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The relationship between trauma and grief.
Source publication
Two divergent areas of study have focused on the experiences of grief, i.e., bereavement, and on trauma and its aftermath. The grief literature has its foundations in psychodynamic and relational theories, and thus treatment modalities have focused on resolving relationship issues through reminiscence and developing a new sense of the relationship...
Context in source publication
Context 1
... these individuals experienced the trauma of near-death and witnessing death as well as grief related to the loss of loved ones. Yet, despite the overlap between trauma and grief (see Figure 1), the two experiences are conceptualized as distinct by some theorists and indistinguish- able by others. Raphael (1997) has considered the differences between the experiences of trauma and grief. ...
Citations
... These models depict the various grieving responses individuals have after experiencing a death-related loss. Death-related losses can become traumatic experiences depending on the circumstances surrounding the death, the relationship the griever had with the deceased, and/or the griever's loss history, making the grieving process more complicated (Regehr & Sussman, 2004). Therefore, as counselors engage with grieving older BIPOC clients, they should consider their clients' trauma histories and be open to traumatic responses appearing as clients process their losses. ...
... Terms including grief, crisis, and trauma tend to be delineated from one another and have their unique components (Regehr & Sussman, 2004), but counselors must not consider these experiences in isolation. If counselors rely solely on the grief models mentioned earlier, or other counseling frameworks that do not consider trauma, then the counseling process can result in more harm to older BIPOC clients. ...
As Black, Indigenous, and people of color (BIPOC) endure losses throughout the life span, their grief can impede daily functioning and interactions. This is especially true for older individuals (age 65 and over) who have a history of losses and traumatic experiences. We describe BIPOC's common losses, along with practical implications for integrating grief counseling and trauma‐informed principles.
... These phone calls can represent a sort of primary preventive intervention for bereavement, that the literature suggested as important especially when it is accessible and free of charge (Stroebe et al., 2007). Based on existing literature in similar situations to COVID-19 pandemic (Regehr & Sussman, 2004;Rose et al., 2002), the treatment procedures (e.g., psychoeducation, mental health assessment, small relational/psychodynamic actions like dialectical thinking, active and compassionate listening, reminiscence, meaning-making, and cognitive-behavioural actions like cognitive restructuring of ruminative or maladaptive thoughts)) might be useful for providing early support to a normal grief process (and to prevent complications) in a stressful, traumatic, and violent situation of loss for COVID-19. ...
A proportion of persons affected by coronavirus disease-19 (COVID-19) die and do so in extraordinary circumstances. This can make grief management extremely challenging for families. The Clinical Psychology unit of an Italian hospital offered a bereavement follow-up call to such families. This study aimed to explore the families' experiences and needs collected during these calls, and the role that the psychologists played through the call. A total of 246 families were called over 3 months. Multiple qualitative methods included: (i) written reports of the calls with relatives of patients who died at the hospital for COVID-19; (ii) qualitative semi-structured interviews with psychologists involved in the calls; (iii) observation of psychologists' peer group discussions. A thematic analysis was conducted. Six themes emerged: without death rituals, solitary, unexpected, unfair, unsafe, coexisting with other stressors. Families' reactions were perceived by psychologists as close to a traumatic grief. Families' needs ranged from finding alternative rituals to giving meaning and expressing different emotions. The psychologists played both a social-institutional and a psychological-human role through the calls (e.g., they cured disrupted communication or validated feelings and choices). This study highlighted the potential of traumatic grief of families of COVID-19 victims, and provided indications for supporting them within the space of a short phone call.
... The majority of TAPS suicide loss survivors who sought additional trauma-informed care report (when asked) that their trauma was either overlooked or not discussed at all by providers during their initial assessment of needs. Regehr and Sussman (2004) note that "it is imperative that mental health professionals respond with approaches that do in fact assist to relieve suffering and do not carry the risk of elevating symptoms" (p. 290). ...
The TAPS Suicide Postvention ModelTM is a three-phase approach to suicide grief that offers a framework for survivors and providers in the aftermath of a suicide. This framework proposes guidance on how to build a foundation for an adaptive grief journey and creates a research-informed, proactive, intentional pathway to posttraumatic growth. The Model follows the Tragedy Assistance Program for Survivors’ peer-based model of care and has supported more than 16,000 military suicide loss survivors over the past decade. The Model is applicable to anyone grieving a suicide loss or coping with any associated trauma.
