Embracing Traumatic Grief and Loss
Featured Guest: Kathleen Parrish
When a traumatic loss hits, how can treatment providers and loved ones know what to do to help someone heal without impeding their grieving process?
We’ll discuss this with counselor Kathleen Parrish on this episode of Recovery Unscripted.
Interviewer: Well, I’m here with Kathleen Parrish. Thank you for being with us.
Kathleen Parrish: Thanks for having me.
Interviewer: Yes. Let’s get started by having you tell us a bit about your own personal story, and the journey you took to becoming involved in the world of recovery.
Interviewer: Wait, I’m going to move this real quick.
Kathleen: I became interested in the field of counseling a long time ago. I graduated with my Master’s in 1999. I became a Licensed Professional Counselor in 2002.
Actually 2001, I’m getting old, forgetting the dates. I got really excited when I found treatment and understood what happened there. I really like the work of treating co-occurring disorders, not just substance use.
Actually, my background and training in expertise is in treating trauma PTSD. I get really excited about watching people move through recovery and beginning to embrace a new version of who they are in recovery, and really learning to understand what they’ve survived and whether it’s trauma in life. Over time, that’s just evolved into something that I’m really passionate about.
Interviewer: Yes. Like you said, you have a long history working with trauma. What drew you to work with trauma survivors specifically?
Kathleen: Well, I think we all have a little trauma in our lives, right. I’m always touched by that willingness of people to be real and to be vulnerable and to connect. Those are pieces that fit really well for me, in terms of how I continue my journey through life and in recovery. As I’ve grown and learned just who I am, I think connecting with people in that way has been really powerful for me. I’m really grateful to show up for other people that same way.
Interviewer: Yes. Were you a survivor of trauma yourself, or did you have some personal experience with that in your family or something?
Kathleen: Yes. Coming from a divorced home when I was a child, I think there’s some elements there that were traumatic, and just figuring out how you move forward in life and how you understand your family system. I think for me it’s inspired a willingness to be really compassionate for people who are suffering. Yes.
Interviewer: Now you’re serving as Director of Clinical Services at Cottonwood, Tucson. What led you to that particular opportunity?
Kathleen: Well, I’ve been at Cottonwood for almost 17 years, a long time. When I stepped on the campus, I fell in love. It’s a fabulous facility.
Interviewer: That’s in Arizona?
Kathleen: It’s in Tucson Arizona. It’s cooling off there right now, so it’s a good thing. It does get really hot there in the desert in the summer. I love Cottonwoods very unique. It’s a truly individualized treatment program, everyone touts individual treatment. It is probably one of the best examples of individualized treatment that I’ve ever seen. It’s a really caring nurturing facility. It’s a really safe place for people to recover. It’s very spiritual, we’re out in the desert with the cactus and the Coyotes and the javelinas.
Interviewer: Openness. Yes.
Kathleen: If you know what a javelina is.
Interviewer: It’s like a pig.
Kathleen: It’s part of the rodent family actually, but it looks like a giant pig, looks like a wild boar, they have tusks and they smell bad, but they’re pretty fabulous to see them from a distance. One of my favorite memories is, is that we had a mama Bobcat with her babies, and the babies were in the trees with their paws swinging in the air, they were lounging around. It’s a really neat place to be. People feel there. People tend to stay a very long time with us in their journey. Yes, it’s pretty great we have a great team of specialists who are really caring compassionate.
Interviewer: Do you feel like there’s a spiritual connection with the desert and the openness and all that?
Kathleen: Yes, it’s really great.
Interviewer: At the conference you’re giving a presentation on grief and loss titled, Embracing The Abyss. Grief and loss are such universal themes, but I’m guessing it affects each individual differently, right?
Interviewer: What are some common responses you see?
Kathleen: One of the things I was talking about as I was sharing with a group, is that grief is really part of the human condition. We are all one of us at any given time, either one of us are going to experience a grief. Understanding that piece because it’s part of our human condition, it also means that we have the capacity to recover from it. That we’re equipped to deal with grief, it’s part of our experience in life. Understanding that helps us with the building blocks of how we recover.
