Tuesday, August 11, 2009

Grief, Trauma and Traumatic Grief

I was recently asked to assist at a school where a student had died after a lengthy illness. The usual characters had assembled -- the Principal, the counselors, the social worker, the district communications person, and me on behalf of the crisis team. As we started to think about what needed to be done, one of the others at the table said,
Let's not have a secular response to a spiritual event.

What a great way to put it. This child's death was very sad. Staff and students were grieving, and grieving hard. But they were, indeed, grieving. They were not traumatized. They didn't need intervention, they needed support. My colleague wasn't advocating prayer in public schools, he was advocating recognition that this event was fundamentally different than death from a car accident or a suicide.

I often run into trouble explaining this difference to people. Saying that a death isn't a critical incident, isn't a crisis or isn't a traumatic event is sometimes heard as saying that the event isn't hard or horrible, and that's not what I mean at all. It's just that grief and trauma are different.

If you look up the two words in the New Oxford American Dictionary, you find the following:

Grief: Deep sorrow, especially that caused by someone's death.

Trauma: Emotional shock following a stressful event or a physical injury, which may be associated with physical shock and sometimes leads to long-term neurosis.

The difference between trauma and grief does not have to do with how serious a situation it is, or even with how upset you are. Trauma, however, involves shock, and grief does not. You can see this when you talk to people who have experienced the traumatic death of a loved one. While they may feel sad, that sadness is not usually the primary emotion. Instead, they are shocked, angry, scared or in a state of disbelief.

You can see a difference in the signs and signals of distress that people exhibit with grief and with trauma as well. While those who are traumatized may cry, those who are grieving don't usually experience the numbness and physical ailments that come with trauma.

Traumatic incidents do, of course, very often cause grief. The death of a loved one in a car accident is still a death. What we find, however, is that the trauma gets in the way of the grief. Until people have processed the trauma and its effects, they can't really face and process their grief. The biggest mistake people make in dealing with trauma is trying to talk immediately about the loss and grief and skipping over talking about how it happened and all the reactions surrounding that. When someone dies, we think we're supposed to feel sad and talk about the person who died. We don't allow ourselves or others the room and time to deal with our own reactions to how it happened and to the shock.

On the flip side, it's easy for those of us trained in trauma intervention to treat everything like a trauma, even when it's not. Once an organization has a CISM team, they often want to do CISM for everything. But the C and the I in CISM stand for Critical Incident, and while those trained in CISM may have some good people skills, the techniques of CISM are not designed for uncomplicated, non-traumatic grief.

I don't know if I'd say that trauma is secular and grief is spiritual, but I see what my colleague is getting at. And if it helps us remember to use the right tools at the right time, I'm all for saying that we shouldn't use a secular response for a spiritual event.


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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at www.SchoolCrisisConsultant.com
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