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Evaluation of existing Literature on the treatment of Young Adults Grief and Trauma

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Evaluation of existing Literature on the treatment of Young Adults Grief and Trauma

Death is common in society. By the time a person reaches college years, he or she may have lost a loved family member, a close friend, or a member from an extended family. According to Johnson et al. (2017), by the time young adults (18-25 years) graduate from high school, at least 71% have experienced a loss to a person intimately known to them. Most research only focuses on studying its impact on children that have lost their parents or siblings to illness or trauma but pay little attention to the adolescents that have lost their peers or grandparents (Johnson et al., 2017). Young adults usually find it challenging to respond to such loss, as it may be the first time they have experienced it. They tend to grieve for a prolonged time due to their dependency and the level of friendship developed with the departed person. Besides, they risk developing depression and other psychological complications when they do not receive timely help. Young adults struggle most from grief, as they are not used to it and require moral and professional help from people in their surroundings to help them overcome the physical and emotional effects as a result of Trauma and loss of life. Due to their tender age and immaturity, the existing treatment literature is reviewed to ascertain its impacts in treating young adults to minimize prolonged periods of grief and trauma that might result in depression.

The Concept of Bereavement and Grief

Bereavement is an objective situation where a person loses another person intimately known to them through death. In the case of young adults, he or she may lose a peer to violence or other traumas such as drug abuse. Grief would then result in a distress response from the loss. One may experience physical or emotional difficulties when grieving. However, his or her response to such situation depends on various variables, such as age, stage of development, gender, history of previous loss, the level of closeness they had with the deceased, the psychiatric state of mind, and the type of loss (Johnson et al., 2017). In most cases, the anticipated loss may cause short-term grief since the soul was psychologically prepared for it. On the contrary, losing a loved or a peer from violence or drug use is usually associated with increased distress and maladaptive coping (Johnson et al., 2017). Studies and researches have been conducted to ascertain the proficient treatment methods that eradicate continuous stress that leads to loss of life of an individual.

Johnson et al. (2017) summary article on bereavement advocates that young adults suffer from various disorders depending on the closeness of the person lost. Most young adults develop mental disorders especially when they lose their parents and grandparents. The research conducted revealed that if the bereaved young adults did not access medication and counseling will result to depression consequently resulting to death. For the young adult to curb stress for themselves, some start engaging in social crimes to get relief. Some of the social crimes that results from stress include drug injection, drug trafficking, immorality due to inadequate counseling and some end up committing suicide. The author results depict how young adults respond to the loss of their peers and close friends who they have schooled together. They feel lonely and deprived of important people in their lives. However, despite the concerted efforts done to unravel the proficient treatment of the young adults, the research population was obviously young especially those below 15 years of age. The population should have at least 15 years of age as most of the young children as the age of 13 years rarely understands the significance of owning property. In addition, administration of questionnaires to a young bereaved adult would not have the mental stability to write the correct responses. The author should have open interviews to collect reliable data that can be used in treating young adults suffering from trauma and loss of a close person.

 

 

 

Emotional and Physical Effects of Grief

Emotional Effects

The first emotional effect of losing a loved one is disbelief. Right after the loss, one may experience a hard time coming to terms with what happened. The loss appears too sudden, as one may have been in contact with the deceased recently. Besides, the last memories they shared are still fresh in mind, which contributes to increased denial. As a result, one may feel numb, experience difficulties accepting it, and even denying the truth (Smith, Robinson, & Segal, 2019). In the case where the deceased was someone dearly loved, one is likely to keep expecting him or her to show up and talk to them, despite knowing that they are gone forever. Accordingly, disbelief and denial mark the first stage of grief. Hashemi et al. (2018) highlights the coping strategies that the young adults need to adopt to reduce extended crying and mourning of their bereaved ones. Traumatized young adults should visit health care providers for guidance and counseling of their emotions (Hashemi et al., 2018). This guidance will minimize the prolonged emotional effects that may result to depression thus causing death. The author fails to address on methods that should be used to convince young adults to visit health care centers to get treatment and guidance. Voluntary young adults will obviously copy the appropriate strategies that motivate them to forget the past occurrences as they devote their minds on the positive activities.

Sadness is the second emotional effect of grief. According to Smith et al. (2019), profound sadness is a common symptom of grief that anyone can experience. It does affect not only young adults but also adults and the elderly equally. Such a level of grief is often characterized by feelings of emptiness, despair, yearning, and deep loneliness. One starts to feel the gap left by the deceased in their lives. For example, if the deceased was a love partner, one may start yearning for the sweet romantic moments they shared. When the deceased was a peer, a young adult may desire the fun they enjoyed together. Since these feelings cannot be fulfilled, the bereaved are likely to cry a lot and feel emotionally unstable. Marvin acknowledges that young adults should seek guidance from other people to calm down stress and emotional distress (2017). Individual efforts of young adults is an essential element in treating trauma and the depression. Affected individual should seek guidance as they engage in group discussion, participating in group activities, for instance, sports, music, drama, dancing, and henceforth. However, the author fails to address the issues of treating young adults who are in the advanced stage trauma and depression to high intake of drugs.

