Thursday, July 22, 2010

Thursday's Therapy - Complicated Mourning ~Therese A. Rando, Ph.D. - Part Two

Thursday's Therapy

Complicated Mourning

~Therese A. Rando, Ph.D.

Part Two

Traumatization Caused by Sudden Death

Challenges Created by the

Personal Traumatization Brought to You by Your Loved One's Sudden Death

(Rando, 2011, In Press)

1. Your traumatic stress responses provoked by your loved one's sudden death intensify and complicate your mourning, and create additional problems for you in other areas.

{In other words, you are not simply grieving over your loss; you are also traumatized by your loss, so Loss + Trauma greatly complicate your mourning, plus the Loss of a Child in and of itself leads to Complicated Mourning as a NORM for processing through your grief.}

2. Your capacity to cope is overwhelmed.

{Trauma overwhelms you, which interferes in your coping with your Loss.}

3. Your assumptive world is violently shattered.

{What you assumed to be true of the way things worked in the world (your assumptive world), the way things worked with God, the way things worked in many ways in this lifetime, are shattered when you lose a child. Assumptive beliefs have to be re-examined and sorted out all over again right when you need a solid foundation of beliefs to help you cope with the sudden loss of your child.}

4. The loss does not make sense to you.

{Your mind is confused and cannot make sense of something as absurd and out-of-the-ordinary as losing one's child. Plus, your rational brain has been stymied by the severe life-and-death trauma so that a part of the brain (the hippocampus) is traumatized and will not allow the material sent in by the senses to be processed through the rest of the brain (as would normally happen), thus leaving your cognitive portion of the brain (prefrontal cortex) incapable of ferreting out what you need to do to cope with such an unexpected death.}

5. You experience a profound loss of security and confidence in the world, affecting all areas of your life.

{When you are left so shattered by your child's death, your confidence in who you are and how the world works, as well as in your safety in general are shattered right when you need them to be solid. Such shattering of confidence and safety impacts you in many facets of your life as well.}

6. Emotional and physical shock prevail within you, in whole or in part, for an extended duration of time.

{In Sudden-Death Loss, the traumatization to your person is so great that the body defends itself by producing a greater "Emotional and Physical Shock" for you to be able to deal with the loss.

This shock enables you to better cope with the early onset of your trauma and loss; the downside, however, is that you can easily get a false sense of security that you think you'll handle this loss and grief fairly well.

Then months, and particularly years later, as the shock wears off and the raw grief feelings and traumatic reactions set in, it leaves you feeling almost "crazy" as you wonder why you seem to be getting worse instead of better.}

7. You feel dissociated.

{The traumatic shock makes you feel "shell-shocked" so to speak, so that all your faculties are not accessible to help you walk through the severe grief. Many facets of your loss, trauma, and grief need to be processed and worked through so that your prefrontal cortex of your brain can help you make better choices for coping and grieving.}

8. Your acute grief reactions persist for a prolonged time period.

{You have been traumatized which sets off cortisol stress hormones in the body that do not go away for a long, long time. These hormones set you up for many seemingly neurotic reactions because you have been so knocked off kilter by the death of your child. These reactions (i.e., hyperarousal, hypersensitivity, increased heart rate, increased anxiety, flashbacks, etc.) compound on one another affecting many different facets of your life in an adverse way.}

9. Your mind doesn't work properly.

{See my response to item #4.}

10. In your traumatized state after your loved one's sudden death, conditions exist for you to make decisions, agree to things, and/or take courses of action that you can later deeply regret.

{This is oh-so-true, leaving us with the mantra, "Don't make any major decisions for the first year after your severe trauma and loss." You also want to avoid as many toxins as possible (e.g., toxic people, for instance who do not understand you nor your grief, and thus do not validate you in the way you know that you need to be able to grieve) so that you don't complicate even further your already very complicated mourning.}

11. You can simultaneously have increased sensitivity, awareness, and/or responsiveness in some areas, while they are decreased in others.

12. The presence of greater anger and irritability, coupled with less patience, causes more family, relationship, and work problems to develop.

{Your "emotional plate" is already filled to the max, so anger, irritability, and impatience will surface readily when you are unnecessarily harassed by anyone.}

13. Your bereavement will not meet the expectations that society has for responses to losing a loved one (which tend to be based upon deaths that are anticipated).

{In other words, you can EXPECT that no one will "get it" when it comes to the depth of your grief and your long-term vulnerabilities, (except maybe other child-loss grievers who have actually lived what you are living). This unfortunate dynamic sets you up for all kinds of unrealistic expectations from family, friends, fellow church-members, even all those folks who may have been extremely helpful to you in the critical first days after the loss.

Such misunderstandings by folks who are so close to you and who have been so helpful to you at another time during your grief can be very disappointing and very confusing to you in your time of deep mourning (usually 2-7 years after the loss of your child). Being let-down by the very people you most expected to help you can cause secondary trauma which can complicate your grief even further.}

14. You have a higher probability of developing complicated mourning, and also developing a diagnosable mental and/or physical disorder.

{You can count on it: as a Child-Loss griever, you WILL HAVE Complicated Mourning! It simply comes with the territory of such a severe and personal loss. As Dr. Rando says however, such Complicated Mourning should be considered the NORM for Child-Loss grief, and should never be pathologized!}

15. There are definite issues posed by the "six-month phenomenon" and the "two-year phenomenon."

{Some people rush right into mental-health counseling in the first six months of grief. However, there is little the counselor can really do for you until many months, and sometimes even years later, usually somewhere between 2 to 7 years after the loss when your shock has worn off and the reality of the raw grief and loss are being more deeply realized. If however, you had already gone to counseling during the first six months of grief when your body was actually keeping you in shock, you are going to think that counseling didn't do much for you then, so how could it help you when you are now feeling so much worse. It is an unfortunate dynamic, but it happens, and then grievers do not get the help that may very well be out there in the professional field for them.

Then unfortunately, two to seven years after the sudden death, the griever is afraid s/he is "backsliding" in grief when the deeper mourning (without the benefit of shock) is actually normal, or to be expected, though it may be very difficult through which to navigate!}

16.Your inability to move forward as quickly on loss-related matters because of your traumatization places you in more situations where your and others' expectations of you are not met (e.g., you think you are not where you need to be since you don't have grief reactions of the type, and at the time, expected), and others think you should be further along or "over it" long before you could be, with your being pathologized as a result.

{This is where self-help grief groups such as Compassionate Friends or Bereaved Parents of the USA (both of these are groups designed for Child-Loss grief support) could be very helpful. Within such groups, as you hear other child-loss parents' stories of dysfunction, you begin to realize your own severe dysfunction within your Child-Loss grief is actually very normal. The people within these groups are typically helpful in accepting you where-you-are in your grief, and therefore, enabling you to accept and love yourself no matter in which Loss and/or Trauma issues you find yourself "stuck."}

{Pink italicized comments, mine}

Dr. Rando is working on a book now, written on Traumatic Bereavement, 2011, In Press, in which the above content should be included.)


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