emotions/feelings

The Relationship Between Trauma & Grief

August 24, 2021 By Nathalie Himmelrich 2 Comments

Many of the people I have been working with have shown signs of Trauma & Grief intertwined. So, you might wonder, what is the difference and how do I know whether I or someone else is experience grief, trauma, or both?

Defining experiences

Normal Grief, as defined by MedicineNet, is: The normal process of reacting to a loss. The loss may be physical (such as a death), social (such as divorce), or occupational (such as a job). Segen’s Medical Dictionary says: Grief over the loss of a loved one begins to fade into adequate coping mechanisms within six months. This is obviously a very general definition. It leaves me wondering what they define as adequate coping mechanisms. It also does not incorporate the fact that it is highly dependent on which loved one it is (child, parent, partner, or friend?) or through what circumstances the loss occurred (old age, illness, accident, or, for example, murder?)

There is no such thing as ‘normal’ grief. Grievers know that there is nothing that feels normal in their experience. Grief makes them feel like they are going crazy. Normal Grief is grief that follows expected reactions and responses (check out Chapter 2 – Understanding Grief and the Bereaved in the book Bridging the Grief Gap). From a therapeutic point of view, grief progresses in a normal way when the bereaved gradually moves towards acceptance of the loss, and, as time goes by, they are able to re-enter life and engage in daily activities. It can also be called Uncomplicated Grief.

Traumatic Grief is a normal grief response to a loved one’s death that is perceived to be horrifying, unexpected, violent, or traumatic. This includes accidents, murder, abduction, abuse, or cruelty happening to the loved one. Trauma needs to be treated as well as the grief response. The distress experienced may be severe enough to impair daily functioning.

Trauma isn’t what happens to you
It is what happens inside of you as a result of that.
Gabor Mate

Grief, trauma or both?

If you or someone else is experiencing a loss that is paired with horror, violence, or happened suddenly, out of order, or unexpected there is also trauma involved.

Trauma is stored in the body, in the tissue, in the muscles, bones, ligaments. It leads to people’s responses that can be classified into four categories:

fight
flight
freeze or
submission

Most often we are used to or have heard of the fight or flight reaction to trauma. In the event of traumatic loss, freeze is more often the case. Traumatic loss often leaves people helpless, hopeless, overwhelmed, and in despair.

It is important to be aware of the trauma aspect and have support in treating not just the grief, but also the trauma.

Permanent change

Grief changes people. They see life in a different light and speak a different language. One sentence I hear from grievers over and over: “I will never be the same again.” And even though they can’t know for sure what happens until the end of their life, they express the immensity of the effects of the life-altering experience: a significant loss.

Having studied trauma and the effects on human beings, I’ve come to realise that even though not all losses are experienced as traumatic many grievers grapple with the effects of the trauma related to their loss. The following paragraph is a summary of the effect of trauma in relation to loss, and its neuroscientific effect on the brain.

Following the death of her dad, journalist Amy Paturel wrote a story which appeared in the Discover magazine called The Traumatic Loss of a Loved One Is Like Experiencing a Brain Injury. “According to a 2019 study published in Social Cognitive and Affective Neuroscience, grievers minimize awareness of thoughts related to their loss. The result: heightened anxiety and an inability to think straight” wrote Paturel. Additionally, Paturel shares scientists increasingly view the experience of traumatic loss as a type of brain injury.

Grief affects the brain. The loss of someone meaningful is a stressor that triggers the pituitary gland to release adrenocorticotrohin (ACTH). This sends a signal to the adrenal glands to release cortisone, a stress hormone. Given that the stressor isn’t temporary but intense, the body remains flooded by cortisone. This can cause your immune system to falter which leads to a run-down feeling. A traumatized brain leads to the primitive areas (including the fear centre) being overactive adding to feelings of stress and despair. Higher cortical areas are underactive, for example, the area that regulates emotions.

“The problem isn’t sorrow; it’s a fog of confusion, disorientation, and delusions of magical thinking,” writes Lisa Shulman, a neurologist at the University of Maryland School of Medicine, in a blog post for Johns Hopkins University Press about her book Before and After Loss: A Neurologist’s Perspective on Loss, Grief, and Our Brain. Shulman also explained that the emotional trauma of loss results in serious changes in brain function that endure.

