Death AFTER A TRAUMATIC
Mothers Against Drunk Driving 24-Hour Victim Help Line 877.MADD.HELP madd.org/help
Joey was only 18 years old when he was killed. The person who killed him had been taking drugs, drove onto the sidewalk, hit Joey, and fled the scene but was later arrested. Joey was walking home from work and only two blocks away from the house. After the crash I went through a lot of emotional stages. What I want people to know is that you can’t give up; you have to be strong. If you have a strong love, go as far as your love will take you so that you can survive. I got involved with MADD and started going to a support group to help my daughters. I stayed busy after the crash. I got involved and passed a law in Joey’s name. That helped me more than anything else. Remember that everybody’s different and you have to find what works for you to make it through each day.
Jesse’s son Joey was the youngest child out of 5 kids that Jesse raised as a single parent. Joey wanted to join the military like his dad and eventually become a police officer.
Traumatic Grief Substance Impaired Driving Drugged Driving Hit and Run Grief and Gender Differences
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Unique Components of Male Grief Unique Components of Female Grief
Coping with Traumatic Grief Mourning Triggering Events/Holidays Finding Ways to Cope Complications of Traumatic Grief Survivor Guilt General Survivor Guilt Parental Survivor Guilt Survivor Guilt with Specific Incident Realistic vs. Unrealistic Guilt Seeking Help for Survivor Guilt Post Traumatic Stress Disorder (PTSD) Treatment for PTSD Death of a Child Death of an Only Child Stepchild Grief
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Complications in Blended Family Relationships
Coping with the Death of a Child Death of a Grandchild Grandparents as Parents Coping with the Death of a Grandchild Death of a Parent Spousal/Partner Grief Losing Your Best Friend/Partner Friend Grief The Family’s Reaction Coping with Death in the Workplace When Your Loved One Was the Substance Impaired Driver How to Help Others Impacted by a Traumatic Death Provide Supportive Assistance Tips for Providing Ongoing Support Final Thoughts
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Grief is not an event, but a process of experiencing the effects of a death or other loss. Grief is something that everyone experiences at some point in their lives. Traumatic grief is different and even more difficult. When someone is killed suddenly and violently, grief reactions of family and friends can be intense, complicated, and long lasting. If your loved one was killed in a substance impaired driving crash involving alcohol or drugs, you may feel angrier than you have ever felt and sadder than you ever thought possible. After a crash, your world is changed. Your thoughts and feelings may change from minute to minute or hour by hour, and you could feel completely out of control. You may even feel like you are “going crazy,” causing you to question your own sanity. Because there is no way to prepare for this type of loss, many people find traumatic grief to be uncharted territory.
Every person struggles when they receive the sudden news that someone they love has been killed. Some people go into shock, exhibiting symptoms such as sweating, thirst, and dizziness. Shock can make people feel confused, and unable to think clearly, plan, or comprehend what is being said to them. It may also make them feel numb. In some ways
There is no way to prepare for sudden loss.
shock can also be helpful because it prevents them from feeling more emotional pain than they can handle in that moment. These are normal reactions to a very abnormal event. Others do not experience this numbing. They may exhibit extreme emotions such as crying, intense anger, anxiety, and fear. Again, these are normal reactions to a disturbing event. Each person grieves differently and on their own timeline. Some people draw into themselves for a period of time and find everyday tasks to be utterly overwhelming. Others throw themselves into activity to avoid pain and to create structure. Still others alternate between numbness and frantic activity. Deep mourning, including crying and sobbing, can drain a person to the point of exhaustion.
Grief reactions may be manifested through nightmares and flashbacks, depression, inability to concentrate, confusion, lack of motivation, and unexpected displays of grief. These reactions can last for months. Substance Impaired Driving Substance impaired driving includes people who are driving under the influence of alcohol or drugs. There are a number of factors of a substance impaired driving crash that can make coping with grief difficult. First, there is the aspect that someone chose to drive impaired by a substance. The fact that their death
could have been prevented intensifies grief. Second, frustration with the legal system, and lack of knowledge about what can and should happen may hinder you from being able to cope with how your loved one died. Third, the senseless nature of the crime
Many ask, why did this happen?
