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Traumatic Bereavement

Traumatic bereavement is a combination of trauma and grief responses that often impairs functioning in various life domains such as spousal relationships, parenting, and work. These responses may occur following the sudden death of an important person, often through shocking circumstances. Types of deaths most likely to precipitate traumatic bereavement include acute natural events (e.g., brain aneurysm), accidents, homicide, suicide, natural disaster, and war. Survivors typically experience painful grief symptoms, such as yearning for their loved one, as well as trauma symptoms, such as disturbing intrusive thoughts.

In most cases, survivors' defenses are completely overwhelmed by experiencing a sudden, traumatic loss. In a single instant, their lives have been fundamentally changed. As one survivor expressed it, “It was as though someone had cut my insides out.” Their symptoms are typically more intense and prolonged than those following a natural death. Even years later, many have difficulty comprehending the finality of their love one's death and coping with its ramifications.

Prevalence of Sudden, Traumatic Deaths

According to the National Vital Statistics Reports (2007), sudden, traumatic deaths represent the largest single causes of death among people between the ages of 1 and 44. Causes of traumatic deaths change over the life span. Accidents are by far the most common cause of death among infants and children. This is also the case for teenagers and young adults. Those in the 15 to 24 age group are approximately nine times more likely to die in an accident than to die from cancer, which is the leading cause of natural death in this age group. Beginning at age 15, homicide and suicide emerge as prevalent causes of death. Those in the 15 to 24 age group are six times more likely to die as a result of homicide or suicide than to die of cancer. And although deaths from accidents, homicide, and suicide become less common after age 44, deaths resulting from sudden cardiovascular events become more prevalent.

In most cases, a single traumatic death triggers a cascade of suffering and heartache, affecting the spouse, parents, siblings, and children of the person who died. Extended family members, close friends, and coworkers are also affected by the tragedy. Expanding our knowledge of this population, and identifying effective treatments to help them, should be an important national priority.

What does Traumatic Bereavement Look Like?

When Grief and Trauma Coexist

As survivors attempt to pick up the shards of their lives and move forward, what lies ahead for them? These mourners face the twin tasks of accommodating the loss of their loved one and coping with the trauma associated with the death. Available evidence suggests that the combination of loss and trauma can greatly intensify the symptoms common to both, making it difficult for survivors to process and resolve the loss.

Although there is great variability in how people respond to the death of a loved one, there is general agreement about the grief symptoms most likely to accompany such an event. Most people report an overwhelming sense of loss, as well as strong feelings of longing or yearning for the person who died. In many cases, survivors experience shock, depression, and anxiety. It is common for survivors to feel a profound sense of emptiness and a feeling that a part of them has died. In many cases, bereaved individuals lose interest in the world around them, and feel hopeless about the future. Feelings of fatigue, restlessness, irritability, and guilt may also be present.

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