Trigger Warning: The following content contains mentions of death, trauma, and loss which could potentially be triggering.
India, along with the world at large, is witnessing a horrific nightmare unfold. People are losing their loved ones unexpectedly. The magnitude of the loss being suffered is unimaginable, to the extent that even a brief opportunity to process the harrowing emotions is out of sight. In this blog, I explore the manifestations of complicated bereavement and traumatic grief, which specifically occurs after a loved one passes away in a traumatic, sudden, and unexpected manner, and the interventions that can help people address the trauma and engage more with life.
A massive chunk of our population has been left devastated, numb, and frightened to engage with life amidst the pandemic. Inevitably, losing a loved one brings along unbearable pain, pandemic or not. Trauma and grief seep into life and often leave one fighting to quell the anxiety, sadness, and uncertainty in life.
American Psychological Association defines traumatic grief as a severe form of separation distress that usually occurs following the sudden and unexpected death of a loved one. Grieving is a normal process of adapting to a loved one’s demise; however, traumatic grief goes on longer than is considered healthy and is extremely overwhelming. While traumatic grief results from an intense and unexpected death, any loss can be traumatic regardless of the circumstances it occurred in and if the interpretation of the passing felt traumatizing to the individual grieving. According to Wortman and Latack (2015), death is considered traumatic if it occurs without warning; if it is untimely; if it involves violence; if there is damage to the loved one’s body; if the survivor regards the death as preventable; if the survivor believes that the loved one suffered; or if the survivor regards the death, or manner of death, as unfair and unjust. This is an essential factor to understanding to prevent discounting others’ loss and trauma because it does not seem to be traumatic at the outset. Other trauma risk factors include making decisions about life support, limited social support, and having a history of trauma.
The key signs that indicate the presence of traumatic grief include the trauma response that interacts with the grief (which is what makes traumatic grief different from other forms of grief) and the breakdown of expectations that guide us and keep us safe in the world (for instance, expecting that things always happen for a reason- there is no reason good enough to justify the passing away of a loved one). In this way, traumatic grief challenges the core of an individual’s belief system. It also involves a preoccupation with the deceased and an inability to accept their demise. Some might also experience pain in the same area as the deceased or hear their voice amongst other more common symptoms that include anger about the death, survivor’s guilt, loneliness, the envy of others, and upsetting, traumatic memories.
While grief is experienced when someone very close passes away, children and teens might experience symptoms of traumatic grief even without anyone’s demise. Any life-altering development such as a parent being diagnosed with a terminal illness like cancer or going through a traumatic separation can trigger traumatic grief symptoms. [The brain is not fully developed till the age of 25 (Arain et al., 2013), and thus these symptoms may be experienced more easily.]
Even though traumatic grief is distinct from other mental health disorders, it is not considered a diagnosis in the fifth edition of the Diagnostic and Statistics Manual (DSM- V). However, experiencing traumatic grief and not addressing that it exists can lead to Post Traumatic Stress Disorder, depressive disorders, anxiety disorders, obsessive/compulsive disorders, addictive disorders, and dissociative disorders. (Applebury, 2020). If you (or someone you know) are exhibiting symptoms of traumatic grief that are interfering with your everyday functioning, you might benefit from seeking traumatic grief therapy.
Jennifer R. Levin, Ph.D., a traumatic grief expert, and therapist defines traumatic grief therapy as “therapy that simultaneously addresses the trauma response and grief associated with a traumatic death.” The goals of this form of therapy include emotional regulation, reducing and managing trauma symptoms, processing grief, and a transition from suffering to healing and from pain to growth. (Deering, 2021)
Levin also highlights the general steps that are expected during the therapy. The first step is the Stabilization of Trauma, wherein the individual rebuilds a safe and trusting environment and works on skills to decrease symptoms and increase coping skills. After building a safe environment, the individual begins to process the trauma and grief. The final step aims mainly at meaning-making, which is the process of finding meaning in current life and accepting and understanding the loss and post-traumatic growth. (Always make sure that the therapist is licensed and experienced in dealing with trauma and grief.)
Through her work, Levin noted that many people benefit immensely from traumatic grief therapy. She noticed a decrease in symptoms, better coping mechanisms, post-traumatic growth, and hope for a meaningful life. Instead of bottling up negative emotions and pretending that grief does not exist, seeking therapy or the help of support groups can help one feel less isolated and find meaningful ways to engage with life. Even reading literature about traumatic loss can help with processing grief and make one feel less alone as one looks into others’ experiences with traumatic grief.
Losing a loved one can leave your entire world shattered, and the emotional turmoil it brings along can feel unbearable. However, nobody has to go through this alone. People experiencing traumatic grief can grieve, heal, and grow by seeking professional help as well as the company of support groups. Traumatic grief is an intense and challenging emotion to process, and thus patience and acceptance are essential factors in healing the trauma. People deserve as much time as they need to grieve and recover from their immense loss.
REFERENCES:
- A Teen’s Brain Isn’t Fully Developed Until Age 25. (2021, February 25). Paradigm Treatment. https://paradigmtreatment.com/teens-brain-fully-developed-age/
- APA Dictionary of Psychology. (2020). American Psychological Association. https://dictionary.apa.org/traumatic-grief
- Applebury, G. (2020). What Is Traumatic Grief? LoveToKnow. https://dying.lovetoknow.com/ideas-advice-coping-grief/what-is-traumatic-grief
- Arain M., Haque M., Johal L., Mathur P., Nel W., Rais A., Sandhu R., Sharma S. (2013). Maturation of the adolescent brain. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621648/
- Bifulco, A. (2007). Loss Trauma. Encyclopedia of Stress, 612–615. https://doi.org/10.1016/b978-012373947-6.00547-x
- Cote, K. (2018, November 7). Stuck In Grief? The Ways Trauma Can Halt The Grieving Process And How EMDR Can Help. Evolve Counseling, LLC. https://evolvecounselingco.com/stuck-grief-ways-trauma-halt-grieving-process-how-emdr-can-help/
- Deering, S. (2021). How Traumatic Grief Therapy Works. Verywell Mind. https://www.verywellmind.com/what-is-traumatic-grief-therapy-5097276
- Haley, E. (2021, March 30). Grief After Traumatic Loss. Whats Your Grief. https://whatsyourgrief.com/traumatic-loss/