As we've discussed before, what we recognize as grief is a combination of dramatic psychological, emotional, and somatic changes that result from a devastating loss of meaning dependent on a significant relationship. The loss results in intense conflict between the need for an orderly world in a chaotic reality and an agonizing search for an explanation for the loss.

This explanation is intended to allow the bereaved person to see the world as predictable and controllable as well as allow them to comprehend why such a loss should have occurred. Parkes (1997) refers to the process of revising "basic assumptions, habits of thought and behavior that have been learned over many years and which we tend to take for granted" (p. 246) as psychosocial transition (PST).  But what does one use to move through this process?

Throughout the grief process, the bereaved develop a story that helps them to make sense of their loss. Figley has called this a "healing theory" and I wrote about this in my chapter I assigned for this unit. This story/theory can then act as a sort of bridge between what was seen as normal before the loss and what makes sense afterward.

The healing theory  must account, in some way, for thoughts and feelings that are inconsistent with their world view prior to the loss. It also incorporates elements of their experience as well as those borrowed from the experiences of others. Information from cultural and family myths as well as religious or philosophical beliefs will be tested for inclusion in the modified view.

The grieving individual may find him or herself turning to the person who has died throughout this process and some of the odd experiences of grief (labeled as hallucinations or delusions) may be understandable parts of the development of a healing theory and a new sense of normal that results from the grief process.The underlying goal of this process is to find some sort of understanding and new sense of stability in life as well as to gain a sense of mastery and control with regard to the end products of the death.

Traumatic losses confront what appears to be a basic belief of our Western culture that present the world is fair and just. The loss that is unfair or unjust can only be described as a loss of balance between the linked processes of action and result in their lives (" If I am good, good things must come to me") .

Janoff-Bulman (1992) has proposed that social laws are used to answer the "why" questions that result form a death. These are laws centered on justice and control, which allow us to see a pattern of cause and effect and legitimate ends that results from previous behavior.

The initial response to this imbalance is to look to previously held meaning structures for guidance and then, if they are lacking, to search elsewhere for answers. Those grieving may look for a religious or spiritual explanation, a physical or medical one, a social or psychological one. Ultimately, they may find that the only answer is that there is no answer, or they may reach a point where, rather than asking "Why me, why us?" they ask "Why not me, why not us?"

Anger as a Part of the Grief Process

The process of grief is not an easy one and this is even more so when the loss is a traumatic one.  The intensity of some emotions and thoughts, which may recur repeatedly, often surprises and frightens the bereaved and those around them. In particular, an intense anger of a power many had never experienced before may stay with the bereaved or he/she may experience episodic bursts of anger and rage.

One woman whose daughter had been raped and murdered said she would experience waves of anger so intense that she feared they would knock her to the floor. A normally easy going man, months after he and his wife had experienced their third pregnancy loss (this time, late in the pregnancy), found himself almost out of control with rage when a neighbor was making noise early in the morning. It was only his wife's quick intervention that stopped him from confronting and possibly killing his neighbor.

In some instances, the anger is unfocused, sometimes so overwhelming as to be incapable of being focused. In some cases, it may be expressed as a generalized sense of frustration and unfairness at being "angry at the whole world." They might target a particular individual or individuals (e.g., the perpetrator, God, the medical staff) or a particular institution (e.g., the court system, the medical establishment). It may also be accompanied by a powerful urge toward revenge. Anger may be directed toward the individual who has died and this may lead to intense feelings of guilt at such thoughts.

The Interminability of Traumatic Grief

One issue we have gone back to, over and over, is the idea of grief as an ongoing, although varying phenomenon.  What this means is that grief does not completely end, as some might expect, but will become a part of who that person is, sometimes intense and sometimes existing as a type of "background noise" in their lives.  The grief remains, but the intensity of it is manageable.  People who thought they could never laugh and feel joy do so.  They may be surprised, uncomfortable, and guilty at the thought of feeling joy, but they do. They may even feel the same emotions they felt before.  With traumatic loss, the time until these life affirming emotions are felt will be extended and they may never feel them to the same intensity or they may forever after be experienced through the filter of grief.

