The Paradox of Trauma and Growth in Pastoral and Spiritual Care: Night Blooming (Emerging Perspectives in Pastoral Theology and Care) 1498519938, 9781498519939

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The Paradox of Trauma and Growth in Pastoral and Spiritual Care

EMERGING PERSPECTIVES IN PASTORAL THEOLOGY AND CARE

Series Editor

Phillis Isabella Sheppard, Vanderbilt University The field of pastoral care and counseling, and by extension pastoral theology, is presently at a crossroads, in urgent need of redefining itself for the age of postmodernity or even post-postmodernity. While there is, to be sure, a rich historical foundation upon which the field can build, it remains for contemporary scholars, educators, and practitioners to chart new directions for the present day and age. Emerging Perspectives in Pastoral Theology and Care seeks to meet this pressing need by inviting researchers in the field to address timely issues, such as the findings of contemplative neuroscience, the impact of technology on human development and wellness, mindfulness meditation practice for reducing anxiety, trauma viewed through the lens of positive psychology and resilience theory, clergy health and wellness, postmodern and multicultural pastoral care and counseling, and issues of race and class. The series will, therefore, serve as an important and foundational resource for years to come, guiding scholars and educators in the field in developing more contemporary models of theory and practice. Titles in the Series The Paradox of Trauma and Growth in Pastoral and Spiritual Care: Night Blooming, by Mary Beth Werdel A Womanist Holistic Soteriology: Stitching Fabrics with Fine Thread, by Lahronda Welch Little The Speed Method, Awareness in Four Steps: Lonergan’s Approach for Pastoral and Spiritual Counseling, by Barbara Marchica A Postcolonial Political Theology of Care and Praxis in Ethiopia’s Era of Identity Politics: Reframing Hegemonic and Fragmented Identities through Subjective In-Betweenness, by Rode Molla Pastoral Care in the Anthropocene Age: Facing a Dire Future Now, by Ryan LaMothe Pastoral Virtues for Artificial Intelligence: Care and the Algorithms that Guide Our Lives, by Jaco J. Hamman Religious Trauma: Queer Stories in Estrangement and Return, by Brooke Petersen Tilling Sacred Ground: Interiority, Black Women, ad Religious Experience, by Phillis I. Sheppard Christianity, LGBTQ Suicide, and the Souls of Queer Folk, by Cody J. Sanders Warriors Between Worlds: Moral Injury and Identities in Crisis, by Zachary Moon Pastoral and Spiritual Care in a Digital Age: The Future is Now, by Kirk Bingaman

The Paradox of Trauma and Growth in Pastoral and Spiritual Care Night Blooming Mary Beth Werdel

LEXINGTON BOOKS

Lanham • Boulder • New York • London

Published by Lexington Books An imprint of The Rowman & Littlefield Publishing Group, Inc. 4501 Forbes Boulevard, Suite 200, Lanham, Maryland 20706 www​.rowman​.com 86-90 Paul Street, London EC2A 4NE Copyright © 2024 by The Rowman & Littlefield Publishing Group, Inc. All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without written permission from the publisher, except by a reviewer who may quote passages in a review. British Library Cataloguing in Publication Information Available Library of Congress Cataloging-in-Publication Data Available ISBN: 978-1-4985-1993-9 (cloth : alk. paper) ISBN: 978-1-66695-447-0 (ebook) The paper used in this publication meets the minimum requirements of American National Standard for Information Sciences—Permanence of Paper for Printed Library Materials, ANSI/NISO Z39.48-1992.

For Peter, William, and Alex. My prayer is that you never know the night but, if you do, that you find a person to sit with you through your night who understands the paradox of night blooming.

Contents

Introduction ix Chapter 1: The “T” in PTG



1

Chapter 2: The Paradox of Trauma and Growth



19

Chapter 3: Night Blooming: A Metaphor of Posttraumatic Growth

37

Chapter 4: Religion, Spirituality, and Night Blooming: Engaging, Coping, and Virtue in the Paradox

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Chapter 5: Witnessing the Night Bloom: Working in the Paradox



73

Conclusion

87

References

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Index

105

About the Author



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Introduction

I had an experience years ago that perhaps many in the pastoral and spiritual helping professions have had as well. I was in line at a small coffee shop while on vacation in a quaint town. It was a sleepy town, quiet, peaceful, and off the beaten path. While waiting to order my morning cup of coffee, a woman, probably in her mid-30s, entered the shop. A second woman who was sitting at one of the small tables saw her, stood up, and embraced her. No words at first: the two started instantly crying. Eventually, once seated, one woman said to the other, “I don’t even know what to say,” as they continued to hug. It was an emotional exchange in a small shop; it was hard not to notice. As inconspicuously as I could, I paid for my coffee and left. I had the sense that I had witnessed a piece of someone’s narrative that was deeply painful, and an encounter between friends that was sacred. It was the kind of moment that stays with you for some time. Working in the field of professional care taking and counseling, I have repeatedly heard a version of a phrase from the mouths and hearts of people confronting suffering: “I don’t even know what to say.” The unexpected death of a loved one, a diagnosis of a terminal illness, a tragic accident, a sexual assault, a natural disaster, racial or gender-based attacks, each of these events can create a volcanic hole in a person’s way of understanding the world. Extreme stress and trauma leave people without a script to follow, without a pre-cut, shelf-stable meaning of life to be superimposed onto one’s deeply personal life event and lived context. The incomprehensibility of what some people are asked to endure in stressful and traumatic events may overwhelm a person’s biology, psychology, and their social, cultural, and spiritual self. Sometimes, pieces of one’s social, cultural, and spiritual self that have been handed down by previous generations are traumatic, which then makes the comprehensibility of future stressful and traumatic events even more confusing and debilitating. Stress and trauma can accumulate. It may make sense that sometimes family members, friends, neighbors, and coworkers don’t know what to say to a person after they have experienced ix

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great stress or trauma, like what I could only imagine preceded the encounter I witnessed in the coffee shop. No words can adequately capture the confusion, sadness, or disruption left in the wake of extreme stress and trauma. Perhaps the phrase “I don’t know what to say” expresses most authentically the internal response of a supportive friend, relative, or colleague. Extreme stress and trauma can cause heads to shake “no” in disbelief, perhaps as a futile attempt to disconfirm the painful reality of human suffering. One’s heart may feel helpless; one’s soul may feel breathless; one’s words may feel so far from being able to summarize one’s reaction that language is deemed useless. To face human suffering is to face an abyss of darkness, a psychological, and spiritual night. However, in my experience, most people want to have a more grounded and purposeful response than an expression of confusion as they witness, and perhaps accompany, a person who is suffering. In the best cases, family members, friends, and coworkers do have words to convey connection, understanding, empathy, and love from a trauma-informed place. For when they do not, they may feel helpless and the other’s loneliness and distress can compound. When one is in the role of pastoral care worker, pastoral counselor, mental health clinician, spiritual director, pastor, or clergy member, the response must be substantially more than not knowing what to say or not knowing what to think. Even if the response is—for a moment— intentional silence and authentic bewilderment, soon after, it must be more than an expression of astonishment. Responses of trained pastoral, spiritual, and clinical professionals must acknowledge personal and individual experiences of human suffering without offering a shelf-stable platitude about the meaning of life that negates a person’s emotional experience. Responses must carry with them a sense of knowing and not knowing at the same time. The caregiver must honor the thoughts and feelings related to making sense of suffering. Knowing what to say at such times is possible when one works with an understanding of trauma and traumatic growth. No concept is more essential for spiritually minded caregivers at the intersection of psychology and spirituality than the concept of posttraumatic growth (PTG). This is because perhaps no concept is so easily misunderstood by spiritual and psychological professionals. The study of PTG acknowledges that pain and suffering exist, and that they are not the whole of the narrative. Pain and suffering are not the thesis statement of life. The space where suffering, spirituality, and growth meet can be a liminal space where witnessing the paradox reveals a complex reality of the human experience not previously understood or embodied. To an under-trained professional listener, sometimes one believes that one’s role is to make darkness light. This is simply untrue. Moreover, it is delusional to think a caregiver has that power, and it is dangerous to act from such a place.

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However, there is a real connection between trauma and growth that is useful to explore. The term “posttraumatic growth” was first presented in the early 1990s by psychologists Richard Tedeschi and Lawrence Calhoun (2004) and later in descriptions of similar phenomena such as Crystal Park’s (2008)‌‌‌‌‌‌ conceptualization of stress-related growth and Alex Linley and Stephen Joseph’s (2011) concept of adversarial growth. These ideas suggest that sometimes, for some people, moving through stress and trauma allows them to experience new understandings of themselves, of others, and of their experiences of being in the world that are intrinsically positive. New appreciation for life, new spiritual change, new possibilities in life, new ways of relating to others, and newfound personal strengths that a person develops post-trauma are all considered examples of PTG. Emerging research that examines collective trauma and growth suggests that community-level posttraumatic growth is possible too (Ortega-Williams et al., 2021). The implications of understanding the paradox of trauma and growth may be life- and community-altering. This psychological construct of PTG—that a person may grow as a result of enduring suffering—has long had a home in varied spiritual and philosophical texts and understandings. Making sense of suffering is theological terrain too. Christian scripture, for example, reads “Not only that, but we rejoice in our sufferings, for suffering produces endurance and endurance hope.” Thich Nhat Hanh (2019), the Vietnamese Buddhist monk, suggested that we have a desire to move away from suffering and seek happiness, but that without knowing suffering, knowing happiness is not possible either. Ram Dass, Hindu spiritual teacher and writer, said, “Suffering is part of our training program for becoming wise” (ramdass.org). Suffering, redemption, wisdom, growth, the movement of the mind and heart—these are not new constructs in the human experience. Theologians and philosophers alike might even suggest that the growth that occurs as we move through suffering is the human experience. Catholic theologian and scholar Henri Nowen (2013), in his book Reaching Out, writes, “Learning to weep, learning to keep vigil, learning to wait for the dawn. Perhaps this is what it means to be human” (p. 35). The idea of the importance of meaning, and the great psychological devastation of meaninglessness, perhaps has no louder response than from religion and spirituality. What is the meaning of life? Why do pain and suffering exist? Amidst despair, where is the presence of a great and powerful God? These questions, fueled by experiences of stress and trauma, are at once psychological and spiritual in nature. People who are suffering do not leave the spiritual piece of themselves, or the spiritual part of their question, “at the door” when talking to a mental health therapist. Nor do they leave the psychological piece of themselves, or the psychological part of their question, “at the door” of a trained spiritual listener. Their questions intersect and engage the professional

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disciplines of psychology and spirituality all at once. Their questions are complex, nuanced, whole, and living. So then must be the theories that professional listeners work from in their caretaking roles. Professional helpers must have insight into the varied ways that extreme stress and trauma overwhelm a person’s ability to cope, must understand pain and suffering, and must hold an awareness of growth, while having no expectation that growth is a necessity. Knowledge at the intersection of the areas of traumatic growth and spirituality allows the caregiver a unique way of containing others’ experiences of suffering. Some people will integrate trauma, growth, and spirituality to find, as the existentialist Jean Paul Sartre (1942/2003‌‌‌‌‌‌) suggests, that life is found in the freedom discovered by moving through despair. For other people, the words of Psalm 18:28 will be lived: “The Lord my God will enlighten my darkness.” Two things are clear when one considers the interdisciplinary paradox illuminated by psychology and spirituality as it relates to PTG. First, spiritually minded caregivers cannot outsource all the trauma knowledge to counselors and psychologists. All caregivers need not be trauma professionals, but all spiritual professionals must be trauma-informed. Trauma work is for all people who work with people. Without being trauma-informed, professional listeners may place trauma at an extreme. Either all stress is framed as traumatic and not addressed for fear of crossing a professional boundary, or traumatic experiences are engaged too readily, without respect and understanding for the wound that exists and the further injury that poking a wound will cause. Second, mental health professionals cannot outsource all the spiritual content to clergy, care workers, chaplains, and spiritual directors. Spirituality is complex and nuanced, and all who work in the intersection must be aware of the way varied experiences of spirituality relate to psychological growth or decline. There must be at least a knowledge of both areas so that caregivers do no harm. Professional helpers must be aware of the current research that integrates psychological understandings of growth with spiritual writings and philosophies so that spiritually related interventions of caregivers and counselors are not trite at best and dangerous at worst. This is the space spiritually minded professional listeners are called to inhabit. The paradox is not an easy space to work. It can be difficult to understand, misunderstood, or deemed illogical and so abandoned. A painful example of what happens when a caretaker does not have adequate knowledge of psychology and spirituality comes to mind. During a class I taught for graduate students in the caretaking fields, there was a discussion of phrases that open people up to experience God’s presence in suffering and phrases that close people to experiencing God in suffering. The class had astutely realized that pacing is an important factor to consider when working with grieving people. A phase that may be helpful at one point in the

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grieving process can be destructive in another. When spiritual imagery comes from the grieving person it can be useful to the grieving process. When it is given to the grieving person from the caretaker, it is often not psychologically useful at all. One student shared a story of her friend, the parent of a young child who had died of cancer. The mother was grieving, barely able to walk up the stairs to the church for the Catholic funeral mass without the help of her husband. Tearfully she approached the presiding priest who confronted the mother with a cheerful “Congratulations!” Confused and bewildered, the mother looked up at the priest. Oblivious to the reality of the grieving mother, the joyful priest continued, “Congratulations! Today you have an angel in heaven!” The student shared that her friend never returned to church after the funeral mass because of that encounter. It makes sense that this mother did not return to church. Professional helpers have a good deal of power given to them by those in their care. The words they speak matter not merely as one person’s view that is shared with another. The words of trained listeners can represent whole organizations, churches, and professions to the vulnerable people listening. Clergy and pastors may represent all of religion. Counselors may represent all of psychology. Clearly, the priest in the above example had no understanding of the psychological reality of traumatic grief, and arguably caused psychological and spiritual harm to this mother. In the instance of an untrained or undertrained listener, silence may, in such an instance, be better than words. When the work of caregivers straddles multiple fields—as is the case for chaplains, pastoral counselors, pastoral mental health clinicians, and spiritual directors, pastors, and clergy—not being trauma-informed comes at a very great price. Not knowing trauma and traumatic growth literature may leave grieving families burying their faith with their child. In this book, the paradox of trauma and growth for those in pastoral and spiritual care will be explained in the hopes of averting forms of spiritual aggression such as the one recounted above. Yes, professionals must be grounded in their fields. Chaplains must be allowed to care for the spiritual needs of clients; counselors must be allowed to care for the psychological. However, there is research to suggest that interdisciplinary conversations and understandings are necessary to deeply understand and work in the paradox of suffering and growth. This book presents an understanding of trauma and PTG, the challenge of working with such a paradox, and gives special attention to how religious and spiritual perspectives enrich and, at times, complicate the process of seeing and working with PTG. Chapter 1, “The ‘T’ in PTG,” articulates the necessity for professionals to begin a study of traumatic growth deeply rooted in an understanding of trauma. In professional caretaking, ministry, and education alike, providing trauma-informed care is now an ethical necessity. The chapter covers the

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definition of trauma, the concept of complex trauma, the impacts of trauma on the brain, the impairments to relationships, and established and emerging interventions for treatment. Chapter 2, “The Paradox of Trauma and Growth,” explores paradoxes: opposing, bounded ideas that, when reasonably considered, exclude each other, and yet when presented together, express wisdom. Positive psychology and second-‌‌‌‌‌wave positive psychology—or positive psychology 2.0 (Wong, 2011)—ground the theoretical study of the paradox by moving beyond the polarity of positive and negative emotions. Considering a more complex interplay between positive and negative phenomena keeps one from slipping into the cognitively easier mental task of reframing the paradox of trauma as growth, and connects one to the harder task of finding the wisdom in the relationship between trauma and growth. The psychological necessity for meaning in life, and Park’s (2008) “Meaning Making Model of Coping,” is a way of understanding the process of PTG that can hold the tension of the paradox. Missing or misunderstanding the paradox of trauma and growth entails three risks: (1) trading wisdom for simplicity in the search for meaning, (2) limiting the definition of well-being, and (3) compromising the ability to build resilience in the world. Such losses have psychological and spiritual implications. Chapter 3, “Night Blooming: A Metaphor of Posttraumatic Growth,” presents the rare night blooming plant, the cereus cactus, as a metaphorical image of PTG. Through the metaphor, the chapter explores several variables related to how and why some people bloom in the night (Werdel, 2014). The variables of personality, levels of distress, social connections, and cultural context each tell part of the story of the night bloom. Understanding how each factor relates to the paradox of trauma and growth serves to ground a person in their role of listener, helping them stay open to the possibility—without expectations, judgment, or denial—of growth. Chapter 4, “Religion, Spirituality, and Night Blooming: Engaging, Coping, and Virtue in the Paradox,” explores how religion and spirituality in lived experience relate to PTG. Religion and spirituality are multidimensional and multifaceted constructs that have both positive and negative connections to psychological flourishing and growth. Religious and spiritual variables can buffer stressful life experiences, providing social support and a sense of grounding as one seeks to integrate a traumatic experience, or they can serve as a source of struggle, increasing depression or blocking joy. Religion, religious experience, and spirituality appear to support a person in highly stressful and traumatic experiences in three broad and interrelated ways. Religion and spirituality help a person to engage questions related to meaning making and suffering, to cope as they move through experiences of distress, and to develop and deepen virtues that encourage PTG. Finally, religion as trauma and spiritual bypassing are briefly discussed.

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Chapter 5, “Witnessing the Night Bloom: Working in the Paradox,” recognizes the challenge of working with a paradox, the move one must make away from categorical thinking and toward a both/and perspective when needed. The question of how one works with a paradox is addressed. The chapter outlines how witnessing is central to working with the pastoral and spiritual implications of the paradox of trauma and growth with implications for at least three realms: (1) as a psychological intervention that allows for the containing of the therapeutic space and a genuine expression of deep compassion necessary for trauma work and growth; (2) as a spiritual context that acknowledges and expresses an interconnectedness to each other as well as, from a Buddhist perspective, a form of consciousness that allows one to embrace the paradox; and (3) as a cultural expression that is an integral part of the process of systemic change that acknowledges intergenerational, historical, and communal traumas. Extreme stress and traumatic experiences create human suffering. Some people hear experiences of deep anguish and they want to cover them, bury them, or run away from them as fast as their bodies and minds allow them. Another group of people may hear the very same experience and want to stay and be a caretaker. They want to move toward another person who is suffering, understand their suffering, and remain with the person who is suffering in useful and comforting ways. However, if one does not have knowledge about trauma and traumatic growth, staying can cause more harm than running away. People with big hearts can be quite dangerous if they lack understanding. Yet, with an appreciation for, and engagement with, the paradox of suffering and growth, and an understanding of the ways that spirituality and religion are integrated with psychology, a pastoral and spiritual care worker or counselor may hold within them a needed perspective for a person in their care. Clinicians, caretakers, and compassionate listeners of all kinds need to have a nuanced understanding of trauma and growth to witness and work in the paradox, especially so for those in pastoral and spiritual care. Professional listeners do not need to extinguish darkness. How could we really extinguish darkness anyway? Nor should we solely focus on the light, even though it could appear at first pass to be psychologically and spiritually safer to do so. However, to witness and work in the paradox, we do need to learn how to not be swallowed by the night, not to run away from the night, not to glorify the night. To witness and work in the paradox, we do need to learn how to stay awake through the night. Such a task is far easier when we believe there might be something rare and uniquely beautiful to stay awake for, and that witnessing such a thing could have great consequences for living a meaningful life.

Chapter 1

The “T” in PTG

In the book Night, Elie Wiesel (1956/2006) captures one of the darkest moments in the story of humanity: a personal account of his experience as a teenager taken by German Nazis to a concentration camp. It is a death story that depicts the physical, psychological, and spiritual evil that human beings are capable of inflicting onto an entire culture. Wiesel tells his story as a teenage boy who has lost everything: his family, his God, his naiveté, time, place, and space. It’s the story of the annihilation of love. It’s the story of the direct dismantling of human dignity. It’s the story of the death of day and a life of nights. Sadly, if anyone believes that the human narrative has moved far away from the ability to inflict suffering upon one another, they are wrong. Night still exists. Some nights are caused by individual traumatic experiences such as sexual assault and rape. Other nights are the result of repeated exposure to adverse experiences, such as childhood physical or verbal abuse. Nights can also be caused by floods or hurricanes, and experienced across large geographic areas. For some, the night is passed down intergenerationally, as people carry the suffering of their ancestors. For others, born and raised in a systematically oppressed culture, night is their normal. Very stressful, sometimes traumatic, experiences happen every day. Millions of motor vehicle crashes take place each year. Natural and technological disasters are increasing with the current climate emergency. Illness and disease such as multiple sclerosis, cancer, heart disease, and Alzheimer’s claim thousands of bodies and minds. Gun violence destroys physical life as well as the psychological safety of schools, shopping malls, and spaces reserved for sacred communal worship. People lose their jobs, lose their homes, and with these their identities. Parents die in the arms of their children; children die in the arms of their parents. Black, Indigenous, and people of color continue to endure systemic oppression. People’s bodies, minds, and spirits are asked to hold these events. 1

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What happens to a body, a mind, or a spirit when one endures extreme stress and trauma? What happens to a person’s ability to be relational? What happens to their assumptions about how the world works, if they are worthy of love, and if their God is compassionate? How can we best work with people who experience trauma? Questions such as these were once reserved for a handful of trauma-psychologists. However, trauma-informed care is no longer a niche area of work solely for mental health professionals. All professional caretakers, ministers, and educators, especially those who are pastoral or spiritually focused, who sit with people who are suffering, must be able to have working answers to the questions above. Becoming trauma-informed is now essential to working ethically with people across multiple disciplines. Becoming trauma-informed will certainly mean different things to different professionals. For some, trauma-informed work might mean making a referral for a person to a different type of professional listener, such as a psychologist or counselor. For others, trauma-informed work might mean listening differently to a person’s narrative, asking different questions, and expecting different responses. For others still, it might mean changing curricula, programming, or adding space for self-care. While pastoral and spiritual caretakers are not all mental health professionals, trauma is a relational, embodied experience, and a brain-based process; it will affect many aspects of a person’s life, not only their psychological world. There are implications in trauma work related to the way a person engages, interprets, and lives their experiences of faith, religion, and spirituality. One of the more hopeful places of trauma work is in the area of posttraumatic growth: the idea that as we enter night, sometimes something paradoxical happens. Sometimes, for some people, moving through trauma leads to intrinsically positive experiences and realizations about oneself, others, or one’s understanding about the world. Sometimes, as a person moves through the night, they not only grow—they bloom. The psychological research that exists supports the spiritual intuition of many pastoral and spiritually minded care professionals: namely, that certain experiences of spirituality encourage PTG. However, one should not place the study of traumatic growth before, or separate to, the study of trauma. Rather, those interested in traumatic growth must start with an understanding of the essential components of trauma. The deeper one understands the night, the more sacred it is to witness the paradox of the night bloomer. Trauma expert Judith Herman (1992) has suggested that “the study of trauma has a curious history—one of episodic amnesia. . . . It has been periodically forgotten and must be periodically reclaimed” (p. 7). Anxiety, denial, self-protection, and vicarious trauma, all may lead a person to abandon the pursuit of becoming trauma-informed. Reading, listening, or talking about trauma can be triggering to people who have experienced or have worked

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with trauma. It can be deeply ungrounding to the reader, listener, or speaker. Grounding exercises such as deep breathing, wiggling toes and fingers, repeating a mantra, and taking small or big breaks from material to perform self-soothing and self-caring activities, is often necessary in trauma work and study. Grounding exercises allow a person access to, and an awareness of, being fully present in the here and now. It discourages dissociative flashbacks and intrusive thoughts that can be painful, distressing, and can lead to self-harm. Readers are encouraged to personalize and practice grounding exercises in the process of reading this book and to even seek out professional help from a mental health practitioner, if needed. Trauma can make one want to move away from knowing more. It might be necessary to intentionally step away from trauma study or trauma work for a moment and re-engage the work if, and when, one can. BECOMING TRAUMA-INFORMED It is an impossible task to distill all that is known from the psychological trauma literature into 20 pages or so. There is a significant psychological research base to cover. However, there are four main points that are a foundational necessity for pastoral and spiritually minded caregivers to understand before considering posttraumatic growth. The four points are these: 1.  Stress and trauma are related but different concepts. 2.  Trauma changes the brain in profoundly negative ways, blocking the rational part of the brain and the emotional part of the brain from communicating with each other, in essence trapping trauma within a body. 3.  Trauma changes a person’s basic assumptions about the self, others, the world, and God. 4.  Trauma does not need to be terminal. Several evidence-based interventions are effective in reducing negative symptoms of trauma. New and emerging research points to effective interventions to work with trauma. The four points are far from an exhaustive understanding of trauma. However, professional caretakers often want to know more about trauma once they begin to see that trauma is a clearly defined experience, that the trauma brain works differently, that the very assumptions of how the self and the world works are altered, and that there are evidence-based ways to encourage a person to be fully present in their body and in the world.

