What Abi Taught Us

by Lucy Hone

  Factors that contribute to post-traumatic growth

  • Understanding that shattered beliefs about ourselves, others and the future are ‘normal’ responses to trauma.

  • Being able to reduce anxiety by using techniques to control intrusive thoughts and images.

  • Sharing our stories of trauma with others, rather than bottling it up (which leads to worsening physical and psychological symptoms).

  • Creating a personal narrative around the trauma, which may include identifying personal strengths used, noticing how some relationships improved, or a new appreciation for life and enhanced sense of gratitude, a deepened spiritual life, and so on.

  • A readiness to accept growth and develop a new life stance such as viewing oneself as more altruistic, or noticing a heightened sense of compassion.

  Lisa Bucksbaum, who runs Soaringwords.com, a non-profit organisation assisting ill children and their families to heal, interviewed Richard Tedeschi in 2014. Lisa shared her interview with me for this book, but you can read more about Lisa’s work online at www.soaringwords.org.

  Lisa Bucksbaum (LB): When bad things happen people feel as if it will break them. Dr Tedeschi, could you explain what post-traumatic growth (PTG) is?

  Richard Tedeschi (RT): In addition to the distress that comes in the aftermath of various kinds of traumatic events, people often find that they learn something of value, they change in ways that they value, they experience what might be for some a personal transformation. So this struggle, to cope and to figure out how to live with this difficulty, and the outcomes that people experience in the aftermath of these events, we call PTG.

  LB: Scientists like you have been studying PTG for the past 30 years but the concept comes from ancient traditions.

  RT: That’s right, we’ve given this scientific name to it, PTG, but it’s a concept that’s been explored by theologians and philosophers for centuries. So you find in the great religious traditions a lot of discussion about how we should respond to suffering in our lives, they all have something to say about this aspect of human living that’s inevitable. We find there’s a great literature on suffering and transformation. Then when we look at philosophy, they talk about how we are inevitably going to experience some kind of suffering and trauma in our lives and how we should respond to that by trying to find some meaning despite the suffering, so we make meaningful suffering, not just suffering in vain. For example, Viktor Frankl, who was a holocaust survivor, is almost a father to this field in modern times, because he described how going through the concentration camps he found some way to make that time and that difficulty meaningful to him. So it’s a purpose that developed out of that.

  LB: The sense that the last freedom that one has is the freedom to choose one’s attitude towards circumstances. We can’t control our circumstances but we can control how we respond to them.

  RT: That’s exactly right. So what we’ve done now is try to learn about it from a scientific perspective, that is we’ve tried to look at what are the data that support the idea of post-traumatic growth. We’ve found that maybe half to two thirds of people report post-traumatic growth. It’s not a universal thing but it’s not uncommon—more people report post-traumatic growth than post-traumatic stress in the aftermath of various kinds of traumatic events. We’re not talking about the trauma itself creating the change, we’re talking about what people do in the aftermath of the trauma, about how they get through it and who can be around them that can help them make that difference so that they find something of value in it.

  LB: How can other people help?

  RT: Other people are really important in this process because they can help the person face up to what’s happening and embrace it in some sense, by taking a look at how it’s affecting you, how you are thinking about things differently now. Another person can be encouraging of that process. We want to see ‘expert companionship’, we want to see other people learn how to support trauma survivors in a really expert way: not expert in terms of being a professional, but someone who is a really good companion, who can listen to difficult stories, doesn’t offer platitudes, but can actually learn from the person who’s going through the difficulty rather than having the answers to their problems. So it’s an attitude towards listening, supporting, being a presence for another person. That person who is traumatised gets a chance to articulate their experience and explain themselves—so that they can start to learn about their own way of responding to this.

  In some circumstances there really aren’t words, sometimes it’s just knowing that someone is there and you can count on them. The expert companion is someone that stays connected to you, they don’t have to be a medical practitioner, just someone who is prepared to stay with you for the long run.

  During this interview, Tedeschi also identified the five different ways in which people report they’ve changed as a result of their reaction to trauma.

  1. A sense that they are stronger than they ever thought they could be: Going through the traumatic event has been a great challenge, but they’ve found personal resources to draw upon that they weren’t previously aware of.

  2. Appreciation of life: This is the idea that people appreciate the time that we have on Earth and appreciate the things around them that they might otherwise have taken for granted.

  3. Relating to other people in a new and better way: People report being more compassionate, empathetic and understanding, perhaps allowing themselves to get closer to other people emotionally. Talking about traumatic events almost forces us to be more vulnerable in a way that encourages closeness.

  4. New possibilities: Traumatic events may shut off old ideas about what’s important, and usher in new priorities. New possibilities may start to open up.

  5. Spiritual change: This encompasses a range of experiences, from religious beliefs, to existential change and the recognition of new ways of living. People may also find strength in the transformative power of nature or music.

