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Did you know there have been many recent advances in the effective treatment of traumatic grief that have not been featured in the mainstream literature?
Well, I’ve been working feverishly over the last six months to put these together in a book I’ve written called, Transforming Traumatic Grief: Six Steps to Move from Grief to Peace after the Sudden or Violent Death of a Loved One.
My motivation to write the book initially grew out of my excitement about the trauma and grief interventions I’d learned through Jon Connelly’s Rapid Resolution Therapy. Dr. Connelly helped me with my own traumatic grief several years ago and I’ve had phenomenal success using his approach with my clients over the last four years.
I grew even more excited as I began to research other methods for clearing grief and found they paralleled what I learned from Dr. Connelly. For instance, Columbia professor of psychiatry, Katherine Shear has developed an empirically validated model for treating complicated grief that was featured in the Journal of the American Medical Association (JAMA) that includes a protocol for reprocessing traumatic memories and having an imaginal conversation with the deceased. Similarly, Seattle psychiatrist, Ted Rynearson has a very effective model for helping families of homicide victims called Restorative Retelling that he’s been using for years.
In the book, I put together interventions that these successful models have in common along with other tools like mindfulness and community resources that help people heal. The book is written for both the bereaved as well as the people who help them such as therapists and clergy. In it you will find:
- Mindfulness and imagery scripts that promote healing
- Methods to stop nightmares and intrusive images/thoughts
- How to clear guilt/regrets and foster resilience from loss
- The value of connecting to “the living story” of the deceased and sensing them as a supportive presence in one’s life
- Ways to obtain social support through family, community, and online resources
Currently, you can get PDF and e-book versions of the book at Smashwords.com where I can offer you a 20% discount through 5/30/11. To get your discount, use the code: ST98L. I will also be donating 10% of the proceeds to the American Red Cross to help those negatively impacted by the tornadoes and storms in the southeast last week.
If you prefer paperback over digital, you will be able to get a print version of the book this June through Amazon.com and other online book retailers.
Over the next several weeks, I’ll continue sharing excerpts from the book here on the blog. We’ll be discussing big changes in the field of grief and trauma therapy as well as tools that promote peace and healing. Please join us in the discussion!
Photo Credit Department of the Army
Last week, I had the honor of working with a courageous Iraq war combat veteran who sustained a traumatic brain injury (TBI) in the war and suffered severe flashbacks.
He asked if Rapid Resolution Therapy (RRT) would work for him, given the TBI. While I told him I was not sure how the TBI would impact things, I was sure we could clear the impact of the trauma. I reassured him that he’d already completed the hard part by surviving the war. He laughed and agreed that meeting with me could not be any worse than what he’d already experienced in combat.
When the soldier arrived at my office, he had a service dog with him, which led me to think he had a visual impairment. So, I offered to fill out the paperwork for him as he verbally gave me his answers. The soldier laughed and said,
“I can see just fine. My service dog accompanies me because my flashbacks have been so bad. When I have a flashback, my dog walks in a circle around me clearing the area to protect me and other people. Then, he licks my face and helps me wake up and come back to the present time and place.”
Wow. I was totally impressed with him and his dog, and it motivated me even more to free this guy up of those flashbacks. He told me he’d not been allowed to drive due to the flashbacks, and really wanted his freedom back. Here this guy dedicates his life to fighting for our freedom, and now this PTSD had imprisoned him. I was totally dedicated to this mission to fight for his freedom now.
We cleared his trauma in just under 2 hours. Though the TBI caused him to have some delay in his speech and thought process at times, he had a wonderful sense of humor and a keen intellect. His favorite part of RRT was the “goat and the snowflake” story (see this post for an explanation).
Upon hearing this story and playing the “pants” game to help him stay present, the soldier quickly realized that the horrific images were just images now, and the events were no longer in existence. We only had to discuss one event in detail, and he was able to apply the same concept to the other traumatic events he had experienced. I watched in amazement as he smiled and said, “Yes, there is no IED exploding. It no longer exists. My commanding officer is okay now and is not pinned under that truck. I am not getting shot at this moment. There are no piles of beheaded bodies that I have to clean up anymore. Those guys left their bodies and they are at peace now.”
