Download Unique Aspects of Trauma

Unique Aspects of
Trauma-Related
Bereavement
Janice Harris Lord
www.jhlord.org
[email protected]
817-492-9208
At the end of this Session
participants will be able to:
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Name at least three unique aspects of
trauma-related bereavement
Differentiate common and different
components of trauma-bereavement,
depression, and post-traumatic stress
disorder
Describe a somewhat structured
chronology of treatment goals
Killing and dying are VERY different.
Unique Features of Homicide
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Sudden
Unique Features of Homicide
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Sudden
Violent
Unique Features of Homicide
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Sudden
Violent
Someone’s Fault
Unique Features of Homicide
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Sudden
Violent
Someone’s Fault
Justice system Involvement (homicide only)
Unique Features of Homicide/Suicide
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Sudden
Violent
Someone’s Fault
Justice system Involvement (homicide only)
Financial Issues
Unique Features of Homicide/Suicide
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Sudden
Violent
Someone’s Fault
Justice system Involvement (homicide only)
Financial Issues
Spiritual Issues
Death Notification
Homicide/Suicide-Related
Trauma Death (Rynearson, 1998)
Natural Grief
Thoughts: Reunion
Feelings: Longing/Yearning
Behavior: Searching
Homicide/Suicide-Related
Trauma Death (Rynearson, 1998)
Natural Grief
Thoughts: Reunion
Feelings: Longing/Yearning
Behavior: Searching
Traumatic Grief
Thoughts: Reenactment
Feelings:
Intrusion/Avoidance
Behavior:
Approach/Avoidance
Differentiating Between Trauma Grief,
Depression, and PTSD
Symptom
Trauma Dppsn PTSD
Grief
Grief Spasms
X
Specific Guilt
X
Spiritual/Mystical Visitations
X
Wishes to Die
X
Rage/Revenge Fantasies
X
Pre-occupation with manner of death
X
Differentiating Between Trauma Grief,
Depression, and PTSD
Symptom
Trauma Dppsn PTSD
Grief
Recurrent Intrusive Memories
X
Avoidance
X
Death-Related Dreams
X
Eating Problems (significant weight gain or
loss)
X
Grief vs. Depression (Simons, 1985)
Trauma Grief
Depression
Responds to comfort & support
Does not seek or accept support
Often openly angry
Irritable and complaining but not
openly expressive of anger
Relates feelings to loss
Depressed feelings generalized
Can still experience moments of
enjoyment and satisfaction
Exhibits an all-pervading sense of
doom
Feels sad and lonely
Feels hopeless and empty
Transient physical complaints
Chronic physical complaints
Guilty over specific aspect of loss
Generally guilty
Temporary loss of esteem
General loss of esteem
Differentiating Between Trauma Grief
Depression, PTSD
Symptom
Eating problems (significant weight gain or
loss)
Trauma
Grief
X
Dpsn
X
Psychomotor agitation/retardation
X
Fatigue most of every day
X
Worthlessness/generalized guilt
X
Suicidal Ideation, plan, or attempt
X
Fear/anxiety/panic attacks
X
Sometimes
PTSD
Post-Traumatic Stress Disorder
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Traumatic event (includes death)
Intrusive symptoms
Avoidance symptoms
Arousal symptoms
PTSD often related to:
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Death Notification
Visual Re-Enactment (real or imaginary)
Powerlessness to Protect
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Much higher rates of PTSD following
homicides, suicides, and vehicular crashes
than anticipated deaths.
Differentiating Between Trauma Grief,
Depression, and PTSD
Symptoms
Trauma
Grief
Dprssn
Sometimes
PTSD
Fear/anxiety/panic attacks
X
Recurrent intrusive recollections
X
X
Recurrent distressing dreams
X
X
X
Intense fear, helplessness, horror
X
Dissociative flashbacks
X
Intense psychological reaction at exposure
X
Differentiating Between Trauma Grief,
Depression, and PTSD
Symptoms
Trauma
Grief
Dprssn
PTSD
Intense physiological reaction at exposure
X
Inability to recall important aspects
X
Significantly restricted range of affect
X
Sense of foreshortened future
X
Hypervigilance
X
Exaggerated startle response
X
Time distortion*
X
General Chronology of Treatment
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Physical and Emotional Safety
Education about Trauma Reaction
Assessment
Stabilization of Symptoms
Identification of Strengths and Resilience
Traits
General Chronology of Treatment
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Addition of Case Management as Needed
Narration of Trauma Experiences
Reach Rational thinking Before Behavior
Relationship Skills
Meaning Making and How to Go On