More specifically, I talked a lot about traumatic grief. I think that more and more we’re seeing people who are affected by trauma who have a grief hardwired into that. We’re looking at some of the events over the last several years, the mass shootings, terrorist attacks, those things where people have suffered quite traumatically and that there’s a grief intertwined with that and the loss of someone they loved, or in losses that are implied in some of those events.
Interviewer: Yes, and a loss of innocence almost.
Kathleen: Loss of innocence, loss of safety, loss of trust. Loss of what we perceive to be our reality versus what it really is. The loss is so many things really wrapped up in those events.
Interviewer: How do you describe the difference between grief and then this traumatic grief?
Kathleen: I think any grief, we can experience grief around so many things. We can be grieving the loss of a job that we loved, or the loss of a relationship, a breakup, or something like that. We can experience the loss of a pet that was really beloved, because I’ve been through that loss. I don’t know if you’re a pet person.
Interviewer: I’m allergic, unfortunately.
Kathleen: Okay. Well, I’ve lost dogs that have been– really leave a terrible void. We can have grief around any number of things. We think of grief typically when we lose someone that we love, and that’s truly the case you that that we experienced a very specific painful time of grieving when we lose a loved one. Traumatic grief is that loss we weren’t expecting. It’s the loss that comes from a suicide, that comes from violent death, that comes from an injury and accident, something we weren’t anticipating. A lot of people experience traumatic grief when lose a child. It’s a loss you were not anticipating. Children aren’t supposed to die before their parents.
Interviewer: Right. Yes.
Kathleen: That kind of loss is very traumatic for people. What happens is that when they have that loss, it’s encoded in their brain in terms of all the level of experiences that they had at that time. Sights, sounds, smells, last memories, significant feelings of guilt or soft blame that you see wrapped up in that loss.
Interviewer: Yes, you say that’s like hardwired coded in.
Kathleen: Hardwired, it’s encoded in the brain. People don’t grieve that in the natural way that we would tend to grieve and expected or anticipated loss. Now if we have a parent that’s aging and we know, my parents are starting to age and my mom’s been ill, and you anticipate at some point that they will move in that direction. It’s when it’s unexpected and you didn’t anticipate that that was going to happen. If someone dies in a car crash, or as I said, in some of the more traumatic events.
We’ve seen– we just hit the one-year anniversary of the Las Vegas shooting, and you think about the level of people that were impacted by that and such a fearful thing. As a result, some of the losses for us is, we can’t enjoy being outdoors in a large concert because what do you think about when you think about the risks for those who are directly impacted, or know someone that was directly impacted. There are traumatic grief really involved in that whole event.
Interviewer: Yes. What are some other of the key aspects of traumatic grief, complex grief that you see in your work?
Kathleen: What I see is that people don’t move on, they don’t really recover, their life stopped when they lost their loved one in that way. They have a lot of guilt, a lot of “I should have, I could have.” It’s like the before and after. Before this loss here’s who I was, and then after this loss I don’t know who I am now. I’m really lost. People tend to stay in that space of traumatic grief or complicated grief for many many years without resolution, versus traditional grieving.
If you’re looking diagnostically, they say that grief symptoms usually resolve it in six months to a year. I don’t know how true that is. I think some people may have grief for a long period of time. Traumatic grief is very different and complicated. Usually what you see is, is that you see people having not just symptoms of complex grief, but also of post-traumatic stress disorder.
Interviewer: It can last longer.
Kathleen: Yes, that can last for a lifetime. I’ve worked with people who lost someone traumatically years ago, and they still had ongoing symptoms that were disturbing and interrupting their ability to function.
Interviewer: That’s just part of the normal journey. It’s not like they should be getting somewhere faster, right?
