Grief is a profound sorrow or emotional distress experienced in response to a significant loss. It is a natural, multifaceted response, and everyone navigates it differently. Many people tend to think of loss solely as a death. But death is not the only loss we experience. “Some loss is more profound and significant. It could be the death of a spouse, parent, child, or sibling,” says Mary Beth Lamey, MSW. “But loss can be experienced in several different ways: someone that you love moves away, you lose your job, your health, or your hopes and dreams are dashed.”
A licensed clinical social worker who worked in hospice before joining Thompson Funeral Home as a community care coordinator and funeral director apprentice, Mary Beth graduated from the University of South Carolina with a Master of Social Work degree. She has provided counseling and support to grieving families in the Columbia area for over twenty years. It’s easy to see why grieving family members feel comfortable talking to her: Mary Beth radiates kindness and patience, infused with humor and a fondness for Taylor Swift.
“When we talk about grief, what we’re talking about typically are losses. When we start talking about trauma, the symptoms may overlap.”
Understanding Trauma
Trauma can be defined as a response to loss, such as a death, or a deeply distressing or disturbing situation, like an assault. Trauma overwhelms an individual’s coping ability, causing many physical, emotional, and psychological complications.
Cheryl Stevenson, MA, LPC, works with trauma patients in Columbia, South Carolina. She has been the lead counselor and owner of Chronos Care Counseling since 2003. A graduate of Columbia College with a Master’s degree from Webster University, Cheryl offers psychotherapy counseling for individuals, couples, and families. Her decades-long career as a licensed mental health counselor constantly brings her face-to-face with people suffering from trauma: “Trauma is our internal response to an external event. A lot of people, when they see something traumatic happen, they experience disassociation. They may describe it as an out-of-body experience where they’re up high and looking down on it. And that’s normal to a certain extent. You just don’t want it to stay like that.”
She adds: “Often people come to me with numerous things that have happened to them. They have difficulty putting it together, putting it in perspective, relating it to current problems, making that connection, connecting those dots.”
‘Big T’ and ‘little t’ Trauma
“Big T” and “little T” are terms used in psychology and trauma therapy to differentiate between traumatic experiences based on their perceived severity and impact. These terms help professionals and individuals categorize trauma, but it’s important to note that everyone’s reaction to trauma is subjective.
Big T Trauma
“Big T” traumas refer to major traumatic events typically recognized by individuals and society as severe and potentially life-altering. Examples include:
- Natural disasters (e.g., earthquakes, hurricanes)
- Violent assaults, including physical or sexual assault
- Death of a loved one
- Major accidents, such as car crashes
- War or combat exposure
- Prolonged abuse
Little t Trauma
“Little t” traumas can still significantly impact an individual’s emotional well-being. These can be distressing events that might affect self-worth perception of the world or create emotional scars:
- End of a significant relationship
- Difficulties in workplace environments
- Persistent stress due to financial worries
- Bullying or relational aggression
- Emotional neglect or minor incidents of abuse
- Humiliations or deeply embarrassing moments
It’s essential to recognize the subjective nature of trauma. Just because an event falls into the “little t” category doesn’t diminish its importance or the validity of someone’s emotional response. It underscores the necessity of validating and addressing all kinds of traumas for holistic well-being.
The Link Between Grief and Trauma
Grief, while a natural response to loss, can sometimes intensify into traumatic distress, blurring the lines between mourning and trauma. This intersection demonstrates how deeply intertwined and complex our reactions to significant life events can be.
In particular, when death comes violently and unexpectedly, particularly to the young or vulnerable, the result can be traumatic grief. The intensity and duration of the traumatic response can vary widely depending on individual resilience, support systems, and the nature of the loss.
Mary Beth’s young sister died in an automobile accident in 1990. She was young but recalled: “It had a tremendous impact on our family. I was a curious observer of how her death impacted me, how I felt, what it was like to have lost a sibling, and watching my parents grieve. It framed many experiences that people do not necessarily have until later in life and was the start of my interest in grief and loss. And then from there, I’ve worked in several different settings, but all of them shared a similar thread.”
What fascinates Mary Beth is that grief and trauma are so unique: “You can take, within the context of a family, multiple members that have experienced the same loss. Each will have their unique response to how they process, perceive, and move through that experience with grief or in response to that trauma.”
