Posttraumatic Growth: A Choice
By Megan Bronson
Being victimized is not a choice, nor is being the survivor of a traumatic incident, such as a motor vehicle accident or other type of incident that causes a burn injury. No one—not a child, an adolescent, or an adult—chooses to suffer this sort of injury. Even those individuals who appear to have made the desperate decision to inflict such devastating injuries on themselves do not do so out of sound problem-solving or clear-minded judgment.
It’s not just the survivor of an injury who is affected by such an incident, but also their family members, friends, and significant others. They also had no choice in the traumatic event happening. Surely everyone involved in a burn injury would gladly have taken a pass on the trauma occurring.
In fact, traumatic injury, such as a burn, occurs in an instant and, in that instant, lives are changed. Every aspect of one’s being—spiritual, physical, emotional, mental/psychological, and social—is profoundly affected in the moment the burn occurs. And just as the incident wasn’t a choice, neither is the suffering that occurs in early treatment or the adjustment to the burn injury. Even the best pain management cannot take away all of the physical and emotional pain and discomfort.
What makes an incident a trauma?
The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IVTR) describes a traumatic event as one in which “the person experienced, witnessed, or was confronted with actual or threatened death or serious injury, or there was a threat to the physical integrity of self or others. The person’s response involved intense fear, helplessness, or horror.” Certainly most burn injuries meet these criteria.
Traumatic injury affects our basic sense of safety in the world and can leave survivors feeling fragile, victimized, and out of control of their lives. Early in the process of recovery from burn injury most survivors struggle physically and emotionally and seek meaning related to their traumatic injury. It’s not uncommon to hear, Why me? Why my family? What did I do to deserve this? Why am I being punished? How will we ever get through this? “This is so unfair,” is another common response, as well as placing the blame on others. The future looks uncertain and is often anxiety-provoking for all concerned.
Phases of Recovery After Traumatic Injury
Victim: Identifies oneself as a victim and sometimes feels hopeless, helpless, and victimized.
Survive: Feels less at the effect of the trauma and is beginning to reclaim hope and formulate a plan for going on with life in spite of the trauma.
Thrive: Reengaged with life and reclaiming previously enjoyed activities and relationships and also pursuing school, employment, new activities and interests.
Transcend: Has found a way to transform the pain and suffering of his or her trauma into a way to give back and help others.
While traumatic incidents are rarely, if ever, our choosing, recovery, healing, finding a way to move forward in life, and transcending trauma are. These are possible when we choose to heal and recover and set our intention on these. The concept of posttraumatic growth (PTG), once rarely considered as a possibility, is entering the consciousness of more and more survivors, as well as caregivers, counselors, and burn care professionals. PTG refers to the possibility of recovery, positive change, and spiritual growth after traumatic injury and traumatic loss. Human beings have the potential to make positive, life affirming choices in response to trauma. Many survivors decide to do something positive with their lives in spite of their trauma and also for some survivors because of it.
Families and significant others of the burn survivors have not chosen to have their loved one experience a burn injury. However, they can, and most often do, choose to support and accompany the burn survivor on the long and difficult path that leads to recovery and healing. Those who are part of the burn survivor’s support system also can experience PTG in the process of healing and recovering after burn injury.
What are the factors that are predictive of a positive recovery after burn injury? And what are the factors that predict the likelihood of PTG? Richard Tedeschi, PhD, and Lawrence Calhoun, PhD, are pioneers in the study of PTG and are part of the Posttraumatic Growth Research Group of the Department of Psychology at the The University of North Carolina at Charlotte. The areas of change that the research group has identified as common areas of PTG are closer relationships, experiencing an increased sense of connection to others who suffer and an increased sense of their own strength, and a greater appreciation of life in general. (More information is available regarding the work of the PTG Research Group at http://www.ptgi.uncc.edu.)
Research indicates that the most important factors in the recovery and healing process after traumatic injury and traumatic loss are:
- A strong social support system
- Cognitive and emotional processing to the trauma
- An openness to spiritual growth and change
Resources that facilitate and support recovery and growth after a burn injury include the following:
- Burn support groups, grief and trauma groups, 12-step programs
- Burn camps, family retreats, and age-appropriate retreats for adolescents, young adults, and adults
- Support from family, friends, church or community groups
- Tai chi, ki gong, yoga, therapeutic massage, reiki, sensory motor work
- Therapies that facilitate cognitive and emotional processing of the trauma, such as cognitive behavioral therapy (CBT) (http://www.nacbt.org) and eye movement desensitization reprocessing (EMDR) (http://www.emdria.org)
- Online supportive resources—Phoenix Society for Burn Survivors website (http://www.phoenix-society.org)
- Phoenix Society’s World Burn Congress and Phoenix Society’s UBelong children’s program
There are many things to be learned from physical, emotional, psychological, and spiritual struggle. Many survivors share a new sense of purpose in their lives, a profound shift in priorities and sense of what matters in life. They also can find a way to transform their suffering into a way to help others who suffer and to make a positive difference in the world. Posttraumatic growth is possible and begins with the choice to set one’s mind, body, heart and spirit on healing, recovery, and growth.
Megan Bronson is a board-certified psychiatric mental health clinical nurse specialist in private practice as a consultant and psychotherapist. She has extensive experience, both nationally and internationally, in grief, loss, trauma and traumatic loss, adjustment to illness, and death and dying issues. In working with children and adults, families, and groups, Megan focuses on helping people to work through their emotional pain, process the effects of trauma, and reclaim life and the ability to find meaning and happiness in life. She has facilitated many retreats for burn survivors and is a frequent presenter on pediatric and adult burn and trauma related issues. Megan is the author of many articles on emotional and psychological recovery after burn trauma, as well as Helping Children to Heal the Effects of Loss and Trauma After Burn Injury: A Guide for Parents and Caregivers, published by the Phoenix Society for Burn Survivors.
This story is an excerpt from The Phoenix Society’s® Burn Support News, Issue 2, 2013. Burn Support News is a quarterly publication that contains articles on the emotional, psychological, and social aspects of burn recovery. All Rights Reserved.