Understanding Traumatic Grief: A Collision of Loss and Trauma

Grief is a natural reaction to loss, but it doesn’t follow the same path for everyone. When a death is sudden, violent, or deeply shocking, it can lead to what is known as traumatic grief - a complex collision of intense mourning and psychological trauma. Unlike more expected or gradual losses, traumatic grief can shatter a person’s sense of safety and overwhelm their ability to emotionally process what has happened. In addition, while the emotional and mental effects of grief have received significant attention, its profound impact on physical health is an equally important but often overlooked aspect. Understanding the nature of traumatic grief is essential to supporting those who experience it, and to providing appropriate care that acknowledges the depth of their pain.

What Is Traumatic Grief?

Traumatic grief occurs when the emotional impact of loss is compounded by trauma-related symptoms that overwhelm a person’s ability to cope. It's often part of the "fight or flight" response, where the brain struggles to process the situation and temporarily shuts down to protect itself. This can happen after a death that is unexpected, violent, or profoundly distressing, such as the loss of a loved one to homicide, suicide, accident, war, or medical negligence. It can also occur when the relationship with the deceased was exceptionally close or when the mourner was present during a painful or chaotic dying process. In these cases, the mind and body may react not only with sorrow but also with trauma responses such as dissociation, flashbacks, panic attacks, or hypervigilance.

How It Differs from 'Non-Traumatic' Grief

While acute grief is painful and disorienting, most people gradually adjust over time, finding ways to integrate the loss into their lives. In traumatic grief, however, the mourning process becomes complicated or stalled. People may become stuck in the moment of the death, replaying it over and over. They might avoid reminders of the person or the event, or they may feel numb and disconnected. Sleep problems, nightmares, anxiety, and feelings of guilt or self-blame are common. Unlike 'non-traumatic' grief, which can ebb and flow, traumatic grief often remains consistently raw and intrusive, even years later. The typical 'grief waves' may not be present and an inability to cry is common.

Indeed, while grief is often associated with visible expressions of sorrow - especially crying - traumatic grief can disrupt this emotional process. Some individuals find themselves unable to cry at all, even when they experience profound inner distress. This absence of tears doesn't mean the grief is less real or less profound. Instead, it can reflect the overwhelming nature of the trauma, which may leave a person emotionally numb or frozen. The shock of the loss, particularly if sudden, violent, or deeply destabilizing, can shut down the body’s natural ability to release emotions. In these cases, the inability to cry may be a protective response; a way the nervous system attempts to manage the unbearable. However, this emotional blockage can be deeply distressing, creating a sense of disconnection or guilt, as if something essential is missing from the mourning process. Recognizing that grief expresses itself in many forms - some visible, some silent (even in 'non-traumatic' grief) - is an important step toward (self) compassion and healing.

Psychological Impact

Traumatic grief can affect every domain of a person’s functioning. Emotionally, it's associated with depression, anxiety, and post-traumatic stress disorder (PTSD). Cognitively, individuals may struggle with concentration, memory, or decision-making. It can also significantly impact an individual's experience of time. This can manifest as a distorted time perception where a person cannot accurately estimate the amount of time that has passed. Socially, they may isolate themselves or feel misunderstood by others. Common symptoms include intrusive thoughts or images of the deceased; intense yearning or longing; avoidance of reminders of the loss; emotional numbness or detachment (dissociation); profound rumination; difficulty accepting the reality of the death; guilt, self-blame, or feelings of worthlessness. There may also be an intense preoccupation with the circumstances surrounding the death, ruminating on details of how the loss occurred, and finding it difficult to shift focus away from these thoughts. Unlike 'non-traumatic' grief, which gradually lessens over time, traumatic grief can persist for months or years and may even worsen.

Physical Impact

Traumatic grief can significantly impact physical health by triggering prolonged stress responses that disrupt the body’s balance and compromise its functioning. Common consequences include sleep disturbances, fatigue, and a suppressed immune system, making individuals more vulnerable to illness. The cardiovascular system is particularly affected, with increased risks of heart attacks, strokes, and stress-induced cardiomyopathy (“broken heart syndrome”). Grief can also lead to gastrointestinal issues such as appetite changes, and digestive problems due to stress hormones like cortisol. Additionally, traumatic grief can result in chronic pain, with emotional distress manifesting as somatic symptoms that can persist and diminish overall quality of life.

Risk Factors

Not everyone who experiences a traumatic death will develop traumatic grief. Risk factors include prior trauma, a history of mental illness, limited social support, a lack of opportunity to say goodbye, or perform meaningful rituals. Cultural or societal factors such as stigma around the death (e.g. suicide) or lack of recognition of the loss can further complicate the mourning process (as in 'disenfranchised grief', i.e. grief that is not, or cannot be, openly acknowledged, socially validated, or publicly mourned). Survivors who feel guilt or responsibility for the death may struggle with intense self-blame, especially when the loss is socially unacknowledged or stigmatized. Multiple losses in a short period can further compound grief and heighten the risk of traumatic stress.

Paths to Healing

Healing from traumatic grief requires more than time; it requires safety, validation, and often professional support. Trauma-informed therapy, such as EMDR (Eye Movement Desensitization and Reprocessing), somatic therapies, and grief counseling, can help individuals process the trauma while also working through the layers of grief. Importantly, trauma and grief must be addressed together; treating one without the other often leads to incomplete healing. It's also crucial to monitor physical health, employ stress reduction techniques such as mindfulness and exercise, and establish strong social support networks. Indeed, support groups, rituals, and storytelling can provide community and meaning. Kind, patient, and compassionate care is essential. This also includes acknowledging the uniqueness of each person’s loss, and that there is no timeline for grief, and no “correct” way to mourn. Acknowledging the reality of traumatic grief, rather than dismissing or pathologizing it, is essential for supporting individuals in their journey toward healing and integration.

Conclusion

Traumatic grief is a profound and painful disruption of the mourning process caused by a death that overwhelms the emotional system. It touches every aspect of a person’s life and often requires specialized, trauma-informed care. By understanding what traumatic grief is, how it differs from other forms of bereavement, and what support is needed, we can create more compassionate spaces for healing and recovery. In doing so, we honour not only the loss that was endured but also the resilience of those who carry it. Recognizing the signs of traumatic grief and integrating trauma informed therapy, and physical health care into bereavement support, can lead to better outcomes and, ultimately, a healthier process of healing and forward movement.

If this is something you’ve been affected by, please leave a comment below. If there’s something important you’d like to add, please do so. I'd love to hear from you.

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Dr. Ingela Thuné-Boyle is a licensed Practitioner Health Psychologist and a Doctor in Behavioural Medicine who specializes in stress and loss, especially in improving the quality of life of people struggling with long-term health problems, chronic pain and (medical) trauma. She runs a private online (telehealth) practice at www.ingelathuneboyle.com.

Please note: Advice given in this blog is not meant to take the place of therapy or any other professional advice. The opinions and views offered by the author is not intended to treat or diagnose, nor is it intended to replace the treatment and care that you may be receiving from a licensed physician or mental health provider. The author is not responsible for the outcome or results following their information and advice on this blog.