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Joyce Boaz & Dr. Frank Ochberg, M.D.

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Grief & Loss from a Tragic Death

Q: Dear Frank,

Here is a question from one of our support pals having to do with PTSD and unresolved trauma.

"I was wondering if you knew of (or could ask Frank) anything having to do with PTSD and unresolved trauma? Or the person with PTSD feeling as though they have the ability to possibly prevent the trauma before the trauma anniversary date?

My grandmother was murdered. Every year my brain tells me to try to figure it out to prevent it and this year I didn't do any of that obsessing over it and it's coming up soon... Which has resulted in not good things for my head.

Just wondering if this is a PTSD thing or if I'm the only one who has such problems. Thank you."

A: Dear Joyce,

This is a thoughtful question and I'll try to help. Violent death is different from natural death. It has a way of lodging in our minds, of causing us to revisit the scene -even if we weren't there, but learned some of the details afterward- and it results in ritual remembering. Perhaps that is part of deep and adaptive human wiring: we obsess in order to assure that justice is done, that no stone is left unturned, that the crime will eventually be adequately punished. My friend, Ted Rynearson, is the psychiatrist-scholar of unnatural dying and his work explains this human habit. After we are finally finished with obsessive return to the scene of the crime, and the unfortunate mental image of our loved one as a victim, we then face all the problems of PTSD: trauma memory that has a frightening and vivid quality; a numbing of our positive, joyful emotion; a pervasive anxiety.

And after PTSD runs its course and becomes tolerable, we have the grief of loss. That is considered normal, not a disorder, but it is sad and painful. After bereavement is over (perhaps not completely over, but subdued) we can finally reflect on the life of the one we miss, and that can be full of warmth and gratitude. So my advice is to think hard about the love you have for your grandmother. Try to imagine her still loving you. See if you can't create a two-way path in your mind from you to her and her to you. You needn't believe in afterlife. You just have to believe in her good qualities when she was alive, and the way those qualities were transmitted to you. Celebrate her life, mourn her death, and do your best to leave the rest to those professionals who investigate crime and have the tools to defend themselves from traumatic remembering.

Frank M Ochberg, MD

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