References:

Paturel, Amy (2020). The Traumatic Loss of a Loved One Is Like Experiencing a Brain Injury,

https://www.discovermagazine.com/mind/the-traumatic-loss-of-a-loved-one-is-like-experiencing-a-brain-injury

Shulman, Lisa (2018). Before and After Loss: A Neurologist’s Perspective on Loss, Grief, and Our Brain, MD: Johns Hopkins University Press

Photo by Shifaaz shamoon on Unsplash

Best Questions to ask – Supporting Questions

August 9, 2021 By Nathalie Himmelrich 2 Comments

“The answers you get depend on the questions you ask.”
― Thomas S. Kuhn, Author of the book The Structure of Scientific Revolutions

Supporting yourself or someone else through the throws of grief and trauma really depends on the conversations that are happening, inside and outside. It is about the thoughts we have in our minds and the questions we ask those we are supporting.

In order to understand the power of questions in grief support, let’s look at the most important three different types, adapted to the situation of grief, loss, trauma, and the support with those situations.*

Closed questions

Closed questions often invite a one-word answer, such as ‘yes’ or ‘no’. For example, ‘did she die immediately?’ or, ‘did you feel numb?’ They could also include answers to factual or multiple-choice questions, such as ‘how old was he when he died’, or ‘does it hurt more in the morning or in the evening?’

These questions are easy to answer and don’t require much detail. They, however, don’t really invite the person asked to open up about how they feeling or to share what they would need to talk about.

Useful for: getting a quick answer, not overwhelming the other person

Be mindful that: these questions do not open up for a deep conversation

Open questions

Open-ended questions can’t be answered with a simple yes or no response. They require a little more thought and readiness from the questioner to the potential of emotionality this might bring up in the person asked. These kinds of questions however also encourage wider discussion and elaboration. For example: ‘what do you think of the doctor’s advice?’ Or ‘why did you choose that kind of treatment?’ Or ‘what does it bring up for you to be without your mother on Mother’s Day?

Useful for: critical or creative discussion, finding out more information about a person or subject

Be mindful that: open questions can elicit emotions but also really allow the person to share from their heart, which is important

Probing questions

These questions are useful for gaining clarification and encouraging others to tell you more information about a subject. Probing questions are usually a series of questions that dig deeper and provide a fuller picture. For example: ‘when would you like me to come over, or would you like to give me a call when you are ready?’

Useful for: seeing the bigger picture, encouraging a reluctant speaker to tell you more information, and avoiding misunderstandings

Be mindful that: they need to be asked with sensitivity as the griever or traumatized might easily feel criticized or attacked for their way of dealing with their situation

A word on tone

Did you know that we take more than half of the meaning of a conversation out of body language? In addition, tone, context, and intonation, all help us make sense of what is being asked of us. But what happens when you throw technology into the mix and place a digital screen between the interlocutors? All those over 50% of the message carried by body language, tone, and intonation gets lost in translation.

Emojis and gifs have made their way into conversations everywhere. They can be useful but also lead to misunderstandings. Generally, I would always, if possible, prefer talking face-to-face with someone in distress over the phone or by text.

With a certain level of carefulness towards tone and a knowledge of how to ask questions in the right way, you can get a lot more out of your conversation.

Best supporting questions for the bereaved or traumatized

Choosing the best and most supportive questions to ask really depend on the circumstances and on the relationship between the people in conversation.

Here are some of those that I have found work really well to get a conversation going:

How are you doing today?
Based on what you know and what works best for you, what would help you the most? (you might like to follow up with 3-5 suggestions, if the person doesn’t come up with an answer themselves)
What has supported or helped you cope in the last few hours/days/weeks/months?

When working with people I found that when I have established a deeply trusting and supportive relationship with the client I can ask almost any question. This naturally is based on my lengthy experience and my sensitivity to the topic of grief, loss, and trauma.

👉🏼 Griever Input

Letting the people surrounding you know what is helpful and what is not is your right. They don’t know better, what you need, than YOU.

👉🏼 Supporter Input

Experience has shown that grieving or traumatized people appreciate being asked with sincerity and the intent of support. They do tell you when they don’t want to talk about certain things. They generally react well to being asked what they need, rather than being told.

*The types of questions are from the article ‘The 8 essential questioning techniques you need to know’ adapted to grief, loss, trauma.

How Did You Survive Child Loss?

July 11, 2021 By Nathalie Himmelrich Leave a Comment

This is probably the question that most would want to ask, did they have the nerve to listen to the answer. In fact, some do, because – really, how does one survive the death of one’s own child?

Let me tell you – you will survive this loss.

The perspective of time and the myth of time

Writing this article, I’m now looking back 10 years to the time my daughter A’Mya, the younger of identical twins, died in my arms, just three days old.

