The Unseen Wounds: Understanding Disenfranchised Grief

As a mental health therapist, I have encountered countless individuals grappling with loss. It is likely that if you are reading this (or have lived any length of time in this human existence) you have encountered loss, too. Loss, and the ensuing mourning and grief that comes along with it, can take many forms. Sometimes we suffer losses that don’t quite fit within the “norms” of what we have come to see as acceptable painful experiences. While many find solace in communal mourning and societal acknowledgment, others endure a more insidious form of suffering—disenfranchised grief. This form of grief, often overlooked and misunderstood, can have profound and lasting impacts on mental health and well-being.

What is Disenfranchised Grief?

Disenfranchised grief, a term coined by Dr. Kenneth Doka, refers to grief that is not acknowledged or validated by society. This can occur for various reasons: the relationship with the deceased may not be recognized, the loss itself may be minimized, or the grieving process might be deemed inappropriate by societal standards (Doka, 1989). For instance, the grief experienced by ex-spouses, caregivers, or pet owners often falls into this category.

The Impact on Mental Health

The effects of disenfranchised grief can be profound. Without societal validation, individuals may feel isolated and unsupported in their mourning. This isolation can exacerbate feelings of sadness, anxiety, and depression. Disenfranchised grief can lead to more complicated and prolonged mourning processes. Oftentimes, people find themselves in situations where those around them do not understand how to help them manage the pain associated with loss. Feeling connected to someone else who can offer compassion, patience, and stability when you are grieving is a piece of community that is sadly uncommon for many of us. When we find ourselves in these situations, it can compound the pain experienced in the losses that may not fit our societal parameters for grief.  

Compounding Factors

Several factors can compound the impact of disenfranchised grief:

1. Lack of Social Support. When grief is not recognized, it often means a lack of support from friends, family, and the community. This can leave individuals feeling alone in their sorrow, without the necessary emotional scaffolding to process their loss.

2. Stigmatization. Certain types of loss, such as those involving addiction, suicide, or miscarriage, may carry a societal stigma. This can further alienate grieving individuals, who might fear judgment or blame.

3. Ambiguous Loss. Disenfranchised grief is often tied to ambiguous losses—situations where the loss is unclear or unresolved. Examples include the disappearance of a loved one or the cognitive decline seen in dementia. These ambiguous losses can make it difficult for individuals to find closure.

Moving Forward with Grief Therapy

Addressing disenfranchised grief requires a shift in societal attitudes and greater awareness. By acknowledging and validating all forms of grief, we can provide more comprehensive support to those suffering. As we continue to learn and grow in our understanding of grief, we strive to ensure that no one feels alone in their mourning.

If you find yourself struggling with something that feels like this, consider partnering with a therapist at Bridger Peaks Counseling to understand and address the nuances of disenfranchised grief. By recognizing the unseen wounds, we can navigate the grief journey toward healing and wholeness together.

Get Support in Grief Counseling Today at our Bozeman, MT Practice

Grief can be a lonely journey, especially when your pain is overlooked or misunderstood. At Bridger Peaks Counseling, we believe that all forms of grief deserve recognition and care. If you're struggling with disenfranchised grief or any form of loss, don't go through it alone.

1. Contact us now to start your journey toward wholeness.

2. Connect with a compassionate grief therapist who can help you navigate your unique experience and find the support you need.

3. Together, we can honor your grief and guide you toward healing.

Other Therapy Services We Offer in Missoula & Bozeman, MT

Our team of caring counselors at Bridger Peaks Counseling is happy to provide a variety of mental health services. Our team is happy to offer services including addiction counseling, teen counseling, group therapy, rising strong workshops, and body image counseling. Furthermore, we provide depression treatment, grief and loss counseling, and online counseling. Along with EMDR, postpartum anxiety depression counseling, marriage counseling, and psychiatric care. Visit our blog or FAQ to learn more today!

References

• Doka, K. J. (1989). Disenfranchised Grief: Recognizing Hidden Sorrow. Lexington Books.

