Grief, Loss, and Trauma

Posted on May 12, 2012


Grief can sometimes be complicated by traumatic aspects of the death.  The acronym NASH offers a general outline of how the cause or circumstances of the death add traumatic factors which make working through the tasks of mourning (see last post) more difficult.  In ascending order of propensity to induce trauma are deaths by 1) Natural causes (i.e. illness), 2) Accident, 3) Suicide, and 4) Homicide.  In the case of death from illness, there is usually an opportunity to bring closure to the relationship and to say “goodbye” that does not exist in the other three categories.   Further, “survivor guilt” may become an issue with any death, but it is increasingly so for the more traumatic causes of death.  Surviving family members are often haunted by questions of “why?” and “what could I have done to prevent this?”  The underlying experience is that “this is somehow my fault” and that “I am to blame.”   As survivors strive to find meaning in the loss, they may experience crises of faith.  Where was God when this happened?  Why did he not prevent it?  In the case of suicide, the sense of being abandoned increasingly complicates the grieving process.

San Diego Hospice (2010) identified a number of signs of complicated grief.

  • Persistent somatic complaints, physical problems, or chronic illness
  • Acute anxiety or panic
  • Excessive hostility and anger
  • Inability to work
  • Poor self-care or inability to meet daily needs of self and dependents
  • Social Isolation
  • Increase or new alcohol/drug/nicotine use
  • Sleep disturbances
  • Eating disturbances, appetite changes, or major weight loss or gain
  • Lasting or agitated depression
  • Excessive and unrealistic guilt
  • Suicidal thought or plans

Many people find bereavement counseling a helpful part of the process of working through the tasks of mourning.  When grief is complicated, it is increasingly important to obtain therapeutic support, particularly when there is a traumatic aspect to the loss.  Working with a therapist experienced in addressing both trauma and bereavement can help the grieving person cope with the trauma and work through the tasks of mourning.


San Diego Hospice (2010). Signs of complicated grief.  Unpublished document.

“I work with individuals, couples, and families to help develop secure connections
and craft manageable solutions.”

More information is available on my website  I am also available for speaking engagements, seminars, and retreats

Scott Wood is a registered marriage and family therapist intern (IMF67385) and is supervised by Dr. Melinda Reinicke, Psychologist (Psy11011).

Tagged: , ,
Posted in: Grief, Therapy, Trauma