Gaining an Understanding of Loss (& Grief & Trauma & Traumatic Loss)
This is a piece I’ve been writing over several months and I’m publishing it on Sunday 8 December at the end of National Grief Awareness Week 2024, after a series of LinkedIn posts covering different perspectives on loss & grief.
When I do my talks & workshops on “Gaining An Understanding of Loss”, I emphasise two key points in particular:
1) there are many different types of loss experience.
Most people’s education and understanding tends to be very narrow and limited to their own personal experience.
2) every loss & grief experience is very personal — in fact, unique.
You can help and support, empathise and sympathise, research and try to understand…but you can never have someone else’s experience.
Depending on how long I have for my talk or workshop — from a 30 minute conference keynote to a full-day workshop — I summarise what I’ve learned from my professional work as a researcher, consultant, coach & counsellor (with an Advanced Study Major in Loss & Grief as part of my Counselling Diploma), and from my own personal (multiple) experiences of loss, grief, trauma, and traumatic loss.
The feedback suggests that many people get a lot out of these talks & workshops, and different people get different things out of them.
Again, it’s personal!
I also cover the relationship between loss & trauma and suicide risk.
Sadly, anyone who experiences any form of loss or trauma is more likely to have thoughts of ending their life.
It’s especially common for those losing loved ones — no matter how they’ve died — to have thoughts of ‘wanting to be with them’.
For some people, this passes quickly; for some it’s a lingering thought; for some it’s a regular recurring thought for the rest of their lives; and for some it can lead to a plan to end their life, even following through on their plan and taking steps to end their life.
Anyone who experiences any form of traumatic loss is at a heightened risk of making a suicide plan and following through on that plan.
And ‘traumatic loss’ can take many forms, eg suicide, murder, losing a child in a preventable accident, losing a baby, an ‘unexplained death’, losing a lifelong partner to a ‘sudden natural death’ or losing a loved one to a long slow decline in their physical or mental health.
Again, it’s a personal experience and every experience is unique.
And every painful loss is exactly that — a painful loss for those affected.
It’s important that we show universal kindness and compassion for those who are grieving, and not diminish anyone else’s loss & grief experience.
Healthy Peer Support and Unhealthy Comparative Loss
As I discovered when I started training and practising as a counsellor, there’s a tendency for people who experience ‘traumatic loss’ to think or believe that their loss experience is worse than other people’s loss.
Like most cases of comparison in our lives, this is usually — ultimately — not a healthy thought, for either those having such thoughts or for the many people hearing or seeing such thoughts expressed.
As my friend Chukes Maxwell says “there’s no hierarchy in suffering”.
As I heard Amelia Wrighton put it when she spoke at the ‘Let’s Talk About Suicide Lancashire’ Conference on 2 October 2024 in Blackpool, this is not “The Grief Olympics”!
And as many others express it, especially when they’ve reflected on their own loss & grief journey including what helps others and what harms others, “Bereavement is not a competition”.
But everyone has to work through their own personal unique loss & grief journey, work through their own personal unique experience of trauma, or work through their own personal unique experience of traumatic loss, with appropriate support along the way — if they are open to seeking such support…and not everyone is of course.
Also, what’s ‘appropriate’ differs from person to person, and it changes over time as their needs, circumstances and preferences change.
This can mean going through a phase where ‘comparison’ appears to be helping; thinking or believing that ‘your loss’ or your ‘form of loss’ is worse than other people’s loss or form of loss; gravitating to other people who’ve had the most similar types of loss experience as yourself rather than different loss experiences, including specific peer support services, networks or communities that appear to understand what you’re going through, and sometimes including people who reinforce your belief that you’re experiencing ‘the worst type of loss’.
It can also be the reverse experience, ie meeting people who’ve had traumatic loss experiences that you think are much worse than yours.
This is still a ‘comparative’ and even ‘competitive’ mindset which is often unhealthy, and can be a barrier to moving forward with your ‘grief process’ and moving forward with your life.
It’s highly complex, it’s highly sensitive, it’s highly personal.
