Grief After Traumatic Loss

Recently a reader emailed us and asked if we’d write a post about grieving a violent death. She’d been looking around the Internet for resources and information on the topic and had noticed the literature was a little light.  That’s not to say good resources don’t exist, it just means they’re hard to find, so if you have a recommendation please feel free to share in the comments below.  Anyway, we are going to do our part to fill in the void, however we’re going to broaden the conversation a bit and discuss the concept of traumatic loss.

Now before I start throwing around labels and making generalizations, I have to make my usual speech about the differentness of individual grief.  Although commonalities often exist amongst people who have experienced a certain type of loss, individual grief is as unique as the person experiencing it and their relationship with the person who died. Although some people might be able to relate to aspects of another person’s grief, no one can completely understand how anyone else feels. On a whole, we recommend you learn what you can from what is ‘typical’ for a certain type of grief, but take differences with a grain of salt. Okay, with that said.

A note about trauma:

Just a little more talk of subjectivity (sorry for those of you who like things black-and-white); it’s important to note that it isn’t necessarily the specific nature of the death that makes it traumatic, rather how the event is interpreted and experienced by the individual. One cannot underestimate the impact of personal factors like emotional regulation, cognitive responses, secondary stressors, coping style, prior history of trauma, and access to support and resources in determining how a person responds to an event.  

It is true that certain types of death happen in a way that they are more likely to be experienced as traumatic, but it isn’t a given.  So, for example, it is not a fact that a loved one’s death by homicide or MVA will be experienced as traumatic, only that it potentially could be.  Ultimately, one must allow for a wide range of variability when it comes to potentially traumatic events.  All deaths have the capacity to overwhelm, shock, terrify, and shatter worldview.  In fact, research has shown that PTSD symptoms are not only found in those who survive violent and sudden deaths, but also those who experience the death of a close person to terminal illness. 

Okay, so what is traumatic loss?

There’s variation in how traumatic loss is defined in the research, but for our purposes I think this definition from Wortman & Latack (2015) does the trick:

“A death is considered traumatic if it occurs without warning; if it is untimely; if it involves violence; if there is damage to the loved one’s body; if it was caused by a perpetrator with the intent to harm; if the survivor regards the death as preventable; if the survivor believes that the loved one suffered; or if the survivor regards the death, or manner of death, as unfair and unjust.”

That’s a pretty broad definition, and we should also add circumstances in which the survivor witnessed the death, when their own life was threatened, and when the mourner experiences multiple deaths.

In addition to the nature of the death, other trauma risk factors include:

  • Having to make medical decisions about life support, organ donation, etc
  • Uncertainty about whether the person has a died because they are missing or because information about their condition has not been disclosed
  • Media attention
  • Limited opportunities for social support
  • Being blamed for the death
  • Prolonged court precedings
  • Having a prior history trauma

What is the impact of experiencing a traumatic loss?

Generally speaking, it has been shown that traumatic death, especially violent deaths, lead to increased distress.  For example, a 2003 study looking at the bereavement trajectories of 173 parents who experienced the death of a child by accident, suicide, homicide, or undetermined causes found that five years after the violent death 27.5% of mothers and 12.5% of fathers met the diagnosis for PTSD.  These rates were significantly higher than those in the general population.

When someone experiences a traumatic death, their challenges become two-fold.  One, they must cope with the trauma and two, they have to cope with their grief.  The experiences of trauma and grief are two different things unto themselves, yet after a traumatic death they get thrown into one big emotional blender. Things get tangled, thoughts and emotions get fused, and people sometimes find themselves utterly stuck.  Understandably, it is not uncommon for people who’ve experienced a traumatic death to experience significantly more intense, pervasive, and prolonged symptoms.

