The 17th anniversary of the Sept. 11, 2001, terrorist attacks brings to consciousness the catastrophic deaths of about 3,000 people in downed passenger jets, the Pentagon and collapse of the World Trade Center Towers. More recently, lethal violence erupted in Florida against innocent victims at a nightclub in Orlando, a high school in Parkland and a video arcade in Jacksonville.
We react with shock and sadness at the senseless deaths, while we are mindful of the survivors, family members and loved ones who were directly impacted by these tragedies, and may remain deeply affected weeks, months, and even years afterward. Mental-health professionals have made considerable advances in understanding the consequences of the interactions of trauma and grief following lethal violence, and psychotherapists have become better equipped to offer solace to those who cannot find relief from their suffering.
Grief, mourning and bereavement are similar terms that describe the emotional reactions that follow the death of a loved one. These responses are shaped by an individual’s personal history, personality and cultural background. In the public memorial services for U.S. Sen. John McCain, viewers could share in the sadness for the loss of a hero whose image, voice and struggles were familiar to many Americans.
Sen. McCain contended with an incurable illness for the last year of his life, which gave him time to plan his funeral and for his family to prepare psychologically for his impending death. Under such circumstances, mourners can process their loss while experiencing sadness, especially when reminded of the deceased. As months pass, the waves of sad feelings tend to decrease in intensity and frequency, as emotional ties weaken and new relationships and interests develop. This normal grief process typically runs a course of a year or so, though there are considerable variations. However, some mourners have great difficulty moving on in their lives, and they could benefit from counseling.
On the other hand, in the aftermath of a sudden, unexpected and violent death, the grief process is disrupted and could become perilous. Imagine taking cover during the carnage of a sniper shooting. Overwhelming feelings of danger, anxiety and physical arousal, combined with the sights, sounds and smell of people dying, may become the basis of powerful recurrent memories and nightmares. Family and friends who were not eyewitnesses may later visit the scene of the violence and become deeply affected by what happened there to their loved ones.
One of this year’s Oscar-winning films, “Three Billboards Outside Ebbing, Missouri,” portrays the failed coping strategies of a woman whose daughter was raped and murdered while she was walking from her home to town. Her mother’s traumatic and guilt-ridden memories of their last interactions markedly interfered with her ability to grieve. Efforts to reminisce about her slain daughter were stymied and replaced by disturbing thoughts of her horrific death. Her sadness morphed into rage with terrible consequences. The actors’ prize-winning performances allowed the audience to empathize with the mother’s suffering and appreciate how it led to tragic consequences for herself and her town.
Fortunately, it is by no means inevitable that a person facing the violent death of a loved one will be unable to cope. There are paths to recovery and even growth, and psychotherapists have the skills to foster a positive outcome.
The first priority is usually to address the violence by working through the experience using the techniques that have been proven effective for post-traumatic stress. When the individual is empowered to remember the deceased without feeling the terror of lethal violence, then the mourning process can proceed safely and effectively. No one should feel ashamed of suffering the pain of morbid grief — there are mental health professionals who can help.