Understanding Complex PTSD: Beyond the Surface

Complex PTSD (C-PTSD) is a psychological condition that develops from prolonged exposure to traumatic events, particularly in interpersonal contexts characterized by betrayal of trust or power imbalances (Herman, 1992). Unlike Post-Traumatic Stress Disorder (PTSD), which typically arises from a single traumatic incident, C-PTSD evolves over time, often originating in childhood or early adulthood due to repeated trauma and inadequate support.

Defining Complex PTSD

C-PTSD is distinguished by exposure to prolonged trauma, such as ongoing abuse, neglect, or captivity, often in environments where individuals feel powerless or under constant threat (van der Kolk, 2005). This leads to pervasive emotional, psychological, and sometimes physical consequences that significantly impact an individual’s life.

Common Examples of Complex PTSD

Examples of situations contributing to C-PTSD include:

1. Childhood Abuse:

Enduring physical, emotional, or sexual abuse during childhood without a supportive caregiver can lead to profound emotional wounds that persist into adulthood (Cook et al., 2005).

2. Domestic Violence:

Experiencing ongoing emotional, verbal, or physical abuse from an intimate partner can cause significant psychological distress and trauma.

3. Long-term Neglect:

Chronic neglect in childhood, where basic emotional and physical needs are consistently unmet, can result in developmental trauma that shapes the individual’s self-concept and relationships (Perry et al., 1995).

Metaphors for Understanding C-PTSD

Metaphorically, C-PTSD can be likened to navigating through life with an emotional backpack filled with rocks. Each rock represents a traumatic experience or unresolved emotion that weighs heavily on the individual’s psyche (van der Kolk, 2015). Trauma therapy and healing at Bridger Peaks Counseling involves carefully unpacking these rocks. Our goal is to help you understand their origins, and find ways to release their burden.

Another metaphor is that of a tangled ball of yarn. Each traumatic event or abusive relationship adds another layer of complexity, intertwining with previous experiences to form a knotted mess that is difficult to unravel (Herman, 1992).

Recent Research and Insights

Recent research on C-PTSD underscores its distinct clinical presentation compared to PTSD. It emphasizes symptoms such as:

• emotional dysregulation

• chronic feelings of shame or guilt

• distorted self-perception

• difficulties in forming and maintaining relationships (Ford, 2013; Cloitre et al., 2014)

Neurobiological studies have explored alterations in stress response systems and brain structures related to emotional processing and memory in individuals with C-PTSD (van der Kolk, 2015). Studies have shown alterations in key brain regions involved in emotional regulation, memory processing, and stress response, such as the hippocampus, amygdala, and prefrontal cortex (van der Kolk, 2015).

Chronic exposure to trauma can lead to dysregulation in these areas. This can affect an individual’s ability to regulate emotions, form coherent memories of traumatic events, and engage in adaptive decision-making (Perry et al., 1995). Additionally, changes in neurotransmitter systems, particularly those involving serotonin, dopamine, and norepinephrine, have been observed, further influencing mood, arousal levels, and the perception of threat (van der Kolk, 2015). These neurobiological findings underscore the complexity of C-PTSD as not only a psychological condition but also a physiological one, necessitating integrated approaches in treatment that address both psychological and neurological aspects of healing. Understanding these neurological changes helps therapists tailor interventions that promote neuroplasticity and support recovery from the effects of prolonged trauma.

Trauma treatments in Missoula, mt

Therapeutic approaches for treating Complex PTSD (C-PTSD) are multifaceted, aiming to address both the psychological and neurobiological impacts of prolonged trauma.

• Trauma-focused cognitive-behavioral therapy

  • (TF-CBT) is often employed to help individuals process traumatic memories, manage distressing emotions, and challenge maladaptive beliefs about themselves and the world (Cloitre et al., 2012). This approach incorporates techniques such as cognitive restructuring, exposure therapy, and stress management strategies to promote desensitization and emotional regulation.

