Read What Abi Taught Us Online
Authors: Lucy Hone
What Abi Taught Us (22 page)
During training at Westpoint, Seligman and colleagues found that 90 per cent of cadets were familiar with PTSD, but fewer than 10 per cent had heard of post-traumatic growth. This is medical illiteracy that matters, warns Seligman. âIf all a soldier knows about is PTSD, and not about resilience and growth, it creates a self-fulfilling downward spiral. Your buddy was killed yesterday in Afghanistan. Today you burst into tears and you think, “I'm falling apart; I've got PTSD; my life is ruined.” These thoughts increase the symptoms of anxiety and depressionâindeed PTSD is a particularly nasty combination of anxiety and depressionâwhich in turn increases the intensity of the symptoms. Merely knowing that bursting into tears is not a symptom of PTSD, but a symptom of normal grief and mourning, usually followed by resilience, helps put the brakes on the downward spiral,' he contends.
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I'm not so keen on Seligman's description that the people demonstrating post-traumatic growth (PTG) were âbetter off ' within a year. While I realise he is referring to growth in terms of measurable scientific outcomes, the term âbetter' is too easily misconstrued: as though we are casting those who don't grow as failures. But I do agree with his views on the importance of medical literacy: if we've never been told about post-traumatic growth and resilience, it's all too easy to place our symptoms
as PTSD when in fact they are utterly normal and
temporary
responses to grief.
Joe Kasper, an American physician and colleague, who lost his teenage son Ryan to a rare genetic disorder, says he credits much of his recovery to the awareness of the possibility of growth after trauma, and to the awareness that positive and negative emotions are separate and distinct emotional spectrums. âIf we want to increase well-being,' he explains, âwe must clearly try to minimise misery; but in addition, we must also attempt to add positive emotion, meaning, accomplishment, and positive relationships to our lives. Given the recent advancements in positive psychology and bereavement research, and through my own experience, I now know that so much more is possible. You can grow and become a better, more complete, more empathetic and altruistic person as a result of this type of trauma. This is not to say that we should ever prescribe or wish tragedy on someone to promote growth or well-being.'
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Richard Tedeschi and Lawrence Calhoun, the research team behind the work on post-traumatic growth, define it as positive psychological change experienced as the direct result of the struggle with highly challenging life circumstances.
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Richard Tedeschi is a professor of psychology at the University of North Carolina and a licensed psychologist specialising in bereavement and trauma. For the past 20 years he has led bereavement support groups, as well as publishing extensively on post-traumatic growth. Bereavement, as a highly challenging life circumstance, does present a platform for post-traumatic growth, he says. This is not to suggest that we celebrate trauma and bereavementâfar from it. Rather, it is helpful to acknowledge that the worst life moments at times spark a turning point: âIt
would be a misunderstanding to think that trauma is goodâ
we most certainly are not saying that
. What we are saying is that despite these distressing experiences, people often report positive transformations, what we have called post-traumatic growth. An important way to think about this, which has implications for clinical practice, is that the traumatic events set in motion attempts to cope and that the struggle in the
aftermath
of the trauma,
not the trauma itself
, produces the post-traumatic growth. In addition, the empirical evidence indicates that post-traumatic growth is common but certainly not universal, and as clinicians, we should never have the expectation that every trauma survivor will experience growth or that it is a necessary outcome for full trauma recovery.'
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Factors that contribute to post-traumatic growth
⢠Understanding that shattered beliefs about ourselves, others and the future are ânormal' responses to trauma.
⢠Being able to reduce anxiety by using techniques to control intrusive thoughts and images.
⢠Sharing our stories of trauma with others, rather than bottling it up (which leads to worsening physical and psychological symptoms).
⢠Creating a personal narrative around the trauma, which may include identifying personal strengths used, noticing how some relationships improved, or a new appreciation for life and enhanced sense of gratitude, a deepened spiritual life, and so on.
⢠A readiness to accept growth and develop a new life stance such as viewing oneself as more altruistic, or noticing a heightened sense of compassion.
Lisa Bucksbaum, who runs
Soaringwords.com
, a non-profit organisation assisting ill children and their families to heal, interviewed Richard Tedeschi in 2014. Lisa shared her interview with me for this book, but you can read more about Lisa's work online at
www.soaringwords.org
.
Lisa Bucksbaum (LB): When bad things happen people feel as if it will break them. Dr Tedeschi, could you explain what post-traumatic growth (PTG) is?
Richard Tedeschi (RT): In addition to the distress that comes in the aftermath of various kinds of traumatic events, people often find that they learn something of value, they change in ways that they value, they experience what might be for some a personal transformation. So this struggle, to cope and to figure out how to live with this difficulty, and the outcomes that people experience in the aftermath of these events, we call PTG.
LB: Scientists like you have been studying PTG for the past 30 years but the concept comes from ancient traditions.
RT: That's right, we've given this scientific name to it, PTG, but it's a concept that's been explored by theologians and philosophers for centuries. So you find in the great religious traditions a lot of discussion about how we should respond to suffering in our lives, they all have something to say about this aspect of human living that's inevitable. We find there's a great literature on suffering and
transformation. Then when we look at philosophy, they talk about how we are inevitably going to experience some kind of suffering and trauma in our lives and how we should respond to that by trying to find some meaning despite the suffering, so we make meaningful suffering, not just suffering in vain. For example, Viktor Frankl, who was a holocaust survivor, is almost a father to this field in modern times, because he described how going through the concentration camps he found some way to make that time and that difficulty meaningful to him. So it's a purpose that developed out of that.
