NASW Social Work Talks - EP 127: Understanding Traumatic Grief

Episode Date: February 27, 2025

Grief and trauma are universal experiences and, as social workers, we know these issues will show up in our work, no matter our practice area. Grief is an inevitable part of life—but trauma can make the grieving process much more complex. That's where the Wendt Center for Loss and Healing comes in. With decades of experience, they provide critical support to individuals and communities navigating the intersection of grief and trauma. Since 1975, the Wendt Center has been a lifeline for people in the Greater Washington area, helping them rebuild a sense of safety and hope after loss, illness, violence, or other trauma. Nationally recognized for their expertise, they offer specialized support to children, adults, families, and communities, helping them heal from life's most challenging experiences. In this episode, we sit down with Melissa Sellevaag, LICSW, who leads the Wendt Center's Training Institute, to discuss how mental health professionals and allied workers can increase their capacity and confidence to support those impacted by grief and trauma. Don't miss this insightful conversation on a critical topic that touches us all.

This episode of Social Work Talks is sponsored by Ironwall by Incogni. From the National Association of Social Workers, this is Social Work Talks, and I'm your host, Elizabeth Lamott, and I am so pleased to be sitting down with social worker, Melissa Salavag. We are going to be talking about the intersection of grief and trauma. Melissa is, as I said, a social worker. She's the Director of Training and Education at the Wendt Center for Loss and Healing in Washington, D.C. And we know as social workers and as humans that grief and loss are universal. They're a part of life and they're bound to come up in our social work practice, regardless of our area of work. What we tend to know less well

is that when trauma intersects with grief, the healing process is more complex. And Melissa is a real pioneer in the field when it comes to training and supporting communities and individuals with respect to the intersection of grief and trauma. So, Melissa, welcome to Social Work Talks. Thank you so much for joining us. It's a pleasure to be with you, Elizabeth. Thanks for having me. Could we start with you telling us a bit about the Wendt Center for Loss and Healing here in Washington, D.C.? All right. So, the Wendt Center has been around for 50 years. Our focus is solely on grief, loss, and trauma. We provide individual and group mental health care to kids all the way through senior citizens who are navigating life's worst moments. We offer in-person services in our

office as well as telehealth services to those in the D.C., Maryland, and Virginia area. We're also in D.C. public and public charter schools providing grief and trauma groups to kids in middle school, elementary, middle, and high school. And then we do a lot of training and education for the community members on understanding grief and trauma and how it impacts us and how it impacts how we show up and interact with other people. Really with the intention that the more we understand grief and trauma, the more we can support our community members and each other. I think it's really important that we understand that. So, Melissa, I want to especially thank you for making time for us so soon after the tragic plane crash here in Washington, D.C.

Is it okay if we talk about your experience this past week? Yeah, absolutely. Absolutely. First and foremost, our hearts and thoughts go out to those who are impacted by the plane crash and the victims that were lost that day. The Wentz Center is uniquely positioned to provide support in the wake of mass casualty events. We are part of the larger mass casualty response system in Washington, D.C. In this case, the on-site support was provided through other mechanisms. So we have been called in by specific agencies and groups to provide support to those who are impacted. And support in the wake of acute traumatic grief

looks like offering information. This is what you might be experiencing. It looks like offering regulation strategies and skills to navigate the immediate days and weeks. You know, we were on site at various locations. The event happened on a Wednesday night and by Friday we were on site places providing support, holding space to hear what people were experiencing, provide some psychoeducation around traumatic responses, some very basic coping skills such as drink water, get horizontal, turn off the news, stop looking at social media, and then strategies to support kids. because we know that this impacted adults and children across the board so really yeah providing that information to caregivers and to be able to provide support to their kids because what we know is that kids who are impacted by traumatic loss need some predictability and stability and need adults who are able to take care of themselves so they have capacity to show up and take care

of their kids so really in the immediacy after a loss such as that it's a lot of psychoeducation, a lot of validation, a lot of body regulation, and just a lot of sitting with it. Can you break down what you mean by body regulation? Just describe that a bit further. Yeah, absolutely. So when we experience something traumatic, our nervous system kicks into gear in a protective mode, right? Everybody knows fight, flight, freeze. Our bodies kick, our nervous system kicks into gear in order to help us stay safe and so that can mean that our nervous system is operating in this kind of activated state some people call it triggered I use the word activated because I think it's more a better

