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"No one ever told me that grief felt so much like fear. I am not afraid, but the sensation is like being afraid. The same fluttering in the stomach, the same restlessness, the yawning. I keep on swallowing. At other times it feels like being mildly drunk or concussed. There is a sort of invisible blanket between the world and me. I find it hard to take in what anyone says. Or perhaps, hard to want to take it in.   -   C.S. Lewis, A Grief Observed
 
8 things to think about immediately following a traumatic loss:
  • Start gathering your support system around you. You will want to and need to express strong feelings about what happened and how you feel. It isn't healthy to suppress these urges. Having trusted family and friends around who can listen and share memories will be important now.
  • Have a support member start notifying the people who most need to know. It helps to notify those who can easily contact others for you. Some people will need to be notified in person. 
  • Identify those in your support system who will be responsible for protecting your privacy from the media. You will be approached by reporters. Determine how you will deal with their questions. Decide if you will watch the news coverage or not. You may want to record news for a later time.
  • Try to get some rest and think about your own health. Contact a family doctor, grief counselor, and clergy. Get time off from work if possible. You will be easily distracted. Be very careful driving now. 
  • Do not try to maintain an appearance of false strength. Be honest with others about your feelings. Nobody expects as much from you as you do right now.
  • Know that everyone grieves differently.
  • You will experience physical and emotional symptoms of grief beyond your control. Be prepared for them. 
  • Try to eat, get rest and even walk a bit if possible. 
  • Don't let people take advantage of you now.
Funeral arrangements will need to made soon. Religious observances may need to be communicated to the authorities and those handling the body of your loved one as soon as possible.  Be sensitive to the input of those closest to your loved one when making arrangements, but keep the number of decisions to a minimum.  
 
Talk to the police further.
 
Other difficult things you may be called upon to do: 
Identifying the body will be emotionally difficult. Have someone go with you.
 
If you are a witness, police and others may need to question you.
 
Make priorities for what is most important right now and don't do less important things. 
 
You may need to reclaim personal belongings.
 
Dealing with other legal matters related to the death: 
The funeral director will obtain the death certificate and help you determine how many copies to ask for.
If a will exists, locate it immediately.
Begin dealing with the associated costs of the death.
Begin filing insurance and other related claims.
Don't make life-changing decisions right away or without consulting with a trusted person.
You may want to consider a memorial gift or request contributions in your loved one's memory. 
 
(Excerpts from What to Do When The Police Leave: A Guide for the First Days of Traumatic Loss by Bill Jenkins) 
 
Whenever someone receives news of a sudden and tragic loss the body responds physically and emotionally. You body goes through automatic changes in order to enable you to cope with the trauma. These responses happen automatically which means that it may feel out of your control, which may be scary if you don't know that it is normal. Most happen to others some may only happen to you. Some responses last for a short time and others for a longer time. Some occur one at a time and others all at once. 
 
Many professionals agree that there may be 5 responses that often accompany traumatic loss:
  • Shock
  • Disbelief or Denial
  • Anger
  • Guilt
  • Acknowledgement or acceptance ( I know that some have shared with me that they will never accept that this terrible thing happened but they will acknowledge it). Words are very powerful at this time especially.
Please don't push yourself to move faster than you already are going. You will probably not have the strength to do certain things at this time, so don't. If you have to do something enlist help from a trusted person. Your mind and body are slowly adjusting to the reality of this tragedy.
 
Many talk about an intense yearning for their loved one. You may have an overwhelming feeling of wanting and needing them back, even if for one brief moment. Many share how they expect them to call, walk through the door at anytime. Joan Didion who wrote the Year of Magical Thinking (following the sudden death of her husband) kept his shoes by the front door knowing that at any moment he would walk through the front door and need his shoes.You may call out to them, have dreams of them or have nightmares. You may decide to not touch any of their things. Please take your time if you can on big decisions.  Don't allow others to tell you what you should do. So many have shared with me (myself included) that they removed all of the loved one's clothing immediately at the prompting of "helpful friends and family" only to later on regret having done so. 
 
Many talk about anger at the world. Some feel angry at the person they feel may have been responsible, even if it seems illogical. We want to blame someone for this tragedy. We may blame loved ones, our selves, God, the doctor, the funeral director and even those who are trying to help.  Anger can be a very normal and natural response to loss, especially traumatic loss. You had no control over what happened.  Please try not to let your anger destroy you. Don't allow yourself to engage in violence. Find healthy ways to express your anger and even rage. Find constructive ways to get it out. Some smash a tennis ball against a wall, punch a punching bag, shoot baskets, run, walk, bike, chop wood, fix things around the house, yell and scream, cry, talk about it, write about it, create something lasting to remember the person, and get involved in a cause, are a few of the things that grievers have shared with me.  
 
