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Wednesday, May 03, 2006

Coping Tips Following a Traumatic Loss

The DOD's Deployment Health and Clinical Center website makes information available to help troops deal with what they call 'operational stress'. Their Stress and Trauma factsheet lists possible reactions to stress, what to expect as recovery continues, suggested post-trauma do's and don'ts, and what to do about flashbacks. Today I'll share the closing topic with you: coping with bereavement.

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From the DOD's Stress and Trauma factsheet:

Coping With Bereavement

The loss of someone close, especially as a casualty during deployment or war, is one of life's most stressful events. It can leave you so numb that you have difficulty recognizing the reality of death or coping with its impact on your life.

Even so, you're forced to deal with ideas that cause a great deal of pain. We know, for example, that a refusal to acknowledge "the facts of death" is a disservice to the dying and the living alike, but doing so forces the acknowledgment of how real this situation is, and it hurts.

This fact sheet was not created to make the pain go away--unfortunately, nothing can do that for you--but to help you understand the intense emotions you're experiencing or are going to soon feel.

Background
Bereavement literally means "being deprived by death." It describes a process all people go through when someone close dies. Each person experiences this process differently, but there are some characteristics common to most instances of bereavement:

It doesn't progress in an orderly fashion.
You probably won't find yourself moving systematically from one well-defined stage to another. Instead, you'll probably drift back and forth from what might best be described as overlapping, fluid phases of anger, denial and acceptance.

It involves emotions and behavior that wouldn't be described as normal under other circumstances.
While some people benefit from professional help to cope with their grief, you shouldn't automatically interpret emotions or acts as a sign that you're losing your sanity.

It's frequently complicated.
The initial numbness makes the later physical and emotional upheaval all the more frightening, or seem a sign of weakness but it is not. Grieving is a healthy, necessary process, and refusing to grieve may postpone inevitable reactions that build up into later crises.

By design, bereavement is self-centered.

You need all your energy to cope with your emotions. Resist the inclination to put your own needs aside in an effort to meet those of your family; a healthier idea would be to secure outside support and guidance from a mental health professional.


The Experience Of Normal Grief

Feelings - sadness, anger, guilt, anxiety, loneliness, helplessness, hopelessness, shock, yearning, relief, and numbness.

Physical Sensations - hollowness in stomach, tightness in the chest, tightness in the throat, oversensitivity to noise, a sense of depersonalization, feeling short of breath, weakness in the muscles, lack of energy, dry mouth, and fatigue.

Cognitions
- disbelief, confusion, preoccupation, sense of presence, hallucinations, and dreams about the deceased.

Behavior - sleep disturbance, appetite disturbance, social withdrawal, absent-minded behavior, avoiding or seeking out reminders of the deceased, sighing, restlessness, crying, and visiting places or carrying objects that remind the survivor of the deceased.


Phases

1. Numbness
2. Yearning
3. Disorganization and Despair
4. Reorganized Behavior


What Helps?

Effective coping with bereavement really depends on your ability to mourn properly. When a loved one dies, there are many things which will help you cope better with the pain. Some examples include:

People who care.
Family, friends, neighbors, colleagues, and strangers in a mutual support group who have "been there" can all offer support. A lifetime habit of close, caring relationships is the best possible preparation for bereavement.

Understand the "facts of death."
This is a particularly important in time of war. Knowing what to expect and knowing your options helps. Express your feelings--talk, be angry, weep. You are not alone; all grieving people need such outlets.

Reach out for help.
Others cannot always make the first move. They may be afraid of intruding on your privacy. Make your needs known. Seeking out a mutual support group in your community is a great first step.

Keep in touch with your physician.
Following your physician's advice can help you deal with physical side effects.

Accept the inevitable.
Some things in life, and certainly in war, have no basis in logic; they just happen. Accepting this can prevent much bitterness and self-blame.

Don't rush into major life changes.
Moving, changing jobs, or remarrying are too important to rush. This is no time to make major decisions. Your judgement may be poor and the changes are only likely to add to your stress. Wait a year. Make big decisions then. Introduce new relationships gradually and carefully--let them grow.

If you find yourself in need of more assistance than friends and family can provide, contact your clergyperson or your physician. Your local Mental Health Association can also help you find the support you need.


How To Help Those You Care About

  • Understand that emotional consequences follow a traumatic experience

  • Don't expect that the person you care about will "get better" in a certain amount or time or in a certain way. Sometimes recovery is a long and difficult process. If the person requires more time than you expected, you may feel frustrated or even angry.

  • Tell the survivor how you feel: that you are sorry they have been hurt.

  • Encourage the survivor to talk to you about how they feel. When they do, listen without interrupting or making judgements about what you hear. All survivor's feelings are ok even if you might not feel the same way.

  • Remind the survivor that their confusing emotions are normal.

  • DO NOT attempt to impose your explanation on why this has happened to the survivor. It probably won't be the explanation the survivor believes and imposing your view might hurt your relationship with them.

  • DO NOT tell the survivor, "I know how you feel" or "Everything will be all right." Often, these statements are really efforts to relieve your own anxiety about how you feel about what has happened to the survivor. Survivors say that when they hear these statements they thing that people do not care about or understand them.

  • Go to any court hearings, community meetings or other appointments that relate to the trauma. This is an important way to provide support to the survivor.

  • Be willing to say nothing. Just being there is often all that you can do to help.

  • Don't be afraid to encourage a survivor to ask for help in the form of post-trauma counseling. You might even go to the first appointment to show your support and concern.
Take a look at the entire factsheet; lots of good information contained in it.

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