... Tout au long du siècle dernier, les travaux menés sur le deuil ont tenté d'explorer comment les gens affrontent cet évènement (Regehr & Sussman, 2004). ...
... Puisque le deuil est un phénomène « normal » de la vie humaine, certains auteurs se sont posé la question de savoir si le terme « clinique du deuil » pouvait avoir un sens ou non (De Leo et al., 2013). En outre, une conceptualisation du processus de mouvement vers la résolution du deuil a été débattue et certains auteurs ont étudié les phases et les étapes au cours desquelles les individus élaborent leur perte (Regehr & Sussman, 2004). Elisabeth Kübler-Ross (2014) Dans les moments initiaux, il est fréquent de ressentir une douleur aiguë à l'intérieur, due à l'engourdissement, à la pensée constante pour le défunt et au déni de la réalité de la perte. ...
... La première est que les individus doivent exprimer leurs émotions désagréables, afin de s'approprier leur chagrin, et la deuxième est que ce processus douloureux aide les endeuillés à se détacher du défunt et à parvenir à une résolution du deuil. Cela a guidé la plupart des interventions cliniques sur le deuil, ayant comme objectif principal d'aider les endeuillés à exprimer des émotions, à la fois agréables et désagréables dirigées envers eux-mêmes et envers le défunt (Regehr & Sussman, 2004). Cette expression émotionnelle est importante pour la résolution du deuil, car cette étape favorise l'intégration d'une approche équilibrée et réaliste quant à la mémoire du défunt plutôt qu'une approche idéalisée ou négative (Humphrey & Zimpfer, 2007;Worden, 1991). ...
En médecine d’urgence, certaines procédures médicales urgentes pourraient s’avérer porteuses de répercussions psychologiques sur les proches endeuillés. Du point de vue des soignants, lorsque les interventions de soins sont dispensées dans un contexte « inhabituel », celles-ci pourraient avoir un impact psychologique sur eux. L’objectif de cette thèse est d’évaluer les répercussions psychologiques liées à la proposition faite à un proche d’assister à la réanimation cardio-pulmonaire (RCP) de son parent en arrêt cardiaque et liées à l’annonce du décès effectuée simultanément à la demande urgente de prélèvement des organes. Les répercussions psychologiques liées à la participation à un contexte de soins « inhabituel » comme les attentats ont été estimées auprès des équipes soignantes urgentistes. Cinq études ont été menées. La première étude est une étude quantitative portant sur la détermination de l’impact psychologique de la proposition faite aux familles d’assister à la RCP du patient. Les résultats de cette étude ont été approfondis au travers d’une étude qualitative sur l’expérience des proches. La troisième étude (revue systématique) décrit la synthèse de l’impact psychologique de la demande de don d’organes, ce qui a permis la réalisation de l’étude prospective portant sur l’évaluation de la procédure simultanée d’annonce de décès et de demande de prélèvement d’organes. In fine, la cinquième étude s’est intéressée à l’effet de la participation directe aux interventions urgentes, lors des attentats de novembre 2015, auprès des soignants. Les implications par rapport au modèle patient-family centered care dans la médecine d’urgence pré-hospitalière ont été discutées.
... Although the fields of trauma and bereavement are connected (Green, 2000;Figley et al., 1997;Raphael, 1997;Regehr and Sussman, 2004;Stroebe et al., 2001), research on psychopathology among immigrants and refugees has mainly emphasized trauma, its aftermath (posttraumatic stress disorder [PTSD], depression, anxiety) and its contributing factors. Much of the research has demonstrated that refugees are at high risk for PTSD, with Fazel et al. (2005) estimating this risk to be 10 times higher for adult refugees resettled in Western countries compared to an age-matched general population. ...
... A study by Claycomb et al. (2016) showed that Bosnian adolescents who had experienced cumulative grief following the deaths of loved ones due to the Bosnian civil war and deaths not related to the war scored higher on PCBD, PTSD, and depression measures than a matched group who struggled solely with either war-related deaths or non-war-related deaths. Prior research has suggested that maladaptive grief reactions may interfere or overlap with PTSD (Green, 2000;Nakajima et al., 2012;Neria and Litz, 2004;Nickerson et al., 2014;Regehr and Sussman, 2004). According to some researchers (e.g., Armour, 2006;Layne et al., 2017a), the complex interrelation of trauma reactions and grief may delay recovery. ...