Screen Shot 2016-01-19 at 11.30.23 AM

After a Traumatic Loss One May Experience:

Shattered assumptions about the world, themselves, and others: 

Many people live with the assumption that the world is a predictable, fair, and just place.  They believe that they are in control, that they are generally safe and secure, and that other people can be trusted.  Experiencing a traumatic death, something that feels profoundly meaningless and unjust, can shatter each of these assumptions and lead to a sense that the world is unsafe and unpredictable, that others are malicious and evil, and that one is powerless in protecting themselves.  Going along with this, it is also common for one to question their faith and to feel abandoned by God after experiencing a traumatic event.

Ruminations:  

It is common to ruminate about a death regardless of the circumstances.  However, someone who has experienced a traumatic death might experienced increased rumination as they seek to answer questions such as…

  • Why did this happen?
  • Who is to blame?
  • Did my loved one suffer?
  • Could their death have been prevented?
  • Did they know they were going to die?
  • Were they afraid?
  • What is the meaning, reason, or purpose for all of this?

Unfortunately, many people fail to find the answers they are searching for and they continue to struggle with the randomness and senselessness of the death as well as the pain of imagining what it must have been like for their loved one at the time of their death.

Feelings of guilt and blame:  

Even when a person is clearly not at fault, it is common to struggle with feelings of guilt and self-blame.  For example, one might feel guilty for circumstances that preceded the death but which could have played a part in the chain of events.  A person might make appraisals about the inadequacy of their own actions, feelings, and behaviors at the time of the death or even ruminate over actions and conflicts between the mourner and deceased well in the past.  Negative thoughts about guilt and self-blame can impact how a person adjusts to bereavement and are often associated with feelings of depression and anxiety.

Fear of grief and trauma reactions:  

After a death mourners often feel as though they are going crazy, and, as noted, those who have experienced a traumatic loss often experience intensified and prolonged grief/trauma reactions.  If a person interprets their symptoms as dangerous, threatening, or indicative of a larger mental or physical problem, they are more likely to fear and inhibit their reactions.  Concerns about one’s own reactions following a death add to existing emotion by causing additional anxiety, depression, anger or shame.  Those who are fearful of their reactions may also engage in maladaptive and persistent avoidance of triggers or reminders which can contribute to the development of postraumatic stress disorder and which prevent the mourner from finding meaningful ways to continue their bond with their loved one.

Poor social support:  

Evidence suggests that social support can reduce the impact of stressful life events.  Sadly, after a death many people don’t receive effective support for a number of reasons.  This is especially true after a traumatic death when the enduring impact of acute grief can last much longer than society has been taught to expect it.  A few reasons why people do not receive effective support after a death include:

  • People don’t know how to provide grief support
  • People make comments that minimize grief, discourage expression of grief and discussion of loved ones, and push mourners to move on
  • The bereaved may be inclined to physically and emotionally isolate, especially when they feel misunderstand by others
  • The bereaved may feel they feel ashamed, abnormal, or weak because they continue to struggle
  • The bereaved may seek support from therapists who are not trained in grief and/or trauma
  • Avoidance of trauma and/or grief related triggers prevent the bereaved from engaging with others

How do I cope after a traumatic death?

After a traumatic loss, it is important to find ways to process and cope with complicated emotions and reactions regarding the death and the trauma. I encourage you to look around the site at the hundreds of articles we have about coping with grief – especially those related to coping stylesself-care, understanding avoidance, secondary loss, guilt and grief, positives and pitfalls of support groups, and identifying an effective support system.

Finally, if you plan to seek support from a therapist I want to caution you that not all grief therapists have an understanding of trauma.  Be selective when choosing a therapist, make sure they are licensed and ask questions about their experience working with trauma and grief. If you meet with a counselor a few times and don’t feel as though things are going well, then don’t be afraid to find someone else.