Mary Beth and Cheryl agree that addressing and treating trauma, though painful, is essential for moving through it. There is no expiration date for when traumatic grief stops affecting us. And there’s no minimum age for treatment, either. “From birth, if you’re old enough to form an attachment, you’re old enough to experience grief. There’s no magic or particular age to seek help,” noted Mary Beth.
The Dangers of Ignoring Trauma
A native Carolinian with the polished drawl to prove it, Cheryl admits, “We have a saying in the South, which is ‘I’ll deal with it later.’ But I think that’s human nature, everywhere, to avoid dealing with things. Which causes lifelong difficulties: withdrawing from people, drug abuse, alcoholism, and trouble with their marriage or relationships.”
Trauma manifests in a variety of physical, emotional, and behavioral symptoms:
Physical
- Fatigue
- Chronic pain or aches
- Sleep disturbances (insomnia or nightmares)
- Being easily startled or jumpy
- Changes in appetite
- Heart palpitations
- Gastrointestinal problems
Psychological
- Persistent feelings of sadness, despair, guilt, or shame
- Anger or irritability
- Feelings of numbness or detachment
- Chronic anxiety or fear
- Feelings of guilt or shame
- Intrusive thoughts
- Feeling alienated or isolated from others
- Persistent negative beliefs about oneself or others
- Distorted feelings of guilt or blame
Behavioral
- Avoidance behaviors (e.g., avoiding places or people that are reminders of the trauma)
- Social withdrawal or isolation
- Engaging in risky or self-destructive behaviors
- Difficulty functioning in work or social situations
- Changes in personal hygiene or appearance
- Increased use of alcohol or drugs
Identifying Trauma
There are clinical tests to determine if you’re suffering from trauma. Cheryl says the gold standard is the Caps Synapse Dash Five to identify PTSD. Although she does not clinically administer the test, she works with clients diagnosed with trauma. She also has practical suggestions for people who have experienced trauma: “Practice mindfulness. I’m a huge advocate for people who want to get in touch with themselves seriously, take time, and listen to what’s happening with them. You’ve got to get in touch with yourself and understand that some of your actions are harmful.”
Listen to the people closest to you, too: “Let others tell you things you must think about. Hear them when they say they are worried about you. The people who love you and notice a change or something a little bit awkward or out of whack can help you learn about yourself.” Cheryl concluded: “You have to be a little vulnerable to heal.”
Mary Beth concurs. She looks for common themes. If she’s counseling a grieving family member, for example, she listens for clues: I’m having difficulty sleeping, I’m not eating well, I feel sad, and my body feels weary. “These symptoms can be attributed to grief as well as trauma. Early support is great, but it’s the quality of the support. Getting folks in there and getting them connected to the best support as soon as possible is very helpful,” she said.
Effective Therapies for Trauma
Two prominent therapeutic techniques effectively address trauma, among other psychological challenges: EMDR (Eye Movement Desensitization and Reprocessing) and CBT (Cognitive Behavioral Therapy).
EMDR focuses on utilizing guided eye movements to help patients process traumatic memories, aiming to change the emotional response to a traumatic event, making it less distressing. On the other hand, CBT concentrates on identifying and challenging negative thought patterns and behaviors. Both therapies help equip individuals with the resilience and understanding to navigate their psychological challenges.
As a counselor specializing in trauma, Cheryl prefers EMDR: “From what I’ve experienced, EMDR helps patients process things more rapidly so they can get on and move on with their lives. EMDR is not for everyone, including those who disassociate or are recovering drug addicts. Not everyone is comfortable with the EMDR process, so my other go-to therapy is CBT. Patients learn coping skills and what to do when they experience a trauma trigger. Both therapies are at the top of my list for trauma.”
Trauma Support Groups: Helpful or Not?
Grief and trauma support groups can be helpful, but Cheryl encourages people to choose wisely. “In Columbia, we have excellent, established in-person support groups. I’ve had clients find success in these. You want to avoid a group that focuses only on the woe-is-me. You want a group that helps you. You want to move through it.”
Thinking It Over
No one enjoys the aftermath of loss, whether it’s the death of a loved one, a divorce, or another significant life event. Grief and trauma often intertwine and may trap us in negativity, depression, and anxiety. Whether we’re grappling with the subtle sting of “little t” traumas or the overwhelming weight of significant loss, recognizing the signs and seeking timely intervention can pave the way for healing. Therapies like EMDR and CBT offer promising avenues to process and overcome these challenges. Embracing support, whether through treatment, community, or self-awareness, is a crucial step toward resilience, recovery, and reclaiming the joys of life.