“Everything will be okay in the end. If it’s not okay, it’s not the end.” -- John Lennon

If you’d told me seven years ago that a day would come when I’d be sincerely grateful for my deeply painful experience with a patient’s death and malpractice litigation, I’d have raised my eyebrows. Or cringed. Or felt angry or thought you insensitive. I may have even done all of those things in a flash, then settled on presuming you had no point of reference for understanding the depths of my suffering in that moment.

How is it, then, that you could have been exactly right? And more than that, how is it that gratitude is only a tiny piece of all the beauty I experience as a result of those terrible events? Turns out, scientists have a name for that. It’s called “post-traumatic growth.”

Let’s talk about trauma

Events that we perceive as disturbing or frightening have the potential to generate a complex internal injury psychologists call “trauma.” You might recognize that you’re having this experience if you notice a fight-flight-or-freeze response or an out-of-body feeling in yourself. You may become fixated on an experience or ruminate over it. Or you may sense confusion, fear, anger, or grief. 

As I’ve written elsewhere, we physicians and other healers often experience unforeseen, adverse patient outcomes as traumatic to us, too. I suspect that the finely tuned mirror neurons that underpin our compassionate nature set us up to experience events which threaten our patients’ lives in some ways as if they were our own. 

Unprocessed, the effects of trauma have the potential to interfere with our capacity to live long, healthy, productive lives. Amazingly, though, that is not the only way trauma plays out in human beings. We have another option.

What is Post-Traumatic Growth?

 “The cave you fear to enter holds the treasure you seek.” - Joseph Campbell

According to the Posttraumatic Growth Research Group, post-traumatic growth is “positive change experienced as a result of the struggle with a major life crisis or a traumatic event.” (italics mine) 

Sounds simple enough. After all, the notion that humans “can be changed by their encounters with life challenges, sometimes in radically positive ways,” has been present for eons in religious and spiritual traditions.

We who work in healthcare see post-traumatic growth all around us every day. Patients and families give us the extraordinary privilege of seeing ordinary people confront terrible circumstances with love and dignity, often wresting from them something beautiful for themselves, others, or generations yet to come.  They use their “setbacks as opportunities to ... positively affect the world,” as Kristin Wong puts it.

Post-traumatic Growth and Post-traumatic Stress

When I first heard the term, I thought that post-traumatic growth was diametrically opposed to post-traumatic stress. As it turns out, that’s not the case at all. In fact, the growth emerges not due to the trauma itself, but rather “as a result of the struggle” with it, the Posttraumatic Growth Research Group says. By definition, where there is struggle and crisis and growth, there will be stress.

In my experience, most physicians find a patient’s adverse outcome and a malpractice lawsuit deeply stressful. I certainly did. The question is: do we become stuck in the post-traumatic stress? Or can we find a way to let it rise and fall, maybe even use it to our advantage? 

Join me next time where we’ll begin to explore the 5 ways post-traumatic growth shows up in our lives and concrete steps we can take to find it for ourselves.