Traumatic Grief

Grief: deep sorrow, especially that caused by someone’s death.

Trauma: Trauma literally means “wound, injury, or shock.” In psychological terms, “traumatic events” have traditionally been considered those that harm the psychological integrity of an individual. A given stressful event is not traumatic in itself, but may be so in its effect on a particular individual. Thus not every individual who experiences an extremely stressful event will actually be traumatized, although some types of events are so extreme that they are likely to be traumatizing to most people. Approximately 10% to 25% of adults who are exposed to an extreme stressor may develop simple acute stress disorder and PTSD (Breslau, 2001; Kessler et al., 1995; Yehuda, 2002).

Researchers are attempting to determine what makes some individuals more vulnerable to the damaging impact of trauma, and what factors help foster resiliency. It appears that both aspects of the traumatic event, the context in which the event takes place, and individual characteristics influence the person’s risk for developing psychological problems subsequent to trauma. There is a strong interaction between types of severe stressors and the integrative capacity of a given individual that determines whether someone will be traumatized. Interpersonal violence tends to be more traumatic than natural disasters because it is more disruptive to our fundamental sense of trust and attachment, and is typically experienced as intentional rather than as “an accident of nature” ( Breslau et al., 1999; Darves-Bornoz et al., 1998; Holbrook, Hoyt, Stein, & Sieber, 2001) . In fact, the meaning an individual assigns to a stressful event (e.g., an accident, an act of God, a punishment, one’s own fault) is significant in the development of PTSD (e.g., Ehlers, Mayou, & Bryant, 2003; Koss, Figueredo, & Prince, 2002). Events that are perceived as a threat to life and limb are more prone to cause problems, as are those that involve important attachment loss (Waelde et al., 2001) or betrayal (Freyd, 1996). Events that are intense, sudden, and unpredictable, extremely negative, and evoke severe helplessness and loss of control are more difficult to integrate (Brewin, Andrews, & Valentine, 2000; Carlson, 1997; Carlson & Dalenberg, 2000; Foa, Zinbarg, & Rothbaum, 1992; Ogawa et al., 1997) . Prolonged exposure to repetitive or severe events, such as child abuse, is likely to cause the most severe and lasting effects. Traumatization can also result from neglect, which is the absence of essential physical or emotional care, soothing, and restorative experiences from significant others, particularly in children. Chronic childhood abuse and neglect may have the most pervasive and deleterious effects on an individual because of a child’s immature integrative capacity and psychobiological development, his or her special needs for support and secure attachment, and chronic familial dysfunction in daily life that impedes healthy skills development.

Several of an individual’s characteristics predict whether an event will result in trauma-related disorders in adults. These include a history of prior traumatization, especially chronic child abuse and neglect; poor psychological adjustment prior to the event; family history of psychopathology; perceived threat to life during the event; and peritraumatic emotional reactions and dissociation (Brewin et al., 2000; Emily et al., 2003; Ozer et al., 2003).

In fact, peritraumatic dissociation is a strong predictor of PTSD (e.g., Birmes et al., 2003; Gershuny, Cloitre, & Otto, 2003; Marshall & Schell, 2002; Ozer et al., 2003). In addition, the presence of peritraumatic “vehement” emotions, i.e., panic and emotional chaos, also predicts development of trauma-related disorders ( Bryant & Panasetis, 2001; Conlon, Fahy, & Conroy, 1998; Janet, 1889, 1909; Resnick, Falsetti, Kilpatrick, & Foy, 1994; van der Hart & Brown, 1990 ).

