Grief and Trauma: Matching Theory With Experiential Knowledge                          

Following a sudden and unexpected death what are some of the initial reactions people experience?

Shock

Yearning

Loss of trust

Disbelief

Searching

Loss of interest/motivation

A sense of unreality

Hopelessness

Being forgetful

Numbness

Helplessness

Judgmental of others

Fear

Confusion

Anxiety about being alone

Anxiety

Loneliness

Loss of confidence in parenting

Anger

Absentmindedness

Over-protective parenting

Emptiness

Guilt

Feeling judged

Blame

Fear of subsequent loss

What Is Trauma?

Trauma is the normal response to an unnatural event

What Are Some Of The Reactions People Experience Following Trauma?

Flashbacks

Restlessness

Avoidance

Difficulty relating to others

Strange and vivid dreams

Loss of appetite

Irritability

Reminders of past traumas

Agitation

Sleeplessness

Hypervigilence

Physical illness

Depression Ante/post – natal depression

All of these reactions are natural and normal following significant trauma.

The Experience of Grief¹

It is important to understand the various experiences of grief. Everyone does not necessarily go through every experience, nor do they go through them in any set order. Each person has his/her own timetable and his/her own style of grief. You may struggle with several feelings at the same time. The depth and duration of each experience is different for everyone. You may experience a feeling briefly, intermittently or struggle with it daily. Understanding the various phases helps you to cope. Knowing that others have gone through this pain and have eventually been able to reinvest themselves in life gives one a sense of HOPE.

DISBELIEF: “It can’t be true”. You keep thinking that any minute you will wake up from a bad dream/nightmare. Sometimes you can’t cry at first because you don’t really believe it happened. Often people will comment on “How well you are doing”. Inside you know that the reason you appear to be doing so well is that you just don’t believe it.

SHOCK: Shock is nature’s way of softening the blow. It serves as a cushion – giving you time to absorb the fact of your loss. You hear the words, but do not comprehend the full impact. Emotions seem frozen. You feel disoriented, restless, numb, bewildered, stunned and unable to think. It takes everything just to function. You go through the motions like a robot and feel as if you are an observer watching this happen to someone else.

SOBBING/CRYING: Sobbing means to weep aloud with short, gasping breaths. Sobbing is an outlet for the deep strong emotions that accompany the death of a loved one. Some people cry often and a lot. Others push down their tears, but this may lead to psychological or physical problems. It is helpful to cry – to release all that pent-up emotion. Cry alone or with others – but take time to cry. The book, “When Going to Pieces Holds You Together”, says it very well. The advice “don’t cry” is ill advised. Accept the grief – don’t try to be brave and fight it. At first, you need to take time to grieve daily. Looking at pictures/mementoes, playing special music, may aid in releasing pent-up tears. Men can and should cry. Crying is a good model for children. When adults cry, children learn that it is “okay” to cry and to express their feelings. Children learn to share their feelings instead of suppressing them and struggling alone.

PHYSICAL SYMPTOMS: You may experience some of the following: lack or increase of appetite, sleeplessness or oversleeping, knot or emptiness in pit of stomach, tightness in throat, shaky legs, headaches, stomach aches, sighing, trembling, chills, fatigue, chest pains, general aches, difficulty swallowing and/or speaking, digestive disorders (indigestion, nausea, diarrhea), feeling weak/faint, tension, slower in speech/movement and temporary paralysis of limb or sight. It helps to understand some of these symptoms may be a part of grief and emerge anytime. It is advisable to have a physical checkup to make sure that there is not another cause for your physical ailments. Take care of yourself by establishing a simple routine (good nutrition, adequate rest and time for relaxation). Exercise aids sleep and may lighten depression.

DENIAL: The phone will ring, the door opens, or you will see someone and at first you think that it is your loved one. You may subconsciously be searching for your loved one when out in a crowd. It takes time to believe what has happened. Even though you know the fact of death, you continue to not really believe it. Many habits continue, such as setting the table for the same number, expecting your loved one to come home at the regular time, buying his/her favourite food, watching a TV program and saying: “I’ve got to tell him/her what happened.” This shows our unconscious denial of their death. Denial provides a buffer zone from the reality of what happened.

WHY? Often we keep asking “WHY?”, “Why did he/she have to die?” We don’t necessarily expect an answer, but the question “WHY?” seems to need to be asked repeatedly in an effort to make sense of the loss. The question may be unanswered, but it is important to ask the question until we can take the step of letting the question go. Rabbi Kushner states in his book “When Bad Things Happen to Good People” that often the “why” is not a question, but a cry of pain.

