Traumatic Grief: What You Need to Know

General ideology held by members of our society: 

•  The perception of the world as meaningful and comprehensible 
•  The view of ourselves in a positive light 
•  Belief that it can’t happen to me 
•  We make sense of the world by regarding what happens as controllable 
•  Believe we can prevent misfortune by cautious behaviours 

So what happens when we are affected by an unexpected and undeserved, sudden act which shatters these preconceived ideas of our world?

TRAUMA

Trauma is any event which can make one feel unsafe in the world, and which affects the mind and nervous system thus creating psychological harm. 

Major traumatic events include: 

 death of a loved one; 
 being affected by criminal activities or anti social behaviour of another person; 
 road incidents where injuries or death occur; 
 assault, robber, 
 being bullied, threatened or intimidated; 
 breakdown in relationships, etc 


 When a person is confronted with a threatening or violent situation they experience a rush of adrenaline. This is the body’s way of preparing for either fight or flight. This adrenaline rush causes a state of alertness where all the attention is focused on the immediate situation, accompanied by feeling of intense fear, anxiety and/or anger. 


 It is not unusual for a person be become detached and calm and seems to freeze. The psychological term for this phenomenon is dissociation. When people suffer from dissociation they often lose all sense of self. They can lose all trust in themselves and other people. They suffer feelings of guilt, and thoughts that they should have somehow, done something to stop the event from occurring.

 Understanding Grief 

Grief is an emotion. It is a natural attempt to make internal and external adjustments to the undesired change is one's world brought upon by loss. It is a process involving many changes over time and is experienced mentally, emotionally, spiritually and physically. Where the loss is sudden and unexpected there is the added ordeal of shock and disbelief which exacerbates all of the adjustments which the body has to adjust to. 


 When we suffer from the loss of loved one our bodies are called upon to adapt to major changes. These changes are the same as those which occur when danger is evident and the basic instinct for survival "fight or flight" comes into force. Natural chemicals are produced which cause physiological changes in our body. These physical changes can last from a few minutes to months and can reoccur every time we are faced with a new experience which we have not had to face previously.  

Common Symptoms of Grief 

While loss affects people in different ways, many people experience the following symptoms when they’re grieving. Just remember that almost anything that you experience in the early stages of grief is normal – including feeling like you’re going crazy, feeling like you’re in a bad dream, or questioning your religious beliefs. (1)

• Shock and disbelief – Right after a loss, it can be hard to accept what happened. You may feel numb, have trouble believing that the loss really happened, or even deny the truth. If someone you love has died, you may keep expecting them to show up, even though you know they’re gone.  

• Sadness – Profound sadness is probably the most universally experienced symptom of grief. You may have feelings of emptiness, despair, yearning, or deep loneliness. You may also cry a lot or feel emotionally unstable.  

• Guilt – You may regret or feel guilty about things you did or didn’t say or do. You may also feel guilty about certain feelings (e.g. feeling relieved when the person died after a long, difficult illness). After a death, you may even feel guilty for not doing something to prevent the death, even if there was nothing more you could have done.  

• Anger – Even if the loss was nobody’s fault, you may feel angry and resentful. If you lost a loved one, you may be angry at yourself, God, the doctors, or even the person who died for abandoning you. You may feel the need to blame someone for the injustice that was done to you.  

• Fear – A significant loss can trigger a host of worries and fears. You may feel anxious, helpless, or insecure. You may even have panic attacks. The death of a loved one can trigger fears about your own mortality, of facing life without that person, or the responsibilities you now face alone.  

• Physical symptoms – We often think of grief as a strictly emotional process, but grief often involves physical problems, including fatigue, nausea, lowered immunity, weight loss or weight gain, aches and pains, and insomnia. 

 When working with people who have suffered the loss of a loved one it is important that from the first time that we meet with them we begin to assist them to rebuild their sense of personal power and choice. This will then help them to cope when any future trauma is experiences. 

 Understanding Cycles of Grief 

 Cycles of grief are individual for each person who suffers a loss. There is no set pattern to the cycles and how we handle the process will often depend on our previous learning experiences and how we have learnt to deal (or not deal) with trauma, on previous occasions.


• Avoidance - one of the initial responses to loss is a desire to avoid acknowledgment of that loss. Shock, denial, numbness and disorganisation are all natural initial responses to severe loss. Denial allows the person time to absorb the reality of the situation slowly and thus enhance their ability to cope with the situation. It is during this stage that there is a need to know the details of how and why the situation occurred. 