Kathleen: Right. Everybody’s grief is different. There’s really no beginning and end point. We can’t really trace beginning and end, but what we know about traumatic grief is that, it doesn’t make sense. We have a file. As I said earlier, we have a file in our brain. We understand aging parents, they’re going to pass away. We don’t understand when a child gets killed. Or someone suicides, or a child overdoses on opioids. That doesn’t make sense in our brain. We don’t have a file for that. Our brain is trying to make sense of something that doesn’t make sense. As a result, we have all of those symptoms of complex and traumatic grief.
Interviewer: Yes, the example of like a child dying. You’re telling me, I have two small kids. What do you say to someone? What are the first steps that are healthy, that are positive steps that you can take when you’re in that place of depth?
Kathleen: Well, I think we all mean well, don’t we? When someone passes away we want to say the right thing. We want to be comforting. We want to have all those things that we say that are the right thing. Sometimes the right thing to say is, “I don’t know what to say.” I don’t have words, because I know I don’t, if I’m talking to someone who’s had that kind of loss. I don’t have right parts, and anything that I say to them at that point is going to sound terrible. It’s going to sound–
Interviewer: Like belittling it.
Kathleen: Belittling, it’s going to sound like I want them to just hurry up and move on. Like their loved one didn’t really matter. Sometimes we may say things in meaning, well we might say, “I’m sorry for your loss and life goes on, or God bless you or they’re with the angels now.” Or whatever we might say, usually we’re saying those things because we want to feel better, and we’re uncomfortable.
Interviewer: Right, it is uncomfortable yes.
Kathleen: It’s very uncomfortable. We are uncomfortable with grief. When someone loses someone that they love, we want them to hurry up and get over it.
Interviewer: You can get back to normal.
Kathleen: We’re uncomfortable particularly when it’s a traumatic loss. We’re shocked, we don’t know what to say. More importantly, we’re terrified. We’re terrified by the possibility that something like that could happen to us.
Interviewer: Right, it gives us a glimpse of our own fragility.
Kathleen: We want to go back to the point where we feel like we have control, “That could never happen to me.” We want to hurry up and move on. The important thing when we have someone in our life or we’re working with someone we know that has traumatic grief, is really acknowledging how horrific that loss is and being present with that suffering, which is very hard to do. Holding that space for someone who’s had that level of loss and sometimes holding it for a long time.
One of the things I talk about is, we want them to move on. We want them to leave the cemetery, but that cemetery is now part of their life. That gravestone that represents the loss of their loved one, is forever part of their life now. Their work is to really integrate that loss, and for them to begin to understand, “How now do I live with this loss? Because this loss has now become a part of who I am.” Versus this place, we get a lock-down and never talk about it again.
Interviewer: Yes, because that’s not healthy. That’s not sustainable yes.
Kathleen: One of the other things I think is really important is allowing that person to talk about their loved one. Exploring that. “Tell me what you miss most about that person? What’s it like since they’ve been gone.” Because we don’t want to ask us questions. We want to just stop talking about it. It’s really painful and it’s hard to be with, but it’s so important because what we’re doing is we’re acknowledging that their loved one existed, and we’re acknowledging that they mattered.
Doing those two things can help that person even when it’s a traumatic loss to move forward. Acknowledging this doesn’t make sense. It doesn’t fit. It wasn’t supposed to happen. Those things can really help people heal, versus the opposite of handing out platitudes.
Interviewer: Wow, yes. Then looking at this from a therapeutic standpoint, what are some of the unique challenges and barriers that you see that people go through in this type of traumatic experience?
Kathleen: Well as I said earlier, a lot of people coming in with a traumatic grief, or a complicated grief. They have a lot of symptoms that don’t make sense, and sometimes unfortunately what we see is on top of that struggle that they’re having, they may have other diagnoses. They may have depression, they may have anxiety. They may be struggling with a substance use disorder that developed in the wake of that loss.
Interviewer: Yes, I was going to say all of these could be connected for sure.