But time in itself didn’t do the surviving, the healing.

Grief takes a lot of work. Work dealing with strong emotions, with the bleakness of life without your child, with finding the will to live again, even if it’s hard.

“Time does NOT heal all wounds”, especially not the pain of grief. It does however give perspective because looking back, I can see the gems of wisdom, understanding, and the practice of letting go I have gathered along the way.

The helpful…

So, what specifically does help?

I suggest you try to …

find someone to talk to, preferably someone professionally trained with grief or someone who does understand, because they have been where you are now.
find a community of supportive, understanding companions, such as a peer support group or a grief support group.
find someone specific who you can relate to who is a couple of years ahead of you in terms of their loss and talk to them about what you are experiencing. In the best case, they will normalize what you experience.
find something that you find supports you with strong emotions. This is individually different: for some it is the above mentioned, for others it is reading how others dealt with it, for yet others it is a creative, healing activity or phyisical activity. For me, for example, it was walking in the forest along a stream, which really supported me.
share your story, talk about your child, remember and celebrate them.

And the not-so-helpful…

There are other things that didn’t support me. Some of those, I noticed right away, others only much later. Let’s see if they ring a bell:

people proclaiming grief myths (you can read about some here, here or in the book Bridging the Grief Gap).
people no longer talking to me. I would have wished for them to stick around and say things like: “I don’t know what to say, but I’m here” or “I don’t think I’m a big help… I don’t know what to do” and at least stay in contact with me.
exposing myself to grief triggers early on, in my case identical twins. That really made me angry at the perceived unfairness of life.
people sharing their religious or spiritual beliefs about “there is always a reason for everything” or “God has a plan”. Those sentences really pissed me off!
people implying I should ‘move on’ or be ‘feeling differntly to what I was feeling’.
people giving advice who had no idea of the situation we were in. They were just trying to make themselves feel better.

Do not just survive, thrive

If you’re in your early, raw stage of grief this paragraph might not make sense to you. Believe me, it didn’t enter into the realm of possibilities for me either at that time.

For the first two years, I didn’t even put on any mascara, let alone make-up. I didn’t care. I had a baby to care for and I did my best but I didn’t have the energy for much else. Having said that, we moved from Sydney, Australia to Zurich, Switzerland, 11 months after her loss, so I really don’t remember who on earth I managed that.

I was angry A LOT of the time and remember telling my husband, about 18 months post-loss: “You can leave anytime, I’m stuck with myself.” I was so fed up with the ‘new normal self’ that was supposed to be me. I was angry at my mother, who died of suicide just 4,5 months after my daughter. I wrote a lot, I walked the forest, I growled, I cried and in the second year I was pulled to write the first book, Grieving Parents: Surviving Loss as a Couple.

In writing that book, I interviewed about 20 bereaved parents and support professionals. I got to see ahead in time as some of them were further out from their loss. I understood more and more about my grief, even though I was already a trained counsellor before my loss.

With time, I found that I didn’t want to just survive this. I wanted to thrive. As a friend of mine says: I wanted to gather all the vitamins this life challenging situation had in store for me. Big sigh. It was hard work, but worthwhile nevertheless.

Mother’s Day After Loss

May 6, 2021 By Nathalie Himmelrich Leave a Comment

My Mother and her grand-child – Personal Archive

This article was originally published in the Erlenbacher Dorfbott, May 2017

I walk along Bahnhofstraße, past the parish hall, and reach the Erlenbach church. Although I am not religious, I am sometimes drawn there. It is a place of retreat, a place of silence and reflection. I walk through the gate, along with the old and new graves, down the stairs, past the statue of the young girl, and go to the community grave right by the lake. Through the bushes and branches, I can see the vastness of the lake with its mirror-like surface. This is my mother’s final resting place, the place she chose before she died.

The funeral

I was here for the first time when my mother was buried a little over five years ago. We had arrived from Sydney a few days earlier, from summer to winter. I remember walking as a family from my parents’ home to the church. It was a cold January day, but I didn’t feel much of that. I met familiar faces that I had hardly seen during my 15 years abroad. At 2 p.m. the church bells rang to signal the beginning of the funeral sermon. Even today the church bells remind me of that day. The church was full to bursting. We sat in the front row, in front of us on an easel a picture of my mother. I still couldn’t believe it. It had only been a week since my father called to tell me she had died. I turned around and saw the crowd, all the friends, acquaintances, and relatives who were here to honor my mother.

