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Traumatic Loss: A Double Blow

Talking is often essential to grieving, but what if the loss is "unspeakable?"

A month after I lost my brother to suicide, I realised I had also lost one of my best friends. Thirty days had passed, and I hadn’t heard from her. Not one call, not one message.

I asked the reason for her silence – admittedly, with more than a little anger and a good dose of hurt.

She replied that she hadn’t wanted to upset me by mentioning “it,” and she worried that sending a message would “remind me” of my loss.

I was utterly bewildered.

How on earth would anybody imagine that?

A friendly text won’t send me tumbling into darkness – I live there, curled up at the bottom of the hole. I can’t sleep. I can’t think. I’m scared. I’m confused. I have the most utterly horrifying images seared into the meat of my brain.

If anything, a friendly message could have brought me out of that for just a moment.

My friend’s attitude doesn’t make a lot of sense, but it’s an example of the profound lack of knowledge and confidence many of us have where it comes to speaking with people who have suffered traumatic loss. I have plenty of other examples – some funny, some sad, some completely awful, and even some from my own life, when I was inadvertently the thoughtless one.

It also serves to demonstrate the hugely important role that therapy can play in helping us process a loss. It’s a safe place, removed from real world relationships – and real world consequences. It’s a space where we can do the work of re-configuring ourselves around the emptiness left behind.

As I have written about before, there’s a time and place for therapy in grief work. For most of us, it won’t speed up the process of grieving. Grief takes time, and though therapy may offer some cathartic release in the moment, that doesn’t translate to quicker movement through the grieving process.

But for people suffering from what has been termed ‘complicated grief’, therapy can be invaluable. It’s possible to get ‘stuck’ in the grieving process, and for the painful emotional distress associated with the loss to stay the same or even get worse over time.

Research has shown a heightened risk for complicated grief around certain types of traumatic losses. All loss is traumatic to some extent, but some losses involve particularly horrifying or disturbing circumstances – things like violent accidents, murder, and suicide. These are the bereavements that tend to ‘stay with us’. They’re also the ones that are hardest to talk about – and the ones we need help with processing the most. Our brains literally need other brains – other people, whom we trust and feel safe with – to make sense of ourselves. There’s a reason why solitary confinement torments people so much, and has such a profound impact on mental wellbeing.

The problem with talking about trauma is that a lot of people don't know how to stay present in a conversation about horrific things. There’s a reason we call some things ‘unspeakable’ – people struggle to bear witness to such pain. This can manifest as anything from painful awkwardness (understandable and more forgivable) through to avoidance, thoughtless throwaway comments, and outright unkindness.

Being with a person who has suffered a traumatic loss – listening to them, being present with them, aiding them in their process – can be incredibly helpful, but also incredibly challenging. It’s frightening to fully acknowledge the horror of what has happened, because it means knowing – really knowing – that these things happen (and can happen to anybody).

Some people are capable of talking about trauma, and I don't wish to discourage people from reaching out and trying to be heard. It doesn’t necessarily need to be a therapist who listens and reflects for you. If you’ve got a trusted, understanding, kind and available person who you can talk to, that may well be enough. But it can often be really difficult to find such people, even if you have strong family relationships and friendships. It’s common for everyone to be struggling individually with the weight of the loss and be thoroughly incapable of offering support to anybody else.

In psychotherapy theory, we talk about each of us carrying within us ‘relational constellations’. A sort of internal map of who the people in our lives are to us, who we are to them, and who we are together.

In a psychological sense, a star has quite literally gone dark in your sky. It takes a while to learn how to navigate again – and sometimes a little help.

References

Boerner, K., Mancini, A. D., & Bonanno, G. (2013). On the nature of complicated and uncomplicated patterns of grief. In M. Stroebe, H. Schut, & J. van den Bout (Eds.), Complicated grief: Scientific foundations for health care professionals (pp. 55-67). New York: Routledge.

Rando, T. A. (2013). On achieving clarity regarding complicated grief: Lessons from clinical practice. In M. Stroebe, H. Schut, & J. van den Bout (Eds.), Complicated grief: scientific foundations for health care professionals (pp. 40-54). New York: Routledge.

Shear, K., Frank, E., Houck, P. R., & Reynolds, C. F. (2005). Treatment of complicated grief: A randomized controlled trial. JAMA, 293(21), 2601-2608. doi:10.1001/jama.293.21.2601

Simon, N. M. (2015). Increasing Support for the Treatment of Complicated Grief in Adults of All Ages. JAMA, 313(21), 2172-2173. doi:10.1001/jama.2015.105

Solomon, C. G., & Shear, M. K. (2015). Complicated grief. The New England Journal of Medicine, 372(2), 153-160. Retrieved from http://ezproxy.aut.ac.nz/login?url=http://search.proquest.com/docview/1…

Stroebe, M, Schut H., & van den Bout, J. (2013). Complicated grief: Assessment of scientific knowledge and implications for research and practice. In M. Stroebe, H. Schut, & J. van den Bout (Eds.), Complicated grief: scientific foundations for health care professionals (pp. 295-211). New York: Routledge.

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