The third emotional effect of grief is guilt, which is also the third stage of mourning. One may start regretting the things they failed to do to save the life of the deceased (Smith et al., 2019). For example, in case the deceased died by a road accident, and one may feel that they could have saved their lives by informing them to travel using an alternative method. Such a feeling is hard to control even if there was nothing much one could do to save the life of the deceased. Besides, an individual may feel relieved after someone died from prolonged suffering, which also contributes to guilt. Such feelings are usually hard to control since they are beyond one’s ability.

Anger is another emotional effect one may experience from grief. Even in a situation where the death was of natural cause, one may still feel angry and resentful. Such feeling is usually directed to self, other people, and even the deceased. For example, a young adult may be mad at himself or herself for not saving the dead. Alternatively, he or she can be angry with other people, such as God and doctors, for not protecting the deceased (Smith et al., 2019). One can as well get mad towards the dead for abandoning them. Thus, this level of grief is marked by the tendency to blame someone for the injustice experienced.

Another emotional effect of grief is fear. Upon losing a person to death, one may develop many worries and anxiety about the unknown. For example, if a young adult loses a person they used to share an intimate relationship, he or she may develop fear of uncertainty about the many aspects they used to share together. Besides, one may feel anxious, helpless, or even insecure. Fear is usually a stage of grief that may take some time to overcome. According to Smith et al. (2019), the death of a close relative or a loved one may trigger personal mortality fears. Due to the first-hand experience, one soon realizes that they can die at any time, which may cause more distress when grieving. One can surpass fear by learning to develop alternative defensive mechanisms, which would eventually assist in the grieving process.

Physical Effects

A heart attack is the first physical factor a young adult may develop due to grief. Such an effect is usually caused by intense stress (Mendoza, 2019). According to GoodTherapy Staff (2018), one specific heart syndrome from losing a loved one is called “takotsubo cardiomyopathy,” or broken heart syndrome. This health complication results from the disruption in the blood flow to the specific section of the heart. As a result, one may experience chest pains or shortness of breath, but is only a temporary situation. Though the condition is treatable, one may heal naturally a few weeks after the syndrome to reverse. However, if one experiences excessive chest pains and shortness of breathing after the death of a loved one or close friend, he or she should seek medical assistance immediately.

Another physical problem that may result from grief is lowered immunity. One may catch a cold or flu after developing immense stress from the death of someone known to them. A 2014 study found that older adults are more susceptible to suffering the effects of reduced immunity after losing a spouse (GoodTherapy Staff, 2018). However, the same situation can affect young adults that have lost someone close to them, such as a peer, family member, or relative. With reduced hormonal balance, the body fails to produce some type of white cells. As a result, the condition exposes one’s body to infections.

Body aches and pain is another physical effect one may develop due to grief. According to GoodTherapy Staff (2018), excessive grief is known to cause back pain, joint pain, headaches, and stiffness. The excessive release of stress hormones to the body causes pain, affecting the body muscles as the rate of blood flow is distorted. Stress hormones affect the body, as they cause heart diseases, difficulty in digestion of food, insomnia, and instant loss of libido. An example of a stress hormone produced in grief is cortisol. According to Goldade (2017), the prolonged high levels of this hormone have harmful effects on the body’s physicality. As one grieves for an extended period, the brain continues to produce more adrenocorticotropic (ACTH), leading to more stress hormones (Goldade, 2017). Besides, stress hormones can lead to the constriction of blood vessels as more oxygen is channeled to the muscles as the body responds to the action, it can also result to instant weight accumulation and loss of memory in the long-term. Anyone grieving, irrespective of age and gender, can experience body aches and pain. Though they heal over time, one should consult a physician if the situation persists.

Another physical effect of grief is a digestive challenge. One is likely to experience a queasy stomach after losing a friend, relative, or family member to violence or other traumas. Some of the digestive complications from grief include loss of appetite, binge eating, and nausea (GoodTherapy Staff, 2018). Being aware of these symptoms could be useful for alleviating them, which may as well help overcome the grief itself.

Sleeping problems and fatigue are other common effects of grief. Someone that has witnessed death, such as accident or suicide, is likely to develop sleeping issues. For young adults, this could be common for those whose friends commit suicide or die from a drug overdose. Such deaths are usually abrupt or unexpected. Disruption of sleeping parts causes more frustrations to the body. Besides, one may continuously feel sad, anxious, and exhausted (GoodTherapy Staff, 2018). Though it is a temporary feeling, it is advisable to report to a doctor if one is unable to sleep for a prolonged period.

