Post-Traumatic Stress Disorder
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Can Grief and Loss Be Traumatic?

Jamie Marich, Ph.D., LPCC-S, LICDC-CS, RMT, edited by C. E. Zupanick, Psy.D.

At this point, you may be wondering where grief and loss fits into all of this. If a loved one has died, or if I've lost something that is very dear to me (e.g., my job, my home), can that be described as traumatic? Although professionals tend to have differing opinions about the connection between trauma and loss, it must be stated that wherever there is trauma there tends to be loss. For instance, natural disasters and violent accidents often involve a loss of safety/security in the world, a loss of innocence, and a loss of hope/optimism. While it is safe to say that trauma nearly always involves loss, the reverse is not true: loss is not always traumatic.

girl in cemetaryLikewise, grief can simply be defined as the experience of loss- a wound that is in need of healing. According to the highly acclaimed grief scholar and clinician, J. James Worden, grief is simply the experience of loss in one's life; there is nothing inherently pathological or problematic about the human act of grieving (Worden, 2008).

Bereavement is the adaptation that one needs to make in response to loss. Mourning is the process that one goes through adapting to that loss. When the adaptation to the loss is inadequate, problems can result and a person's life can be negatively affected. By definition, this is complicated mourning (sometimes called complicated grief or complex bereavement). Consider Darlene, a woman who comes into her counselor expressing, "This office is the only place where I can cry about my best friend's death. There are some times that I want to cry at home, but I can't because I know it upsets my husband and kids." Darlene could be at risk for developing emotional and behavioral problems (such as excessive absences at work) or even unexplained physical symptoms.

Most trauma-informed professionals recognize that if the grief is not appropriately experienced and healed, it will continue to affect people, often in subtle and obscure ways. Well-respected grief scholar George Engel, M.D. (1961) related the mourning of a death, to the healing of physical wounds; implying, the loss of a loved one is psychologically traumatic to the same extent that being severely wounded or burned is physiologically traumatic. Thus, while not all cases of grief or loss may meet criteria for PTSD (the clinical criteria are reviewed in the next section), they can be viewed within the larger discussion of trauma and adverse life experiences.


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