1 understanding post traumatic growth logos conference: 25.11.09 david c. blore researcher,...

31
1 Understanding Understanding Post Traumatic Growth Post Traumatic Growth Logos Conference: 25.11.09 Logos Conference: 25.11.09 David C. Blore David C. Blore Researcher, University of Birmingham Researcher, University of Birmingham

Upload: yasmine-manser

Post on 15-Dec-2015

214 views

Category:

Documents


0 download

TRANSCRIPT

1

Understanding Understanding

Post Traumatic GrowthPost Traumatic Growth

Logos Conference: 25.11.09Logos Conference: 25.11.09

David C. BloreDavid C. BloreResearcher, University of BirminghamResearcher, University of Birmingham

2

The objective of this The objective of this presentation is not to teach you presentation is not to teach you anything… rather it is to make anything… rather it is to make you question what you already you question what you already

understandunderstand

“The more we know about Post Traumatic Growth, the more we realise we know very little about it” (Tedeschi & Calhoun

1998)

3

AgendaAgenda

A taxonomic anarchy Several lessons from history

Changing or reverting? A balanced view

The role of suffering according to religion

Paradox: when common sense is not common enough

Focus: struggle – not the trauma

4

"Our English language is deficient in some respects. We have the word 'trauma' to denote an unfortunate blow that injures the personality, but as yet we have no word

that describes an experience that is fortunate, that strengthens the personality. The closest we come to this is to say it is a blessing, but counting our blessings does not

really meet our need for a word directly opposite in meaning to 'trauma'."

Margaret Mead 1901-78 Cultural anthropologist

5

Hollister coined the word ‘Stren’ Hollister coined the word ‘Stren’ as the antonym of ‘trauma’as the antonym of ‘trauma’

Post Traumatic Growth (PTG) is now the Post Traumatic Growth (PTG) is now the widely used label for ‘positive change’ widely used label for ‘positive change’

following trauma…following trauma…

…but who’s ever heard or used the

word ‘stren’?

6

A ‘taxonomic anarchy’A ‘taxonomic anarchy’no DSM or ICD for ‘positive change’ …a good or bad thing?no DSM or ICD for ‘positive change’ …a good or bad thing?

Stren conversionStren conversion (Finkel 1974, 1975)(Finkel 1974, 1975)

Drawing strength from adversityDrawing strength from adversity (McCrae 1984)(McCrae 1984)

Positive reinterpretationPositive reinterpretation (Scheier et al 1986)(Scheier et al 1986)

Positive psychological changesPositive psychological changes (Yalom & Lieberman 1991)(Yalom & Lieberman 1991)

Perceived benefits Perceived benefits andand Construing benefits Construing benefits (e.g. Calhoun & Tedeschi 1991)(e.g. Calhoun & Tedeschi 1991)

Transformational copingTransformational coping (e.g. Aldwin 1994)(e.g. Aldwin 1994)

ThrivingThriving (O’Leary & Ickovics 1995)(O’Leary & Ickovics 1995)

Post Traumatic GrowthPost Traumatic Growth / / Posttraumatic GrowthPosttraumatic Growth (Tedeschi & Calhoun 1995)(Tedeschi & Calhoun 1995)

Stress related growthStress related growth (Park et al 1996)(Park et al 1996)

Discovery of meaningDiscovery of meaning (Bower et al 1998)(Bower et al 1998)

FlourishingFlourishing (Ryff & Singer 1998)(Ryff & Singer 1998)

Positive illusionsPositive illusions (Taylor & Brown 1998)(Taylor & Brown 1998)

Positive emotionsPositive emotions (Folkman & Moskowitz 2000)(Folkman & Moskowitz 2000)

Adversarial growthAdversarial growth (Linley & Joseph 2004) who also use:(Linley & Joseph 2004) who also use:

BlessingsBlessings Positive by-productsPositive by-products Positive adjustmentPositive adjustment Positive adaptationPositive adaptation

But do all these labels describe the same

thing?

7

The modern study of ‘positive

change’ subsequent to

psychological trauma is in its

infancy (about 35 years old)…

whilst studies into negative

outcomes of (say) anxiety and

depression, outnumber studies of

‘positive change’ by several orders

of magnitude…

this leaves the impression that

positive change is trivial…. Has this

always been so?