Women are more prone to PTSD than men, perhaps because they are more likely to experience interpersonal violence, or perhaps because of hormonal and brain differences. Children are more vulnerable than adults because their brains are not mature enough to integrate what has happened: the younger the age, the more likely trauma-related disorders will develop ( Boon & Draijer, 1993; Brewin et al., 2000; Herman, Perry, & van der Kolk, 1989; Liotti & Pasquini, 2000; Nijenhuis et al., 1998; Ogawa et al., 1997; Roth, Newman, Pelcovitz, van der Kolk, & Mandel, 1997). And finally, those with less social support are more likely to develop the disorder than those with adequate relationships and support (Brewin et al., 2000; Emily et al., 2003; Ozer et al., 2003; Runtz & Schallow, 1997). – From


Resources

https://thewisdomoftrauma.com/

In The Wisdom of Trauma, we travel alongside physician, bestselling author and Order of Canada recipient Dr. Gabor Maté to explore why our western society is facing such epidemics. This is a journey with a man who has dedicated his life to understanding the connection between illness, addiction, trauma and society.
“Trauma is not what happens to you.
Trauma is what happens inside you,
as a result of what happens to you.”
— Gabor Maté

https://drgabormate.com/

A powerful videos series and course. Co-created exclusively with Wholehearted.org. For the first time Gabor Maté MD has created a program specifically for families and individuals, focused on healing trauma and addiction. This unique series unfolds as a step-by-step “how to” workshop that represents the culmination of Dr. Maté’s decades of research and clinical experience. Each episode and lesson expands on the knowledge in his worldwide bestselling books on addiction, childhood trauma, and mental health.

https://lifestance.com/blog/four-types-trauma-response/

https://grief.com/the-five-stages-of-grief/


https://www.psycom.net/anxiety-complicated-grief/

https://ct.counseling.org/2021/05/untangling-trauma-and-grief-after-loss/

https://www.gvsu.edu/counsel/grief-and-loss-week-two-335.htm

https://www.helpguide.org/articles/grief/coping-with-grief-and-loss.htm

https://uhs.berkeley.edu/coping-trauma-grief-loss-and-tragic-news-and-events





For Professionals


https://compassionateinquiry.com/online-training/

What is Compassionate Inquiry?
Compassionate Inquiry is a psychotherapeutic approach created by Dr. Gabor Maté and developed by Sat Dharam Kaur ND. Dr. Gabor Mate evolved this therapeutic approach over 20 years of his personal journey, and from his work with patients in family practice, palliative care, and addiction. He developed his system further while facilitating integration workshops focused on healing trauma through the use of psychedelics.

https://www.isst-d.org/about-isstd/.

The International Society for the Study of Trauma and Dissociation is an international, non-profit, professional association organized to develop and promote comprehensive, clinically effective and empirically based resources and responses to trauma and dissociation and to address its relevance to other theoretical constructs. Check out the different categories of membership here.

PTSD and ASD

https://www.isst-d.org/resources/trauma-faqs/

Acute Stress Disorder (ASD) is only one of two disorders (along with PTSD) that are defined by DSM-IV as being directly related to a traumatic event. ASD begins no more than four weeks after a stressful event and lasts from two days to four weeks. When the symptoms persist beyond four weeks, the diagnosis becomes PTSD. ASD is strongly predictive of subsequent PTSD (Brewin, Andrews, Rose, & Kirk, 1999; Classen, Koopman, Hales, & Spiegel, 1998; Grieger et al., 2000; Harvey & Bryant, 1998). Thus, some authors argue have suggested that ASD be subsumed under PTSD (e.g., Marshall, Spitzer, & Liebowitz, 1998). Even though ASD is listed as an anxiety disorder, its diagnosis is partly made on the basis of having three or more so-called dissociative symptoms, and like PTSD, many consider it to be a dissociative disorder. Additional criteria include persistent reexperiences, marked avoidance of trauma-related stimuli, and marked hyperarousal or anxiety.

PTSD began to be recognized formally as a serious psychological problem in combat veterans of World War I. At that time it was called “shell shock.” In World War II it was referred to as “combat neurosis.” Only after the Vietnam War did the name “posttraumatic stress disorder” evolve, and eventually it was recognized that PTSD was not unique to male soldiers, but affected survivors of other kinds of traumatic events. Although PTSD is currently listed in DSM-IV as an anxiety disorder, many have proposed that it is a dissociative disorder (Brett, 1996; Chu, 1998; van der Hart et al., 2004, 2006).

