This was released as Episode 373 of Counselor Toolbox Podcast. You can find specific episodes and CEU courses based on the podcasts at https://allceus.com/counselortoolbox You can also subscribe on your favorite podcast app like Apple Podcasts, Google Play or Castbox.

1. Trauma, Grief and Loss
Presented by: Dr. Dawn-Elise Snipes, PhD, LPC-MHSP, LMHC
Executive Director, AllCEUs Counseling Continuing Education
Host: Counselor Toolbox Podcast
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 1

2. Objectives
 Conceptualize grief in terms of the response to
any loss
 Identify the 10 core concepts for understanding
trauma
 Identify how failure to deal with grief can impact
a person
 Explore the stages of grief
 Review activities and interventions to help people
grieve
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 2

3. What is Grief
 Grief is a label assigned to all of the emotions associated with dealing
with any kind of loss
 Physical (Things, abilities, freedoms)
 Self-concept (Roles, values, labels)
 Worldview (Innocence, safety)
 Dreams (How things should be)
 Social (Loss of relationships…)
 Trauma is a psychological, emotional and behavioral response to an
event or an experience that is deeply distressing or disturbing
 Not all losses are traumatic but all traumas involve loss
 To help people accommodate to their “new normal” we must
understand how the trauma/loss impacts them on a biopsychosocial
basis
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 3

4. 10 Core Concepts for Understanding Trauma
 #1 Traumatic experiences are complex
 Emotional: Depression, anxiety, resentment, guilt,
anger
 Physical: Sleep, HPA-Axis, pain, GI symptoms
 Interpersonal: Dependency, withdrawal, distrust,
jealousy
 Spiritual: Anger at HP, sense of disconnection, loss of
meaning, loss of direction
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89 4

5. 10 Core Concepts for Understanding Trauma
 #2 Traumatic occurs within the context that includes the
individual’s personal characteristics, life experiences and
current circumstances
 Prior stressors in the last 6 months (Physical, emotional,
interpersonal, environmental)
 Mental health issues
 Cognitive developmental stage (all-or-nothing; egocentrism;
concrete or formal operational; comparative experiences)
 Ability to meet biological and safety needs
 Social support
 Proximity to a “safe” space
 Current coping skills and tools
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89 5

6. 10 Core Concepts for Understanding Trauma
 #3 Traumatic events often generate secondary
adversities, life changes, and distressing reminders in
people’s daily lives
 Housing changes
 Physical illnesses or injuries
 Sleep difficulties
 Mood changes
 Shame, guilt, anger
 Loss of significant people or things
 Visual, auditory and olfactory reminders that trigger
flashbacks or strong emotional reactions
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89 6

7. Core concepts cont…
 These secondary losses/adversities also need to
be acknowledged and grieved.
 Loss of a part of ourselves
 Loss of identity
 Loss of self confidence
 Loss of a chosen lifestyle
 Loss of security or a sense of safety
 Loss of dreams
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 7

8. Core concepts cont…
 What secondary losses/adversities might occur for
these events?
 Death of a parent
 Separation or divorce
 Miscarriages
 Injury or disability
 Moving to a new place (military children)
 Being placed in foster care
 House fire/tornado/flood/hurricane
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 8

9. 10 Core Concepts for Understanding Trauma
 #4 People exhibit a wide range of reactions to trauma/loss
 Grief Reactions
Denial: Numbness, dream, alternate explanations
Anger/Anxiety: The unknown, loss of control, death,
isolation, shame/failure—(shouldas and couldas),
resentment, jealousy
Bargaining: If I … then I will wake up and realize this was
only a really bad dream
Depression: Helpless, hopeless
Acceptance: Radical acceptance that the loss occurred
and determining how to proceed from there
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89 9

10. Core concepts cont…
 #4 People exhibit a wide range of reactions to trauma
and loss
 Posttraumatic stress
 Disruption of attachment and/or peer relationships
 Problems with emotional regulation
 Aggression/irritability
 Withdrawal or constant immersion in relationships
 Reduced level of functioning at home, at school/work, and
in the community.
 Exacerbation of preexisting mental health or addiction
problems
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89 10

11. 10 Core Concepts for Understanding Trauma
 #5 Safety is a core concern
 Trauma can:
Magnify concerns about dangers
Make it more difficult to distinguish between safe and
unsafe situations
 Placing people in physically safe circumstances may not
be sufficient to alleviate their fears or restore their
disrupted sense of safety and security (B&E, cancer,
DV)
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89 11

12. 10 Core Concepts for Understanding Trauma
 #6 Traumatic experiences affect the family and
broader caregiving systems
 Family members’ or social supports’ own distress can
impair their ability to support the traumatized person
 This compounds the survivor’s reduced sense of
protection and security
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89 12

13. 10 Core Concepts for Understanding Trauma
 #7 Trauma and post-trauma adversities can
strongly influence development (even in adults)
 Regressive behavior
 Reluctance, or inability to participate in
developmentally appropriate activities
 For children, developmental accelerations such as
leaving home at an early age and engagement in
precocious sexual behavior.
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89 13

14. 10 Core Concepts for Understanding Trauma
 #8 Neurobiology underlies reactions to traumatic
experiences
 Capacities to appraise and respond to danger are linked
to the HPA-Axis
 This “threat response system” controls
Appraisals of dangerous situations
Emotional and physical reactions
Protective actions
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89
14