makes it difficult to understand. The question of why did this happen is one that plagues many victims/survivors. Usually there is no clear or good reason as to why, or sometimes even how, a crash takes place. Finally, most victims/survivors of crashes unfortunately never get to tell their loved one goodbye. You may or may not have had the opportunity to say “I love you,” “I’m sorry,” or “Thank you.” Drugged Driving Drugged driving crashes carry unique circumstances that can affect the loved ones of those who have been killed. The prosecution of drugged driving crashes can be extremely challenging due to the fact that testing for illicit or prescribed drugs doesn’t happen nearly as often as testing for alcohol. Many times officers aren’t trained to recognize drug impairment as often as they are trained on alcohol impairment. There are specially trained Drug Recognition Officers; however, they may not always be available to test a supsect at the scene. Many drugs can also leave the suspect’s system very rapidly. By the time law enforcement is at the scene or a test is administered, there is little to no evidence of drug impairment.
Because testing is often delayed in drugged driving crashes, media may not report that any type of impairment was involved, which can hurt family members who fail to see the crime recognized in media coverage.
In many crashes, there is also a mix of alcohol and drugs, whether prescribed or illicit, which is called poly-use and can also make prosecution difficult if accurate testing isn’t done. Drugs that are legal, such as prescription drugs, aren’t always perceived by the public
Many times there is a mix of alcohol and drugs.
to be potentially dangerous while driving. Education about the dangers of driving while taking certain prescription drugs is sorely lacking. People who don’t pay attention to the labels on their bottle or who take their prescriptions at much higher doses than prescribed may be too impaired to safely operate a motor vehicle. Politics surrounding the legalization of illicit drugs may also affect the perceptions of the public, which may impact a family grieving the loss of a loved one. Often, the public doesn’t understand the seriousness of the crime and may not offer support or even go so far as to verbally attack victims of drug impaired crashes or their family members. In both drunk and drugged driving crashes, hurtful comments online or in person can cause setbacks in the healing process for victims/survivors. Hit and Run Victims of hit and run crashes, where substance impairment is suspected, often have a very difficult time mourning the loss of their loved one when the offender isn’t caught or brought to justice. If this has happened to you, you may never have your “day in court.” You may never find out what actually happened or may hear community members say it wasn’t a substance impaired driving crash. Without prosecution of a substance impaired driving case often victims/survivors of hit and run crashes aren’t able to access funds that are available to other victims of crime.
The fact that someone decided to hit your loved one and then flee the scene without rendering aid may be horrific to you. Questions like, “Would my loved one have lived if medical personnel were called?” or “How could someone do something like this?” may cross your mind. Know that you are not alone. Try to reach out to others who have gone through something similar for support. Find people and groups, such as Mothers Against Drunk Driving (MADD), who will advocate on your behalf and try to find helpful resources. Grief and Gender Differences When looking to your spouse, partner or other family member
to share in the grief process, remember that everyone grieves differently. Women and men are different. The manner in which they cope can also be different. Because of these differences in coping styles, family members are sometimes unable to communicate effectively and as a result, are not always supportive of one another.
Men and women
often cope differently.
Many of these differences come from social expectations and how we are raised. Men are often taught to focus on tasks or jobs, while women are often taught to focus on family and relationships. Women may deal more directly with feelings, while men may focus on the details of the situation in order to understand them. It is important to point out that some men grieve more openly, and some women aren’t as open with their grief experiences. Each person is unique, so every grief process is unique. A time frame for working through grief is not definite or predictable and can be different for men and women. The suddenness of the death, the age of the person killed, the degree of violence to the body, and the quality of the relationship all affect how and how long we grieve.
