Under Construction
As a way of starting the discussion, we will start with a story of a loss and the successful processing of that loss as an illustration of both trauma and of the generic aspects of the coping process. We then will then discuss what differentiates this adaptively processed truama from the maladaptive processing characterized by Post Traumatic Stress Disorder.
Our story of healthy processing describes a Jill's loss of her mother, Dora. Jill's father had died a decade earlier. At the time of her mother's death, Jill, an only child was 60, happily married, with three of her own children with whom she had good relationships. Jill had always been very close with her mother.
Jill lived in the town in which she had grown up. She attended the same church that her mother attended and had a rich social support network in her community. Her mother was well-known and well liked in the community.
After a diagnosis with brain cancer, Dora was told she had three months at most to live. She declined treatment and took hospice at Jill's home. Jill and her mother were able to spend much time discussing her mother's life and pending death. Hospice services made things as comfortable for Dora as possible. Jill's husband and children were emotionally and physically supportive of Jill's efforts to care for her mother. Dora was at peace with dying and was pleased with how her life had been spent. She slipped into a coma two months after diagnosis and passed quietly while Jill was holding her hand.
Jill felt immense grief and disorientation after her mother died. If not for the help of family and friends, she did not feel that she could have held up as well as she did. She felt that she could not think straight, was forgetful, felt out of control of her emotions at times, and could not stop thinking about the loss of her mother.
Based on Dora's requests, Jill's family had already started preparations for the funeral. They had let family and friends know how ill their mother was, had enouraged visitors when Dora wished to and was able to receive them. After Dora passed, the pastor of their church escorted them to visit the funeral director to make burial arrangments and to plan the funeral. Many people from their extended family, church, and community offered their support even before the service. Obituary notices appeared in the town papers with a photo of Dora.
On the day of the funeral, the church was packed with family, friends, church and community members. People came to the church appropriately dressed. They spoke in the hushed, polite reverant tones we take on at funerals. People attending knew not to sit in the front row, as family occupies this. The pastor spoke, described her qualities, summarized Dora's life and her contributions to family and community over her life, and asked those present to support the family through this difficult period. Jill and others cried and, as befits a funeral, felt appropriate doing so in front of hundreds of people. The ceremony had a rythym that took the family into their grief and tears and then brought them back into a thankful and supported place.
This ritual was repeated in a shorter form at the graveside. Afterwards, many dozens of people showed up at the family home which had been prepared for a post-funeral reception by supportive friends. Those visiting brought casseroles and other foods. The visitors to the home knew more or less what to say to Jill and her family, how to talk, how to behave, and when to leave.
Over the next few months, family and friends made a special effort to be supportive to Jill. After a few months more, these same friends made efforts to get Jill out of the house, as she seemed to be getting depressed and not to be socializing enough. Her children made a point of bringing the grandchildren by regularly, as this cheered Jill. Those friends who had more recently recovered after losing their mothers seemed to take a special interest in getting Jill out more and in confiding in her their own recovery from the loss of a parent.
After six months, Jill no longer felt depressed and once again felt in control of her emotions and thoughts, but it took two years before the sense of heaviness left and she could think of her mother without pain. Her mother's passing was now viewed in a way that was consistent with her sense of the meaning and philosophy of life.
The above account is of one of the most severe losses that one can experience. Yet the story above involve a type and a context of trauma that we as individuals, families, and communities are comparatively prepared and competent at handling. We are so commonly competent that the victim usually recovers without a need for psychotherapy.
As a way of starting the discussion, we will start with a story of a loss and the successful processing of that loss as an illustration of both trauma and of the generic aspects of the coping process. We then will then discuss what differentiates this adaptively processed truama from the maladaptive processing characterized by Post Traumatic Stress Disorder.
Our story of healthy processing describes a Jill's loss of her mother, Dora. Jill's father had died a decade earlier. At the time of her mother's death, Jill, an only child was 60, happily married, with three of her own children with whom she had good relationships. Jill had always been very close with her mother.
Jill lived in the town in which she had grown up. She attended the same church that her mother attended and had a rich social support network in her community. Her mother was well-known and well liked in the community.
After a diagnosis with brain cancer, Dora was told she had three months at most to live. She declined treatment and took hospice at Jill's home. Jill and her mother were able to spend much time discussing her mother's life and pending death. Hospice services made things as comfortable for Dora as possible. Jill's husband and children were emotionally and physically supportive of Jill's efforts to care for her mother. Dora was at peace with dying and was pleased with how her life had been spent. She slipped into a coma two months after diagnosis and passed quietly while Jill was holding her hand.
Jill felt immense grief and disorientation after her mother died. If not for the help of family and friends, she did not feel that she could have held up as well as she did. She felt that she could not think straight, was forgetful, felt out of control of her emotions at times, and could not stop thinking about the loss of her mother.
Based on Dora's requests, Jill's family had already started preparations for the funeral. They had let family and friends know how ill their mother was, had enouraged visitors when Dora wished to and was able to receive them. After Dora passed, the pastor of their church escorted them to visit the funeral director to make burial arrangments and to plan the funeral. Many people from their extended family, church, and community offered their support even before the service. Obituary notices appeared in the town papers with a photo of Dora.
On the day of the funeral, the church was packed with family, friends, church and community members. People came to the church appropriately dressed. They spoke in the hushed, polite reverant tones we take on at funerals. People attending knew not to sit in the front row, as family occupies this. The pastor spoke, described her qualities, summarized Dora's life and her contributions to family and community over her life, and asked those present to support the family through this difficult period. Jill and others cried and, as befits a funeral, felt appropriate doing so in front of hundreds of people. The ceremony had a rythym that took the family into their grief and tears and then brought them back into a thankful and supported place.
This ritual was repeated in a shorter form at the graveside. Afterwards, many dozens of people showed up at the family home which had been prepared for a post-funeral reception by supportive friends. Those visiting brought casseroles and other foods. The visitors to the home knew more or less what to say to Jill and her family, how to talk, how to behave, and when to leave.
Over the next few months, family and friends made a special effort to be supportive to Jill. After a few months more, these same friends made efforts to get Jill out of the house, as she seemed to be getting depressed and not to be socializing enough. Her children made a point of bringing the grandchildren by regularly, as this cheered Jill. Those friends who had more recently recovered after losing their mothers seemed to take a special interest in getting Jill out more and in confiding in her their own recovery from the loss of a parent.
After six months, Jill no longer felt depressed and once again felt in control of her emotions and thoughts, but it took two years before the sense of heaviness left and she could think of her mother without pain. Her mother's passing was now viewed in a way that was consistent with her sense of the meaning and philosophy of life.
The above account is of one of the most severe losses that one can experience. Yet the story above involve a type and a context of trauma that we as individuals, families, and communities are comparatively prepared and competent at handling. We are so commonly competent that the victim usually recovers without a need for psychotherapy.