• Mindfulness-based interventions

  • Such as Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT), are also beneficial in C-PTSD treatment, fostering present-moment awareness and acceptance of difficult emotions without judgment (van der Kolk, 2015).

• Relational therapies, including attachment-based therapies and EMDR,

  • These additional therapies focus on rebuilding interpersonal trust, enhancing the sense of self, and core beliefs. These therapeutic modalities not only address symptoms but also aim to restore a sense of safety, agency, and resilience. This facilitates long-term recovery and the development of adaptive coping mechanisms in individuals with C-PTSD.

Final Thoughts from a Trauma Therapist in Missoula, MT

In conclusion, understanding Complex PTSD requires acknowledging the profound impact of prolonged trauma on an individual’s psychological and emotional well-being. By recognizing the complexity of their experiences and providing compassionate support, our trauma therapists can help those affected by C-PTSD embark on a path of healing, reclaiming their sense of self, and building healthier, more fulfilling lives.

Start your healing journey today

If you need support with C-PTSD, our team of caring therapists would be honored to help you in your journey. To start trauma counseling with Bridger Peaks Counseling, please follow these simple steps:

1. Make an appointment online

2. Meet with one of our professional Missoula mental health therapists

3. Begin your journey toward healing with our trauma therapy.

Other Therapy Services We Offer in Missoula & Bozeman, MT

Our team of caring counselors at Bridger Peaks Counseling is happy to provide a variety of mental health services. Our team is happy to offer services including addiction counseling, teen counseling, group therapy, rising strong workshops, and body image counseling. Furthermore, we provide depression treatment, grief and loss counseling, and online grief counseling. Along with EMDR, postpartum anxiety depression counseling, marriage counseling, and psychiatric care. Visit our blog or FAQ to learn more today!

References:

● Cloitre, M., Garvert, D. W., Brewin, C. R., et al. (2014). Evidence for proposed ICD-11 PTSD and complex PTSD: A latent profile analysis. European Journal of Psychotraumatology, 5(1), 10.3402/ejpt.v5.27324.

● Ford, J. D. (2013). Complex PTSD: Research Directions for Diagnostic Validity and Future Study. Journal of Traumatic Stress, 26(5), 488-494.

● Herman, J. L. (1992). Complex PTSD: A Syndrome in Survivors of Prolonged and Repeated Trauma. Journal of Traumatic Stress, 5(3), 377-391.

● Herman, J. L. (2015). Trauma and Recovery: The Aftermath of Violence—From Domestic Abuse to Political Terror (Revised Edition). Basic Books.

● Perry, B. D., Pollard, R. A., et al. (1995). Childhood trauma, the neurobiology of adaptation, and "use-dependent; development of the brain: How "states" become;traits; Infant Mental Health Journal, 16(4), 271-291.

● van der Kolk, B. A. (2005). Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401-408.

● van der Kolk, B. A. (2015). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (Revised Edition).

Navigating Decision Fatigue

In today’s fast-paced world, we are constantly bombarded with choices—from what to wear, eat, and buy, to more significant decisions like career moves and relationship issues. While the abundance of options can be empowering, it can also lead to a phenomenon known as decision fatigue.

What is Decision Fatigue?

Decision fatigue refers to the deteriorating quality of decisions made by an individual after a prolonged decision-making period. This concept, first described by social psychologist Roy F. Baumeister, suggests that the more decisions we make, the more our cognitive resources are depleted, leading to poorer decision-making over time (Baumeister et al., 1998). The mental energy required for decision-making is finite, and as it gets used up, our ability to make thoughtful and well-considered decisions declines. Essentially, our brains get tired, just like our muscles do after physical exertion.

The Psychological Mechanism Behind Decision Fatigue

The process of making decisions involves the prefrontal cortex. This part of the brain is responsible for complex cognitive behavior, decision-making, and moderating social behavior. Each decision, no matter how small, uses up some of our mental energy. When this energy is depleted, it becomes harder to make decisions. Then, the quality of our choices diminishes.