Three days after our session, I gave him a follow-up call. He said, “I feel great. I have not had any flashbacks, even when my kids were screaming or I heard a loud noise. I have been driving again. I am able to imagine being on the beach watching the cranes when I feel stress and it immediately calms me. I am free again.”
I thanked this brave soldier for his service and we celebrated his return to freedom! You do not have to be imprisoned by trauma or your past. There is a way to return to freedom and reclaim your life.
Courtney Armstrong is a Licensed Professional Counselor as well as a Master Practitioner and Associate Trainer in Rapid Resolution Therapy. She has a private counseling practice in Chattanooga, TN where she specializes in treating trauma, anxiety, and grief. To contact Courtney, click here. To learn more about Rapid Resolution Therapy, click here.
photo courtesy of Cliff1066 via flickr
Recently, a client made this most insightful and delightful comment:
Courtney, you’ve really helped me overcome my childhood abuse. I’ve worked with a lot of therapists over the years and I now realize I didn’t want sympathy. I wanted a TROPHY- I mean a BIG Wimbledon-sized trophy and some applause. I’ve just wanted to hear someone say ‘Well done! That was a tough journey and you made it! That was quite an accomplishment, good for you.’
Her comment is something to which all therapists should pay attention. Most therapists were taught the way to help an adult heal from physical, sexual, or emotional abuse is to sanction the client’s status as a “victim-survivor.” Then the next steps in therapy might be to show a lot sympathy as you encourage the client to re-live the event over and over again to get “repressed feelings” out. After that, the therapist might urge the client to confront her abuser and do a lot of imagery and letter-writing to comfort her inner child. While all these approaches are certainly well-intentioned, I find they just keep people stuck.
I learned through my training from Jon Connelly’s Rapid Resolution Therapy to take a different attitude. With RRT, we acknowledge the painful impression a traumatic event may have left on a person’s psyche. But, then we are interested in revising this impression by making less of a big deal about the event itself, and instead, make a big deal about the client’s fortitude and resilience in surviving the darn thing! We encourage them to view themselves as heroes, realizing that not only are they still valuable and whole, but they are also wiser, stronger, and more compassionate. This is a far more accurate view of the situation and far more therapeutic for clients. Using this view, clients walk out of my office literally standing taller and smiling.
This particular client who made the “trophy” comment said in the past she had been thinking the way to heal was to forgive herself, forgive her father, and hope that one day he would show her the love and respect she’d been craving. After our work together, she was able to realize her father was just limited emotionally and interpersonally and that it was not her fault. We compared her father to the wizard in the Wizard of Oz. She had finally pulled back the curtain to see he was not so big and powerful, but a frail old man who was trying to keep the facade going. She’d been waiting for him to give her a “medal,” like the wizard hands out to Dorothy and her friends at the end of the story. Now, the story ends with my client realizing the wizard is too weak and preoccupied to hand out medals, so she decides to pick up the bag of medals herself and hand them out as she sees fit.
Recently in the media, there has been so much focus on horror and destruction around our world. Seeing such images over and over again can make us feel helpless. But, aren’t you more uplifted, inspired, and motivated when you hear stories of how people are helping one another, creatively surviving, and coming up with innovative ways to get through these tragedies? Let’s change our focus to where we can be resilient and creative in the face of adversity. Let’s start a new movement. Please share your “hero” stories here!
Just want to honor single folks on Valentine’s day, acknowledging the gifts of being alone and enjoying one’s own company. This film by Andrea Dorfman featuring poet/songwriter Tanya Davis is absolutely beautiful and uplifting!
photo courtesy of oddsock via flickr
Need more incentive to meditate? A recent study headed by Sara Lazar and colleagues at Massachusetts General Hospital documented measurable changes in brain regions associated with memory, empathy, and stress after just 8 weeks of daily meditation practice.
More specifically, the MR images showed increased grey-matter density in the hippocampus, known to be important for learning and memory, and decreased grey-matter density in the amygdala, known for its role in fear conditioning and stress. This has strong implications for utilizing mindfulness meditation in treating trauma, as people with PTSD have been shown to have reduced volume of the hippocampus and larger volume in the amygdala area of their brains, making them more prone to anxiety and memory problems. Could a trauma survivor reverse this through regular practice of mindfulness meditation?