Given the characteristics of the loss itself and events surrounding it may mean that a traumatic loss is irreconcilable, and is interminable, that is, never ending (Think of parents whose child has been murdered by a drunk driver and their resulting, ongoing grief).

As we have discussed in class, a powerful belief about grief in our western world is that grief should be resolved in a reasonable period of time and that the bereaved should be able to move on to new relationships. This last part has been interpreted to mean that they should be able to "abandon the deceased" and, after heaving him or her behind, form new relationships independent of the previous one.

If we think of our experience of grief as a story, the grief of traumatic loss may seem like some horrible never ending story. In this, the bereaved are unable to reconcile themselves to their loss and thus are unable to achieve a sense of closure (Note: remember that it is possible to have a sense of "closure" on some aspects of one's grief without abandoning the relationship with the deceased. Also as you know, there is controversy over the casual use of this term and, if and when it is used, should be at the discretion of the bereaved.).

I'd like to direct you specifically to the web readings on children's issues as they are related to children and grief. Think back to Unit 4 and ways in which children's grief is unique. In particular, think about issues of their continuing development and how that might act as a trigger of recurrent or revisited grief.

Families Coping with Traumatic Loss

In a similar process to the one they used to explore the literature on traumatic loss, Figley and McCubbin (1983) identified 11 functional coping strategies for coping with trauma. They proposed that, after a trauma, certain behaviors in families are functional while their opposites are dysfunctional. They indicate that, in order to successfully cope with loss, families should take the following approaches:

    * adopt a solution-oriented approach to the problem, rather than simply blaming

    * showing tolerance for other family members (and acknowledging their right to grieve differently from each other);

    * clearly expressing commitment to and affection for other family members;

    * engaging in open and clear communication among members;

    * maintaining high family cohesion;

    * establishing and maintaining considerable role flexibility within the family;

    * making appropriate use of resources inside and outside the family;

    * not using overt or covert physical violence or (coercion); and

    * not abusing chemical substances (as well as alcohol and illegal drugs, this includes over the counter drugs, prescriptions drugs, and tobacco).

Although Figley and McCubbin present this as an opposition dichotomy, you might find it best to think of each factor as appearing on a continuum of functionality, particularly if you present these to families. Faced with a traumatic loss, many (sometimes all) family members will face periods of time when they will be overwhelmed by the loss and its meaning.

There will be times when individual family members will need to step back from their participation in family processing of the loss and focus on their own needs. They may simply be overwhelmed by their own pain, unable to maintain their role in the family. By viewing the family's response on a continuum, the tendency to view this "self-focus" as inevitably dysfunctional for family recovery may be reduced.

In my chapter, I wrote about the ways in which couples dealt with the loss of their child. The factors I identified as functional for the maintenance of their relationship were:

    * communication,

    * a positive view,

    * sharing the loss

    * flexibility, and

    * sensitivity to each other's needs.

One concern expressed to me, and something you may wish to discuss in class, is that these coping efforts focus more on the maintenance of families or relationships within families. It may be that these do not facilitate the grief of individual family members and may be contrary to the needs of more individual, cognitive, solitary grievers.

General Conclusions

Traumatic losses are overwhelming and are highly likely to complicate the grief process.

A wide variety of factors contribute to this. These include, but are not restricted to, the following: the death of a child, sudden death, ambivalence in the relationship, pre-existing factors, perceived preventability of the death, centrality of the relationship to the bereaved person's life, lack of diversity of social roles, concurrent crises, lack of social support, and human-made vs. natural causes.

The process of making meaning is made more complicated in the case of traumatic loss by is intense and surprising emotions, especially anger. Of particular issue, here and elsewhere, is that of human development.

Certain family patterns of behavior and family resources appear to be effective in helping families and their members to cope with traumatic loss. Caution should be taken to remember that there is a range of performance of these patterns, and that families should not be dichotomized into either functional or dysfunctional.

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