8

A lesson from history…A lesson from history…

The approach to The approach to psychological trauma in the psychological trauma in the Western world is Western world is overwhelmingly based onoverwhelmingly based on negative symptomatologynegative symptomatology

This is understandable This is understandable because of thebecause of the priority of priority of healthcarehealthcare to reduce painful to reduce painful suffering and stems directly suffering and stems directly from thefrom the medical modelmedical model

Historically this negative Historically this negative perspective is atypical. For perspective is atypical. For most of recorded history, most of recorded history, thethe Aristotelian philosophy Aristotelian philosophy of positiveness of positiveness dominateddominated

9

A lesson from history…A lesson from history…

We have the English Civil We have the English Civil War philosopherWar philosopher Thomas Thomas HobbesHobbes (1588-1679) to (1588-1679) to thank forthank for psychological psychological egoismegoism a deeply negative a deeply negative view of human nature…view of human nature…

……supremely negative !supremely negative ! Hobbes believed that men Hobbes believed that men in a state of nature, that in a state of nature, that is a state without civil is a state without civil government, are in a war government, are in a war of all against all, in whichof all against all, in which life is hardly worth livinglife is hardly worth living

10

A lesson from history…A lesson from history…

Within a 100 years of Within a 100 years of Hobbes,Hobbes, Jean-Jacques Jean-Jacques RousseauRousseau (1712-1778) (1712-1778) was supporting the was supporting the Aristotelian position by Aristotelian position by espousing that humans espousing that humans werewere born moral and born moral and with thewith the potential for potential for goodgood

In psychology, In psychology, McDougallMcDougall (1820-1903) tried to (1820-1903) tried to oppose the negative oppose the negative position by declaring that position by declaring that humans had anhumans had an empathic empathic instinctinstinct

11

A lesson from history…A lesson from history… However, and unfortunately However, and unfortunately

because of the power he because of the power he wielded,wielded, FreudFreud belonged to the belonged to the Hobbesian school when in 1918 Hobbesian school when in 1918 he declared: he declared:

“ “I have found little that is I have found little that is good in human beings on good in human beings on the whole. In my experience the whole. In my experience most of them are trash…”most of them are trash…”

But was this human negativity But was this human negativity the artefact of our view of the artefact of our view of humans?humans? Scheff Scheff (1966) warned (1966) warned that a categorisation such as that a categorisation such as mental illness becomes an mental illness becomes an identity, thus stabilising the role identity, thus stabilising the role and reinforcing adoption of the and reinforcing adoption of the negative human view.negative human view.

12

A lesson from history…A lesson from history…

All this andAll this and DSMDSM as well ! “Sad as well ! “Sad to say our theories of therapy to say our theories of therapy are principally theories of are principally theories of psychopathology”psychopathology” Held Held (1991)(1991)

So despite efforts to the So despite efforts to the contrary, the negative view of contrary, the negative view of self- interest, remained the self- interest, remained the “primary and true motivation”“primary and true motivation” ((Jørgensen & NafstadJørgensen & Nafstad 2004), 2004), even accounting for moral and even accounting for moral and unselfish behaviour so…unselfish behaviour so…

Altruism doesn’t exist Altruism doesn’t exist after allafter all

13

Changing or reverting?Changing or reverting?

However,However, MaslowMaslow (1954) and (1954) and later:later: Tedeschi & CalhounTedeschi & Calhoun (1995) - the authors who (1995) - the authors who coined the termcoined the term Post Post Traumatic GrowthTraumatic Growth - started to - started to reverse over 300 years of reverse over 300 years of ‘Puritan negativity’‘Puritan negativity’

This positiveness broke This positiveness broke through more decisively with through more decisively with the creation of a new field in the creation of a new field in psychology:psychology: Positive Positive PsychologyPsychology associated most associated most strongly withstrongly with Martin SeligmanMartin Seligman (from 1999 onwards)(from 1999 onwards)