Mother’s Day without a mother

Soon it will be Mother’s Day again. This day, which is for all mothers, is emotionally complex. On the one hand, because my mother is not here. On the other hand, because I have another daughter besides my bright, soon-to-be six-year-old daughter. One that no one sees and few people remember: her twin sister, who died on the third day after her birth. In the span of four and a half months, I became a mother, a mother without her younger daughter, and a motherless daughter.

…and without a child

My first Mother’s Day five years ago was also my first Mother’s Day without my mother. As a half-orphaned daughter, the well-meaning sayings of Mother’s Day cards burned me like salt on a wound. I became painfully aware that on Mother’s Day my younger daughter would never make a drawing, leap towards me and fall around my neck. It’s a fact I’m still acutely aware of today and one that requires me to take a deep breath. I’m hardly the only one who feels this way. That the mother will eventually die is to be expected. But did you know that one in four pregnancies ends in loss? Losing your baby through miscarriage, stillbirth, or having to bury your child happens more often than you think. Mother’s Day has become so commercialized that it is impossible to avoid it. In my case, it inevitably reminds me of what I no longer have.

Many people carry their grief in silence. Pregnancies, according to the advice of gynecologists, ‘should’ not be told before the 12th week, as the percentage rate of loss drops noticeably in the second trimester. Even if people may not show it so openly – a loss (of one’s own mother or a child) never passes someone by without leaving a trace.
As a psychotherapist, I have been working with people in grief for 15 years. So one might assume that I should have been prepared for the grieving experience. But that knowledge, while it helped me understand my process, had no diminishing effect on the emotional roller coaster I had to go through.

Do you have other children?

The often-asked question, “Does your daughter have any siblings?” is one that I meet with openness and honesty. However, many react helplessly when they hear my story. The reality that my child died in my arms makes people speechless. Infant death is taboo. It does not correspond to the natural sequence when children die before their parents. Parents do not even want to imagine this situation. Some break off the conversation, others avoid me. Few continue to talk and have the courage to ask questions. It is my intent to show them that I am not hurt if they continue to talk or ask questions. I want to encourage people to deal more openly with death and grief. Even if we don’t want to admit it, sooner or later we all have to deal with it.

Since I returned from Australia with my family almost five years ago, we have been living in Erlenbach, my mother’s last home. Living here connects me with her. After a period of adjustment, I feel very comfortable today. I cherish my home and Erlenbach is the place my daughter will remember as her first home. People continue to be present even when they are no longer physically in this world. I have been very aware of this since the death of my daughter and my mother. Perhaps you, who are reading this, know a mother who cannot raise all her children, or a daughter who no longer has a mother. Have the courage to reach out to them.

This coming Mother’s Day, I will walk to the cemetery again. Not out of sadness for the loss, but out of remembrance and gratitude to the mother who contributed a lot to what I am doing with my life.

A Letter To The Friend Of A ‘New Normal’ Grieving Mother

April 23, 2021 By Nathalie Himmelrich 2 Comments

Dear Friend,

It’s been awhile since I’ve contacted you. I was busy. Busy surviving. Busy grieving.

I have been more focused on my journey and me than anyone else’s. I had to. For my own and my family’s sake. Otherwise I might no longer be around.

My child has died and even if/though this is months or even years ago, my memory is as fresh as if it was yesterday. For the outside world it has become a story, the story people tell each other at the shop about the woman who lost her baby. But even those conversations have started to die as the news is no longer headline worthy. In the best of cases, it has become a memory. A fading memory.

I might seem better from the outside and in comparison to the first weeks and months I am… Or so it seems. And then grief rolls over me like the unexpected wave that catches me from behind. These were the moments I didn’t recognise myself. The moments I was the crazy ‘new normal’ woman loudly cursing every detail about her life, wishing death upon her to end this pain. This however usually happened (not so) quietly behind closed doors. They have become less frequent… By not contacting you, you were spared those moments. You wouldn’t have liked them. I didn’t and still don’t. You might have been so shocked by your ‘new normal’ friend that you never contacted her again.

It has been a hard road to get used to the ‘new normal’ me, which honestly is nothing like the normal me you and I knew. Ask the husband, the rock – who knows how he managed to not walk out the door. I’ve kept the ‘new normal’ inside a lot because you see, she has no (or little) social grace. I prefer to spend time with her by my own, not that she is pleasurable company but she just doesn’t fit in my life pre-loss. It was my way to save whatever face was left.

