How to Foster Post-Traumatic Growth

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How to Foster Post-Traumatic Growth Bonus 3, Part 2 - Transcript - pg. 1 How to Foster Post-Traumatic Growth How to Help Clients Complete the Journey From Trauma to Post-Traumatic Growth Part 2: 3 Core Elements that Move Clients from Pain to Growth with Bill O Hanlon, LMFT; Ron Siegel, PsyD; and Ruth Buczynski, PhD

How to Foster Post-Traumatic Growth Bonus 3, Part 2 - Transcript - pg. 2 How to Foster Post-Traumatic Growth: Bonus 3, Part 2 3 Core Elements that Move Clients from Pain to Growth Dr. Buczynski: Could therapy be contributing to a client s inability to experience post-traumatic growth? Well, in a way as you ll soon hear from Bill O Hanlon. But first, Bill will expand on the 3 key factors that may allow some people to experience post-traumatic growth while others might not. Mr. O Hanlon: I've done a lot of thinking about this because, sometimes in our own lives and sometimes in our client's life, we know there are some people that come in that have been through horrendous things and somehow, even though it was a terrible thing to go through, they come out better. When people are traumatized, they tend to dissociate or disconnect from themselves or from other people. And some people come out, and they're just wounded and really diminished by that experience for decades and forever, maybe. And I've thought about what makes the difference? And here, based on the research and my clinical experience, I've come up with three elements that make the difference. One is we know when people are traumatized that they tend to dissociate or disconnect, and they disconnect in three areas: from themselves that's called dissociation where they split from their emotions or they split from a memory, or even in the most severe cases, they develop dissociative identity disorder where they split into multiple personalities; or, from other people socially they kind of withdraw or feel different from other people. The first element that makes a difference between post-traumatic stress and post-traumatic growth or success is connecting. The initial disconnection is obvious. We disconnect because we were hurt, and we're trying to protect ourselves. But if that carries on, you're likely to have post-traumatic stress. If you can find a way to connect with yourself more deeply and better If you can find a way to connect with yourself and other people more deeply, you can turn trauma into post-traumatic growth.

How to Foster Post-Traumatic Growth Bonus 3, Part 2 - Transcript - pg. 3 in the wake of trauma and connect with other people more deeply and even connect with a sense of meaning beyond yourself, God, or, "What does this all mean?" then I think you can turn it into post-traumatic growth. So, the first element the first C is Connection. The second is Compassion in the wake of trauma, we sometimes become self-critical or critical of other people. You can't trust people. People are bad. People are evil. If you can develop selfcompassion in the wake of trauma because you've suffered, you now have more empathy towards other people, and can develop post-traumatic growth. The world is evil that kind of stuff. So, if you can, instead of becoming more defensive and pushing people away, or criticizing people or yourself, or being down on yourself... if you can develop self-compassion and compassion for other people in the wake of trauma because you've suffered, you now have more empathy towards other people and say, Yeah. I'm not going to get out the judgment. Let he who is without stone cast without sin cast the first stone. I've been through this terrible thing. I'm not going to judge anybody else. I think Bob Dylan once said his grandmother told him, Be kind to everybody because everybody is struggling with something really difficult that you don't know about. And that's a compassionate sort of invitation. If you can be more compassionate in the wake of trauma, you can develop post-traumatic growth. If you're less compassionate, or harsher towards yourself or others, you re less likely to develop post-traumatic growth. So, there are 3 Cs: Connection, Compassion, and Contribution so, the third is: Contribution. You take this terrible hurt and turn it into something that you can now make the world a better place or help somebody else. If you were abused as kid, you go volunteer at the Boys and Girls Club and help some kids, or you become a Big Brother or a Big Sister and help somebody who is struggling themselves in a similar way you were. That, in a weird way, helps you kind of heal your own wounds while you're helping somebody else and making the world a better place. Take this terrible hurt and turn it into something that you can now make the world a better place or help somebody else. Dr. Buczynski: So, just as a quick review, Bill s 3 Cs of post-traumatic growth include: Connection the idea of finding meaning and helping the client connect and share with themselves and