Background
With conflict driving millions of refugees away from their homes worldwide, there has been an increase in interest in the field of refugee trauma. However, while trauma and bereavement interlink, prior studies have focused on trauma and its related disorders (PTSD) and predictive factors. This paper reviewed up-to-date literature on the prevalence rates of prolonged grief disorder (PGD), its comorbidities, and associated risk factors among adult refugees.
Method
We systematically reviewed the literature using five databases (PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences Collection, Academic Search Elite, and PubMed). The process of study selection was designed according to PRISMA guidelines.
Results
The initial search generated 126 articles, of which 12 met the inclusion criteria. The pooled prevalence of PGD was 33.2% (95% CI: 15.2–54.2%). Being an older refugee, traumatic and multiple losses implying the death of first-degree relatives appeared to be consistent risk factors for PGD, combined PTSD/PGD, depression, idioms of distress, and functional impairment. PGD, PTSD, and PTSD/PGD intersect on PTSD-intrusions and painful memories.
Limitations
All included studies adopted a cross-sectional design, thus limiting the understanding of causal pathways.
Conclusions
Our findings showed that the high prevalence of PGD and related comorbidities were influenced by the load of traumatic circumstances surrounding the death(s). The findings shed light on the current proposed grief-related diagnostic criteria . Psychopathological and transcultural aspects are discussed, and we provide concrete recommendations for improvements to future research in this field.
... Although the fields of trauma and bereavement are connected (Green, 2000;Figley et al., 1997;Raphael, 1997;Regehr and Sussman, 2004;Stroebe et al., 2001), research on psychopathology among immigrants and refugees has mainly emphasized trauma, its aftermath (posttraumatic stress disorder [PTSD], depression, anxiety) and its contributing factors. Much of the research has demonstrated that refugees are at high risk for PTSD, with Fazel et al. (2005) estimating this risk to be 10 times higher for adult refugees resettled in Western countries compared to an age-matched general population. ...
... A study by Claycomb et al. (2016) showed that Bosnian adolescents who had experienced cumulative grief following the deaths of loved ones due to the Bosnian civil war and deaths not related to the war scored higher on PCBD, PTSD, and depression measures than a matched group who struggled solely with either war-related deaths or non-war-related deaths. Prior research has suggested that maladaptive grief reactions may interfere or overlap with PTSD (Green, 2000;Nakajima et al., 2012;Neria and Litz, 2004;Nickerson et al., 2014;Regehr and Sussman, 2004). According to some researchers (e.g., Armour, 2006;Layne et al., 2017a), the complex interrelation of trauma reactions and grief may delay recovery. ...
... Rather, the approach of thanantologists and traumatologists has often been to minimize the interconnectivity between trauma and loss (Figley, Bride, & Mazza, 1997;Regehr & Sussman, 2004). To weave these two areas together, I provide an overview of (a) the representations of time in human psychology, (b) the unique relationship between time and posttraumatic stress reactions, and (c) the trends in the literature regarding grief and bereavement. ...
Objective:
This article explores the universal concept of time with the aim of enhancing our ability to help those affected by loss and trauma as well as those who study and treat them. The help comes in the form of a new framework that focuses on how we think about, and represent, time in scholarship and practice.
Method:
In this conceptual article, I outline traditional approaches to incorporating time in psychological research and discuss the many related concepts, such as anniversary reactions. The main aim of the article is to introduce a reconceptualized framework of time, including the assertion of meaningful time and markers in time. The premise of this framework is that social behavioral sciences should consider time as an uneven, meaningful, and overt force that influences trajectories of adaptation in the context of traumatic loss.
Results:
This article describes the ways in which markers in time push our current representations of time forward and, in doing so, alter the narrative around pathological grief by removing the time limitation on grief and mourning. This framework recognizes grief as a cyclical process that unfolds in the context of meaningful, rather than chronological, time.