14

A balanced view…A balanced view…

This doesn’t mean that we should This doesn’t mean that we should view responses to psychological view responses to psychological trauma astrauma as eithereither positivepositive oror negative, but thatnegative, but that bothboth should be should be involved to obtain a complete involved to obtain a complete picturepicture

ThisThis dual complimentary approachdual complimentary approach to psychological trauma (or any to psychological trauma (or any healthcare issue) takes us into the healthcare issue) takes us into the area traditionally occupied (in the area traditionally occupied (in the East) byEast) by Taoist philosophyTaoist philosophy in which in which the ‘whole’ requires a balance of the ‘whole’ requires a balance of positives and negatives: known aspositives and negatives: known as ying and yang ying and yang (in the West this is (in the West this is traditionally equivalent to thetraditionally equivalent to the Aristotelian balance of the 4 Aristotelian balance of the 4 humourshumours))

15

A balanced view…A balanced view…

Adopting this balanced Adopting this balanced approach would lead to approach would lead to identification of dis-ease by identification of dis-ease by examining theexamining the presence of presence of negativenegative symptomatology symptomatology andand absence of positiveabsence of positive growthgrowth

Do you feel uncomfortable Do you feel uncomfortable with using the wordwith using the word symptomatologysymptomatology in this way? in this way? It just shows how closely It just shows how closely associated the word is with associated the word is with negativity…negativity…

……a totally different DSM and a totally different DSM and ICD would ultimately be ICD would ultimately be needed !needed !

The Taoist DSM

16

ReligionReligion

Taoism is just one perspective on meaning-making… religion in the widest context

could be seen as a form of…

Meta-meaning making

i.e. a ‘higher’ way of making meaning of situations that seem to have no meaning…

…Particularly suffering

17

ReligionReligion

Buddhism:

“…perceives that the origin of suffering lies in desire, and that desire comes from misconception about the nature of things, in particular the nature of self. By removing this ignorance (Buddha) was able to bring suffering to an end in the experience… called Nirvana… which literally means to ‘blow out’ the fire of ignorance and desire…” (Eckel 2005, p.195-6)

18

ReligionReligion

Islam:

“…is based on the fundamental notion of the imperfection of human life. “Verily, we have created man into a life of pain, toil and trial” (Qur’an 90:4). Humans are on this Earth so that their faith in God be tested. A test necessarily requires calamities and misfortunes.” (Haq 2002)

19

ReligionReligion

Christianity:

“…our present sufferings are not worth comparing with the glory that will be revealed in us.” (Romans 8:18 NIV)

and furthermore,

 

“…we also rejoice in our sufferings, because we know that suffering produces perseverance, and perseverance, character; and character, hope. And hope does not disappoint us…” (Romans 5:3-5 NIV)

20

ReligionReligion

Hinduism:

“Hinduism adopts a rather different approach to suffering based on Karma (a sort of tally of good and bad that is carried across reincarnations), which Hindus consider accounts for why the seemingly innocent suffer” 1 (see Narayanan 2005).

1 Glenn Hoddle, the ex-England football manager adopted very similar beliefs in relation to his thoughts concerning disability (see The Independent on Sunday: 31.1.99 available at: www.independent.co.uk/news/glenn-hoddle-the-trouble-with-glenn-1077340.html However, Glenn Hoddle is an evangelical Christian not a Hindu.

21

ReligionReligion

Sikhism & Judaism:

Sikhism is associated with a great emphasis on being active in the relief of suffering (Thompson 2007), almost as though suffering needs to exist so that a Sikh can demonstrate relief of suffering.

Similar to this is Judaism which sees suffering as a test of God, whether that be in the Book of Job or as manifest in the Holocaust (Thompson 2007).

22

ReligionReligion

More on Taoism:

“Taoism deals extensively with suffering, but it focuses more on the cures than the problems, and it does so in a lighthearted way. It is almost as if the author of the Tao Te Ching knew that to take suffering too seriously will only entrap one even more deeply in suffering. A light, delicate touch is needed. It is the way of acceptance and detachment.” (Slabbert 2001, see also Lao Tzu uk/2005)

23

ReligionReligion

Shintoism:

“The sufferings of life are the sufferings of the divine spirit in search of progress in the objective world.” (Mason 2002)

 

…so suffering is not the fault of the individual, but of an outside causality.

