Authored by Wendy Bonnarens – Head of Education Australis College
Covid-19 has created a new way of life for nearly everyone. It’s been a long time since the world has seen so much heartache with job losses, loss of lives and people isolated from one another. Any loss on a person’s life can have the potential to cause grief.
There are many different grief reactions which include Cognitive (confusion, hallucinations, obsessive behaviour), Spiritual (meaning system changed, loss of faith), Emotional (anxiety, sadness, guilt, anger, depression, shame, emotional numbness), Physical (nausea, headaches, loss of energy) and Behavioural (mood swings, constant crying, poor sleeping habits). The way a person reacts to grief will depend upon their age, socioeconomic status, culture and gender.
There are two types of grief, Primary Loss and Secondary Loss. The onset of grief occurs as the impact of the primary loss is experienced by a person. Secondary loss is the consequence of the primary loss. For example, losing your job changes your financial situation this can then impact on the pain caused by the primary loss.
Grief Can Be Invisible
First, you need to understand the grief can be invisible, some people will show an outward expression of grief and others will be reluctant to display their feelings. Secondly, you need to listen, provide an open and friendly environment for the person to grieve. Help them to understand that you are there to listen when they are ready to talk. Finally, don’t think you can ‘fix’ their grief. Grieving is a process, ask questions, encourage the person to communication and share their memories and thoughts with you. Grief is not linear; it can come and go in stages. A person may feel like their world is ending one minute and seem to get on with life the next.
It is ok to:
|Be angry||Feel sad|
|Have fun and move on with life|
There is a multilayer effect when disaster strikes a community. Everyone will feel grief; however, the intensity will be different. For example, disenfranchised grief can occur when a person may not be affected by the tragedy directly, but they are still grieving. Disenfranchised grief describes a person’s experience when they incur a loss that is not acknowledged in sociality, socially sanctioned or publicly mourned.
The reason why disenfranchised grief is not readily accepted and acknowledged in society can be due to societies expectations of what people should grieve for. Children can often feel this type of grief when there are major changes in their life or when things are changing so much, and they are unsure of what is happening.
People who are suffering from disenfranchised grief usually mourn privately. They may not see that they have disenfranchised grief but may have several other symptoms such as insomnia, substance abuse, depression, or anxiety. By not accepting and validating disenfranchised grief in time may lead to depression.
Some common signs:
|Lack of interest in things that used to bring joy||Loss of self esteem|
|Feeling like a failure||Feeling fearful|
|Feel hopeless, sluggish, tired all the time||Physical changes such as sleeping, eating and stomach upsets|
|Difficulty getting out of bed in the morning||Unable to sleep or restless sleep|
|General feeling of sadness||Crying spells|
Common Reactions to Trauma
How people deal with trauma can be as varied as a person themselves but can also relate to three things: the degree of the exposure to the trauma (did a loved one die of Covid-19, where they directly affected?), pre-existing vulnerability to trauma (have they been in a situation before with a pandemic?) and the extent of the adversity in the aftermath of the event (this could include financial difficulties long after the pandemic).
Most people who directly experience a major trauma can have severe problems in the immediate aftermath. Some people then feel much better within three months after the event, but others recover more slowly, and some do not recover enough without help. It’s important to become aware of any changes since the trauma as this is the first step towards recovery.
Some of the most common problems after a trauma are described below.
Fear and anxiety Anxiety is a common and natural response to a situation such as a pandemic. For many it lasts long after the trauma ended. This happens when views of the world and a sense of safety have changed. A person may become anxious when they remember the trauma. But sometimes anxiety may come from out of the blue.
Triggers or cues that can cause anxiety may include places, times of day, certain smells or noises, or any situation that reminds you of the trauma. As the person begins to pay more attention to the times they feel afraid they can discover the triggers for their anxiety. In this way, they may learn that some of the out-of-the-blue anxiety is really triggered by things that remind them of their trauma.
Re-experiencing of the trauma People who have been traumatized often re-experience the traumatic event. For example, a person may have unwanted thoughts of the trauma, and find themselves unable to get rid of them. Some people have flashbacks, or very vivid images, as if the trauma is occurring again.
Nightmares Nightmares are also common because these symptoms occur because a traumatic experience is so shocking and so different from everyday experiences that they can’t fit it into what you know about the world. So, in order to understand what happened, the persons’ mind keeps bringing the memory back, as if to better digest it and fit it in.
Increased arousal Increased arousal is also a common response to trauma. This includes feeling jumpy, jittery, shaky, being easily startled and having trouble concentrating or sleeping. Continuous arousal can lead to impatience and irritability, especially if a person is not getting enough sleep. The arousal reactions are due to the fight or flight response in your body. The fight or flight response is the way we protect ourselves against danger, and it occurs also in animals. When we protect ourselves from danger by fighting or running away, we need a lot more energy than usual, so our bodies pump out extra adrenaline to help us get the extra energy we need to survive.
People who have been traumatized often see the world as filled with danger, so their bodies are on constant alert, always ready to respond immediately to any attack. The problem is that increased arousal is useful in truly dangerous situations, such as if the client finds themselves facing a tiger. But alertness becomes very uncomfortable when it continues for a long time even in safe situations. Another reaction to danger is to freeze, like a deer in the headlights, and this reaction can also occur during a trauma.