In this study, the participants demonstrated brain changes after only 8 weeks of attending a weekly mindfulness meditation class and practicing meditation at home for an average of 27 minutes a day. Lazar and others had published previous studies that demonstrated experienced meditators appeared to have thicker areas of the middle pre-frontal cortex, an area associated with empathy, emotional regulation, and attunement to others. Yet those studies could not prove that these differences were actually produced by meditation. In contrast, the participants in this study had no prior meditation practice and therefore the researchers were able to surmise the measurable structural brain changes were associated with daily practice of meditation. Moreover, this study included a control group that did not meditate and did not show any changes in the study’s pre and post tests.
In my opinion, this study provides further evidence that integrating mindfulness practices into treatment for anxiety, PTSD, and other trauma related problems is a good idea. Traditionally, research has indicated practicing meditation at least 20 minutes per day produces measurable benefits within 2-3 months. To give people even more incentive, I am offering a free 20 minute Mindful Relaxation audio download on my website, get it by clicking here.
To read the full article, refer to: Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Research: Neuroimaging, 2011; 191 (1): 36; authors: Britta K. Hölzel, James Carmody, Mark Vangel, Christina Congleton, Sita M. Yerramsetti, Tim Gard, Sara W. Lazar.
I greatly appreciated Jon Stewart’s touching and honest commentary regarding the impact the Arizona shooting had on our country.
Although people are tempted to blame politicians, let’s not make this a political event. As Stewart says, “You can’t outsmart crazy. You don’t know what a troubled mind will get caught on,” and Jared Loughner clearly has a troubled mind.
Let’s keep this thing in perspective. Let’s put our energy into things that would be of benefit to those who were harmed by this tragedy, rather than waste energy churning anger and blame. Let’s focus on the acts of heroic kindness witnessed during this event that are a testament to the unity of the human spirit, rather than focus on things that divide people.
Watch this witty and poignant talk by Brené Brown, a University of Houston professor who studies human connection. She found those who are happiest in relationships are those who are willing to feel vulnerable and admit that they are imperfect.
Thanks to my friend Linda Graham, LPC for sharing this video.
photo courtesy of nieve44 laluza flickr
How do you get through traumatic grief around the holidays, especially if a holiday marks the anniversary of a traumatic loss? Below are some ways that others have found to deal with their grief and ease the pain this time of year.
1. Alter your traditions- Sometimes it helps to do something different, even if it is just one thing, to shift the focus off the loss. I’ve known families who have decided to go away to the beach or some other place that has fewer associations with the loss. Others want to keep old traditions, but may just change them up slightly, signifying a fresh start.
2. Special tributes- One way to alter your tradition may actually be to include some sort of special tribute to your loved one during the holiday get togethers. You might light a special candle in honor of your loved one at the holiday table. Or, you may give people the opportunity to share special memories of your loved one verbally or in writing. You may just have a moment of silence to remember that person at some point in the day. A special tribute is not meant to highlight the loss, but rather to honor your loved one and affirm their presence with you through this holiday season.
3. Give yourself alone time- Grief can zap you of energy, so its important to plan some alone time time to rest. You do not have to attend every event, or endure the duration of each event. Find a balance between solitude and socializing.
4. Let others know its okay to talk about your loved one- Many people avoid mentioning the name or any memories of the deceased for fear it will be awkward or painful. But, most people enjoy hearing stories about their loved ones. Let people know, and reassure them if it is okay to openly talk about your loved one.
5. Attend special services or support groups in your community or online- More people are recognizing the value of having special services to honor those we’ve lost and support those who are grieving this time of year. On this blog, I’ve written about Blue Christmas services that many churches are now offering. If there is no such service in your community, perhaps you can get a small group of family members or friends to create one yourselves.
6. Remember it is just one day- The anticipation of a holiday or anniversary is often worse than the actual day itself. Remember this is just one day, one week, one season. You do not have to relive your loss or dive headlong into your grief on this day to prove how much you loved someone who has died. Instead use this time to acknowledge your gratitude for having known the person and find ways to affirm their presence with you throughout the season.
Take care and be well.
photo courtesy of alice popkorn flickr
Our culture tends to pressure people to use the holidays as a time of merriment and celebration. But, for many, the holidays can be a source of pain, stress, and grief. Therefore, many communities are including “Blue Christmas” services into the holiday season activities. These services are usually held on the night of the winter solstice, as it is the the longest night of the year. This year’s solstice falls on December 21st.