description of what actually happens on the body so when our bodies are activated they can feel restless they can have feel like it's hard to sit still it's hard to concentrate our legs are going a mile a minute as we're sitting there, we're having, you know, stomach discomfort, nausea, our heart might be racing, our chest feels heavy. So literally our body is giving us clues that we are uncomfortable and not okay. And if we pay attention to those body responses, there's things we can do to tend to that and help get our body a little bit back to a little bit more comfortable. You know, clinically we call it the window of tolerance, right? But when I'm working with, you know,

individuals in the community we talk about comfortable and so that can look like discharging that energy through you know movement through breath work through drinking cold water through humming and activating our vagus nerve through humming hugging and touch you know bilateral tapping right which is a part of emdr and is so stabilizing for people yes yep and we need to go back to basics when we're feeling really activated and remind people take a breath with me you know because we're engaging in shallow breathing or we're holding our breath like let's take a breath together and we're regulating our breath that way let's walk and talk you know kind of really the more we can provide that information and validation the less people feel like i'm losing my mind i'm

going crazy. I'm not okay. And you're not okay. And we can provide some skills and some strategies so that you can get back to comfortable while you're navigating the traumatic loss. And what would you say you observe between parents and children in an unfolding of something of this nature? You know, I mean, most of us are in shock and disbelief. It's hard to wrap your heads around it and there you know there's a great book about the grieving brain by Mary Frances O'Connor that I recommend and you know she talks about the science of the grieving brain and how it takes you know a period of time for our brains to actually understand this this experience and create new

pathways and so we're in shock we're in disbelief and there's a lot of depending on culture, there can be a lot of outward and vocal expression of emotion. Maybe there's not depending on culture. So there's, you know, that shock and disbelief and that need to do something to get back to feeling okay. Like your sense of safety and stability is shattered. And so what can we do to provide some of that safety and stability in this moment when our entire sense of safety and stability has been rocked? As a social worker, you face unique challenges including potential threats from clients and antagonistic situations. These threats are more dangerous when your home address and other personal information

is easily accessible on thousands of websites. Ironwall by Incogni removes this content wherever it resides online, so it cannot be weaponized against you. You focus on helping others while Ironwall will keep your home and family safe. Call 844-476-6360, extension 300, or visit ironwall360.com slash social 2024 for more information. Mention Social Work Talks and Ironwall will send you a personalized risk assessment showing you which websites now have your private information. And what is it like for you when you get the news about something like this and you're entering a situation? And how has that changed as you matured as a clinician?

Yeah, it's a great question. First and foremost, there's a running joke that we talk about. What's the fastest way to get a therapist regulated? Well, it's to put them in front of a a client, right? So I love that. We talk a lot about like, they're just like we tell caregivers, you need to take care of yourselves. I have to be actively aware of what my body is doing. So I'm highly attuned to like, my chest is tight, my stomach is tight, my appetite is disrupted. And that makes sense. And here's what I'm going to do to take care of myself. I also have the privilege of being surrounded by amazing clinicians. You do.

I know this. It's like, pick up the phone, call somebody. Within minutes on a Thursday morning, we were on calls talking about how we were going to proceed if we were called upon to provide support. So in a situation that is as large as this one is, people kind of come out of the woodwork that we know and trust. And so we've got a beautiful network of people that we can call on to step in and provide support.

supports. You know, but for myself, it's how am I taking care of my basic needs? How am I regulating my body? How am I moving after I've been sitting with people? Who can I call and get consultation with and share about my experience and get that support? And who in my immediate family kind of knows what I'm going through so that they can lighten my emotional load in other area so that I've got capacity to respond. It's so important and it's reminding me of another of the many powerful passages in the book that you suggested where she writes, combat veterans will not form a trusting relationship until they are convinced that the therapist can stand to hear the details of the war story. Rape survivors, hostages, political prisoners, battered women,

and Holocaust survivors feel a similar mistrust of the therapist's ability to listen, to really listen. In the words of one incest survivor, these therapists sound like they have all the answers, but they back away from the real shitty stuff. So respond to that because I think it gets to the rub of what many of us have a lot to learn about from you and from this conversation. Yeah. You know, so that when you are sitting with people who are navigating traumatic grief, the part of our human being that gets activated is our helplessness. We get into this profession to help, to make things better, to help people feel better. When a grief event occurs and a traumatic grief event occurs, we have to notice that part of us that's getting activated, that

helplessness part, that I can't fix this, but I have the courage to go into that space and sit in the pain and to hold that space and to hear what they are offering me and so when I can when I can stay regulated stay present stay attuned as they are sharing some of these really challenging details then they know I can handle their story and that actually gives them it starts that that that awareness that with with with therapy and with that connection and with that attunement they they too can navigate this. That it's not so hopeless, that nobody can handle this, I can't handle this.