LB: The sense that the last freedom that one has is the freedom to choose one's attitude towards circumstances. We can't control our circumstances but we can control how we respond to them.
RT: That's exactly right. So what we've done now is try to learn about it from a scientific perspective, that is we've tried to look at what are the data that support the idea of post-traumatic growth. We've found that maybe half to two thirds of people report post-traumatic growth. It's not a universal thing but it's not uncommonâmore people report post-traumatic growth than post-traumatic stress in the aftermath of various kinds of traumatic events. We're not talking about the trauma itself creating the change, we're talking about what people do in the aftermath of the trauma, about how they get through it and who can be around them that can help them make that difference so that they find something of value in it.
LB: How can other people help?
RT: Other people are really important in this process because they can help the person face up to what's happening and embrace it in some sense, by taking a look at how it's affecting you, how you are thinking about things differently now. Another person can be
encouraging of that process. We want to see âexpert companionship', we want to see other people learn how to support trauma survivors in a really expert way: not expert in terms of being a professional, but someone who is a really good companion, who can listen to difficult stories, doesn't offer platitudes, but can actually learn from the person who's going through the difficulty rather than having the answers to their problems. So it's an attitude towards listening, supporting, being a presence for another person. That person who is traumatised gets a chance to articulate their experience and explain themselvesâso that they can start to learn about their own way of responding to this.
In some circumstances there really aren't words, sometimes it's just knowing that someone is there and you can count on them. The expert companion is someone that stays connected to you, they don't have to be a medical practitioner, just someone who is prepared to stay with you for the long run.
During this interview, Tedeschi also identified the five different ways in which people report they've changed as a result of their reaction to trauma.
1.
A sense that they are stronger than they ever thought they could be:
Going through the traumatic event has been a great challenge, but they've found personal resources to draw upon that they weren't previously aware of.
2.
Appreciation of life:
This is the idea that people appreciate the time that we have on Earth and appreciate the things around them that they might otherwise have taken for granted.
3.
Relating to other people in a new and better way:
People report being more compassionate, empathetic and understanding,
perhaps allowing themselves to get closer to other people emotionally. Talking about traumatic events almost forces us to be more vulnerable in a way that encourages closeness.
4.
New possibilities:
Traumatic events may shut off old ideas about what's important, and usher in new priorities. New possibilities may start to open up.
5.
Spiritual change:
This encompasses a range of experiences, from religious beliefs, to existential change and the recognition of new ways of living. People may also find strength in the transformative power of nature or music.
I believe it is important to know that growth can occur from all forms of trauma, including grief. But I want to emphasise once more that growth is different from improvement and betterment. Abi's death may have led to growth, but I regard that less as self-enhancement and more as an alteration in direction. Coping with her loss has precipitated a change in perspective, a slight change in occupational priorities, and a full-frontal awareness of life's volatile and unexpected path. I'm not a better person because of it, just a different person. By covering research insights on post-traumatic growth here, I would not want to put additional pressure on any grieving person to believe that their loss has to lead to life improvement, but rather simply to know that growth is possible.
I WANT TO PRESS PAUSE
for a momentâin the middle of the section on Reappraisal and Renewalâto stress how exhausting grieving is and to reiterate that it's not okay that any of us has to deal with it. I know that it is all part of life, and I've told myself time and again that death doesn't discriminate, but there are times when none of this works.
Eighteen months after Abi died, I lay in bed weeping, thinking to myself over and over again, It's not okay, it's not okay, it's not fair that Abi, Ella and Sally died and that we have to cope without them. It's not fair for them, for us or for anyone who loved them.
I'm not a slave to resilience; I hope I'm not a painfully positive fool. I certainly allow myself to succumb to my grief, to the helplessness and ongoing (although by now intermittent)
misery. I often take myself off for a nap, or a walk, to hide from others in the afternoons. I can feel small, pathetic and vulnerable too. I miss Abi so much, so often and so very deeply. I hate all the good times her brothers, cousins and friends are never going to have with herâthat they all would have enjoyed so much.
Even as we start to rejoin the world and find ways to relearn it, there are times when we regress. Oscillation is the normâback and forwards we go. Don't beat yourself up over deadlines, how you think you should feel or act. There is no single way, and your way doesn't have to be my way. Grieve at your own pace and take all the rest and breaks from it you need.
THE RESILIENT GRIEVING MODEL
I have thought long and hard about the shape of my model of resilient grieving: is it a linear progression or am I moving through a cycle? In the end, I realised that, for me, grieving more resembled a jigsaw puzzle than any model containing stages to go through or tasks to be accomplished. Learning to live with grief is learning to live in a shattered world, where the familiar components have been scattered into disarray and we are left to rebuild our lives with different pieces.
Picturing the strategies I've relied upon, and covered here, as pieces of a puzzle has helped spur me on and brought some kind of order to the chaos. The pieces of the puzzle (shown overleaf) are like signposts and keys that have enabled me to navigate the ongoing process of relapse and recovery, reappraisal and renewal, acceptance and struggle, while acknowledging that this is the very nature of life.
Perhaps it is this realisation that prompts the tears that sometimes well up at someone else's loss or struggleâthe overwhelming feeling of sadness that comes from knowing life is hard, and that being resilient, coping, picking up the pieces, doing it all over again is tough and tiring. It is our journey and we each have to find the pieces that fit our personal jigsaw puzzles. But we have to do it, there is no choice. We simply have to keep on going, over and over again, doing the best we can each day, each month, each year, as life comes together and falls apart, spurred on by (and savouring) the good things in our lives in a way that only the bereaved can.