Kathleen: They could be outcomes of that kind of loss. Sometimes figuring out where to start in terms of how we treat that or how we address that, is a little bit tricky. I try to find what’s the part of the wound that hurts the most and let’s go there, because if we can get a little relief to that area that hurts the most, then generally we get people stable. Sometimes we’re working on just containment. Giving people skills to cope with the pain that they’re feeling, because they’re not coping well, they’re falling apart. We may do some containment for them, give them some strategies to suit themselves a little bit.
Interviewer: Just make it through to the next day.
Kathleen: Yes, and just breathing and walking. Sometimes people are struggling with basic daily functioning. They’re not showering, they’re not eating, they’re not well, they’ve really fallen apart. Particularly when you see someone that’s lost someone they’d been with their whole life, a life partner, the impact that the person who shared every life experience as far back as you can remember is now gone. Your every waking, every single day, your meals, everything together, that person’s gone. Even just going back to restoring daily functioning, and helping them create new routines and new ways of experiencing life are really important.
Interviewer: What are some types of therapies or techniques that you have seen work well for starting to rebuild this life after all of this?
Kathleen: One of the things I talk a lot about is that narrative, because sometimes what happens with grief is that it’s not necessarily the loss itself, that’s the problem. It’s what the person believes about the loss that’s difficult. It’s that underlying meaning or the underlying narrative that they tell themselves about the loss, that is causing them the most pain or the most struggle.
Interviewer: What’s like a specific example of that?
Kathleen: There’s a traumatic loss, I used an example of one of the moms from the Sandy Hook shooting. One of the things that she talks about is that, she blamed herself for not being there for her child. That the place that they should have been safe, they weren’t. That narrative underneath is, “It’s my fault.” I worked with a young lady years ago who had lost a parent in a shooting, and as a child her narrative, because she was very egocentric as children are, that it was her fault.
That somehow she could have prevented that shooting from happening. If she had only done X, Y, Z, then maybe her dad might not have been in the place he was in. Looking at that narrative piece, because if you’re carrying the weight of that traumatic event and the loss that ensued, if you’re carrying the responsibility for that, imagine how difficult and painful that must be. Sometimes understanding what the narrative is, even if it’s not accurate. Even if there are pieces of that that’s missing or it’s distorted, I want to know what that narrative is.
Interviewer: It’s like narrative therapy right?
Kathleen: A little bit of narrative therapy. There’s also some spiritual impact. It’s really assessing what the meaning is of that event. What did that event mean to that person? It means something to them, because they’re struggling, it’s something very difficult. We got to figure out what that means. Assessing and just having people tell me the story and asking them, “What does this mean to you? What do you tell yourself about the event? What are some of the beliefs that are really hard for you?”
People are willing to talk about those kinds of things. When I can understand that, then I can start working to change the narrative and rewrite the story. It’s not supposed to happen that your child dies before you, it’s just not. That’s their narrative, is that, “This thing happened that wasn’t supposed to happen. Now I can’t trust, or now I’m broken, or the world is not a safe place.” Those are some of the other narratives that can sometimes be difficult for people.
If I can understand what those are, then we can begin to challenge those. Sometimes that’s a really helpful approach for people. Sometimes helping them reestablish a connection, a spiritual or emotional connection with the person that they lost is really important, because sometimes when it feels like the loss is finally forever, it’s a finality and it’s done, that’s a really difficult thing. If they feel like they can still have the spiritual or emotional connection with a person that they lost, it can help them heal much differently.
Interviewer: What does that look like in practical sense?
Kathleen: Sometimes I’ve just had people take a walk and just go sit quietly for a little bit, and just see if they can allow themselves to connect with the image, or the idea, or the emotional connection, they had with their person that they loved just for a minute. Allowing themselves just to think about or be present with the image or the notion of that person. Sometimes it’s terrifying for people, they don’t want to do that. It’s really painful, but it can be really helpful for them just to pay attention to that. I had a woman once who told me that every time she saw a penny, it made her think of her aunt.
