A Remarkable Recovery From Unspeakable Grief and PTSD

512px-Pedra_do_Baú_-_Campos_do_Jordão_-_São_Paulo

Some stories stick with you. The word “heartbreaking” is not enough to describe them; nor do “resilience,” “survival,” and “overcoming misery” say enough.” Yet all those words apply.

The therapist in the tale who helped enable a positive conclusion was Donald Meichenbaum, Ph.D. He related this account in a video focused on finding meaning in the aftermath of trauma: PTSD & Complex PTSD: Ways to Bolster Resilience. 

Don’t read further if you wish to avert your eyes from tragedy, but understand this: you cannot know of the treatment that allowed for a redemptive, healing story unless you face it.

The woman: a young, bright, intelligent mother. A good mother. Her husband was away on a business trip. Home held only her daughter and herself. An intruder could be heard downstairs. Mom entered Vicky’s room and they hid in her closet. The burglars left without going upstairs. The event upset both Vicky and the mother, worried such an episode might happen when the husband/father traveled once more to make his living. The adults installed a security system and alerted the police. They lived in a safe neighborhood. No reason to expect another forced entry. Still, the man insisted his wife get a gun, just in case. She did not like firearms, but relented. The night stand next to her bed harbored the weapon.

Time passed. The man traveled again. Late and stormy darkness. Noises downstairs. Was the mother dreaming, reliving an imaginary or remembered version of the home invasion?

No. No. No. Not again.

Yes, again.

The mother urgently reached for the gun and moved toward her bedroom door to go to Vicky’s room, just as she had the first time. Vicky came running and pushed the mom’s door open. It struck the mother’s hand and the firearm discharged. Vicky died immediately. The mother sat with her dead daughter for 24-hours until the husband returned.

No words are possible. The parents’ lives were forever changed. Guilt, horror, marital separation, grief, depression. Even loving friends became unavailable, unable to bear the story. Alienation and isolation. As the mother saw it, a life not worth living. She deserved to die.

What is a therapist to do? He can never undo the tragedy, but perhaps he can help the survivor to find a reason to live, a meaning for the rest of her life. Here is what Meichenbaum did:

The psychologist knew his job was first to establish a therapeutic alliance, to show compassion, and accept, not judge. He needed to allow the patient to tell her story as she was able, permit its unfolding, not push. A plan to prevent the woman’s self-harm was created. The therapist allowed his emotions to be touched. His own tears came as he listened.

The psychologist asked a question to understand more about the loss. The client had said that Vicky was “special.”

In what way?

She was wise beyond her years.

The first session ended and the doctor arranged a second appointment in two days’ time. Meichenbaum made a request. He said he would be “honored and privileged” if mom brought in a photo album of Vicky, but only if she wanted to: no pressure. He wished to get a further sense of who the child was.

Reviewing the pictures together was painful in the extreme. Yet this marked the beginning of the doctor’s effort to embed the only moment the mother focused on (the accident and death) within a broader narrative of Vicky’s life and her own life: to pull his client out of the single instant of horror into the stream of her ongoing existence — perhaps to create a potential redemptive story projected into the future.

This is not to suggest any kind of treatment would ever erase the pain or guilt completely. Yet, it might still be possible to help the mother give Vicky’s memory meaning. And perhaps to transform the patient’s life in the process.

The therapist asked his client another question. Two, actually. He wanted to know what this child (who was “wise beyond her years”) might say to the parent’s wish for oblivion:

What advice would Vicky give and what would happen to the memory of her if you kill yourself?

The mother affirmed the obvious answers which had escaped her: Vicky would not want her to die. Moreover, the memory of Vicky would also die with the death of the one who knew her best. Meichenbaum’s questions led her to realize she might do some good in the world, something to perpetuate Vicky’s memory and give meaning to the child’s short life. Treatment continued. Mom became a public advocate for gun locks and gun safety, thus transforming her loss and honoring Vicky.

In part, Donald Meichenbaum assisted the patient to fashion a new story of her own life different from one ending with two deaths. She became aware her time on earth was not yet completed. And that Vicky’s impact on the world offered a potential future, if only the parent gave her daughter a metaphorical life — gave voice to what her daughter’s death could still achieve.

This is not at all to suggest the mother wouldn’t have traded anything — anything — to get Vicky back. Yet, the mom might yet continue her existence with a constructive narrative of redeeming value in spite of complicity in the child’s loss.

Meichenbaum is famous for asking questions — for creating a Socratic Dialogue with his patients. He did not give his patient advice, but led the conversation so she might grasp the next rung on the ladder of recovery, not simply be handed it. Therapists should know “directions” from the counselor don’t produce as much “ownership” of the treatment process, nor as much motivation to change, as occurs when he helps the client uncover her own way, not just follow advice.

Might you also find your own way? Might the rest of your story be one of value?

