Traumatic loss

This article is part 5 of a series on trauma written by the Fortem clinical team. To read part 4, click here.

First responders are frequently exposed to death. You bear witness to tragic and senseless loss of members of the public and encounter the grief and anguish of those who love them. Additionally, you may also experience the sudden, unexpected, and violent loss of colleagues, friends, or family members. 

All of these loss experiences take a toll. While death has long been integral to the definition of trauma, the experience of loss in such events, even when it involves strangers, has often been overlooked as a cause of traumatic stress for first responders. 

What is traumatic loss? 

Traumatic loss refers to the sudden, unexpected, and often violent loss of life under traumatic circumstances that are experienced as tragic, horrifying, and senseless.  

Examples of traumatic loss include: 

• loss of someone close through accidents, natural disasters, violent crime, or acts of terror 
• death of a vulnerable person (e.g. child, elderly) 
• personal connection or identification with the victim of an accident or crime (e.g. same age as own child) 
• loss of a colleague, friend, or family member through suicide 
• mass casualties (both human and animal) 

Grief is part of life and a natural response to loss. However, after a critical incident, disaster, or even just the usual flow of first responder work, there are many things that can disrupt the normal process of grieving.  

Traumatic loss is not a formal diagnosis. Often referred to as traumatic grief, the nature of traumatic loss can intensify the grieving process and may lead to complicated and prolonged grief reactions and post-traumatic stress symptoms. 

Symbolic loss for first responders 

While traumatic loss in the general population usually refers to the loss of someone that is known or close to you, first responders can also experience traumatic loss in relation to strangers encountered during work.  

This type of symbolic loss is surprisingly common among first responders. This is where you have no direct personal connection to an individual but are deeply impacted because of a symbolic connection. The person can remind you of someone (a child or sibling) or be representative of vulnerability (elderly). While the person may not be known to you, this loss can leave an indelible emotional impression that is both deep and long-lasting. 

What does traumatic loss look like? 

Traumatic loss can be experienced first-hand or learned about after the fact. It is not uncommon to grapple with feelings of responsibility in some manner and if you were also involved in the event, you can feel guilty about surviving. 

You can experience intrusive thoughts, nightmares, and flashbacks related to the traumatic event. You might also struggle with feelings of numbness, detachment, or difficulty expressing emotions. 

It is not uncommon to become preoccupied with the loss. This can lead to disconnection from other relationships and withdrawal from enjoyable activities due to concerns about dishonoring the memory of the person. 

What does traumatic loss feel like? 

Traumatic loss is often experienced as tragic, horrifying, and bewildering.  

Thoughts can often turn to the person’s last moments, where you wonder what they were thinking, whether or not they suffered, or if they felt alone. 

There may be a sense of unfairness and wasted life and it can cause intense feelings of shock, grief, guilt, anger, and concerns for human vulnerability and dignity. 

Processing traumatic loss 

Experiences of traumatic loss can be deeply wounding, hard to understand, and even harder to communicate. There are no established norms for how to process such feelings. When suffering from traumatic or symbolic loss you can find yourself stuck in a cycle of guilt and self-restricting behavior through a drive to remember – or more accurately, to not forget – the individual.  

The important thing is not whether you should pay respect and honour their memory but learning to do this in a way that allows you to live your life and enjoy the connections that remain. 

It may be beneficial to seek specialist support to process the personal impact and significance of the traumatic loss. This can be a crucial step towards healing, resilience, and finding a renewed sense of hope in the face of profound loss. 

What’s next?

Next week we will be exploring the topic of Post Traumatic Growth. 

Article written by Dominic Hilbrink, Senior Clinician at Fortem Australia.