Conclusion:
The article concludes by addressing the practical implications of this reconceptualization and the potential to greatly impact scholarship and clinical approaches to addressing the needs of clients coping with traumatic loss. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
... Most participants were very isolated prior to coming to the shelter and expressed positive emotions regarding some of the relationships they had established with shelter residents and staff, sometimes even referring to them as family: Participants' reactions of shock, disbelief, despair, anger, and even relief have all been associated with initial phases of grief identified in the literature (Kübler-Ross, 1969;Regehr & Sussman, 2004). Seen as the first step towards healing, these emotional reactions suggest an active process of attempting to make sense of a significant loss and moving towards adjustment. ...
... Findings suggest that experiences of homelessness were marked by intense grief reactions that were either acknowledged and validated or overlooked and disenfranchised. Although participants' reactions echoed the psychological stages characterized in many models of grief (Kübler-Ross, 1969;Regehr & Sussman, 2004), participants' grief was rendered disenfranchised by difficult shelter conditions, impersonal practices, and the double stigma associated with being both older and homeless. Doka (1989) coined the concept disenfranchised grief, defining it as occurring in relation to "a loss that is not or cannot be openly acknowledged publicly, mourned, or socially supported" (p. ...
... Our findings support previous research on grief and loss suggesting that positive social support and validation are important components in processing grief (Regehr & Sussman;Worden, 1991). Thus, we suggest shelters to consider integrating support groups into shelter programming to help residents accept the circumstances associated with their losses, so that they can connect with one another, adjust, and move forward with their lives. ...
RÉSUMÉ
Bien que l’itinérance chez les personnes âgées soit un sujet qui se soit développé ces dernières années, peu de recherches ont considéré les expériences des « nouveaux » itinérants plus âgés à partir de leur propre perspective. La présente étude, reposant sur la théorie constructiviste, vise à combler cette lacune en explorant les liens entre la perception sociétale de l’itinérance et du vieillissement, d’une part, et l’accès au logement et aux services, ainsi que la perception de soi, d’autre part, pour 15 personnes âgées vivant dans des refuges d’urgence pour sans-abris à Montréal (Québec, Canada). Les résultats démontrent que l’itinérance provoque une réaction de deuil caractérisée par le choc, le désespoir, la colère et, dans certains cas, le soulagement. Le fait d’entrer en contact et de recevoir de l’appui d’autres personnes vivant dans les refuges et du personnel sur place ont aidé les participants à reconnaître et à faire le deuil de leurs pertes. Cependant, les conditions difficiles de la vie en refuge, le stigma associé au vieillissement et à l’itinérance, et la non-reconnaissance ou l’absence de validation des expériences de deuil ont contribué à empêcher la reconnaissance du deuil. La conceptualisation de l’itinérance au grand âge comme un deuil non reconnu contribue aux études concernant le vieillissement et l’itinérance, et trace une nouvelle voie pour améliorer la compréhension et la validation des expériences d’une population vulnérable et âgée en croissance.
... They found that security, safety, hopes of being cared for and being purposeful, all supported older people in preparing for moving. Regehr and Sussman (2004) identified that the personal attributes of "mastery, control, flexibility, and optimism" (p. 293) as a cluster of personality traits had positive effects on people's ability to work through traumatic occurrences. ...
INTRODUCTION: This exploratory study, undertaken in 2013, sought to examine how older people, living in Auckland New Zealand who did not have family living locally, experienced the move from living at home, through a hospital admission to living in residential care. METHOD: Nine qualitative, semi-structured interviews were conducted with participants while in hospital and following discharge to a residential care facility. Data were analysed thematically.RESULTS: For most, this move was a major, traumatic event in their lives. Participants identified both hindering and supportive factors through this process.CONCLUSION: The process of transition from hospital is helped by older people being involved in decision making, and having adequate time and prior information. An assisted living facility that enables autonomy, has flexibility, and services in place to meet on-going physical and psycho-social needs supports the settling-in process. Continuity of social work interventions, advocacy and reviews of policy may also be useful.
... 'Grief work', or Sigmund Freud's psychoanalytic notion of working through grief, supposes the ultimate goal of letting go of and separating from the deceased (Regehr & Sussman, 2004;Bonanno & Kaltman, 1999). Launching a new understanding of grief, John Bowlby's (1979) work on maternal-child attachment and loss provided a corrective to earlier psychoanalytic theories. ...
