Dealing with the toll of grief, loss, and trauma
When Rachel Zimmerman’s husband, MIT robotics professor Seth Teller, died by suicide in 2014, she thought her family was doomed.
“Our kids were eight and 11 at the time,” recalled Zimmerman, a journalist who spoke at an Oct. 8 event on the toll of grief, loss, and trauma, hosted by The Studio at Harvard T.H. Chan School of Public Health. Zimmerman went on to write a memoir about her experiences, Us, After: A Memoir of Love and Suicide. “The book is really about this arc from believing that your life is over, and you’ll never be able to rebuild your family, to coming to some semblance of resurgence and thinking that you can go on—because that is our human impulse, to go on,” she said.
Other panelists included Karestan Koenen, professor of psychiatric epidemiology at Harvard Chan School, and Matthew Nock, Edgar Pierce Professor of Psychology in the Harvard Faculty of Arts and Sciences and a professor in Harvard Chan’s Department of Epidemiology. Harvard Chan’s Christy Denckla, assistant professor of social and behavioral sciences, moderated the session. The panelists addressed topics including expectations and myths about grieving, how trauma can impact health, and what individuals and communities can do to help those who’ve suffered trauma.
No one way to grieve
Zimmerman found that her two daughters needed to process their father’s death in very different ways. “The eight-year-old really wanted details,” she recalled. “She wanted to know how her father died.” Teller had been dealing with tinnitus—ringing in the ear—and Zimmerman learned after his death that he’d been sleeping only one or two hours per night and had expressed suicidal thoughts to his doctor. He took his life by jumping from the Tobin Bridge in Boston.
To answer her questions, Zimmerman said that her father had an illness in his brain and that he was suffering from immense pain that overwhelmed him. Zimmerman’s 11-year-old, however, didn’t want any information. “Every time the younger one asked for details, she would leave the room,” Zimmerman said.
Zimmerman’s younger daughter spent time at The Children’s Room in Arlington, a facility that helps children, teens, and families in Massachusetts who are grieving. There, her daughter connected with other kids dealing with grief, did art projects, and processed her pain in an age-appropriate way. Her older daughter, a fan of musical theater, spent time singing and performing. “That was a way of expressing her grief without having to directly be in the room with a therapist and talk about it,” Zimmerman said.
Nock said that although scientists have attempted to explain the stages of grief “neatly and cleanly,” research over the past few decades has shown that everyone moves through grief differently. Research from Columbia University’s George Bonnano has shown that most people, over time, are actually quite resilient after a loss or traumatic event, Nock said. Some struggle for longer periods, and some experience what’s called “complicated grief,” which impairs a person’s ability to cope and fulfill daily activities. “But that’s a small minority of cases,” Nock said.
In his own research, Nock has been able to improve predictions about which people in a given population are at elevated risk for suicide, for instance by accessing data, with patients’ permission, from wearable sensors. Those at high risk can then be sent supportive text messages or emails. “We can … reach out to them and try to help before their thoughts progress to [suicidal] behavior,” he said.
“We’re still not good at identifying which person is at risk and when,” Nock acknowledged, “but I’m very optimistic about where science is heading in this area.”
Trauma’s aftermath
Research has shown that traumatic experiences, such as losing a loved one to suicide or unexpected death, don’t cause only mental anguish—they also affect physical health and have been linked to chronic disease later in life, according to Koenen. “We don’t just experience it in our mind, we experience it in our bodies,” she said.
Zimmerman concurred. “Grief really takes a toll on your body,” she said. “You feel heavier. You feel exhausted.”
Trauma takes away a person’s sense of control, Koenen noted. “So one of the best things you can do is actually listen to what the person [dealing with trauma] needs and wants,” she said. Community support in the wake of trauma—from family, friends, schools, or religious institutions—is also key. “One of the biggest predictors of how people do over time, whether they have persisting anxiety and depression or not, is community resources,” she said.
Nock noted that simply hearing from people who care can help. He cited a 2001 study by psychiatrist Jerome Motto that found that, among people who’d been hospitalized because of suicide risk and then returned home, those who received hand-signed postcards from a healthcare worker who’d worked with them, expressing care, concern, and a desire to stay in contact, had a significantly lower risk of suicide death than those who didn’t receive the postcards.
Koenen practices and teaches yoga and meditation breathwork, both of which can help ease symptoms of PTSD (posttraumatic stress disorder). In fact, she said, some recent studies have suggested that these practices can be as helpful as a traditional PTSD intervention called “prolonged exposure,” which involves having patients reimagine their trauma. “There’s evidence that … doing things with our body can also help with our mind—not just vice versa,” she said.
Nock added that healthy habits can also play an important role in helping people deal with trauma or grief. Decades of research have shown that good diet, regular aerobic exercise, and sleep regularity can have very strong antidepressant, anti-anxiety mental health effects, he said.
Seeking answers
For her own part, Zimmerman spent time after Teller’s death wondering if there was anything she could have done to prevent it. She cited one example: After dropping her kids off at day camp on the day Teller died, she stopped for coffee. Later, she kept thinking, “Maybe if I had given up my Americano, I could have gotten home in time.”
She went into journalist mode, seeking out experts who could help explain the tragedy. Nock was one of the people she reached out to. He helped her understand that suicidal ideation feels like being in a burning building—and that even if a person doesn’t want to die, they also can’t stay in the burning building. Nock also told her that suicide is often a very impulsive decision.
Zimmerman never found the clear answers she was seeking. “You just have to accept that this unbearable pain was in somebody’s brain, and if you haven’t been there, you don’t know what it is,” she said. “You have to accept this unknowable phenomenon. And that’s really hard.”
Over time, though, things got better. “As a journalist, it was deeply unsatisfying that I could not find the meat of the story. But what I learned was that I really had to focus on being in this world with my kids and going on. … And I got remarried. My kids are great. They have relationships and jobs and passions. And I never could have imagined any of that.”
