Understanding traumatic and complicated grief

When grief and trauma occur together, subsequent reactions tend to be more prolonged and distressing. The suddenness, violence, and sense of injustice associated with the loss, as well as the nature of the relationship between the deceased person and the survivor, may cause people to suffer trauma and grief simultaneously, leading to traumatic or complicated grief.

Complicated grief reactions tend to be more prevalent following extreme losses, such as the suicide or murder of a loved one. The death of a child is uniformly associated with prolonged and complicated grief in parents.

However, people who have suffered such extreme losses can be resilient in different ways:

• A commitment to finding a meaningful purpose in life.
• The conviction that one can grow from both positive and negative life experiences.

Viktor Frankl, reflecting on his experiences in the Auschwitz Concentration Camp (1969), holds the positive existential view that complicated grief could be accepted as a crisis that encourages new meaning in life. This view would help the bereaved client try to make sense of this inevitable human situation.

As Frankl poignantly points out: 

 “We must never forget that we may also find meaning in life even when confronted with a hopeless situation when facing a fate that cannot be changed. For what then matters is to bear witness to the uniquely human potential at its best, which is to transform a personal tragedy into a triumph, to turn one’s predicament into human achievement. When we are no longer able to change a situation… we are challenged to change ourselves.” (Frankl, 1969, p. 135).

It appears that the role of meaning-making accounts for nearly all the difference in positive bereavement outcomes for people whose loved ones died traumatically, as opposed to those who died of ‘natural causes’.

It is also worth bearing in mind that traumatic loss does not necessarily require a reappraisal of life’s meanings, as many will find consolation in systems of secular and spiritual beliefs (spirituality, nature, mosque, church) and practices that have served them well previously.

I would therefore agree with Frankl (1969, p. 171): 

“What matters, therefore, is not the meaning of life in general, but rather the specific meaning of a person’s life at a given moment.”

No doubt, to be effective, psychotherapeutic or counselling interventions always need to meet the client’s specific needs. The therapist will join the client where they are, explore their ways of being and functioning to the particular circumstances of the bereavement, and finally allow and encourage the practice of new ways of being that foster well-being and psychological development.

Effective therapy will always support the bereaved client in their meaning-making process.

References

Frankl, V.E. (1969) *Man’s search for meaning: an introduction to logotherapy.* London: Hodder & Stoughton.