Avoidance Avoidance is a common way of managing trauma-related pain. The most common is avoiding situations that reminds a person of the trauma, such as the place where it happened. Often situations that are less directly related to the trauma are also avoided, such as going out in the evening if the trauma occurred at night. Another way to reduce discomfort is trying to push away painful thoughts and feelings. This can lead to feelings of numbness, where a person may find it difficult to have both fearful and pleasant or loving feelings. Sometimes the painful thoughts or feelings may be so intense that the client blocks it from their mind, or they may not be able to remember parts of the trauma.
Many people who have been traumatized feel angry and irritable. If a person is not used to feeling angry this may seem scary as well. It may be especially confusing to feel angry at those who are closest to them. Sometimes people feel angry because of feeling irritable so often. Anger can also arise from a feeling that the world is not fair.
Trauma often leads to feelings of guilt and shame. Many people blame themselves for things they did or didn’t do to survive. For example, if a person has self-isolated and their neighbour went to the shop to buy groceries for them, then in turn got sick. They may blame themselves for the other person getting sick. Others my feel that if they had gone to the shop they would have caught Covid-19. They may feel ashamed because during the trauma they acted in ways that they would not otherwise have done. Sometimes, other people may blame them for the trauma.
Feeling guilty about the trauma means that the person is taking responsibility for what occurred. While this may make them feel somewhat more in control, it can also lead to feelings of helplessness and depression.
Grief and depression Grief and depression are also common reactions to trauma. This can include feeling down, sad, hopeless or despairing. A person may cry more often, may lose interest in people and activities they used to enjoy, may also feel that plans they had for the future don’t seem to matter anymore, or that life isn’t worth living. These feelings can lead to thoughts of wishing they were dead or doing something to hurt or kill themself. Because the trauma has changed so much of how they see the world and themself, it makes sense to feel sad and to grieve for what they lost because of the trauma.
Seeing the world as an unsafe place With social distancing and social isolation its hard not to see the world as an unsafe place. However, we will get over this and once more be able to interact with others. Some people may not fully recover and will still struggle to trust anyone. If they used to think about the world as a safe place, the trauma may suddenly make them think that the world is very dangerous, and others are not to be trusted. These negative thoughts often make people feel they have been changed completely by the trauma. Relationships with others can become tense and it is difficult to become intimate with people as their trust decreases.
Many of the reactions to trauma are connected to one another. For example, a flashback may make a person feel out of control and will therefore produce fear and arousal. Many people think that their common reactions to the trauma mean that they are “going crazy” or “losing it.” These thoughts can make them even more fearful. Again, as they become aware of the changes they have gone through since the trauma, and as they process these experiences during treatment, the symptoms should become less distressing.
Foa, Hembree, Riggs, Rauch & Franklin. Centre for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania. Source: National Centre for Posttraumatic Stress Disorder.
How to Help Someone Through Grief
Show empathy, sensitivity and be open minded. Sit and listen to them, focus on them, be open yourself, be respective of their emotions, develop trust and understanding.
Compassion Fatigue Burnout or compassion fatigue is the physical, emotional and mental exhaustion caused by the long-term involvement in emotionally demanding situations. Compassion fatigue is different to having a burnout as compassion fatigue has a sudden onset and there is a sense of being overwhelmed and feeling incapable of helping a client.
Signs that you have compassion fatigue:
|Excessive blaming||Loss of compassion|
|Bottled up emotions||Substance abuse|
|Mentally and physically tired|
The above symptoms may lead to burnout or counter transference. Compassion fatigue can happen to anyone in the caring field, learning to read the signs are the first step to ensuring that you stay mentally healthy. By being a self-aware you are less likely to be shocked if the symptoms developed and more inclined to seek treatment.
Road to Recovery
|Meditate||Eat healthily and drink plenty of water|
|Care for your mind, body and soul||Organise your life so you become proactive as opposed to reactive|
|Laugh and enjoy life||Find things that humour you|
|Share your emotions.||Connect with friends and loved ones|
|Maintain a healthy balance between work and play.||Don’t take work home|
|Understand the boundaries and have realistic expectations of yourself and your clients||Ensure you have the support of your peers and supervisors|
Burnout is the extinction of motivation or incentive. It is a state of physical, mental and emotional exhaustion; the complex human reaction to ongoing stress and your inadequate ability to manage the stress. Burnout is the consequence of excessive work, complex human reaction to ongoing stress, feeling that you are inadequate to manage the stress. When problems seem insurmountable, difficult to get anything done can spill over to other areas of your life. Burnout can be caused by being overworked, having a stressful job, lifestyle factors, taking on too much, even your personality trait can determine whether you will suffer from burnout of not.
Strategies to combat burnout:
|Be proactive not passive||Clarify your job|
|Take time off||Keep active|
|Have a balanced diet||Avoid excessive consumption of substances|
|Speak to someone||Look after your mind, body and spirit|
Recommended Support Services
If you need help or someone to speak to the following organisations can assist:
Beyond Blue https://www.beyondblue.org.au/get-support/get-immediate-support
Suicide Call Back Service https://www.suicidecallbackservice.org.au/
Want to Learn More?
Counselling skills can be applied in all aspects of your professional and personal life. If you would like to learn more about counselling, counselling topics or qualifications follow the link below or contact our team on 1300 887 991.
Enjoyed the Article?
Did you enjoy reading the above article? Good News! Australis College will be featuring another article in next months DRTA Newsletter. This time industry profession and valued Australis College team member Jodie Schleusener will be discussing the abundant opportunities for Diversional Therapists and the NDIS.