That we can be highly attuned and stay present and stay regulated and hold what they're holding. Now that being said, there is something about pacing. When you are in a clinical setting, you know, somebody wants to come in and let it all out. My first job is to ensure safety. So I might want to pause people and say, this is so important what you want to share, but let's pause. Let's take a break. what our bodies are telling us because there's an urgency to get it out and i want to make sure that

they stay um safe and that they're present and that they're regulated so that um they're not leaving dissociated and kind of um in an unsafe situation so pacing is critical but also making sure that they're feeling that attunement in that presence because that sends the message that i'm here and i can handle what you're going to talk to me about could you give another example of showing up and holding space that clinicians can learn from in terms of perhaps a place where we commonly may move too fast or may not show up as our best clinical selves. Yeah. And I'm not sure who said it. I know a couple of my colleagues here at the center have named it and it might be attributed to somebody else so forgiveness for not quoting

the right person but it starts with this idea that our capacity as clinicians to sit with somebody else's pain will never exceed our capacity to sit with our own pain so it really starts with like what are my um what are my beliefs my narratives my family of origin story about grief and trauma how am i able to sit with my own discomfort what are the tools and strategies I have for being able to regulate myself to stay present and attuned and resist the urge to jump in and say something. You know, many, some modalities in their training and one of my colleagues talks about that acronym WAIT. Why am I talking? And so really it's that idea of like slowing ourselves down and giving our clients that space to be able to share at their pace what they would like to

share and what they're ready to share. But part of it is really becoming aware of that part of us that comes up with helplessness. So noticing that and that our urgency to fix it and to make it better, because of course it's hard to watch somebody in pain. It's really important that we're in touch with that and that we have mechanisms for attending to that as well. How does what you're describing relate to the trainings that you have for social workers, which I imagine some or many of our listeners and viewers may be quite interested in? Yeah, great question. So over the years, we've been able to offer trainings on grief and trauma and the intersection of grief and trauma and specific, working with specific causes of death

and types of grief. And so first thing is that in graduate school, I don't know about you, but grief was an elective. It was one semester if you wanted to take it. So we're not even talking about it and equipping our clinicians to sit in this space. So I think that's important to name that the social work profession, this very natural thing that we're all going to go through, we could probably do a better job of putting into our training and equipping people to be able to sit in that, right? Almost as if the programs struggle to go there and that can carry over into our professional development. Absolutely. Absolutely. So I think starting there that, you know, clinicians, it's not a sign of

weakness to seek out additional training. I work at the Wendt Center and I've done, you know, extensive training with other folks on grief and learn through my conversations and collaboration with clinicians here. We've been doing the work for a long time. The other thing is like through our trainings we often start with presence and use of self and I've noticed that sometimes that frustrates some of our participants who are like give me the interventions give me the doing and yes there are interventions and there is doing but initially it's the being and it's how am I using my presence tolerating this discomfort and showing up and being connected with somebody It goes back to that basics of building relationship, establishing trust.

And so when we want to jump to the interventions, that part of us comes from a good place, but it's the fixer part. And so we'll get there in our trainings and we'll give you some tools and some strategies and some interventions to use that have worked. But those won't work if we don't start with the presence and the attunement first. Isn't that something? So you mentioned training and social work, education, and there is something that blew my mind in this book, Trauma and Recovery. I learned in graduate school that the field of therapy began when Sigmund Freud, a doctor, had patients with unexplained ailments and they sat down and talked about how they felt and their symptoms alleviated. That's what I learned. This book describes something much deeper than that.

What she says is that in 1896, Freud worked with 18 so-called hysterical women. And what he discovered with all 18 of them by truly listening is that they all had a history of child sexual abuse. And he wrote a paper that still stands up today about the post-traumatic history of hysteria and how it had to be connected to trauma in childhood, child sexual abuse. And he was essentially counseled for this paper and backed away from it. is that your understanding as well? You know, it's interesting. I haven't done as deep a dive on that as you have. But I do think, you know, through Judith Herman's work, through the neurobiology work that's been done with the advances in neuroscience and technology and Bessel van der Kolk's work and the Body Keeps Score, you know, Stephen Porges, I mean, the list

