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Find jobs for new grads and experienced social work practitioners at http://www.socialworkjobbank.com, THE NEW SOCIAL WORKER’s online job board and career center.

 

 

     There is such a heavy focus on trauma in social work treatment, and this focus is both essential and timely. There is trauma everywhere, whether in the foster care system or ongoing wars or simply the news. However, the more we use the word trauma to describe the sequelae from psychological stressors, the more we lose the nuance around the different ways that trauma can show up and make itself known. There is confusion around the distinction between trauma, complex trauma (otherwise known as C-PTSD, and grief. Below are some clarifying questions AND answers on how we can understand the differences between how trauma lives in one mind versus another.

 

     The truth is that there is no simple answer to this question. The reason why is because the idea of an event threatening death or harm can be experienced subjectively, based on individual nervous symptoms, neurobiology, attachment histories, and past trauma. So, someone who has been in a nearly fatal car accident can get rear-ended several years later, and it can feel life-threatening because of how the original memory is stored in the brain.

 

     The other confounding issue is that of neglect. While neglect does not threaten immediate death or harm, it does diminish one’s capacity to connect and relate to others. It also diminishes a person’s ability to respond to their own internal cues about what is and is not dangerous. The impact of neglect, though not an obviously acute trauma, often takes the shape of Complex PTSD.

 

     A lot of people describe grief as a form of trauma. Sometimes grief does become trauma, and often it does not. To begin, we are all prepared for the fact that death is a part of life. We don’t want to lose people, but somehow we are wired to do so and to adapt to the reality of loss. There are occasions, however, when this adaptation becomes complicated and morphs into a trauma.

 

     It is widely understood that a parent losing a child can result in trauma. This is because it feels out of the “natural” order of things. However, if that child had been sick for a while and there was a significant lead up to the loss, grief can remain as it is, a sad and upsetting state that does not result in traumatic or hypervigilant responses.

 

     Further, if a loss occurs at the hands of violence, it is more likely that the loss will manifest itself in a type of trauma, whether that is PTSD or C-PTSD. If that violence is witnessed, the risk of developing a trauma diagnosis increases. Our ability to remain squarely in the realm of grief often rests on how much meaning we can make of the loss and how openly we are able to discuss and process it over a lengthy period of time.

 

     The more underrepresented way that grief becomes PTSD is when something called a hagiography occurs. The word, though not commonly known, means to create a biography of someone (post mortem) that idealizes that figure. Upon someone’s passing, there is a strong pull to start to discuss and hold memories of the person in a strictly positive light. In 1917, Sigmund Freud wrote about the distinction between mourning (grief) and melancholia (trauma or depression). He hypothesized that we are more likely to experience grief if we can tell the truth about who we lost and not create a fiction or fantasy about that person. He went on to suggest that a traumatized or depressive state would ensue if we were forced into some sort of secret keeping over how we really felt about the person who died. The secret keeping would be ensured by largely held ethics around “not speaking ill of the dead” or “only thinking positive thoughts.”

 

     Shame and trauma are closely linked, and secret keeping, which is often created by the need to preserve fiction and fantasy, creates shame. The link between idealization of the dead and trauma is one that has long been considered but has not been widely discussed.

 

 

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