Grief and Loss and Trauma
Five years ago, I was referred a client for an anxiety disorder. However, it became clear pretty quickly that she had PTSD. Also, the client had a separate therapist for grief because she had lost her father to cancer. Tragically, it was a long and ugly battle. At points he wasn’t aware of who his family members were. He dealt with many physical indignities, which were sometimes witnessed by his children. Sadly, it was cancer at its worst.
Eventually, this client’s PTSD symptoms showed. They came after witnessing the suffering her dad endured. So, not only did she have to work through tremendous grief, but she had nightmares and startle responses and avoidance and hypervigilance all related to the healthcare system. One day, a grandparent went into the hospital. When the client came to her therapy session, she endured a complete panic attack at the thought of visiting.
Unfortunately, trauma and grief often go hand in hand. If your teen is dealing with trauma related to the situation that caused grief, then your teenager may struggle to even start grieving. The act of grieving can trigger a trauma response.
What causes PTSD?
By technical definition, PTSD is when someone witnessed an event causing immense suffering or potential death to the self or someone close to the self. The traumatic response occurs within 3 months of the traumatic event(s). For the first month after the event occurs, we call it “Acute Stress Disorder.” However, if it hasn’t resolved by the 1 month mark, then it becomes PTSD.
If your teenager loses someone close to him or her, your teen has the possibility of developing PTSD related to the event. However, the majority of teenagers do not develop PTSD after a death. This means you cannot automatically assume your teen was traumatized by the death of someone close. Being traumatized means having an extremely distressed response after the fact.
What are some symptoms of posttraumatic stress?
Adolescents with posttraumatic stress exhibit a mixture of symptoms. Common ones include nightmares, flashbacks (reexperiencing the event after a trigger), hypervigilance, paranoia, panic attacks, trouble sleeping, trouble concentrating, and guilt or shame. One of the first things I notice as a therapist who treats PTSD is a strong avoidance of certain situations. For example, in the case of the client from the beginning of this post, she strongly avoided doctor’s offices and especially hospitals.
What do I do if my teen has grief and traumatic stress?
You get help. Typically, PTSD and grief become complicated. PTSD responds to treatment, but the treatment is complex. Thankfully, if a therapist helps your teen calm down their whole mind and body instead of remaining in a stress state, then your teen can start the grieving process. Getting through some of the grief also lessens the stranglehold of guilt and anxiety that PTSD has on its sufferers.
How is PTSD treated?
There are several methods for therapeutic treatment of PTSD. The two discussed here are primarily what we use at Teen Therapy OC. Firstly, we use EMDR (usually done by Carrie Johnson). This is a form of treatment that should establish different neural pathways for trauma cognitions. The idea is that the sufferer of PTSD no longer runs into the same emotional dead-end when trying to process trauma.
Secondly, we utilize CPT (cognitive processing therapy). Veterans with PTSD often use CPT, but it also works well with the non-military population. CPT seeks to reduce the shame and guilt associated with PTSD. This reduces the power of negative thoughts in the trauma process, which relieves the cycle. Typically, teens who complete the CPT protocol show marked improvement in their PTSD diagnostic scores. At TTOC Lauren or Mark does this therapy.
Call if You’re Unsure
In any case, if you are reading this post, then your family may have been through something very difficult. Our hearts go out to you and your teen. Please feel free to call and talk about your situation to see if therapy makes sense for you. The phone call is free.
Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT
