When someone dies without warning, in an accident, from an overdose, by violence or by suicide, there is no time to prepare and often no chance to say goodbye. People describe two things happening at once: missing the person, and being unable to stop thinking about how they died.
This article explains what clinicians know about grief after this kind of death, how it overlaps with trauma, and where to find help in Greater Boston and nationally. If you are having thoughts of suicide yourself, call or text 988, or call 911 in an emergency.
What is different about grief after a sudden death?
The American Psychological Association's Dictionary of Psychology defines traumatic grief as a severe form of separation distress that usually occurs following the sudden and unexpected death of a loved one. It adds that numbness and shock are frequently accompanied by a sense of futility and the meaninglessness of life.
The National Cancer Institute lists emotional numbness, shock, disbelief and denial among the reactions that often come immediately after a death, particularly an unexpected one. It also lists frequent intrusive images of the death among ordinary grief reactions. So replaying what happened, or picturing it when you do not want to, is not by itself a sign that something has gone wrong.
Why might you feel numb?
Many people expect to be overwhelmed and are frightened to find they feel very little. The VA's National Center for PTSD addresses this directly: "If the death was shocking, it can cause you to feel numb and it may delay or interfere with grieving. It's important to not feel badly or judge yourself for not 'feeling' something like what you or your family would expect."
Numbness does not measure how much you loved someone. There is more on the range of early reactions in what grief feels like.
Is it grief, trauma, or both?
It can be both. Clinicians separate the two by what the distress centers on. Prolonged grief disorder, a diagnosis for grief that stays intense and disabling long after a death, centers on yearning for the person and preoccupation with them. Preoccupation with the circumstances of the death is something the researchers behind the current criteria noted could instead be captured by a diagnosis of post-traumatic stress disorder (PTSD). The criteria ask clinicians to check that grief symptoms are not better explained by PTSD, and both conditions can be present in the same person.
Sorting this out is a clinician's job, not something to work out alone. The VA's advice is practical: if you continue to struggle with daily activities or feel high levels of distress from grief, post-traumatic symptoms or depression, there are experts who can help, and it suggests talking to someone who focuses on complicated or prolonged grief. Dr. Rabin's work with trauma is described on her trauma therapy page.
Does a traumatic death make prolonged grief more likely?
Research suggests it raises the risk. The American Psychiatric Association says the risk for prolonged grief disorder is greater when a death happens very suddenly or under unnatural circumstances, and it lists deaths from violent causes among the risk factors.
How much greater is uncertain. A 2020 meta-analysis pooled 25 articles on people bereaved by accident, disaster, suicide or homicide and found a prolonged grief disorder rate of 49%, with a wide margin of error (33.6% to 65.4%). The authors wrote that the findings should be interpreted with caution because the studies differed so much in their methods. The figure describes the people in those studies. It is not a forecast for any one person, and many people bereaved in these ways do not develop the disorder. The diagnosis itself is explained in prolonged grief disorder.
How fast should you face it?
At your own pace. One model of grief, the dual process model published by Margaret Stroebe and Henk Schut in 1999, describes healthy coping as a back-and-forth in which a grieving person at times confronts the loss and at other times avoids it. The model treats taking a rest from grief as an integral part of coping, not a failure to cope.
That matters after a traumatic death, when the details can be too much to hold all at once. Stepping away from them for a while, to work, to look after children or to do something ordinary, is part of how people manage.
Where can you find support for this kind of loss?
Peer support has a particular place here. A 2019 systematic review of 32 studies of peer support after sudden or unexpected death, not all of them randomized trials, found that most showed it was helpful, and that it appeared especially valuable for survivors of suicide loss.
- If someone you love died by suicide: Samaritans SafePlace runs virtual and in-person groups in the Boston area, facilitated by trained volunteers who are themselves survivors of suicide loss. Meetings are free, ongoing and open on a drop-in basis, at any time after the loss. Samaritans also offers one-on-one Survivor to Survivor visits.
- Also after a suicide loss: the American Foundation for Suicide Prevention (AFSP) offers Healing Conversations, which connects loss survivors with volunteers who are themselves loss survivors, along with a support group directory and a guide called Surviving a Suicide Loss. AFSP does not run or endorse the groups it lists.
- After a homicide: the Louis D. Brown Peace Institute in Dorchester offers families emotional and practical support 24 to 72 hours after a homicide. Its services are free and confidential, and include a burial and resource guide and help with the victim compensation application. Phone 617-825-1917.
- For any mental health concern in Massachusetts: the Massachusetts Behavioral Health Help Line, call or text 833-773-2445, is free, open 24 hours a day and available without insurance. It connects people to treatment in their community.
- In a crisis: call or text 988 to reach the 988 Suicide and Crisis Lifeline, which is free, confidential and available at all hours. You do not have to be suicidal to call. If someone is in immediate danger, call 911.
When might therapy help?
Most people who are bereaved do not need therapy, and that includes many people bereaved suddenly. It is worth considering when grief and trauma symptoms are keeping you from daily life, when the distress is not easing, or when you want a private place to talk about a death that is hard to discuss with others.
Dr. Rabin's grief and loss therapy is trauma-informed, and she works with grief that is tangled up with trauma. She trained at The Trauma Center. There is no fixed timeline, and the pace is set with you. She sees clients in person in Brookline and by telehealth across Massachusetts, and offers a free consultation of about 15 minutes by phone through the contact page. The treatments that have been studied are compared in types of grief therapy.
Keep reading
Sources
- American Psychological Association, APA Dictionary of Psychology: traumatic grief (2018)
- U.S. Department of Veterans Affairs, National Center for PTSD, Grief: Taking Care of Yourself After a Loss (2026)
- National Cancer Institute, Grief, Bereavement, and Coping With Loss (PDQ), Health Professional Version (2024)
- Djelantik, Smid, Mroz, Kleber and Boelen, The prevalence of prolonged grief disorder in bereaved individuals following unnatural losses: Systematic review and meta regression analysis, Journal of Affective Disorders (2020)
- Prigerson, Boelen, Xu, Smith and Maciejewski, Validation of the new DSM-5-TR criteria for prolonged grief disorder and the PG-13-Revised (PG-13-R) scale, World Psychiatry (2021)
- Bartone, Bartone, Violanti and Gileno, Peer Support Services for Bereaved Survivors: A Systematic Review, Omega (2019)
- Stroebe and Schut, The dual process model of coping with bereavement: rationale and description, Death Studies (1999)
- American Psychiatric Association, Prolonged Grief Disorder (2025)
- American Foundation for Suicide Prevention, I've lost someone (accessed 2026)
Last reviewed October 2026. This guide is general information, not medical advice or a diagnosis. If you are in crisis, call or text 988, or call 911 in an emergency.