REPETITION: You may find that you are saying almost the same things to the same people. The same thoughts keep running through your head. In saying the words and hearing ourselves over and over again, it helps us to believe what has happened. It is important to find friends who will listen, especially someone who has experienced a similar sorrow.

REALITY OF DEATH: “It’s true.” “It really happened.” This is a frightening time. We feel that we are getting worse. Often this happens after people who have been so helpful have left. It seems as if we are going backwards. Actually, this reality has to “hit”. The best advice is to “lean into the pain”. As much as we don’t want to hurt, we must.

CONFUSION: “I can’t think.” “I forget what I am saying halfway through a sentence.” The simplest decisions seem impossible. It is difficult to concentrate and follow through on things. You feel disorganised and error-prone. Bereaved people often feel impatient and want to do something, but feel unclear as to what to do. Sometimes motivation to do something may be very low and basic survival needs may not even be met. Confusion abounds because you are using all your emotional energy to grieve and there is very little left over for anything else. The weariness due to grief may affect thinking and concentration.

IDEALIZATION: At first, you may only focus on the best qualities – seeing your loved one as perfect. It is a very normal reaction, but it is important to be aware of others in the family. They may compare themselves to the “perfect” loved one and feel that they are not as loved – that it would be better if they had died instead.

IDENTIFICATION: Many people seek to identify with their loved one who has died by wearing their clothes, taking up a sport they liked, planning to follow in their footsteps, etc. It is a way of “staying close”.

ANXIETY/PANIC (Fear of Losing Control): At first you may fear being alone. You worry about the future and may be afraid that something else will happen to another loved one. You often panic at the approach of special dates (birthday, holidays, anniversary of the death). Usually they are not as difficult as the days prior. This is due to our unbelievable panic and apprehension. You may feel as if you are “going crazy”. It may seem as if you are losing control of yourself. Usually we don’t tell anyone that we think that we are “going insane”. Sometimes a bereaved person may have thoughts of suicide being the only way to escape the physical and emotional pain. We panic at the prospect of “always feeling like this”. We feel that we should be doing better and panic when we don’t. Our situation may seem hopeless and our thinking becomes jumbled. Panic is normal. If panic seems intolerable, you need to do something about it. Talking about our feelings, getting busy with something, sobbing, screaming, exercise – all may help to release the “panicky” feelings. Emotional and physical fatigue contributes to our panic. Good nutrition and rest are vital.

BARGAINING: You want “things to be as they were.” You may hope that just wishing will bring back the person. You may try to bargain with God “that things will be different”; that you will try to be a better person if only the loved one can be alive again.

DEPRESSION: It is a feeling of being in the “pits”. You hurt so much. Sometimes you just don’t care about anything. You just sit. Mornings are terrible. So is the time and the day of the week that your loved one died. It’s an effort just to get out of bed, to shop, or fix a simple meal. Talk things over with a friend who cares and will listen. This is one action that may help a person not to become seriously depressed. Talking to others in a support group of bereaved people who know what you are going through also helps a great deal.

SEVERE DEPRESSION: It is a feeling of deep, overwhelming sadness and hopelessness that lasts for longer than two weeks. Other symptoms may be: loss of appetite, insomnia, inability to enjoy anything, anxious or restless behavior, apathy, preoccupation with thoughts of suicide, wishing to be dead, loss of interest in sex, difficulty in concentration and making decisions, poor memory, irritability, feelings of worthlessness, inability to cry even if one desperately needs and wants to, intense guilt and withdrawal from relatives and friends. It is important for bereaved people not to become alarmed, because everyone experiences some or all of these symptoms at some time. If six or more of these symptoms are severe and continue over an extended period of time (so that pain and problems outweigh pleasure much of the time), then it would be advisable to get professional help.

RELIEF (Laughter): This phase comes and goes. Often after the reality “hits”, or after a particularly troublesome time, you feel better and may even think that the difficult times are over. There is a sense of great relief at no longer feeling down. Appreciate the relief, the grief will return soon enough. It is helpful to recall the fun times. Wholesome fun and laughter are beneficial. It is not being disloyal to our loved one to enjoy life. In fact, plan things to which you can look forward to. Having a sense of humour is often mentioned by bereaved as being helpful.

