Trauma, Loss and Bereavement - MADD Canada (PDF)

TRAUMA, LOSS AND BEREAVEMENT Trauma, loss English 7/25/05 9:42 PM Page a  MADD Canada’s Mission is to stop impaired driving and to support victims of this violent crime. This brochure has been designed to assist victims dealing with the aftermath of an alcohol or drug-related crash. It is our hope that this booklet will be of value to you and comfort you during this difficult time. Please don’t hesitate to contact us for information or support. 1-800-665-6233 www.madd.ca [email protected] MADD Canada 2010 Winston Park Drive, Suite 500 Oakville, Ontario L6H 5R7 Please see the last page for a list of additional MADD Canada resources and services for victims of impaired driving. Trauma, loss English 7/25/05 9:42 PM Page b  Table of Contents Part 1 - The Challenge of Grief Following Sudden Loss Why should I read this? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 How should I use this information?. . . . . . . . . . . . . . . . . . . . . . . 3 Frequently asked questions about grief . . . . . . . . . . . . . . . . . . . . 4 The common challenges of grief . . . . . . . . . . . . . . . . . . . . . . . . 11 What is the impact of sudden and traumatic loss?. . . . . . . . . . . 17 Common grief reactions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Death of a child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Death of a spouse or partner . . . . . . . . . . . . . . . . . . . . . . . . 28 Death of a parent or guardian . . . . . . . . . . . . . . . . . . . . . . . 29 Death of a sibling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Death of a friend . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 What can I do? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Do I need professional help? . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Recommended readings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Part 2 - Grieving Together A parent’s guide to childhood bereavement . . . . . . . . . . . . . . . . 46 A parent’s guide to adolescent bereavement . . . . . . . . . . . . . . . 54 TRAUMA, LOSS AND BEREAVEMENT Trauma, loss English 7/25/05 9:42 PM Page c  This project would not be possible without the expertise, compassion, knowledge and effort of the following people: Dr. Paul Robinson provided the material for Part 1 of this brochure. Dr. Robinson is a registered psychologist in the Province of Ontario, as well as a member of the Canadian Register of Health Service Providers in Psychology. He is a certified member of The Academy of Cognitive Therapy, an international organization that identifies and certifies practitioners who have demonstrated an advanced level of expertise in Cognitive Therapy. Dr. Robinson works in Toronto, Ontario at North York General Hospital, as well as in private practice. In addition to the general practice of clinical psychology, loss and grief has been an area of specialty. As well as conducting research and writing scientific articles and book chapters on the topic of adjustment to loss and the implications for intervention, his clinical practice includes counselling and therapy with bereaved individuals. Agnes Struik provided the material for Part 2 of this brochure. Agnes Struik worked as a teacher for ten years, an elementary school principal for five years and taught everything from grades two through nine. She was on the faculty of ISIS, an expressive arts therapy training program for five years. Ms. Struik has been an expressive arts psychotherapist for thirteen years and has a private practice in Toronto. She works with both children and adults and part of her practice is with First Nations people. Ms. Struik is also a children’s consultant with Bereaved Families of Ontario-Toronto where she is involved in training children’s facilitators, supervising facilitators, and assessing readiness of children for groups as well as numerous other activities. In addition, Ms. Struik presently serves on the board of the Ontario Society of Psychotherapists. Trauma, loss English 7/25/05 9:42 PM Page d  THE CHALLENGE OF GRIEF FOLLOWING SUDDEN LOSS 1 Why should I read this? If you are reading this brochure, you are among those who have experienced the sudden, violent death of a loved one as a result of an impaired driving crash. The nature of this type of loss brings uniquely painful and difficult challenges to those left behind. The purpose of the following information is to provide you with an overview of the various factors that may be involved in your reaction to this trauma. While it may seem inconceivable to you that you will ever be able to live with this experience, we offer you this information to provide you with an understanding that you are not alone on this journey, and with hope that you can find meaning and joy in your life once again. 1 1 The following information is based on the author’s own experience as well as reference to the work of several prominent researchers, clinicians, and authors who have written extensively on the topic of grief. So that this brochure is more readable, these primary references are listed at the end of this brochure rather than noted throughout the presentation of information. Trauma, loss English 7/25/05 9:42 PM Page 1  Trauma, loss English 7/25/05 9:42 PM Page 2  How should I use this information? The readers of this brochure will vary in many ways. For some of you this may have been a very recent loss, and for others a longer period of time may have passed. In light of this, there will be some information that will not be relevant to you, at least at a given point in time, or may be difficult for you to think about. Thus, we recommend that you read this material when you feel a need to understand your experience, and/or when the consideration of such information feels timely to you. Once you have read what you want, keep the brochure handy, and read it again at another time. Each time you read this, you may get a new insight, or relate to something that you did not relate to before. We hope that this information provides a way of exploring and further understanding your own personal loss experience. In the following, you will find a description of: • Frequently asked questions about grief • the common challenges of grief • a description of the impact of a sudden loss such as you have experienced • a description of other factors that will affect your grief reaction, and • some general ideas about what you can do in the face of these challenges. Since we can not provide you with all of the valuable and extensive information that is available regarding the experience of grief, you will find some suggestions for further reading at the end of this brochure. 