It was as though her aunt was dropping pennies from heaven. For us it might sound silly, but for her it really was the piece of meaning and the ongoing connection she could have with this aunt that she loved. I don’t judge those pieces, because that’s where that person’s healing. That’s where they’re allowing themselves to move on and to feel like that person hasn’t quite left, that there’s still this connection, because we’re emotional beings. Because someone is physically no longer with us, it doesn’t mean that the emotional aspect of our relationship with them has to die.
Interviewer: Yes. How do you describe Narrative Therapy then, and how does that play into all this?
Kathleen: With Narrative Therapy, I’m really looking at the idea of the story, and how we tell the story, and if we could change the story, what might that look like. We don’t always get to choose what happens to us, but we can choose where we go from here with the story. We can change how we want the story to go. There’s a lot of different things you can do with the idea of Narrative Therapy.
You can have people began to think about writing the story from sometimes to have them write the story from a third person perspective, describing their experience with compassion. They might begin to tell their story about, if my name is Sue, I might write a story about Sue, and the day she lost someone she loved, and what that was like, what was happening in her world, who was Sue really as a person.
I would describe myself with compassion, and I would talk about the loss that was experienced, and not just the loss of we can observe, but sometimes the implied losses as well. What are the other pieces of the loss that happened, and writing those out and exploring those. Sometimes when we can do that from a third person perspective, it can help change our view on how that is that we get out of our own mind for a little bit.
Interviewer: Was something, did like a traumatic loss. I mean is there any way to prepare yourself, strengthen yourself. I mean, there’s just nothing. It’s just kind of, it is what it is, if and when it happens.
Kathleen: I wish that we had like a magic shield, don’t you? We could just put around ourselves and buffer ourselves against trauma. The truth is, we can’t, but we also can’t live in fear, because when we’re living in fear, we’re not living authentically. We’re living in a protective stance that keeps us from really connecting.
Interviewer: We’re not enjoying.
Kathleen: We’re not enjoying. We’re not and I don’t want to live in fear. You don’t want to live in fear. Knowing that trauma can happen, and knowing that when it does happen, that we do heal, we do recover, and staying open in spite of the pain that we might feel and finding support. When we have trauma, we’ve got to have support. I don’t think it was meant for us to go through those things alone. Allowing ourselves to connect with other people and telling our story over and over and over, helps us heal. Writing our story, drawing or story, painting our story. There’s a lot of different ways that we can tell our story, and that goes back to the concept of Narrative Therapy.
Interviewer: That’s a good point. They were saying about opening yourself up, and not living in fear. I mean, I’m sure there’s lots of like movies and poems and books that have said, “To love is to open yourself up,” but it’s worth it even with that risk of loss of being hurt. That’s just how we live.
Kathleen: Yes, that’s how we were meant to live. That’s not how we always live, but I believe, that’s how we were meant to live. That we rise up again, even when we’ve been wounded. When we can do that we come back. If we allow ourselves, we can come back with a greater sense of compassion, and a greater sense of love, and just an awareness that we struggle, that we’re human. We will hurt each other sometimes. Sometimes we will traumatize one another and learning from that, and growing from that, rather than shrinking back.
Interviewer: Yes, so a wrap up with this final question. You’ve devoted a lot of your life to this mission, I mean, two decades plus. Could you end by summing up why helping people heal from grief and loss of trauma is so important to you?
Kathleen: I think that for me, this work is part of my spirituality. It’s how I give back to the world. It’s how I express gratitude. It’s part of my being, I think, is just connecting. I feel like, if I can help somebody and move toward empowerment, toward taking their life back, toward living out the mission that they were supposed to live out, then I think that’s really important. I’m really grateful for people who have invested their time in me, and people who have really seen me, and reached out to me. That have made a difference for me. I think in turn, it’s our responsibility to use our gifts and abilities in that same way to reach out, to see people to connect, to help them heal when they need it.
Interviewer: Yes. All right. Well, Kathleen, thank you for your time.
Kathleen: Thank you so much. I appreciate it.
Interviewer: All right.