EXPECTATIONS: We often expect too much of ourselves. We want to handle the grief better and more quickly than is humanly possible. Submerging our feelings is very detrimental because we still have to face these feelings eventually. The expectations of others, “You must be over your grief by now”, only adds to our burden. Often we will expect that after the holidays, or after some special day, we will feel “much better”. This kind of expectation only hinders the grief process. It is more helpful not to have a timetable of how we should feel, or when we will get better. Taking one day at a time, or half a day, or one hour at a time is more realistic.

LOWERED SELF-ESTEEM: A bereaved person’s confidence is often undermined. In a study on self-esteem using a scale of 100, it was found that an average person’s self-esteem was in the 70’s and generally a bereaved person’s was in the teens. Understanding the impact of grief on your self-esteem may help you find ways of coping.

PREOCCUPATION: Your loved one who has died may be in your thoughts constantly. You may think of nothing but the loss. You may even dream of your loved one, or be preoccupied with his/her image. Even at work, church, or doing the dishes. In fact, no matter what you are doing, you may find that parts of your thoughts are always about your loved one. The intensity of this preoccupation usually lessens with time.

GUILT: Many people are tortured by “if onlys”, and “what ifs”. “If only I had called;” “If only we hadn’t let him/her take the car that night;” or “If only I had taken time to listen and visit”. We tend to blame ourselves for something we did/didn’t do that may have contributed to the death, or for things that we wish we had done for our loved one. Feelings of guilt are normal, even though not realistic. It is best not to push down the guilt. Talk about it until you can let it go. Hopefully, in time, you will realise that you did the best you could under the circumstances. None of us are perfect/ the past is behind us. All we can do with the guilt is to learn from it for the other people in our lives. When the death is by suicide, it is especially important to remember we can’t control the behaviour of another person.

ANGER: Anger may be directed at ourselves, others (including family members, spouse, doctors, nurses, person who caused accident), the person who died, God or we may experience a general irritability. We may feel angry towards people who push us to accept our loss too soon, or who pretend that nothing happened. Anger is normal. Pushing down anger is harmful and may cause things like ulcers, high blood pressure or depression. Unacknowledged anger may be directed at innocent people and unrelated events. It will come out one way or another. It is often difficult to admit being angry. Erroneously we may think, “nice people don’t get angry”. It is important to recognise our anger. It is helpful to find ways to express our anger, such as screaming in a private place, walking, swimming, aerobic classes, tennis, golf – even installing a punching bag in our home. Talking about our anger also helps us to define, understand and learn how to handle it. To suppress anger can lead to deeper than normal depression and bitterness. It is important to acknowledge our anger and to take steps to handle it.

LONELINESS: After the initial help, relatives/friends usually pick up their own lives and we are often left to deal with our grief alone. Co-workers, friends, neighbours and sometimes even family may avoid us or change the subject. Some friends withdraw, because they are hurting, and do not know how to help us. We often become isolated in our grief. The widowed often say, “I not only lost my spouse, but my friends as well”. In reality, few people are able to help or to understand. Support groups can be helpful. Some aspects of grief cannot be totally shared, even in the same family. It is difficult for husbands and wives to help each other. As Harriett Schiff, author of “The Bereaved Parent” states: “It is difficult to lean on someone who is already doubled over in pain”. Especially at first when we are hurting so much, we realise that we are not much fun for others to be around. When others have all their loved ones alive, it makes us feel even lonelier. We may feel intense loneliness due to the absence of our loved one, because we are unable to share thoughts and feelings, to touch and to be understood. We feel empty without our loved one.

DESPAIR: “How can I go on?’ You may come to the point where the agony seems intolerable. You can’t bear it – you think that you won’t be able to survive. Your hopes/dreams are dashed. It may seem as if there would be little difference if you lived or died. You may have suicidal thoughts; feelings of desperation, despondency, pessimism and loss of all hope seem to surround you. If you are a smoker you may smoke more than ever due to nervousness, or to an attitude that you don’t care if you ever take care of yourself again. Sometimes it is blackest before the burden of grief begins to lift. Talk to someone who has made it through grief.

SADNESS: We miss our loved one and feel deprived of his/her presence. We may feel unhappy, inconsolable, distressed, sorrowful, dejected and heartbroken. These feelings seem to pervade our life.