Far from depressing, Blue Christmas services give people an outlet for sadness and grief, while gently fostering hope for the future. Many people who have attended Blue Christmas services say the service helps ease their pain because they receive support and realize they are not alone.
My friend Lisa Kendall recently shared a blog post that Pastor Chris Owens wrote about the Blue Christmas service at his church. Pastor Owens commented, “It’s a quiet, reflective time of prayer, sharing, and singing meaningful songs of faith that are not loud and rapturous but tender and soothing… I could see the weight of unacknowledged grief coming off of our shoulders and peoples’ tears flowing steadily and unhindered. You could sense the release and freedom in that time of worship.”
Similarly, pastor, DeBorah Barnwell, started Blue Christmas services at her church in Virginia Beach several years ago. Pastor Barnwell said the service is not only for people grieving the loss of a loved one, but also for people who are struggling with illness, mourning a job loss, dealing with divorce, or just feeling down. The service also welcomes families separated by military deployment.
Four candles are often lit in these ceremonies: 1) One candle is lit for those who have passed, giving thanks to the memory that connects them to us this season; 2) One candle is lit to redeem the pain of the loss; 3) One candle is lit to honor ourselves; and, 4) One candle is lit for the gift of faith and hope symbolized in the Christmas story.
I am grateful more communities are offering these Blue Christmas ceremonies. Such services give us a way to honor our loved ones who have passed and feel more connected. In my opinion, ceremonies that can help us keep perspective and allow some quiet reflection time are so needed at this time of year. The richness and depth of the holiday season can get missed if we’re too busy trying to keep up with parties and gift exchanges.
Take care of yourself this season. Celebrate it in a way that makes sense and is special to you.
photo courtesy of Pseudo Victor via Flickr
Watching the rescue of the Chilean mine workers was such an emotional event for many. Now people are wondering if the miners will continue to be okay, or are they at risk for developing post-traumatic stress disorder?
Several experts around the world are weighing in on this issue, and they are actually quite optimistic the majority of the miners will return to their daily lives without any emotional fallout. Dr. George Bonanno, who was featured in my last post on grief, did an interview with Discovery news noting that most people recover from traumatic events without any PTSD symptoms. He says, “I believe we’re innately wired to handle these events.” In his long-term studies, Dr. Bonanno observed that most people are exposed to at least one traumatic event during their lifetime, yet only 30% of people actually develop PTSD.
What factors seem to keep people from developing PTSD after a traumatic event? The data is not fully clear on this, but it seems people who develop PTSD are those who feel incredibly unprepared and helpless during the traumatic event. People who develop PTSD also tend to lack social support during or after the trauma, leaving them feeling more isolated, helpless, and misunderstood.
Because the Chilean mine workers knew the risks of their profession, experts opine they may have felt more prepared to deal with this event than say, a group of visitors to the mine. In addition, the 33 miners engaged in active social support. Discovery news reported that the men sat in a circle every day and talked about their feelings. During the event, the miners also had some access to food, water, and contact with the outside world. After the event, they were welcomed with celebration, love, and support, providing further buffers from developing post-traumatic stress.
While the news is optimistic, the mine workers may still have some reactions as a result of the traumatic experience. For example, they may find they are not as eager to jump down into a mine. Or, they may notice feelings of apprehension when they experience certain smells, sounds, or other sensory associations from the event.
In my work with trauma survivors, I’ve noticed that many may not have the full blown diagnostic criteria for PTSD. However, they can still encounter feelings of dread, anxiety, and exaggerated responses upon encountering reminders of the traumatic event. The survival oriented part of our brain has a tendency to encode certain sensory data from the experience and tag it as a sign of something potentially dangerous. While the process is meant to alert and protect us from future trauma, it can interfere with our lives when this part of the mind confuses similar and same.
Overall, I think the Chilean mine workers will be okay and I applaud their courage.While I agree with Dr. Bonanno that we are wired for resilience, I’ve observed that sometimes our wires get crossed up! Fortunately, trauma treatments like Rapid Resolution Therapy can help you straighten them back out. So, even for those who develop PTSD, the news is still optimistic that you can recover and live a full life.
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