  I believe it is important to know that growth can occur from all forms of trauma, including grief. But I want to emphasise once more that growth is different from improvement and betterment. Abi’s death may have led to growth, but I regard that less as self-enhancement and more as an alteration in direction. Coping with her loss has precipitated a change in perspective, a slight change in occupational priorities, and a full-frontal awareness of life’s volatile and unexpected path. I’m not a better person because of it, just a different person. By covering research insights on post-traumatic growth here, I would not want to put additional pressure on any grieving person to believe that their loss has to lead to life improvement, but rather simply to know that growth is possible.

  Chapter 17

  Press pause

  I WANT TO PRESS PAUSE for a moment—in the middle of the section on Reappraisal and Renewal—to stress how exhausting grieving is and to reiterate that it’s not okay that any of us has to deal with it. I know that it is all part of life, and I’ve told myself time and again that death doesn’t discriminate, but there are times when none of this works.

  Eighteen months after Abi died, I lay in bed weeping, thinking to myself over and over again, It’s not okay, it’s not okay, it’s not fair that Abi, Ella and Sally died and that we have to cope without them. It’s not fair for them, for us or for anyone who loved them.

  I’m not a slave to resilience; I hope I’m not a painfully positive fool. I certainly allow myself to succumb to my grief, to the helplessness and ongoing (although by now intermittent) misery. I often take myself off for a nap, or a walk, to hide from others in the afternoons. I can feel small, pathetic and vulnerable too. I miss Abi so much, so often and so very deeply. I hate all the good times her brothers, cousins and friends are never going to have with her—that they all would have enjoyed so much.

  Even as we start to rejoin the world and find ways to relearn it, there are times when we regress. Oscillation is the norm—back and forwards we go. Don’t beat yourself up
over deadlines, how you think you should feel or act. There is no single way, and your way doesn’t have to be my way. Grieve at your own pace and take all the rest and breaks from it you need.

  THE RESILIENT GRIEVING MODEL

  I have thought long and hard about the shape of my model of resilient grieving: is it a linear progression or am I moving through a cycle? In the end, I realised that, for me, grieving more resembled a jigsaw puzzle than any model containing stages to go through or tasks to be accomplished. Learning to live with grief is learning to live in a shattered world, where the familiar components have been scattered into disarray and we are left to rebuild our lives with different pieces.

  Picturing the strategies I’ve relied upon, and covered here, as pieces of a puzzle has helped spur me on and brought some kind of order to the chaos. The pieces of the puzzle (shown overleaf) are like signposts and keys that have enabled me to navigate the ongoing process of relapse and recovery, reappraisal and renewal, acceptance and struggle, while acknowledging that this is the very nature of life.

  Perhaps it is this realisation that prompts the tears that sometimes well up at someone else’s loss or struggle—the overwhelming feeling of sadness that comes from knowing life is hard, and that being resilient, coping, picking up the pieces, doing it all over again is tough and tiring. It is our journey and we each have to find the pieces that fit our personal jigsaw puzzles. But we have to do it, there is no choice. We simply have to keep on going, over and over again, doing the best we can each day, each month, each year, as life comes together and falls apart, spurred on by (and savouring) the good things in our lives in a way that only the bereaved can.

  Chapter 18

  Rituals and mourning the dead

  PUBLIC MOURNING RITUALS, such as funerals, have a clear purpose. By gathering people together around the bereaved, they help mourners strengthen their bonds and re-enter the social world after a major loss. But establishing personal rituals to help us mourn our dead is increasingly recognised by bereavement researchers as an effective mechanism for coping better after loss. We’re not talking traditional mourning rituals here—wearing black, sitting shiva, post-funeral wakes (though these of course are vital for some)—but regular, repetitive actions that bring back memories of those who have died.

  American researchers Michael Norton and Francesca Gino asked 76 research participants to write about a significant loss (the end of a relationship or the death of someone they love) and to describe how they coped with that loss, including any rituals they engaged in.1 (These researchers defined ritual as ‘a symbolic activity that is performed before, during, or after a meaningful event in order to achieve some desired outcome’.) They were surprised to discover that only 10 per cent of the described rituals were performed in public; 5 per cent were performed communally, and only 5 per cent were religious in nature. Most of the rituals were therefore private, routinely practised rituals that were unique to the individual. For example, one woman who lost her mother would ‘play the song by Natalie Cole “I miss you like crazy” and cry every time I heard it and thought of my mom’. One man mourning his wife wrote: ‘In these fifteen years I have been going to hairdressers to cut my hair every first Saturday of the month as we used to do together.’ Another widow in the study described how she washed his car every week just as her husband used to do.

  THE RITUALS WE CONDUCT IN MEMORY OF THE DEAD BIND US TO THEM, THEY WORK TO MAINTAIN OUR CONNECTION WITH THEM.

