Hi Healing Tribe! I am excited to have a friend of mine and fellow therapist Alex Michaud on the blog today talking about the relationship between grief and trauma. I love how clearly he emphasizes that grief is not linear, taking the "should" out of one of the most human experiences. You can check him out on Facebook @AlexMichaudCounseling for more on grief healing. 

Hello everyone. My name is Alex Michaud and I’m here to talk to you about how grief and trauma overlap. But first, a special thanks to my good friend Marisa Hughes for letting me take over her blog for this post. Have you checked out her take-over of mine H.E.R.E. Okay, let’s start with a story:

It was a normal, quiet evening at the office. A client and I had been sitting together for 30 minutes already that evening and there was no lack of conversation happening. On this night, however, it wasn’t our exchange of words that caught my attention as being special. Rather it was his decided, momentary pause and deep sigh mid-sentence, atypical for him. He sat there for a second having a deep personal realization:

“You know”, he said. “Sometimes the grief process feels more traumatic than actually losing her”. 

It was a profound statement from a man who normally likes to keep things close to the chest. Fighting tears, he talked about the occasional anguish that he still felt over the loss of his wife and how it caught him off-guard at times — intense and sudden. It wasn’t that her passing wasn’t distressing but he had worked through the initial impact of that. Now came the hard part — learning how to rebuild a life without all of the pieces. 

More conversation followed about the transition through her death and his transition back into life and I couldn’t help but notice the overlap between Trauma and Grief throughout. It made me wonder why we don’t talk about them in the same sentence more often. Thinking back over the years of working with clients who had either experienced a traumatic event or had grieved a loss, there certainly seemed to be a shared link in their processes of healing.

To start understanding their similarities, we can being with a definition. Psychological trauma has been defined in many ways: when an overwhelming amount of stress affects an individual causing them to exceed their emotional resources; a “stuck” process in which an individual has difficulty accommodating or assimilating significant sudden information into their normal world view. Grief often can be described in a similar way — as the deep and conflicting feelings that come as the result of the end of or the change of normal patterns of being. 

Much like my client hinted at above, the process of grieving the loss of someone you love can be intense in itself. Most people are familiar with Elizabeth Kubler-Ross’ “Stages of Grief”: Denial, Anger, Bargaining, Depression and Acceptance. But when it comes time to grieve they often look to this information to inform what their process “should” look like. What most fail to be aware of is how varied the grieving process actually is and how unique it can be day to day. In fact, one of my first questions to clients is “How do you think you are SUPPOSED to do this?”. The answer often has an impact on how they would have grieved alone had they not come to see me, or how we start our work.

Similar to working through trauma, grief is no short process and it looks very different from person to person. With so much variability, how can any therapist really help either group of people? Well, fear not. There are great approaches to help people work through both. If you know Marisa, you probably know that she uses a skill set called EMDR to help guide her trauma-affected clients overcome their challenges. As for me, I use a model called Acceptance and Commitment Therapy to help my grief clients. Here’s a basic view of the model and a little bit about how the steps apply to grief specifically. 

Acceptance is the first principle of Acceptance and Commitment Therapy. The raw process itself is about learning to not avoid feelings and thoughts we judge as “bad” or “negative”. When it comes to grieving, this step can be tough. It means making room in your emotional world for the thoughts and feelings you’re having to exist. We learn to breathe into those feelings and allow them to be what they’re going to be. Often, I see clients really fight this step because they are afraid they’re going to drown under the weight of the emotions — they try many different things to hide from their thoughts and feelings (which only makes them worse in the long run). Acceptance for grief also means forgetting any “rules” you thought there were about how to grieve properly; “I SHOULD be doing this” or “I SHOULD be feeling that”.  Holding on to those rules will only slow down the process. In many ways, this is similar to the Exposure piece of EMDR.

This acceptance is somewhat predicated on being engaged with two other main areas in ACT; Mindfulness and Defusion. 

Mindfulness is being aware of and in-contact with your present moment. To deal with all the thoughts and feelings we’re having, we need to know what they are. For many people this means stopping to be present and, in grief work, to anchor ourselves. When we let our brain latch on to its stream of consciousness it can carry us away like we are being swept out to sea. Stopping to turn our attention toward our general state of being in the present tense can help us feel grounded. 

Defusion is a secondary process of Mindfulness in that it also helps us feel grounded. Defusion is the active process of putting some space between ourselves and our thoughts. Normally, we live a very “first person” life with our thoughts: we “are” the thought: we call that “Self-as-Content”. But by defusing, we can become an observer of our thoughts — i.e. I notice that my thoughts are racing, I notice that I’m having feelings of being overwhelmed. This nonjudgmental process allows us to recognize that we aren’t actually our thoughts but they happen in a larger context of life. This is called “Self-as-Context”. It serves to help us recognize that our thoughts and feelings are manageable.

Values is another key step and living in agreement with our values is the important part. As you’re working through your grief process are you honoring what’s actually important to you? If family togetherness is important to you, are you leaning into that or are you pushing away from them? Doing so will create more psychological friction. 

The Committed Action step is all about moving forward. One of the things I see that keep people stuck in grief (possibly turning it into complicated grief) is a “standing still” or a “moving backwards”. There is much to be learned about ourselves from the grieving process: our true nature, our capacity to love, our range of emotions. Using that information to move forward is extraordinarily helpful. When people shut down and don't engage in these processes or, worse, sabotage themselves it fuels the grief process more. Not only does it not help the grieving process but it means that you’re having to overcome even more during the later parts of the process. 

Much like dealing with trauma, grief work and the secondary trauma that can come requires self-compassion. It works best when we can minimize our amount of unhelpful self-judgement and can maximize our psychological flexibility. The overlap, at this point, seems obvious between the two challenges and I hope that by reading this, you now know a little bit more about how they fit together and how I approach the healing process. 

If you’re engaged in this process now or know someone that it, I would be happy to answer any questions you have. I feel blessed to have been a part of so many grief journeys and would love to be a part of yours, even in some small way. Feel free to reach out to me on Facebook @AlexMichaudCounseling if you want to connect or to follow along.