Unique Components of Male Grief Men tend to express grief by: • keeping busy, holding things together, and working more hours • being concerned for grieving family members • believing someone must be punished for the death • showing less intensity in their grief A change in self-identity can be especially problematic for men, such as going from a husband to a single man; from a father to a childless man; or from a brother to an only child. Men tend to assume full responsibility for their bereavement, almost as if mourning were an illness they need to “get over” as soon as they can. As children, boys are taught to consciously suppress pain and grief. Then, as men, their painful feelings continue to be unconsciously repressed. Repressed grief lasts much longer than acknowledged grief and can lead to complications. For many men, the longer their grief remains repressed, the more reluctant they are to allow it to surface. They know how deep the pain will go if they allow themselves to feel it. Men often find themselves in the role of the protector and provider for their loved ones. Sharing feelings, weeping and talking about what happened over and over may not feel empowering to men. Men may keep their thoughts and feelings about the death to themselves. Not saying anything, or saying very little, protects them from the “appearance of being weak” by expressing their feelings. Their silence is often interpreted by others as withdrawal, mysteriousness, defensiveness, or even lack of caring about the death of their loved one. “Doing something” seems to help men more than simply talking about it. Physical challenges, such as tracking down the prior convictions of the substance impaired driver, filing a lawsuit or helping collect evidence for the criminal case, can be very useful for men because it puts them in control, at least for the moment. • hiding anxiety and depression • expressing few feelings out loud
Although interacting with others through the criminal justice system may satisfy the need for activity, anger and frustration may increase as men learn more about the system’s inadequacies. This only adds to their mental anguish, drive to do something concrete and specific, and can result in rage. Men can be obsessive about staying busy. Some men work longer hours or take more business trips in an effort to “do” something. In order to stay busy, men may participate in risk-taking behaviors, physical conditioning, sports and increased sexual activity. These things are not necessarily bad, but if used as substitutes for grief by consuming physical and psychological energy, time and money, they may not be serving you well. intensity, kissing, hugging, affection and tenderness, which is a normal, healthy need to stay connected. Grieving can also cause temporary impotence, but it usually isn’t permanent and subsides during the grieving experience. Many believe that the slightly higher death rate for men than women after the death of a spouse may be the result of this increased activity and repressed grief and mourning. Physical symptoms include increased cholesterol levels, ulcers, higher blood pressure, asthma, and depression. Avoidance of expressing grief-related feelings can also lead to escalating anger. Men may feel angry at doctors, their spouse, their surviving children, the law enforcement agency, God, the world in general, and even themselves. Anger can set up a barrier against the pain. When anger blocks out feelings of sadness, grief work is difficult to accomplish. Some men’s addictive behaviors escalate, such as abuse of alcohol and other drugs. Addictions increase among both grieving men and women, but more so among men. The addiction numbs painful emotions. Since alcohol and other drugs reduce judgment, angry outbursts can become frequent, adding to family chaos. Experiencing your feelings is a part of the healing journey. In some instances, men are faced with the death of their sexual partner. Some widowers decide that they must now abstain from any sexual relationship, as if that is the inevitable outcome of losing their sexual partner. Or they may feel the need for emotional
If you are a man going through the grieving process, you may find that you are using some of these coping strategies. Although common, they do not relieve the grief. Hopefully, you can recognize what isn’t working for you, evaluate their purpose, and understand that you must now deal with your grief squarely rather than avoiding it.
Avoid coping strategies that bring more harm than good.
Unique Components of Female Grief Women tend to express grief by: • communicating thoughts and feelings with others, verbally expressing their grief • demonstrating more intensity in their grief • reporting more anxiety and depression • feeling angry toward family members or friends for not sharing their grief • feeling overwhelmed with their emotions • starting the grief process very soon after the initial shock • being afraid to be happy or laugh again Women are more likely to reach out to people around them, to talk more openly about their grief. They are more inclined to display their grief to others. Under stress, women tend to nurture those around them or make connections with those that they feel safe with. Women also have societal expectations of being more emotional. Women tend to spend more time talking about their feelings. They may also be uncomfortable with feeling angry or vengeful. They may be overwhelmed with the amount of emotion they are experiencing and not quite sure how to process all of those emotions. When a tragedy happens, women tend to stop caring about life’s typical needs. Getting the dishes done, the bills paid, or making sure the laundry is clean may not be the priority any more. After an initial period of shock, women, more so than men, tend to begin the process of grieving right away. They may not realize what they are doing, but the emotions that are being
felt are part of the grieving process and helps them begin their healing journey. Many women are able to enjoy intercourse only when they are feeling well emotionally. Grieving significantly decreases their desire. It may take a considerable amount of time for a woman to readjust her intimate life. If you are a woman going through the grieving process, you may want to talk to your family about their feelings and wonder why your family or friends don’t seem to care or shed a tear. When coping with grief, you may be overly critical of yourself or others. You may blame others for what happened or be angry
toward everyone. You may stop attending to your physical needs or the needs of your children or partner. All of these negative coping skills may ultimately hurt you or your relationships. It’s important that you recognize harmful coping skills and have patience with yourself and the loved ones around you who may not
Communicate your needs honestly and openly.
be grieving in the same way that you are. Many times a loved one or friend is worried that by talking to you about the death that they may hurt you even more. Above all it’s important that you communicate your needs honestly and openly. People will only be able to help if they know what you need.
