How to Foster Post-Traumatic Growth

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How to Foster Post-Traumatic Growth Bonus 3, Part 1 - Transcript - pg. 1 How to Foster Post-Traumatic Growth How to Help Clients Complete the Journey From Trauma to Post-Traumatic Growth Part 1: Navigating the Rite of Passage to Post-Traumatic Growth with Joan Borysenko, PhD; Rick Hanson, PhD; Kelly McGonigal, PhD; Ron Siegel, PsyD; and Ruth Buczynski, PhD

How to Foster Post-Traumatic Growth Bonus 3, Part 1 - Transcript - pg. 2 How to Foster Post-Traumatic Growth: Bonus 3, Part 1 Navigating the Rite of Passage to Post-Traumatic Growth Dr. Buczynski: How can we help clients retain their growth after trauma? According to Dr. Joan Borysenko, when a client can connect to the meaning of their experience, it can be a game-changer. Here, Joan shares 2 specific ways to help clients integrate positive growth. Dr. Borysenko: First of all, post-traumatic growth is such an interesting way to frame what happens when people do the healing work from a traumatic experience. Ruth, I want to say something Time and time again, I come back to this so that there will be a context for understanding what things I think really work to maximize post-traumatic growth: On a number of occasions, I've mentioned the rite of passage when there's a trauma, the first stage is your world falls apart. You grieve and all that. The second stage after a traumatic experience is a liminal stage, I ve mentioned the rite of passage when there s a trauma, the first stage is your world falls apart; the second stage is a liminal stage, the time between no longer and not yet; and the third stage is the return, and you come back at a new stage of integration. the time between no longer and not yet. The old life is done. It's been changed in some irreparable way. A new life has not yet happened. The post-part has yet to be. And of course, so much of the healing goes on in the liminal stage. The third stage of a rite of passage is called the return. And that is, you come back at a new stage of integration. One of the most important parts of the return is actually I never thought that I could do it, but when I did, every aspect of my life improved. Now I feel like I have to share that in all my affairs. sharing the wisdom that you ve gained with others. If people do not have an outlet for sharing, I find it's harder to hold on to the posttraumatic growth. So, let me give you an example. If you go to an AA or NA meeting or, really any kind of 12-step meeting what you have is a lot of people in the process of return; and a lot of people who have had post-traumatic growth and who will be saying, "I

How to Foster Post-Traumatic Growth Bonus 3, Part 1 - Transcript - pg. 3 never thought I could do it, but when I did, every aspect of my life improved, and now I feel like I have to share that in all of my affairs. And part of what keeps me coming back to meetings or sponsoring others is sharing it." And that's a very, very important thing. I ran support groups for many, many years in a hospital setting for people with stress-related disorders. They were more than a support group. They were really a psychoeducational mind-body group but also for people with cancer and for people with AIDS. And a very, very big thing was people coming back to volunteer in those groups with others. And that's so very important to say there's hope: what you went through, I also went through. For example, for breast cancer survivors, at many hospitals, women post-breast cancer who have had mastectomies and A very, very big thing for people is volunteering; it s important to say there s hope. have either had reconstruction or have prostheses come in to talk to women who are in the midst of the process of decision making or who are post-mastectomy. Somebody who has coped with it, has wonderful things to say, has practical things to say about prostheses, is helpful not only to the hospital staff, but to the person they're helping. How have you grown from this? What has changed in your life? Is it your beliefs? Is it your behaviors? What did you do? And it's so important to them because it gives meaning to what has been a tragedy or trauma in their own life. They can give back. And I think all of us really, really want to give back. So, I can't stress that highly enough. One more thing I've found useful for people is writing exercises. Physically write down How you have grown from this? What has changed in your life? Is it your beliefs? Is it your behaviors? What did you do? People do a variety of things. Oftentimes after a fair period hopefully a long period of time they will make, make big changes. They might change a job. They might change a relationship. And it's important to keep track of the decision-making process through writing. I tend to use a lot of writing with clients and myself in any case. What this does is it creates more of a depth

How to Foster Post-Traumatic Growth Bonus 3, Part 1 - Transcript - pg. 4 of mindfulness, it helps people to hold on to behavior changes and belief changes that really constitute what we mean by post-traumatic growth. Writing a poem about experience is a really integrative thing to do. Dr. Buczynski: Joan offered a helpful way to look at trauma in the context of a rite of passage, which is part of the larger arc of the hero s journey. To review, there are three stages in this process from devastation to triumph. One, there s the immediate after-effect of trauma, which includes the pain and suffering and the grieving over what has happened and what has been lost. Two, there s what Joan calls the liminal stage the place in between the client s old life - which has changed drastically - and the unknown life yet to be. And three, there s the return. This is where the client integrates their experience and seeks outlets for sharing. And it s in this stage that growth happens. To help illustrate how this third stage can help clients hold onto post-traumatic growth, Joan shares a story from her early days of practice. Dr. Borysenko: I'm going to tell you a story of the first AIDS patient that I ever met. I met him while he was hospitalized. That, of course, was way back, perhaps in 1982, when AIDS was almost always 99.9% of the time fatal within maybe two years. Being a long survivor was two years back then. He had been very, very ill. When I first saw him, he was hospitalized with Pneumocystis Pneumonia and also had the first signs of Kaposi's Sarcoma. That can be very disfiguring dark spots on the body and on the face. And he was quite ill. But as he recovered, he really became very interested in being part of one of our mind-body groups. I didn't have a separate group for AIDS patients at that time. And because we didn't know what the vector of the illness was we didn't know whether it might be airborne through coughing, or whether you could pass it from hand to hand, we just didn't know the hospital didn t feel good about my running a group for AIDS patients in the hospital. So, this young man who I've always called Sam not his real name decided that he would volunteer his

