What Is Traumatic Grief Therapy?

When a loved one passes away unexpectedly, the people left behind often experience traumatic grief. Traumatic grief therapy can be a helpful and healthy way to deal with intense feelings of grief, also helping us process painful emotions.

Jennifer R. Levin, PhD, a therapist with expertise in thanatology (the study of death, dying, and bereavement), explains that traumatic grief therapy "simultaneously addresses the trauma response and grief associated with a traumatic death." Here we explore this therapy in greater detail, including how to get started.

What Is Traumatic Grief?

Traumatic grief takes place after a loved one passes away in what Levin describes as "usually, but not always, in a sudden, unexpected manner." Examples of death that might lead to traumatic grief include:

• Accidents
• Homicide
• Medical crises
• Overdoses
• Suicide

"Traumatic grief can also occur when an individual, who is a survivor, is involved in the incident that took a loved one’s life, witnessed what happened, or found a deceased loved one," Levin says. Additionally, if someone needs to make difficult medical decisions regarding a loved one's care, such as resuscitation or terminating life support, a trauma response can follow.

Traumatic Grief Therapy Techniques

The goals of traumatic grief therapy include emotional regulation, reduction of trauma symptoms, learning skills to cope with and manage the trauma, and processing losses associated with the grief. This therapy is often tailored to address an individual's specific needs and symptoms.

Traumatic grief therapy can draw on various techniques to achieve its goals, including those associated with:

• Cognitive behavioral therapy (CBT)
• Acceptance and commitment therapy (ACT)
• Interpersonal therapy (IPT)
• Brief eclectic therapy (BET)

What to Expect With Traumatic Grief Therapy

Everyone’s traumatic grief therapy journey differs. That said, Levin outlines some general steps that can be expected throughout the therapy process.

Stabilization

Stabilization is the step in which a sense of rapport and feelings of safety are developed between the person and their therapist. The focus is on routine and structure so the person can rebuild an environment in which their body will begin to trust again.

Processing

After building a solid foundation, the person begins to process their trauma and grief using the skills learned in the first step. If this leads to feeling overwhelmed or other trauma responses, Levin says that stopping and going back to earlier skills can help decrease symptoms and increase coping skills.

Continual Grief Work

This step focuses on several things, some of which include:

• Continued processing of feelings associated with loss
• Living with the uncertainty of the trauma
• Addressing what has been left undone
• Rewriting narratives
• Meaning-making
• Developing continual bonds
• Facilitating post-traumatic growth

In this stage, participants may seek further treatment through individual therapy, group therapy, or both.

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How Traumatic Grief Therapy Works

There are two key signs that someone may be dealing with traumatic grief. One is a trauma response that interacts with grief. "The trauma response is what makes traumatic grief different from other forms of grief," Levin explains.

The other is the shattering of assumptive expectations that guide us in the world. Trauma upends some of our most basic assumptions, such as:

• We and our loved ones are safe in the world (at school, work, crossing the street, etc.).
• The world is predictable and not random.
• Things happen for a reason.
• We will be rewarded for our work.

When these expectations are challenged with a sudden and painful loss, traumatic grief can shake the very core of our belief system. Traumatic grief therapy works to help restore normalcy and help us better process and understand the trauma and its effects.

Benefits of Traumatic Grief Therapy

Traumatic grief therapy can provide many benefits, according to Levin, some of which include:

• A decrease in symptoms
• Improved coping mechanisms
• An increased likelihood of post-traumatic growth
• Continuing bonds with the deceased
• Ability to envision future possibilities
• Continue living a meaningful life

"So many of my clients cannot envision continuing on without their loved one," Levin says, "especially when a spouse dies." While many are not suicidal, they often show a lack of motivation or desire to engage with the world. Traumatic grief therapy helps. With time, patience, and the belief that life can improve, many go on to lead meaningful lives.

Effectiveness of Traumatic Grief Therapy

Research suggests that therapy can be an effective tool for helping people manage the symptoms and experiences of traumatic grief.

• One study published in the European Journal of Psychotraumatology found that brief eclectic psychotherapy was effective in helping people cope with symptoms of traumatic grief. Strategies used in this intervention included reviewing the traumatic event, finding meaning, writing assignments, and farewell rituals.
• Another study found that a day treatment program designed to help people with traumatic grief could also be effective. Such programs could be especially helpful for people who have experienced a natural disaster or war-related trauma.

Why Dealing With Grief Is Important

People who bottle their grief or pretend it doesn’t exist may resist seeking out traumatic grief therapy. But taking this approach can have a number of negative effects on personal well-being.

Levin says that people may experience a "continuation or an increase of trauma symptoms, including rumination about details of the incident, flashbacks, nightmares, hypervigilance anxiety, and depression."

"You may be able to repress symptoms for the short term," Levin says, "but it will come back and cause bigger issues, or you will have multiple issues to address."

Getting Started With Traumatic Grief Therapy

If the trauma symptoms a person is experiencing and/or the pain of grief is making it difficult to function in areas such as work, taking care of others, getting out of bed, or getting through the day—it’s likely time to seek out traumatic grief therapy.

Talk to a doctor about the symptoms experienced and ask them for a referral to a mental health professional who can provide this type of therapy. Some research also suggests that web-based options may be helpful for relieving symptoms associated with grief and bereavement, so online therapy is also an option.