24

Religion(?)Religion(?)

One secular commentary on religion:

“If the immediate and direct purpose of our life is not suffering then our existence is the most ill-adapted to its purpose in the world: for it is absurd to suppose that the endless affliction of which the world is everywhere full, and which arises out of the need and distress pertaining essentially to life, should be purposeless and purely accidental. Each individual misfortune, to be sure, seems an exceptional occurrence; but misfortune in general is the rule.” Schopenhauer (1850/2004, p.3)

25

So what does common sense So what does common sense (another (another

Aristotelian concept)Aristotelian concept) tell us about positive tell us about positive outcomes after trauma?outcomes after trauma?

It may be common sense not to take notice of the media, but the media does gives us clues

How would you rate Simon Weston for PTG?

Common Sense tells us he has been through a traumatic experience, we read however that despite suffering, he is internationally respected – how come? Paradox?

26

Is PTG really a paradox then ?Is PTG really a paradox then ?

Not really, it is Not really, it is our perspectiveour perspective that is paradoxical that is paradoxical

We expect (fervently) one thing to be right……yet it isn’tWe expect (fervently) one thing to be right……yet it isn’t

We would have expected Simon Weston to have been miserable, to hide himself We would have expected Simon Weston to have been miserable, to hide himself away, be depressed and so on…away, be depressed and so on…

But he is incredibly cheerful, positive, dynamic and has fervently committed But he is incredibly cheerful, positive, dynamic and has fervently committed himself to his charitieshimself to his charities

He has a new role in life, one that without trauma he couldn’t have hadHe has a new role in life, one that without trauma he couldn’t have had

Have you ever wondered why there are so many self help groups? Have you ever wondered why there are so many self help groups?

27

Learning about PTG Learning about PTG throughthrough paradox paradox

Probably the first paradox is, that what Probably the first paradox is, that what amounts to PTG, has been recorded since amounts to PTG, has been recorded since ancient times and yet it is a very recent ancient times and yet it is a very recent ‘discovery’ in the psychological literature‘discovery’ in the psychological literature

28

PTG and paradoxes galore…PTG and paradoxes galore…

Loss seems to produce something of valueLoss seems to produce something of value

Vulnerability makes for strengthVulnerability makes for strength

Facing one’s own mortality through traumatic Facing one’s own mortality through traumatic experiences leads to an increased sense of personal experiences leads to an increased sense of personal capacities to survive and prevailcapacities to survive and prevail

When choices are severely limited it is possible to When choices are severely limited it is possible to discover the vastness of humaneness from the best discover the vastness of humaneness from the best to the worst in othersto the worst in others

Events that estrange us from everyone, lead to Events that estrange us from everyone, lead to forging the strongest of relationsforging the strongest of relations

29

PTG and paradoxes galore…PTG and paradoxes galore…

Survival focuses the mind on death and lifeSurvival focuses the mind on death and life

Previously important things are considered less so, and vice Previously important things are considered less so, and vice versaversa

Religious, spiritual and existential philosophy changes occur Religious, spiritual and existential philosophy changes occur amongst those who were sceptical (Cat Stevens becomes amongst those who were sceptical (Cat Stevens becomes Yusuf Islam)Yusuf Islam)

Shattered philosophies result in more meaningful philosophiesShattered philosophies result in more meaningful philosophies

PTG doesn’t necessarily result in less emotional distress PTG doesn’t necessarily result in less emotional distress (reverse paradox)(reverse paradox)

30

Focus on the struggle rather than the trauma

My My Trauma… Trauma… Your ClientYour Client

The Incredible The Incredible story of how story of how

psychotherapy psychotherapy changed my lifechanged my life

Ann OtherAnn Other

31

Thank you for listeningThank you for listening

Acknowledgements for ongoing research into: post RTA, post EMDR, PTG being conducted at the University of Birmingham:

Dr. Derek FarrellProfessor Collette CliffordSimon WestonDr. Alexandra Button

Relevant presentations can be downloaded at:

www.davidblore.co.uk/news.phpwww.davidblore.co.uk/news.php