Kindness and compassion also comes in many forms, including the ability to respect everyone’s unique personal experience of loss without feeling the need to compare experiences or create hierarchies of loss or ‘bereavement competitions’.
You might even feel that you have ‘objective’ data or evidence to ‘prove’ that you’ve experienced ‘the worst kind of loss’ — I’ll address this issue later — but there’s only ever one ‘worst type of loss’…and that’s the loss that you’ve experienced, or the loss you’re experiencing right now!
It’s Personal As Well As Professional For Me Too!
In my talks & workshops on “Gaining an Understanding of Loss”, I open up about my own personal experiences of loss & grief, including traumatic loss, and this helps others to open up.
My first ever memory of loss was my Granddad dying when I was very young.
I wept buckets without understanding why, and I was left on my own in the bedroom, and it was never talked about again.
I didn’t go to his funeral and never got the chance to grieve, so all that was stored up for later, as was the case with so many people of my generation.
More deaths followed, including my first experience of suicide loss in 1980, and losing 15 blokes to suicide in our community in Teesside — none of them with any prior history of mental ill-health, all victims of an ideological government policy which systemically de-hoped communities.
No-one talked about suicide, as those were the times, we just talked about what ‘Thatcher’ had done to our communities.
When Margaret Thatcher died in 2013, old industrial communities like ours in Teesside turned out in their 1000s…to be able to turn their back on her coffin!
This was part of the grieving process, and ‘closure’ for some, just as many of us bonded in our angry grief by listening to Elvis Costello’s Tramp The Dirt Down.
Even in 2013, there was little conversation about suicide.
I’d just started working in suicide prevention, after experiencing my own suicide crisis, in a series of events triggered by the death of my Dad in 2010, which hit me much harder than I expected.
I’d set up a new business in Australia in January 2010, after getting dual citizenship in 2009, and already made two trips to the UK, including in April when my wife and I took Mam and Dad on a reflective tour of some significant places from our history, which was a big high.
A big low followed in July when Dad was diagnosed with cancer, and the rapid decline in his health was traumatic, partly as I was living 12,000 miles away and my parents didn’t do online communications so it was ‘phone calls and desperately trying to arrange my next trip over whilst struggling to keep my new business going.
I finally flew over in October, my Dad had wasted away with the cancer which was hugely shocking when I first walked in the house.
We had a birthday party for him which was a huge high, followed by the huge lows of saying my final goodbye, knowing I’d never see my Dad again, and then getting the confirmation he’d died 4 days later.
I didn’t use the term ‘trauma’ then but, on reflection, I now know how hugely traumatic that experience was for me, and my mum, and my sisters, and how it impacted on the wider family, and how it impacted on me, including spiralling into severe depression and then, due to a range of other factors, including my business struggling, a suicide crisis.
Having now had multiple trauma and loss experiences, and having now trained and practiced professionally as a counsellor specialising in Loss & Grief, I can more easily recognise the signs and impacts — in clients, colleagues, peers, friends, family members and all those I come into contact with.
I’ve had many personal and professional conversations where trauma and loss experiences have surfaced which had previously been deeply buried in the sub-conscious, not acknowledged at the time or since for what they were, and the impacts not recognised, including the compounded effects and how the grieving process can open up and connect these multiple loss & grief experiences.
I now do my talks and extended workshop sessions on “Gaining An Understanding of Loss” and, each time, I always get feedback from audiences and workshop participants that:
1) they weren’t aware of the many different types of loss experience we have which we don’t acknowledge and grieve for;
2) this realisation has helped them put their own life and work struggles into perspective.
And, as mentioned in the opening summary above, I cover the complex and sensitive topic of ‘comparative bereavement’.
The Worst Kind of Loss?
When I trained, qualified, and first practiced as a Loss & Grief Counsellor, one of the hardest things for me was the constant stream of people telling me about their traumatic loss experiences, and saying:
“My loss is the worst kind of loss”.
I heard about so many awful tragic loss experiences, including suicide, murder, rape-murder, murder-suicide, loss of an only child in a car accident, cot death, miscarriage, ‘losing someone twice’, totally unexplained deaths of people appearing to be in peak health & fitness, group death pacts…
…and it was very common to be told “mine is the worst kind of loss”.