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DEFINING TRAUMA The word “trauma” is used in everyday language, but not always correctly. People use the terms “stress” and “trauma” interchangeably in colloquial language when, in actuality, the experience and consequences are not the same. In the words of Dr. Lisa Cataldo, a professor of psychology and religion who specializes in trauma and trauma-informed care, “Trauma is not all bad things that happen to people” (personal communication, April 10, 2023). Bad things that happen to people might be traumatic, or they might be stressful situations. Stress feels bad. It can be experienced when one starts a new job, adds a new family member, moves to a new state, has an important project in school or work, learns to drive a car, sits in traffic, or is raising a family. Stress can signal a challenging life moment. In stressful situations, a person’s whole brain remains fully functioning in the moment. There can be significant negative effects on one’s physical body and mental health if stress is not addressed, as it increases the risk for death from heart attacks or strokes. As well, it can lead to significant decreases in long-term cognitive functioning, as found in correlations between stressful lives and a later diagnosis of dementia. Stress is destructive. It should not be minimized. However, stress is an experience where a person maintains the ability to cope. With determination, social support, and resources to make changes to their diet, exercise, routine, schedule, or—most essentially—their way of thinking, stress can be managed. Sometimes a person may use coping skills they have practiced before, and other times they may learn new ways of coping. Trauma is different. It is an event or experience that is perceived as a threat to a person’s life or the life of someone they love. The threat is so great that the brain cannot process the event. The brain functions, and we feel well, when the rational part of the bran and the emotional part of the brain can be in conversation, helping us make sense of the world. However, trauma overwhelms the brain, altering how the brain works, essentially silencing the brain’s rational functioning and with it the ability to think or plan. The amygdala, the fight-flight response, is not meant to be in charge of day-to-day human experience. The emotional and the rational parts of the brain have evolved to be in conversation. Renowned trauma expert and author of The Body Keeps the Score, Bessel Van der Kolk’s (2015), research using brain scans have evidenced that in trauma, the rational and emotional parts of the brain are cut off, leaving one trapped in emotional and body-based reactions that they cannot think their way out of, and so without the ability to be “fully and securely in the present” (p. 73). He suggests trauma is akin to psychoanalyst William Niederland’s

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(1980) conceptualization of “soul murder . . . you lose track of who are, of what you are feeling, and of what and whom you can trust” (p. 136). Stress and trauma, though used interchangeable in everyday language, are clearly very different. Stress can be evidenced in brain scans too. However, in stress responses, one is in the present moment with accesses to all regions of the brain. In stress, one does not lose the ability to be fully human, more than a fight-flight response. In stress, one’s soul is not so readily at stake. Trauma can, but not does not always, result in posttraumatic stress disorder (PTSD). Factors that may increase the likelihood of experiencing PTSD include the severity of the trauma, repeated exposure to the trauma, and family history. The symptoms of PTSD can appear immediately after an event or might take years to develop. PTSD first appeared in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM III) published in the 1980s. The most current DSM, the DSM 5-TR (APA, 2022), specifies that PTSD is a mental health diagnosis that is given to clients who have experienced or witnessed events where death, was actual or threatened, or that involved serious injury or violence. This can include directly experiencing the event, witnessing the event, or indirectly experiencing the event by learning about a close relative or friend who was exposed to a trauma (APA, 2022) Additionally, according to the DSM 5-TR, a person must experience a number of trauma related symptoms that last over a month and cause significant impairment in functioning to meet the criteria for PTSD. This includes reexperiencing the trauma (through flashbacks, nightmares, etc.), avoidance of trauma related thoughts, feelings and/or reminders; increased disturbances thoughts and moods (negative thoughts and assumptions about oneself or the world, a sense of blame for the trauma, decreased interest in activities, feelings of isolation); and increased levels of arousal or reactivity (increased irritability, aggression, risky or destructive behavior, hypervigilance, a heightened startle reaction (see APA, 2022, pp. 271–272, for detailed diagnostic criteria). Complex Trauma In Trauma and Recovery, Judith Herman (1992) argued that a PTSD diagnosis is not sufficient in capturing the reality of trauma that is the result of enduring persistent stressors over a long period of time, or what has been identified in the field as “chronic trauma.” This type of trauma is not a one-time event such as a car crash, an armed robbery, or a domestic assault. It is enduring and persistent trauma that happens over months or years. Examples of complex trauma include living in a war zone, repeated childhood physical, sexual, and/ or emotional abuse from a caregiver, living in a violent community, systemic racism, and historical trauma. The trauma literature identifies such persistent

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traumatic exposure as resulting in complex trauma. Complex trauma, as its name suggests, can be more difficult to identify by the person experiencing it and by the clinician working with it, and thus can be more challenging to treat. Persistent exposure to extreme stress can result in difficulty controlling emotions, difficulty in developing and maintaining close relationships, disconnection from the traumatic narrative including a total lack of memory of it, a negative view of the self, and a loss of meaning in life. The DSM 5-TR does not identify complex trauma as different from PTSD, as evidence suggests that most people who would fit a clinical example of complex trauma also fit into the diagnostic category of PTSD. Clinicians working with complex trauma as PTSD do so often with the specifier Disorders of Extreme Stress Not Otherwise Specified or PTSD/DESNOS. However, in 2018 the World Health Organization’s most recent version of the International Statistical Classification of Diseases and Related Health Problems (OCD-11), did include complex trauma as a separate diagnosis, C-PTSD. In working with someone with complex trauma presentation versus a person with a one-time traumatic event, one may notice the challenges of the work. How do you integrate trauma with no memory? While the symptoms may be similar in presentation, the experience of complex trauma in clinical work and care can be confusing for both the client and clinician alike. Such confusion, of course, is not limited to clinical work. It is part of educational experiences, friendships, marriages, work experiences, and religious experiences alike. The more research that accumulates on complex trauma, the clearer it is that trauma-informed care is necessary in helping relationships. Clinicians and care workers may work with people who have no memory of trauma or who have a sense of detachment from the trauma, including oppositional children, children with attention deficits, adults with emotional regulation deficits, people with a persistent lack of meaning or extreme negative images of self, and people who forget or minimize their experiences of enduring persistent stressors over prolonged periods of time. They may not report experiences of trauma, or they may report them in ways that dismiss profound negative effects on their functioning. The challenge of recognizing the difference between stress and complex trauma is illuminated in the fictitious case of an 8-year-old girl adopted at the age of 2 by attentive and caring parents. Her family history prior to the adoption is unknown; however, there is suspicion of physical abuse in her birth family. The child presents with a number of concerning symptoms. She demonstrates outbursts in social relationships at school. She is aggressive on the playground. She is rage-filled when a child teased her. She struggles in her classwork, as it was hard for her to sit still in school. She cannot regulate

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her body in many social situations. Yet, there is not always a clear identifiable trigger to the outbursts. She hates loud noises. She hates chaos. She likes her home, especially her room. When she is unregulated, everyone around her knows it. In her unregulated moments, she has no concern for how others see her. Her parents as well as her teacher believe she might have attention deficit disorder or, perhaps, oppositional defiant disorder, or an autism spectrum disorder. She has symptoms that seem to match all three at times. But there is something more, and different, than any of these diagnoses in her presentation. She also is seemingly regulated at times. She demonstrates the ability to take turns playing board games. She has experiences of losing and winning well. She can express, at times, great love and affection toward her family. She has moments that her parents can recall of extreme thoughtfulness and kindness. She can draw cards and bring little gifts to her parents. She can be thoughtful and connected. While the positive experiences stand out as examples of how she can regulate, her parents cannot help her think or act differently in what they considered high-stress situations. To see this child is to see the difference between stress and trauma. While the child has no memory of trauma, nor do her parents have any confirmed narrative of abuse that was experienced from birth to two years of age, somewhere in her 8-year-old mind and body there is a story of complex trauma being told. The most skilled parents or educators couldn’t teach her to think or act differently. What she needs is not cognitive learning alone. She needs to feel different in her body. She needs her brain to work in ways that allowed her to self-regulate and cope. However, trauma alters her access to regions of her brain that would allow her to do so. In times that her parents and teacher label as stressful moments, her brain is signaling trauma and treating the situation as such. To her brain, incidents are more than “stressful moments”; they are life and death as understood by her brain. So then her body reacts accordingly. THE TRAUMA BRAIN While a detailed explanation of the brain is beyond the scope of this book chapter, there are some very basic understandings necessary to understand that help to articulate the way the brain holds trauma. Briefly, the brain is one organ with separate regions that are uniquely responsible for different components of being human. The very front of the brain is the prefrontal cortex. It is the rational part of the brain, used for cognitive processes such as thinking, analyzing, and reasoning. The prefrontal cortex is active in the process of regulating emotions, self-control, and executive functioning. The amygdala

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is where a person’s fight-or-flight response lives. It is the instinctual part of the brain that works to keep a person to stay alive when there is an actual, or perceived, threat. The medial prefrontal cortex, or the middle brain, allows the rational brain to connect to the emotional brain. Only though this connection does self-awareness exist. It is here that a person can identify and make sense of their different emotional states. The final region of the brain, the hippocampus, is the part of the brain where memory is stored, and so allows a person to distinguish between past and present experiences (Bremner, 2006). All parts of the brain are necessary for learning, living, and loving fully in the present moment. When the brain works together, indicators of well-being are possible: academic achievement, new learning, building and maintaining social relationships, an ability to be present in the moment, and narrative cohesion. Healthy brains that develop through primary social relationships allow people to have warm, close relationships, feel safe in their bodies, and quiet space in the minds. They are neither over- nor underactivated. They have access to a broad range of emotions such as happiness, joy, sadness, loneliness, and anger. Healthy brains can tolerate the rise and fall of the emotional experience. Well-functioning brains can regulate emotions so that anger does not become rage. When the brain is working well, the body works well too. Research indicates that when the brain has balanced levels of stress hormones such as adrenaline and norepinephrine, then immune systems are healthy, able to fight off illness and disease (Dube et al., 2009). The trauma brain works very differently. The mind has a natural, normal, and protective instinct to pull away from psychological trauma when confronted with such events. During a traumatic event, the amygdala triggers the fight-flight response. From an evolutionary perspective, this instinctual response is very helpful, for example, when our ancestors were hunting for food and trying to not be hunted. When the amygdala takes over, there is the experience of jumping into action before rationally processing an event. In order for the amygdala to gain control, the middle part of the brain—the part that allows the rational brain and the emotional brain to communicate—shuts down. After all, there is no time, or need, for self-awareness and emotional regulation when one is running from a lion. There is only the need to run fast. However, once the traumatic experience is over, the brain does not simply return to normal functioning. After the experience is over, the brain may register aspects of the past threat experience as current threat. If the amygdala continues to perceive threat, then, in less than a second, as psychologist Daniel Goleman (1995) described, the amygdala will “hijack” the rest of the brain, rendering it useless. Over time, amygdala hijacking becomes a neurological reflex that happens without a person’s awareness or control, and that will strengthen over time. Without intervention the trauma brain will get better at alienating the self.

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Additionally, traumatic memory is stored in different, fragmented locations in the brain. Traumatic sights, sounds, and smells will all be activated; yet, with no access to rational memory, they may be experienced as present events, not past. Without help from the middle brain, the rational brain and the emotional brain will not be able to communicate, leaving memory and emotion separated, and traumatic responses will continue. The once-normal instinct to separate the emotional and rational brain for self-preservation is now no longer protective but debilitating, as the disjointed brain disables a person’s ability to sense or trust themselves, and leaves them without executive functioning capabilities. A person can’t simply talk themselves out of the trauma response, leaving a persistent and overwhelming feeling of being ungrounded and at risk of danger or peril. Bessel Van der Kolk (2015) suggests: Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become experts at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from themselves. (p. 97)

Without brain regions functioning together, there can be evidence of a lack of well-being. This includes decreased academic achievement; a decreased number of, and closeness in, social relationships; a restricted range of emotions; an inability to be present in the moment; and a lack of a sense of narrative cohesion—the idea that a person has a life story. Unhealthy brains leave people feeling distant and uneasy in close relationships, unsafe in their bodies, and with constant noise in the mind. They may have overactive reactions such as a flight response, or underactive reactions, such as frozen responses. A major negative consequence of this is an experience of disengagement, numbness, and alienation from the self and the world. Symptoms of disengagement may show up in a narrowing of existence, as a person may experience pervasive avoidance of places, people, and thoughts, a sense of numbness, and shifts in moods (APA, 2022). Research suggests that, in the trauma brain, when stress hormones rise in reaction to fear responses, they stay elevated long after the fear is removed, and they take longer to fall to a baseline when fear is removed (Bremner, 2006). This can have a negative effect on physical health as well. Elevated levels of stress hormones can negatively affect a person’s autoimmune system, gastrointestinal functioning, and the functioning of major organs (Dube et al., 2009). New research provides evidence that trauma experienced in early childhood can lead the brain to age faster (Colich et al., 2020). The research on trauma and the brain can be challenging to read. It suggests that, without treatment, trauma will remain trapped in a person’s body.

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While this is true, becoming more informed about the trauma brain can have significant, positive implications for the pastoral and spiritual care provider. An understanding of trauma might allow a person to reconsider programs, pedagogy, and curricula through the lens of trauma. It might change the questions a caretaker asks and the responses one might expect to hear. It might encourage referrals for a different form of care. It might change how a caretaker sees, and so receives, another. In regards to traumatic growth, the literature on trauma and the brain suggests that even if the caretaker wanted to ignore the trauma and only speak of growth, even if one’s goal was—misguided as this would be—to reframe night as positive or good, the trauma brain will not allow it. Trauma and the trauma brain will always be negative. The body will continue to respond from a trauma brain until a non-trauma world can be experienced. TRAUMA AND THE ASSUMPTIVE WORLD Human beings are relational beings. Relationships are not just something nice in a person’s life—they are necessary. The psychological literature on attachment theory articulates how early primary relationships relate to the development of internal models that help to determine how a person learns to relate to others, how they feel in relationships, how they learn and grow, and thus how the very basic assumptions of the self, others, and the world are formed. Imagine a newborn baby. Imagine their tiny being. In envisioning this small, new person, one recognizes how dependent we are on another for survival. Infants cannot eat, stay clean, remain warm, move, or soothe themselves. Infants survive only because of relationships. However, infants thrive because of a particular kind of relationship. Bodies and brains begin developing before a person takes their first breath. If the biological mother eats well, avoids harmful chemicals, has minimal stress, and engages in activities that support well-being, bodies and brains most often develop in healthy ways. Once a child is born, a loving relationship is the lynchpin to healthy development. Psychologists John Bowlby (1969/1983) and Mary Ainsworth (1978) were the first to suggest that internal working models of the self, which include a sense of security in the world and one’s ability to regulate emotional self-states, are formed and developed in relationship to a primary caregiver, most often a mother. When a child is born, they slowly recognize their existence through relationships. If the primary caregiver responds to the child’s cues appropriately, the child begins to recognize predictability, care, responsiveness, and safety in their world. Can a caregiver recognize the difference between cries for hunger, fatigue, cuddles, playing, and discomfort? Does the caregiver make the child feel good through

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signs of affection and nurture? If the caregiver is psychologically and physically available to the infant and responds in predictably loving ways, then a child develops a secure attachment style. This means that eventually a child will be able to separate from their caregiver with minimal distress, feel internally organized in the caregiver’s absence, and when the caregiver returns the child can reunite in a warm and affectionate way. They will be able to explore their world without the presence of their primary attachment figure because they have formed, through their primary relations, a secure base to draw from. The world is safe, the self is organized, and the child’s caregiver will respond when needed. Why would they not explore the world and slowly build autonomy? Attachment theorist Mary Ainsworth (1978) developed a noteworthy exercise called the “Strange Situation.” In her experiment, Ainsworth studied how young children, when left by their caregivers in a waiting room with a stranger, reacted both immediately after the caregiver left, and then again when the caregiver returned. The experiment, which took place at John Hopkins University in Baltimore, Maryland, helped to provide data to identify and clarify how a child’s internal world is developed in relationship with the caregiver. By studying the ways that children responded in the "Strange Situation" relative to the relationship between the caregiver and child, a pattern of attachment styles emerged. This gave attachment researchers evidence to support the psychological importance of a present, consistent, loving primary attachment, and the enduring effect it has on a person’s ability to feel safe in relationships and in the world. When a child has a healthy primary attachment with their caregiver, they feel worried for a short period when the caregiver leaves, are able to seek and receive comfort and affection from the caregiver, and continue to play independently after reunification. Research also suggests that long after a primary caregiver is no longer present, we carry with us the story of our primary relationship with love. Furthermore, relationships continue to support well-being as we grow, beyond the early development years. Positive social relationships provide space to process life events, connect a person to the world, and are predictors of life outcomes such as longevity, physical well-being, and mental health. Relationships are not just nice to have, they are necessary to live and love fully in this world. When relationships underperform, are weak, or worse yet are physically or emotionally abusive, there are significant negative effects on the formation of future relationships, and on a person’s assumptions about the world. Sadly, people possess the capacity to destroy each other. A person can negate pieces and parts of another, either slowly—as seen through unavailable primary attachments from enduring years of adverse childhood experiences such as neglect and abuse—or all at once in one traumatic life event. A person can

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demolish another’s life before they have a known identity. Before one can crawl, speak, walk, or chew, a relationship can destroy human capacities to contain negative emotions, desires to wonder and wander, and abilities to feel trust in one’s emotional states and the physical world. Emerging studies on intergenerational trauma and epigenetics suggest that parents’ exposure to environmental stressors may result in lasting changes in DNA that will be passed down to future generations in utero (Yehuda & Lehrner, 2018). So then, even before one is a potential zygote, the environment of one’s parents matters to the formation of oneself and one’s assumptive world. Early relationships can leave a person feeling like a foreigner in their body, far removed from parts of their mind, and fearful of their world. Through neglect, unresponsiveness, and the cruel presence of another person, one’s ability to have a fully developed, stable sense of self can be destroyed, as is often seen in people with borderline personality disorder. One may have a restricted range of emotions that feel safe and may learn to feel uncertain in the world, challenged in regulating emotions, fearful of exploration, and uncertain of play. Long after a caregiver is no longer present, the person carries with them the story of adverse childhood relationships and insecure attachment. A person may fail to thrive because of a particular kind of relationship. Drawing again on attachment theory and research, if the primary caregiver cannot respond to the child’s cues appropriately, then the child begins to recognize the lack of safety of the environment. If the caregiver is psychologically and physically unavailable to the infant and responds in unpredictable and unloving ways, then a child develops an insecure attachment style. They are unable to separate from their caregiver without distress, and feel internally disorganized, and when a caregiver returns they cannot reunite in a warm or affectionate way. They are unable to explore their world because they have an insecure base from which they draw on. The child responds anxiously as they cling to the caregiver, or is avoidant, dismissing the caregiver. Both forms of attachment later translate to an inability to freely explore one’s surroundings. The child learns that the world is not a safe place and that people are not predictable, kind, helpful, or loving. In the “Strange Situation” experiment discussed above, Ainsworth (1978) discovered that children who did not have a consistent loving caregiver, or who experienced significant disruptions in caregivers in their early lives, were either not able to seek out, or not able to receive, comfort from their caregiver. It is not the number of toys a child has, their socio-economic status, or the number of vacations they experience that leads to basic assumptions of worth and feelings of safety in the world. What is of consequence when it comes to secure attachment is the presence of a consistent loving, responsive, and secure caretaker. It is not necessarily the amount of interaction a caretaker

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has with the child that matters. Rather, it is the quality of the interaction that shapes the child’s world. To live, to love, to be alive, to explore, to try new things, and to go to new places, they must feel safe in their bodies to do so. A large part of feeling safe is the predictability of the world. This predictability allows us to form our basic life assumptions. The assumptions that a person has formed about the self, others, and the world is not something one might reflect upon when life feels okay. However, in times of distress, they become evident. In her book Shattered Assumptions, Janoff-Bulman (1992) describes the idea that each person must hold three fundamental life assumptions in order to function well: (1) the world is benevolent (e.g., the world is a good place full of people who are good, kind, and caring); (2) the world is meaningful (e.g., things that happen to people make sense; they happen for a reason); (3) the self is worthy (e.g., I am a good person). When the world is benevolent, one is surrounded by a safe environment filled with people who are loving and kind. When the world is meaningful, one feels order and a sense that one’s actions have consequences, experiences are predictable, and the world is not random. There is a meaning to existence. When the self is worthy, a person feels that they matter. They are good. They are worthy of life and love. For the spiritual person, these basic life assumptions may translate into the ideas that God is good and that they are a holy and sacred being. Without such basic life assumptions, well-being and normal development are compromised. Janoff-Bulman goes on to suggest that trauma destroys the basic life assumptions of safety, benevolence, and worth. Such assumptions are shattered or erased. If God is good, why would He let wildfires destroy a community? If life is good, why would a person have cancer? If people are holy and lovable and good, why would a person be abused? Trauma creates a pre-trauma assumption of the world and a posttraumatic experience of the world. There is life before the trauma and life after the trauma. The two can only be reconciled by either denying the existence of goodness or denying the trauma. When trauma happens in early childhood, or when one is born into a systematically oppressed culture, the fundamental assumptions about the goodness of the world may never form. The world has always been unjust, so then there is a risk that the self will be internalized as always having been unworthy, unlovable, unholy, or bad. People who have experienced a traumatic event, or for those who experience complex trauma because of multiple adverse childhood events, intervention is needed. The passage of time is not sufficient to provide relief from trauma reactions. Deeply painful, horrific life events do not go away; they go deep into people’s bodies and brains. Without intervention, life is filtered through a trauma brain. Without intervention, losses are multiplied and

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suffering is exponentially compounded. With trauma interventions, a different way of being in the world is possible. TRAUMA INTERVENTIONS Trauma unbalances human relationships with the self, with others, and with the world. The goal in trauma work is to reunite a person with the ability to tolerate their emotional self-states, increase awareness of the self-states, and neurologically to get the middle region of the brain to connect the rational and emotional brain again. Trauma work attempts to re-engage a person to life and connect a person to their internal world—perhaps, for some, for the first time. Trauma work involves helping the brain and the body realize that the trauma lives in the past (Van der Kolk, 2015). Perhaps it goes without saying (but it’s still worth saying) that every intervention must be client- and case-specific. Trauma interventions are not one-size-fits-all. Also, many trauma interventions are reserved for mental health professionals with specialized training and supervision. Some require certification. However, if working in pastoral care settings, knowing the language of trauma work is important. What follows are some of the interventions that are important to know. Prolonged Exposure (PE) Therapy Prolonged exposure (PE) therapy is an evidence-based treatment for treating PTSD that was developed by Edna Foa, PhD. The intervention is based on emotional processing theory (Foa & Kozack, 1986). Research provides evidence to support that, if a person can emotionally process the traumatic memory, PTSD symptoms will diminish. By learning to gradually tolerate increased exposure to traumatic memories, new learning can happen that will allow a person to desensitize the traumatic material. The theory suggests that trauma results in fear associations that can be weakened through habituating to the experience and by replacing fear associations with adaptive associations. The intervention includes psychoeducation about trauma; training clients to breathe calmly; real time, “in vivo” exposure to objects and places associated to trauma; and repeated “imaginal exposure,” a process by which a person imagines the traumatic memory (Foa et al., 2007).