Evidence-Based Treatment for Grief

 Cognitive behavior therapy (CBT) is the most reliable technique for treating grief. CBT focuses on clearing the cognitive obstacles to heal. The CBT model views emotional problems as the outcome of the interaction between the environment and the cognitive and behavioral influences. For the case of young adults, the CBT model identifies and addresses the harmful and intrusive cognitions instances that emanate from traumatic loss, such as an accident or drug overdose. According to Kosminsky (2016), trauma is known to disrupt cognitive processing that exposes the survivors of traumatic loss to memory fragmentation and exaggerated beliefs concerning their roles in the death of their peer or loved one. CBT focuses on highlighting the negative feelings one develops and tries to replace them with alternative reasoning. For example, a victim can be asked to recall the best times they shared with the departed person and try to replace negative thoughts with positive experiences. Thus, such an approach will help a young adult to overcome the fears of guilt and anger that usually emerge from sudden or unexpected death.

Despite the widespread execution of CBT in treatment process, the method has not fully solved complicated mental disorders. It is only appropriate when the patients involved in the treatment process are cooperative and yearning to change. The method should focus on unravelling the cause of trauma and stress to solve the existing and future problems that may arise from the same problem. In advanced scenarios, patients have failed to cooperate rendering the process inappropriate.

Psychotherapy is another evidence-based treatment method for the grief that can work for young adults. According to Mayo Clinic (2017), psychotherapy is often used in case one suffers from complicated grief. Such a technique applies the same method used for treating patients with PTSD and can be more effective when done individually or in a group format. The treatment method focuses on helping the victim adjust to the loss and redefine their life goals. For example, a young adult affected by grief can hold a conversation with a close family member to retell the circumstances of death. Such a mechanism mainly applies to sudden or unexpected death. The images and thoughts that keep emerging in their minds about the deceased would become less distracted by retelling the story. Utilizing this method is advisable for exploring and processing thoughts and emotions. Consequently, one may overcome the feelings of guilt, blame, sadness, and anger that lead to grief.

Compassionate support is another evidence-based method that could be used to help a young adult overcome grief. Iglewicz et al. (2019) assert that all grieved persons benefit from compassionate care. Someone that turns to a clinician for help already understands the pain and discomfort of losing a person to death through violence or trauma. In return, the clinician can provide compassionate care by helping the patient to accept, normalize grief, and bear witness to the pain (Iglewicz et al., 2019). While evaluating the patient, the clinician may ask questions about the essential losses, such as what they miss most from the deceased. After finishing the diagnostic evaluation, the clinician should show the patient natural compassion for the loss through non-verbal and verbal communication. Showing compassion also means paying attention to voice tone, use of pauses, and body language (Shear et al., 2016). Applying this method will help a young adult to understand that what they are experiencing is normal, which will then help them accept the situation and begin the healing process

However, administration psychotherapy requires patience to witness its outcomes. This approach also requires absolute trust between the therapist and the patient. In some instances, unprofessionalism results to therapist leaking the secretive health status of a patient. This leaking of information results to loss of confidence of the therapist thus preventing many potential patients from accessing the medical services.

Another evidence-based treatment method is adopting coping mechanisms. According to Smith et al. (2019), stress from a significant loss can deplete one’s energy and emotional reserves. One should look after his or her physical and emotional needs by adopting specific coping mechanisms. One of these strategies is facing feelings as opposed to suppressing grief. A young adult should learn to acknowledge the pain since avoiding feelings of sadness and loss prolongs the grieving process. Another coping mechanism is expressing feelings tangibly or creatively. For example, one can write a letter or a journal communicating the message that they never got the opportunity to tell the deceased (Smith et al., 2019). Maintaining hobbies and interests is another coping mechanism that can help one to overcome grief. A young adult can quickly regain comfort in activities that bring joy and help connect with other people. Besides, planning ahead of grief “triggers” and looking after personal physical health other recommended coping mechanisms.

Cultural Considerations in Dealing with Grief

Culture is another aspect that should be incorporated into the treatment of grief. Some cultures tend to have rituals of mourning after a death. Crying is the most common culture exercised universally. However, the bereavement process usually varies from one culture to another. According to GoodTherapy Staff (2019), culture may influence a person’s attitude towards death. For example, Western cultures usually display death-denying traits, which the Eastern cultures characterize death as part of life. Culture also affects how a person remembers the deceased. Cultures like Hopi or Achuar encourage grieving as a method to help the bereaved forget much about the dead. In contrast, in other cultures, it may be a taboo mentioning the person’s name or even touching their belongings (GoodTherapy Staff, 2019). Another aspect of culture is the display of emotions. Some tend to encourage mourners to grieve for extended periods while others only limit the period of mourning. Thus, the culture of a young adult should be considered when helping them through the grieving process.