I haven’t just been a crappy ‘new normal’ friend I’ve also been crappy ‘new normal’ mother, wife, sister, daughter, human being. Once I’ve realised that I actually had to merge with the ‘new normal’ myself, I struggled with this truth. She or rather I had to relearn what it means to live, to treat people, to care for myself, to be in relationship, to be a responsible human being, to treat things and people respectfully… Most of all myself.

The ‘new normal’ doesn’t have energy nor desire to be pleasing as I was before. I’ve given up on returning to or getting back the self that used to be me – I’ve given in on being ‘new normal’. Resistance is exhausting and fruitless. The more honest and straight-forward I’ve noticed the ‘new normal’ was and is, the less socially digestible I’ve found myself to be. A simple ‘starting-a-conversation’ question like “and how many children do you have?” make the ‘new normal’ a party killer. And for those who know the story, I can imagine them rolling their eyes and thinking: “Here we go again…”

The sad truth is I’ve become quite used to the fact that my friends prefer to stay away from ‘new normal’ and I can sort of understand their potential motivation. As much as the ‘new normal’ has needed to talk about it she/I might have also strained your ears and overused your capacity to listen. I myself would prefer the ‘new normal’ would be able to tell a different life story.

Now I want to be a good new normal friend.

The new normal good friend is honest, real and authentic.

When I integrate the new normal…

I will call or contact you when I truly feel like it.

I will tell it like it is.

I will always mention all my children, dead or alive.

I will learn to love myself, life and what I’ve come here for.

I will appreciate your patience, love and care.

I will be human, fallible and imperfect.

And I’ll hope you to meet your humanness too.

Thank you,

Your friend

This article was first published July 1, 2015 in Still Standing Magazine.

Dear Fear

April 17, 2021 By Nathalie Himmelrich Leave a Comment

Having published my book Grieving Parents: Surviving Loss as a Couple a year ago and being weeks away from having the book published in its German translation, I’ve been reminded of the vulnerability it brings: Having my name out there, my opinions, my story, my suggestions – they all leave room for criticism.

The idea of having your most vulnerable time of your life neatly packaged in 200 odd pages for the whole world to read can bring up fear, as I was reminded in a recent conversation with a fellow grief coach, who is contemplating putting her story into a book. I said: “fear has a role of protection” and “have a conversation with the fear” which I thought was a great suggestion for myself too – maybe even for you?
Here is mine.

My conversation with fear

Dear Fear,

We need to talk. You’ve been with me on and off all my life. I know you protect me from pain, hurt and disappointment. I get it. I appreciate your concern and caring protection.

Whereas in the past you visited from time to time, it seems now you’ve moved in permanently.
In the past few years since the death of my child and my mother you’ve become ever present. I can feel you in my bones. I can feel you in my recurring thoughts, day and night. It’s draining my energy to have you live here with me. Is it that you feel I can’t continue living without you?

You’ve been with me, holding me while I held my daughter as she passed away and you sent your companions ‘numbness’ and ‘shock’ to ease the pain. It worked for a while… Until I noticed that I couldn’t avoid the pain. Even if you would have done anything for me to avoid it, it wasn’t possible on the long run.

You’re with me all of the time

You kept me at home, under the duvet, ignored calls for me and had me stare blankly into the world. You’re with me, every step of the way, alongside my parenting journey. I can even see you in my husband’s eyes, hear you in his ‘be careful, or you’ll hurt yourself’ sentences. You’re right by my side in every step my daughter takes and you make me scream at her for fear she might get hurt – and for fear that I would get hurt in the process of it. That’s when you send your colleague ‘self-judgement’ to come in right after you’ve done your job.

What you couldn’t turn away was the hurt I felt from someone’s thoughtless comments. Friends have disappeared and you make me wonder what I might have done wrong. You’re worried I’ll end up old and lonely. At times you’ve even gently suggested not to mention my daughter, when the question asked was: “Is this your only child?”

You’re present when I talk, walk and even when I sleep. You tell me to become better again, to become a nice sociable person again, or people won’t like me. I worry more, sleep less, question more, think deeper.

‘Anger’ isn’t your friend, nor colleague or companion. You’re afraid of the anger because you can no longer control me, while he’s around. You fear the things I’d do or say when the anger is around. You fear the people that will leave me for my anger. You make me afraid of my anger and its destructive tendency.

I need to be brave

As much as I appreciate your concern and care, you’ve also kept me from stepping out and doing things, trying things in a new way. As true as it is that I’m tired of pain and hurt, I also need to be brave to make a difference, to continue living boldly and allow my daughter to do just the same.

How can we find a way together?

This article was first published August 5, 2015 in Still Standing Magazine.