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Thursday's Therapy
Unpackaging
The Princes' Top Ten TRUTHs
About Child-Loss Grief
Truth # 6 Old Losses Can Resurrect...
Truth #6) Old losses can get re-opened...as well as the old ways we used to cope with them. You can expect to regress, and old self-destructive acts and addictions to re-surface.
Life is real, and trauma, despite the best efforts of cultures or individuals, cannot always be worked through; its effects remain.
...the capacity to mourn is often impaired as a consequence of traumatization (Danieli, 1981 and Krystal, 1981). The mourning from previous, analogous losses is rarely completed, and new losses may well trigger suppressed and postponed grief. Grief was and is hard to bear not only because of the loss and death of loved ones, but also because of the loss of an empathic and positive self-image, of former beliefs, and of basic trust. The anxiety-arousing reminiscences of the traumatic past can be serious hindrances in the mourning process...
~Bessel A. van der Kolk
Beginning around year two into our grief, it seems our otherwise simple, nurturing world was turned on its head. We are not sure exactly what contributes to what as, other than what van der Kolk has written above about losses triggering losses, and Rando capturing the anxiety, fear, panic schemata that you're headed for, we think most so-called therapists DON'T HAVE A CLUE what you are grappling with.
What we believe to be happening is this scenario:
At the moment of any physically assaulting trauma and/or emotionally-assaulting trauma, the body releases high levels of cortisol, the stress hormone, to help you navigate through flight or fight. It also releases high levels of opiates! In the words of van der Kolk:
"When a person sustains a physical and/or a psychic or emotional injury, opiate receptors are activated, and the person goes numb, just to survive.
"Trauma survivors' blood streams are similar to drug addicts, they have high levels of opiates circulating in their system."
For us, these opiates served us well for about two years into our grief. BUT NOBODY WAS THERE TO WARN US ABOUT WHAT WAS SOON TO COME! THE HELPING FIELDS ARE SO NEW TO DISCOVERING SOME OF THESE DYNAMICS THAT THERE ARE NO "WARNING, DANGER AHEAD" SIGNS BECAUSE IT IS ALL SO NEW, AND IN MANY WAYS "CIVILIAN" (Non-Child-Loss Griever) HELPERS DON'T HAVE A CLUE THE PERVASIVENESS OF THE TRAUMA TO COME. (They tend to think our grief is just all about our child, and they forget, or never learned, the body has chemicals that begin to take on a life of their own that are about to set us up for EVEN FURTHER TRAUMA.)
So, for about two years of grief, the grief is incredibly raw yes, but typically we were able to manage it in our safe and sweet, nurturing environment with one another as a genuine, loving helper to our grief. And science now teaches us, we had hidden physiological helpers such as cortisol to help us deal with stressors, and opiates to numb us when the pain became too great.
BUT THEN, WHAM!
The extreme trauma wears out its physiological helpers. The cortisol levels DEPLETE. This injury is NOT a mental one; it is a PHYSICAL injury (that definitely impacts our mental state). And about the same time, the opiates that were so helpful to soothe us are no longer there - our opiate receptors are burnt out, another PHYSICAL injury from the demands of severe trauma. This too impacts our mental state. So, then we enter into this state of DYSREGULATION.
We then enter into Post Traumatic Stress Disorder.
"People with PTSD tend to feel weird, defective, or crazy. Traumatic things happen so fast, they don't have enough time to be encoded into narrative memory... The symptoms of PTSD are far-reaching, intrusive, terrifying, and almost impossible for non-sufferers to comprehend."
