Loss — Donna The Book: A Blog

My loveltrs2d Instagram Account was opened six months ago. It was started as a place to connect with people, like me who have experienced loss and grief. My goal is to share what I have learned since Donna’s death and learn from others. Though we all grieve differently we can all learn from each other. Our differences unit us and help us. Reading, posting, and following on IG loveltrs2d I see many meaningful and touching memes about grief, loss, and heartbreak. The majority of these point a path to heal. They are points on a compass giving direction though the trauma of loss and subsequent grief.

A few years back I researched and wrote about Post Traumatic Growth (PTG). PTG is positive psychological change following trauma. It is not going back to who we were but fundamentally changing who we are. Many have characterized PTG by “what doesn’t kill us makes us stronger“. How true. The science sees it this way: PTG is a positive psychological change, which occurs following a traumatic life experience, and those negative experiences drive people to reexamine their world and life. (30 -70 % of survivors say they’ve experienced positive changes Linley & Joseph 2004) Put another way, we fall into shit and come up smelling like a rose.

Memes, poems, messages, and videos about grief and loss are not idle thoughts banging around a social media beaker hoping to heal someone by creating a new compound. It turns out there is a bit of science and evidence going on that makes these memes work harder to heal us.

This is an abbreviated post based on one written November 2013 titled “Caregiving, Loss, Grief, and Recover: A Journey”. That longer post is on my other site and contains many scientific references and links.

Background

That November 2013 blog post was the result of a TBI I suffered after a bike accident and compounded by Donna’s death two years earlier. Part of my recovery was pretty extensive in unit rehab following which I began seeing a neuropsychologist.

I was making progress and adapting to the loss. Yet there remained a sense of emptiness. I was hitting the grief hard, doing what was needed. It was a year post Donna’s passing that I had a bike accident and developed a subdural hematoma. Those are slow bleeders that took a month and friends and neighbors to be discovered, almost too late. Emergency surgery, a month in rehab, family and friends caring for Nina and me. My grief for losing Donna was replaced by a grief for my being limited to a wheelchair and having to do PT and speech therapy. But again it was all about working my butt off not wanting any more institutional food, getting the hell out of rehab and on my own. After a month I went to my sisters. For the first few days I was afraid to cross the street. But one foot in front of the other I was going to get back to normal. Hell with traffic. The neurologist and neurosurgeon said I have fully recovered.

For nine months of working with my neuropsychologist I understood the person I became after Donna’s death and TBI was not me. I learned that grief and trauma alter our self-perception in ways both subtle and dramatic. It changes who we are. We can either become that which the loss, grief, and trauma created or we can pad in our bare feet down the darkened hall and find who we were and integrate what we’ve learned post trauma to discover something new. This is not a story of how I ran a marathon or climbed K2. It’s simply me setting out a goal of not wanting to vomit thinking about Donna’s death, and trying to learn from life, friendships, and discovery.

Post Traumatic Growth (PTG)

Following a traumatic event people have self-identified the following:

Relationships are enhanced and improved
Their self-assessment and views change
They have changed their life philosophy

Tedeschi & Calhoun, 1996 “The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma” introduced post-traumatic growth along with a tool to measure PTG called Post Traumatic Growth Inventory it is considered the start of PTG. PTGI identifies five factors:

Relating to others
New possibilities
Personal strength
Spiritual change
Appreciation for life

Clinical psychology works to moderate or eliminate negative emotional states. Positive psychology is focused on activating positive emotional states. Do we feel better about what we are doing and thinking? PTG is about gaining more autonomy, environmental mastery, positive relations with others, openness to personal growth, purpose in life, and self-acceptance. And the research at this point is examining the association between actual and perceived growth. Post-traumatic growth does occur and what I will share below are reviews of the literature that examine PTG and its elements.

The single best paper on this topic is from 2006 Zoellner and Maercker “Posttraumatic growth in clinical psychology- A critical review and introduction of a two component model”. It is exceptionally well-written and accessible to most of lay people and for the scientists reading this, an excellent critical review. I would advise reading this paper for a complete understanding of the topic. I want to highlight what the authors found when they examined the empirical investigations on cognitive factors and processes that may help predict PTG.

Openness to new experience: These are people identified as imaginative, emotionally responsive, and intellectually curious. They “draw strength from adversity”. It correlates with new possibilities and personal strength.

Hardiness and sense of coherence: These individuals have three sets of cognitions: commitment, challenge, and control. Commitment is our curiosity about making sense of the meaningfulness of the world. Challenge is our expectation that change is what life is all about. Control is our belief that we can influence course of events. Think how I identified myself as driven to provide caregiving and learn and my control of that. Zoellner and Maercker noted that the data for hardiness was associated more closely among POWs or those with higher levels of PTSD.

Dispositional optimism: Seems pretty clear Pollyanna works. The authors note that those self-identified as optimistic are more problem focused. They reframe and accept those uncontrollable situations. They also note that the evidence points out optimism and personal growth seem related and second, optimism and PTG may not have as strong a relationship.

Internal locus of control: This is where individuals employ personal resources to drive successful coping. Said another way if you perceive personal growth and the perception of controllability of the event then it is real. Perception is reality. But they go on to note the data here points to ‘an illusory side in PTG’.

Positive re-appraisal: Following a trauma how do we review and assess the event as in work our butts off (love the word Zollner & Macrcker use here effortful) processing beneficial information. This is a coping strategy and as such leads to PTG.

Acceptance coping: This is one of the more important factors that can lead to personal growth. “PTG was highest for those who used adaptive coping strategies including positive reinterpretation, the use of humor, and acceptance coping.” It was noted that this was associated with a highly stressful event.

Sense making and the quest for meaning: Trying to find meaning is central to psychological adaptation and associated with the perception of PTG. The authors note “The quest for meaning seems to be involved in PTG, but PTG is not necessarily linked to having found meaning.”

Rumination: Taking a long hard look at what happened and what you feel. It is important that rumination can be adaptive or maladaptive. Someone who lost their husband at about the same time I lost Donna tells me she cannot get him out of her thoughts and how lost her life is to the point of crying for hours on end. The evidence here supports cognitive processing as helpful.

Grief has no shelf life or expiration date. It lives within us forever even when we deny it, move on, find closure, or hide. It is there. We can allow grief to subtract from our lives, let grief just be white noise, or we can use it as a fulcrum to move our lives forward. PTG is evidence that within and from trauma springs hope and new. PTG is not easy to achieve nor does it just happen. We must look long and hard at our trauma and allow our minds and heart to connect.