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Eye Movement Desensitization and Reprocessing (EMDR) Developed by Francine Shapiro in 1987, EMDR is an empirically supported trauma intervention that suggests that rapid bilateral eye movements can help a person’s brain to integrate traumatic memories (Shapiro, 2018). It is based on the Adaptive Information Processing Model that suggests the need for the reconsolidation of traumatic memory. By following a therapist’s finger or another object as it moves back and forth and asking a person to bring up the distressing memory in the mind, a person can access the traumatic memory and stimulate a processing system that then allows them to store a new, altered memory of the trauma that does not cause negative or dysfunctional reactions (Shapiro, 2018). Research has suggested that the eye movements highlight the part of the brain called the interior singlet. This is a nonconscious part of the brain that allows a person to focus on relevant information. Research suggests that EMDR can reduce PTSD symptoms in as little as one session. EMDR must be implemented by a trained therapist. Internal Family Systems (IFS) Therapy IFS was developed by Richard Schwartz, a trained family therapist. The theory postulates that the self is composed of eight Cs: compassion, curiosity, clarity, creativity, calm, confidence, courage, and connectedness. There are three parts of the self that are distinct mental systems, much like a family is made up of distinct people. Exiles are the younger, emotional, vulnerable part of the self that hold the memory of unprocessed trauma. Managers are the part of the self that keeps a person going. Firefighters are an extreme version of the manager that may take over if they feel the manager is unable to protect the exile. In this way, the manager and firefighter together help “protect” a client from the pain of exile. There is evidence to support the use of IFS when treating complex trauma by helping the parts of the self to harmonize in their roles. This happens when internal conflict with the parts of the self can be resolved and the traumatic memory can be processed in a way that does not retraumatize the client (Anderson et al., 2017; Schwartz, 2023). Emotion Focused Therapy for Trauma (EFTT) Developed by Paivio and Pascual-Leone (2010), EFTT is an integrative approach to treating complex trauma that is grounded in an emphasis on affective processes, meaning, and meaning construction, as well as attachment theories and the understanding of the centrality of healthy relationships in healthy human development. It is a semi-structured intervention that is

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completed in 16 to 20 sessions. Paivio and Pascual-Leone (2010) suggest that change happens when a therapist can provide a safe, empathetic therapeutic relationship and when clients identify strong emotional reaction to trauma imagery, identify processing difficulties related to emotions, and resolve unresolved issues with key people, usually attachment figures in childhood (Paivio & Pascual-Leone, 2010). Somatic Experiencing Developed by Peter Levine, somatic experiencing is a body-based form of therapy to treat trauma. Levine’s interest is what happens in the body when trauma is experienced. He suggests that the body contracts, and sometimes collapses. So then, the key to the work is becoming aware of internal sensations and then renegotiating the experience. He suggests that talking about trauma alone will be an unsuccessful intervention. Rather, one needs to find new experiences in the body that contradict the experiences of contracting and collapsing. This involves revisiting the body’s memories of the trauma (Levine; 1997; 2010). Yoga and Meditation There are a number of interventions that are non-traditional, non-talk therapies. Based on what is known about the trauma brain, such alternative therapies have great support. Each of the interventions are aimed at rewiring the brain. Support for non-talk therapy has increased as more neurological studies support the need to rewire the brain and the body-brain connection. For instance, Van der Kolk’s (2015) research on yoga practice found that yoga worked better than drugs as an intervention to treat highly traumatized patients. It was suggested that yoga is useful to trauma survivors as it can improve heart rate variability (a measure of the balance between the sympathetic and parasympathetic nervous systems), allow a person to gain awareness of sensations in their body, and increase emotional regulation. Methylenedioxy-Methamphetamine (MDMA) There is emerging research on the use of the synthetic drug MDMA, commonly known as the recreational drug Ecstasy, in the treatment for trauma. Research suggests that, in a controlled treatment environment, and as part of psychotherapy treatment, MDMA may be useful in treating severe PTSD and PTSD with a dissociative subtype. In 2017, the FDA gave the treatment breakthrough status. As research on safety and efficacy builds, the treatment will likely expand.

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A PLACE FOR POSTTRAUMATIC GROWTH As dark and destructive as trauma is, for some people, with the correct intervention and the compassionate presence of a skilled clinician, trauma can live in a person’s past. Trauma work can help a person emotionally regulate, gain access to fragmented memory, have narrative cohesion in their life story, feel in control, hold a sense of predictability in a benevolent world, believe that life is meaningful, and feel their self-worth. The work of many of the interventions above come from the medical model. The goal is the reduction of negative symptoms and a return to what is called a “baseline level of functioning.” Research suggests that, for some people, a return to a baseline level of functioning may not be possible. Interventions that exist to date have not proven successful for everyone. It may be that the trauma is complex—the memories are too fragmented, frightening, or inaccessible. In the case of trauma from multiple adverse childhood experiences, a baseline level of functioning may have never fully formed, making it more challenging to claim. Without ever experiencing a pre-trauma world, some find that the hope of a post-trauma world can feel illusionary at best. How does one claim a post-trauma self when there was no fully formed pre-trauma self? The reality that current interventions do not work for some people is hard for many professional listeners. We want to believe that all people can “get better.” If one is to work in the area of trauma and suffering, one must recognize that some people are held captive by the night. For a second group of people, a return to baseline is possible. Interventions work. The trauma reactions stop. Hypervigilance, flashbacks, and fear responses to benign objects and experiences are extinguished. Trauma is a storm that causes a person’s neurological flood waters to rise and flow uncontrollably. Intervention stops the water, helps find a place for it to safely flow, and so the flood subsides. The trauma narrative has cohesion, a beginning, a middle, and an end. A self is restored. There is a post-trauma world that is benevolent and meaningful, with a self that is capable of being present in life, of being secure in relationships, and of feeling joy, love, and worth. This is the goal of trauma work. Clients do not return to a narrative that erases trauma. Yet, they claim a narrative where the traumatic parts of their story do not fill all the pages of their life. For this group, the night ends. The research on posttraumatic growth identifies a third group of people for whom something more than a baseline level of functioning may be possible. As a person moves through their night, they come to discover pieces that are new, relationships that are improved, and ‌‌‌‌‌‌philosophies or understandings about life and living that are different and positive. This something “more” is

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understood as posttraumatic growth. For this group the night ends, just as it does for the second group. Yet for this third group, in their night experience they find that a part of themselves starts to bloom. They have come to see themselves, others, or the world in a way that is stronger, wiser, deeper, or more brilliant than they had known before. They have a new vantage point, a new perspective, a new experience of witnessing a paradox that is intrinsically good. Posttraumatic growth is not about ignoring the night at all. Without the night there would be no bloom. Yet it is not about glorifying or reframing the night either. It is about recognizing that the night creates a place that is painful and destructive. Moving through it is the goal. As people do, some come to witness something limited and beautiful, that leaves them reoriented to how they live, how they love, how they experience loss, and maybe even how they die. Surely, all rational people would give up the experience of witnessing the extraordinary paradox that is the night bloom (Werdel, 2014), if they could forgo the night. A night bloom is not enough to make up for the significant losses associated with trauma. Yet, without a swap to be made, the work of the professional caretaker is to understand the paradox of trauma and growth in order to increase the change of noticing a rare night bloom.

Chapter 2

The Paradox of Trauma and Growth

Paradoxes bring together two ideas that appear, at first, to be contradictory to logical thinking. Yet, when antithetical concepts are considered within a whole statement, the illogical thinking is determined to be quite logical and even profound. A paradox can convey a truth that is not possible to express without incongruent forces. Paradoxical statements use opposing, boundaried ideas that, when reasonably considered, exclude each other, and yet presented together express wisdom. If there were a way to express the meaning in a paradoxical statement differently, it would be done. However, the peculiar reality of a paradox is that only the seemingly illogical contradiction holds the ability to express a deeper truth. Depending on the paradox, it might be confusing to understand, and perhaps even harder to experience. Literature, nature, and philosophy alike provide paradoxes to consider. Take, for example, the infamous adage that is often attributed to the Irish playwright George Bernard Shaw: “Youth is wasted on the young.” At first, one can see how this statement is illogical. Youth is, by definition, a state of being young. How could youth ever be experienced by a person of another developmental period? Youth only can be possessed by the young. However, the paradox suggests that being youthful is a special and rare experience in life. Young people often have excess energy, enthusiasm, wonder, and a sense of awe. Yet, by nature of being young, by lack of experience in life, many in their youth lack the perspective and understanding that come with age. If older people had both the life experience that comes with age and the energy of youth, everyone would benefit. Likewise, consider the Zen Buddhist aphorism on death that suggests: “If you die before you die, then when you die you will not die.” A similar idea has been attributed to the Sufi poet Rumi, who suggested: “Die before you die.” It is a contradictory, illogical idea when considered at first. How could one ever die before they die? Physical death is irreversible and permanent. Death 19

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is the state of the end of life. Where one begins, the other ends. Once one has reached death, another death in life is not possible. Yet, the idea expresses a logical thought process as well that reveals a sense of deep wisdom. If a person lives life with a sense of imagining, considering, and confronting their unique and individual mortality, when death comes it will not be the same experience and might even lose some of its “deathness.” If a person commits to die before they die, they may then live with a sense of totality and fullness of life in the present moment, such that when death comes, it doesn’t feel like a permanent experience—it is the experience of the moment. The present moment is all one ever has or can really know. This immediacy of living in the moment is, of course, truth. There is only one now. If one tries to live in the future, or with an avoidance or denial of death, one creates a sense of suffering. With death, the non-essential things in life lose power and the essential things in life are illuminated. When a person “dies before they die,” they reorient themselves to life in the here and now. In all the moments up until, and even including the death moment, a person continues to live in the present. In this way, a person lives their death rather than dying their death. There is a cognitive tension suggested in paradoxes that is the result of holding two opposing views at the same time as truth. There is cognitive dissonance created when an illogical thought is presented as logical. It is paramount to a mental attempt to fit a square peg into a round hole. It will be impossible. A life without paradoxes is cognitively simpler. Yet, if one can tolerate the cognitive tension that is created, the unique space that one can come to know and experience by embracing a paradox presents life in more layers. Knowing how profoundly negative trauma is, it can feel blasphemous to speak of the paradox of trauma and growth. How can one imagine anything positive associated with something as harmful as trauma? At first, the idea of connecting trauma and growth may not only seem illogical, but perhaps even delusional, ignorant, or naive. Furthermore, it can be dangerous to place trauma and growth together in a simplified way. If the paradoxical nature of the relationship is crude or misunderstood, the connection of trauma and growth will have serious negative consequences on a person’s emotional well-being, their spiritual life, and their ethical care. Growth, especially spiritual or moral growth, has a history of being used to justify human suffering. Take, for example, the history of the justification of physical and emotional abuse of children. Not long ago, corporal punishment was the normative and acceptable style of parenting in the United States. Hitting, whipping, beating, slapping, and shaming were at one point in time in the U.S., and still now in many countries around the world, considered appropriate. The aphorism “spare the rod, spoil the child,” with its related Christian Biblical reference, has been used to encourage the practice of the

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physical discipline of children. Alice Miller’s (1980) seminal work, For Your Own Good: Hidden Cruelty in Child-Rearing and the Roots of Violence, outlines clearly the destructive, enduring effects of the physical abuse of children in the name of parenting. Hurt children grow up to be hurt adults who have learned to reframe and even dissociate from violent acts they witness or commit. In therapy, some clients who express feelings of being chronically misunderstood, unsafe, angry, withdrawn, isolated, lonely, or empty as adults, describe childhood traumatic abuse by parents as “good,” as the very reason they have positive attributes, or even as signs of deep parental love. It should be clear that there is no accurate reframe for trauma. As chapter 1 outlined, a person’s body and brain will live out negative trauma reactions that will hinder their ability to be in secure relations, to believe in a meaningful and benevolent world, and to feel a sense of self-worth that is necessary for well-being. Trauma will lock away people, places, sounds, and smells in fragments, leaving one a prisoner in one’s own body, reactively experiencing states of hyperarousal, hypersensitivity, anger, rage, dissociation, and fear. A person’s ability to self-regulate and to form a sense of narrative cohesion is compromised. People lose childhoods, homes, education, employment, sleep, finances, a sense of safety, an ability to trust, and their personal identity. If trauma is not successfully treated, negative symptoms often endure and may even be passed down to future generations. Even with proper diagnosis and intervention, some people’s suffering persists. A person in a significant life relationship with someone who experienced trauma is negatively affected as well, even if they were not in relationship with the person when the traumatic event was experienced. Traumatic grief and loss may consume individuals, communities, and generations. Simply put, the best world is the world without trauma. Still, there is another seemingly illogical truth that suggests, for some, that trauma reveals itself to be a paradox. For some, the profoundly negative experiences of trauma and intrinsically positive experiences of growth not only coexist but also relate. To understand the paradox, one needs to look beyond the polarity of positive and negative emotions and look at their relationship. Understanding the area of positive psychology, positive psychology 2.0, and the unique way that positive emotions work, can keep one from slipping into the cognitively easier mental task of reframing trauma as growth, and keep connected to the harder task of finding the wisdom in the relationship between trauma and growth.

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POSITIVE PSYCHOLOGY Traditional psychology is rooted in the medical model that treats disease. Its focus is on negative symptoms, on the things that are going wrong in a person’s life. The goal of this model is to examine and repair what is ill so that one can become less ill, or well (as defined by being “not ill”). Positive emotions do exist in traditional psychology, as they suggest that negative symptoms, while present in some form, are not causing a disordered way of thinking or feeling. However, the focus of traditional psychology and its connected interventions is negative emotional phenomena. Positive psychology is different from traditional psychological theories. The positive psychology movement was named by Martin Seligman, past president of the American Psychological Association, in his 1998 presidential address. Dr. Seligman encouraged a new line of scientific inquiry, a theoretical shift to focus on building upon what is strong, not fixing what is broken. His definition of positive psychology did not suggest that negative emotions do not exist or should be ignored, but rather something is lost when the sole focus is on the medical model. Seligman (1999) suggested, Medication or the technique of therapy holds as much promise for serving as a buffer against mental illness as does human strength. But psychology’s focus on the negative has left us knowing too little about the many instances of growth, mastery, drive, and character building that can develop out of painful life events. (p. 560)

He went on to call the field of psychology to turn its focus beyond negative symptoms and toward questions that would bring insight into how human beings flourish. The shift to human thriving suggested the important implications of questions not asked by psychology before: How does one live their best life? How does one develop character strengths of happiness, gratitude, forgiveness, joy, and meaning? How does one flourish, promote human goodness, and experience excellence? How does one not merely feel good, as suggested by a hedonic understanding of well-being, but rather, how does one live “the good life?” What is the role of positive emotions? What importance do religious and spiritual factors have on the development of a sense of purpose in life? Can one become resilient to stress? And if confronted with painful life experiences, can one grow? Positive psychology suggests that the study or questioning of such themes need not be ancillary to traditional psychology. Positive emotions are core elements of being a person and thus are core elements of psychology too. Some people wrongly believe that positive psychology is solely the study of happiness. While it is true that the study of a certain form of happiness would

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fall under the area of positive psychology, the field is far broader than this. Thankfully so, since if it were simply the study of happiness there would be no connection to the field of trauma, as happiness decreases significantly with trauma (Krause et al., 2017). The goal of positive psychology is to find and encourage areas of growth and flourishing that allow a person to live with meaning, purpose, hope, and a sense of happiness. Building upon strengths and generating positive emotions aid in repairing and even preventing negative emotional experiences. Positive psychology is a movement that asks people to take a giant step backward from the focal point of traditional psychology and to see a broader perspective of the human story that is interested in more than diagnosis and decreasing negative symptoms. Positive psychology presents a balanced picture of the human narrative (Maddux et al., 2004)—a fuller picture. It suggests that when you only ask questions about what is going wrong in a person’s life, you will never clearly understand what is going right, limiting the potential to prevent stressful experiences through the development of factors that buffer stress, and the potential to develop interventions to promote flourishing when possible. As a professional listener, you can ask many types of questions: open-ended questions such as “Tell me about your childhood,” negatively skewed questions such as “Tell me what was hard about your childhood,” or positively skewed questions such as “Tell me what was good about being a child.” Sometimes open-ended questions lead people to recollect positive experiences. However, research suggests that people are primed to consider negative emotions, so even when a professional listener asks positively skewed questions, chances are they will hear mostly negative emotions and negative experiences. So then, the exploration of positive emotions must be intentional. Without intentionality on positive emotions, one will often end up down a rabbit hole of negative emotions, as psychological researcher Barbara Fredrickson’s (2001) work on positive emotions, the broaden-and-build theory, suggested. Fredrickson’s research was transformational, as it clearly articulated how positive emotions work in very different ways than negative emotions. Negative emotions are evolutionary. They exist to protect survival by limiting the focus of attention on only that which is necessary for survival. Negative emotions create a sense of tunnel vision. One limits one’s peripheral perspective of life experience, hyper-focusing on the negative aspects of life. However, positive emotions work quite differently. Rather than limit one’s vision, they broaden one’s vision. Creativity, exploration, play, and taking in new information, for example, are all processes that are supported and stimulated by positive emotions. Positive emotions turn out to be mechanisms for individual growth as they broaden one’s perspective, which then results

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in the building of new, and helpful, psychological resources (Fredrickson, 2001). Furthermore, research suggests that new psychological resources claimed through positive emotional experiences endure over time. So then, tapping into positive emotions can assist a person not only in the moment of experiencing these emotions, but long after. Feelings of happiness, joy, and gratitude, experienced in fleeting life moments such as social celebrations with close friends, expressions of love from family, or connections to community through service projects, can be called upon by a person in subsequent difficult times to protect a person from negative experiences such as depression and despair. A number of research studies support the above connections. For example, Fredrickson et al. (2003), in a study of college students before and after the 9/11 terrorist attacks in the United States, found that positive emotions experienced prior to an adverse life event can buffer people from experiencing depression post-trauma. Likewise, in a series of three studies by Ong et al. (2006), examining naturally occurring daily stressors in a sample of recently bereaved widows, daily positive emotions were found to buffer reactions to stress and helped people recover from stressful life experiences. Positive emotions were both protective against feeling the depth of stressful reactions, and helped make the stress that did still exist dissipate quicker. The field of positive psychology made great movement in developing a broader understanding of what it means to be human. It allowed insight into how growth and flourishing are not achieved by the absence of negative emotions, but rather formed and encouraged in unique ways that lead to different outcomes. Furthermore, ignoring positive emotions risks decreasing one’s understanding of the human experience, and potentially restricts the human experience, as positive emotions can be called on at a later time to aid in adverse life experiences. Positive psychology revealed that growth is real, that supporting and encouraging growth matters, and that doing so may even help one ward off a psychological night. POSITIVE PSYCHOLOGY 2.0 Positive psychology has not been accepted without critique, even from within the positive psychology community itself. Some voices have suggested that while positive psychology is useful in providing a more balanced approach to psychology, the dichotomy of traditional psychology versus positive psychology is too dualistic and still not nuanced enough. There is an even more balanced approach to understanding psychology than that provided by the 1998 positive psychology movement. The original movement lacks a complex understanding of the relationship between positive and negative emotions,

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and by extension the potential for paradoxical understandings, and by extension truth and wisdom. In the dualistic approach that positive psychology takes, positive emotions such as happiness may be glorified in such a way that people seek it and strive for it, and when they are not experiencing it as a constant state, they may feel more readily depressed. In such a scenario, the pursuit of happiness may become a deeply joyless experience. Recently, some positive psychologists have moved their focus away from the dichotomy of positive and negative emotions and more closely on the relationship between the two phenomena (Lomas & Ivtzan, 2016). An argument can be made that if positive psychology is only looking at what is going right, it is no longer a true exploration of the full picture of the human experience similarly to only examining what is going wrong. It is merely looking at the other side of the coin and still not an exploration of the whole coin. If one only considers one side of a coin at a time, do they not miss the true meaning of the coin in its fullness? To borrow from phenomenological reasoning, it is the “coinness” of the coin, its essence, that must be understood. Examining its parts, and never their relationship to the whole, will result in loss. It is the relationship between the positive and negative emotions that provides the fullest picture of human experience and truly moves the field away from the dualistic thinking of the medical model versus the positive psychological model. Clinically, how can one ever understand a human being if one does not understand positive emotions, negative emotions, and the ways they relate to each other in human experience—the way they fight, play, encourage, discourage, and grow with each other? There is loss related in looking only at one side of the human experience at a time. There is something more to understand by knowing how both strength and illness coexist, co-relate, and co-create meaning. Second-wave positive psychology (SWPP) (Ivtzan et al., 2015; Lomas & Ivtzan, 2016), or positive psychology 2.0 (Wong, 2011), is an emerging response to the potential dangers of dichotomizing phenomena as positive or negative, and so missing the relationship between both positive and negative emotions and states that contribute to well-being. Tim Lomas (2016), a leading voice in SWPP, writes: SWPP recognizes that flourishing . . . involves a complex balance, a subtle, dialectical interplay between ostensibly positive and negative phenomena . . . while this recognition may have been implicit in the first wave of the field, SWPP involves making it explicit. (p. 3)