How to Foster Post-Traumatic Growth Bonus 3, Part 2 - Transcript - pg. 4 others after a traumatic event. Compassion this is where the client is able to find empathy for others as well as for themselves. They can be more open and compassionate, and less critical. And the last C is contribution. We ve heard several examples in this program on how clients can experience tremendous growth by using their pain to help others. Now Bill will share a story that helps illustrate this. Mr. O Hanlon: I actually learned this from a guy who's no longer with us a psychologist named Sol Gordon. He told me a case of his that I think illustrates this really well. He was a sex therapist, and so he specialized in sexual issues but not really trauma. But one time he was semi -retired. He grew up in New York or was in New York for many years, and he was in North Carolina, and he was pretty famous around there because he'd written a bunch of books, and he was teaching a lot. He got a referral from one of the local therapists of a client who had been in five years of therapy with one therapist who specialized in dealing with sexual abuse issues, and then she wasn't getting any better. And then another five years with another therapist. And then finally, she got the referral to him. And she told him, "I have this miserable life. I work, and I'm really good at my job, and I make a lot of money. But when I'm home, I'm miserable. I overeat. I just sit alone. I don't do anything. I have no hobbies, no interests, and I'm just miserable. I was messed up by my childhood. I was sexually abused. I was physically abused and verbally abused, and I just hate myself. And 10 years in therapy hasn't made any difference." Sol Gordon hears all this and he says, "You know, I don't think psychotherapy is going to help you." And she was really shocked, like, "You're giving up on me?" He said, "No, no, no. I'm not giving up on you. I just think you've tried that approach, and you've tried to understand and work through it and everything." He said, "I recommend mitzvah therapy." She's not Jewish. She doesn't know what mitzvah is. Mitzvah is a complicated word but it mainly, the way he

How to Foster Post-Traumatic Growth Bonus 3, Part 2 - Transcript - pg. 5 was meaning it, go out and do something good for other people, a blessing of something good. He said, "You were abused and neglected. Why don't you find a place that deals with abused and neglected kids? They're always underfunded and understaffed. Go volunteer there. File, answer the phone, sweep up, whatever you need to do." And she did. She found a place, and he said, "Come back in a month after you've done that and talk to me again." She comes back in month and says, "You were right, Dr. Gordon. This has made a major difference. I found a place that treated abused and neglected kids, and they're overwhelmed, and all they want me to do is sit with the kids not do therapy with them sit with the kids and just entertain them and be with them. And I love these kids, and they love me. I'm not trying to do therapy with them. As soon as I hit the door, they're all over me because I'm playing with them. I'm paying attention to them. I'm loving them. I'm being kind to them." She said, "I had so much love in my heart and nobody to give it to, and I'm pouring it out to these kids. And what's weird is I'm getting it back a thousand times more than I'm giving it out, and I can feel my heart healing much better than I was in therapy." So he says, "Okay. Continue your mitzvah therapy for another month. Come and see me." She comes back, and she goes, "You won't believe it. It's even better than last month." He said, "What could be better? That was a pretty good report." She said, "There's this guy who works there," and she said, "Look at me. I'm overweight. I've had this overeating problem for years. He's fallen in love with me and asked them out for a date. He loved the way I interacted with the kids, and he saw my heart and my soul underneath this body." And she said, "He's no prize either in physical looks, but I've fallen in love with him." She said, "This mitzvah therapy stuff, it's good stuff." Get out of yourself an into the world... We're often focused so much on people doing the inner work that we sometimes forget to engage in the world. I think what he was saying is: get out of yourself and go out into the world. In therapy, we're often focused so much on people doing the inner work that we sometimes forget to engage in the world.