~Bessel A. van der Kolk (as found online*)
The following After-Shocks of PTSD then begin to play out:
- Anxiety, fear, panic
- Hyperarousal; hypersensitivity; emotional lability; physical symptoms
- Avoidance, numbing, and forgetting
- Flashbacks, intrusions, and other reexperiences
- Anger
- Guilt
- Impaired mental functioning; confusion; bewilderment
- Focus on the traumatic aspects of the death
- Shattered assumptive world/loss of meaning
- Withdrawal/isolation from others
- Acting out/impulsvie/addictive compulsive behaviors such as the following 9 unhealthy regressions:
- Using substances for self-medication
- Gambling
- Sexual activity (compulsively or addictively)
- Working (compulsively or addictively)
- Eating (compulsively or addictively)
- Shopping/Spending (compulsively or addictively)
- Exercising (compulsively or addictively)
- Procrastinating
- Internet use (compulsively or addictively)
And don't forget, despite the above traumatic stimuli with which one may be grappling, there is still the ongoing parental bereavement over your precious child that must still be walked through!
List, by Therese A. Rando, (2011, In Press)
NOW, TOMMY AND I (IN HINDSIGHT) SAW AN INTERESTING PHENOMENON TAKE PLACE:
These physiologcal dysregulations of internal chemicals and anxiety states take us to SUCH A VULNERABLE AND UNSTABLE PLACE, that the HELPLESSNESS triggers OLD LOSSES, LOSSES WE EXPERIENCED PERHAPS WHEN WE WERE CHILDREN OR TEENAGERS, and for whatever reason were not completely resolved. Look back at the first statement of this post of van der Kolk's:
"Life is real, and trauma, despite the best efforts of cultures or individuals, cannot always be worked through; its effects remain."
SO, the extreme helplessness throws us into such anxiety states as to trigger hyperarousal (danger is coming from everywhere). The hippocampus is damaged by the prolonged release of cortisol (corticosterone), so the hippocampus physiologically shrinks. Our short-term memory becomes impaired. And our memory that places things in a temporal time and place is impaired. If we cannot sort out what was in the past and what is not, think about it - ALL OUR OLD PSYCHIC (EMOTIONAL) INJURIES CAN BE RESURRECTED AS IF THEY ARE IN THE HERE-AND-NOW. The body signals danger; the hippocampus cannot sort out whether the danger is relevant or not, so that everything frightens, and everything that frightens turns us into a hyper-alarmed state:
The hippocampus is involved in the evaluation of how incoming stimuli are spatially and temporally related to one another and with previously stored information. It also determines whether the new stimuli involve reward, punishment, novelty, or nonreward (Ademac, 1991; Gray, 1987). Decreased hippocampal functioning causes behavioral disinhibition and hyperresponsiveness to environmental stimuli (Altman, Brunner, and Bayer, 1973; O' Keefe and Nadel, 1978). The neurotransmitter serotonin plays a crucial role in the capacity of the septo-hippocampal system to activate inhibitory pathways that prevent the initiation of emergency responses until it is clear they will be of use (Gray, 1987).
~Bessel A. van der Kolk
Old injuries are resurrected. But so are our childish ways of coping with them. And remember, this all feels like it is in the Here and Now. So, like the child, we feel completely helpless, powerlessness, and at the mercy of our old woundedness. Whatever ways we used to cope as a child are resurrected. So we regress into child-like thinking to handle the very traumatic atmosphere in which we find ourselves!
So, now Angie experiences the Damaged Teenager in Tommy, and Tommy experiences the Damaged Teenager in Angie. Teenagers we never knew existed! What happened to our loving, mature, soothing soul-mate? They disappeared, and here comes the narcissistic, demanding teenager who is scared and threatened and is holding on for dear life to CHILDISH WAYS OF COPING such as Acting out/Impulsive/Addictive/ and or Compulsive behaviors.
Goodbye Happy Home.
Hello Hell.
And there is not a therapist out there that "gets it." Thank goodness we are both therapists and could find our way (barely) through the maze. And thank goodness, we left that traumatic two years of terror a little over five months ago!
Therese A. Rando, Ph.D., BCETS, BCBT (premier trauma therapist), July 10, 2010 Workshop: "Intervening After Sudden and Traumatic Death: Contending With A Special Type of Complicated Mourning"
* www.cirp.org/library/psych/vanderkolk2/
