed. He refuses care, paces, screams, "Why, why, why!" repeatedly, and scratches at his arms as if trying to tear the flesh. A nurse says, "Geez, he's going to hurt himself. We'd better admit him to psych." Which explanation for the nurse's response is most likely?