How to Foster Post-Traumatic Growth Bonus 3, Part 2 - Transcript - pg. 6 She'd already done that inner work. It wasn't that she neglected that, but I think it was time for her to move out, and that was one of those components of post-traumatic growth that I talked about. She developed connections that she hadn't had. She developed compassion for these kids, and she was making a contribution and that was more healing to her than those 10 years of therapy, which probably got her ready for that in some way as well. Dr. Buczynski: In this story, we saw how Bill s 3 Cs of post-traumatic growth were realized by helping the client go beyond traditional therapy. And this made me wonder about the way we sometimes approach our interventions. So, I asked Bill - does therapy focus people too much on themselves? Mr. O Hanlon: I think sometimes it focuses on the trauma. You and I have had discussion for the last number of years about brain science and therapy. One of the things we've learned that gives us a little caution about trauma therapy is the more you focus on something, the stronger the brain connection gets. And the stronger, the faster, the brain pathways get. So, you have to do this balance you've got to talk about the therapy. You've got to talk about the trauma. That's what they're there for. But if you focus on it exclusively, you're sort of reinforcing those pathways where the trauma keeps recurring again and again. Getting people to tell their story multiple times may reinforce it rather than help them move on. So I think in some ways, in therapy, it's a challenging thing. You can't not listen to people and not let them talk about it. But you can't exclusively focus on that. I heard a story about this woman in Cambodia who was The more you focus on something, the stronger the brain connection gets... So, if you focus on trauma exclusively, you're reinforcing those pathways where the trauma keeps recurring again and again. treating trauma victims from the Khmer Rouge. And they would get so depressed in the wake of trauma they would have a child, and they wouldn't even feed the child sitting next to them who was crying because they were so paralyzed by the after-effects of trauma. And this woman was talking about, what do you do with these people? And she said one of the things, "I had to get them up and moving. Go collect firewood." And the other thing

How to Foster Post-Traumatic Growth Bonus 3, Part 2 - Transcript - pg. 7 They were so healed by touching people in a kind way and contributing to somebody else. was, she'd have these women give each other pedicures and manicures. It's like, what? It's because you're connecting with someone else, and you're doing something kind to someone else to beautify them. And she said they were so healed by touching people in a kind way and contributing to somebody else. Then they started taking care of their infants once they were engaged in the world. So you think you always have to find this balance. She said these women's minds were so filled with the horrors that they'd been through, there was no room for anything else. So, the first thing for them to do was tell their story once and never tell it again. And then I started to fill their minds with other things besides the horror. And I think, again it's always a balance when you're dealing with trauma. You have to deal with it in some way. But if you focus on it exclusively and forget about the other stuff and life out there, you can sometimes reinforce those neural pathways and the brain pathways we've talked about for so many years, now that we have a good understanding of how the brain works. Dr. Buczynski: As Bill said, the neuroplasticity of traumatic memory can be a tricky part of successful interventions. According to Dr. Ron Siegel, this can create challenges for the practitioner when trying to develop a treatment plan. You see, on the one hand we want to help clients deal with the pain so they can move on from it. But we also want to make sure we ve helped them develop other resources that can give them some space from the pain. Here s Ron with more. Dr. Siegel: You know, there are so many ways that we can be kind to ourselves and resource ourselves. But to some degree, they do all take us away from the moment-tomoment experience of the pain or the grief or the difficulty. Sometimes There are so many ways that we can be kind to ourselves and resource ourselves.

How to Foster Post-Traumatic Growth Bonus 3, Part 2 - Transcript - pg. 8 they don t sometimes they simply open the heart so that we can experience them but some of them really are designed to create a sense of safety in the here and now, and connect to others; they re designed to give us a little bit of space from the difficulty. So, I ve decided increasingly over the years, I don t expect me to know; I don t expect to know. I work on engaging the client or the patient in collaboration as much as possible to try to outline for them, you know, I m kind of torn between these two directions, both of which I think are useful: that, on the one hand, it s absolutely going to be useful to be able to feel these feelings to heal these feelings, but it s also really important that you can feel like you can do it and feel resourced and all this. Which do you sense that you need more of right now? And interestingly, if we lay out a map, I think very often people can tell us. They can even tell us which movement feels kind of more defensive at the moment, or which movement feels more like the cutting edge of the work that they need to do. It s interesting that either component can be defensive; it can be defensive, of course, to just, oh, I m just going to emphasize the good and install positive experiences so that I don t feel those painful things. But one can also stay over and over with the painful things in order to avoid the possibilities of living life differently in order to maintain a victim role you know, there are all sorts of defensive aspects to that also. It takes enormous openness to know that we don t know. So I think it takes enormous openness to know that we don t know and we shouldn t just use whatever worked for us more lately as our guide. I think that s a temptation of therapists like, oh, I got in touch with these my resources, so my patients need to do that. difficult feelings so my patients really need to do that, or, I really developed It s probably best to test both and engage our clients in the decision-making process. Dr. Buczynski: To admit that we don t always know the correct path in treatment can be a little frightening. But it can also be liberating in the sense that you can include your client in the decision-making process. We hope you enjoyed these special bonuses to the Post-Traumatic Growth program and that you found something you can use in your work with clients.