How to Foster Post-Traumatic Growth Bonus 3, Part 1 - Transcript - pg. 5 apartment, and we would have AIDS groups there. And it gave him a meaning for his life. He poured his soul into that, into going out into the community, to AIDS support groups, telling them there's a mind-body group. It would help if you would learn meditation, if you would learn mindfulness, if you would learn how do we create meaning and cope in a time when we're really looking at our death. So, he really began to work with other men who were living with... It gave him meaning for his life. He poured his soul into that... And he had tremendous posttraumatic growth from this. AIDS. And I think we probably ran as many as five or six eight-week groups in his apartment, and he had tremendous post-traumatic growth from this. He felt that it somehow helped him harvest so much meaning from life in general. And it was very, very important. As his death came closer, he volunteered to be with other men when they were hospitalized to keep the death vigil from time to time with other men. The spiritual growth was so great for him. For me, as a healthcare practitioner, it was one of the most memorable things in my entire life. I wrote a whole chapter about this young man. It was the last chapter in my book Minding the Body, Mending the Mind, and so, so very touching. I think this is something I'd like to say: when we, as therapists, are present to the post-traumatic growth of other people, we, ourselves, grow. It's such an enormous privilege. Just wonderful. Dr. Buczynski: When a client is able to share their experience with others who are suffering, it can give a deeper meaning and purpose to their life and the trauma they ve experienced. And this in turn can strengthen their post-traumatic growth. Dr. Kelly McGonigal and Dr. Ron Siegel have some further thoughts on Joan s idea of this rite of passage. But first, here s Dr. Rick Hanson. The result of trauma is the sense of being a broken, damaged, tainted, irreparably damaged goods. Dr. Hanson: What struck me about it is that it embodies a felt sense when one does that, of personal value you have worth to offer to other people. And I think that is so reparative. So often, the result of trauma is

How to Foster Post-Traumatic Growth Bonus 3, Part 1 - Transcript - pg. 6 the sense of being a broken, damaged, tainted, irreparably damaged goods, stained kind of being. And to be able to come back and bring some of your own hard-won lessons Prometheus bringing fire down from the mountaintop your own hard-won lessons back to other people, is really reparative because it teaches you in the process of it that you still have good inside yourself. You still have value, and you still have things to offer to other people. By the way, that was really touching and beautiful. To be able to come back and bring some of your own hard-won lessons teaches you in the process of it that you still have good inside yourself. Dr. McGonigal: I think she's referring here to the hero's journey or the monomyth that Joseph Campbell described and so many others have described. And I think it's actually really important to acknowledge that this basic myth, the ultimate narrative of a human experience that you see across cultures and across individuals and across time, it ends with someone who has suffered in some way, learned something important, and becomes the teacher that comes back and offers their learning and puts their learning in service of their community. The ultimate narrative of a human experience, that you see across cultures and across individuals and across time, ends with someone who has suffered in some way, learned something important. It's really powerful to recognize that that is embedded in this ultimate myth that is in human consciousness. I think it's embedded in our biology in ways that is underappreciated. I really think this is about fundamental human survival, and it's why it's so embedded in our mythology about a hero or heroine's journey. We know that sort of the worst possible outcome of a traumatic experience is sometimes described as a defeat response or defeat cascade, where you feel so defeated by life that you end up taking your own life. And it often is determined by feeling completely isolated from your community, not just no one cares, but also that you have nothing to offer. And I really think that the instinct to help others is this kind of primal will to live that emerges when one might be going down that defeat cascade. The worst possible outcome of a traumatic experience is described as a defeat response or defeat cascade. It comes out of our human nature that says, I do have something to offer, that, I'm not going to be defeated by this. And I've seen it again and again.

How to Foster Post-Traumatic Growth Bonus 3, Part 1 - Transcript - pg. 7 When I was writing my last book, I cannot tell you the number of examples of people who survived tremendous trauma or adversity by putting in service of helping others. Nothing came close. Nothing I encountered no therapy, no intervention, nothing compared to the benefits of putting your own suffering in service of helping others, particularly who have experienced something similar. I appreciate that Joan put it in terms of this it's part of the return. And I think we should recognize, not as just a useful thing to do, but possibly the most fundamentally human response to trauma. Dr. Siegel: It's interesting. As I hear you talk, I've recently been reading a lot of evolutionary psychology, and there certainly is a significant thrust in evolutionary psychology that runs counter to the most discouraging aspects of dog-eat-dog dominance hierarchies, sexual predation and the like there really are hardwired impulses toward altruism. The tend-and-befriend system is quite hardwired as well. But I haven't heard anybody chew on how natural selection might have developed the hero with the thousand faces as a basic part of brain wiring. And yet, it makes quite a bit of sense that it might have. Dr. Buczynski: That s an interesting idea how we may be hard-wired for the hero s journey by simple evolution. When we add that to the overall arc from trauma, to uncertainty, to a heroic return when those factors come together, it can mean powerful growth for our clients. In part two of this bonus, we ll look at a 3-stage roadmap to post-traumatic growth. I ll see you then.