In my broader counselling training, and my broader mental health training, I’d been taught about the damage comparing ourselves and our life & work experiences with others can do, and to help those struggling to focus on their own situation not compare themselves with others.
But it was new to me to see and hear so many people experiencing loss & grief to be comparing themselves with others and, at worst, treating bereavement as a competition.
In my work, it was — and still very much is — important to highlight peer group and peer community support options for people experiencing loss & grief, as many people benefit tremendously from being connected to other people who’ve had similar experiences to them and, therefore. ‘understand what I’ve been through’.
But there are also dangers from ‘getting stuck in a bubble’, losing rather than gaining perspective, and not being able to move forward as a result.
There are also dangers in the ‘Toxic Positivity’ and ‘Toxic Cheerleading’ that characterise some unregulated or poorly facilitated peer groups or peer communities, or just informal conversations between bereaved people.
Just trying to give people streams of unconditional positivity, confirming every belief system and narrative they absorb in their grief, and unconditionally praising everything they say or do is not really kind, it’s usually not helpful in the long-term, and it can be harmful.
Many of the people constantly giving these positive affirmations are doing it more for their own comfort, or because they felt it comforted them in their initial grief, but it can be counter-productive even for themselves.
Sometimes, these risk factors combine — ‘stuck in the bubble’, ‘Toxic Positivity’, ‘Toxic Cheerleading’ and ‘Ours is the Worst Type of Loss & Grief’ — and it can be a very unhealthy mix for those who’ve got their wagons round in a circle, as well as potentially harming other people who feel their own loss & grief experience is being diminished.
Where harm is being caused to others by those who are grieving, it’s almost always sub-conscious of course.
People get so wrapped up in their own grief, it can be hard to see someone else’s grief unless they’ve had — or think they’ve had — a similar type of loss & grief experience.
Valuable Peer Support or Stuck in a Bubble?
Someone who’s lost a loved one to suicide after years of depression often feels they can empathise with someone else who’s lost a loved one to suicide after years of depression, but they might struggle to empathise with someone who’s lost a loved one in a terrorist attack or a murder of any kind or even another type of suicide death.
The bereavement landscape can be prone to silos and ghettoisation, cliques and cults.
It’s common — and, indeed, many would say ‘normal’ — for people who’ve experienced traumatic loss to want to cluster with people who they think have had a similar loss experience rather than people they think have had a different loss experience.
Bereavement support groups often go very narrow in their membership.
People often think that ‘mainstream’ bereavement and counselling services won’t understand their loss experience so they gravitate to more specialist support or they set up their own bereavement support services.
Such services can be very helpful in the short-to-medium-term in supporting people through the early phases of their grief.
People often feel safer in such an environment; they feel they can ‘just be’ without having to say much; and, when they do want to start ‘opening up’ about their loss experience, they feel they’re in a safe, supportive space to do so.
It’s understandable and, initially, it’s often very helpful.
It can be problematic in the long-term though, from both an individual perspective and a ‘system perspective’.
Individuals can find it harder to ‘move forward’ with their lives, especially if they become too dependent on narrow peer support groups or communities, particularly if these groups or communities are characterised by Toxic Positivity or Toxic Cheerleading.
In all other walks of life & work, a key success factor in personal development and growth is being exposed to diversity in all its forms, including diversity of experience.
Recovery and then ‘moving forward’ after loss & grief experiences are no different.
And from a ‘system perspective’, people often say that the ‘mainstream’ bereavement services and ‘non-specialist counselling’ services don’t understand their particular loss & grief experience so there’s a need for specialist services or a need to set up new support services.
Up to a point, this creates healthy choice.
After this point, there can be unhealthy fragmentation and lack of viability.
And if we never educate the ‘mainstream’, we’re not tackling a key underlying problem.
Plus, of course, such arguments can be frustrating and distressing for counsellors who feel they can support anyone through any form of loss or grief experience; and with their exposure to multiple forms of loss & grief experience being one of the benefits they provide!