Coping with Traumatic Grief
Mourning You will always feel sorrowful knowing that your loved one died tragically and that the relationship you might have enjoyed was cut short. However, this sorrow is not the emotional equivalent to the intense grief that most victims/survivors experience for the first months or years. A sense of sorrow is not the same as being overwhelmed by grief. While the initial responses to the death are defined by the term grief, mourning refers to the internal processes associated with adapting to life without your loved one. Some have described mourning as a “misty fog on life.” You are not always aware, yet you realize that life is not quite as bright, not quite as
light as it was before. Your values may have changed, and you may be impatient with things you deem unimportant or trivial. The grief journey involves restructuring and reorganizing life, which can include changing goals, directions, or relationships. Unfortunately, because our society places so much value on the ability to “carry on,”
Mourning can seem like a misty fog on life.
many mourners are abandoned shortly after the funeral. To be truly helpful, your support system must appreciate the impact this death has had on you even if they cannot fully understand what the loss means to you. They must recognize that in order to heal, you must be allowed – even encouraged – to mourn long after the burial. Triggering Events/Holidays It is likely that you will experience twinges of grief from time to time for many years. Victims/survivors are often surprised to find that in the midst of a series of good days, something brings on an episode of grief. These feelings may be brought on by something called a trigger. A trigger is something that reminds you of your loss. Anniversaries, holidays, and birthdays often trigger reminders of the death or absence of your loved one. Perhaps the most significant and most difficult anniversary is that of the crash. The annual date of the crash may cause anticipatory anxiety and can contribute to renewed grief for victims/survivors. Other annual celebrations, such as religious holidays, birthdays, Thanksgiving, Mother’s Day and Father’s Day, will continue to take place year after year. In the past, these times of joy brought your family together. Now and forever, they will trigger memories of your loved one who was lost.
Today, these holidays and anniversaries will be difficult, but later will provide you with reasons to remember your loved one fondly and begin creating new traditions. Planning ahead for holidays and birthdays not only allows you to mentally prepare for those events, but also provides ongoing and open communication between family members.
Planning ahead can open lines of communication.
Examples of Other Triggers: • Seeing your loved ones favorite food, color, objects or things that were special to them. • Seeing the way other families/loved ones interact with each other. • Finding out important news that you would have shared with your loved one. • Smelling a loved one’s favorite scent. • Having a dream about your loved one or about the crash. You will never forget your loved one and will always wish that you could share more time with them. As time passes, the memories associated with your loved one will no longer bring the same intensely painful thoughts and feelings. The loss will take on new meaning and you will eventually develop a new perspective of the world around you.
Finding Ways to Cope Friends and even some family members may not be able to support you while you grieve. Many people who attempt to comfort victims/survivors, including some professionals, do not understand that intense and long-lasting grief is appropriate for victims of substance impaired driving crashes. You may hear things like, “You’ll be okay,” or “It’s time to move on,” or even something like, “They had a good, long life.” In these situations, people often aren’t trying to hurt you, but they are probably unaware of how these statements might affect you. When someone approaches you with that type of a remark, if you are comfortable sharing, express how you are feeling and what you are thinking. You may be able to teach them the value of listening.
Remember, grieving doesn’t mean that you have to forget. Healing is an ever-evolving process that takes time after you have
Take time to care for yourself.
suffered the loss of a loved one. You will be forever changed. Take the time to care for yourself and remember your loved one. Coping Tips: • Give yourself plenty of time to grieve. • Experience your grief in your own way; permit yourself to honestly experience grief. • Set a few goals for yourself and work towards them one at a time. • Focus on making small life changes as opposed to major life decisions. • Find others who will listen. • Create a journal to express your thoughts and emotions. • Create an art project that focuses on your memories of your loved one. • If possible, keep photos and keepsakes around; as hard as it may be to look at now, over time these visual reminders may become treasured memories. • Consider attending a support group. • Seek professional counseling if needed by interviewing potential counseling professionals and inquire if they have experience with traumatic grief. • Surround yourself with supportive people. • Avoid people who are not helpful. • Spend time with family and friends who are caring listeners. • Seek the support of others who have experienced a similar loss. • Make a memorial or create a ritual that reminds you of your loved one and honors their legacy. • Don’t feel pressured to do things others think you should do. • Exercise, eat healthy food, and get plenty of rest to give yourself energy.