15. Core concepts cont…
 #8 Neurobiology underlies reactions to traumatic
experiences
 Traumatic experiences evoke strong biological
responses that can persist and, in children, alter brain
development
 The neurobiological impact of traumatic experiences
depends in part on:
The developmental stage in which they occur.
The number and intensity of traumatic experiences
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89
15

16. 10 Core Concepts for Understanding Trauma
 #9 Challenges to the social contract, including legal and
ethical issues, affect trauma response and recovery
 Traumatic experiences often constitute a major violation of the
expectations of the child, family, community, and higher power
 Survivors are often acutely aware of whether justice is
properly served and the social contract is upheld
 The perceived success or failure of these institutional
responses may exert a profound influence on the course of
people’s post-trauma adjustment, and on their evolving
beliefs, attitudes, and values regarding family, work, and
civic life (B&E, DV, cancer)
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89
16

17. 10 Core Concepts for Understanding Trauma
 #10 Protective factors can reduce the adverse
impact of trauma.
 High self-esteem
 Self-efficacy
 Possessing a repertoire of adaptive coping skills.
 Positive, secure attachment
 Effective, reliable social support
 A supportive school/work and community environment
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89 17

18. Impact of Unresolved Grief/Trauma
 Most people get stuck in either anger or
depression
 Anger (shoulda, couldas and if onlys)
 At self
 At others
 At higher power
 Depression (Hopelessness, Helplessness—I don’t
now how to go on)
 At self
 At others
 At higher power
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 18

19. Denial
 Denial, numbing is the mind’s way of protecting people
from what lies ahead.
 Facing the loss
 Understand the events of their lives and reconcile the losses
they have experienced (clarification)
 Anger is the power play
 Break down the walls (Bricks or legos, handball wall, soda cans
with the losses and threats represented)
 Bargaining, Pining
 Mindfulness
 Radical acceptance and living in the And
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 19

20. Denial
 Depression, Disorganization and Despair
 Address hopelessness and helplessness by focusing on
what can be changed
Death Disappearance
Loss Nothing will ever be okay again
Failure Failure at everything
Bad thing happens It has to happen again
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 20

21. Denial
 Acceptance/Reorganization
 Redefine worldview integrating new experiences and
strengths
 Visualize a positive future
Who am I? (Identity)
Where am I going? (Vision of a RML)
Who is with me? /What are my resources (Supports)
How will I get there? (Goals)
How will I know when I have arrived? (Claiming and safety)
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 21

22. Not a Linear Process
 Most people experience reactions surrounding a
traumatic loss for at least a year.
 Holidays
 Anniversaries
 Reminders (people, places, things, media)
 Many people will vacillate between depression and
anger.
 Normalize people’s experiences
 Encourage them to reach out to supports
 Address happiness and survivor guilt (death, DV)
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 22

23. Self Care for Grief
 Emotionally
 Express feelings
 Ask for and accept help
 Don’t let anyone tell you how to feel—and don’t tell yourself
how you “should” feel
 Be patient
 Be kind to yourself
 Add happiness triggers
 Be aware of your grief triggers
 Embrace the dialectic
 It is gone but I have the memories/what I learned
 I cannot change it but I can impact how it continues to impact
me
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 23

24. Self Care for Grief
 Physically
 Get plenty of quality rest
How to handle being alone with your thoughts….
 Exercise
 Eat a healthy diet
 Avoid alcohol
 Pay attention to persistent changes in eating, sleeping,
mood or energy levels
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 24

25. Self Care for Grief
 Psychologically
 Write things down
 Simplify
 Set short term goals
 Distract/engage in pleasurable activities
 Start writing the next chapter in your story
 Plan ahead for grief triggers
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 25

26. Self-Care for Grief
 Interpersonally
 Rebuild relationships (even understand they can be
members of more than one family)
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 26

27. Activities
 Heart-Break Pot (break into large pieces)
 Using paint pens and markers, have each family
member or child write on the inside of the broken
pieces.
 Instruct them to identify their feelings about being
alone in their grief.
 On the outside of the pieces write about or draw their
sources of support.
 Glue back together
AllCEUs.com Unlimited CEUs and Specialty Certifications $59
27

28. Activities
 Jenga (cards)/Beach Ball/Worksheets/
 My favorite memory is…
 The hardest part of the loss is…
 Something I learned about myself/the situation…
 Something I did to make myself laugh this week was…
 May supportive people are…
 2 things that help me most right now…
 The hardest time of day is…
 When I am alone, I can…
 Some things I enjoy…
 Changes in my family because of the loss…
 I am feeling…
 3 ways to release feelings of sadness…
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 28

29. Summary
 Losses encompass more than death or a person or loss of
property
 Losses can be traumatic
 Failure to acknowledge losses and deal with the traumatic
reactions can cause problems in similar future situations
 It is important to explore feelings and reactions in terms
of their functionality---how are they benefitting the
person
 It takes at least a year to deal with significant losses
 Many times there are multiple ancillary losses that need
to be addressed
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 29

30. Summary
 How people deal with grief and loss varies widely.
 After a traumatic loss, the body is on high alert which
likely impacts sleep, eating and energy to work or
socialize
 Minimizing vulnerabilities is important to reduce
unnecessary frustration and avoid confirming helplessness
 Ultimately it is hoped that the person can identify how
they are stronger or better off from the experience
AllCEUs.com Unlimited CEUs and Specialty Certifications $59 30