Thinking Outside the Box: Post traumatic growth
By Emily Schottman, LPC, FCOVD, OD. Recently, I watched the movie, Breakfast Club with my daughter who was in awe of how a 30-year-old film could still capture the feeling of adolescence. It struck me that all adults were once teenagers and my counseling focus on identity after a health crisis or life change could be summed up in the closing quote from the stereotyped characters; “You see us as you want to see us - in the simplest terms, in the most convenient definitions.”
One of the most painful parts of growing up, or growth in general, is the sense that we are not seen for whom we really are or who we think we should be. Tiffany Ballard, DO said it well in her June Therapy Matters blog; “It can be painful to keep trying to squeeze yourself into a box that was never meant to fit you.” This applies to jobs, relationships, and even diagnoses of Post-traumatic stress disorder or Cancer. The labels can be simplistic but the experiences are not.
Especially in times of professional and personal crisis, your struggle is not your identity; it just feels like it.
My career transition in my mid-40s brings a certain adolescent view to my work as a counselor. In some ways, I am looking at therapy as an outsider, refusing to be boxed into traditional talk therapy, which can feel a little rote and isolating to the part of me that wants to connect deeper. In other ways, I feel a rebel, using my nerdy eyeball and brain knowledge to navigate the storms of sleep, mood and relationship disturbances following traumas, like divorce and cancer. I can easily feel like these life events I have personally experienced are blemishes on the face I present to the world. I respond by getting very in my head and hard on myself: a Geek and a Freak!
Since I see individuals who have lost some of themselves while working through grief and pain, I have noticed a common tendency to intellectualize or be self-critical. Change that is thrust upon us from our parents, partners, bodies or careers creates a unique internalized brain reaction, that I simply call “post-traumatic stress”.
When we face something traumatic, visual information skips the usual pathway to the back of the brain and the rational outer layers of thinking while the core, emotional (fight or flight) part of the brain is in control. Our memories are not encoded in the regular way, which contributes to the classic definition of Post-Traumatic Stress Disorder, PTSD, to include flashbacks, impaired memory and heightened startle responses.
But, this is not how it feels!
When I went through relationship and medical trauma, I was unable to flash backward or forward (i.e. think about the future) or know what memories were skewed. I was overwhelmed most of the time by most of the things in my life (relationships, career, etc). It felt more “numb” than anything else and I was not startled or surprised; I really thought I was defective. The label of PTSD did not fit exactly, yet helped, in some ways, to give certainty to an uncertain set of symptoms and validate a very common set of emotions and beliefs following tragic events.
Not all trauma happens at war and post-traumatic stress definitely impacts how we see ourselves and everything around us.
Around this same time, I began to listen to the talks of neuroscientist, Beau Lotto. He explains that what we see is skewed by our personal history and expectations. It is our brain’s way of reducing uncertainty, which works well for efficient every day life but not things like trauma, which is a limbo highway of uncertainty.
When we have been traumatized, our emotional brain (amygdala) continues to expect more chaos as the norm. Try dating too soon after a divorce! Or going back to the doctor who diagnosed you every six months for the rest of your life.
When I first heard this, in the midst of my own PTSD diagnosis, I was angry. Nothing I am seeing is accurate? Am I cursed to be broken forever? And darn if that anger felt good, like a rebellious teenager, especially when shared with fellow survivors of your particular trauma.
Dominant culture says not to express yourself, especially with cancer, since we do not want to burden others, yet that is exactly what we need to heal the deep brain wounds of traumatic memories. A mentor told me that repressed emotions are common in cancer population and I agree, it is, because the experience is so intensely personal and embarrassing. And yet the labels of being “brave” or “strong” or “repressed” were not helpful to me and have inspired me to help others in a more empathic and conducive way.
My clients say, “Don’t call me strong or brave. I am a reactive, terrified, angry, projecting shell of a human.” And that may all change in the next ten minutes, too!
I love this honesty and found that my own tolerance for limbo, rage and hopelessness makes me a better counselor for couples and individuals facing crisis. It also makes me careful about labeling others and offering inclusive sensitivity to cultural stereotypes.
I was humbled to read of a therapist who got this wrong in the words of a client Contessa Louise Cooper. “Why didn’t you see all of me? Why didn’t you know that I had had enough of being “strong?” Post-traumatic stress is exacerbated by those who do not see what they think they cannot bear to see, a person in true distress needing true human kindness.
Strength and struggle are not mutually exclusive.
One of my oncologists pointed out that some of her patients get the wake up call from cancer, live more simply and intentionally and outlive many. This was very hopeful and helpful to me. Because the next thing that happened was that I became acutely aware of my values of family, joy, simplicity, art and connection. I began to study Post-Traumatic Growth (PTG), which is how we can reset our brains to receive simple sensations through gratitude and existential meaning in our lives. Read this NPR story about a PTG veteran here.
PTG is still being studied and does not cure PTSD; they can coexist and come from the same tragic events. Finding the right therapist or fellow survivor or support group is critical to override the shame and internalized post traumatic stress and increase your PTG likelihood.
PTG gives me permission to fly my freak flag, change my career, dance in my kitchen, pick my battles and move beyond stuck pain into deeper connections. I have found a gift in my traumas with softer definitions of what it is to be successful and compassionate. I can barely understand it myself but I value it.
Emily Schottman, LPC, FCOVD, OD flies her freak flag as a Counselor specializing in visual, brain-based techniques in Austin, Texas. She sees adult individuals and couples and leads cancer/chronic illness groups. You can learn more at www.austinmentalwellness.com and www.austinbrainspotting.com.
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