Markers in Time: Expanding Our Concept of Trauma Triggers to Include Subjective Experiences of Time Among Adults Surviving Traumatic Loss

Abstract

We outline two studies that collected exploratory data on the meaningful time approach and explore the notion of temporal triggers that emerge in the process of coping with traumatic loss. Qualitative data analysis was completed on data gathered from face-to-face interviews as well as open ended responses to an online survey. 35 themes and sub-codes were identified. 30 of these were replicated in both studies. Our data supported the notion of “markers in time” and identified three clear phases to these markers. Participants also noted the consequences of loss on their lives, and the influence of societal and religious approaches to bereavement on their process of coping. Results of this study support a cyclical approach to understanding coping with loss and provides clinicians working with bereaved individuals yet another tool to address the dynamic experience of bereavement.

Keywords

Trauma Trigger Bereavement Coping Adaptation

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References

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing.

American Psychiatric Association (2022). Diagnostic and statistical manual of mental disorders (5th ed TR.). Washington, DC: American Psychiatric Publishing.

Atwoli

Stein

D. J.

King

Petukhova

Aguilar-Gaxiola

Alonso

WHO World Mental Health Survey Collaborators , et al. (2017). Posttraumatic stress disorder associated with unexpected death of a loved one: Cross-national findings from the world mental health surveys. Depression and Anxiety, 34(4), 315–326. https://doi.org/10.1002/da.22579

Azarian

Miller

T. W.

McKinsey

L. L.

Skriptchenko-Gregorian

Bilyeu

(1999). Trauma accommodation and anniversary reactions in children. Journal of Contemporary Psychotherapy, 29(4), 355–368. https://doi.org/10.1023/A:1022934923275

Baier

Buechsel

(2012). A model to help bereaved individuals understand the grief process. Mental Health Practice, 16(1), 28–32. https://doi.org/10.7748/mhp2012.09.16.1.28.c9281

Boelen

P. A.

(2016). Improving the understanding and treatment of complex grief: An important issue for psychotraumatology. European Journal of Psychotraumatology, 7, 32609. https://doi.org/10.3402/ejptv7.32609

Boerner

Stroebe

Schut

Wortman

C. B.

(2017). Theories of grief and bereavement. In Pachana

(Ed), Encyclopedia of Geropsychology (pp. 1–10). Springer. https://doi.org/10.1007%2F978-981-287-080-3_133-1

Bonanno

G. A.

(2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? The American Psychologist, 59(1), 20–28. https://doi.org/10.1037/0003-066X.59.1.20

Bonanno

G. A.

Kaltman

(1999). Toward an integrative perspective on bereavement. Psychological Bulletin, 125(6), 760–776. https://doi.org/10.1037/0033-2909.125.6.760

10.

Bowlby

(1969). Attachment. New York: Basic Books.

11.

Freud

(1895). Studies in hysteria. In Strachey

(Ed. & Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 2, pp. 1–305). London, UK: Hogarth Press.

12.

Freud

(1922). Mourning and melancholia. The Journal of Nervous and Mental Disease, 56(5), 543–545. https://doi.org/10.1097/00005053-192211000-00066

13.

Freud

(1957). Mourning and melancholia. In Strachey

(Ed. and Trans.), The standard edition of the complete psychological works of Sigmund Freud (pp. 152–170). Hogarth Press. (Original work published 1917).

14.

Gabriel

M. A.

(1992). Anniversary reactions: Trauma revisited. Clinical Social Work Journal, 20(2), 179–192. https://doi.org/10.1007/BF00756507

15.

Green

B. L.

(2000). Traumatic loss: Conceptual and empirical links between trauma and bereavement. Journal of Personal and Interpersonal Loss, 5(1), 1–17. https://doi.org/10.1080/10811440008407845

16.

Haesler

(1986). Psychodynamics of anniversary-reactions. The Scandinavian Psychoanalytic Review, 9(1), 3–29. https://doi.org/10.1080/01062301.1986.10592474

17.

Hamdan

Berkman

Lavi

Levy

Brent

(2020). The effect of sudden death bereavement on the risk for suicide: The role of suicide bereavement. Crisis, 41(3), 214–224. https://doi.org/10.1027/0227-5910/a000635

18.

Hidalgo

R. B.

Davidson

J. R.

(2000). Posttraumatic stress disorder: Epidemiology and health-related considerations. The Journal of Clinical Psychiatry, 61(Suppl 7), 5–13. PMID:10795604.

19.