The Suicide Loss Bubble
As I have personal lived experience of suicide loss and suicide crises, and I work professionally in suicide prevention, including suicide bereavement support — which is another form of suicide prevention —I want to highlight the problem of ‘the suicide loss bubble’ (other bubbles are available!).
Many people who’ve been bereaved by suicide regularly post and talk about those who’ve been bereaved by suicide being at greater risk of suicide themselves, without acknowledging that any group of people experiencing any form of traumatic loss have a heightened risk of suicide.
It’s part of the problem of ‘comparative bereavement’, of wanting to believe that their form of loss experience is worse than other people’s loss & grief experiences, leading to this phenomenon of ‘bereavement as a competition’ or ‘The Grief Olympics’.
It’s a problem compounded by isolated peer support communities with Toxic Positivity and Toxic Cheerleading
And, as happens with people who have a personal belief they find comforting or which they feel helps them to advocate or campaign around their belief system, they go looking for some ‘evidence’ to support their belief system…and, of course, they find some!
In the case of people bereaved by suicide who believe their loss experience is ‘the worst form of loss’, they usually gravitate to the news headlines that say people bereaved by suicide are ‘two-thirds more likely to die by suicide’ or ‘65% more likely to die by suicide’ or ‘63% more likely to die by suicide’ — there are these three variations in the news headlines.
People who grab on to ‘evidence’ that appears to support their belief system rarely read beyond the headlines and the news reports, they rarely study the detail behind it, usually not even referencing the source material, and they rarely go out to search for other ‘evidence’ that might give a contrary perspective or even a complementary perspective.
The motivation (conscious or sub-conscious) is to support an existing belief, so one piece of evidence that appears to support their belief is enough, and they stop looking.
This two-thirds higher/65% higher/63% higher example for heightened risk for those bereaved by suicide is usually taken from the media coverage of a study by Alexandra Pitman, David Osborn, Khadija Rantell & Michael King.
And I say ‘the media coverage of a study…’ because I know, in many cases, the figure has been taken from a media report or even just the headline and, when questioned, people almost always say they haven’t read the actual study in detail.
Indeed, most people never read the studies themselves, just the media reports.
Let’s Look More Closely at the Research…and the Research Process
Here’s the link to the paper itself in BMJ Open:
This study did indeed find an increased risk of a ‘suicide attempt’ among those bereaved by suicide, and people bereaved by suicide to have a significantly higher suicide risk than people losing someone to a ‘natural death’.
But, and there are a few buts:
1) the study was published in 2016, based on data collected in 2010, so the dataset the conclusions are drawn from is not only pre-Covid (which changed a lot of trends & patterns), it was 14 years ago;
2) the data is from a survey among staff & students at UK universities aged 18–40 who’d lost a friend or relative after the age of 10 (614 by suicide, 712 by ‘sudden unnatural causes’, 2106 by ‘sudden natural causes’);
3) there was evidence of a higher risk of suicide among those experiencing bereavement via any form of sudden ‘unnatural’ loss (eg fatal road traffic accident or murder) compared with those experiencing bereavement via sudden ‘natural’ loss (eg a heart attack or stroke);
4) there was a high degree of overlap of experience, ie multiple loss experiences, and therefore co-correlations, with 43% of those experiencing bereavement by suicide also having experienced a sudden ‘natural’ death and 22% having experienced another form of sudden ‘unnatural’ death.
Once again, it’s important to state that this study did find evidence of an increased risk of suicide (attempt) among those bereaved by suicide but there was also a heightened risk of suicide among those bereaved by other forms of sudden unnatural death, and the study had a number of limitations, eg due to the sample being aged 18–40 and being staff & students at universities, and the data set being collected 14 years ago.
If this study was repeated today, and with a broader sample going beyond university staff & students, and including people aged over 40 as well, it may reach the same conclusions, but it may not!
As is common in many, if not most, academic research reports…’more research is needed’ — or, perhaps, different research is needed?!
Certainly, more up-to-date research is needed, among a more robust & representative sample, and with more opportunity to test the extent to which different forms of traumatic loss result in a heightened suicide risk.