3 Trauma, loss English 7/25/05 9:42 PM Page 3  Frequently asked questions about grief The situation in which you now find yourself is an extraordinary one, and likely far outside any experience you have had before. Thus, you may not know what to expect of yourself, and have many questions about what you are going through. Here are some of the most commonly asked questions about the experience of loss and grief.2 Am I going crazy? Grief is a natural, human reaction to separation from those we love. It has been said that it is the price we pay for loving. As you will see, however, the nature of this response varies greatly from person to person. Since most of us have not experienced something as significant as this in our lives, we likely do not know what to expect. As a result, there can be a strong sense that there is something “wrong” with our reactions. Be assured that there is a wide range of thoughts, feelings, and behaviours that are considered to be normal reactions to an abnormal situation such as the one you have experienced - you are not going crazy. 4 ? 2 With regard to the definition of terms used throughout this brochure, the term bereavement refers to the state of having suffered a loss of a loved one. The terms grief and mourning refer to the actions, reactions, adjustments, and processes as you cope and live with this loss. The terms grief and mourning will be used interchangeably throughout this brochure. Trauma, loss English 7/25/05 9:42 PM Page 4  Will I go through stages of grief? In contrast to popular belief, there are no “stages” of mourning that everyone goes through. Instead, current experts in this field now believe that while there may be some similarities amongst those who are grieving, grief also is one of the most personal experiences you will encounter. It is coloured by numerous factors, including the mourner’s personality, the nature of the relationship with the deceased, the impact of other loss experiences you may have had, the nature of the death (e.g, sudden or prolonged), the multiple personal meanings of the loss, and a wide variety of other influences. Some of these personal factors are discussed later in this brochure. Trauma, loss English 7/25/05 9:42 PM Page 5  What should I do? While this tragedy was not a choice on your part, you do have many choices and options in the process of coping with, and grieving, this loss. This idea contrasts with the popular belief that grief following loss is something that happens to us, and that we have no say in how it proceeds. Experts now believe that there are endless choices in the process of adjusting to loss, and that an awareness of these choice points, as small as they may be, can be most helpful to the bereaved person in bringing an increased sense of control back into their lives. Trauma, loss English 7/25/05 9:42 PM Page 6  Will I ever forget my loved one? Your relationship with your deceased loved one continues, even though the actual physical contact is no longer possible. In this sense, therefore, you may find that over time your love for this person continues or grows stronger, or changes in some way, even as you forge a life that does not include their physical presence. Some bereaved people describe actually sensing their loved one’s presence, or find themselves talking to the deceased. If you have experienced this, such an occurrence may or may not be comforting to you. The relationship may continue more internally, as one refers to the loved one’s values for guidance, thinks of what they would do in a certain situation, or incorporates certain activities into one’s life because of their influence. 7 Trauma, loss English 7/25/05 9:42 PM Page 7  Does grief ever end? Even as people learn to go on with their lives and live fully again following the death of a loved one, the normal grief response includes a recurrence of strong feelings related to the loss, over the course of a lifetime. This does not mean that grief is constant, but rather there are times of revisiting feelings or memories, that involve strong emotions and upsurges of grief. Things such as new developments in our lives, the occurrence of meaningful dates on the calendar (e.g., anniversary of the death, birthdays, holidays, etc.) or in the event of any reminder of our deceased loved one, thoughts and feelings about them naturally will be activated. It is important to understand that you are not “back to square one” at such times but, rather, this is normal and expected. Trauma, loss English 7/25/05 9:42 PM Page 8  How do I make sense of this? Any loss, and certainly the type of loss that you have experienced, will assault your assumptions about the world. For example, prior to this tragedy, you may have held a view of your personal life as generally predictable and safe. Following this loss, however, such an outlook no longer makes sense to you. Part of the normal grief process involves the incorporation of this loss experience into your perspective in a way that allows you to perceive the world in balanced or reasonable terms again. Will I ever be my old self again? You will be forever changed by this experience. As you may have gathered by the ideas presented thus far, grief is not a time-limited experience, after which you return to your old self. While the bereaved do find meaning and purpose in life again, we now understand that the grief process leads people to feel that they are different than they were before. 9 Trauma, loss English 7/25/05 9:42 PM Page 9  Trauma, loss English 7/25/05 9:42 PM Page 10  The common challenges of grief While there are no set stages of grief, there is a consensus that grief poses some common challenges for those who have experienced the death of a loved one. In this section, we briefly outline these commonly identified factors for you. While these are presented in a certain order, each can come and go, occur in any combination or sequence, and will vary in terms of their prominence from person to person. Indeed, all three of these major challenges are present, in one form or another, all of the time. If you are going to be reading further about grief, you will see this list of factors or challenges also described with words such as processes, needs, choices, or tasks. Whatever the term used, your understanding of these common challenges may provide you with some insight into your current experience and expectations for the future. 11 Trauma, loss English 7/25/05 9:42 PM Page 11