Check out our print resource – Surviving the Grief of a Traumatic Loss

Surviving the Grief of a traumatic loss

 

 

 

 

 

 

 

 

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April 12, 2017

33 responses on "Grief After Traumatic Loss"

  1. A good friend killed himself in my driveway in
    My brothers car right next to my brother a few feet away from me inside my house as I was looking out my screen door I seen it and ran to him to try and keep him alive ( I’m in the medical field). we called 911 on three different phones and couldn’t get thru for help those seconds were what seemed like forever blood was everywhere I don’t think I’ll ever forget the look on his face in that first sec he did what he did to himself. I have constant waves of an uneasy feeling in my heart when I’m doing anything nothing has eased this since. I just wish everyday we would of seen this coming. Or that I would of just got up to go out there and hug him and say hi maybe that would of changed the night before Easter this year maybe he would still be here 🙁

    • Profile photo of Litsa Williams

      A friend, it is so easy to go back and rethink every moment, wishing we had done things differently. Depression and suicide are devastating and so often even those closest to someone don’t see it coming or cannot change the outcome. We have posts on suicide, guilt, hindsight bias, regret, and self-forgiveness that may be a place to start. Please take care and we hope you find some support on our site.

  2. My sister died unexpectedly 5/13/15 from issues with her heart that we were unaware of. In fact, I had taken her to the doctor two weeks prior and the doctor said to her “well, of all the things going on with you, your heart looks great” We joked about it, laughed even. She called me the day before, I was busy..didn’t call back. Emailed that I would call her the next day. I never got the chance. At 6:58am her husband called to say he found her at her computer hunched over and blue. He did cpr until paramedics got there. They worked on her another 40 minutes to no avail. She was my best friend, my sister. I feel like a cannon has blown me apart. I cry every single day and the physical pain is unbearable. I really don’t know how anyone survives these things. I can’t come to gripes with it, can’t make it real in my head. I don’t want to.

  3. Katrin, I will be praying for you. I don’t have any other worder to confort you. I also lost the man I love 2 months ago through suicide.

  4. My mom and dad were killed by a habitual drunk driver who never went to jail.

  5. Thank you so much for this article! It helps validate my emotions and PTSD and definitely my not being able to properly mourn my loss even though it’s been almost seven years. My grief is still so raw like it happened yesterday. I would love to find more info on dealing with traumatic death because I for one do feel like no one understands it. And society should stop telling me to get over it.

    • have you jad EMDR therapy i lost my husband to suicide long story but the trauma had immense effect on my after three yrs ive just ginished EMDR its helped me so much x

  6. My daughter’s godfather saw people die in combat. Two of them were his sergeants. He liked both of them really well but he seems closest to the one who was his direct Sgt: William Blanton. Sgt. Ferguson was commander of the other unit making up the platoon.

    I feel like I know the Sergeant Blanton through his memories and he “introduced” me to Bill. He took us to Bill’s final resting place on Veteran’s Day and talked to him as if Bill could hear him. That somehow made it more personal to me even though I never met Bill in life. I was 3 when he died.

    These are the photos of his two Sergeants. I got them from Vietnam Veteran’s Memorial Fund. I don’t know how to upload personal photos. He has those too.

    http://www.vvmf.org/Wall-of-Faces/4342/BILL-E-BLANTON
    http://www.vvmf.org/Wall-of-Faces/15909/LOWELL-V-FERGUSON-JR

  7. The remaining killers of my daughter’s dad, my former husband, had their death penalty taken off the table too: no thanks to the people who had them tortured for further information and introduced a mitigating circumstance that would save their lives and make every exTREMIST Liberal feel more sorry for THEM than they do the thousands of their own people that these prisoners paid to have murdered in a terrorist act.
    Now all I ever see are 50,000 posts of “proof” that every Muslim on earth is a decent human being. Well the ones who paid to have all those people killed on September 11, and had concrete evidence tying them to the crime beFORE they were tortured, WEREN’T “nice little angels.” Being tortured didn’t turn them into nice people. It turned Dick Cheney and company into idiots. IMO. I have no ability to feel sorry for the two terrorist suspects who had evidence gathered against them before they were tortured and have shown no remorse for a single thing they did.
    Even other Muslim people I know think they did something wrong. The only people who seem to disagree are those who would be a 10L on the scale of How Liberal to How Conservative are you? That exists on Crowd Pac.
    When it comes to this issue I’m not Republican or Democrat. I’m a person who lost a family member. My daughter’s still family and it was her dad. It doesn’t feel political to me at all but I dislike the ones who did it and have solid evidence supporting that from beFORE they were tortured.
    Just because Dick Cheney thought he was Darth Vader (“We had to work the dark side”) doesn’t mean evidence didn’t exist before he (they) went and ruined the case.