 • Confrontation- this is the time when we are confronted with intense grief, and move through extremes of emotions. These emotions often include: anger, guilt, yearning and despair as we begin to come to terms with the incident, trying to find some meaning to what is usually a meaningless situation. There will be times when accute grief may occur and at these times the affect can be termed as "grief spasms" which may be intense and overwhelming. Repeated review of the loss experience is common. It is at this stage that symptoms of depression usually occur. 


 • Integration - during this part of the grief process the waves of intense grief get further apart and lose some of their intensity. Positive memories become more frequent, people are now able to talk about their grief and complete any unfinished business. There is the beginning of a return to and hope. 

The Difference between Grief and Depression 

We highly recommend reading:
Children in Grief: How to Cope with Loss

Distinguishing between grief and clinical depression isn’t always easy, since they share many symptoms. However, there are ways to tell the difference. 

Remember, grief can be a roller coaster. It involves a wide variety of emotions and a mix of good and bad days. Even when you’re in the middle of the grieving process, you will have moments of pleasure or happiness. With depression, on the other hand, the feelings of emptiness and despair are constant. (1)

Other symptoms that suggest depression, not just grief: 
• Intense, pervasive sense of guilt 
• Thoughts of suicide or a preoccupation with dying 
• Feelings of hopelessness or worthlessness 
• Slow speech and body movements 
• Inability to function at work, home, and/or school 
• Seeing or hearing things that aren’t there 

Can antidepressants help grief? 

As a general rule, normal grief does not warrant the use of antidepressants. While medication may relieve some of the symptoms of grief, it cannot treat the cause, which is the loss itself. Furthermore, by numbing the pain that must be worked through eventually, antidepressants delay the mourning process. 

When to seek professional help for grief 

If you recognize any of the above symptoms of complicated grief or clinical depression, talk to a mental health professional right away. Left untreated, complicated grief and depression can lead to significant emotional damage, life-threatening health problems, and even suicide. But treatment can help you get better. 
Contact a grief counselor or professional therapist if you:
 • Feel like life isn’t worth living
 • Wish you had died with your loved one 
• Blame yourself for the loss or for failing to prevent it 
• Feel numb and disconnected from others for more than a few weeks 
• Are having difficulty trusting others since your loss 
• Are unable to perform your normal daily activities

Healing Grief  - Advice for Family and Friends

• Simply ask them what they want, rather than giving them advice 
• Don’t feel that you can’t talk about their loss, they will want you to. More than anything they will appreciate the chance to talk to someone who really listens and who does not judge them.
• It is normal to be confused and to forget things, be more anxious, have trouble sleeping or eating and need time of work. They will appreciate you offers of practical or even financial support. 
• Don’t avoid them or pretend you can’t see them, talk to them, they need you to acknowledge their loss, even though this may be difficult for you to face. 
• Write them a note; Phone them; Cook them a meal 
• Be yourself, you are their main support – it is ok to cry, laugh, share their pain. 

If you are not sure what to do….ask them how you can help. 

Grief Resources on the Web:

• Grief Net: An email based support group for all kinds of grief, loss of spouse, child, partner, parent, etc. Groups are separated by type of loss, specific groups just for kids as well. Cost is $10 a month to join a group. All discussions are monitored.

• Kids Aid: a companion site to grief net for children. Also provides an email based group to join. Groups are separated by age, 12 and under and 13 to 18. Site provides kids a place to submit artwork and writings, as well as a posting board to have your questions answered.

• The Dougy Center: A place for children, teens, adults and families to share their experiences with grief. List of books, DVDs and training opportunities.

• Grief Recovery Online (GROWW): Grief chat room organized into different branches for specific losses. Designed to have an opportunity to talk 24 hours a day, 7 days a week. (2)

How We Can Help:

Since 1995 The Enough is Enough Counselling and Support Unit has provided effective counselling and support groups services drawing from proven therapies and our own unique experience working with people in crisis to bring about healing, hope and growth for all members in our community.

We provide a professional service with fully qualified counsellors - all our Counsellors belong to professional Counselling Associations.
We conduct group or individual, face to face, and telephone counselling. Counselling is available for everyone, regardless of cultural or religious background. You can be referred by an agency, a family member or friend, or refer yourself to our service.

If you are in Sydney, please contact us on 02 9542 4029 for an appointment. 

We highly recommend reading:
Mindfulness as a Practice

Resources: 

(1) Coping with Grief and Loss
Understanding the Grieving Process ( http://www.helpguide.org/mental/grief_loss.htm)
(2) Grief- Where to Get Help (http://lifework.arizona.edu/ea/articles/grief)