is endless right dan siegel there's some really amazing amazing authors and clinicians out there what we've been able how i interpret that and i and i don't think i'm alone in this this is not a melissa ism this is you know through conversations with people is that the human brain and body is incredibly resilient and adaptive and so we look at the women who are labeled hysteric hysteric right like his um hysterical and actually we could look at that as well they came up with some coping strategies to manage what they went through so we can look at these as adaptations that they had to create to survive it goes back to that it's not what's wrong with you it's what's happened to you and how did you survive exactly and what happened when he put this theory out

there is that his colleague didn't sit with that horror just like what we're talking about and so he had to walk it back because the reality of that possibility was just too disturbing. There had to be something wrong with these women. And it really, it inflicts that kind of that shame narrative that we talked about. And so even sometimes just providing that information and psychoeducation about how the brain works and how it adapted to what you experienced as a child with pervasive abuse and exposure to intimate partner violence and community violence. And the list is kind of you know endless how you how your brain adapted to that and the coping strategies you came up with are remarkable and perhaps now they're not

serving you so let's prop like use some of our tools to process this and come up with some different coping strategies to manage life stressors so it's like a both-and we can have new coping strategies and we have these amazing tools through EMDR and sensory motor and play therapy and sand tray and all of these modalities that really help us sit with a client to process their trauma, but not necessarily in that traditional kind of let's just sit down and talk it out kind of way. Is there anything further you would say about how you determine what modality is the best fit for a particular person going through something traumatic? You know, so at the Wynn Center, our clinicians are

trained across multiple modalities. We have clinicians that are trained in, you know, you know, sensory, you know, somatic experiencing and psychomotor and sand tray and EMDR and, you know, attachment theory and lots of art-based work. And I think it's first and foremost is it's going back to that core responsibility that we have as social workers is to practice within our competency. And so that's sometimes recognizing, wow, I need to get training in this, or I need to get consultation, or I need to seek some supervision. So I think that's key, that it's okay to say, I think I'm in over my head, I need to refer out or get some consultation on this particular case. The other is recognizing that with trauma and traumatic grief in particular,

traditional talk therapy, like your insight-oriented questions and your active listening isn't going to be enough because it doesn't exist in the verbal parts of our brain. And the neuroscience has shown us that, that it actually exists in the nonverbal parts of our brain. So this is where engaging in modalities and in therapy activities that help us integrate left and right brain can really help us bring the trauma over to the parts of our brain where we can actually access language. When I talk about this with people, it's like when you've experienced the death of somebody and somebody says, how are you doing with that? Tell me about it. And you're like, I have no words. Well, of course you have no words, right? It's not in that verbal part of

our brain and it's not even encoded in that way. So really having other modalities that allow us to support the client in integrating that and giving language and giving skill, I think is really important. And this is where continuing ongoing professional development is critical. You're talking about the vast skill set of the clinicians at the Wendt Center. And I think it's important for me to note that there is no organization like the Wendt Center that I am aware of with such a substantial focus on grief and traumatic loss. What drew you to work there? Tell us about that story. So this is a special place, and you know, Elizabeth, I'm biased, but this is a really special place, and I am honored and privileged to work here with

what I think are some of the most talented and gifted clinicians in the country, period. So in 2003, I was a baby social worker just out of graduate school a year or two, and my then boss, Michelle Palmer, who used to be the executive director at the WEN Center, was not the executive director there. But she was like, you got to come do this thing with me this summer. You got to volunteer at Camp Forget-Me-Not. I was like, what is that? And so in the summer of 2003, I became a volunteer at Camp Forget-Me-Not, which is now called Camp Forget-Me-Not Camp Aaron, D.C. And this is one of our flagship programs. It's been around for our 26th year of camp. each summer we bring together kids 6 to 17, 18 years old who are navigating death-related losses

and we intermix grief and trauma work with camp and fun and adults and it's this remarkable opportunity for kids to meet other kids who are grieving and for adults to step into that space and share you know some of their experiences. So I was a volunteer pre-COVID we used to go to sleepaway camp. And I was a volunteer at camp and came back year after year and, you know, started as a buddy, paired up with a kid, you know, got to be a group assistant and then got to be on the clinical team facilitating grief groups. And my first camp that summer, again, I was a baby social worker. It really changed my life because you are witnessing, you know, 50 or 60 young people who have the courage to show up to a place where they might know nobody and share the story of their

