A Shot of Hope

Dear Dr. Neimeyer,

I’ve heard about your work with traumatic bereavement and decided to reach out with a question. I hope you don’t mind.

How would you recommend I work through your process of meaning making after loss — is it through your book/workbook or with a counselor? Four years ago, I survived a head-on collision, but my husband did not. While I’ve had different kinds of therapy, and some of it with very compassionate therapists, I still feel imprisoned, maybe like I’m still trapped in the car. I’m wondering if walking through the tangible process you describe of retelling the loss might be my missing link? I don’t know what will help but I figured at this point it really couldn’t hurt to ask an expert for advice.

It’s been a long and hard four years, and I am looking for a shot of hope.

Shakti

Dear Shakti,

Your loss is heartbreaking by any account, even in this briefest of summaries. To lose your husband and the life you knew in one horrific instant must have flooded you with grief and disbelief, and it is easy to imagine that you continue to feel trapped in that surreal instant, with no “jaws of life” to set you free. However supportive and well intentioned, most otherwise competent therapists could feel equally helpless in the face of such traumatic loss, which requires something more than compassionate bereavement support, though it requires that, too.

As your question suggests, I do believe that finding safe passage and guidance in walking through that experience, making a fuller kind of sense of what happened to you and what was happening within you, could be very useful in integrating this tragedy into your life without it becoming your life. Having experienced the suicide of my father at an early age and having worked clinically with countless others who have suffered their own versions of tragic loss reminiscent of your own, I do believe in the reality of resilience even in such extremes.

But I also know that it requires great courage and willingness to step to the very edge of the abyss—well accompanied, so that we don’t slip in. Unfortunately, we can never master that which we avoid. What is essential is finding secure grounding to stand near the experience, in all of its uncensored detail, but anchored in an emotionally regulated state, as we sift through it. Sometimes this can be done by standing in the presence of it silently, as in grief-informed versions of EMDR, and sometimes it can be done by sharing it, a scene at a time with a trusted therapist or group, as in prolonged grief treatment. Narrative versions of this procedure involve finding words or images to capture the scene and slowly convey its relevant emotion and meaning to your therapeutic companion(s). This is slow, careful work, probably best undertaken with a skillful therapist. However, there are aspects of it—such as subsequently reviewing an audio-recorded version of your retelling and perhaps journaling further about it—which might be practiced with active guidance and safeguards between sessions with your therapist.

Of course, to describe this form of narrating of the experience as “emotionally regulated” is not to say it is neutral and unemotional, but rather to say that it needs to be kept within your “window of tolerance”, your capacity to experience the sadness and anxiety of the experience without feeling like you are falling apart. Doing so and having your words or images received and held by one or more caring witnesses, with no attempt to offer a quick “solution” or disputation of them, is key. Gradually, perhaps across a few sessions of revisiting the internalized scene of the accident, you are likely to find that it begins to transform, become fuller, the pieces fitting together more coherently, and the electric charge of the trauma dialing down as you build the capacity to face it, supported by others who can “be there” for you in the moment in a way that was impossible in the accident itself. Sometimes “rescripting” of the image is a helpful next step—imagining in sensory detail how you might have preferred to be there lovingly for your husband, even if unable to save him in the moment of his passing. At its core, this form of restorative retelling, which has been used with thousands of traumatic loss survivors, amounts to finding a way to approach and bear the scene(s) of the loss with less reactivity and more resilience, and then to be able to re-enter life.

There are two recent books, both of them quite affordable, which could prove useful for both you and your therapist in pursuing such work. The first is my book, Living Beyond Loss: Questions and Answers about Grief and Bereavement, written in response to 100 earnest questions like your own posed by the bereaved themselves and the professionals who accompany them. Dozens of these questions concern violent and sudden loss, the death of partners, and inquiries about specific therapeutic methods. Another is The Traumatic Loss Workbook by Jennifer Levin, which provides intelligent advice for persons like yourself to support your self-care as you work on and through tragic bereavement. Both could prove good companions on the journey.

I hope and believe that, with the right therapeutic guidance and your own determination, you can move toward a less traumatized way of navigating this life-altering loss. Nothing will erase the utterly tragic death of your husband and what you yourself went through in the same accident. But with courage, commitment and the right companionship, you can come to hold the story, rather than having the story hold you.

–Dr. Neimeyer

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