SWPP suggests that there is a dialectical process between positive and negative emotions, one that cannot be understood through a dichotomy of “good” and “bad” emotional states. As argued by Lomas and Ivtzan (2016), at times

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positive emotional states such as optimism can both encourage and discourage well-being. Likewise, the negative emotional state of anxiety can be protective. Lomas and Ivtzan’s argument for the nature of well-being is rooted in four dialectical principles: • The Principle of Appraisal: One cannot judge a phenomenon that contributes to an experience of well-being as good or bad without context; • The Principle of Co-Valence: Emotional states that are at first considered polarities reveal themselves to be blendings of light and dark; • The Principle of Complementarity: Positive and negative aspects of living are dependent upon each other in the phenomenon of well-being; and • The Principle of Evolution: Phenomena evolve through thesis-antithesissynthesis, a process taken from German philosopher Hegel’s (1812) understanding that first one argues a point, then one argues the counterpoint, then one synthesizes the two together to reach new understanding. (Lomas, 2016; Lomas & Ivtzan, 2016, p. 1756–1757) Together the principles suggest that positive and negative experiences are not easily separated, as they are intertwined with each other in a dynamic process that creates an experience of human flourishing. In the intertwining of opposite states, there is the presence of explicit tension that comes from linking seemingly opposite forces. SWPP creates a space for understanding not only polarities of trauma and growth but also the unique tension created in the paradox. The road to wisdom is not one in which a person in darkness can solely focus on light. Nor is wisdom found by trying to make darkness light. Rather, the wisdom of the paradox of traumatic growth is seen only by allowing dark and light to coexist, recognizing how they correlate, and finding a way to synthesize new meanings that can say more than either polarity could explain on its own. For some people, this newly synthesized meaning leads to growth. MEANING MAKING AND POSTTRAUMATIC GROWTH Meaning is one of the ultimate concerns in existential theory. Irving Yalom (1980), author of Existential Psychotherapy, suggests that all psychological internal conflict, and so the negative emotional experiences that follow, are grounded in either death, freedom, isolation, or meaninglessness. People may live without an awareness of the ultimate concerns for a period of time. However, when one is forced through life experiences to face one or more ultimate concerns, the opportunity for personal growth and transformation is

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presented. While negative life experiences are deeply painful, distressing, and debilitating, they create space for the possibility of engaging with the core experience of living. Once ultimate concerns are confronted, what is learned in the process may alter a person’s experience of life. In When Nietzsche Wept, Yalom (2012) poignantly writes, “If we climb high enough, we will reach a height from which tragedy ceases to look tragic” (p. 209). A person has a capacity to change their perspective of events that may then change how they experience life. The ability to locate meaning in stressful life events can increase a person’s well-being; the absence of a sense of meaning in life can increase a person’s despair. Psychologist Crystal Park’s (2008) Meaning Making Model suggests a framework for the development of growth after trauma. Trauma forces people to confront meaninglessness, and this to potentially find new meaning, in a way that non-traumatic events don’t. The unique components of traumatic experiences leave a person unable to use familiar strategies of problem solving or emotional coping that are often employed when confronting minor life stresses. However, in major life stresses, when actual or perceived death is confronted, an awareness of a sense of meaninglessness cannot be escaped. In the crisis moment created by trauma, a person questions the assumptions and meanings they have consciously or unconsciously formed about life and that guide the way they think and feel. Sometimes the meaning in life a person holds may help move them through negative experiences. However, trauma is often so radically in opposition to previous understandings of life that a sense of distress and meaninglessness can result. Confronted with such meaninglessness, a person engages in an intrapsychic cognitive process of meaning making; cognitive adaptations and the transforming of meaning related to intense life experiences become an essential cognitive task after trauma (Park, 2016)‌‌‌‌‌‌‌‌. Park’s model distinguishes two sets of meanings at play in the cognitive process. First, there is a person’s global meaning, which includes a combination of global beliefs, goals, and assumptions about life. This form of meaning influences a person’s day-to-day interpretations of the world, daily strivings and projects, and the degree to which a person experiences a sense of meaningfulness, life satisfaction, and positive affect. A second form of meaning, situational meaning, is a meaning assigned to specific life events (Park, 2008). It is the meaning a person gives to their experience of a motor vehicle crash, of a sexual assault, a tornado, or the death of a child. Both sets of meaning systems are deeply personal. The difference is that situational meaning is assigned to a particular event while a global meaning is informed by multiple factors, some of them situational events. Both forms of meaning can change. This becomes important especially when the meaning systems do not align. When they are in conflict, a person will experience

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distress. The negative experience of distress is the impetus to engage in the meaning-making process. A person cognitive processing life events through a reappraisal of situational meaning or global meaning in a more positive way, or through negative accommodations that allow for the possibility of the distressing events. The process ends when there are no longer conflicting forms of meaning and the distress dissipates (Park, 2016). There are three possible outcomes to the meaning making process. The first is that a person cannot find a way to restore or retain their pre-trauma assumptions, and their distress continues. The second possible outcome is that a person can retain their pre-trauma assumptions and the distress dissipates. The final possibility is that a person changes their global assumptions in ways that lead to experiences of themselves, others, or connections to the world in a way that is new. If this new understanding is higher than a baseline level of functioning pre-trauma, and if the new meaning is positive, then a person has experienced ‌‌‌‌‌‌‌posttraumatic growth. Positive growth includes changes in the perception of the self, changes in the perception of others, and changes in priorities and commitments one has in life (Tedeschi & Calhoun, 2009). The Meaning Making Model of coping reveals meaning as not merely nice to have. Meaning is essential to feeling well. Meaning provides a frame that holds a person and connects them to themselves, others, and the world. Meaning provides a sense of structure to one’s life narrative, without which one would feel uneasy, untethered, and lost. With meaning, life makes greater sense. The meaning a person holds changes how they live. Some meanings might limit a person’s well-being, but they are maintained because they are familiar. Other meanings are layered, complex understandings that can be called upon to move through future stresses with an intact sense of resilience and hope. Without recognizing the paradox, as challenging as this can be, some aspects of living are at risk. THREE RISKS OF MISSING THE PARADOX Psychologist Peter Levine (2010) suggests that “the paradox of trauma is that it has both the power to destroy and the power to transform and resurrect” (p. 37). It is only through a nuanced understanding of the paradox, an experience of the tension of the paradox, and the subsequent formation and experience of new meaning in life that a sort of transformation and resurrection becomes possible. If the cognitive complexity of the paradox is not understood, there will be loss. Post-trauma, a reorientation to different ways of being with oneself, others, and the world will not be acknowledged, processed, or lived. Three risks that lead to loss reveal themselves in missing or misunderstanding the paradox of trauma and growth: (1) trading wisdom for simplicity

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in the search for meaning, (2) limiting the definition of well-being, and (3) compromising the ability to build resilience in the world. Such losses have psychological and spiritual implications. Risk 1: Trading Wisdom for Simplicity in the Search for Meaning Trauma leads a person on a search for meaning. Sometimes in that search the paradox of trauma and growth is discovered. If one is able to tolerate the tension of the paradox, and make sense of it, wisdom may be found. However, other times the potential for wisdom found in the paradox can be traded for a simpler meaning post-trauma, sometimes without an awareness that one has made such a trade. Worse still, some incorrectly believe they have found wisdom, when in fact all they have done is reframe trauma as good to abandon making sense of the paradox. The need to have meaning in life, especially in a deeply painful part of one’s story, should not be minimized. It is a fundamental human motivation (Frankl, 1964). In the most extreme cases, meaninglessness will present as suicidality. At diminished levels, experiences of meaningless may present as depression, despair, drug and alcohol abuse, fatigue, and somatic pains. Meaninglessness does not feel good; meaning does. Knowing the importance of meaning, trading potential wisdom for an end to feeling emptiness begins to make sense. The need for meaning starts early in development. Infant brains are not fully developed and so the idea of meaning and the ability to reflect on meaning and meaninglessness are not present in the way that they are in adults. However, research suggests that even infants have biopsychosocial competencies that allow them to make meaning about relations to other people and themselves. Unlike with older children and adults, infants’ meaning making is demonstrated in non-symbolic ways, but is arguably real nonetheless (Tronick & Beeghly, 2011). As children grow into young adults and later adults, the need for meaning in life becomes more evident and directly related to well-being. Meaning in life provides self-cohesion. Meaning provides direction. Theories have noted that, when looking at an ambiguous image that has two or more equally valid forms, the brain works to find one form. We must see something in the chaos. Such is the case in times of stress and trauma. Lack of meaning leads to distress and drives a search process; once meaning is found, the distress ends (Park, 2008).‌‌‌‌‌‌‌ Empirical studies support that meaning is connected to feeling well. Take for example a study by Dezutter et al. (2013), in which the researchers examined the relationship between two distinct forms of meaning (the search for

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meaning in life and the presence of meaning in life) and three aspects of psychological well-being (satisfaction with life, optimism, and acceptance). Researchers identified four categories a person could fit into based on the above forms of meaning: (1) high level of presence of meaning and high level of search; (2) low presence of meaning and a high search for meaning; (3) high presence of meaning and a low search for meaning, and finally (4) low presence of meaning and a low search for meaning. In a sample of 481 medically ill patients, the researchers found that well-being was associated with a high presence of meaning in life regardless of whether a person was assessed as low or high in the measurement scale of searching for meaning. Adaptive coping styles were related to the category of high presence of meaning in life and high searching for meaning in times of medical illness. Maladaptive coping styles were related to low presence of meaning and low search for meaning. The results suggest that it is not merely the absence or presence of stress (e.g., a medical illness) that determines well-being, but rather the ability to experience meaning in the time of stress. If a person has access to meaning, even when their very life is at risk, their ability to feel psychologically well remains intact. Meaning in life can ground a person psychologically in a way that can hold extreme levels of stress. Meaning in life helps a person feel emotionally good. Likewise, empirical studies have supported the idea that the absence of meaning leaves a person feeling bad. Lack of meaning in life is associated with experiences of distress and various forms of psychopathology such as depression and anxiety (Bryan et al., 2013). A person’s sense of belonging in the world also decreases with lack of meaning in life, which then further decreases feelings of well-being (Baumeister & Leary, 1995; Baumeister & Vohs, 2002; Joiner, 2007; Joiner & Van Orden, 2008). Why does one exist? Where is one grounded? What is one moving toward and why are they doing so? To feel good, a person needs to hold a framework that answers such questions. Wandering through life is a psychological risk. Meaning keeps one safe. Traumatic experience creates an acute need for one to have meaning in their life. C. S. Lewis (1961), in his book A Grief Observed, suggests: You never know how much you really believe anything until its truth or falsehood becomes a matter of life and death to you. It is easy to say you believe a rope to be strong and sound as long as you are merely using it to cord a box. But suppose you had to hang by that rope over a precipice. Wouldn’t you then first discover how much you really trusted it? (p. 23).

Meaning making after trauma creates a unique context where one does not want to know abstractly what life is about. One needs to have meaning in life

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to end psychological stress. In Lewis’s metaphor, a person needs to know that the meaning in their life will hold them safe as they climb over a dangerous space. As one moves through the life-and-death experience that is trauma, any meaning found related to paradoxical growth will be necessarily layered and complex, with transcendent qualities not found in searches for meaning with far less at stake. However, the need for meaning can be so strong post-trauma that there is a risk one will give up the cognitive tension of the paradox and the suffering of living momentarily, without making meaning associated with the dialectical relationship between trauma and growth. The paradox will no longer exist if growth is deemed illusory, is dismissed, or if trauma as growth is reframed as positive meaning making. Without engaging the paradox, transcendent qualities of meaning are no longer accessible. What such a trade looks like will be unique to the person making the trade. For some, the meaning made will be trauma as good; for others, the meaning will be that God invited the traumatic suffering to teach them a life lesson; for others still, the meaning made will be transcendent abandonment because of a lack of self-worth. However sense is made, when wisdom is traded for simplicity in the search for meaning in life after trauma, there is indeed a sense of loss that has psychological and spiritual consequences. Humans need meaning, but the meaning they find is not all the same and is not always PTG. Risk 2: Limiting the Definition of Well-Being Misunderstanding the paradox of trauma and growth risks a second form of loss, related to limiting the very definition of what it means to be well. Traditional psychological literature defined well-being as hedonic and subjective well-being (Diener et al., 1999). These constructs of well-being are concerned with the processes and reasons why people experience life in positive ways that include increased experiences of pleasure, life satisfaction, and positive affect (Diener, 2009). Such experiences of well-being are not to be discouraged or looked down upon. Pleasure, life satisfaction, and positive affect are all positive emotional experiences. This is an important form of well-being, but not the only necessary form. If the definition of well-being is limited to hedonic understandings, then one’s global meaning of life, one’s global assumptions, and one’s goals become limited to the pursuit of pleasure. As a counterpoint to subjective well-being, positive psychology introduced the term psychological well-being, suggesting that human flourishing, purpose in life, and meaning in life were equally important to living well as feeling good (Ryff, 1989). Eudaimonic well-being, coming from the Greek term eudaimonia, is derived from two words: eu (translated as good) and daimon (translated as soul). This form of well-being suggests that purpose in life,

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self-realization, and self-actualization all matter, but differently from how “feeling good” matters (Huta & Waterman, 2014). Eudaimonic well-being is interested in tapping into ideas that drive human existence toward a sense of wellness beyond a momentary psychological state. Psychologist Stephen Joseph and his colleague Kate Hefferon (2013)‌‌‌‌‌‌‌ have suggested that eudaimonic well-being may serve as a primary explanation for PTG. PTG is developed through a mental process of considering and discovering what is essential to living a good life. Thus, to dismiss the paradox of suffering is in essence to dismiss the idea of PTG. Including eudaimonic well-being broadens the possibility that living with meaning and purpose may be of equal consequence as living with satisfaction and happiness—that one can forgo momentary lapses in life satisfaction for long-term accessibility to purpose in life. However, a misunderstanding of the paradox of trauma and growth could limit the definition of well-being by suggesting that psychological well-being is more important than hedonic well-being, or worse yet, that it is the sole important form of well-being. Misunderstanding the paradox will limit the definition of well-being to one form or the other. Of course, picking either pleasure or purpose as the unilateral goal of life will lead to loss. A deeper understanding of the paradox helps one to see that human beings really need both forms of well-being. While philosophical theory outlines that eudaimonic and hedonic are distinctly different understandings of living well, psychologists have evidence that suggests the two are related (Huta and Waterman, 2014). Researchers have identified that eudaimonic well-being and hedonic well-being are unique yet correlated variables (Bojanowska & Zalewska, 2016; Joshanloo, 2016). Furthermore, researchers have argued that the effects on well-being are increased when both forms are present (Huta & Ryan, 2010; Huta & Waterman, 2014). Pleasure and wisdom can co-exist and co-relate. Both are needed in defining well-being. A life of meaning without a feeling of satisfaction can still lead to being unwell. The wisdom of the paradox is experienced when both forms of well-being have space to matter and to inform one’s understanding and are encouraged in be integrated in new ways to one’s assumptions and goals in life. Risk 3: Compromising the Ability to Build Resilience in the World The final risk that misunderstanding the paradox presents is the loss associated with a compromised ability to build resilience in the world. There are important distinctions and connections between the constructs of PTG and resilience that suggest that (1) resilience is an extremely beneficial

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characteristic, (2) PTG presents itself as an opportunity to become resilient, and (3) without claiming PTG the associated opportunity for resilience is lost. Resilience is the experience of moving through stressful life events with an ability to maintain assumptions and meaning in life. Resilience is a dynamic process that allows a person access to previously established abilities to adapt in positive ways, and access to effective coping strategies when presented with adverse and stressful life experiences (Luthar et al., 2000). The need to grow is not necessary, as a person has the cognitive and emotional resources to move through stress and maintain meaning in life. The construct of resilience was named by Dr. Norman Garmezy, a clinical psychologist from the University of Minnesota. In a longitudinal study named Project Competence, he explored educational and emotional outcomes in children of parents with schizophrenia. Results of the study demonstrated that not all children experienced being raised by parents with schizophrenia in the same way. When certain family characteristics were in place, some children formed adaptive behaviors that resulted in an experience of being “stress-resistant.” Protective factors of family stability (quantified as the number of family moves, marriages, jobs, upkeep of home) and family cohesion (quantified as frequency of family activities, level of manifest affection, presence of rules, and adequacy of communication) buffered experiences of stress, allowing children to be competent through challenging moments. Specifically, high levels of family stability and family cohesion correlated to higher IQ scores and decreased the likelihood that a child would be disruptive in stressful situations (Garmezy et al., 1984). Garmezy’s research suggests that resilience reflects not a numbing of stress experiences, nor a lack of momentary incapacity in stress, but rather the ability to quickly recover and so maintain necessary behaviors that allow for the ability to be academically successful and emotionally regulated (Garmezy, 1991). In subsequent research, he identified three categories of protective factors that encourage the process: individual factors, family factors, and social support factors. Around the same time as Garmezy’s research, similar studies on resilience were underway, studying children who had experienced one or more adverse childhood experiences. Most notable was a longitudinal study under the direction of psychologist Emmy Werner and Ruth Smith. Together, they followed 698 infants born in 1955 into adulthood who lived on the island of Kauai, Hawai’i (Werner & Smith, 1982). The results of the studies were in line with Garmezy’s conclusions, suggesting three categories of protective factors that contribute uniquely to buffering stress: individual, family, and community-level protective factors. Werner and Smith (1982) surmise that resilience is evidenced not in the absence of stressful life events, but in the people who “worked well, played well, loved well, and expected well” (p. xv) despite stressful life events.

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Research continues to support the idea that some children and adults demonstrate a sense of resilience in highly stressful life experiences. They move through adverse life events experiencing few or no visible negative effects. Their level of functioning dips at first, but they quickly bounce back to a baseline level of functioning. A combination of protective factors such as the presence of positive, available adults in children’s lives, learned optimism, safe environments, opportunities to master small challenges, family cohesion and stability, and social support and relationships all help to build coping resources that one may draw upon when stressful life events occur. This group of people demonstrates resilience. Research suggests that PTG is experienced as the result of shattered assumptions about life and discrepancy in meaning that demands the development of new meaning. An outcome of the process of PTG is an increased sense of resilience, as the learning gained as one grows through trauma is then helpful when confronted with new challenges. PTG is surely not the only way to become resilient. Arguably there are less harmful ways, not rooted in trauma. Still, PTG is a noted way of becoming resilient. The connection between PTG and resilience suggests that if a person does not engage the paradox, misunderstands the paradox, and thus misses the opportunity to claim PTG, then there is also a missed opportunity to increase resilience for the person and in the world. Without successfully claiming true growth, resilience is compromised. This loss comes with significant negative implications, since resilience is part of what makes life feel better. Knowing that it is impossible to live in a world without trauma, the next best hope is living in the world with a deep sense of resilience. Missing or misunderstanding the paradox compromises such a hope. SUMMARY In his book Ninety-Three, French novelist Victor Hugo (2017), who lived from 1806 to 1885, suggested an idea akin to PTG, in a gloomy character named Cimourdain. Hugo writes: “Whatever causes night in our souls may leave stars. Cimourdain was full of virtues and truth, but they shine out of a dark background” (p.101). As Hugo suggests, painful life experiences may leave one with a sense of interior darkness where virtues and inner truth may come to shine. The examination of the paradox of trauma and growth is not an attempt to see something negative as positive. It is to see how they may coexist as related polarities, and how coming to know their relationship can lead to something positive and new. The darkness remains dark. Despair is not transformed into

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joy. It is not a justification for the night; it is an understanding of the complex reality of the formation and observation of stars. The paradox of trauma and growth suggests that there is a different way of looking at trauma than purely from a medical model. Questions that are grounded in the disease model assumptions are not the same questions asked by those interested in human flourishing. Questions that believe in a paradox, in illogically opposing forces logically creating space for wisdom, are different questions still. Like the phenomenological underpinnings for the argument of second-wave positive psychology, questions related to the paradox aim to look at what the world often so quickly looks through. Borrowing the imagery of Victor Hugo, those interested in daylight ask different questions than those interested in the discovery, formation, experience, and implication of witnessing stars. Light and darkness are easily placed in opposition. However, PTG dwells in the relational approach. It is not about making darkness into light; trauma is not helped with a reframe. If that were all, one would only need cognitive behavioral interventions that could be implemented by dear friends or even casual acquaintances with no professional care or counseling backgrounds. It is not about making the light that exists in darkness brighter; intense light can blind, can it not? The relational approach suggests that darkness and light exist. They are distinct. And they blend. Making sense of the relationship is where wisdom comes. Sometimes, as one experiences darkness, moves through darkness, the movement leads one to experience the unique and distinct light that exists too. Some people do not merely survive their dark nights; some come to transform pieces and parts of themselves in ways that are intrinsically positive. Of course, when it comes to trauma, daylight is a major goal. No one should feel encouraged to live in darkness. Yet, with eyes focused on the relationship between the night and at the light, one may find daylight and acknowledge any starlight that exists along the way. The examination of the paradox of suffering brings into focus the potential for a wiser way of moving through life, a fuller and more complex sense of well-being, and a hope of a more resilient world. To discount, dismiss, or reject the paradox of human suffering is to discount the very human ability to make meaning, to live well, and to be more.