• Become active in changing things in the world that bother you by getting involved with MADD or other organizations. • Watch out for harmful behaviors, such as substance abuse or hurting someone else.
Complications of Traumatic Grief
Survivor Guilt After a traumatic event, some individuals may question why they survived. In basic terms, survivor guilt occurs when an individual feels he or she should not continue to live following the event of another’s death. It is a normal part of grieving, particularly when the death was sudden and traumatic, such as in the case of a death resulting from a substance impaired driving crash. There are different types of survivor guilt, including general, parental, and survivor guilt with specific incident. General Survivor Guilt General survivor guilt refers to feelings of guilt associated with Many mourners often feel like they should have been able to stop the crash or that they could have protected their loved one. They have “what if” questions, such as: What if I hadn’t asked them to come over? What if I had kept them on the phone with me 5 more seconds? What if I had gone with them? The fact is that the “what if” questions can never be answered because we can’t know what would have happened or changed. If it was possible to have done one or more of the things differently, you need to know that it’s possible things could have been better, or could have even been worse. The truth is that it’s not your fault that it happened. Further complicating general survivor guilt is the fact that some survivors struggle with unresolved conflicts with the one Survivor guilt can bring about additional challenges. living and going on after someone else dies or is killed. It is difficult to reconcile feeling grateful to be alive while knowing that others did not share the same fate.
who was killed. Survivors may feel a certain loss of hope in knowing that they were unable to make amends before a loved one’s death. Parental Survivor Guilt Parental survivor guilt occurs when a child dies, yet the parent survives. This type of survivor guilt is particularly distressing because of the unique challenges brought about when a child dies before his or her parents. It really doesn’t matter if the child was a tiny baby or old enough to be a grandparent. The unique connection between parent and child leaves a parent especially vulnerable, and however unnatural, unjust or illogical it may seem, a child may die before a parent. Every parent expects to die before their child. When the very essence of parenting is protecting and assuring life, the sudden and violent death of a child in a substance impaired driving crash is nothing less than devastating. Survivor Guilt with Specific Incident Survivor guilt with specific incident takes place when an individual survives a traumatic event, while others involved in the same traumatic event did not survive, such as with a substance impaired driving crash. Under these circumstances, survivors were in the same place at the same time with those who died, yet experienced a different outcome, which can create doubt and confusing feelings. Realistic vs. Unrealistic Guilt If you are living with the emotional pain associated with the traumatic death of a loved one, you may experience occasional
feelings of survivor guilt. Don’t be alarmed. Each person grieves in their own way and one moment at a time. But it is important to recognize when survivor guilt gets in the way of processing grief. When survivor guilt leads to interruption of life activities, such as work, relationships, and health, it is time to seek help. Guilt is a term that refers to a perception or
Each person grieves in their own way.
realization that you have done something wrong. Some feelings of guilt are realistic, while others are unrealistic. Both differ from regret, which is something you feel when you wish you could have done something differently.