Horowitz

M. J.

Siegel

Holen

Bonanno

G. A.

Milbrath

Stinson

C. H.

(1997). Diagnostic criteria for complicated grief disorder. The American Journal of Psychiatry, 154(7), 904–910. https://doi.org/10.1176/ajp.154.7.904

20.

Jordan

J. R.

Neimeyer

R. A.

(2003). Does grief counseling work? Death Studies, 27(9), 765–786. https://doi.org/10.1080/713842360

21.

Jordan

(2003). What we learned from the 9/11 first anniversary. The Family Journal, 11(2), 110–116. https://doi.org/10.1177/1066480702250158

22.

Kaltman

Bonanno

G. A.

(2003). Trauma and bereavement: Examining the impact of sudden and violent deaths. Journal of Anxiety Disorders, 17(2), 131–147. https://doi.org/10.1016/S0887-6185(02)00184-6

23.

Kersting

Kroker

Steinhard

Lüdorff

Wesselmann

Ohrmann

, et al. (2007). Complicated grief after traumatic loss: A 14-month follow up study. European Archives of Psychiatry and Clinical Neuroscience, 257(8), 437–443. https://doi.org/10.1007/s00406-007-0743-1

24.

Krosch

D. J.

Shakespeare-Finch

(2017). Grief, traumatic stress, and posttraumatic growth in women who have experienced pregnancy loss. Psychological Trauma: Theory, Research, Practice, and Policy, 9(4), 425–433. https://doi.org/10.1037/tra0000183

25.

Kubler-Ross

(1969). On death and dying: What the dying have to teach doctors, nurses, clergy, and their families. New York, NY: Scribner.

26.

Kubler-Ross

Kessler

(2005). On grief and grieving: Finding the meaning of grief through the five stages of loss. New York, NY: Scriber.

27.

Latham

A. E.

Prigerson

H. G.

(2004). Suicidality and bereavement: Complicated grief as psychiatric disorder presenting greatest risk for suicidality. Suicide and Life-Threatening Behavior, 34(4), 350–362. https://doi.org/10.1521/suli.34.4.350.53737

28.

Lietz

C. A.

Zayas

L. E.

(2010). Evaluating qualitative research for social work practitioners. Advances in Social Work, 11(2), 188–202. https://doi.org/10.18060/589

29.

Lund

D. A.

Caserta

M. S.

(1998). Future directions in adult bereavement research. OMEGA - Journal of Death and Dying, 36(4), 287–303. https://doi.org/10.2190/efgk-lral-3fmb-897j

30.

Mawson

Marks

I. M.

Ramm

Stern

R. S.

(1981). Guided mourning for morbid grief: A controlled study. The British Journal of Psychiatry: The Journal of Mental Science, 138, 185–193. https://doi.org/10.1192/bjp.138.3.185

31.

McDevitt-Murphy

M. E.

Neimeyer

R. A.

Burke

L. A.

Williams

J. L.

Lawson

(2012). The toll of traumatic loss in African Americans bereaved by homicide. Psychological Trauma: Theory, Research, Practice, and Policy, 4(3), 303–311. https://doi.org/10.1037/a0024911

32.

Middleton

Raphael

Burnett

Martinek

(1998). A longitudinal study comparing bereavement phenomena in recently bereaved spouses, adult children and parents. The Australian and New Zealand Journal of Psychiatry, 32(2), 235–241. https://doi.org/10.3109/00048679809062734

33.

Mintz

(1971). The anniversary reaction: A response to the unconscious sense of time. Journal of the American Psychoanalytic Association, 19(4), 720–735. https://doi.org/10.1177/000306517101900406

34.

Mitchell

A. M.

Terhorst

(2017). PTSD symptoms in survivors bereaved by the suicide of a significant other. Journal of the American Psychiatric Nurses Association, 23(1), 61–65. https://doi.org/10.1177/1078390316673716

35.

Morgan

C. A.

III Kingham

Nicolaou

Southwick

S. M.

(1998). Anniversary reactions in gulf war veterans: A naturalistic inquiry 2 years after the gulf war. Journal of Traumatic Stress, 11(1), 165–171. https://doi.org/10.1023/A:1024473519720

36.

Nemeth

D. G.

Kuriansky

Reeder

K. P.

Lewis

Marceaux

Whittington

, et al. (2012). Addressing anniversary reactions of trauma through group process: The Hurricane Katrina anniversary wellness workshops. International Journal of Group Psychotherapy, 62(1), 129–142. https://doi.org/10.1521/ijgp.2012.62.1.129

37.

Neria

Litz

B. T.

(2004). Bereavement by traumatic means: The complex synergy of trauma and grief. Journal of Loss and Trauma, 9(1), 73–87. https://doi.org/10.1080/15325020490255322

38.