Chapter 3

Night Blooming A Metaphor of Posttraumatic Growth

There are a number of environmental requirements for plants to grow. Water, temperature, wind, soil pH, and light, are all needed in various degrees based on the particular requirements of individual plants. Some plants need many hours of sun, others far less. Some plants need dry temperatures; others can survive in humidity. Some are sensitive to extreme heat; others are not bothered. All plants, however, are similar in that they use sunlight as an energy source to convert the air they breathe and water from their roots to grow in a process called photosynthesis. A flowering plant that is mature enough, and not undergoing stress from a lack of environmental conditions necessary for staying alive, will not only grow—it will bloom. Blooming involves a complex cellular process connected to plant genetics that is related to both pollination and fertilization. Pollination, the process of transferring grains of pollen in and between flowers, leads to fertilization, a process where new seeds or fruit are formed. If pollination and fertilization do not take place, then a plant will age and die. Some plants are “self-pollinators,” requiring no insects. Some plants are pollinated by wind. Yet most flowering plants are pollinated by bees, hummingbirds, butterflies, and beetles—all insects that are most active in the daylight. So then, almost all plants bloom in daylight. There is a family of cacti, the cereus cacti, that are in a unique category of plants. Like other plants, the cereus cacti need the right combination of water, temperature, wind, soil pH, and light. However, unlike other flowering plants, this often large and gangly cactus blooms in the night (Werdel, 2014). Colloquially known as the “Queen of the Night” or the “Princess of the Night,” these plants grow, like every other plant, because of the light. Yet their infrequent, brief bloom only happens at night. They are night bloomers. Adding to their mysterious nature, these ephemeral flowers often bloom for just one night, only once or twice a year, with a single, large, beautiful, 37

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fragrant white flower for anyone who is committed enough to remain awake through the night to see it. By morning the bloom is most often gone. How wonderous it must be to witness this rare occurrence of a bloom. How strange and spectacular it must have been to first discover the plant, to have happened by night and seen it bloom only for it to be gone by morning. Perhaps one could still note the fragrance left behind from the bloom. How easy, at first, to believe the blooming was impossible, fictitious, wishful thinking, a dream, nonsense, or even a bold lie. Or perhaps it was believed to be a spirit, possessing or blessing one’s vision, depending on the meaning made. The ratio of night-blooming plants to day-blooming flowers makes night bloomers rare but no less real. The moonflower, the chocolate daisy, the dragon fruit cactus, the red flare water lily, each have a unique story that includes a nocturnal bloom. There is, in actuality, a very clear explanation for this seemingly odd category of plants. Night bloomers are pollinated by moths and nectar-feeding bats, creatures active only in darkness. If they bloomed in daylight, pollination and fertilization would not take place, and so they would age and die. Blooming in the night is a sign they will live, and in the living something beautiful is formed. The night bloomer is a metaphor for the psychological construct of posttraumatic growth (Werdel, 2014). The idea that moving through night experiences may result in a person finding new understanding of their personal strengths, new opportunities in life not known before, closer relationships, more appreciation for life, and deeper spiritual lives (Calhoun & Tedeschi, 2013). The night bloomer is a connection between the darkness of trauma and the bloom that signifies the growth of new life. The beauty of the bloom does not erase the night. The night does not extinguish the bloom. They exist together, in a relationship. If the plant is under too much stress, the bloom will not happen. Even if a bloom does happen without care and attention, a night bloom may come and go, never noticed, never claimed. The world goes on without new meaning made about the paradox. Without a nuanced understanding, night blooms may be misunderstood, or worse yet, used to glorify life’s night experiences. However, with care and attention to the story of the night bloomers, something uniquely beautiful becomes possible to hold that can shape one’s meaning in life in positive ways. WHO ARE THE NIGHT BLOOMERS? As professional listeners, one might wonder, who are the night bloomers in this world? Were they born night bloomers? Did they transform into night bloomers? What are the necessary environmental conditions that they need to bloom? What will discourage their bloom or lead an observer to miss

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witnessing their bloom? Considered in psychological terms, what interpersonal and intrapersonal qualities and characteristics are related to posttraumatic growth (PTG)? In what ways do social and cultural factors encourage and discourage PTG? If meaning making is essential to growth, what ways of orienting or grounding oneself helps a person find meaning in situations that feel so meaningless? Over 30 years of psychological research on PTG provides scientific evidence to help demystify the night bloomer. It also serves as a call to those who work with people experiencing psychological and spiritual nights to come to understand as much as they can about night bloomers for the benefit of both the individual and the world. Reading across hundreds of research articles, people who experience PTG tend to: be open, optimistic, and direct energy toward others; have experienced and moved through significant levels of distress and trauma; and live in a culture, often religiously and spiritually grounded, with stories that frame the possibility of blooming in the night. In the life narrative of the night bloomer, they have close relationships they find helpful to them. They have found ways to allow positive and negative phenomena to be in dialogue without feeling great existential distress. They have made sense of the relationship between light and dark in ways that do not seek to turn darkness into light. Almost unequivocally, they would gladly give up their rarity as a night-blooming plant if they could return to a world where only day bloomers exist. Yet knowing they cannot, they have claimed the night bloom, and it has changed their understanding and experience of life, and so how they live it. Many will do this with professional help, though some will find their way on their own. There are factors related to night bloomers that are outside of a person’s locus of control. One does not choose their parents, the adverse childhood experiences one is asked to endure, the systemic oppression, racial discrimination, and micro- and macro-aggressions supported by pejorative language and colonizing cultures that one is born into and asked to live in. Other factors are within one’s control. One’s way of thinking about growth, the timing of when one considers growth, the relationships one nurtures before and after stressful times, and whether or not one engages connections that consider growth on a social and cultural level, are all within a person’s control. Increasing one’s awareness of the factors related to PTG will help professional caregivers see the potential for working with the night bloomer. The Influence of Personality “Personality” refers to the somewhat stable and consistent pattern of thinking, feeling, or behaving that makes a person their individual self. A person’s personality structure is one of the most predictive variables of psychological

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outcomes. Personality can predict levels of happiness, subjective well-being, aspects of spirituality, longevity, physical health indicators, qualities of peer and family relationships, and even occupational satisfaction and volunteerism. To quote psychologists Daniel Ozer and Veronica Benet-Martínez, “Personality has consequences” (2006, p. 401). Personality has enduring and pervasive influences that affect the very way a person experiences life events (Costa & McCrae, 1992) including the experience of the paradox of trauma and growth. There are varied ways of defining and measuring personality based on the theories that underpin them. For example, psychoanalytic theory would suggest that personality is shaped by one’s unconscious motives. Behaviorists, on the other hand, would propose that one’s environment determines the formation of personality. Social-cognitive theory posits that through a process of observing and learning from interacting social, cognitive, and behavioral factors, one’s unique personality character develops. Trait theorists believe that there are common traits of all personalities and that what makes a person unique is the strength and intensity by which one differs from others on common traits. The most widely recognized way of measuring personality in psychological research is Costa and McCrae’s (1992) Five Factor Model (FFM) of personality. It assesses a person’s levels on each of the “Big 5” personality trait domains: neuroticism, extroversion, openness, agreeableness, and conscientiousness. Research has found that there are personality domains and dispositions that relate to PTG in predictable ways. Neuroticism, the degree to which a person experiences affect and is prone to distress (Costa & McCrae, 1992), tends to have a modest negative association with PTG in studies, suggesting that as a person’s sensitivity to experiencing negative emotions and feeling distress increases, their levels of growth decrease (Garnefski et al., 2009; Werdel & Wicks, 2012). The more a person’s personality expresses enduring character traits, such as sadness, depression, anxiety, or emotional instability, the less likely they are to make new meaning, as they move through traumatic experiences, that positively reorient them to life. Too much negative affect might challenge a person’s ability to see something positive alongside something deeply painful. On the other hand, the remaining domains of the FFM—openness, extraversion, agreeableness, and conscientiousness—all tend to demonstrate positive relationships to PTG in studies (Garnefski et al., 2009; Lechner et al., 2008; Werdel & Wicks, 2012; Wilson & Boden, 1998). This makes conceptual sense, as high scores on these domains connect to character traits useful in the meaning making process: high openness expresses a sense of imagination and a desire to learn; high extroversion equates to enjoying new people and making new friends; high agreeableness expresses empathy, care, concern, and a

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sense of getting along; and high conscientiousness tends toward thoughtfulness, constraint, and goal-orientation (Widiger & Crego, 2019). The domain of openness, with the specific subdomain of openness to new experiences, demonstrates the strongest relationship to growth compared to other personality factors. This suggests that a willingness to engage in new cognitive work most strongly encourages the likelihood of experiencing growth (Tedeschi & Calhoun, 2009). Specifically, the coping style that people with open personalities tend to use in stressful life moments encourages PTG. Research on military veterans from the Iraq wars suggests that those with higher levels of openness have more adaptive coping styles, in which a person looks into themselves, their own knowledge, and their own internal natural strengths as resources, to see what they can work with to move positively through highly stressful situations. Seeking social support, seeking professional help, meditation, exercise, turning to God, finding new meaning in events, and planning are all examples of active adaptive coping. Employing active coping styles is useful for adjusting after stressful life events (Wood & Bhatnagar, 2015), and for some, part of the adjustment may result in growth. Similar results were found between adaptive coping and PTG in a sample of front-line health care workers during the COVID-19 pandemic in Greece (Kalaitzaki et al., 2022). Front-line health care workers around the globe experienced extremely stressful, and for many, traumatic situations during the pandemic. They were asked to risk their own lives to triage and treat people in medical crises in a time of a new pathogen. At the beginning of the pandemic, little was known about how the virus originated or spread. There were no medicines, no evidence-based treatments, no science to follow other than how one treated viruses that presented in similar ways. There were new protocols of personal protective equipment coupled with, at the start, a lack of resources to follow these protocols. Many endured long work shifts, isolation from their family to protect their loved ones, and social stigma (Billings et al., 2021). However, front-line healthcare workers who used adaptive forms of coping, in line with the forms of coping people with high levels of openness tend to use, were able to move through the health crisis and experience various forms of PTG. This research study suggests that being open to new experiences can encourage healthy adaptations and a sense of growth even when facing a context that places one’s own life at risk. Openness to new experiences does more than help someone survive stress; it helps them thrive. Along with personality domains captured in the FFM of personality, research has found that the personality attribute of optimism is often found in night bloomers. Optimism is an attributional style, a way of viewing setbacks as temporary, changeable, and attributed to external forces. It is the antithesis of the pessimistic style that views setbacks as stable, global, undermining all one does, and attributed to internal forces (Seligman, 2006). In the eyes of an

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optimist, success in one experience is generalizable to other parts of life. On the other hand, the pessimist will view success as an isolated experience, not generalizable to other circumstances. Where the optimist sees potential, the pessimist sees doom. Optimists see their ability to change negative situations; pessimists see a fixed negative situation (Seligman, 2006). Optimism and PTG are consistently related in psychological research studies. As optimism levels increase in a person, so too do levels of PTG (Bostock et al., 2009; Helgeson et al., 2006; Linley & Joseph, 2004). One explanation as to why optimism is useful in times of trauma, similar to the explanation for the connection between PTG and the personality domain of openness, is related to coping styles. An optimistic person tends to use more active and adaptive forms of coping, which in turn lead to the ability to experience more psychological growth. This connection was evidenced in a study of 224 breast cancer survivors’ coping styles: active coping was the strongest predictor of growth (Bellizzi & Blank, 2006). The connection was also supported in a study of 90 post-operative women with breast cancer: patients who were more optimistic used more adaptive coping strategies, which then lead to the development of PTG (Büyükaşik-Çolak et al., 2012). Openness, optimism, and adaptive coping alone will not end a night if it is traumatic. However, openness, optimism, and adaptive coping strategies will allow a person to believe they have, or can acquire, the resources to move out of the night. The meaning one can make moving through the night, with openness, optimism, and an adaptive coping style will lead to more positive meaning than one can make with closedness, pessimism, and maladaptive forms of coping. There is an important distinction between openness and optimism when it comes to working with night bloomers. Personality psychologists believe that the domain of openness, like all five domains of personality, are stable and enduring. Even highly stressful or life-changing events do not alter a personality domain once it is formed by nature and nurture. However, it has been suggested that optimism is not a fixed trait. At many stages and places in one’s life, optimism can be learned. This is helpful if one is seeking to gain or strengthen the attribute of optimism. Yet the changeability of optimism also implies that one can lose levels of the attribute as well. Optimism can be forgotten, discouraged, and unlearned. In fact, stress and trauma can do just this, serving as a threat to a person’s level of optimism (Lechner et al., 2008). One’s levels of optimism that may be helpful in times of trauma may then not be readily accessible to be used in coping, or they may even be extinguished by the stress and trauma, arguably when the attribute is needed the most. The good news, however, is that professional caretakers and clinicians may be able to intervene in ways that encourage levels of optimism and a sense of openness, even if this does not shift levels of openness as understood by

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the personality domain. Through the use of cognitive behavioral therapy techniques, both optimism and openness can be strengthened (Knaevelsrud et al., 2010). In a desire to increase optimism, one must also be mindful that being stronger is not always better. Increasing levels of optimism ad infinitum is not necessarily living well. The second-wave positive psychology movement has been critical of glorifying optimism, citing research that suggests that too much optimism can be related to maladaptive coping rather than adaptive coping. High levels of optimism during trauma may contribute to an illusory form of PTG, allowing people to see positive change that may not truly exist (Zoellner et al., 2008). This may lead a person to self-report that they have changed in positive ways that are not real; they may believe they have experienced a night bloom when it was, in fact, a memory of a flower blooming in daylight. There may be times when pessimism is beneficial to well-being (Ivtzan et al., 2015). The theory of defensive pessimism supposes that imagining, anticipating, and planning for challenges, even worst-case scenarios, can be a helpful form of coping. The defensive pessimist will redirect negative thinking, and the affiliated anxiety of the worst-case scenarios, into a positive form of managing stress. An emerging line of research on personality and PTG suggests that PTG can be re-conceptualized as a positive personality change (Jayawickreme & Blackie, 2014; Jayawickreme et al., 2021). The researchers postulate that there is both true and illusory growth reported in research studies. However, a distinguishing quality of true growth is not the meaning that is made as one moves through the trauma, but that a person’s personality structure is altered. The amount of alteration is less subtle than what prior theories of PTG suggest. Significantly more research is needed still for the theory to have veracity. However, if it were to gain scientific support, the implications for personality research and trauma work would be profound. For now, the implications that are evidenced and significant suggest that focusing on healthy levels of optimism, cultivating a sense of openness to new experiences, and practicing forms of adaptive coping are all likely part of the way a plant comes to bloom in the night. The Influence of Distress Distress is a reaction to challenging life circumstances. Marriage, raising children, the death of a loved one, divorce—each can feel stressful. While many people feel stress in similar life circumstances, stress is not event-specific nor a universal reaction in similar life events. What causes one person to feel high levels of stress may cause another to experience less, or even none at all. Take, for example, the experience of walking down the street and seeing

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an unfamiliar dog on leash approaching with its owner. Even if the dog is a calm and well-trained animal, people’s stress reactions will be different. A person who is unfamiliar with or fearful of dogs may start to feel their heart beat fast, their body tense up, and may even cross the street to avoid the dog. Another person may walk past the dog feeling neither positive nor negative reactions. And still another person may experience great joy from the experience, endorphins released as they greet a new furry friend. Stress responses are not event-specific. They are person-specific. Stress responses are different from traumatic responses, though both have a body-brain connection. If a threat is perceived, the amygdala is activated and a signal is then sent to the hypothalamus, instructing the body to prepare for a version of fight-or-flight mode. Stress responses are rooted in survival instincts. Reactions may include increased heart rate, increased breathing rate, increased blood pressure, changes in lung function, the release of hormones such as adrenaline and cortisol, and a sudden burst of energy. Prolonged stress responses over time can lead to heart attacks, stroke, and death. Thankfully, there are a number of ways of coping with stress. Meditation, exercise, friendships, taking breaks, eating well, and healthy connections to a religious community or spiritual rituals are all ways to cope with stress. Through coping strategies, negative effects of stress can be minimized or diminished completely. Stress can dissipate. Trauma is different from stress. As outlined in more detail in chapter 1, trauma is a neuropsychological response to a distressing event that overwhelms a person’s ability to cope, essentially shutting off parts of the brain as a means of self-protection. Memories become stored in fragments. The ability to emotionally regulate or make sense of narrative cohesion is compromised. The brain is not able to cope with trauma as it is with stress. With therapy, trauma can be treated. A person’s self can be integrated and the negative symptoms of trauma can be alleviated. Trauma, in similarity with stress, is not event-specific. Trauma is person-specific. Returning to the imagery of meeting a new dog, this might trigger a trauma response if the person had a previous encounter with a dog that was terrifying. The nature of stress and trauma have two implications for PTG. First, just as stress and trauma are not determined by an event alone, PTG is not eventspecific. War, terrorist attacks, a cancer diagnosis, and motor vehicle crashes all could lead to PTG. The event is not the linchpin in determining night bloomers. Second, in the development of PTG, the level of perceived distress is most consequential. PTG will not develop with either an overload or lack of stress. Rather, there is an inverted U-shaped relationship between PTG and perceived stress (Coroiu et al., 2016; Lechner et al., 2003; Levine et al., 2008).‌‌‌‌‌ Meaning making is fueled, then, by just the right amount of distress (Park, 2008), revealing again a parallel to the cereus cacti.

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In all flowering plants, too much stress will cause a plant to forgo a blooming process, conserving all its energy and resources to stay alive. This is the trauma response too. There is no time for real growth when one is living through trauma reactions. The only movement is toward a fully functioning brain and a body that can release trauma. Too much distress, too much flooding with the trauma reactions of hyperarousal, hypervigilance, and avoidance (as can happen in the case of untreated trauma), and a person will not engage in the meaning making process that leads to growth. They are seeking only survival. Blooming, after all, is about continuing life. Trauma is about believing life may very well be ending. Too much stress, and a night bloom cannot take place. However, one also needs some level of distress that challenges basic assumptions in life. Distress ignites and fuels the search for meaning that leads to PTG. People do not engage questions that reach global levels of meaning, that frame a person consciously and subconsciously in life, without some experience of threat. When little distress is experienced, as can happen either in resilient people, non-traumatic situations, or long after the trauma is integrated into the self, and PTG is not evidenced either. Psychologically, moving through stress with resilience, with a shaking but not shattering of global meaning in life, is better than PTG. No good comes from glorifying PTG in ways that demand that everyone bloom in the night, or that mistake day bloomers for night bloomers. However, sometimes a person does not stop to wonder about if there may be a night bloom. Sometimes no one asks them to consider how new meaning may be formed after extreme stress and trauma that could change one’s life in small or even profound ways. Of course, extreme stress reactions right after an event signal that it is not the correct moment to look for PTG. It takes time, and often therapeutic treatment, for traumatic stress reactions to reduce. Yet, as they do—as the perceived stress starts to fall back down the other side of an inverted U shape—one might start to look around in the night, not pressing or hoping or needing growth, but looking for the possibility of the bloom. Once daylight comes, the chance to be with a night bloom has passed. In daylight, one can only make sense of a memory of the night bloom, not engage with it in real time. The research on distress and PTG suggests that night bloomers feel distressed but are not overwhelmed. The stress is not so great that they cannot engage in a search for meaning, and not so vague or weak that the event may be assimilated into the meaning systems that exist without anything new. They retain the cognitive ability to reconstruct new meaning in life with the pieces of presumptions of how they thought life ought to have worked versus how it revealed itself to be. They don’t want to find new meaning in life, yet they must in order to stop the distress. They don’t seek to bloom at night. Still,

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the moths and bats are busy at night doing work, not only keeping the plant alive, but encouraging it to be well. The Influence of Social Connections In the storybook The House on Pooh Corner, A. A. Milne (1956) presents a philosophy of being in the world through the beloved, wise, and soft bear character, Winnie the Pooh, and his endearing animal friends: Piglet, Tigger, Eeyore, Kanga, Roo, and Rabbit. At one point in the storybook, Pooh and his friends become lost in the Hundred Acre Wood. After 30 minutes of wandering together looking for home, the story reads: Piglet sidled up to Pooh from behind. “Pooh!” he whispered. “Yes, Piglet?” “Nothing,” said Piglet, taking Pooh’s paw. “I just wanted to be sure of you.” (p. 120)

Milne, through the conversation between Piglet and Pooh, demonstrates the crucial role that social relatedness plays in providing physical presence and emotional connection in stressful times. Through a story of fictitious, personified animal characters, Milne suggests to readers an important psychological reality. Human beings are relational beings; they need the presence of others to be well. In psychological literature, the benefit of social connection is often conceptualized as coming from the construct of social support: the belief or actual, tangible experience of being cared for. Social support can include family members, friends, colleagues, teachers, mentors, religious or spiritual communities, or others who a person feels they can turn to in a time of need. It is the belief that you will be supported if, when, and how you need it. High levels of social support are associated with improved self-esteem, increased autonomy, improved physical health, and even improved learning and school achievement (Berkman & Glass, 2000; Ikiz & Cakar, 2010; Schuitema et al., 2016). Social support is also positively associated with coping, making it useful in stressful situations. Social support serves as a protective factor that can buffer the painful and debilitating effects of enduring negative life events (Cohen et al., 2000; Szkody et al., 2021). Relationships make hard things feel easier and allow a person to figure out adaptive ways to move through hard moments. A lack of relationships can make hard things feel even more difficult, as it increases the likelihood that a person will appraise a situation as a threat (Hawkley et al., 2003). Piglet would experience the Hundred Acre Wood as more frightening if not for the presence of Winnie the Pooh.

