Meaning from Suffering

I believe it is often essential to find meaning in suffering before you can move past it.  When I say this to people, their typical response is, "How am I supposed to do that?"  There is no universal answer to that question.  Still, I believe it is vital for a person who is suffering to find a satisfactory answer before he or she can move beyond his or her pain.

A lot of my patients are people who have experienced some sort of trauma.  Some of these patients are able to "recover" from the symptoms caused by their trauma (or traumas); some patients are not.  Some patients seem to fall into despair.  One thing I've noticed about those who fall into despair is that they often view their suffering as meaningless.  When they look back on the trauma and consider the pain they have endured and how much they have struggled as a result they conclude that they are somehow being punished or that they are irrevocably damaged.  They say to themselves, "All of this pain, all of this suffering, and for what?  For nothing!"

So how can a person grow from his struggles?  How can he look at a terrible experience and see a silver lining?    Again, every person must answer this question for himself.  Still, there are some common "categories of meaning-making."  These "domains" were developed after an extensive review of the research on posttraumatic growth and were ultimately incorporated into something called the Posttraumatic Growth Inventory (Tedeschi & Calhoun, 1996).  They are:

1. An increased appreciation for life (especially its simple pleasures) and a change in priorities:   I've heard survivors of potentially terminal illnesses (like cancer) talk about appreciating a sunset for the first time.  Minor irritations and petty squabbles no longer seem important.  Time with family and friends seems more precious and is therefore appreciated more.

2. Closer, more intimate relationships with others:  People might rally around a person who has experienced a trauma, offering love and support; this can lead to closer relationships with these people.  In addition, people who have had similar traumatic experiences (e.g., rape victims, children of alcoholic parents, bereaved parents, etc.) often find particular comfort from one another.  This can lead to a whole new network of mutually supportive relationships based on common past experiences.

3. A greater sense of personal strength: After surviving a trauma, a person might conclude, "If I can survive that, I can survive anything!"  You can't really know how strong you are until you are faced with a situation that forces you to tap into your inner strength.  You might find that you are stronger in a crisis than you thought you would be.

4. Recognition of new possibilities or paths for one's life: Sometimes an event changes a person's life so completely that he is forced to change paths.  In his quest to renegotiate his goals for the future, a person might find himself considering possibilities that had never before come to mind.

5. Spiritual development: Perhaps you've heard the saying, "There are no atheists in foxholes."  People often look to a higher power when confronted with a life or death situation.  Sometimes, when faced with his own mortality, a person begins to seriously consider some of life's existential questions.  This in and of itself can be a profoundly spiritual process.  

Just some things to consider...

Identity Loss

One thing I've noticed over and over when working with people who have experienced some sort of trauma is how depressed they often feel.  When we start talking about the factors that contribute to the depression people often describe feeling lost and unsure of what to do to move forward.  It became increasingly clear to me that whatever trauma they've experienced has fundamentally changed who they are as as people.

Most people realize they aren't the same as they were before the trauma occurred; actually, that's often why they come in to see me in the first place.  Maybe they've recognized it themselves or maybe their loved ones have said to them, "You're a completely different person now."

What most of my patients want is to be how they were before whatever happened took place.  Unfortunately, that's simply not possible.  "You can't un-do what's been done," I explain.  Events that bring a person face to face with death make them acutely aware of their mortality.  This in itself is a very frightening and yet very profound experience.  A close encounter with death or a severe illness or injury forces a person to reconsider his perception of himself as a competent individual who is able to handle threats and is capable of keeping himself safe.  He suddenly realizes that there are many threats from which he is unable to protect himself; this makes him feel very vulnerable and defenseless.

My patients are fundamentally changed as a result of their experiences; they cannot go back to being who they were before.  This is a difficult thing to accept; acceptance take place over time, not all at once.  A person must make a conscious decision to let go of who they were without first knowing who they are going to become instead.  They have to grieve the loss of their former selves.  "I really liked who I was before," one patient lamented early in his grief process.

After that there is a period of limbo.  Creating a new sense of identity takes a lot of hard work.  A person may have to re-examine deep seated beliefs about himself, other people, and the world.  He may need to find new activities that bring him joy and pleasure.  He may have to end some relationships with people with whom he is no longer able to relate.  He may have to seek out new relationships with different kinds of people.  All of this takes time.  Meanwhile, the person feels like he is no one, going nowhere.  He is lost.

For anyone reading this who has been through a trauma, did the experience change you as a person?  Did you go through a period of grieving the loss of who you were before?  How did you come out on the other side of it?