Research by Vohs et al. (2008) has shown that making repeated choices can deplete an individual’s self-control and cognitive resources. This depletion can manifest in various ways, such as procrastination, avoidance, and impulsivity. People experiencing decision fatigue often report feeling overwhelmed, anxious, and stuck, unable to move forward with important life choices.

The Impact of Decision Fatigue

Decision fatigue can have far-reaching effects on various aspects of life. For instance, in the workplace, it can lead to decreased productivity, poor performance, and burnout. In personal life, it can strain relationships and contribute to stress and mental health issues. Notably, decision fatigue can also affect physical health. Individuals may resort to unhealthy behaviors, such as overeating or substance use when their self-control and window of tolerance is depleted (Hagger et al., 2010).

Those experiencing decision fatigue often report feeling overwhelmed, stressed, and mentally exhausted. They may find themselves procrastinating, making impulsive decisions, or avoiding decisions altogether. In some cases, decision fatigue can contribute to anxiety and depressive symptoms, as the individual feels increasingly incapable of managing their daily life.

Managing Decision Fatigue

As a therapist, there are several strategies I recommend to clients to help manage decision fatigue:

1. Prioritize Important Decisions:

   Tackle important decisions early in the day, or whenever you feel most rested and when your cognitive resources are at their peak. Beginning with the decisions that are most important will help ensure that these decisions are made when you have the most capacity to do so.

2. Limit Choices:

   Reducing the number of choices can help conserve mental energy. For example, simplifying routines, like having a set menu for meals or a standard work wardrobe, can minimize daily decisions.

3. Create Habits and Routines:

   Establishing habits and routines can automate some decisions, freeing up mental energy for more critical choices.

4. Take Breaks and Rest:

   Regular breaks and adequate sleep are crucial for replenishing cognitive resources. Taking short breaks during the day will help ensure you are getting enough rest. Prioritizing a quality sleep routine will promote cognitive recovery.

5. Mindfulness and Stress-Reduction Techniques:

   Mindfulness practices and stress-reduction techniques, such as meditation and deep breathing exercises, can help clients stay present and reduce the mental burden of decision-making.

Closing Thoughts from a Bozeman Therapist

Decision fatigue is a pervasive issue in our modern world. It impacts our ability to make thoughtful and effective decisions. Understanding the mechanisms and effects of decision fatigue can help us navigate our daily lives and maintain our mental well-being. By implementing strategies to manage decision fatigue, we can improve our decision-making abilities and reduce the stress associated with an overwhelming number of choices. If you’re interested in exploring therapy options for decision fatigue, reach out to Bridger Peaks Counseling to see how we can help.

Finding Support for Decision Fatigue in Bozeman, MT

If you need support navigating decision fatigue, our team of caring therapists would be honored to help you in your journey. To start therapy with Bridger Peaks Counseling, please follow these simple steps:

1. Make an appointment online

2. Meet with one of our professional Bozeman mental health therapists

3. Relieve decision fatigue!

Other Therapy Services We Offer in Missoula & Bozeman, MT

Our team of counselors at Bridger Peaks Counseling is happy to provide a variety of mental health services. We offer services including addiction counseling, teen counseling, group therapy, rising strong workshops, and body image counseling. Furthermore, we provide depression treatment, grief and loss counseling, and online counseling. Along with EMDR, postpartum anxiety depression counseling, marriage counseling, and psychiatric care. Visit our blog or FAQ to learn more today.

References

Baumeister, R. F., Bratslavsky, E., Muraven, M., & Tice, D. M. (1998). Ego depletion: Is the active self a limited resource? Journal of Personality and Social Psychology, 74(5), 1252-1265.

Hagger, Martin & Wood, Chantelle & Stiff, Chris & Chatzisarantis, Nikos. (2010). Ego Depletion and the Strength Model of Self-Control: A Meta-Analysis. Psychological Bulletin. 136(4). 495-525.

