How Does Traumatic Grief Therapy Work?

Death is inevitable for all living beings. However, those who pass often leave behind loved ones who experience grief at their passing. Grief, a state that is often associated with emotional distress and sadness, is a normal experience for those who have lost a loved one. However, if the loss is sudden or occurs in a way that could create trauma, a person may experience traumatic grief. Recovering from this type of grief is often possible via therapeutic interventions, such as traumatic grief therapy. To understand the potential benefits of traumatic grief therapy, it could be helpful to explore the concept of traumatic grief further. 

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What is traumatic grief? 

Grief is often associated with bereavement. However, the sudden and unexpected passing of a loved one can result in extreme difficulty moving forward. Traumatic grief may result in various responses, including those that are emotional, psychological, physical, and behavioral: 

• Emotional responses: Numbness, disconnection from others, anger, major depression, anxiety, sadness, or inappropriate guilt
• Psychological responses: Confusion or disordered thought patterns, difficulty concentrating, denial of the loss, preoccupation or fixation
• Physical responses: Headache, nausea, heaviness or tightness in the chest, fatigue, dizziness, muscle weakness, gastrointestinal distress, tension, numbness
• Behavioral responses: Difficulties with sleep, irritability, angry outbursts, difficulty enjoying previously enjoyable activities, changes in routine, and potentially harmful coping mechanisms (such as substance misuse, binge eating, or overexercising) 

While each person’s experience with traumatic grief is unique, the following symptom categories often characterize this condition. 

Emotional responses

Individuals who are experiencing grief can feel emotionally numb or disconnected from others. In some cases, numbness may make it difficult to process their feelings. Others could feel angry or outraged at their situation or the circumstances that led them to lose a loved one. Grief could also cause a person to have feelings of depression, guilt, or sadness, which may lead to changes in their behavior and function. 

Psychological responses

Those with traumatic grief could experience disordered or confused thought patterns and difficulty concentrating, which can make it more challenging for them to make sense of their situation. Psychological responses can also involve denial or disbelief, which could further complicate the recovery process. Grief can also cause a person to fixate on their situation, becoming preoccupied with what occurred for long periods after the loss. 

Physical responses

According to the American Psychiatric Association, grief and prolonged grief disorder may cause a variety of physical symptoms, including but not limited to: 

Some people could struggle to understand that grief is causing physical symptoms, leading to anxiety or worry about whether they are experiencing an undiagnosed health condition. 

Behavioral responses

Grief can impact behavior, with some individuals experiencing sleep difficulties, angry outbursts, irritability with loved ones, and loss of interest in previously enjoyable activities. Grieving individuals may also change their routines to avoid situations that could remind them of their lost loved one. Habits can also change, as people could start engaging in harmful coping strategies. These can include but aren’t limited to, binge eating, overexercising, or substance misuse, such as excessive drug or alcohol use (previously referred to as ‘alcohol abuse’ or ‘drug abuse’). 

Traumatic grief may also lead to the development of other conditions. One of these conditions is a long-term type of grief known as complicated grief. 

What is complicated grief?

According to the Association for Behavioral and Cognitive Therapies (ABCT), complicated grief can occur when a person struggles to adapt to the acute grief associated with loss. While acute grief can come with several difficult experiences, including a longing for the lost loved one, persistent sadness, and intrusive thoughts, these symptoms tend to fade with time as the person finds ways to cope. 

Contrarily, complicated grief can cause individuals to have symptoms for significantly longer. Various complications could be at play, such as difficulty accepting the loss, lack of social support, multiple traumatic events after a loss, frequent reminders of the loss, or other responsibilities that may prevent a person from taking the time to grieve properly. 

To treat traumatic grief before it develops into complicated grief, it could be helpful to get treatment. One treatment that may be particularly effective for those experiencing traumatic grief is traumatic grief therapy and professional counseling. 

What is traumatic grief therapy, and how does it work? 

Traumatic grief therapy is a type of psychological treatment designed to address the specific challenges, mental health issues, and complications associated with traumatic grief. According to Bradley University, multiple therapeutic approaches might be used, including the following. 

Acceptance and commitment therapy

Acceptance and commitment therapy (ACT) aims to help individuals accept difficult experiences or feelings, including those that relate to traumatic grief. An ACT provider may guide clients to avoid controlling their grief, instead increasing how often they engage in activities that align with their values. In addition, ACT typically involves a technique known as cognitive defusion, which can allow a person to be more mindful of (and create distance from) negative thoughts. Over time, ACT can enable a person to accept their loss, which could alleviate their traumatic grief symptoms. 

Cognitive-behavioral therapy

Cognitive behavioral therapy (CBT) can allow an individual experiencing traumatic grief to restructure the way they think about the loss of their loved one. This process typically involves identifying potentially negative thought patterns and recognizing how they could impact a person’s behaviors. From there, a CBT provider may help clients replace these negative thought patterns with more positive ones, which could subsequently improve their behavior. CBT can also teach an individual coping skills that could further allow them to cope with symptoms or accept the circumstances of their loss. 

Interpersonal therapy

Interpersonal therapy (IPT) can help an individual with grief connect with their emotions and thoughts while also identifying potential struggles related to current relationships in their life. Depending on the structure of a person’s IPT, their provider may also address their relationship with their lost loved one. This discussion might involve struggles the loved one may have been experiencing or any resentment they may have due to how the person passed. For example, if the deceased individual was impacted by substance misuse that contributed to their death, a person may find it difficult to move on from grief if they haven’t acknowledged how they feel about their loved one’s substance use.

How traumatic grief therapy works

While a traumatic grief program can combine elements of all the therapeutic modalities above, the overarching goal may be to address the symptoms of grief and help a person accept that their loved one is gone. For symptom relief, therapy may focus on alleviating intrusive or repetitive thought patterns, feelings of anxiety, tension, fatigue, and difficulty eating. Traumatic grief therapy can also show a person ways to regulate emotions or cope with nervous system-related challenges, which can involve using components of ACT, CBT, and IPT. Over time, a person could understand that their experience with grief is normal, learn to express their emotions, and eventually, move on. 

However, while therapy can be beneficial for those who are experiencing traumatic grief, in-person therapy may not be convenient or accessible to everyone. For some, traveling to a therapist’s office can be difficult, particularly for those who do not have a reliable form of transportation. Others may be more comfortable discussing grief-related or mental health topics over the phone, through chat, or via video calls. In these cases, they may find online therapy platforms like BetterHelp more accessible. Through these platforms, individuals can also access support groups, which may be helpful for meeting with others who have experienced complicated or traumatic grief. 

Research suggests that online therapy can be effective for those experiencing grief after the loss of a loved one. In a 2021 systematic review and meta-analysis, researchers reviewed data from seven trials to assess the effectiveness of internet and mobile-based interventions for the symptoms of grief following bereavement. They found that these interventions significantly affected the symptoms of grief, while user satisfaction was high. Overall, researchers concluded that internet or mobile-based interventions may be an effective way to treat the symptoms of grief in adults experiencing bereavement.