Traumatic grief: definition, symptoms and how to overcome it.

We review the causes and possible treatments for this type of severe grief.

Death and bereavement are events from which we cannot escape.. Although painful, the cycle of life imposes on us to live through these stages, overcome them and adapt to life as best we can.

The problem is that, contrary to popular belief, time does not heal everything, nor are all deaths the same. The closeness of the bond with the deceased, the situation in which the death occurs, the external support and the personality traits of the mourner (the one who loses a close one) are some of the variables that influence the resolution or stagnation of grief.

• Recommended article: "The 8 types of grief and their characteristic symptoms".

What is traumatic grief?

Traumatic griefs are those that occur with the death of one or more persons in a surprising, unexpected and unfair situation, such as attacks, terrorism, assassinations, natural catastrophes or accidents, among others.These are possibly the ones with the worst prognosis, together with the death of a child, which has been considered one of the worst losses that a human being can experience. That is why I want to talk not only about death and grief, but especially about this type of trauma, which is so unfair and difficult to overcome.

It is not only death that hurts, special attention must be paid to post-traumatic stress:

When we talk about traumas of any kind, psychologists turn on in our brain the alert of Post Traumatic Stress that the mourner may be suffering: re-experiencing what happened, nightmares, avoidance of stimuli reminiscent of the event, dissociative states, anxiety attacks, insomnia, hypervigilance... When there is this type of symptomatology, grief is complicated and may stagnate in some of its phases.

Painful emotions: shame and guilt

In a bereavement it is normal to feel anger and sadness.It is totally adaptive and necessary to get used to a new reality without the deceased person. But feeling guilt and shame can be the beginning of an unresolved grief. Guilt is often felt for not being the one to die, along with repetitive and obsessive thoughts around "what if..." or "I should have..." (what if I had not gotten on the train / what if I had not insisted him to come / I should not have told him this or that, I should have helped him to take care of himself, I should have paid more attention to him...).

Shame arises in front of the society that follows their life, for being "different" or for not wanting to show our feelings in public. Both emotions can block the resolution of the loss, not only at the mental level, but also at the sensorimotor (bodily) level, leaving unconscious memories in the body that block the grieving process.

Hatred

Another emotion that can hinder the resolution of grief is hatred, especially if it is due to an accident, a terrorist act or a murder. Hatred for the wrongdoer blocks progress through the stages of grief, leaving the person anchored in the past and, along with it, in pain.

What can be done to overcome the death?

To say that a person has overcome the death of a loved one, he or she must come to an acceptance of the loss.. Grief usually has a series of non-linear phases (although they usually occur sequentially), but it is common for there to be setbacks or mixed emotions. For didactic reasons, I will present them in a series: denial, anger, sadness, negotiation and acceptance.

• In this article you have more information: "The 5 stages of grief (when a family member dies)".

1. Denial of reality

The first of these is, as the name itself indicates, denial of realitynot believing what has happened. This occurs because the high emotional impact of the loss would be unbearable on a conscious level, so our mind uses this defense to cushion the blow of the news, at least momentarily.

2. Anger, sadness and bargaining

Then we would move on to anger, followed by sadness and negotiation (negotiating with life the new present reality, starting to assume the person in the past, seeing the new way of living, etc.) to finally end up accepting that nothing is as it was before.

As I have said, the phases can mix with each other, this is normal, what is pathological or worrying is to remain anchored in one of the phases, such as the person who years later continues to prepare the table for the deceased as if he/she were still among us (this would be a denial of reality).

3. Acceptance and hope to continue living

In order to overcome a loss we have to take an active role as agents of our own mental change in order to move from grief to hope for life.

Therapy: processes that help us to overcome severe grief

This is why we psychologists like to talk about grief "activities" rather than phases or stages. If you feel the Pain of a loss, follow the following tips:

1. Express grief

Being positive is fine and can help you get through the grief, but death, at least in our culture, hurts.. It is essential to express the emotions that do not give us pleasure, these are anger, pain, guilt, sadness, loneliness ... So that we free the mind and body to contain them without expressing them. To overcome an emotion, we must give ourselves the right to recognize it, name it, feel it and live it. Only in this way it will pass. Find a place and a time to remember the deceased, to feel their absence, to mourn their absence. It hurts, but it heals.

2. The pendulum

It is true that negative emotions must be expressed, but we must continue to live life. That is why we must do the pendulum exercise, where we go from a state of sadness to a state of vitality. We should neither stay in one extreme nor the opposite. We must mourn the death but also continue to enjoy (as best we can in the first moments) the good things. Many people feel that they have no right to feel emotions such as joy or relief, but if they arise, they must be experienced.

Death brings us ambivalences and mental conflicts, accept them and experience them, as in the previous point.Accepting and experiencing them, as in the previous point, is the first step to overcoming them. Do not judge yourself, just feel.

3. Tribute and support

To worship the deceased helps to mentalize that what happened is a fact.. That is why, in major disasters or murders, we see how tributes are made at a social level. The same happens at funerals or wakes, they are places that help us to come to terms with what happened. It is also possible to make a more private tribute, in solitude, but let us remember that, although we feel like being alone, people we trust are a help to move forward.

4. Make a coherent narrative of what happened

The human brain needs to understand, and it does so through stories, metaphors and tales.. That is why in order to overcome what happened we must make sense of it and create a coherent story. Talking about it, looking for explanations, putting the facts together, formulating a narrative that brings together the past, traumatic events, happy events and the future, helps to overcome what happened. It can even be written in the form of a short novel.

The key is not only to remember the negative, but the whole story, with the good memories and the bad ones, so as not to idealize the deceased or just the moment of death (or the burial, wake, etc.).

5. Adapt to the new life

Assuming that the other person is gone includes assuming that there are roles that no one will do anymore or that must be assumed by other people, that our lives are going to change because someone else has to do what the deceased used to do. We also have to assume internal changes, growth and loss, mourning of future expectations and memories.We also have to assume internal changes, growth and losses, mourning of future expectations and past memories.

6. Farewell is not oblivion

It is necessary to say goodbye to the deceased, but not to forget him or her, but to put him or her back in our life in some way.. We must find ways to carry the departed person within us as we continue to live and move forward. Remembrance can produce nostalgia, but each person who passes through our lives leaves us a sign, a teaching. Realizing this helps us to respect their life, their death and their memory.

7. EMDR therapy, sensorimotor therapy and hypnosis

Especially in the case of traumatic grief, it is important to seek therapy.. If you see that even with all of the above you are not able to overcome the loss of your loved one, maybe it is time to ask for help from a professional. EMDR therapy, sensorimotor therapy and hypnosis are proven techniques that will help you overcome your pain. Ask your trusted psychologist.