Resiliency versus Post Traumatic Growth…
I realize that this is just semantics, but is there a difference? I’m starting this blog, which I have written over the course of several weeks (stopping and coming back to it, etc. – so it may be choppy – but it’s a blog!) with this question. Is resiliency accepting an experience and integrating it into your functional and confident developed, identity and maintaining this same sense of “whole”ness and self despite aversity? Is post traumatic growth taking that experience and having to reshuffle pieces, redevelop or develop for the first time an identity that reflects growth from such aversity as oppose to integration? Do resilient individuals not have to change themselves and their sense of identity, but individuals who undergo a post traumatic growth process need to reevaluate their “before” identity, sense of self agency, and “whole”ness in order to redefine their identity?
There is such a difference. Yet, I find myself over the last couple of months since shattering my humerus bone while trying to scoop my little away from danger on a ski mountain, that I really don’t know which process I’m in, or whether I’m even able to reflect, integrate, evaluate how this latest acute trauma on top of chronic trauma and stress has effected me. Resiliency requires that you were able to develop a healthy sense of self identity and to sustain this same confidence and sense of self with such aversity. More importantly, a sense of self agency and the belief that you have the power to change future actions and alter your environment or that you have the ability to have control and agency over how you deal with specific life events, obstacles, and challenges, which are not in your control. Resilient people maintain their sense of freedom and ability to make changes in order to best cope with aversity while keeping the same integrity and identity.
When can we fully say that we have mastered a sense of self agency, or is this not possible? Is part of being human accepting that one cannot always be resilient and there are limitations? Is there a point at which the mind and body shut down to trauma and any self-preserving reaction, despite having always demonstrated resiliency? What does shutting down, numbness, dissociating to trauma look like? When this happens, many people including myself look like we are the most resilient people around. Broken arm, hospital, screaming children, assaulted, child being put under anesthesia, hospitals, death, grieving, surgery, loss of innocence, loss of the innocent (an individual with Complicated PTSD’s stream of consciousness here!). All of this – at some point is a person really a person with integrity, agency, and identity anymore if they are not able to cry, are able to tell stories without emotion and accounts to individuals? What makes an individual numb to pain, trauma, hunger, basic human desires and functions?
I have been struggling with my inability to fully feel the emotional effects of this latest trauma. My detachment as I tell the story and blunt recall of gruesome details and the events is really remarkable. I have not had a good cry, outburst of screaming at the situation; I can’t – there’s nothing. I don’t feel anything. I only am reminded that the trauma happened by feeling my arm, the metal plates, the warmness of the screws, trying to do movements, the sharp pain putting my jacket on, or the subtle changes in yoga positions where I cannot bring my left arm to my hearts center. Without these physical memories of the trauma, I would question if it was real.
Detachment, dissociation, numbness, and apathy do not represent resiliency, and hyperfunctioning should not be dismissed as having an overachieving and perfectionistic personality. These symptoms are not seen, are not validated by oneself or those around them. I am not seen as an individual who is suffering and my hyperfunctioing and detachment from the trauma reinforce others’ belief that I’m not suffering and that I’m invincible and resilient. I have had so much trauma in my life from early on and in the past 16 years since marrying my loving husband; losses, assaults, obstetrical traumas, poking, prodding, physical traumas, 7 surgeries, more loss, more coming to terms with my limitations and not accepting them as limitations and powering forward with detachment and dissociation.
My patterns and coping with trauma have been to self soothe, yes, and to keep moving forward, yes, but it has not included stopping to let myself feel, which has reinforced my detachment and emotional numbness to such tragedy and trauma. I reinforce this behavior to myself and expect nothing less from myself. I would counsel others to show themselves self-compassion and be grateful and impressed with themselves as they recover. I don’t think I’m invincible and I don’t think that I’m better than everyone so that I should just return to normal and I don’t need to recover; this is my symptom and this is all I know how to be and how to survive such terror and trauma. My post-traumatic behavior is neither a form of growth nor a form of resiliency, but a form of survival which I reinforce and whice those around me reinforce. Hyperfunctioning, numbness, distractions that may look healthy are just healthier addictions that reinforce the inability to face trauma and the emotions that come with it. Unlike harmful addictions that render individuals a harm to others, themselves, and into dysfunctional states many of the times, this addiction goes under the radar and is even envied by individuals for being so efficient.