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Social support is an important factor in the process of PTG in a number of ways. Before a traumatic event happens, relationships can be beneficial. Research from attachment theory and resilience work suggests that positive and strong pre-trauma relationships can help build a person’s self in ways that will help them to experience stressful events differently. Early relationships teach children how to self-regulate by providing a secure base that allows a child to build an internal working model for emotions. Children who had secure, predictable, attentive relationships early in life feel safer in the world. Likewise, the lack of a consistent and available caregiver in the first 18 months of a child’s life can create an insecure base that can lead to challenges to self-regulation, finding and maintaining friendships, and feeling trust in the world. Early relationships pre-trauma can also serve as models of effective ways of coping though less stressful events. Relationships that encourage cognitive processing, that validate emotional disclosure, and that promote and teach character strengths such as optimism can prime a person to bloom. After a traumatic event, relationships are important in a number of ways too. First, through sharing the emotional experience of the stressful and traumatic event, a person is provided with the space to talk out loud and make sense of the event. Emotional disclosure of content related to the negative event increases the opportunity for a person to better understand issues involved in the event. The experience of being supported and received through a valued relationship may also provide a person with a new and increased sense of validation of one’s worth (Lepore & Revenson, 2006). Relationships can assist PTG by being part of the process of finding new ways of thinking about or perceiving the world (Tedeschi & Calhoun, 2009). New thoughts arrived at through social support can weaken negative trauma reactions and replace them with positive emotional responses, assisting in positive reappraisals of the self, others, or the world; they can also help to regulate emotions and increase a person’s ability to habituate to negative emotional responses (Lepore & Revenson, 2006; Schroevers et al., 2010). In trauma and traumatic growth, trying to solve another person’s suffering is not useful. Sitting with a person as they form their new meaning about life can help the process of recovery and growth. A final important component of social connections and PTG is rooted in psychologist Roy Baumeister’s (2011) need-to-belong theory, the belief that human beings have a basic, universal, and fundamental need to belong. The drive for social connection is a powerful indicator of meaningfulness and well-being (Baumeister, 2011; Baumeister & Leary, 1995; Baumeister & Vohs, 2002). Human beings have an internal drive to be in relationships that are meaningful and enduring (Baumeister & Leary, 1995). A sense of belonging, and the accompanying social situations that follow, are so important that without them a person’s risk for death by suicide increases significantly

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(Joiner, 2007; Joiner & Van Orden, 2008). Feeling a sense of burdensomeness or thwarted belonging, the lack of connection with friends or family members to turn to in times of need, can have devastating mental health consequences. A sense of belonging does not only buffer the negative effects of stressful life events, in times of trauma it is part of how a person grows. In an 18-month longitudinal study of 156 people bereaved by the death of a loved one by suicide, the results suggested that self-disclosure was a component of social support that facilitated PTG early in the process. However, as the growth process continued, a sense of belonging was the reason why the relationship between self-disclosure and social support endured (Levi-Belz, 2019). Human connection and traumatic growth relate, in that at first a person needs an “I” to talk to, but later needs a feeling of “we” in the listener. If a person finds a sense of belonging as they re-construct meaning in a post-trauma world, it not only increases the chances a person will survive, but that they will grow. Stress and trauma can leave a person feeling like Piglet in the Hundred Acre Wood, lost and afraid in the world. Relationships won’t protect people from getting lost, nor keep a person from ever experiencing fear. But relationships, especially therapeutic encounters, can help stress and trauma reactions dissipate. As a person begins to feel symptom relief, relationships can stay with a person as they find their way home, and can help them, in the process, understand a piece of themselves, others, or the world in a new and positive way. In the metaphor of night bloomers, relationships—both those before and after stressful experiences—are part of the reason why night bloomers grow and bloom. Relationships are a major factor in caring for a plant. Family members, friends, caretakers, counselors, spiritual communities, religious leaders, all in their own way help care for plants. They are part of the soil and sun that feed and fuel a plant. They are part of the moths and bats that pollinate and fertilize the plant They may sit with a person in their night, so they need not be alone, and wonder together about a bloom. The Influence of Culture and Culture-Related Experiences Culture is a deep, rich, important, and complicated connection to consider in understanding PTG specifically, and all mental health processes and outcomes more broadly. The study of culture includes an understanding not only of the shared values, attitudes, behaviors, and beliefs of a group, but also of concepts such as culturally-related experiences that are the result of being an ethnic minority, acculturation, systemic oppression, and racism (Hwang et al., 2008; Schouler-Ocak et al., 2021). Culture must be considered as foundational and integrated into all parts of the process of PTG, not merely a unidimensional factor or understood only as a descriptive criterion. Culture

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is dynamic, alive in language, and connected to all the aforementioned factors related to growth: the formation and expression of personality, emotions, distress, and social connections. The Cultural Influences on Mental Health Model (Hwang et al., 2008) articulates that the effects of culture permeate differences across six domains of mental health: 1.  the prevalence of mental illness, 2.  the etiology and course of disease, 3.  the phenomenology or expression of distress, 4.  diagnostic and assessment issues, 5.  coping styles and help seeking pathways, and 6.  treatment and intervention issues. (p. 211) In psychological processes and outcomes, culture is always relevant. Considering the model through the lens of trauma, culture may influence experiences of stress, expressions of distress, understandings of negative life experiences, coping styles, the likelihood of seeking professional help, and the quality and care of the help received. Culture can influence beliefs about why trauma reactions exist, how they are described and labeled, whether non-traditional forms of treatment are considered, and whether or not one experiences stigma or support because of trauma (Theisen-Womersley, 2021). Traditional cultural practices, enculturation, and social cohesion (Evans-Campbell, 2008; Walters & Simoni, 2002; Whitbeck et al., 2004), all can buffer experiences of stress. Furthermore, racial trauma, intergenerational trauma, and collective trauma all suggest that culture can influence a person’s starting point of trauma. Cultural histories and current unjust systemic realities allow for people to be born into trauma, to pass down trauma intergenerationally, and even make epigenetic changes that can have significant negative implications for a person’s psychological and physical health (Armes et al. 2019; Bradfield, 2013; Myhra, 2011). Trauma must be understood from within the cultural experience. Culture has been articulated in theories of PTG for having two facets of influence in models of growth: proximal and distal (Tedeschi & Calhoun, 2009). Proximal influences are direct influences. They can include people who provide social support, role models of stress and growth that may affect if and how a person shares pieces of their trauma narrative, and any instruction from a cultural context on how to manage emotional distress. If there is a cultural acceptance of talking about trauma, encouragement to recover from trauma, and people available to assist in the process, growth is more likely. Distal influences, on the other hand, are broad, indirect, influences of culture that are shared through movies, literature, television, or social media.

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These types of influences may provide a person with knowledge of culturally relevant societal themes that may be used in the meaning a person makes of trauma by providing “culture-specific thinking styles and beliefs” to draw on (Ji et al., 2022). Beyond individual trauma experiences, there are communal-level traumas that are culturally based. Historical trauma creates the potential for a person to never experience a true “pre-trauma” world. If one is born into systemic oppression, pre-trauma worlds simply do not exist in the same way that they do for a non-oppressed person. This, of course, will have implications both for trauma theories and for interventions related to PTG. Dr. Anna Ortega-Williams and colleagues (2021) argue that a combined framework for understanding PTG and historical trauma has important research and clinical implications. The Historical Trauma—Posttraumatic Growth (HT-PTG) framework addresses group-level transformation and growth on five levels: cultural, spiritual, psychological, social, and historical. Growth and transformation are considered at a communal/group-level as opposed to a psychological individual level as: (1) new appreciation for our lives; (2) collective spiritual change; (3) new possibilities for our destiny; (4) new ways of relating to our ancestors and cultures; and (5) new collective strength (OrtegaWilliams et al., 2021, p. 8). Culture can be understood not only as part of the process of PTG but also in regards to cultural-level change as an outcome. In the metaphor of the night bloom, culture touches and holds the whole life of the plant. Culture is part of the story of day and night. Culture can tell stories of night blooming plants that have come before and provide guidance on how others might bloom too. Culture can also attempt to glorify the night, encourage the night, and sometimes—in cases of systemic injustice and oppression—culture is the reason there is a night. However, culture can also tell people about care taking of plants, can change the soil pH, and can call the wind. Culture is related to it all. Without understanding culture, one understands only a shadow of the night bloomer, a two-dimensional understanding of a three-dimensional shape. With culture, the thickness, the richness, the depth of bloom can be known. SUMMARY Night bloomers might seem mysterious, but a deeper look reveals that they make scientific sense, as plants and as a metaphor for PTG. They might seem like a contradiction, but they are consistent with all that is known about how flowers bloom and why people grow. People grow when life asks them to, when people help them to, when the systems they live in want them to, when the cultures they are born into believe they were designed to. The goal of

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professional listeners is not to make all flowering plants night bloomers. The goal is to pay attention to the plant as one cares for it. Stay open to the possibility—without expectations, judgment, or denial—of growth. Believe in the night bloom, and if one presents itself, allow seeing it to change you too.

Chapter 4

Religion, Spirituality, and Night Blooming Engaging, Coping, and Virtue in the Paradox

The study of religion and spirituality in psychology is not a theological argument. It is not an attempt to prove, or disprove, God. Nor does it necessarily focus on finding a causal link between transcendence and psychological variables such as happiness or depression. While Freud is infamous for suggesting that religion was a collective neurosis of humankind, the field of psychology will never determine, nor is it interested in advising on, whether or not one is best served being religious, practicing communal prayer, or believing in God. Rather, the interest is in the study of how various religious and spiritual practices, beliefs, attitudes, and motivations relate to psychological processes and outcomes. The field seeks to understand what the experiences of being religious and spiritual mean for a person’s mental health. How does a person’s way of religiously or spiritually orienting themselves relate to how they move through life, in both good times and bad? In what ways do beliefs about, and commitments to, faith and ritual encourage or discourage depression, anxiety, hope, and inner peace? How does one’s religious and spiritual frame help to make meaning of challenging life moments? What do a person’s religious and/or spiritual understandings have to say about suffering? Research studies may find a conclusion or implication that supports religious orientations and practices when it comes to psychological flourishing. However, the argument is rooted in psychology not theology.  Perhaps unsurprisingly to anyone who has studied or worked in the field of pastoral or spiritual care, religion and spirituality in lived experience are complex. They relate in important ways to why, how, and when a person feels well. There are ways that religious and spiritual variables promote 53

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psychological growth and flourishing, buffer stress, provide social support, encourage a sense of belonging, and frame life experiences. Likewise, there are associations between religious and spiritual variables and psychological decline, decreased well-being, spiritual struggles that lead to depression, decreased physical health, and increased risks of morbidity in medically ill patients. There is more to know in understanding the function of religious and spiritual variables in psychological processes than whether a person claims a faith. Studying Buddhism, Islam, Christianity, Judaism, or other forms of spirituality is helpful to ethical care; being personally grounded in a religious faith can be helpful as well, as one may understand or connect to a person quickly and in a way that someone outside of the faith may struggle to understand. Yet, from a quantitative empirical standpoint, and from a pastoral and spiritual care perspective too, knowing a person’s religion is demographic information, the start of knowing something but certainly not enough to understand the implications for a person’s psychological well-being. While the name of one’s faith tradition may matter deeply to that person, and too from a historical, cultural, social context, no researcher has found a causal effect between a named religion and an indicator of well-being. And they never will. There are many different ways to be religious and spiritual. It is one’s lived experience of religion and spirituality that shapes psychological growth and decline. DEFINING SPIRITUALITY AND RELIGION One way that spirituality can be understood is as a universal human experience that taps into ideas of interconnectedness and sacredness in life. Spiritual experiences are meaningful moments, rituals, or practices that connect a person to something beyond themselves. Mario Beauregard and Denyse O’Leary (2007), co-authors of the book The Spiritual Brain: A Neuroscientist’s Case for the Existence of the Soul, suggest that “spirituality means any experience that is thought to bring the experiencer into contact with the divine (in other words, not just any experience that feels meaningful)” (p. 59). There is something unique about spiritual experiences, even if they happen in common activities. Spiritual experiences express that existence is more than what is contained in the limits of the physical body, as they connect in some way to something numinous. Spiritual experiences can be found in places of worship, organized faith, nature, art, and poetry alike. Organized religion is not what makes an experience spiritual. In fact, in the United States there is a growing trend to claim spirituality alone as necessary, as people increasingly abandon organized religion.

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According to the most recent Pew Foundation research (Lipka & Gecewicz, 2017), 27% of adults in the United States currently identify as spiritual but not religious (SBNR); this is an 8% increase over the previous five years. The increase is seen broadly across age, gender, race and ethnicity, and political party affiliations. Some believe that without faith traditions to follow, the implication for well-being might be compromised; they may believe being SBNR means a loose connection to the sacred and so a decrease in the mental health benefits of believing in transcendence. However, this has not been found to be the case in regard to psychological variables. Recent research examining differences between ways of being religious and spiritual and outcomes such as meaning in life, life satisfaction, depression, and delusional ideation indicates that while there is a difference in how people scored on measures between those who identify as spiritual versus those who do not, there is no difference between those who identify as SBNR and those who identify as religious. Those who identify as religious or SBNR score higher on measures of meaning in life and life satisfaction than those who identify as non-religious and non-spiritual (Zhang et al., 2022). When it comes to many psychological outcomes, it is spirituality that is of consequence, not religion. Of course, many people only find spirituality through religion. Religion is separate from, and for many people deeply related to, spirituality, so much so that people often use the terms interchangeably. It is arguably not possible to define religion outside of religious terminology specific to the faith. However, building upon the definition above, if spirituality is a connection to the divine, religion is often the context and boundary for how one learns a language for discovering that connection. For many people, religion and religious participation in organized faith communities provides a means for how spirituality is introduced, accessed, practiced, and explored. Religion can be understood as the organized way that a person lives their spirituality. It is a set of beliefs, tenets, and practices—a road map of sorts— for a person to follow that helps them access a relationship with transcendence. There are rituals unique to the faith grounded in historical tradition. There are ways of pleasing God, or a deity, and ways of falling out of favor. There is a sense of transcendence—in Western religions a God—to imagine, to define, to seek, to understand, or to accept that one cannot ever really do so. Religions have sacred texts, stories, and prayers that provide order to, and an explanation of, existence and eternity. They provide structure and rules as to how one ought to live. They do not change easily with time; some are committed to not changing at all. Spirituality and religion alike provide a meaning-making framework and access to a narrative of existence. Both spirituality and religion can provide building blocks for how one understands the story of life, from the beginning that started long before them, and the ending that, based on beliefs, will or

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will not continue when they die. They provide ways of coping as one moves through life that are unique from other means that don’t tap into a sense of sacredness and divinity. Through both spirituality and religion, people may encounter themes of purpose in life and character virtues of forgiveness, humility, gratitude, wisdom, self-compassion, love, and hope. Both religion and spirituality frame life and what it means to live a good life. In all these ways, spirituality and religion are revealed as important in psychological functioning broadly and specifically to the process of posttraumatic growth (PTG). CONNECTIONS TO POSTTRAUMATIC GROWTH Through the scientific study of transcendence, it is widely understood that spirituality and religion are multidimensional and multifaceted constructs that have important and unique relationships with both psychological well-being and psychological decline. There are hundreds of peer-reviewed articles that suggest that religion and spirituality contribute to the development of PTG. There is even evidence to suggest that trauma and growth are only linked through spiritually connected pathways (Khursheed & Shahnawaz, 2020). There is evidence that some aspects of religion and spirituality have positive connections to growth; some have negative connections to growth. This means that depending on one’s orientation to, and motivation for, beliefs about religion and spirituality, these variables may either encourage or discourage growth as one moves through trauma. They may either promote or be an obstacle for growth. In the metaphor of the night-blooming cactus, religious and spiritual variables may be likened to carefully pruning the plant or unknowingly killing it. Research suggests that in highly religious and spiritual people, religious and spiritual variables may have the most predictive power in indicators of PTG, even over such variables as personality and social support (Werdel et al., 2014). The strength of association is not surprising when one considers that religion and spirituality contemplated suffering and the potential connections to growth long before psychology even existed as a field. Religion, religious experience, and spirituality appear to support a person in highly stressful and traumatic experiences in three broad and interrelated ways. Religion and spirituality help a person: 1.  engage meaning making in suffering; 2.  cope uniquely with distress; and 3.  develop and deepen virtues that are pathways to growth.

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Engaging Meaning Making in Suffering Trauma creates big questions about life that may easily go unanswered when put out into the world. The human suffering from traumatic experiences can leave one without words in response to such questions as: Why does evil exist? What is the meaning of life? What is the purpose of suffering? Of course there are no clear, conclusive answers to any of these questions. However, the meaning-making model of coping suggests that one needs to have an answer to questions related to traumatic events in order to not feel debilitating distress. Not having a sense of purpose and meaning of life can, after all, put one’s life at risk: suicidality increases as meaning in life decreases. Janoff-Bulman (1992), in her book Shattered Assumptions, suggests that to face trauma one must hold basic assumptions about meaning and purpose, and goodness of the self and God, even if they are held differently after trauma. Likewise, Stephen Joseph (2011), in his book What Doesn’t Kill You: The New Psychology of Posttraumatic Growth, suggests that trauma is like a shattered vase, and PTG is making a mosaic out of the broken pieces. One must make something with the brokenness, or be cut by shards of a lack of meaning. Religion and spirituality might not provide exact answers as to why suffering exists, but they do provide a useful frame in the meaning-making process that encourages engaging the paradox of suffering and growth. Many religious and spiritual traditions teach that one may grow comfortable approaching paradoxes that do not have definite answers. After all, faith is, by definition, believing without knowing. Religious and spiritual traditions frame an acceptance that there is a purpose in existence, but some of the purpose is beyond human understanding. Some plans are for God or transcendence alone. There can be a sense of ease, not necessarily distress, with not knowing. In many religions it is taught that humans were not designed to know everything, as this separates creation from creator. Elie Wiesel (1956/2006), in the opening chapter of Night, writes of a conversation with a spiritual mentor of sorts named Moishe, a man he met at a Hasidic house of prayer: He explained to me, with great emphasis, that every question possessed a power that was lost in the answer. . . . Man comes closer to God though the questions he asks Him, he liked to say. Therein lies true dialogue. Man asks and God replies. But we don’t understand His replies. We cannot understand them. Because they dwell in the depths of our souls and remain there until we die. The real answers, Eliezer, you will find only within yourself. “And why do you pray, Moishe?” I asked him.

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“I pray to the God within me for the strength to ask Him the real questions.” (pp. 5–6)

The passage suggests that to be religious and spiritual is to ask real questions, not necessarily to have full answers. There is an acceptance that there will be questions asked of God that will not have answers. Some questions are unanswerable. Theologians and spiritual people alike have long tried to make sense of the unanswerable question of human suffering. Perhaps one of the most tension-filled wonders that spiritual and religious people put out in the world is how one reconciles a belief in an all-powerful, all-loving Divine and the existence of suffering in the world. World religious and spiritual writings each consider the existence of suffering, the nature of suffering, and so a potential argument for the purpose of suffering, in some way: the Old Testament of the Jewish faith tradition in the story of Job, the Christian New Testament in the story of Jesus, the Islamic Quran in the words of the Prophet Muhammad, the Buddhist sacred text Tripitaka in the teaching of Dharma. Beyond the primary holy texts of world religions, religious and spiritual leaders in the faith traditions share their attempts to make sense of why suffering exists, what brings suffering into a person’s life, and what to do with suffering in one’s life and in the world when experienced. Religions have a history, a context, a lens, to engage the question of suffering that is not so directly provided in non-religious and non-spiritually-oriented life. Religious and spiritual orientations can engage the question of suffering in a way that medical and psychological professionals cannot. For while there is no scientific evidence to find and share as to why suffering exists, theological and philosophical arguments abound. The attempt to make sense of the simultaneous existence of suffering in the world and a perfect, loving, omnipotent divine presence is called a theodicy. Theodicies often examine five related questions in the process of sense making of the paradox: “(1) the origin of evil; (2) the nature of evil; (3) the problem of evil; (4) the reason for evil; and (5) the end of evil” (Scott, 2015, p. 65). Psychological research suggests that the theodicy a person forms is connected to mental health outcomes such as the degree to they feel a sense of satisfaction with their life (Hall & Johnson, 2001; Musick, 2000). How a person comes to answer the five questions above can inform how they view, and thus move through, a stressful or traumatic experience. The answers can bring feelings of comfort and love, or anxiety, punishment, and pain. The Views of Suffering Scale (VOSS), a 30-item instrument that measures a person’s belief about suffering and God, measures 10 different theodicies rooted predominately in Judeo-Christian beliefs, also to some extent beliefs of Buddhism, Hinduism, and Atheism (Hale-Smith et al., 2012):

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• Encounter Theodicy: God is encountered by experiencing and questioning suffering • Soul-Building Theodicy: Suffering is a way God build people’s character and virtues • Overcoming Theodicy: Humans can diminish personal suffering through turning to a loving God in faith, prayer, and good deeds • Providence Theodicy: God controls suffering and uses it for good purposes • Suffering God Theodicy: Suffering is meaningful as God suffers along with people • Divine Responsibility: God is good and all powerful and able to change suffering • Limited Knowledge Theodicy: God does not have knowledge of the future and so cannot prevent suffering • Retribution Theodicy: Suffering is related to past wrong doings • Random Theodicy: Suffering is random with no purpose • Unorthodox Theodicy: God permits or causes suffering (Hale-Smith et al., 2012, pp. 856–857) Some people make sense of suffering by imagining that God is punishing them, as is evinced in the Retribution Theodicy. Other people hold a Benevolent Theodicy, in which God is loving despite the existence of suffering, such as in the Providence Theodicy, the Suffering God Theodicy, and the Soul-Building Theodicy. The Soul-Building Theodicy, based in large part on the writings of Catholic theologian Saint Thomas Aquinas‌‌‌‌‌‌ (1265/1945), is most in line with the idea of PTG, as it supposes that suffering is intended by God to be a source of, and a catalyst for, personal growth. Suffering is permitted by God because God wants to encourage the development of better people through experiencing hard things and moving through hard things. This is captured in the Christian Bible in many places. For example, 2 Corinthians 1:5–6 reads, “When we are made to suffer it is our consolation and salvation.” Likewise, in Paul’s letter to the Romans it reads, “Suffering produces endurance, and endurance hope.” The idea central to Christian Soul-Building Theodicy is the understanding that suffering is transformative; suffering can be made good; and this good, like all good, is of God. The theological understanding of suffering-madegood is different from the psychological concept of PTG, as in this conceptualization, trauma is not made good. However, the ideas of transformation, of positive change, and of growth that is good are all very similar. Research suggests that the possibility of PTG is dependent on the theodicy one holds (Wilt et al., 2016). For example, Retribution Theodicies are linked to feelings of psychological distress, while benevolent theodicies such as the Soul-Building Theodicy, the Suffering God Theodicy, and the Providence

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Theodicy, are related to experiences of PTG and can even buffer symptoms of PTSD (Harris et al, 2008; Zeligman et al., 2019). If one engages spirituality and religion in a way of making meaning that allows for an image of transcendence that is loving in suffering, the likelihood of night blooming increase. However, when one holds an image of God that is punishing, that the suffering is justified because of the past, all that grows is the experience of night. People experiencing stress and trauma may not use the term theodicy However, people use religion and spirituality to make sense of suffering in lived experience and so form unnamed theodicies. Take, for example, how people made sense of suffering as a result of the global COVID-19 pandemic, a three-year worldwide pandemic that changed almost every aspect of life as people knew it. For the first time in almost everyone’s life, the COVID-19 pandemic presented the world with a novel virus causing significant disease, illness, and death. For close to a year—and longer for some age groups— there were no medical treatments, no preventative vaccines, and no science to follow specific to the virus. Life looked significantly different in regard to school, work, shopping, celebrations, funerals, doctor visits, and vacations. Anxiety increased. Drug and alcohol use increased. Demands on working parents increased. Stress increased. For many who were older or had underlying illnesses, the threat of death increased. There was a great deal of physical, psychological, and spiritual angst in the world. According to a Pew Research (2021) survey of 6,487 adults during the COVID-19 pandemic, while the majority of Americans (80%) did not blame God for world suffering, 50% believed that God could have intervened to stop suffering because of a belief that the suffering that existed in people’s lives was part of a larger plan. A total of 61% of respondents believed that suffering experienced during COVID-19 existed to provide an opportunity for people to come out of the pandemic stronger. For religious and spiritual people, making sense of suffering invokes their religious and spiritual beliefs. These serve as a way for a person to engage suffering, often through a religiously and spiritually rooted theodicy that believes in a meaningful, purposeful, divinely orchestrated connection between human experiences of profound suffering and positive spiritual growth. Coping with Distress Trauma, by definition, is an event in which a person finds themselves unable to cope with the feeling of their impending actual or theoretical death. After traumatic situations have ended, the regular ways that people cope—namely problem-solving coping and emotion-focused coping—just do not work to integrate traumatic experiences in ways that decrease trauma symptoms. Trauma is not stored in the brain as problems to be solved or emotional

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content to be processed. Meaning-making coping helps a person access experiences of growth following trauma as they find new meaning in life. Religious coping is a unique way of locating, accessing, and engaging a religious and spiritual connection as one moves through stressful life events and seeks to make meaning. It may even be the most unfailing way to make meaning (Park, 2005).‌‌‌‌‌‌ Religious coping includes “religiously framed cognitive, emotional and behavioral responses to stress” (Wortmann, 2013). It captures such things as participating in religious or spiritual rituals such as prayer, feelings about trust and comfort in God, turning toward God, and feelings of tension or conflict in relation with God. In some forms, the use of religious coping can provide access to a sense of meaning that secular forms of coping cannot provide (Krause, 1998). In other forms, religious coping might be a reason for continued distress as one moves through sensemaking after trauma. Much like the varied theodicies above, there are different ways that one may use religion and spirituality in coping. Broadly, religious coping can be either positively experienced, as is the case when it is “an expression of a sense of spirituality, a secure relationship with God, a belief that there is a meaning to be found in life, and a sense of a spiritual connection to others” (Pargament et al., 1998, p. 712), or negatively, as is the case when it is “an expression of a less secure relationship with God” (p. 712). In the experience of positive religious coping there is a sense of spiritual support, spiritual connection, spiritual collaboration, religious forgiveness, and benevolent appraisals of God. A divine presence is loving, helpful, supportive, and compassionate to a suffering person. One feels God’s connection in their friends’, family members’, and even strangers’ kindness. In contrast, in the experience of negative religious coping there is a sense of interpersonal religious discontent, a God that punishes, a sense of spiritual discontent, and a questioning of God’s powerfulness. A person has been abandoned by a God who is spiteful, unavailable, and not concerned in the face of human suffering. As people move through stressful life events and seek meaning after trauma, research suggests that a positive religious coping style is connected with PTG, while a negative religious coping style can be an obstacle for growth. Positive coping styles are highly predictive of PTG (Hoshiar et al., 2017; Paredes & Pereira, 2018) and have been found to be an even stronger predictor of PTG than what can be accounted for by social support from friends and an active coping style (seeking information, seeking support, reframing meaning, or problem-solving social support) (Mesidor & Sly, 2019). Negative religious coping is inversely related to growth, suggesting that as struggle with God increases, the likelihood of PTG decreases (Werdel et al., 2014). This makes sense, as negative religious coping includes aspects