As a counsellor, I had many clients who’d experienced bereavement via road traffic accidents, cot death, etc who were having thoughts of suicide.
It was complex though and depended on many factors, such as degree of guilt, eg from not ensuring the seatbelt was on, or driving too fast, or not checking in on the baby often enough.
Surveys are often not sensitive to all these factors and they try to establish correlations between some variables included in the survey but don’t include other factors that could be at least as significant if not more so — at worst, even omitting factors that could be the main explanatory variable!
Academic researchers make a huge issue of the rigour and quality of their processes, including publishing in peer-reviewed journals, but this is a process of review by people who live in ‘their bubble’; and they talk less about the systemic biases in which topics tend to get researched and which topics rarely if ever get researched and therefore included in these research papers in peer-reviewed journals.
As a Trustee with Age UK York, and a member of the national Age UK Influencing Committee, and a person in my 60s who’s concerned about older people, and a person who has a passion for social justice…I’ve studied the issues facing older people, and their experiences.
Older people are a group often subject to systemic bias and discrimination.
Men aged 80+ often have one of the highest suicide rates of all and yet rarely feature in research and rarely if ever feature in national suicide prevention strategies & plans.
It’s all part of society’s and government’s systemic bias & discrimination against older people, which we also witnessed during the Covid outbreak, with evidence from the Covid Inquiry suggesting that policy was being formulated on the basis that older people, especially those in care homes, were ‘expendable’!
When we do take the time to study older people, and older men in particular, we find that the high suicide rates for men aged 80+ are often due to losing a lifelong partner or becoming housebound after an active outdoor life.
Losing a partner they’ve been married to for 40, 50 or 60 years can be devastating, and they often ‘just want to be with them’.
So, they can be bereaved by ‘natural’ causes but still have a heightened suicide risk.
Also, as I’ve found in my own research and my own experience working with older people, they can be traumatised by other factors, especially a partner having dementia.
What might officially be classified as a ‘natural’ death can feel very unnatural to the person losing their loved one — with the trauma of ‘losing them twice’.
As often is the case, it’s more complex and complicated than we first thought.
And if the survey sample was 18+ rather than 18–40, covering the whole population not just university staff & students, it may be that a different picture would emerge.
Those aged over 40 are considerably more likely to experience ‘natural’ deaths, including ‘natural’ deaths that are highly traumatic, such as losing a lifelong partner, and to have a heightened suicide risk after a ‘natural’ death.
And this problem of ‘systemic data & evidence bias & discrimination’ can be further compounded by the tendency to respond to a challenge to ‘the evidence base’ by trying to get more ‘evidence’ to prove what has now become the ‘accepted wisdom’ rather than truly filling complete data gaps which address the underlying bias & discrimination!
Who’s Studying ‘Lonely Loss Syndrome’ and Its Impact?
While I’m on my soap box on this, it should be pointed out that we still have very little research into the trauma impacts of ‘COVID deaths’ and the ‘Lonely Loss Syndrome’ created by the pandemic, which may well have contributed to the recent rise in the suicide numbers, and yet a narrative has been created and fuelled by people, including the lead adviser to government on suicide prevention (and note that he speculates on this, whilst criticising others for speculating without hard data!) that the recent rise in suicide rates is probably due (largely) to economic factors, with no mention of trauma factors like ‘Lonely Loss Syndrome’.
Also we shouldn’t be falling into the trap of just focusing on statistical correlations within population sub-groups when our goal is to get the suicide numbers down among all sub-groups of the population and when we have plenty of ‘cases’ of people with loss & grief experiences with a heightened suicide risk, with lessons we can learn to help prevent preventable suicide deaths in the future.
Is This Helping Us Create and Sustain a ‘Zero Suicide Society’?
For those of us who want to get the suicide numbers on a downward trend, towards zero suicide, including down for men and women, down for people of all ages, down for students and non-students, etc…and down for those bereaved by any means…and down for those experiencing any form of trauma…
…the best way to think about all of this is to conclude that any form of loss or trauma, and notably any form of ‘traumatic loss’, can lead to a heightened risk of a suicide attempt, and so we should get wrap-around support for anyone in this situation.