I remember deep, dark moments in my life. Feeling unsupported except by myself. I remember sadness with these moments, though, but also a feeling of hope. I remember numbness to the reality, but optimism about the future, which kept me going, working, achieving. “This too shall pass.” This was a mantra I always lived by during horrific times, but at what point does it just not pass? Trauma after trauma, that which I would break down from and then bounce back; each adult trauma it took me less and less time to bounce back to the point that I would not even need to confide or tell anyone or really noticeably break down unless I was so physically depleted and traumatized, I could not go under the radar. I would deny the pain and hyperfunction through it. Leave the hospital after a major infection and take a spin class (feeling awful, but “normal”). Feeling like I could still do this thing I enjoyed. Was this or is this resiliency (more like stupidity)? Nah – this is mere Pavlovian adaptation theory to the bell of trauma. It rings and I keep working harder and harder, running to that which I know, which I think of have agency over and can control.
How did this set in? The sense of agency that was trying to develop as a child kept diminishing. Without that full foundation needed to build a permanent sense of agency and belief in control over one’s reactions and choices after even trauma, that mature healthy adults (over the age of 25/26) develop, hope kept dissipating. With dissipating hope came more responsibilities to loved ones, to kids who are innocent and deserve to still have that chance. I cannot control what happens to me and I have no control over my reaction since it's hyperfunctioning and numbness precludes me from ever really effectively analyzing just how traumatic an event may have been and being able to sit somewhat comfortably with the trauma knowing that I can pause. Complicated PTSD has left me dealing with acute trauma as a detached, dissociated individual, numb, but distracted and comforted by the continued impulse to fight through pain.
As I have the unique position of working with young adults and with young children, I can see children effected by trauma in the real time and their grappling with trying to find coping skills to deal with the raw anger, sadness, and hurt that they have to deal with. Some get into fights, some retreat into their shells, some become selectively mute and some pretend nothing has happened and can be overachieving and in denial; they have hope of change of an end to the trauma. Many of these young children may grow up to live normal lives and have used the power of post traumatic growth to develop effective coping skills that allow them to become resilient in the face of future traumas and to retain a sense of self agency.
Some of these students experience repeated trauma, lose their sense of developing self-agency, their reactions to trauma precipitate no interventions and these individuals are not able to use that post traumatic growth to develop a healthy sense of self agency and eventual resiliency. Some of these individuals become underfunctioning and suffer from addictions that cannot go unnoticed such as drugs, alcohol, sex, gambling and others suffer from underfunctioning in other ways such as failing out of school, not reaching academic potential, and from here most individuals including those that go on to be hyperfunctioning (not enviable) develop Complicated Post Traumatic Stress Disorder that is often misdiagnosed based on their maladaptive coping skills to their sense of loss of self-agency. Anxiety, OCD are labels often for hyperfunctioning individuals or even Bipolar II Disorder (how can that person possibly accomplish so much? Clearly they are manic?), Eating disorders (can be comorbid but are a way of regaining control and often are a symptom of trauma – appetite loss, not feeling the human signs of hunger), Depression (shutting out the world around them), psychotic (they have so many flashbacks from multiple traumas that have yet to be synthesized how could they not seem psychotic and disorganized at times?), borderline personality disorder (individuals with Complicated PTSD may express a tremendous amount of distrust towards others and in combination with not being hyperfunctioning, they may be difficult to work with or be in a relationship with), etc.
My hyperfunctioning – I want to be normal – I want to feel emotion, to feel looseness, less tense, to trust, to be able to be held without wanting to push away and to be able to trust that someone else just might have a way of coping or solution that is better than mine (not often 😊 In sex, I want to be normal; because of the tremendous physical/obstetrical traumas and surgeries and the immense amount of scar tissue as well as the long history of assaults, I don’t know what is really normal? If I’m tight or have a painful sensation is it the scar tissue and the compressed pudendal nerve, the muscles spasming from the multiple surgeries or the assaults? And, then, I feel hopeless like I’m dual diagnosed with emotional and physical trauma and have a “shit” prognosis.
Then there’s the traumas that you could never imagine; “Imagine the worst case scenario and let yourself say – what if?” This was a favorite question of my first therapist growing up – a sports psychologist. Well, that’s a pretty crummy question – because right now I can imagine a lot of horrible things but that didn’t prepare me for the pain, horror, and trauma of not recognizing my fingers and arm next to my three year old on the ski slope or the tremendous amount of pain. I could never have imagined that kind of pain and this is coming from someone who was pregnant with 5 babies, had 3 CVSs right in a row, 3 reductions, was on weeks of bedrest, delivered twins early, then hemorrhaged and was taken to surgery after they passed nearly dying. Then 3 c-sections, a broken knee cap, a couple of painful assaults, pudendal nerve entrapment from scar tissue, 4.5 hour abdominal surgery for hernia repair, removal of the uterus, lysis of adhesions to the abdominal and the bladder wall. I’ve had pain – but this was the darkest I had imagined.
