grief and loss

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