  8. My 6 year old daughter (Makayla Joy Sitton) was murdered along with 4 other relatives in our house Thanksgiving night 2009. Here is a brief look into my journey of sorrow. I began writing to relieve my brain of heartache. My ramblings and poems can be found in the photo captions.

    Grief shared is grief diminished.
    Joy shared is doubled.
    https://www.facebook.com/jimmysitton/media_set?set=a.10152969885340283.1073741840.597970282&type=3&notif_t=like
    PLEASE SHARE WITH ANYONE WHO HAS SUFFERED THE LOSS OF A CHILD.
    (My prayer is this album will encourage others in their time of mourning)

    Here is a video from Americas Most Wanted when they were looking for the murderer-

  9. My husband had surgery on one leg when Dr. saw another clot in the other leg . They decided to do next surgery the next day. But early the next morning before they came to get him, he had fallen out of bed. His ear turned black on left side of his head. They ordered a cat scan and took him to surgary. When surgary was done. The Dr. Informed the surgary went well but he now has a brain bleed. Next came coma around 20 min. After coming in to recovery. Ten days later I had to make the of taking him off the respirator. I went and said my good bye and talked to him and less then 15 min. he stopped breathing on his own. I have guilt that if I had just taken him home from the first surgary. I could have saved him and taken him back the next day. He has been gone two years and I can’t seem to focus ,think straight, get my life on track. My family Dr. Has been great but I have been given a special Dr. But I will be making sure it is a grief Dr. I have so much gilt over it.

  10. Thank you for this thoughtful article. It is so accurate for me, especially the rumination, the social isolation, the feelings of guilt, being responsible, blaming myself – the whole thing. Less than 2 years ago my 24 year old son died of a heroin overdose. Let’s talk stigma, shame, blame, isolation, guilt…those were both our feelings. I’m on my third therapist who I found through our hospice bereavement department. She is trained in Complicate Grief Therapy. http://complicatedgrief.org/complicated-grief/complicated-grief-treatment/

  11. My son Michael was killed on April 16,2015. He died in an explosion at his job. He had only been working there for 3 month. Michael got up that morning went to work and never came home, he was only 29. Your article is exactly how I feel, it’s like someone can see inside me. Everyday of my life I play over in my mind his last day. I miss him so much and I am so heart broken.

  12. Very good article! Like many here, I know that to be a fact…I buried my 16.5 year old daughter Kalei, 14 years ago. She was killed in a car crash. In an effort to understand and manage my grief, I analyzed and wrote about what I and those around me experienced. I self-published Forever Kalei’s Mom in 2015.
    The book is separated into 3 lifetimes: A Lifetime Ago (those new to grief will not be interested in that life), A Lifetime I Could Not Imagine (definitely for the new to grief) and A Lifetime Ahead (maybe a later read). I also blog as often as I can. If you think it will help you, my website is http://www.foreverkaleismom.com/
    All that being said, what I really want you to hear from me is…from my heart to yours…I am soooo sorry.

  13. Thank you for this article. I lost my 21 month old son on February 5, 2015. Almost 1 year ago. He was struck and run over by a truck in front of me. I searched everywhere for information but you’re right it is so limited. We have dealt with the media and being blamed by other people. My husband and I and our 2 other children have basically become shut ins because that’s just easier. So thank you, for letting us know we aren’t alone.

  14. Appreciate this article. 5 years ago, I found my son unresponsive in his bed following a seizure. His sisters saw him and assisted with CPR attempts and EMT assistance. We fortunately found a great counselor who walked with us through PTSD diagnosis and grief. It’s very real. 5 years later, the images are still very strong, but we’re trying to find Joy again.

  15. Thank you for this post. Thoughts are with everyone that has commented. My husband died at 37 in a motorbike accident a little more than 2 years ago leaving behind our girls (who were 8 and 11) and me. At the time of his accident he was 16 months in remission having been diagnosed with Lymphoma. I had just started working my way through the life changes that brought and was starting to accept that he was actually in remission and that it was ok to breathe again when he died. I share my ongoing journey through my blog https://widowstrong.wordpress.com

  16. In 2002 my brother in law took his own life. His daughter attended her daddy’s funeral on her 8th birthday. 7 years later at 14 my same niece found her mom (my only sibling) dead. Brooke was now an orphan. She became another daughter to me instead of simply a niece. Another 7 years later and Brooke delivered her baby boy the day after her 21st birthday on August 20, 2015. She was only 22 weeks pregnant. Maddox lived for 4 weeks. After losing her mom, dad, and baby boy, Brooke’s heart was irreparably broken. We lost our beautiful Brooke on Christmas night. I don’t know that this is a grief I will ever be able to overcome or if I even want to try.

  17. Thank you Eleanor!

  18. My son was murdered last month. Myself, my husband and daughters all feel as though we are going crazy. Denial has protected us but when denial slips away, reality slams us. This horror should never have happened. I don’t know how to go on. Normal is not normal anymore because my sweet boy is gone.
    We can check off every thing on that list.

    • Veronica
      My son also was recently murdered, I am not sure how to even begin to go forward in life, if possible can you contact me? Thank you

  19. It hasn’t been six months since my husband passed. He had been in intense chemotherapy treatment, and the doctors were so hopeful. He was scheduled for a stem-cell transplant on 8/15, but suddenly on Thursday, 7/30 he had to be readmitted. It only took a couple of hours to learn that he had relapsed. The doctor met with me outside of ICU to let me know that he probably wouldn’t make it through the night. He managed to hang on until Saturday night when his heart stopped. I deal with the guilt and blame, unanswered questions, no family support, everything that was mentioned in the article, including “I don’t understand why you’re still so sad” from those who have never experienced personal loss. I’m alone and miss him every day, feel like our dreams have been shattered, just trying to find my way without him. Thank you for providing information and support through this website.

    • My husband went through chemo hell and two surgeries that ravaged his body. We too were preparing for transplant when we learned his rare, aggressive had come back with a vengeance and spread to his liver. I feel so much trauma I don’t even know how to sort it out-his suffering and the fact that we had no quality time to spend with our young kids once he was diagnosed, the trauma my babies went through, mal-practice by a uncaring ass of an oncologist, being blamed for his death by my in-laws who didn’t agree with his treatment decisions and who tried to sabotage our family when we were so raw and vulnerable, the traumatic memories of having to intensely nurse him at home between rounds… It is so hard to sort those feelings and the anger from the sadness that is sometimes overwhelming at missing my best friend and my only love, and the agony of watching our children grieve. Thank you for sharing, although our husbands had cancer, as opposed to a sudden unexpected death, it was so traumatic. Seeing a train wreck coming at you doesn’t make it hurt less.