It’s why the Zero Suicide Society framework includes trauma & loss support, as a key ‘piece of the puzzle’ for getting the suicide numbers on a downward trend, towards zero…
…including supporting all forms of loss not just suicide bereavement, and supporting all trauma experiences, not giving any type of traumatic loss a higher or lower value than any other; not creating a hierarchy; and not prioritising with a competitive mindset:
Final Thoughts
Based on my many years of working in suicide prevention, and my research, and my studies and practice as a counsellor, and my own personal experiences of loss…
…I’ve come to one inescapable conclusion, which is…
…the ‘worst kind of loss’ is the loss that you’re experiencing!
Loss and grief is a unique personal experience, so the kind and compassionate response is to respect each person’s loss and give everyone support and care relevant to their personal needs.
Whilst you might feel that your own loss, or your ‘type’ of loss, is so much worse than someone else’s, saying that out loud can be hurtful to others, even harmful if it can lead to a heightened risk of depression and thoughts of suicide.
You might want to say it out loud in a ‘peer group’ or one-to-one conversation where you think it helps those in that peer group or the person in that one-to-one conversation, but saying it outside these specific environments carries risks, even dangers.
Hopefully, in time, with the right support, everyone can move forward in their loss & grief experience to a point where they appreciate the need to extend their compassion to people ‘not like themselves’ as well as people who are ‘like themselves’.
This usually requires therapy or highly enlightened peer support groups or transitioning from, say, ‘suicide bereavement groups’ to broader ‘bereavement groups’ to broader social groups where they can both support others experiencing loss, grief or trauma and be supported in their own loss & grief journey.
A pertinent example might be having ‘Bereavement Quilts’ not just ‘Suicide Bereavement Quilts’ which bring together diverse communities and challenge stigma by doing so, ie a square remembering someone lost to suicide sitting alongside a square remembering people lost to cancer, dementia, heart attack, MND, murder, traffic accident.
Sadly, some people do get ‘stuck’ and find it very hard to move forward, even impossible to not think that their loss experience is ‘the worst kind of loss’ 10, 20, 30 or more years after their bereavement.
We need to keep trying to find new and different supplies of kindness and compassion, including helping people ‘get outside the bubble’; helping people develop empathy for others even when they initially think (consciously or sub-consciously) that person has had a ‘less traumatic’ loss & grief experience; and helping everyone move forward appropriately and effectively in their lives, work/career, and relationships, including self-care, self-compassion, and self-forgiveness without selfish self-centredness or self-pity.
It’s hard folks, it’s very, very hard.
Please be kind…to everyone experiencing any form of loss or grief!
Please show universal kindness and compassion — don’t make it selective or hierarchical.
Please recognise that kindness comes in different forms, including trying to change some of our unhelpful narratives and belief systems; and calling out anything that’s potentially harmful, and avoiding harmful phenomena like Toxic Positivity or Toxic Cheerleading!
I wish you all well with your current and future grief challenges and, especially, in becoming conscious of all the loss, grief & trauma experiences you’ve had in your life that you’re not yet conscious of, and then joining those dots!
And I look forward to continuing to learn from those who attend my talks and workshops, as well as passing on what I’ve learned.
Paul Vittles FMRS FAMI FRSA is a Research Fellow, consultant, coach, and counsellor — with an Advanced Study Major in Loss & Grief within his Counselling Diploma.
Paul has had many loss & grief experiences, including traumatic loss.
He has personal experience of suicide bereavement and suicide crisis.
Paul is Chief Facilitator for the Zero Suicide Society JoinTheDots Transformation Programme, and Founder of Towards Zero Suicide CIC.
He was Tour Director for the pioneering #ZeroSuicideSociety Humber-to-Mersey #JoinTheDotsTour, 11–23 June 2024 which comprised 19 major events across 15 towns & cities in 2 weeks, and which had 40 public education talks on suicide & #SuicidePrevention, including how those experiencing loss & trauma have a heightened risk of suicide.
