Trauma, Grief, and Loss

1. Trauma, Grief, and Loss Greg Bohall, M.S., C.R.C., CADC-II

2. Nature of Trauma • Experiencing the event • Witnessing in person • Learning that the event(s) occurred to a close relative or close friend; in such cases, the actual or threatened death must have been violent or accidental. • Experiencing repeated or extreme exposure to aversive details of the event(s) (first responders, police officers repeatedly answering child abuse calls);does not apply to exposure through electronic media (television, movies, pictures) unless it’s work related. • (Small, 2011)

3. Posttraumatic Stress Disorder • The essential feature of PTSD is the development of symptoms following exposure to an extreme traumatic stressor. • The response involves intense fear, helplessness, or horror. • Symptoms resulting from exposure to the extreme trauma include persistent re-experiencing of the event. • Persistently avoiding of stimuli associated with the trauma • Persistent symptoms of increased arousal. • Must be present for more than one month. • Must cause significant distress or impairment in social, occupational or other important areas of functioning. • (American Psychiatric Association, 2000)

4. Trauma and PTSD • PTSD is a significant potential negative outcome of trauma exposure. • Not all individuals exposed to trauma develop PTSD. • A growing body of research is showing that the cumulative effects of prior traumas contribute to PTSD symptoms. • Exposure to multiple traumas has been shown to have a stronger effect on subsequent PTSD symptoms than an exposure to one single trauma. • Researchers have also considered the possibility that prior trauma exposure may be a resource for coping with future life stressors. • (Schuster, Park, & Frisman, 2011)

5. Why does PTSD Develop? • Failure to process trauma successfully • Trauma does not fit our understanding of reality. • Causes most people distress and conflict. • An invalidating environment • “It didn’t happen” • Not everyone responds to anxiety the same • Coping mechanisms • (Small, 2011)

6. Posttraumatic Growth • The experience of positive psychological change following highly challenging and traumatic life circumstances. • Relating to others • New possibilities • Personal strength • Spiritual change • Appreciation of life • Posttraumatic Growth tends to help people grow through PTSD. • (Small, 2011)

7. Resiliency • The ability to sustain trauma without developing PTSD • Less likely to see the trauma as a threat to self therefore they are less likely to need to make meaning of a situation. • Many times don’t address the situation. • Tends to be related to certain personal characteristics: optimism, coping, positive affect. • (Small, 2011)

8. Psychological First Aid • Help them decide what type of help they need. • Provide comfort and validation. • Provide information. • Reduce stigma. • Don’t force disclosure. • (Litz, 2004)

9. Discussion Questions • What kind of trauma are you seeing in the homeless population? • What kinds of things can you do on the street that can be helpful to people having symptoms due to a trauma? • How can you improve your personal reactions to hearing some of the trauma people are going through?

10. References American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders- fourth edition- text revision. Arlington, VA: American Psychiatric Association. Litz, B. T. (2004). Early intervention for trauma and traumatic loss. New York, NY: The Guilford Press. Schuster, J., Park, C.L., & Frisman, L. K. (2011). Trauma exposure and ptsd symptoms among homeless mothers: Predicting coping and mental health outcomes. Journal of Social and Clinical Psychology, 30 (8). Small, K. (2011). Cognitive-behavioral approaches to treating ptsd: Empirically based treatment techniques. Brentwood, TN: Cross Country Education.