Life after death: grief therapy after the sudden traumatic death of a family member.

TOPIC. Survivors of the sudden traumatic death of a family member are at increased risk for complicated grief and bereavement. PURPOSES. To present the complicating factors inherent to sudden traumatic death in order to promote adaptive grieving in the survivors. SOURCES. A comprehensive review of the existing bereavement literature, clinical anecdotes, and therapeutic experiences. CONCLUSIONS. Grief is a process and not an endpoint. The goal of grief is not to forget about the loss, a commonly stated goal of survivors; rather, the goal is to remember the decedent, understand the changes created by the loss, and determine how to reinvest in life. Search terms: Bereavement, grief, sudden traumatic death When a family member dies as a result of sudden traumatic death, the immediate shock and chaos that follow can lead toward complicated grief and bereavement (DeRanieri, Clements, & Henry, 2002; Doka, 1996). Because death is an issue that creates great discomfort in many clients and therapists, successful therapeutic intervention after sudden traumatic death depends on an understanding of such a devastating event. Additionally, an understanding of the complicating factors associated with sudden traumatic death can enhance therapeutic guidance and intervention. Survivors, also known as co-victims (Spungen, 1997), often describe the path of grief as a lonely trek. Even when family and friends are supportive, survivors are painfully aware that the grieving process is overtly unique to them. It is not possible to generalize the way that grief affects individuals. In this same light, there is frequently discomfort and often an avoidance of discussing the pain and heartache that individual survivors experience in the shadow of sudden and traumatic loss. Many surviving family members describe a seeming "don't ask, don't tell" attitude toward deaths that are particularly sudden and violent in nature. For example, the acts of homicide and suicide continue to carry negative stereotypes about those who die in this manner (Clements & Burgess, 2002; Clements, DeRanieri, Fay-Hillier, & Henry, 2003; Doka, 1996; Mericle, 1993), whereas car accidents and occupational deaths often carry repulsive gory details of the last moments of life (Bendersky-Sacks, Clements, & Fay-Hillier, 2001; Marshall & Oleson, 1996), and now the nation is confronted with violent and calculated deaths related to war and terrorism (Clements, 2001; Fillion, Clements, Averill, & Vigil, 2002). Whether these attitudes and circumstances exist, the reality for the survivor is that a loved one has died a sudden, unexpected, and often violent death, leaving the surviving family members in the turbulent tasks of reassessment of a new world without the decedent (Attig, 2001). This new world may affect the survivors psychologically, emotionally, physically, socially, and financially. Case Study The Rev. Leroy Allan (pseudonym) was the minister of his church for more than 35 years. In the early afternoon hours of Good Friday, he told his wife he needed to go to the bank. His wife, Maddie, smiled and reminded him that he needed to be back in time to prepare for the first in a special weekend of religious services. Maddie was overtly concerned at 7 p.m. when she had still not heard from him and the church services were about to start. Maddie had already called several hospitals and the police (who told her that missing person reports could be made only after 24 hours). So, there they sat: a congregation of church members, wondering what could have happened to their beloved minister. After 30 minutes of prayer, Maddie awkwardly announced the conclusion of the confused and impromptu Good Friday services, and returned to the parsonage to find a message on the answering machine from the medical examiner's office. Her husband had just been pulled from the river, having been witnessed, by a family having a picnic on the bank of the river, to park his car on the bridge and jump to his death. …