Transcending Burn Trauma-The Journey From Survival to Reclaiming Your Life
By Megan Bronson, PMHCNS-BC
Burn trauma profoundly affects all levels of our being. Therefore recovery needs to occur on all of these levels. Dealing with and healing from the psychological, emotional, and spiritual impact of burn trauma requires stamina, support, and a willingness to go through the process of grief and to let go when needed. Most of all, true healing or transcendence of burn trauma requires a deep commitment to life on the part of the survivor. The aim of this article is to offer both direction and tools for healing the emotional, psychological, and spiritual impact of burn trauma.
Trauma is defined as an event that is outside the realm of usual human occurrence and that threatens the basic safety and security of either the individual who experiences the trauma directly or those who witness the trauma occurring to others. Serious burns certainly qualify as a major trauma by this definition, both for those who directly experience the burn, as well as family, friends, and significant others who witness the burn incident and its aftermath. Intrusive, painful medical treatment procedures may also be experienced by the burn survivor and their loved ones as traumatic, even though the intent of these procedures is to facilitate healing of the physical burn injury.
Healing the Effects of Trauma and Loss
Healing the effects of trauma and loss after burn injury is essential in recovering optimal functioning for the burn survivor, not just physically, but in all areas of his or her life, including social, emotional, relational, and spiritual. Healing is possible and available to all human beings if they choose to focus their energy on healing and if they seek out individuals, groups, and other supports for healing. Healing is not the same as curing; it is not about making everything all better nor as it was before the loss or trauma. Healing is about restoring balance given the truth of the effects of the loss or trauma. We live in an impatient culture that likes quick fixes and assurance of outcomes. We function under the pressure of managed care systems and systems of high control, which do not support true healing but rather support expedient treatment. This is the reality of health care delivery systems at this time; however, that does not have to pull us off track in finding ways to support our own healing or that of others.
The goals of healing trauma are
- To discharge the emotional, physical, and mental energy trapped in the trauma response,
- To re-negotiate the trauma, (to go back through the trauma on different terms), and
- To transform the traumatic experience.
In his book, Walking the Tiger: Healing the Effects of Trauma, Peter Levine states that trauma does not have to be a life sentence.
Healing requires patience and trust and a willingness to go through the grief related to the losses that often accompany serious burn injury. Judith Herman MD, a noted expert in helping trauma survivors, describes in her book, Trauma and Recovery, a three phase-model for emotional, spiritual, and social healing:
Phase I — Recovering a sense of safety in the world
Phase II — Remembering, telling one’s story, and mourning
Phase III — Reconnecting with life
In Phase I, the most fundamental psychological impact of trauma needs to be addressed, namely, the sense of helplessness in the face of an event that is both psychologically and physically overwhelming. This type of event produces a great deal of anxiety in the survivor and challenges a sense of control over one’s life and destiny and ultimately over death itself. Reestablishing a sense of physical safety precedes establishment of safety in the survivor’s social environment. For the burn survivor, control of pain, both from the burn itself, as well as intrusive procedures, is essential in helping the burn survivor reclaim a sense of personal power and control.
Survivors feel not only a loss of control over their bodies, but over their emotions and thinking as well. Survivors of trauma also often struggle with a sense of spiritual crisis or crisis of faith. They may feel spiritually betrayed and/or unprotected. Healing the connection to one’s inner self or spiritual center is an essential part of recovery. Spiritual counseling from a source of the survivor’s choosing can be very helpful at this time. Most major hospitals that house burn centers also have pastoral care departments, which can help to meet these needs.
True healing also requires remembering, telling one’s story, and grieving the losses related to the burn trauma. In Phase II, the survivor needs to be allowed to process the loss and trauma in order to put that in the past. Common losses related to burn trauma are as follows:
- Possessions, such as home, mementos, etc.
- Relationships that may have ended relevant to the burn trauma and injury
- Loved ones who may have died in the fire
- Pets who may have died in the fire
- Dreams and hopes
- Body parts, function, hair, ears, sight, etc.
- Roles, lifestyle, recreational, and employment changes
- Past life—what one used to look like, be like, enjoy doing, etc.
The grieving process is an innate, natural part of the healing process. The feelings of grief include sadness and despair, anxiety and fear, anger, yearning for what was lost, and guilt. These feelings may occur in any order and may last a long time. Going through these feelings, rather than blocking them, helps us to heal. The goal of grief is to help us to integrate the changes brought about by the traumatic event, find meaning in the loss, and find a way to go on with life. Unfortunately, our culture is not traditionally supportive of this natural process, although that is improving. Not everyone is able to be present to the grief of another. Therefore, becoming a part of a support group, such as a burn survivor support group, or seeking supportive counseling (from a professional trained in dealing with grief and trauma issues) can be helpful in moving through grief. Journaling, drawing, and spiritual practices, such as prayer or meditation, are also helpful in supporting grief.
