Posttraumatic Growth? When Loss Has Meaning

Posttraumatic Growth is Possible

“Nothing good comes from cancer. Nothing ever will.”

I read those words written by a local newspaper columnist when I was working as a social worker in the world of pediatric cancer. During that time, I would sometimes look out the hallway window in the cancer unit and see the cars going back and forth on the interstate. I would think that somewhere out there are four or five families that have no idea that in the next month they will be here on the unit, their lives turned upside down.

Earlier in the day, maybe their child had no symptoms at all. Or maybe it looked like the flu or a headache or a muscle strain or growing pains. But when the diagnosis of cancer was confirmed, these families would be in our world and trying to make sense of their new-found situation—seeking any meaning that could be found in the experience.

Trauma-Inspired Clarity

One patient was a charismatic teenage boy and only child of a single mother. He survived his cancer, but there were months filled with surgery, chemotherapy, infections, inpatient stays, clinic visits, and repeated scans. The challenging twists and turns of treatment.

During this time, his mother once commented about how life looked different to her. Priorities were changed and she had a different clarity about what was important both for her and her son. She remarked that I probably heard that all the time.

I responded that I heard that kind of reflection sometimes but not all the time. I affirmed her courageous willingness to consider new ways of thinking in the middle of a very challenging time.

Posttraumatic Growth of Boundaries

A different mother had a toddler daughter with cancer, and sadly, her daughter did not survive. Shortly after I met this mother, she talked of her own history of trauma. As a child she had been sexually abused. She was raped as a teenager and now she was living with an abusive man.

In the traumatic months of her daughter’s treatment, however, she changed in profound ways. After so many terrible experiences as the victim of trauma, something shifted. Between her daughter’s diagnosis and eventual death, she kicked her abusive partner out of the house, reported him for child abuse, and would tell the doctors “no” when she didn’t agree.

The victim role which had defined her had been left behind, and she experienced previously unknown confidence and strength. I commented that she was not the same person who I met. With a knowing look, she agreed.

Positive Changes After Crisis

At the time, I didn’t have a term for the positive changes that I was privileged to witness in these two mothers. The term that I have since learned is “posttraumatic growth.” It doesn’t happen automatically when trauma occurs, and it doesn’t happen for everyone. It also doesn’t come directly from the trauma but rather from the struggle to deal with the trauma.

Significantly, post-traumatic growth doesn’t come instead of pain. Pain is one source of the growth. Without pain, there would be little motivation for change and no need to find new strength, reevaluate priorities, or develop deeper, more durable ways of making meaning.

For most who do find posttraumatic growth, it’s not an even trade—the growth does not fully compensate for that which was lost.

Finding New Strengths During Trauma

In When Bad Things Happen to Good People, Rabbi Harold Kushner gives a profound description of posttraumatic growth following the death of his son:

I am a more sensitive person, a more effective pastor, a more sympathetic counselor because of Aaron’s life and death than I would have ever been without it. And I would give up all of those gains in a second if I could have my son back. If I could choose, I would forego all the spiritual growth and depth which has come my way because of our experiences, and be what I was fifteen years ago, an average rabbi, an indifferent counselor, helping some people and unable to help others, and the father of a bright, happy boy. But I cannot choose.

Posttraumatic growth is a fairly new term for an old reality. Sometimes in the experience and struggle with terrible loss, we learn important insights, find new strengths, and develop greater compassion for others and ourselves. The price may always be unacceptably high, but we experience growth nonetheless. Because we, also, cannot choose.

Can Good Come from Cancer?

“Nothing good comes from cancer. Nothing ever will.” I don’t know how I would respond to those words if I were reading them for the first time today, but I do know how I responded then. I felt angry as they didn’t describe what I was seeing in the families with cancer that knew. These families were working so hard to find meaning and purpose for their lives, and sometimes, many times, they grew.

So, I called the columnist, explained what I did for a living and how the idea that “nothing good” could ever come didn’t fit the reality of what I saw with parents and their children with cancer. He shared that his father died from cancer and nothing good had come from that. I expressed regret that this was his experience. Nevertheless, I held that for many others, the experience was different.

In the Harry Potter books and movies, there is a wonderful metaphor for posttraumatic growth. In the fifth book and movie, Harry sees creatures he has never seen before. They look like horses with bat-like wings and skeletal bodies. His best friends, however, cannot see these creatures and he wonders about his own sanity.

We are Changed by Major Loss

Over time, he learns that the creatures are called “thestrals,” and there are others who can see them, too. He learns that they are magical creatures that can only be seen by those who have seen death. In the fourth book and movie, Harry sees a friend die, and now he can understand something about life that was always there but was never seen before.

Ask someone who has experienced significant loss if there is something they understand about life or themselves that they didn’t know or understand before. Most whom I have met would respond in the affirmative, and many would be willing to elaborate about what they have learned and how they have changed.

Many of us grieving people have learned to see thestrals even though we’d rather not. Although we didn’t and wouldn’t choose our losses, we have grown. And in our growth, we have the opportunity to offer more healing for others and for ourselves. In doing so, we more deeply honor what and who we have lost.

Greg Adams is Program Coordinator at Center for Good Mourning: www.archildrens.org

Read more from Greg Adams on Open to Hope: https://www.opentohope.com/after-a-major-loss-so-now-what/

Greg Adams

Greg Adams is a social worker at Arkansas Children's Hospital (ACH) where he coordinates the Center for Good Mourning, a grief support and outreach program, and works with bereavement support for staff who are exposed to suffering and loss. His past experience at ACH includes ten years in pediatric oncology and 9 years in pediatric palliative care. He has written for and edited The Mourning News, an electronic grief/loss newsletter, since its beginning in 2004. Greg is also an adjunct professor in the University of Arkansas-Little Rock Graduate School of Social Work where he teaches a grief/loss elective and students are told that while the class is elective, grief and loss are not. In 1985, Greg graduated from Baylor University majoring in social work and religion, and he earned a Masters in Social Work from the University of Missouri in 1986. One answer to the question of how he got into the work of grief and death education is that his father was an educator and his mother grew up in the residence part of a funeral home where her father was a funeral director. After growing up in a couple small towns in Missouri south of St. Louis, Greg has lived in Little Rock since 1987. He married a Little Rock native in 1986 and his wife is an early childhood special educator and consultant. Together they have two adult children. Along with his experience in the hospital with death and dying and with working with grieving people of all ages, personal experiences with death and loss have been very impacting and influential. In 1988, Greg’s father-in-law died of an unexpected suicide. In 1996, Greg and his wife lost a child in mid-pregnancy to anencephaly (no brain developed). Greg’s mother died on hospice with cancer in 2008 and his father died after the family decided to stop the ventilator after a devastating episode of sepsis and pneumonia in 2015. Greg has a variety of interests and activities—including slow running, reading, sports, public education, religion, politics, and diversity issues—and is active in his church and community. He is honored to have the opportunity to be a contributor for Open to Hope.