You are not going crazy. You are in mourning. In a moment our entire life has changed. It will never be the same as it was before this traumatic and sudden loss. So many talk about trying to "get back to normal". I find that we have to accept the fact that we will be living a "new normal". Others around us may want us to get back to the way we used to be. But we have changed. Many things in our life seem different. Some drop those who are not helpful in their lives, while others expand their circle to include more and more people. We do remember those who "let us grieve" in our own ways and in our own time without casting judgement. Some want us to "get over it" and "move one". That feels impossible. As one woman shared with me following the sudden death of her son," don't they know that each and every day that I wake up I am moving on...and it is agonizing for me to move on without him."  Many share that they feel that their legs are lead weights after a sudden loss. They can't move. They have difficulty swallowing. They feel exhausted in a way never imagined. They are grieving. 

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Post Traumatic Stress Disorder 
 
80% of all people who survive a traumatic event will have a normal recovery without any form of psychological intervention. 
Lack of power and control are two of the most devastating aspects of psychological trauma. Anytime a person has experienced a trauma it is best to hold that person's individual power to decide the way in which they choose to heal. Some people will choose not to verbally process the event at all, while others may choose to talk about it one to one or with intimate friends and family. Some may seek peace through prayer, while others may turn to such techniques as music, arts, poetry, writing, and other ways. Some will need to share their story in order to heal. They will need others to truly listen and bear witness to their experience. ''
 
Only after a person feels safe and stabilized will that person begin to process their experience.  
 
The following are normal stress reactions and responses to a traumatic event typically lasting 30 days or less. If they continue it is suggested that the person seeks clinical treatment).
  • Hyper-arousal:  hypervigilant behavior, heightened startle response, being easily triggered by things that remind person of the trauma, irritability, and repeating behaviors that are associated with the most disturbing aspect of the trauma. Often these behaviors continue even if the person is now safe, but they don't perceive that they are safe yet. 
  • Intrusive thoughts and images:  Often people will share that they feel that they re-experience the event. This reaction is one of the most common with PTSD. The survivor experiences the event over and over again for hours, days and even weeks. Often along with this are sleep disturbances, nightmares, intrusive thoughts, memories or disturbing images of the event.  
  • Shattered assumptions: Often four basic assumptions are shattered: "I am safe", "I am in control", "Bad things happen to others but not to me" and "I am worthy and my life has meaning". Instead survivors may feel, they are not safe, they are not in control, bad things can happen to me and they can happen again and finally I must deserve this as I must have done something wrong.
  • Numbing and Avoidance: We want to avoid anything that reminds us of the trauma. We may avoid thoughts, emotions, or places connected with the event. We may pull away from people, feel spaced out and forgetful, be depressed or show very little emotion and sometimes even not recognize current threats and risks and wind up in dangerous or engage in risk taking behaviors. 
Maladaptive Responses to Trauma 
 
Smoking
Alcohol Abuse 
Substance Abuse
Eating disorders 
Arrests
Violence
Early sexual intercourse and pregnancy
Unprotected sex and STD's
Refusing treatment for depression and anxiety
Suicide attempts and completions 
 
 
Symptoms of Traumatic Stress:
  • Physical:  fatigue, exhaustion, sleep disturbances, hyper-arousal, appetite changes, digestive issues, headaches, nausea, muscles aches
  • Emotional: fear and guilt, numbness, anxiety, depression, anger, helplessness, irritability, frustration
  • Behavioral: withdrawal, outbursts, hyper alert, change in activity, suspiciousness, startle reaction increases,
  • Cognitive: flashbacks, difficulty with problem solving, change in alertness, amnesia/confusion, decreased concentration, difficulty making decisions, memory disturbances.

 
Carl and Stephanie Simonton provide the following formula for an effective support system:
 
25% self-support
20% spouse support
55% environmental support
 
Few of us have so complete a support system. Relying too much on spouse support often places a great strain on marriages. Relying too much on a spouse or other person alone may prevent us from developing the coping skills we need. 
 
 
Environmental Supports  
(the more people and activities we have in our lives the more expanded and useful our support system)
 
People:
  • Intimates
  • Family
  • Friends
  • Neighbors
  • Colleagues
  • Family Physician
  • Health Care Professionals
  • Psychologists/counselors
  • Clergy
  • Lawyer
  • Insurance Agent
  • Funeral Director
  • Local businesspeople
Other:
  • Job or job change or guidance
  • Volunteer work
  • Clubs
  • pets
  • travel
  • art
  • music
  • dance
  • massage
  • bereavement groups
  • other self help groups
  • reading books
  • sports
  • prayer
  • meditation
  • adult community college courses 

 At some of the darkest moments in my life, some people I thought of as friends deserted me-some because they cared about me and it hurt them to see me in pain; others because I reminded them of their own vulnerability, and that was more than they could handle. But real friends overcame their discomfort and came to sit with me. If they had not words to make me feel better, they sat in silence (much better than saying, "You'll get over it," or "It's not so bad; others have it worse") and I loved them for it.

- Harold Kushner, Living a Life that Matters

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