Grief & trauma counseling

Anticipating the impact of loss or trauma (to the extent than any one can), and during and after the events of loss or trauma, each person has unique emotional experiences and ways of coping, of grieving and of reacting or not. Sudden, violent or unexpected loss or trauma imposes additional strains on coping. When a community is affected such as by disaster both the cost and sometimes the supports are greater. Weeping, painful feelings of sadness, anger, shock, guilt, helplessness and outrage are not uncommon. These are particular challenging times for children^[1] who may have had little ecxperience managing strong affects within themselves or in their family. These feelings are all part of a natural healing process that draws on the resilience of the person, family and community. Time and the comfort and support of understanding loved ones and once strangers who come to their aid, supports people healing in their own time and their own way. Research shows that resilience is is ordinary rather than extraordinary^[2]. The majority of people who survive loss and trauma do not go on to develop PTSD. Some remain overwhelmed.

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This article addresses counseling with complex grief and trauma ^[3], not only Complex post-traumatic stress disorder but those conditions of traumatic loss and psychological trauma that for a number of reasons are enduring or disabling. For example, where an adult is periodically immobilised by unwelcome and intrusive recall of the sudden and violent death ^[4] of a parent in their childhood. One that they were unable to grieve because they were the strong one who held the family together, or whose feelings of outrage and anger were unacceptable or unmanageable at the time or because the loss of the breadwinner catapulted the family into a precipitous fall losing home, community and means of support.

The post-trauma self

Because of the interconnectedness of trauma, PTSD, human development, resiliency and the integration of the self, counseling of the complex traumatic aftermath of a violent death in the family, for example, require an integrative approach, using a variety of skills and techniques to best fit the presentation of the problem. Disruption in the previously supportive bonds of attachment and of the person's ability to manage their own affects challenges traditional, so called 'non-directive' client centred counseling approaches. One example of this paradigm shift in approaches is the Multitheoretical Psychotherapy of Jeff Brooks-Harris ^[5].

The post-traumatic self may not be the same person as before ^[6]. This can be the source of shame, secondary shocks after the event and of grief for the lost unaltered self, which impacts on family and work ^[7]. Counseling in these circumstances is designed to maximize safety, trauma processing, and reintegration regardless of the specific treatment approach ^{[8] [9]}.

See also

• List of counseling topics
• List of basic self topics
• Trauma model of mental disorders
• Complex post-traumatic stress disorder
• Emotional dysregulation
• Attachment theory
• Biopsychiatry controversy

References

1. ^ Kathleen Nader, K 'Understanding and Assessing Trauma in Children and Adolescents Measures, Methods, and Youth in Context' Routledge 2007
2. ^ The Road to Resilience, APA Pamphlet http://www.ndsu.edu/counseling/the_road_to_resilience.pdf
3. ^ Jacobs, Shelby, Carolyn Mazure, and Holly Prigerson. "Diagnostic Criteria for Traumatic Grief." Death Studies 24 (2000):185–199
4. ^ Rynearson E.K, Editor 'Resilience and Intervention Beyond the Crisis' Routledge 2006
5. ^ Brooks-Harris, J. E. (2008). Integrative Multitheoretical Psychotherapy. Boston: Houghton-Miffli
6. ^ Wilson J.P, 'The Posttraumatic Self Restoring Meaning and Wholeness to Personality' Routledgte 2005
7. ^ Wislon, J.P, 'Posttraumatic Shame and Guilt' Trauma, Violence, & Abuse', Vol. 7, No. 2, 122-141 (2006) DOI: 10.1177/1524838005285914 2006 SAGE Publications
8. ^ Julian D. Ford, Christine A. Courtois, Kathy Steele, Onno van der Hart, Ellert R. S. Nijenhuis 'Treatment of complex posttraumatic self-dysregulation' Journal of Traumatic Stress Volume 18, Issue 5 , Pages 437 - 447
9. ^ PAUL A FREWEN, RUTH A LANIUS () 'Toward a Psychobiology of Posttraumatic Self-Dysregulation. Reexperiencing, Hyperarousal, Dissociation, and Emotional Numbing' Annals of the New York Academy of Sciences 1071 (1), 110–124. doi:10.1196/annals.1364.010 (2006)