PTSD is acute when the duration of symptoms is less than three months, is chronic when the symptoms last three months or longer, and has a delayed onset when at least six months have passed between the traumatizing event and the onset of symptoms. In addition to exposure to a potentially traumatizing event, PTSD requires persistent reexperiences (Criterion B), persistent avoidance(Criterion C), persistent hyperarousal (Criterion D), and duration of symptoms for more than one month (Criterion E) (APA, 1994).

Trauma survivors with PTSD feel chronically afraid that the event is happening or is going to happen, and are unable to fully realize the traumatic event is over. Sometimes they involuntarily relive the event to such a degree that they are unable to maintain contact with present reality; these experiences are called “flashbacks”. At the same time, they avoid remembering as much as possible, and as stimuli in daily life trigger memories, they begin to avoid more and more of life. They may feel intense shame and guilt, thinking that they are somehow responsible for what happened, or guilty for what he or she did in order to survive. With chronic hyperarousal, they feel exhausted, have sleep problems, have difficulty concentrating, and are irritable and jumpy. They may purposefully avoid sleep because of terrifying nightmares. Due to emotional numbing they lose feeling a sense of being connected to others, withdraw from loved ones, and may lash out due to irritability, causing whatever support they have to slowly disappear. They may begin to drink, use drugs, work too much, or engage in other self-destructive behaviors to avoid the feelings and memories of what happened.

PTSD

PTSD began to be recognized formally as a serious psychological problem in combat veterans of World War I. At that time it was called “shell shock.” In World War II it was referred to as “combat neurosis.” Only after the Vietnam War did the name “posttraumatic stress disorder” evolve, and eventually it was recognized that PTSD was not unique to male soldiers, but affected survivors of other kinds of traumatic events. Although PTSD is currently listed in DSM-IV as an anxiety disorder, many have proposed that it is a dissociative disorder (Brett, 1996; Chu, 1998; van der Hart et al., 2004, 2006).

PTSD is acute when the duration of symptoms is less than three months, is chronic when the symptoms last three months or longer, and has a delayed onset when at least six months have passed between the traumatizing event and the onset of symptoms. In addition to exposure to a potentially traumatizing event, PTSD requires persistent reexperiences (Criterion B), persistent avoidance(Criterion C), persistent hyperarousal (Criterion D), and duration of symptoms for more than one month (Criterion E) (APA, 1994).

Trauma survivors with PTSD feel chronically afraid that the event is happening or is going to happen, and are unable to fully realize the traumatic event is over. Sometimes they involuntarily relive the event to such a degree that they are unable to maintain contact with present reality; these experiences are called “flashbacks”. At the same time, they avoid remembering as much as possible, and as stimuli in daily life trigger memories, they begin to avoid more and more of life. They may feel intense shame and guilt, thinking that they are somehow responsible for what happened, or guilty for what he or she did in order to survive. With chronic hyperarousal, they feel exhausted, have sleep problems, have difficulty concentrating, and are irritable and jumpy. They may purposefully avoid sleep because of terrifying nightmares. Due to emotional numbing they lose feeling a sense of being connected to others, withdraw from loved ones, and may lash out due to irritability, causing whatever support they have to slowly disappear. They may begin to drink, use drugs, work too much, or engage in other self-destructive behaviors to avoid the feelings and memories of what happened.

Most patients with PTSD (about 80%) have “comorbid” (meaning co-occuring) symptoms in addition to reexperiencing, avoidance, and hyperarousal. If they have many comorbid symptoms, they may qualify for the diagnosis of additional mental disorders (e.g., van der Kolk, Pelcovitz, Mandel, & Spinazzola, 2005). These include anxiety, mood, and substance abuse disorders (McFarlane, 2000), dissociative disorders (e.g., Johnson, Pike, and Chard, 2001), somatic complaints (e.g., van der Kolk et al., 1996), attention deficit hyperactivity disorder (Ford et al., 2000), and personality changes and personality disorders (Southwick, Yehuda, & Giller, 1993).