loss and talk about you know their mom who had died or their brother who has died and be witnessed by adults who are not you know we have trained clinicians there and the Wendt Center is heavily staffed there but we also have accountants and lawyers and cops and teachers and you know you name it kind of coming in and witnessing and holding their grief and so they're able to see people who have navigated life with grief and it changed my world. And, um, you know, seven years ago, uh, the opportunity to work here came around and I jumped at it, um, because there is no other place like the one center. And if listeners have a client who they would like to try to sign up for camp, is that an option or do you have to be in the DMV? So camp is open to kids in the DMV

area there are camp errands and grief camps all over the country so we are not the only one we are one of a few and our camp director Stephanie Handel who has been here for two decades at this point and has run camp for the full 26 years is consults all over the country on how to run a grief camp she's really remarkable at it we in this area we do accept applications they usually open up at the beginning of March you can find that information on our website went center org and it's free 100% free we rely solely on donations and volunteer time and so caregivers can submit the application for their camper and then we

assess every family and camper to make sure it's the right fit we want to make sure that kids can come in and share memories can tolerate the memories and stories of other campers that they want to be there right we've all been with families where a caregiver says this would be really good for my kid and the kid is like, no way. So we make sure that kids know what they're walking into, that they're well prepared. So we screen every kid. At this point, post-COVID, it's three day camps. So we have our little kids that come together on a full Saturday, our tweens that come together, and then our teens. And the caregivers, the beauty of a day camp is our caregivers come back in the evening.

Our caregivers come back in the evening to be able to join in for a family ritual and for a joint family dinner. So we're able to do this grief work, and then we integrate the families. And now in the fall, this happens in the summer, and then in the fall, we offer our family grief camps, which are a mix of both virtual and in-person camps where they're usually on a Saturday or Sunday morning, and we invite the campers and the adults, and they can engage in some grief activity and grief work together. And for clinicians who are interested in training with you? Do they just visit the website and try to keep up to date on that? Yes. Right now, my trainings are not posted there yet, but they will be. So you can go to our website and get to

the training page and you can follow us on Eventbrite. The exciting thing we're working on, we're in the process of getting our ability to provide CEs for play therapists. So we know for kids play is the language of kids and providing high quality trainings in grief and trauma for play therapists is really important to be able to expand the capacity of the community to support grieving kids so we have just submitted um to become a site for um to provide play therapy ces so stay tuned for that we hope to be able to offer play therapy training specific to grief later this spring and into the summer and then later this spring we'll be offering our kind of of basic grief training for clinicians, as well as we'll be able to offer our homicide specific

training and supporting individuals impacted by homicide as well. And we are going to put the website in the show notes section, along with the books that you suggest. One is Trauma and Recovery by Judith Herman. What are the other must read books for social workers? Yeah. So I love Trauma and recovery because she was really the first person that talked about stage-based therapy for folks impacted with trauma and that you have to establish safety first. You can't just jump into the narrative. We have to have a sense of safety. And I think that was really transformative. So that's the work of Judith Herman. I really like The Grieving Brain by Mary Frances O'Connor. She has a new book out, which I have not read yet, called The Grieving Body. So I'm eager to read

that because I think it really her grieving brain book really transformed how we think about the brain and how it integrates grief um uh I'm going through my brain um I love the book um the one that I recommend for for kind of the average folks to read is Megan Devine's book It's Okay You're Not Okay um it's a great book around normalizing the grief responses and talking about the common responses and it also gives really helpful hints on how to support those who are grieving meaning kind of sitting in the pain and witnessing. The book of William Worden he follows these kind of four stages of engaging in grief therapy which we really lean into heavily here and so he's got a great grief therapy book, William Worden. And then Alan Woolfelt has some really good books.

He's out of Colorado and some really good information on his website. And then the last author I really like is Niemeyer, Dr. Niemeyer, who also talks about this idea of integrating grief and looking at it across phases as opposed to stages, but really kind of integrating, working with folks to integrate the grief. So we will put all of that in the show notes section. Melissa Selivog, you are such a credit to the social work field, and I know you're so busy. Thank you very much for taking the time to join us today.

I hope that we can continue this conversation at some time in the future. It would be a pleasure. It was a thrill to be with you, Elizabeth. Thank you for having me. You have been listening to NASW Social Work Talks, a production of the National Association of Social Workers. We encourage you to visit NASW's website for more information about our efforts to enhance the professional growth and development of our members, to create and maintain professional standards, and to advance sound social policies. You can learn more at

www.socialworkers.org. And don't forget to subscribe to NASW Social Work Talks wherever you get your podcasts. Thanks again for joining us. We look forward to seeing you next episode. Thank you.