Irving Yalom, MD, who has extensive background in working with groups and teaching group theory states, “The encounter with others who have undergone similar trials dissolves feelings of isolation, shame, and stigma.” The burn survivor needs to be allowed to tell his or her story in an emotionally safe, nonjudgmental environment. Peer support relationships, burn survivor support groups, burn camps and retreats, and conferences specific to the trauma, such as the Phoenix World Burn Congress, provide such a place. Anyone who has witnessed the healing power of the open microphone sessions at Phoenix World Burn Congress, where burn survivors share their stories, will attest to that.
As reconnecting in supportive relationships and groups becomes easier, it also becomes easier to reconnect to the world of family, friends, job, and other social relationships. In Phase III, the emphasis shifts from being a burn survivor to being oneself in the world again. As healing occurs on deeper levels, the fact that one is a survivor of burns does not constitute one’s identity.
While traumatic incidents are rarely if ever our choosing, recovery, healing, and finding a way to move forward in life and to transcend trauma are. These are possible when we choose to heal and recover, and set our intention on these. The concept of post-traumatic 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 and changes 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. Many choose to take what they have learned from their struggles and suffering on the road to recovery to make a difference for others who are still struggling. The SOAR program of the Phoenix Society for Burn Survivors is a wonderful example of this.
Families and significant others of the burn survivor do not choose to have their loved one burn injured. However,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. We can become less judgmental and more compassionate, caring, and loving human beings.
Research indicates that the most important factors in the recovery and healing process after traumatic injury and traumatic loss are (1) a strong social support system, (2) cognitive and emotional processing to the trauma, and (3) an openness to spiritual growth and change.
Set Your Intention of Recovery, Healing, and Growth
Never underestimate the power of focused will and intent, and the power of the human being, to not only survive profound and unimaginable trauma and traumatic loss, but go on to thrive and even transcend these experiences. Those of us who have the privilege of working with burn survivors can share many examples of this.
Many years ago I worked with a young man who was struggling with a serious physical illness. He was also a long distance runner. He was a profound teacher for me about the power of will and intent. He told me that as he trains for and before he runs a marathon, he always visualizes himself finishing the race. He shared that it is what got him through the tough times and kept him going when he wanted to quit—when he thought he could not endure. He applied the same principle to dealing with his physical illness—he never quit. It was that clear focus of intent that helped him as a runner and also as a human being dealing with adversity. I never forgot the lesson. Focus your intent, will, and goals carefully and deliberately on healing and recovery.
To survive refers to overcoming a threat and to endurance. To thrive refers to resuming growth and to developing potentials. One has to go through the process of becoming a survivor and then learning to thrive again before one can transcend trauma. To transcend trauma and loss refers to a level of healing in which the individual is able to take what they have learned from going through the trauma and the losses inherent in the trauma and to use that learning to make a difference in the world. To transcend means to go beyond or to surpass limitations and to transform suffering into healing for oneself and/or others. That might mean helping other survivors directly, or it might mean making the world a little better place in general by making a difference for others.
The journey of healing and recovery after a burn injury is not a sprint, but is rather a marathon. It takes courage, endurance, and support to recover and find balance after traumatic injury. Like the marathon runner, set your intention on recovery, growth, healing, and reclaiming your life.
Resources That Facilitate and Support Recovery and Growth After a Burn Injury
Burn support groups, grief and trauma groups, 12 Step Program
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, or CBT (http://www.nacbt.org) and eye movement desensitization and reprocessing, or EMDR (http://www.emdria.org)
Online supportive resources—The Phoenix Society for Burn Survivors (http://www.phoenix-society.org)
The Phoenix World Burn Congress and Phoenix UBelong children’s program developed by the Phoenix Society http://www.phoenix-society.org/wbc
Phoenix SOAR (Survivors Offering Assistance in Recovery) Program http://www.phoenix-society.org/soar
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.
Herman J. (1997). Trauma and Recovery. New York: Basic Books.
Levine P. (1997). Waking the Tiger: Healing Trauma. Berkley, California: North Atlantic Books.
Posttraumatic Growth Research Group, Department of Psychology, The University of North Carolina at Charlotte, website. Available at: http://www.ptgi.uncc.edu.
Sanders C. (1992). Surviving Grief and Learning to Live Again. New York: Jon Wiley and Sons.
Yalom I. (1975). The Theory and Practice of Group Psychotherapy, 2nd edition. New York: Basic Books, Inc