Making a distinction between realistic and unrealistic guilt can be difficult because they feel the same. Also, identifying regret can be hard when you are suffering from survivor guilt. It is critical to understand the difference between realistic and unrealistic guilt, so that you can confront the feelings and evaluate what role they play in your grief. Feelings of guilt are natural when you did or didn’t do something that ultimately affected the survival of your loved one. This is realistic guilt. Unrealistic guilt differs in that it involves the belief that there is something you could have done to change the outcome of a particular situation, although there was really nothing you could have done. Seeking Help for Survivor Guilt While survivor guilt is a normal part of grieving for some, if after a period of time the guilt affects you in ways that are preventing you from moving forward in your mourning, it is time to seek help. If you decide to pursue counseling, it is vital that you find a professional who specializes in grief and works with people who have suffered sudden and violent trauma. Post-Traumatic Stress Disorder (PTSD) When people are exposed to a traumatic event, some people experience recurrent and ongoing recollections of the trauma, which can lead to intense emotional distress. Moments such as these may come without warning and over time can cause you to avoid situations you connect with your crash. You may feel on edge, anxious, and/or always ready to react. PTSD is an anxiety disorder that is diagnosed by medical or mental health professionals. A victim/survivor diagnosed with PTSD exhibits three main types of symptoms: • Re-experiencing the traumatic event • Increased arousal–having high levels of anxiety • Avoidance with emotional numbing Trauma victims/survivors who consistently experience these symptoms and others for at least one month or longer may be suffering from PTSD.
Treatment for PTSD The lasting psychological effects after a trauma can vary greatly from person to person. Some people experience few or no long-lasting consequences, whereas others may continue to have problems for months or even years after a trauma and will not get better until treated by a professional. There are two main types of treatment for PTSD: psychotherapy and medication. Some people recover from PTSD with psychotherapy alone, while others need a combination of therapies. There is hope. • Learn all you can about PTSD.
Remain hopeful that you can and will feel better.
• Talk about your symptoms with others. • Seek the treatment of trained doctors and counselors. • Continue counseling or therapy, even though it might feel painful for a while. • Join a support group.
• Take medications as prescribed by your doctor. • Remain hopeful that you can and will feel better.
Death of a Child
The unique connection between parent and child renders a mother or father especially vulnerable to traumatic grief. However unnatural, unjust, or illogical it may seem, a child may die before a parent. When a child is killed in a substance impaired driving crash, this violation of human life produces a deep and painful emotional wound—some call it the ultimate grief. The love for a child is special. Parents want to care for their child, to solace them, and to help them find happiness. Parents feel their child’s joy and find it difficult to see a child in pain, yet be unable to help. In no other relationship is the protective urge as intense or compelling as in a parent’s relationship with their child. Hopes and dreams are lost.
The loss of your child may feel like the loss of your future. Parents remain forever concerned about their children, regardless of their current relationship with their child. To a parent, a child signifies future love, growth, and family. Their child’s future is always present in the parents’ thoughts, and is often a legacy of their own lives. Parents feel that all they do for their children gives life meaning. When a child is killed, the hopes and dreams for a child are lost. Parents whose children have been killed are likely to feel empty—empty of hope and the desire to go on. The death of your child may make everything else seem pointless. With the loss of those hopes and dreams, parents lose much of the meaning in their lives. If there are other children, not all meaning has been removed. And yet even with other children, a huge void exists. You can never replace a child. When a child is killed, the parent is likely to feel the child’s death was deeply wrong for both child and parent, so wrong it can hardly be expressed. The sense of wrongness may come because most people live their lives believing they would outlive their children. Having their child die implies that something unnatural has happened. After the death of a child parents are often terrified that another family member may be killed and go to great lengths to monitor their activities. Death of an Only Child Many aspects of grief are common to all bereaved parents, but childless parents discover early on that some feelings and some issues are different from those confronting bereaved parents with surviving children. Suddenly, you are childless. You are still a parent, but no longer a practicing parent. You will always love your child and have the memories of them. These memories will sometimes comfort you, yet at other times be very distressing. You will endure a similar grieving process as bereaved parents who have surviving children. But, the difference begins when you realize that there will be no children with you to celebrate the holidays and milestones in your life, nor will they be there for you as you age. There may never be grandchildren. You may feel as though you are experiencing a double grief: the loss of your child and the loss of your family’s future.
You may be pre-occupied with the question, “If I don’t have a child, am I still a parent?” And at some point, you will be faced with the dilemma of answering the question, “How many children do you have?” There is no right or wrong answer.
Answer questions in any way
Answer the question in any way that feels comfortable to you. You may answer with, “My precious son or daughter died,” or simply say “None.” Many parents feel guilty when they deny their child’s existence. Another possible response is “I had a son or daughter.” The person may then ask you to tell your story.
that you feel comfortable.
Keep in mind that when you attend a support group, you may be the only parent who has endured the death of an only child or all children. In some communities, there may be specialized support groups for parents who have no surviving children.