Vohs, K. D., Baumeister, R. F., Schmeichel, B. J., Twenge, J. M., Nelson, N. M., & Tice, D. M. (2008). Making choices impairs subsequent self-control: A limited-resource account of decision making, self-regulation, and active initiative. Journal of Personality and Social Psychology, 94(5), 883-898.

Arousal Non Concordance - 3 Signs to Watch For to Know When I am Ready to Engage in Physical Intimacy

Bell, food, salivation. Do you remember the lesson you learned in every basic psychology class about Pavlov’s dog? Here is a quick refresher! A dog hears a bell, the dog gets food, the dog salivates. After enough times, the dog hears the bell and even if the dog does not get food, the dog still salivates. This is a simple example of how dogs (and people!) become conditioned to have a response to a stimulus. Classical conditioning shows up in all areas of our life whether it is walking into the family Christmas party already angry and defensive in preparedness for your mother to bring up why you don’t have a partner with you for 6th year in a row, a trauma response of turtle shelling in your adult life because you were taught not to speak about your emotions as a child, OR … drum roll please…in our sex lives! 

Let’s talk about arousal non concordance. Arousal non concordance is the lack of [a] predictive relationship between your physiological response and your subjective experience of pleasure and desire. To translate, by physiological response I am referring to genital blood flow, which has been depicted by society as women getting wet and men getting a boner. Due to classical conditioning, our bodies can respond to sexual stimuli by increasing in genital blood flow even if we do not associate that stimuli with our subjective experience of pleasure and desire. The success of our bodies accurately reacting is actually between 10-50% (WOAH! That is not a lot!) Men statistically have a 50 percent overlap between their genital response and subjective arousal; whereas, women have a 10% overlap between their genital response and subjective arousal. So what does this mean? This means that we cannot predict someone’s desire for sex just based on our genital blood flow or a partner’s genital blood flow. 

For example, if you are a female and have a hard time getting wet with your partner, that does not mean that you are not attracted to them or want to engage in sex! Getting wet is not the main and only sign that you emotionally and physically want to have sex. The opposite is true as well. If you are getting wet when you know you emotionally and physically do not want to have sex, your feelings are accurate! Our bodies are not always in sync with our subjective experience of pleasure or desire because of classical conditioning. You may have been told your whole life that certain things should arouse you sexually (it is not a hot take that society has made a living telling women they know more about their bodies then they do), and maybe your body is telling you you are turned on because of your genital blood flow. But I am here to scream from the rooftops that that is arousal non concordance, and you do know more about your body than society. Here are some other signs that your body is ready for sex that you can pay attention to:

• Muscle tension. Your thighs, butt, abdomen, wrists, calves and feet are all areas that your muscles can contract to show that your body is engaged and in an aroused state. 

• Your breath. Your pulse may increase and your respiratory rate may increase.

• The MOST important: your words. Your feelings are more accurate than your body’s genital blood flow. Communication is so important. And having a partner you feel safe to communicate with while feeling vulnerable around sex is equally as important.

Because society has told us that the main sign of desire is getting wet or getting hard, this can become damaging in relationships. People can get offended that their partner is not getting what they think is physiologically aroused and then feel like their partner is lying to them if their words are not matching their body’s reactions. I would like to again scream from the rooftops, your partner’s words are more accurate than their genital blood flow. They know how aroused they are, they know their emotions and their desire, and if there is trust in the relationship then they are communicating what they know to be true in their body. So let’s stop being suspicious of our partners when they are communicating the way they feel and start getting suspicious of the false information society has fed us our whole lives. 

For more information or arousal non concordance here are some beautiful resources:

Book: Come as You Are by Emily Nagoski

https://www.youtube.com/watch?v=L-q-tSHo9Ho

• This is a 15 minute Ted Talk by Emily Nagoski talking about Arousal Non Concordance. She elaborates on examples to make it feel more applicable. The examples she elaborates on are found in between minute 4:45 - to the end of the Ted Talk. 

A special thank you to Emily Nagoski for her motivation and effort towards research around demystifying sex myths and normalizing what is actually happening in our bodies.