  When I described these type of rituals to an academic colleague, he suggested them to be painfully sad, saying he’d worry they were more likely to exacerbate depression and misery among mourners than help them heal. I was surprised by this reaction. For me, the value of rituals was immediate and obvious. The rituals we conduct in memory of the dead bind us to them, they work to maintain our connection with them and, specifically, allow us to continue to acknowledge our loss—at a specific time, place or fashion—while getting on with our ‘normal’ lives the rest of the time. In short, they provide something of a long-term solution, enabling us to grieve and maintain normal functioning simultaneously. They are, in essence, the answer to moving forward but retaining the dead in our lives. In this sense, I can see how they lead to the ‘improved coping’ found in Norton and Gino’s study, but I did note on re-reading their work that they have yet to investigate the impact of rituals among people experiencing what clinicians refer to as ‘complicated grief ’.

  Subsequent experiments by Norton and Gino have confirmed the power of rituals to mitigate grief. In a second experiment, the researchers invited 247 grieving people into their lab and had them write about their loss, describing the emotions and thoughts they experienced at the time of loss in detail.2

  The researchers then divided participants into two groups: a ‘ritual group’ and a ‘no-ritual group’. Participants in the ritual group were asked to write about a ritual they performed following the loss. Here, as in the previous study, many people reported private, personal and emotionally moving rituals that connected them to the memory of their lost loves in a deep and powerful way. After the writing exercise was over, the researchers measured the grief of the participants in both conditions. As one would expect, people in both groups became sad doing the exercise, but the people who wrote about rituals were less sad. They reported significantly less grief than those who did not write about rituals. Those in the ritual group, for example, were less inclined to endorse statements (from a standard scale used to measure grief) such as ‘I feel that life is empty without this person’, ‘Memories of this person upset me’ and ‘I feel stunned or dazed over what happened’. What is interesting about this research is the discovery that the benefits of rituals accrued not only to individuals who professed a belief in rituals’ effectiveness as part of the study but also to those who did not. Meaning, whether you like the idea of rituals or not, they can still help you grieve.

  Norton and Gino suggest that the reason rituals help us grieve is that engaging in them helps restore a sense of control and order when we are otherwise feeling utterly powerless. Part of the magic in grieving rituals is that they are deliberately controlled gestures that help counteract the turbulence and chaos that follow loss. Crucially, these researchers also point out that rituals may not only reduce negative emotions, but also increase positive emotions.

  I have developed myriad rituals since Abi, Ella and Sally died. Some of them I do regularly, some infrequently, but all of them I do to honour those we lost, and to retain their presence in our lives. I recently made a wreath out of gathered wild foliage in memory of Sally, and I frequently walk out to the local headland she loved to run on. Doing so offers me the right space and time to think of her. I will make meringues this summer using her recipe, the one the girls loved so much.

  Devising rituals will be instinctive for some, but Norton and Gino’s findings give encouragement for those who are not natural ritual-makers, but who might like to give it a go.

  BRINGING THE BODY HOME—LEARNING FROM MĀORI GRIEVING

  We are not Māori. My first encounter with one important element of Māori grieving came when my own mother died back in the year 2000 and my sister Esther suggested we bring her body home so that we would have a chance to mourn her properly before the finality of death begun. This was my first experience of seeing a dead body, and, while the concept seemed strange at first, once I was ready to spend time with her I found it beneficial. In fact, the whole experience of having my mum at home, spending time with her, not feeling rushed, and growing accustomed to seeing her dead was transformative.

  Having the body of a loved one at home, or being able to view the body at a funeral home in the days following the death, provides our hearts and minds with the chance to catch up. Seeing those we loved dead seems to give us time to process the reality of our loss. Ultimately, I think it serves to place us one step further down the path of acceptance and limits denial.

  We were, as I explained in Chapter 2, able to bring Ab
i’s body home and have her there with us for five days before the funeral. It gave us the time we desperately needed to spend with her. I also think it helped the dreadful truth of her death to sink in: seeing her body there with my own eyes day after day forced my mind to acknowledge its reality, and it gave me time to reflect on her life and to dote on every last contour of her body. It helped.

  Rituals to commemorate

  Rituals are effective and meaningful when they have significance to the deceased and to the survivor. The following are merely suggestions and might be altered and enhanced to appropriately accommodate the relationship involved. The following list features in the Grief Counseling Resource Guide created by the New York State Office of Mental Health.

  • Prepare a favourite meal of the loved one and enjoy it as he/she did.

  • Prepare a favourite dessert—share with family or friends.

  • Watch a movie(s) enjoyed by your loved one.

  • Plant flowers, a tree or a flowering bush in memory of your loved one.

  • Enjoy a toast to your loved one on a birthday, anniversary or holiday.

  • Light a candle and recall the comfort or guiding light he/ she was for you.

  • Read book(s) or article(s) on a favourite topic(s) he/she enjoyed.

  • Play music appreciated by your loved one and see if you can enjoy it now.