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of retribution theodicies (a God image of one who punishes, a self who is sinful and worthy of abandonment), which have also been found to impede PTG. Religious coping style is related to a number of the rituals and practices that one uses to maintain and develop their spiritual connection and their commitment to their spiritual and religious practice. Arguably the most common religious and spiritual ritual is prayer. Dutch theologian and philosopher, Soren Kierkegaard ‌‌‌‌‌‌(1847/2009), in his work Upbuilding Discourses in Various Spirits, suggests that “the function of prayer is not to influence God, but rather to change the nature of the one who prays.” Whether and how one practices their faith can be transformative in a person’s life. It may not change life experiences, including traumatic experiences, but it could change the way a person moves through them. Research has suggested that people who have a higher frequency of daily prayer as a form of coping also have higher experiences of PTG. This has been found to be true in regard to both individual prayer and communal prayer accessed through religious participation, with increased religious participation linked to increased levels of PTG (Harris et al., 2008; Levine et al., 2008;‌‌‌‌‌‌Weaver et al., 2003). The thoughts, behaviors, and attitudes one holds toward religion and spirituality have important implications for pathways of predicting or blocking growth (Zeligman et al., 2019). People who are able to maintain access to loving, comforting religious and spiritual ways of coping are more likely to experience a sense of growth after trauma. Comforting and supportive experiences of religion and spirituality allow people to discover new positive meanings as they process highly stressful and traumatic life events, and to grow. Those who experience punishment, discomfort, and discontent in religious and spiritual coping fare far worse, including experiencing increased trauma-related symptoms and decreased levels of growth (Harris et al., 2008; Pargament et al., 2004). It is noteworthy that, just as negative psychological constructs have a stronger influence on mental health than positive psychological constructs (Baumeister et al., 2001), negative religious coping appears to have a stronger impact on well-being than positive religious coping (Park et al., 2018)‌‌‌‌‌‌. A bad God is stronger than a good God. Asking questions about challenging religious and spiritual beliefs, distressing thoughts, and negative attitudes about religion and spirituality may be helpful in promoting growth by removing negative influences on the process of PTG. It is dangerous to assume that religion and spirituality are only positive or benign influences on a person’s suffering. A negative religious coping style can have devastating effects on one’s well-being, including blocking psychological growth. As a spiritually and religiously minded professional, knowing the ways that a person calls upon spiritual and religious experiences in suffering, how they feel in their religious and spiritual relationship with transcendence, and

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the image they hold of God, is essential to understand as they rely on this to cope and make meaning after trauma. Spirituality and religion can frame many, perhaps all, life experiences, not only ones take place on the Sabbath, or Sunday, or in places of communal worship and prayer. The varied ways of religious coping, like the varied ways of answering a theodicy, have implications for whether, in a night experience, darkness is strengthened or whether one’s willingness to stay awake in the night is fortified. Believing in, accessing, and turning toward a God who loves or a sense of transcendence that feels redemptive encourages the possibility that, as one pieces together new meaning in life, some of the meaning will be positive and new. Developing and Deepening Virtues Embedded in many religious and spiritual traditions is an understanding that the existence of suffering in the world can lead to virtue development. The philosopher Gabriel Marcel (1962/2010) suggests that it is only in the face of despair that authentic hope can truly develop: Loneliness, betrayal by family or friends, the triumph of one’s enemies, the importance of disease or old age, the death of a loved one, a disappointment in business or love, hatred and opposition by other people—all these can teach us Christian hope. (cited in Roberts, 2007, p. 160)

The Buddhist teaching of the Four Noble Truths to reach enlightenment are about suffering: the Truth of Suffering, the Truth of the Cause of Suffering, the Truth of the End of Suffering, and the Truth of the Path that Leads to the End of Suffering. The Hindu belief that suffering is related to the “unfolding of karma,” part of living and rebirth, and so not necessarily negative (Whitman, 2007, p. 610). Across multiple diverse religious and spiritual traditions, a result of commitment to practicing a religion and spirituality is the encouragement to develop core character strengths and virtues. While the drive is for a religious and spiritual reason, there are psychological implications related to flourishing and posttraumatic growth. For some, spirituality is the connection to growth through virtues that help find new positive meaning after trauma (Khursheed & Shahnawaz, 2020). Virtues may even be further strengthened and developed as one moves through stressful life experiences. Positive psychology researchers, through an examination of all the major world religions and moral philosophies, identified six core virtues embedded within these perspectives that have been found to promote human goodness and psychological flourishing: (1) wisdom and knowledge, (2) courage, (3) humility, (4) justice, (5) temperance, and (6) transcendence (Peterson

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& Seligman, 2004). Across the six virtues, there are a total of 24 character strengths including hope, forgiveness, gratitude, perspective, creativity, and spirituality. The character strengths are stable personality traits but can change after significant life events (Niemiec, 2013). Thus, virtues developed through religious and spiritual traditions in diverse cultural contexts are both useful in moving through stressful times and can in turn be strengthened by stressful times. Relationships have been found between PTG and character strengths of hope, self-compassion, forgiveness, and gratitude (Pargament et al., 2004; Park, 2005; Werdel et al., 2014). Studies of hope—a goal-directed cognitive process that involves both hopeful thoughts related to the ability to generate a plan and goals, as well as a belief in one’s capacity and the motivation to use them (Snyder et al., 2002)—have repeatedly found such relationships to growth after trauma. In studies with samples from various countries, and including divergent adverse life experience (Italian adults during the COVID-19 pandemic, Chinese patients with chronic obstructive pulmonary disease, Polish adults with paraplegia from spinal cord injuries sustained over 15 years prior), the more hopeful a person is, the greater the likelihood of PTG (Byra, 2016; Di Corrado et al., 2022; Wang et al., 2021). Research suggests that hope is a powerful character strength that can buffer negative mental health outcomes, increase the likelihood of growth after trauma, and explains, in part, the strong relationship between spirituality and growth. People call upon their lived religious and spiritual experiences to understand suffering and access hope that in turn leads to a sense of growth. The character strength of self-compassion, conceptualized as including self-kindness, common humanity, and mindfulness, has also been found to be part of how people develop meaning in suffering that leads to growth. Self-compassion recognizes that the self is worthy of support, that suffering can connect people, and that a sense of clarity and balance is possible if one avoids overidentifying with negative cognitions or emotions (Neff, 2009; Phillips, 2021). Self-compassion has a similar relationship to PTG as does hope. It is related to increased well-being, can buffer the effects of negative experience on mental health outcomes, and, when grounded in spirituality, has been linked to increased PTG (Keller & Huppert, 2021; Khursheed & Shahnawaz, 2020; Munroe et al., 2022). Viewing oneself kindly, a sense of suffering as connecting one to a shared human experience, and mindfulnessbased approaches can change the way a person both meets suffering and how, if necessary, they rebuild their global assumptions that are shattered from trauma. For many people, self-compassion is developed and strengthened though spiritual practices of mindful meditation and contemplative prayer. Forgiveness is a third character strength that has been found to be related to finding meaning and is a significant predictor of PTG in studies of both

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individual and collective trauma (Cameron et al., 2022; Heintzelman et al., 2014). In many religious traditions, a person, by nature of being human, fails to live in accordance with God, is taught to ask for forgiveness, to forgive others, and they too are forgiven. The Christian Bible, for instance, teaches, “Forgive others as I have forgiven you.”‌‌‌‌‌ Forgiveness suggests a view of oneself as being worthy of being forgiven, and thus as positive, albeit not perfect. Forgiveness suggests a sense of divinity that is loving and able to forgive, perhaps desires to forgive so that a relationship between creator and creation may be maintained. Forgiveness has empirical connections to PTG. In a recent study of 3,534 people from 11 countries in diverse global regions who experienced collective traumas induced by natural and human-made disasters, higher levels of meaning after trauma were associated with increased forgiveness (Cameron et al., 2022). In a study of 286 Muslim Indonesian victims of the Aceh conflict, a 30-year war in the northwestern tip of the island of Sumatra, Indonesia, increased levels of spirituality lead to increased forgiveness, which in turn lead to increased levels of PTG (Hafnidar & Lin, 2012). Traumatic experiences may encourage a person to engage a spiritual or religious framework that preaches forgiveness. Being able to forgive then allows one to experience something new about themselves, others, or the world that is positive and new. Of course, forgiveness, like hope and self-compassion, need not be religious or spiritually motivated. One may learn and practice forgiveness from an agnostic frame too. However, there is evidence that even when a person is not explicitly asked about linking religious and spiritual orientations and forgiveness, they most often still do (Laufer et al., 2009; Schultz et al., 2010). A final character strength with a religious and spiritual connection is gratitude, an affirmation of goodness and a recognition of the source of goodness that is outside oneself (Emmons & McCullough, 2003). For those who hold a religious or spiritual frame, gratitude is understood as a core element of the connection between human and divine (Emmons & Kneezel, 2005), as the source of goodness bestowed on a person is attributed to the creator, the divine, or God. There may be a deep recognition and expression of gratitude in sacred prayers, scripture, and songs of goodness in the world. There is a positivity to gratitude, an appreciation for what one has rather than a focus on what one does not possess. For some, all good things in life are sacred gifts. When a person engages in meaning making with increased gratitude, there follows an increased experience of traumatic growth (Vieselmeyer et al., 2017; Zeligman et al., 2021). As gratitude increases, the likelihood of finding something positive as one moves through trauma increases too (Zhou & Wu, 2015). Gratitude has also been found helpful in decreasing symptoms of PTSD (Vernon et al., 2009), which connects to growth in the sense that while some distress is needed for growth, too much distress will decrease the

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likelihood of growth. Of course, focusing only on the silver lining of events could be used as a defense mechanism to not engage in suffering (see spiritual bypassing below). However, if there is a sense of gratitude to be found alongside the loss and pain, this is suggestive of true psychological growth (Ruini & Vescovelli, 2012). Virtue and the associated character strengths are available to people, regardless of whether they claim a religion and/or spiritual tradition. One can learn to nurture strengths of character and develop virtues in many ways. Yet psychological research suggests that when it comes to night blooming, spirituality’s connection to hope, self-compassion, forgiveness, and gratitude is a pathway to growth after trauma. Research suggests that spirituality increases the likelihood of character strengths, which then increases the likelihood of PTG. Religion and spirituality provide a systematic way to encourage and nurture such strengths. There is a meaning and purpose that underpins why one would desire to practice and reinforce such character strengths. Hope is not worldly hope; it’s a sense of hope in a transcendent plan. Self-compassion is not only a form of self-care; it is an expression that recognizes the sacred reality of the self. Forgiveness is more than an act of letting go of resentment and gratitude, and more than an expression of self-awareness, it is an expression of a relationship with the sacred. Virtues and their associated character strengths need not be grounded in religious or spiritual traditions. However, there is a strong connection between religious and spiritual content in the development of virtues and character strengths that should not be minimized or ignored. A pre-trauma striving for a relationship with the transcendent increases opportunities to grow. POSTTRAUMATIC GROWTH AND SPIRITUAL CHANGE Along with the ways that numinous factors encourage growth, there is the consideration for possible spiritual and existential change as one moves through trauma. This suggests that a person’s sense of spirituality may be helpful and grow stronger as they move through stress and trauma. Like a muscle that grows stronger with use, when one calls upon the framework of spirituality and religion to support them in suffering, it may not only help support night blooming—it may be the night bloom. The Posttraumatic Growth Indicator (PTGI) was the original assessment tool used to measure growth (Tedeschi & Calhoun, 2009). It is a 21-item measure that includes two questions to capture “spiritual change.” However, in 2017, an updated version of the assessment, the PTGI-X, was developed. It is a 25-item measure, with the four items added to the measurement of

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what is now called “spiritual and existential change.” The new items, and the validation of the inventory, move away from a singular understanding of religion from a Western frame that critics noted in the PTGI, and to a broader, more inclusive, and more accurate understanding of spirituality and existential change possible after stress and trauma. The original PTGI was developed using US samples; the PTGI-X was developed including participants from Turkey, a predominantly Muslim country, and Japan, a predominantly Buddhist country (Tedeschi et al., 2017). The updated assessment represents an understanding that the connection between psychological growth and spirituality is significant enough to attempt to refine the measure to be more representative of diverse ways of experiencing spirituality. The more accurate assessment of spirituality is important to capture more deeply and broadly the connection between spirituality, trauma, and growth, even if the deductive reasoning embedded in the quantitative assessment of transcendent and existential experiences may be limited from the start. Whether one captures all or only some spiritual change in quantitative assessments, the part captured continues to suggest that spiritual variables are integrated in psychological processes, including traumatic growth. TWO IMPORTANT CONSIDERATIONS Religion as Trauma It is important to briefly consider two concepts distinctly related to the topic of religion, spirituality, and trauma. The first consideration is that of religion as trauma. Religion is connected to significant trauma in individual lives and in the world. Religion has been a guiding force in war and acts of violence for as long as religion has existed. Violent acts of killing, suicide bombings, harming people, and stealing land, have all been done in the name of religious belief, for a God, or in the name of a God. Whether or not religion causes more violence than secular sources is debatable, as there is evidence that secular ideologies are more distinctively destructive religious ideologies (Cavanaugh, 2009). However, that religious ideology is a source of violence is unfortunately well-documented too. Additionally, religious institutions have been uniquely connected to trauma. Most notably, the Catholic Church is responsible for the sexual abuse of hundreds of thousands of children globally. The leadership of the church knowingly protected clergy and nuns who sexually abused children, and permitted such church figures to remain in their roles, most often to repeatedly abuse more children. The church sheltered, loved, supported, and cared for those in religious life and ignored, silenced, and were cruel to victims. The

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church perpetrated trauma, allowing it to multiply by disregarding care and concern for children. For some people, religion and religious people have had a profoundly dark and destructive force in their lives. Furthermore, numerous faith denominations weaponize sacred scripture to support strong anti-feminist and anti-LGBTQ beliefs that can lead to traumatic experiences connected to faith traditions for women, queer people, and non-cisgender people. Doctrine is used to discriminate, oppress, and condemn people because of gender and gender identity. The result can be fear, anxiety, and shame caused by religious leaders, religious communities, and religious doctrine. Religious patriarchy—the idea that men are favored over women—can be understood as a form of violence against women because of the negative effects it has on a woman’s sense of self-worth and dignity. It can increase the risk of domestic violence and abuse, and significantly limit women’s ability to be free in society (Rakoczy, 2004, 2011). Some of the trauma that pastoral and spiritual caregivers will be asked to hold, some night experiences, are caused by religious institutions and in the name of religious beliefs. The study of religion as trauma is beyond the scope of this book. However, the fact that religion can cause trauma cannot be overlooked in consideration of religious and spiritual variables in PTG. It is worthy of extensive study for anyone interested in working with trauma from a spiritual and pastoral context. Spiritual Bypassing The second important consideration to be aware of at the intersection of spirituality and psychology, particularly in regard to confronting human suffering, is the concept of a spiritual bypass. The term was coined by John Welwood (1984/2000), a psychologist and Buddhist teacher, to describe a person’s focus on spiritual beliefs, practices, and experiences as a form of avoidance, sidestepping, or denial of underlying emotional issues or developmental tasks that are necessary for true development and growth. In the case of trauma, spiritual or religious beliefs may be used to bypass the emotional world or to rationalize a life of suffering and so keep painful parts of a person’s story unattended to, hidden, or unresolved. Spiritual bypassing works by hopping over painful places to create a sense of meaning without the work and emotion that comes with psychological development and adaptation. It may present in a number of ways: denial of traumatic experiences, spiritual narcissism, or the use of spiritual beliefs to justify repressing strong negative emotions (Cashwell et al., 2007; Welwood, 1984/2000) Spiritual bypassing provides a way around having to confront extremely stressful and traumatic situations. Rather than confronting memories of and feelings related to domestic violence, sexual abuse, or war, a person may

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believe their faith has saved them and that their past experiences of trauma are no longer of consequence; they may have a sense of spiritual enlightenment that has dissolved any worldly insecurities; they may believe that this world has less consequence than the next world and so hold ambivalence toward processing any thoughts and emotions that are not forward-focused. When confronted with processing traumatic experiences, a religious or spiritual person may, consciously or subconsciously, choose the spiritual bypass. The use of a spiritual bypass blocks one’s hopes of integrating trauma and thus the chance for any real growth. Of course, the spiritual bypass has a protective function, often lowering one’s anxiety or decreasing depression or negative self-images that may be associated with the psychological work of forming healthy ways of coping, adapting, developing, and growing (Clarke et al., 2013). Like other psychological defenses, there is a psychological reason for the use of a spiritual bypass, but it comes at a price. Both psychological and spiritual growth are blocked when religion and spirituality are used to sidestep painful life experiences (Cashwell et al., 2011). The only way out of trauma is through it (Cashwell et al., 2007). The spiritual bypass can encourage a belief that one has made it through trauma with the grace of God. However, when explored further, a person may have used God to protect themself from having to move through painful emotions, rather than allow their God to be accessible to them for comfort as they integrate their suffering into the story of their life. Believing that one can see the night as daylight because they are spiritually enlightened, or closing one’s eyes and imagining a future without darkness promised by God, does not change the reality that one remains in the night, nor does it count as a bloom, though it could erroneously be attributed to this. Working with a spiritual bypass starts with noticing it for the purpose and function it serves. Only after one can see its psychological usefulness and the potential deficits in psychological development from which the spiritual bypass stems, can one then consider why other paths to meaning and wholeness might better serve a person who desires deep spiritual and psychological joy. Defense mechanisms can be challenging to change. Those grounded in spiritual beliefs may arguably be even more so. There are two ways to work with spiritual bypasses clinically that have been suggested in the psychological literature. Motivational interviewing, a compassionate, strengths-based therapeutic approach to address spiritual bypassing in therapy, is one approach clinicians may take (Clark et al., 2013). The approach is “a collaborative, goal-oriented style of communication with particular attention to the language of change (Miller & Rollnick, 2013, p. 29). It seeks to strengthen personal motivation to change by exploring change from a place of acceptance. There are four tasks of the model: express empathy, roll with

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resistance, develop discrepancy, and support self-efficacy (Miller & Rollnick, 2013). Research has suggested that motivational interviewing may be useful specifically in addressing spiritual bypassing, as it respectfully identifies and accepts ambivalence to change one’s use of a spiritual belief, assesses readiness to change, and encourages one’s ability to change (Clark et al., 2013). A second model of working with spiritual bypasses in clinical contexts is rooted in the Developmental Counseling and Therapy Model (DCT). This model is considered a metatheory of human development, integrating a number of different counseling theories (human development, family systems, multicultural) in a systematic way. Its philosophical underpinnings are heavily rooted in Piaget’s cognitive development model, as DCT supposes that there are four Cognitive-Emotional Development styles: sensorimotor (sensations and feelings in the body), concrete (reasoning and if-then thinking), formal (noting thoughts, feelings, and behavior patterns and the meaning associated with them), and dialectic/systemic (the ability to see multiple perspectives at the same time). In DCT, however, these four styles differ from Piaget’s model in that the styles are not linear, but rather can all be accessed, and even accessed together as one moves through life experiences. A developmental block is noted when a person does not have access to a cognitive developmental style in a lived experience (Cashwell et al., 2004; Ivey, 2000). So then, in the presentation of a spiritual bypass a clinician may approach the defense through a structured process of questioning, imagining and working through the feelings and thoughts necessary to access each development style. For a person who has experienced a traumatic event and made sense of it from a spiritual bypass, one would work through the feelings, reasoning, meaning, and perspective-taking tasks of each stage in a way that allows for the processing of emotional experiences. It has been suggested that “By engaging clients through developmental assessment, their spiritual experiences can be integrated with personal problems and issues, resulting in new experiences of the self and new perspectives on their patterns of behavior, cognition, and feelings” (Cashwell et al., 2004, p. 405). A spiritual bypass identified as a means of coping with trauma experience may provide a person an opportunity to grow developmentally and spiritually in a new and deeper experience of spirituality. Working with changing a spiritual bypass can be, by the definition above, a form of PTG. SUMMARY Most people do not change religious and spiritual beliefs after traumatic experiences (Leo et al., 2021), though certainly some do. However, those who are religious and spiritual engage their beliefs in attempts to make meaning as

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they move through traumatic experience. When trauma shatters one’s life and assumptions about the self, life, and God, religious and spiritual frames offer meaning that has stood the test of time. Religion and spiritual beliefs help rebuild understandings of the self, life, and God that some experience as new and sometimes positive. Having a benevolent image of God in making sense of suffering; feeling that there is a loving, compassionate God to turn toward in prayer for comfort; and using previously developed strengths of character such as hope, self-compassion, forgiveness, and gratitude all are part of the ways PTG develops for people who identify as religious or spiritual. Of course, as one considers the research, one must remember that what can be known from a psychological empirical perspective is limited to what can be defined. The empirical approach certainly brings with it a sense of validity and academic rigor from a social scientific paradigm, and yet too a sense of loss from the rich, deep, complex experiences of the numinous that are part of a spiritual life. Empirical research has certainly given space to legitimizing the integration of religion and spirituality into the conversation around night bloomers. And yet, as it is deconstructed in the research process, one can’t help but wonder how psychological perspectives on religion and spirituality have ignored the roots of religious and spiritual tradition that often intertwine with night blooming. After all, religious and spiritual experience have an intrinsic sense of mystery for many who feel the connection. It is impossible to psychologically study the soul—this part of, or perhaps the whole, indestructible essence of a being. If the soul does exist, surely it would be of some consequence in trauma and growth, even if there is no way to measure it. However, one can understand what religious and spiritual connections, meaning, and participation, can have on a person’s life. According to what can be known, factors related to transcendence matter significantly in the process of growth. One of the key points in spiritual wellness and psychological well-being is that when it comes to night blooming, religion and spirituality are not checklist items to consider as an absolute path to growth. Spirituality and religion are lived experiences, and how a person lives that experience is related to growth. Merely claiming an affiliation of a religion or spiritual tradition has never been enough. Even having religious or spiritual practices is not enough if the God or divine is experienced as abandoning or punishing, or if the meaning made is that the trauma was in any way justified or good. In these instances, a claimed sense of religiosity or spirituality might be more dangerous than not having a faith at all (Werdel et al., 2014). Yet, for those who hold a sense of universality, transcendence, God, or divinity, religiosity and spirituality are parts of the human experience that are deeper than personality. To lose faith is not without consequence. Most people will continue to experience religion or spirituality as central to all of life, even the painful moments.

