Interwoven….Exploring the Intersection of Trauma and Grief

Meghann Crane-Russ, LCSW, PMH-C is a therapist in private practice in California who works with individuals struggling with traumatic grief, medical trauma, parents navigating childhood illness, and bereaved parents. Prior to private practice Meghann was a medical social worker caring for families in hospice, Pediatric Intensive Care Units and Neonatal Intensive Care Units. To learn more about Meghann and her practice place visit www.mcrlcsw.com

Grief, I’ve learned, is really just love. It’s all the love you want to give, but cannot. All that unspent love gathers up in the corners of your eyes, the lump in your throat, and in that hollow part of your chest. Grief is just love with no place to go.
~
Jamie Anderson

In my therapy practice I often remind grieving clients that grief is the price we pay for loving someone. As Jamie Anderson so aptly puts it, “Grief is just love with no place to go”. As experienced grievers know and new grievers learn, grief changes over time, but it endures with you as your life path continues to unfold. One rarely stops loving someone who died, so grief continues. Most grief follows a natural course following losses that are expected due to illness, age, or the nature of the relationship, like an adult child mourning an elderly parent, or a grandchild mourning a grandparent. Grief is most profound immediately following a loss. With normal grief, the intensity of the feeling of grief lessen over time as it is expressed, processed, and the loss is woven into the fabric of one’s life. Grief is a normal anticipated human reaction to loss that follows a relatively predictable course, that is, unless it doesn’t.

There are many factors that complicate or prolong a grief response including one’s relationship to the deceased, for example, the loss of a spouse or child. Sometimes the circumstances of the death can impact the grief process, like when a death is due to violence or suicide, or if there was prolonged suffering. Losses that are not acknowledged by one’s support network or publicly mourned can also lead to a more complicated grief process. An additional factor that can complicate grief is another normal human response: a trauma response.

A trauma response is a person’s response to real or perceived life threating events. Trauma responses can develop following a single event or series of events that are emotionally disturbing. Untreated trauma can cause lasting negative effects on a person’s mental and physical health, as well as social and emotional functioning. Much in the same way people experience and express their grief differently, trauma manifests differently for different people.

Traumatic grief response occurs when a person develops a trauma response following a loss, having symptoms of both grief and trauma. It is often said that trauma is in the eye of the beholder, meaning two people can experience the same situation, one person can develop a traumatic response and the other person responds adaptively. This holds true for traumatic grief as well. The determining factor in the development of traumatic grief is how the loss and events surrounding the loss are interpreted and perceived by the griever, not by the type of the death. For this reason, there is no conclusive definition or list of types of deaths that will lead to a traumatic grief response. However, what is clear and easy to define are the symptoms of a trauma response.

Grief is mourning, missing, sadness, longing, reminiscing, and remembrance. Trauma is reliving, fear, agitation, hypervigilance, rumination, flashbacks, depressed or anxious mood. A griever who is experiencing trauma can feel like they are stuck in the past, reliving the worst parts of the death over and over. Unlike grief, trauma doesn’t lessen over time. Trauma alters the oldest and most primitive parts of our brain ultimately changing how one experiences safety. Trauma, however, unlike grief, can be treated. There are several effective evidenced-based trauma-focused treatment modalities that can be used to heal the traumatic parts of a loss, such as Eye Movement Desensitization and Reprocessing (EMDR), Prolonged Exposure Therapy, and Trauma-Focused Cognitive Behavioral Therapy. Seeking trauma-focused treatment from a licensed mental health professional trained in trauma-focused treatment modalities can change the impact of the traumatic parts of the loss to allow for better integration of the loss and a more normalized grief process.

Normal grief can cause one to feel lost for a time, but as normal grief progresses so does the griever’s life. Traumatic grief causes one to be stuck in the past, reliving the worst parts, unable to carry forward. Traumatic grief can be treated very effectively in a relatively short period of time in most cases, with support from a licensed mental health professional who is trained to treat trauma. Healing the trauma leads to decoupling the trauma from the grief. Through healing trauma one can learn to adapt and regaining one’s sense of safety in the world. The resolution of the trauma allows the griever to continue forward on their life path sharing their love with the person who is gone through the expression of their grief.

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