Grief Counselor on Dealing with Sudden Trauma

Flowers and a teddy bear are placed in front of a plane prior a ceremony to mark the return of the first bodies of passengers and crew killed in the downing of Malaysia Airlines Flight 17, Eindhoven military air base, July 23, 2014.

The sudden downing of Malaysia airlines flight 17 over eastern Ukraine brings into sharp focus an issue that many people in our world have to deal with, sudden, traumatic loss. To find out more about how to deal with that kind of loss and what it can do both physically and psychologically, Now host David Byrd spoke with Ivonne Miranda. She is a child and family therapist at the Wendt Center for Loss and Healing.

BYRD: This airplane crash or downing, however people would like to refer to it is obviously very, very traumatic for the families of those involved. How is a sudden trauma or grief different from someone dying of natural causes, let’s say?

MIRANDA: Well the key component and the most significant difference is the preparation or the anticipation you have of a loss. When you anticipate a loss, there’s ways you can prepare for it but you can’t and don’t have the time opportunity to do when there’s a tragic loss or what we call a traumatic loss. Because you don’t have that preparation and therefore you have to deal with the shock of it all -- to try to cope through it and to try to understand what happened. And so the loss is a little bit complicated. It’s what we call, complicated grief because you have to deal with the event plus all the feelings of the event all of a sudden.

BYRD:Does it affect people psychologically and neurologically, is there actually a neuro-chemical thing that happens in your brain when you suffer sudden loss like this?

MIRANDA: Absolutely. People talk about, you know, traumatic loss as having a huge spectrum of symptomatology they’re both neurobiological, there’s physical and there are emotional. You know people complain of difficulty sleeping. People complain about headaches and stomach aches. People complain about anxiety attacks, panic attacks, or flashbacks. Images just inundate their minds of loved ones and because they don’t know exactly, they were not with them the moment they passed away, they start imagining what that might look like. Depression and sadness are some of the things that are felt. Anger, a lot of people feel anger or confusion, frustration. Another view that often comes is guilt. People feel guilty like, 'is there something that I could have done to prevent this? Is there something I should have said?' You know, it’s a process and everybody goes through it differently. But it definitely, for everybody, has elements of physical and emotional pain.

BYRD: Does this kind of grief take longer to recover from than say someone who dies from a disease that you knew was going to kill them?

MIRANDA: You know our experience at the Wendt Center, traumatic losses are definitely processed and handled very differently than from what we call uncomplicated grief. I think that when you—when people die of natural causes or die and there’s been anticipation of their death and people get the support that they need and are able to establish the resources necessary to feel accompanied through that process. It’s very different from when the loss is sudden and there’s no anticipation of it. It tends to take a little bit longer and the process is definitely different. Like in this case, you know when there are national disasters or public tragedies; it’s hard to grieve when all this is happening. You’re trying to gather information. You’re trying to know what happened and you need to get to a place where you feel a little more of a sense of closure and that doesn’t happen until you get a little bit more information about what occurred. So closure is important, it tends to be delayed in traumatic loss, so that’s why it takes a little bit longer to heal from this kind of grief.

BYRD: What about when the grief is so public and a source of public controversy, what will that do to the grieving process?

MIRANDA: Well you know, we talk a lot about this here in the Wendt center and counselors and therapists who specialize in grief often we debate on this. I think that the public grief is not new, as a phenomenon it’s not new. It’s connecting the loss of a loved one; it’s always something that has happened. And people usually try to access this connection when they go through a loss. However what is different is that media, other media nowadays, it’s different. So I think that it has its pros and its cons. For example, people talk often when they’re dealing with public grief, how supported they feel, how not only their loved ones they have to support them but the world to support them. But I’ve also heard people express how, seeing the tragic event often get played on television can be traumatic and complicate even more their process, the processing of the grief or the processing of the loss. You have to remember that grieving process is different for different people. Some people I think do very well with the attention that they get from the media and some people don’t. I think we just have to be mindful especially in the coverage of the event when we approach those affected and how we do it and to be mindful that this is a trauma and they’re in a very delicate state.

BYRD: Many people had family members who were either waiting for them at Kuala Lumpur or had said goodbye to them in the Netherlands. What is the special problem with people who might have lost children, relatives, boyfriends, girlfriends, partners, etc.? What exactly would you recommend for family members who are affected by this tragedy?

MIRANDA: My recommendation is always to identify resources, where are there resources. You know, definitely seek help. This is something that when it occurs to this sort of exposure, you are confronted by this loss every day. Whether you want it or not, it’s a large scale exposure and my recommendation to anybody going through a loss is not to do it alone: to seek for connection, to seek for support. To let people know what they need. That’s very important. Some people need a little bit more privacy. Some people want the attention and want the support and the outreach, and to definitely reach out, you know? Wendt, who was the creator of our center here, always said that nobody should grieve alone. We really believe that. When we have the support we need, we process the loss much better.

BYRD: And what are the practical steps other than getting support and finding someone to talk to that people can take when they are affected by sudden traumatic grief?

MIRANDA: That’s very important because most people don’t seek help when they go through traumatic loss. The first thing that we need to be mindful of: most people are able to manage and move on from the loss of the tragedy. That’s really important to know that there’s going to be a process and that it takes time. And most people can. And it’s important to think about so the outlook is a hopeful one. Like 'yes, right now I’m in a very difficult place and it’s painful, but this will pass and it’s going to take time and I have to be patient with myself and those around me.' It’s very important to rest and rest well because we know that people who struggle with resting, who don’t care of themselves to the best that they can, have a harder time being able to deal with the emotional components of all this. It is important to reach out to those that we trust and those that we know we are going to be able to hold on to in that moment. It is important to share how we feel and you know, know that what we’re feeling is very real and is very valid. It’s very important that we share our feelings with those that we trust. It’s also important I think, people often talk that in moments like this, the most important thing that they could do for themselves is to get involved with other families that are going through the same thing because they have a shared experience. And when you get together with others that are going through a similar experience, you don’t even having to say much; you're immediately supported. And I think those kinds of things are really important for people, at least in the very beginning to find stability in the presence of this experience.

BYRD: Is there anything I didn’t mention that you think my listeners need to know about this circumstance that will help people cope with sudden traumatic grief?

MIRANDA: Well one, two things. One is that, just for people to remember that we as human beings are very resilient and that we need to trust time, and just give ourselves the time to heal from this thing. Be patient, gentle with ourselves. And the other thing that is really important that I want to mention as a child and family therapist is that we cannot ignore children. Often children are silent grievers and we need to give them a voice or space for them to grieve as well because they often know more than we think, even as much as we try to prevent them from accessing certain information and knowing certain things they do. So we have to definitely give special attention to children and their grief process.

Byrd: That is Ivonne Miranda. She is a child and family therapist at the Wendt Center for Loss and Healing and she spoke to us from here in Washington, DC.