Ritual is another cultural factor that can help a victim overcome grief. Dr. Kenneth Doka encourages grieving persons to practice their traditional rituals to connect with the departed and carry on despite the grief (Ackerman, 2020). There are specific rituals that people can perform after losing their loved ones or peers to death. One of them is the ritual of continuity. Performing this ritual is advisable since it helps to establish that the lost love is still part of the life of the bereaved. It also signals that the bond connecting the deceased and the grieving person still exists.

The second ritual that can be performed is the transition one. According to Ackerman (2020), this ritual is used to mark a significant change that has occurred as part of one’s response to grief. The action can entail cleaning the deceased’s room or donating their belonging. A ritual of affirmation is another cultural method of treating grief. The activity is this ritual may involve writing a letter or poem to the deceased to appreciate the love and support shared. The ritual of intensification is another cultural way of treating grief. Such an act is usually performed to connect the deceased and the grieving person to their group members to help reinforce their collective identity. Such rituals are common among military officers who gather periodically to remember their fallen comrades. Other recommended smaller rituals include lighting candles, traveling to places frequently visited by the departed, visiting burial sites, and going through old pictures. Thus, parents, guardians, and counselors should understand the value of incorporating culture when helping young adults overcome grief.

In summary, there is adequate evidence in the existing literature on the treatment of victims suffering from trauma and survivor loss. Various researchers have conducted research evaluating their strengths and weaknesses to ascertain which treatment will be most appropriate when treating trauma and survival loss. Researchers have shown that each treatment method is appropriate depending on the target group and the level of trauma and depression to a person. Psychotherapist should demonstrate professionally as they get confidential information from the patients. Cognitive behavior therapy should emphasize in ascertaining the causing agent of the problem before it proposes the solution to its patients. However, cognitive is more appropriate in managing trauma and survivor loss to young adults as it entails in depth study of an individual behavior and the existing disorder signs.

 

 

 

 

References

Ackerman, C. E. (2020, April 23). 3 grief counseling therapy techniques & interventions. PositivePsychology.com. Retrieved from https://positivepsychology.com/grief-counseling/

Goldade, J. (2017, June 13). Physical effects of grief on the body and how to cope. Frazer Consultants. Retrieved from https://www.frazerconsultants.com/2017/06/physical-effects-of-grief-on-the-body-and-how-to-cope/#:~:text=Cortisol%20is%20known%20as%20the,more%20stress%20hormones%20as%20well

GoodTherapy Staff. (2018, May 20). When loss hurts: 6 physical effects of grief. GoodTherapy.org. Retrieved from https://www.goodtherapy.org/blog/when-loss-hurts-6-physical-effects-of-grief-0520187

GoodTherapy Staff. (2019, November 5). Grief counseling: The grief process, models of grief, and grief therapy. GoodTherapy.org. Retrieved from https://www.goodtherapy.org/learn-about-therapy/issues/grief

Hashemi, N., Marzban, M., Sebar, B., & Harris, N. (2019). Acculturation and psychological well-being among Middle Eastern migrants in Australia: The mediating role of social support and perceived discrimination. International Journal of Intercultural Relations, 72, 45-60.

Iglewicz, A., Shear, M. K., Reynolds, C. F., Simon, N., Lebowitz, B., & Zisook, S. (2019). Complicated grief therapy for clinicians: An evidence-based protocol for mental health practice. Depression and Anxiety, 37(1), 90-98.

Johnson, L., Torres, C., Sykes, A., Gibson, D. V., & Baker, J. N. (2017). The bereavement experience of adolescents and early young adults with cancer: Peer and parental loss due to death is associated with increased risk of adverse psychological outcomes. PLOS ONE, 12(8), e0181024.

Kosminsky, P. (2016). CBT for grief: Clearing cognitive obstacles to healing from loss. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 35(1), 26-37.

Mayo Clinic. (2017, October 5). Complicated grief – Diagnosis and treatment. Mayo Clinic.org. Retrieved from https://www.mayoclinic.org/diseases-conditions/complicated-grief/diagnosis-treatment/drc-20360389

Marvin, D. (2017). An Analysis of Positive Coping Mechanisms Utilized to Overcome Trauma in Post-Genocidal Rwanda.

Mendoza, M. A. (2019, September 4). When grief gets physical. Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/understanding-grief/201909/when-grief-gets-physical

Shear, M. K., Reynolds, C. F., Simon, N. M., Zisook, S., Wang, Y., Mauro, C., Duan, N., Lebowitz, B., & Skritskaya, N. (2016). Optimizing treatment of complicated grief: A randomized clinical trial. JAMA Psychiatry, 73(7), 685–694.

Smith, M., Robinson, L., & Segal, J. (2019). Coping with grief and loss. HelpGuide.org. Retrieved from https://www.helpguide.org/articles/grief/coping-with-grief-and-loss.htm

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