The pain and rehabbing as well as the realization that I don’t know what my prognosis for my arm functioning, yoga practice, lifting my kids, life as a dominant leftie with an impaired/stainless steel arm, is difficult. Yes… but it’s the subconscious suppression of emotions in order to function physically and to take care of myself physically that has been the most dehumanizing. Yes – my mind knows it cannot deal with the physical and the emotional and the physical is stainless steel – immobile, uncontrolled. Is my ability to navigate my way to Glen Falls in sleet to get a painful EMG and navigate my way back after electric shocks to my arm and nerves so high causing my body to jump from the table, and needles into my muscles of my arm – is this ability to compartmentalize those feelings and navigate my way home and function resiliency or post-traumatic growth? Part of me feels that the past 4 years have forced me to bypass resiliency, since I am a different body in many ways and brought me back to a post traumatic growth mode. I had a hysterectomy, a mesh repair for a hernia, and now a bionic arm along with adapting to a new job and a family of 5. Then, I think to myself – if trauma is severe enough, are we all kind of forced back to redefine ourselves, pick up the scrambled pieces, grow, redevelop and remold in a process of post traumatic growth in order to regain resiliency?
Since this is a blog, I will allow myself the right to ramble. I have to wonder how many “rebirths” or post traumatic growth remoldings and opportunities before the mind and body shut down and it’s just too much. Homeostasis and a sense of “whole”ness is no longer possible – how much is too much? How many times can you continue to ram your head into a brick wall before irreparable brain damage? Cuts, lacerations will heal, but the internal suffers. How does someone know who has experienced a great deal of trauma and is functioning “well,” whether they are merely using functioning and overachieving like an addictive drug and a distraction or whether they are actually resilient and really have bounced back from the trauma?
There are so many questions about complicated traumatic pasts, acute trauma, triggers, multiple PTSD symptoms and how people function after such repeated experiences. There are questions about how trauma effects relationships with others, loved ones, children, the future, as well as an individual’s standards that they hold themselves accountable. If I was able to go through all of that, assaults, surgeries, scarring, near death experiences, broken bones, foreign bodies integrated into my own body, as well as continue to keep going without tears, without much emotion, then I expect nothing less of myself than to be functioning as I would without these traumas, without the acute trauma of nearly losing an arm, the constant reminders of it’s deficits and the unknown of what will be the new baseline functioning. I’m invincible; I’m not allowed to be human. To be human would be to connect to these traumas, scars, and limitations, embrace them, and feel them – emotional and physical pain. But, it’s like I’ve been conditioned to not feel and I don’t know how to learn how to feel, because I’m not sure that I ever had the sense that I could breakdown and not be okay. The couple of times I have broken down, have left me lonelier and feeling as if there is not enough time to get myself together. Breakdowns now that I have children and responsibilities I just can’t tolerate and now I just don’t breakdown.
These traumas, my distractions that allow me to disconnect from their reality, and not allowing myself the time and space to heal and grow after these traumas have, in many ways and negatively, dehumanized me. It’s very hard to find self-compassion when even just a soreness in an ankle or a couple of mediocre reviews on a class that I taught with a shattered arm, less than 1 month after the accident, makes me feel like I’m broken, irreparable, incomplete. There becomes a point where resiliency is no longer an option or that hyper-functioning definitely becomes a sign of distraction and just survival; this moment is when you lose the sense of self agency and the sense that you have the power to change things that have happened OR to decide a pathway that will help you move forward.
Without self-agency and the ability to control anything in one’s life, the individual loses the ability to be resilient along with the ability to grow from trauma. The individual becomes stuck in survival mode, which becomes chronic stress mode and as acute stressors pile up on this already chronically stressed body and mind, the body and mind breakdown, dissociate, and become further from the human experience. Like a piece of ice – no one wants any breaks in the ice, it constantly needs to be smoothed over and glistening – it gets scarred up and then another layer is melted and it becomes smooth, glistening, and beautiful ice again. But, what happens when there is such a huge crack and divot in the ice and if the ice is melted down over and over, how does it get rebuilt and strong enough to skate on?
This is where I am at now – confronting fears, trauma, distrust, memories, flashbacks, triggers and trying to tolerate them in the hopes that repeated exposure and reinforcement that these things are not happening now, understanding that I cannot control the future, but developing the confidence that I can maintain control of how I handle and react to these experiences while being true to myself and maintaining my own integrity. The goal is not to repair, shine, polish, melt away the experiences and scars, but to navigate around each divot, bump, obstacle on my own terms, navigating my own direction, and dictating my own journey.
Pictured - Jack's determination to race, Henry's determination to open that gift, Ruby's determination to jump high - all learning that they have the sense of self and agency to accomplish! Teaching kids that they can!