Pollock

G. H.

(1970). Anniversary reactions, trauma, and mourning. The Psychoanalytic Quarterly, 39(3), 347–371. https://doi.org/10.1080/21674086.1970.11926533

39.

Porcelli

Fava

G. A.

Rafanelli

Bellomo

Grandi

Grassi

, et al (2012). Anniversary reactions in medical patients. The Journal of Nervous and Mental Disease, 200(7), 603–606. https://doi.org/10.1097/NMD.0b013e31825bfb2e

40.

Poznanski

E. O.

Poznanski

E. O.

(1972). The “replacement child”: A saga of unresolved parental grief. The Journal of Pediatrics, 81(6), 1190–1193. https://doi.org/10.1016/S0022-3476(72)80261-0

41.

Renvoize

E. B.

Jain

(1986). Anniversary reactions. The British Journal of Psychiatry, 148, 322–324. https://doi.org/10.1192/bjp.148.3.322

42.

Saltzman

L. Y.

(2019). It’s about time: Re-Conceptualizing the role of time in loss and trauma. Psychological Trauma: Theory, Research, Practice, and Policy, 11(6), 663–670. https://doi.org/10.1037/tra0000435

43.

Saltzman

L. Y.

Hunter

L. D.

(2022). What’s time got to do with it?: A time-informed approach to longitudinal research with trauma affected populations. Journal of Death and Dying, 0(0), 1–9. https://doi.org/10.1177/00302228221096245

44.

Sebastian

(2019). Distinguishing between the types of grounded theory: Classical, interpretive and constructivist. Journal for Social Thought, 3(1), 1–9.

45.

Shaver

P. R.

Tancredy

C. M.

(2001). Emotion, attachment, and bereavement: A conceptual commentary. In Stroebe

M. S.

Hansson

R. O.

Stroebe

Schut

(Eds), (pp. 63–88). American Psychological Association. https://doi.org/10.1037/10436-003.Handbook of bereavement research: Consequences, coping, and care

46.

Shear

Shair

(2005). Attachment, loss, and complicated grief. Developmental Psychobiology, 47(3), 253–267. https://doi.org/10.1002/dev.20091

47.

Siggins

L. D.

(1966). Mourning: A critical survey of the literature. The International Journal of Psycho-Analysis, 47(1), 14–25.

48.

Stroebe

(1991). Does “grief work” work? Journal of Consulting and Clinical Psychology, 59(3), 479–482 https://doi.org/10.1037/0022-006X.59.3.479

49.

Thomas

Hudson

Trauer

Remedios

Clarke

(2014). Risk factors for developing prolonged grief during bereavement in family carers of cancer patients in palliative care: A longitudinal study. Journal of Pain and Symptom Management, 47(3), 531–541. https://doi.org/10.1016/j.jpainsymman.2013.05.022

50.

van der Houwen

Stroebe

Schut

van den Bout

Wijngaards-De Meij

(2010). Risk factors for bereavement outcome: A multivariate approach. Death Studies, 34(3), 195–220. https://doi.org/10.1080/07481180903559196

51.

Watkins

D. C.

(2017). Rapid and rigorous qualitative data analysis: The “RADaR” technique for applied research. International Journal of Qualitative Methods, 16(1), 160940691771213. https://doi.org/10.1177/1609406917712131

52.

Wayment

H. A.

Vierthaler

(2002). Attachment style and bereavement reactions. Journal of Loss and Trauma, 7(2), 129–149. https://doi.org/10.1080/153250202753472291

53.

Wortman

C. B.

Silver

R. C.

(1989). The myths of coping with loss. Journal of Consulting and Clinical Psychology, 57(3), 349–357. https://doi.org/10.1037//0022-006x.57.3.349

54.

Zimbardo

P. G.

Boyd

J. N.

(1999). Putting time in perspective: A valid, reliable individual-differences metric. Journal of Personality and Social Psychology, 77(6), 1271–1288.. https://doi.org/10.1037/0022-3514.77.6.1271

55.

Zinzow

H. M.

Rheingold

A. A.

Hawkins

A. O.

Saunders

B. E.

Kilpatrick

D. G.

(2009). Losing a loved one to homicide: Prevalence and mental health correlates in a national sample of young adults. Journal of Traumatic Stress, 22(1), 20–27. https://doi.org/10.1002/jts.20377

56.

Zisook

Devaul

R. A.

Click

M. A.

Jr (1982). Measuring symptoms of grief and bereavement. The American Journal of Psychiatry, 139(12), 1590–1593. https://doi.org/10.1176/ajp.139.12.1590