What do YOU say?

The photo is titled Pedra do Baú — Compos do Jordáo. The author is Izabel Tartari and it was sourced from Wikimedia Commons.

8 thoughts on “A Remarkable Recovery From Unspeakable Grief and PTSD

  1. Richard Stern

    Gun locks and gun safety dont seem congruent with the purpose of the mother having a gun in her room. Wasnt her purpose once she decided to leave her room to have the gun ready for use if there was an intruder. Really she would have been better off without any gun, as in many tragedies where a child accidentally shoots a sibling, friend, sibling etc. Or where guns are used impulsively in domestic disputes and someone winds up injured or dead. Security systems, police proteccion, alarms, even reinforced doors and bars on windows might do more toward protecting a family than having a gun. In other words, when are we going to eliminate the sale of firearms? . First thing to do instead of reaching for the gun, might have been to dial 911, most communities have 2-4 minute response time to 911. Not totally clear why Vicki came running. Had she also heard the intruder(s)? Well, this is a political response to the description of a psychological crisis. Why is that mostly the victims or families of victims are the ones who become the leading advocates for gun control. Why are we so naive as to wait until it happens to “us”?

    Turning to the psychological aspects, this therapist’s approach seems marvelous. But it Probably will work for some but not for all, also I am sure there are nuances in the degree of recovery in all such cases, including the above. A great movie to see about a similar theme, is called “A prayer for Bobby” with Sigorney Weaver. I recommended it highly. The analogy is not perfect but there are many similarities. A fundamentalist Christian mother totally rejects her 19 year old son Bobby for his homosexuality, and when he commits suicide, apparently largely due to her unmerciful rejection in a previously close family, she goes through a heart wrenching process of guilt, but finally redeems herself (in a grueling process) and finds purpose in life by becoming an activist for gay rights. . Weavers performance is really impressive. Movies like this, smaller independent productions rarely get the recognition they deserve, although this movie has been seen by hundreds of thousands of familiies who have gay children and by the children themselves. By the way, the movie is based on a true story.

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    • drgeraldstein

      I’m going to skip the issue of guns, since, as you say, that was not the focus of the essay. I think people are pretty well fixed in their positions. Regrettably, lobbies of all kinds have much too much influence on our various legislators. A big problem for our republic. Thanks for the recommendation of “A Prayer for Bobby.” I will look for it. Thanks, as always, for your thoughtful commentary.

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  2. Because I subscribe to Moms Demand Action for Gun Sense in America I read a story like this one just about every day. In my own life I know that my best friend’s granddaughter was killed by a playmate with a gun when she was seven years old. A man I knew well shot and killed his own daughter thinking she was an intruder. So far, we haven’t been able to effectively challenge this madness. Individual healing is laudable. We all bear responsibility for the lack of societal healing.

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    • drgeraldstein

      Thanks for this, Joan. Too many needless tragedies in this insecure world. You might be interested in the research on “mortality salience” that is done under the heading of “Terror Management Theory:” the terror or mortality rather than terrorism. When people are reminded of their own vulnerability they bind themselves more closely to institutions like church and perhaps even leaders who appear “strong.” You can see what political consequences this has today.

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  3. Without going into the ins and outs of American gun laws, the ability to turn a tragedy around and bring about a positive change requires a special sort of courage. Here in Australia we have had an example of a couple whose 13yr old son was abducted and murdered while waiting for a bus to go to the shopping centre where he was going to buy his family christmas presents and also a man whose wife and two young girls were killed in the last massacre that changed the gun laws here. These parents have managed to turn their incredible grief into foundations in the memory of their children. In the first instance, the parents of their 13yr old son go to schools in Australia to teach children about safety with DVDs and educational programs. In the second instance their father who lost his wife and daughters has created an organisation to assist children who have experienced violence. These, and many others have managed to find a purpose and to honour the memories of their loved ones and find a reason to keep going in the face of tragedy. They could so easily have become bitter and spill over with rage but instead they have gone forward to assist others, as many as they can. Their efforts to help others has been the key to their own recovery.

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    • drgeraldstein

      Thank you, Claire, as always. The examples of foundations and memorials fit perfectly with Meichenbaum’s work on finding meaning after tragedy.

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  4. What a tragic situation, Dr. Stein! Even worse, it’s not unique. Children continue to die accidentally under similar circumstances. Not all those involved in taking the lives of their children are fortunate to recover from such an event. Asking the right questions helped this mother to see a new way forward in life.

    As a mother, I’ve made choices that impacted the lives of my sons. I have often wished that I could undo the past: to reboot. With the right questions from the people around me at the time, I was able to realize that I was doing the best that I could under the circumstances I faced.

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    • Supportive friends are one of the things that make life gratifying and, sometimes, survivable. Thanks for reminding us of just how important is a strong social network, Rosaliene.

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