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They will call upon it as they search for meaning, as they move through the darkness, through shadows, and into new life. Of course, many religious and spiritual orientations understand that doubt can, and at times, does, lead to a more meaningful experience of faith. Doubt can be transformative in the growth of a new, more meaningful understanding of religion and spirituality, a type of spiritual or existential change that one might consider theologically as “metanoia” or a profound conversion of heart. For the night bloomer who was rooted in sacred soil, religion and spirituality may lead a person to feel deep despair from an abandoning God as they search for the sacred, or the deepest form of hope from a compassionate present God as they move further along in trauma work, or possibly even experiences of both. For some, a pre-trauma experience of religion, faith, or God will be lost, and a new, different experience of religion, faith, or God will be constructed that is more mature, nuanced, able to ask unanswerable questions without overwhelming distress, and that may engage the wisdom of the paradox.

Chapter 5

Witnessing the Night Bloom Working in the Paradox

If night bloomers exist, if trauma can indeed lead to growth, one might wonder: what is the work of professional counselors and caregivers from the pastoral and spiritual context? Night bloomers who seek professional care are not likely to self-identify as such if they find their way to professional listeners. How could they, really? Most often, the drive to see a professional caretaker or counselor is not motivated by the desire for a night bloom. Rather, people often come to the place of professional care in the night, seeking help finding the daylight again. The end of the night is understandably often the only concern of people in distress. Anyone who does present close to a traumatic event with a desire to have deliberate ruminations related to positive growth is less likely to find it and, if they believe they have, it is more likely to be illusory growth than true growth in the end (Zoellner & Maercker, 2006). It is far more likely that anyone who self-identifies as a spiritual night bloomer, who has experienced something profoundly painful as a traumatic experience, is presenting with a pseudo form of posttraumatic growth (PTG) such as that of the spiritual bypass. Research suggests that deliberate cognitive searches for meaning are part of the meaning making process that is only linked to growth when some time has passed from the event. If a deliberate search for positive meaning happens very close to an event, growth is often not found (Nightingale et al., 2010). Furthermore, there is no way to predict with certainty who will bloom in the night, nor during which night, or when the bloom will come. While there are factors that suggest when night blooming is more likely to happen, there is not a cause-and-effect relationship that for certain ends in growth. Mystery and the unknown are always part of working with the human condition. There are many paths a person may follow out of darkness, and even with the implementation of evidence-based practices, in the end they are all deeply personal. However, there is a universal question central to working 73

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in the space of night bloomers that is important to consider for its clinical and pastoral implications. When answered, this question will illuminate the place where professional listeners can ground themselves and will guide the words that they say to those who present the story of their night. The question, rooted in a nuanced understanding of religious and spiritual traditions and psychological understandings of individual and communal PTG, is this: How does one work with a paradox? How does one work with two related yet seemingly contradictory experiences in a way that honors the truth in both? It would be easier if the answer to working with night bloomers was skill-based alone. Of course, there are necessary skills to learn in working with trauma and growth. They are very similar to the skills necessary to working with many human conditions: empathy, openness, non-judgmental presence, a belief in positive change and growth. Yet, working with a paradox is arguably less a skill to be learned and more a way of thinking to nurture within the professional listener. It is about accessing a complex understanding that effects a way of being in the world, that then translates to how one sits with people in their care. It translates to how they hear and hold stories. It translates to what a person says or does not say and why. To work in the paradox of the night bloomers, a person must let go of a tight grip on dualistic thinking—as easy, structured, and comforting as a dualistic mindset can feel—and move closer to the flexible yet bounded reality that the paradox presents. In dualistic thinking, one considers the dyads of good or bad, light or dark, virtuous or evil, present or absent, alive or dead. This type of categorical thinking suggests that one assesses a person, place, or experience and labels them as one or the other opposing force. In this black-and-white mindset, there is no touching of colors. Yet in life, so much is more complicated than an either/or. So much more is possible to see when one allows black and white to touch within the story of a person. Research on the relationship between positive and negative emotions is evidence of just this. As outlined briefly in chapter 2, psychologist Barbara Fredrickson’s work on positive and negative emotions helped the field to understand that positive and negative emotions work very differently in her broaden-and-build theory. Fredrickson and Losada (2005) took the idea further and proposed a “critical positivity ratio” of roughly 3:1, suggesting that there was a tipping point to human flourishing and languishing. When a person experiences three positive emotions for every negative emotion, they are likely to flourish. Any ratio lower than this is predictive of languishing. More updated research suggests that the ratio is not mathematically sound (Brown et al., 2014); however, others have argued that even if a mathematical tipping point for human flourishing has yet to be found, or if arguably there is

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none to be found, negative emotions can and do still coexist in important and meaningful ways (Fredrickson, 2013). The psychology of positive emotions is not about erasing negative emotions and living a life of mania. It’s about seeing their relationship that is uniquely lived in the story of one’s life. For many people, there can be both positive and negative emotions at the same time or closely following one another as emotional states. For many people, emotional states can be experienced as waves that come and go. For many people, positive and negative emotions both exist and have a relationship that is noteworthy. Take, for example, a number of significant life events: moving, marriage, raising children, helping aging parents, new careers, or funerals. They all come with potential for varied, even conflicting emotions. One can be anxious and excited. Sad and relieved. Nervous and confident. The idea that major life events evoke one side of a dualistic emotion can be true. But the idea that as one moves through experiences there might be paradoxes of positive and negative emotions in relationship to each other, and that the relationships between these emotions may be important, is also possible. As second-wave positive psychology suggests, it is the relationship between light and dark, not merely the coexisting of light and dark, that is of great consequence. Non-dualistic thinking requires creating a cognitive and affective place to sit with experiences that may have many different, conflicting emotions, and exploring the meaning of the relationship between the two. If psychological dualistic thinking is akin to the spirituality of the first navitié, seeing the two relate is the complex, nuanced spiritual and psychological life. Dualistic mindsets will never see the possibility of relationships between dualities that are at the heart of a paradox of trauma and growth. The paradox mindset encourages one to develop a more open, creative, and flexible way of thinking and approaching life. It does not suggest that all in life is paradox, or that there are no boundaries to experiences and emotions. It does not suggest that pure evil doesn’t exist. The paradox mindset does encourage moving away from a belief that life is solely categorical, an either/ or frame, and seeing that sometimes life experiences are a both/and reality. Sometimes it’s seeing the relationship of both/and, where deep new meaning and a new sense of wisdom can be found. The paradox mindset suggests that more than one thing may be fully true in some cases, and that the relationship between these truths reveals a way of understanding life that is rich and complex. In the case of night bloomers, night is fully night; trauma is fully negative; blooming is positive, even the seemingly impossible reality of blooming in the night; the night blooming relationship doesn’t always exist, but when it happens it is real.

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PARADOXES AS TRANSFORMATION Paradoxes are at the heart of growth and transformation. Psychological growth is often possible when one comes to accept the seemingly opposite yet related tensions in life. Carl Rogers (1995), in On Becoming a Person, suggests, “The curious paradox is that when I accept myself just as I am, then I can change” (p. 17). Irving Yalom (1980), in Existential Psychotherapy, writing on death—one of the four essential themes of his theory—suggests, “Death and life are interdependent: though the physicality of death destroys us, the idea of death saves us” (p. 30). Learning to see the paradox has psychological implications both cognitively, as it is linked to increased integrative complexity, and affectively, as it is linked to increased levels of creativity (Miron-Spektor et al., 2011). In this way, it is revealed that seeing paradoxes is psychological growth. Paradoxical mindsets are embedded and alive in religious and spiritual traditions and transformations too. The ability to embrace spiritual and religious paradox is often linked to forms of enlightenment. Lao Tzu’s writing of the foundational Taoist text, the Tao Te Ching, is deeply paradoxical, filled with seemingly illogical and contradictory ideas for followers to consider that reveal a mystical reality—for example, the Taoist ideas that the purest white seems stained or that the highest tone is hard to hear. In the Catholic Christian tradition, the Prayer of St. Francis, a commonly recited prayer, suggests, “It is in the giving that we receive and in the dying we are born to eternal life.” In Zen Buddhism, there is the concept of the koan, a paradox that Buddhist monks are asked to meditate on in search of enlightenment. The Japanese Zen Buddhist Dōgen (1200–1253), founder of the Sōtō sect of Japanese Buddhism, suggests, “To study the Way is to study the self. To study the self is to forget the self. To forget the self is to be enlightened by all things of the universe” (quoted in Yokoi & Victoria, 1976, p. iv). Similar to the psychological implications of embracing a paradox, from a religious and spiritual perspective, being able to access a paradoxical mindset is the expression of spiritual growth and transformation. Research often suggests that the greatest change in trauma survivors is their spiritual growth (Magid et al., 2019). WITNESSING AS THE WORK OF THE PARADOX Once a person has let go of a dualistic mindset, for clinicians and caretakers, witnessing is the work in the paradox. It is more than noticing, different from observing, and more meaningful than watching. Witnessing is an act with psychological, spiritual, and cultural roots and implications that express

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connection, relatedness, and a lived belief that human narratives are purposefully, intentionally, and—with important, often sacred, reason—intertwined. Witnessing is a process that involves two or more people: one or more people who are in the role of performing or bearing witness to a traumatic event, and one or more people who are in the role of witness to the one who holds the trauma narrative, and so are now connected to the traumatic event in a unique way. Relative to trauma, spirituality and growth, witnessing has at least three connections that are important for professional listeners to consider. Witnessing may serve as: • A psychological intervention that allows for the containing of the therapeutic space and a genuine expression of deep empathy connected to trauma work and growth. • A spiritual context that acknowledges and expresses an interconnectedness, a spiritually grounded sense of hope, and from a Buddhist perspective, as a form of consciousness that allows one to embrace the paradox. • A cultural expression that is an integral part of the process of systemic change needed for growth relative to intergenerational, historical, and communal traumas. Witnessing as a Psychological Intervention Witnessing is a very powerful psychological intervention connected to why trauma happens, the way through traumatic experiences, and how one works with PTG. From a psychological perspective, the role of the counselor and care worker when presented with human suffering and the potential paradox of growth is to witness. It is to see the night, acknowledge the injustice of human suffering that a person was asked to bear, and to wait, awake, with an awareness that at some point, during some night, there may be a bloom that is worthy of witness too. It is of no help psychologically if at any level a counselor or caretaker demands a bloom. One does not stay awake in the night with expectation of a bloom. One may stay awake with another in the night knowing that blooms can happen, knowing that there are psychological factors are related to when and why blooms happen, and knowing that witnessing a night bloom matters too. Witnessing taps into the interconnectedness of human story, takes power away from painful parts of narratives, and provides evidence of the legitimacy of life events, positive and negative alike. Peter Levine (2010), psychologist and developer of somatic therapy, suggests that “trauma is not what happens to us, but what we hold inside in the absence of an empathetic witness” (p. xii). Humans are relational beings. They have a psychological need for the presence of others in extreme stress.

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Alice Miller (1980), in her work on childhood trauma and maltreatment, suggests the necessity for a process akin to the empathetic witness as a protective factor and a way to diminish the cyclical nature of violence. Miller’s research found that children who experienced maltreatment and violent acts, often in the name of “parenting,” were significantly less likely to repeat abuse patterns of violence as an adult if, as a child, there was an “enlightened helper” present—an adult in the child’s life who could articulate for the child that the maltreatment was not in any way justified, and that they were worthy of love and remained always deeply good. However, without an enlightened helper, the risk of perpetrating violent acts as an adult increased. Sometimes it is only in the absence of a witness that the importance of the presence of a witness is more fully understood as a necessary component for transforming negative emotional experience (Nelson-Becker & Sangster, 2019). Miller found that, without an “enlightened helper” as a child, for healing and growth adults needed to find an “enlightened witness.” This person, often in the role of mental health professional, but certainly not always, is one who listens with deep empathy, compassion, and a nonjudgmental presence, and by doing so validates the traumatic experience as real, painful, and unjust. Through the presence of an “enlightened witness” who sees the inner child that holds the violent narrative, the negative effects of trauma that live in their body and brain and that have a significant negative impact on human relationships and behaviors, can be diminished, even extinguished. An “enlightened witness” has the capacity to change the lived experience of a person, allowing trauma to be processed and moved to part of the past narrative, not alive in the present. Through the act of witnessing human suffering, even if the suffering happened decades ago, a person may decrease isolation, decrease denialism, validate the truth of the traumatic experience, and set free an authentic self, held hostage by childhood maltreatment. Psychologically, witnessing has transformative powers. Similarly, Richard Schwartz (2023), psychologist and developer of internal family systems therapy, a model for working with people who have experienced trauma with over 30 years of supportive research, suggests that a significant part of the work to heal trauma is in teaching clients to take on the role of a “compassionate witness” (p. 127) to the parts of the self that have been traumatized. As briefly mentioned in chapter 1, the theory postulates that the core self is composed of eight Cs: compassion, curiosity, clarity, creativity, calm, confidence, courage, and connectedness. There are three parts of the self that are distinct mental systems, much like a family is made up of distinct people: exiles (younger, emotional, vulnerable, sensitive parts that hold trauma), managers (the parts that keep a person going) and firefighters (extreme versions of the manager). When internal conflict between the parts is resolved, the core self can be the place from which a person meets life.

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Until this happens, often only in therapy with a trained internal family systems (IFS)‌‌‌‌‌ therapist, the parts of the self will react and respond to life with the sole aim of protecting the exile(s), limiting their experience of the world. IFS suggests that the way to resolve inner conflict between the parts is deeply connected to the ability to teach a suffering person to become a compassionate witness to their pain. Only with a compassionate witness to their parts can they know their parts, embrace their parts, resolve conflict between their parts, and transform their experience of life. Without resolved conflict through an ability to compassionately witness, the core self will never be found, will never be able to lead. This means a lack of access to curiosity, to calmness, to courage. This means fettering experiences of wonder, awe, and growth. The importance of witnessing is noted, too, in psychoanalytic writings. Bearing witness to suffering is conceptualized as an essential curative factor in all therapeutic work and a necessary function of the therapist (Ullman, 2006). Relational psychoanalysts have suggested that positive, powerful, deep, and transformative learning experiences are possible when a therapist presents with a combination of authenticity, understanding, and witnessing. Such moments are termed authentic relational moments and are considered places where a therapist and patient experience “something more” than the positive effects of the therapeutic alliance (Békés & Hoffman, 2020). Across the multiple psychological frames noted above, the capacity to see injustice and validate self-worth with the goal of decreasing the negative effects of trauma happens through witnessing. A witness can see only what is in their frame, however, and if their frame does not hold understandings of the paradox of growth, there will likely be no growth to see. If a witness holds a belief that sometimes, for some people, there may be a paradoxical experience of trauma, the witness will also be able to see and validate growth if it exists. A nuanced understanding of the paradox knows that growth that is found very close to traumatic experience is often illusory. For psychologically, one disengages as a protective process soon after traumatic experiences. They do not quickly bloom. Seeing a night bloom is only possible in the night, and so, as has been suggested, the processes of witnessing trauma and witnessing growth may very well happen at the same time (Joseph, 2019). In working with a paradox, to successfully witness the darkness and stay open to a possibility (not a necessity or expectation) of a bloom, one must have a place where they can see both. Witnessing growth should not negate witnessing trauma. Likewise, witnessing trauma should not negate witnessing growth in the paradox of human suffering that sometimes exists.

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Witnessing as a Spiritual Context Across Western and Eastern religious and spiritual traditions and practice, witnessing is a consequential act that has implications for professional counselors and caretakers to understand who work with human suffering from a pastoral and spiritual context. In related yet distinct ways from the psychological context, the role of witness from a spiritual context is part of the process of accompanying others, of meeting the self, and of becoming whole. It is understood as a sacred task that can validate the meaningfulness of experiences of loss, success, and moments of transition (Nelson-Becker & Sangster, 2019). As a spiritual act, witnessing is understood as essential in meeting moments of suffering and flourishing alike. Witnessing acknowledges an interconnectedness between a person and a sense of transcendence. A person may then encourage or discourage suffering and growth dependent upon their ability to witness from a spiritual context. In Western religious rituals, the role of witness and the act of witnessing have a significance in living a holy life. For instance, a person may serve in the role of a witness in the Catholic Church for the sacraments of baptism (a rite of initiation to the religion), confirmation (a rite of full membership into the religion), and marriage. The witness holds a special place in religious practices, as they serve to legitimize, testify, and sponsor those engaging in the religious faith. Witnessing is an act of validating not only the person who experiences the religious rite, and the fact that the religious sacrament indeed happened, but also as a testament to the Catholic faith as real and true. Beyond the Catholic sacramental traditions, many Christian denominations believe that part of living a spiritual life is to share one’s faith story. This is done through the spiritual practice of Christian witnessing, a testimony of one’s personal experience with Jesus shared with others in a public act of faith. Christian witnessing is “intended to awaken in the world belief in and hope of salvation (Durrwell, 1980, p. 121). By sharing personal stories of transformation, often starting with experiences of an unsaved, suffering self who is transformed in relationship with Jesus, a person grows more deeply connected to God, and may even serve to transform others’ lives in important spiritual ways. Through the act of Christian witnessing, individual spiritual transformation is possible. The unsaved are saved. Eastern spiritualities have different, and perhaps even more direct implications of transformation in relation to the paradox of suffering. Across many Eastern spiritualities, a central task in living well is cultivating the witness consciousness. This form of consciousness is thought to live alongside normal consciousness. It involves cultivating a sense of witnessing the self in the here and now without judgment or criticism. Ram Dass (2013) writes of the important role in spiritual practice of cultivating the witness consciousness,

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as it allows non-attachment and nonjudgmental observance of one’s life, thoughts, feelings, and emotions—being fully present in the moment. With the practice of bringing awareness to one’s witness consciousness, one may find a greater sense of self-awareness and centeredness that allows one more access to feeling daily joys in the present moment. Another Eastern spiritual practice of witnessing is the Buddhist act of witness consciousness. At the heart of bearing witness is an understanding that suffering exists in the world. Bearing witness is the intentional process of exposing oneself to the suffering of the world. Bearing witness can be met with the Buddhist understanding of the Middle Way, where one practices a way of thinking and being in which polarities, dualities, the hard pieces of the self and the world as well as the beautiful pieces of self and the world, are met without attachment. Activating such a sense of non-attachment and compassion to the suffering of the world is thought to be connected to finding wisdom (Dalai Lama, 2009). The Buddhist spiritual practices of bearing witness and the Middle Way suggest that harmony and wholeness come when one awakens to life that is more than dualistic thoughts and feelings, and can hold a place of non-attachment to either polarity of existence. So then, in the spiritual context of witness, hope is alive, growth is possible, and suffering and growth are even expected, though the attachment to either is discouraged. One experiences the need to not deny or disregard suffering, and the need to not deny or discount growth alongside suffering. In the spiritual context of witnessing, one learns it is a spiritual goal to learn to hold the paradoxical space where trauma and growth may simply both be. Witnessing as Cultural Expression and Transformation Researchers almost ubiquitously consider the paradox of trauma and growth on an individual level as the changes a person recognizes as they make meaning moving through trauma. Yet, of course, trauma is experienced on a systematic and collective level too. Wars, genocide, slavery, oppression, all can create trauma reactions in the people who have experienced the traumatic events as well as future generations that continue to live out trauma reactions even if the event is in the past. Intergenerational trauma, also referred to as generational trauma, is trauma experienced by an individual or community that is passed down to future generations. Historical trauma is the psychological and emotional wounds accumulated over a lifespan and across generations from a group-level trauma (Brave Heart, 2000, 2003). Historical traumas are widespread events that have malicious intent to harm groups of people and that cause collective suffering (Wesley-Esquimaux & Smolewski, 2004).

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The work on PTG to date has been exceptionally helpful in moving the lens of trauma from a sole focus on negative symptoms to a more balanced understating, a more complete picture of the individual that sometimes, for some people, includes positive transformations. The individual trauma level is important, necessary, and incomplete, as it doesn’t make space or provide a framework for the collective experience of trauma and so a collective experience of healing and growth. The idea to look at systemic or collective trauma in the construct of PTG in psychological research literature is a new idea, with very few articles that directly consider the relationship. This is not surprising, as the history of trauma work specifically and psychology more broadly for a long time examined understanding from an individual lens. However, now there is certainly consensus that individuals are impacted by the systems they live in, and that trauma can be experienced communally, passed down intergenerationally, and experienced not as an acute experience with a beginning and an end but systematically, in effect leaving a person with no pre-trauma world to even consider. The identity of the self in such a case is formed in a systemic trauma narrative. Just as the positive psychology movement encouraged a giant step backwards to examine positive growth, understanding of PTG is at a place where there is a need to take another step back to consider communal growth and transformation. Ortega-Williams et al. (2021) suggest that the growth is possible on a communal level too: if clinicians can see the individual and collective traumas, they can work with the individual and collective growth at the same time, with a framework that allows for both. We can only experience collective growth when we allow ourselves to witness the collective trauma. The hope is that group-level witnessing can undo harmful realities of collective trauma and systems of oppression rather than perpetuating masslevel wounds. From a collective trauma perspective, more than individual psychology is needed to turn toward trauma, to witness trauma, if it is ever to be integrated and processed in society. Colonialism, slavery, racism, and genocide are all widespread soul wounds that one is born into and that we as a society mostly spend energy, perhaps unconsciously, turning away from. Intergenerational trauma, historical trauma, race-based trauma—all results of horrific and evil expressions of humanity—happened in the past but are all too alive today in the systems, structures, and so the narratives of living people. These forms of communal trauma do not die with the person who lived through them. They are passed to future generations who are removed from the original experience but live with the legacy of trauma today. Just as unintegrated and unprocessed trauma will affect an individual, so too will trauma continue to affect our collective experiences, systems, structures, ideologies, and beliefs.

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Communal-level traumas such as historical trauma, race-based trauma, and intergenerational trauma are directly spoken of far less in PTG literature. However, trauma can and should be considered on the communal level, so that the meta-narratives that structure how people live, love, are born and die will not continue to be a vehicle for the perpetuation of oppression, injustice, and harm. Unless PTG is considered on the communal level, the positive transformation and growth of our collective selves is fettered too. Witnessing is a cultural expression necessary to acknowledging and integrating collective traumas, transforming society, and claiming collective growth. Psychologist and activist Melanie Joy (2019) suggests is an “antidote” to oppression and the necessary action in revolutionary systemic change. Psychologist Kaeth Weingarten (2003) likewise suggests that witnessing is the healing response to “othering” that is part of collective trauma and develops through tapping into a sense of shared humanity. When one takes on the role of compassionate witness, one who can pay attention with empathy and without judgment, social transformation from acts of communal violence is possible. