Traumatic Grief

By Nancy Crump

Since the late 1980’s, we have seen an increase in interest and research on the effects of trauma on the grief process. We have learned that the grief process from the sudden, unexpected, and often violent deaths of suicide, homicide, auto accidents, natural disasters, and other types of deaths, is very different from the grief process of those who have died from natural causes, old age, or long-termed illness. Many, if not all, of the deaths faced by Bio Technicians fall into the category of traumatic. Those family members who hire you have usually been touched by the trauma of the death. Understanding the traumatic grief process and its differences from other types of grief may be of some help to you as you deal with these family members.

There are several key elements that make the responses by family members to a traumatic death difficult. First is the suddenness of the death. Family members usually did not have time to prepare themselves for the death and to make the psychological adjustments to cope with the news of the death. Also, the suddenness of the death does not give the family an opportunity to say goodbye to the victim before their death. Second, the violence of the death may leave the family with horrific memories and nightmares that often interfere with the grief process. Third, many of these types of deaths require police intervention and the family is often not given the support, information, and compassion they need at the time. Another element can be the presence of the media at the time of the death, as well as weeks and months later if legal issues follow the death. Most traumatic deaths involve young people who’s parents, grandparents, and siblings may still live. Certainly, the death of a child or young person is very difficult to cope with.

Reactions to a traumatic death can be very different, more intense, and longer lasting than other types of death. The emotions following a traumatic death are often conflicting and intense. There is a tendency to relive the death event over and over in an attempt to make it real. Intrusive thoughts and nightmares are very common. Intense physical responses such as inability to eat or sleep, stomach aches and headaches, muscle tension, high blood pressure and a decrease in the autoimmune system are also common. Many times, the survivors must deal with intense feelings of guilt or remorse, feeling that they were somehow responsible or could have prevented the death “if only”. Family members have the need to tell the story of the death over and over again in an attempt to gain a sense of the reality of the death. They often have an overwhelming need to learn all they can about the circumstances of the death - how the person died, whether they were in pain, did they know they were dying, what were their last words, who saw what happened, and in cases of homicide, who committed the murder. All of these reactions are ways the survivors use to grasp the reality of the death and to begin the grief process.

As Bio Technicians, you are often called by family members or meet them upon arrival to the scene. Understanding some of the dynamics of trauma on the grief process may help as you help the family. Understanding the “normalcy” of the reactions you may see can help you feel more competent and assured to speak with family members without wondering whether or not you are saying the “right” thing. Some suggestions are listed below, but the most important thing is to convey sincerity and compassion to the family. They are very vulnerable and sensitive to words, expressions, and body language. Just make sure that what you say and do is congruent with how you feel or you will come across as insincere and uncaring.

Soon after a traumatic death, most survivors simply need to tell the story to anyone who will listen. It is important for their recovery to be able to do this. If you have time to listen, do so. They are not necessarily looking for any input from you; they just need someone to listen.

Remember that there are two basic rules for grieving people – you don’t hurt yourself or someone else. If, during the conversation, you hear comments that indicate the person is thinking of either, you might suggest they go talk to someone else before making a decision to do something like this. Create a list of counselors, therapists, or mental health centers to hand out at times like these. Take comments about thoughts of suicide seriously and offer to call a friend or family member to be with the person and get them help. Suicide rates often increase after a sudden, traumatic death of a loved one. These are very difficult situations for you as a caregiver, but you need to set limits as to what you can and cannot do. Listening and having resources available are all you need. The survivor needs to take some responsibility for them, and others who are better trained to handle these situations need to be contacted.

Although many reactions may look and feel “crazy”, most are normal reactions to the situation. Again, as long as they don’t hurt themselves or someone else, they are probably reacting normally to an abnormal situation. Helping normalize these reactions is very helpful to the survivor. Encouraging the survivor to talk and to express what they are experiencing is also helpful. Making a simple statement such as, “I think I’d feel the same way if this happened to me”, helps the survivor feel less out of control.

There are many support groups available to survivors that would make a good resource for them. Creating a list of those in your community or in nearby communities is a great gift for survivors. They may not want to attend a support group, but usually someone from the group is always willing to talk to them by telephone or offer assistance.

In the work you do, you may find yourself in situations of dealing with survivors who have needs you do not feel comfortable or competent in dealing with. That’s okay as it is not your responsibility to be all things to all people. However, there are these simple steps you can take to help your families in a meaningful way. You can listen. You can refer. You can offer resources. Having some general knowledge of the traumatic grief process may make you feel more competent in dealing with your families and knowing that you are being supportive and helpful in a meaningful way.

Below are some national organizations that offer support groups in almost every locality. They are specific to either the type of death or the relationship to the person who died and are more appropriate to traumatic deaths. They all have web sites or central telephone numbers that can be contacted for local information.

The Compassionate Friends – for parents’ whose child has died of any cause.
MADD – Mothers Against Drunk Drivers offer support for parents who a drunk driver killed child
Widowed Persons Service – sponsored by AARP for spousal death
SOS – Survivors of Suicide support groups
POMC – Parents of Murdered Children and other victims of homicide.

These and many other groups may be listed at your county’s Victim Assistance Office usually located in the office of the District Attorney. Also, check with your local hospices or hospitals. They offer support groups that are open to the public. Some local churches may also host support groups. As you create your list, don’t try to keep up with the dates and times of group meetings as they change frequently. All you need is the name of the group, a telephone number, and possibly a contact person. Leave it to the survivors to take the responsibility to make the calls on their own behalf.