HELPLESSNESS: “What am I going to do?” We feel helpless about our feelings, our grief. It seems as if we are unable to help ourselves to cope, or to get better. We do not seem to be capable of aiding other family members. We may feel self-pity. Although we realise that we had no control over what happened, we feel a sense of powerlessness at not being able to prevent it.

ENVY: You may feel jealous of people who still have their loved ones to enjoy. With a child’s death, dreams of their future are gone. This pertains to college, job, wedding and grandchildren – things you would have shared together. When a spouse dies, you may envy others watching their children/grandchildren grow up and enjoying retirement together.

FRUSTRATION: Many frustrations are a part of our grief. “Why am I feeling so upset for so long?” We become disappointed with ourselves that we are not coping as well as we think we should. So many impulses, thoughts, feelings and actions that had become habits are stopped in mid-course. We are left with these unfulfilled emotions, desires and thoughts buzzing about in our heads or sitting in our stomachs.

RESENTMENT/BITTERNESS/HATRED: Bereaved people often feel resentful about the death and their changed circumstances. Sometimes there is a (sub) conscious hostility towards others whose families are still intact. Some bereaved feel hatred toward those responsible for the death. These bitter feelings should be recognised and worked on, or the bitterness could last for many years. Hatred and bitterness drain you of energy and may be destructive to your health and relationships. When these feelings are left unattended, healing becomes blocked.

LIMBO: Eventually we may reach an in-between point between the reality of death and the point where life seems worthwhile again. We may feel a little better at last, but be uncertain of what to do next. It may take much longer than we would like before our zest for living returns. We often live behind a façade – masking our feelings and saying, “we are fine”.

HOPE EMERGES: You realise that your grief is softening. At first the pain was with you constantly. Now the pain of grief is briefer and comes less frequently. The good days outbalance the bad days. You feel encouraged that you will get better. Things like shopping (which had been so painful before), painting the living room, looking forward to events, etc., all become a part of your life again. Once again you are effective at work and home, able to make decisions and handle problems. Generally, you are able to sleep and eat as you did before. You are able to care about others. You begin to realise that you are moving forward and can once again find some joy in life. You smile and laugh once again and are rewarded with the smiles of family, friends and strangers.

MISSING: You will always miss your loved one. Special family events, such as holidays, birthdays, weddings, anniversaries, even a song or a special TV program will trigger the feeling of longing for your loved one. Seeing other families enjoying special events “that might have been for you” also deepens your feeling of yearning. You can’t help but wish your loved one was alive. You miss countless things that were special about your relationship … a hug, a kiss, a smile, a phone call, or hearing them say “I love you”, or “Thank you”. For some people, when there was a special relationship, the missing can be more acute. If relatives do not live at home, they may find coming home for a visit especially difficult. Their feelings of missing, anger, guilt, etc. may be intensified. The reality of the death is more believable at home where their loved one is undeniably missing.

STRUGGLE WITH NEW LIFE PATTERNS: You realise that you have a choice. You can rebuild a new life. It will be different without your loved one, but life can be enjoyed again. It is important to seek meaning in living. Learn how to make happiness happen in your life. … You need to reinvest in work, activities and friends. New friends can be found among other bereaved. You may find it necessary or helpful to move, find a job, do volunteer work, join a support group, etc. Be open to renewing familiar patterns and friendships, but be ready to try new ways of living.

LIFE IS WORTH LIVING: Eventually we are able to think and talk about our loved one with happiness and a sense of peace. We have learned to accept the death and can see options and possibilities for the future. We may experience renewed meaning in life. There is the possibility of emotional, spiritual and personal growth. Often we become a different person – stronger, more involved, wiser, more compassionate, concerned, understanding and aware. Our loved ones have entered a beautiful new life without pain and problems. We will be together someday. Meanwhile, they would want us to live, love and appreciate this life and the people in it to the fullest.

PRIDE: For many of us, we are too “proud” to ask for or accept help. When asked how we are feeling we say “fine” – when in reality we are falling apart inside. We are apt to think “I can do it by myself”, not realising how unprepared we are for the death of a loved one. Sharing such deep grief does help us to cope and understand. The verb “be proud” means to hold one’s self high, to turn one’s head. The bereaved person so often do this to overcompensate for how really low they feel. We are stubborn about letting anyone know how we feel. This makes it difficult for others to give us the help we so desperately need. We should consider if our PRIDE is complicating our grief, and if so, work on ourselves to ask for and accept help.

Last reviewed: 25/4/24