  20. A year and a half ago my youngest son, his beautiful wife of five years and my 2-year old grandson were found shot to death in their home. Their bodies were not found for 36 hours. The police did an investigation that spanned about 20 minutes before they made the tragic call that would forever change everything about his surviving family’s lives. They called it a murder/suicide. My son was a loving and dedicated father of three. He had two grown children from a previous marriage so we all experienced who he was as a father for 21 years prior to that day. But none of that counted for anything. Of the criteria that defines a traumatic loss – we have hit almost every single item on the list. It is multiple, occurred without warning, It involved a child and though that is not on the list – it definitely should be – it involved violence, damage to the bodies, caused by someone with intent to harm, was preventable, we believe that they suffered, unfair/unjust, media attention, had to make horrific decisions that at least equal medical decision, information was undisclosed, limited social support plus so much more; like being told my son caused another family this horrific loss of their child and grandchild and that he harmed the baby “he” and I both adored. And the trauma of feeling my son has to carry this terrible undeserved legacy and we have to live with the frustration and anger of knowing that we were lied to about the thoroughness and extent of the investigation while all criminal evidence was destroyed. While we were not blamed for their deaths – we have all suffered social stigma and resulting feelings of guilt because of the determination that “murder” was involved. There are so many layers that I cannot begin to heal. I thank you for writing this but I just do not see how in fact that one can even live through something like this and stay sane. I’m strong but no one is that strong.
    http://www.Stillbriansmom.blogspot.com

  21. On April 14, 2014 I had to make the decision to take my husband of just six short years of marriage (he was 63) off life support after he suffered a catastrophic stroke that paralyzed from the mouth down. He was on life support for 10 days and he could only blink in response to a question. Was it traumatic ………. absolutely, for him and for me. I live with decision every day. I know as I have been told many times, it was for the best. Yes, it was the best for him for he would have never wanted to live that way. Day by day I could tell he was giving up until the 10th day he could not even wake up. It’s those that are left behind that have to deal with having to make such a decision and I feel that is always traumatic. I miss him, very much.

    • Thank you for this. My dad died 10 days ago in similar situation- massive stroke after sepsis from complications of prior stroke. It blinded him, had internal bleeding, and he would never walk, talk or have any quality of life. He could nod or shake head in response to ques. He died ten days later in an end of life unit (we followed dr advice to place him there). I wrote in comment section somewhere else on this site that I don’t feel able to grieve because the things we witnessed in those 10 days was horrific (what we smelled, heard and saw) and those are the things that I think about and they’re huge and terrible and scary. I know I’m doing the whole avoidance thing but it seems my only option if I want to stay sane,

  22. My spouse died unexpectedly in early November. He went missing on 11.6.15 after an ATV accident. We found his body on 11.9.15. My children and I continue to live and try stay afloat with SO MANY unanwered questions. When did he die? What caused the accident? I have searched for any documentation on sudden loss and have read “I wasnt ready to say goodbye” by Noel and Blair. I recommend this book to others whom has also entered the virtual nightmare of sudden loss.

  23. yes, thank you …I know people treat grief equally and it is equitably horrible but the sudden tragic loss of my son last year is incapacitating at times. others don’t get it. No time to anticipate, no time to grieve. Its an unexpected blow.

  24. I, too, have looked for information that might pinpoint what is considered a traumatic death experience. My husband died a little over a year ago from a sudden heart attack. I had to call 911, and then I had to give him chest compressions to keep a pulse until the ambulance arrived. When they got there, he had a faint pulse; there were about 6 guys working on him for over 40 minutes. While this was going on, I was trying to reach someone by phone. He passed in the ambulance on the way to the hospital (we live about 3 minutes from there). I still feel the same way about it all now as when it was going on…in disbelief. It was real, and reality when I finally saw his body. It has been over 13 months, but I still somewhat moving is slowness, somewhat in a fog.

  25. You’ll find an extensive list of resources related to this unique kind of loss on my website’s Traumatic Loss page, here: http://www.griefhealing.com/traumatic-loss.htm

    • Marty, thank you. Thank you also to WYG, I appreciate this article as it is difficult to find resources and information to help with traumatic loss.
      In August 2015, my fiance, our friend, and I were attacked by 3 crazy armed men (unknown to us.) Myself and friend were forced face down to the ground. We were made to listen to them torture and beat my fiance. The robbery/attack ended in my defenseless fiance being shot in the stomach. The men ran off after the shot was made. Our friend and I tried to save my sweethearts life and called 911 too. He died in my arms shortly thereafter. Nothing could ever prepare me or anyone for such a horrific loss. The aftermath I wont even get into because I could easily write a book on this neverending nightmare.

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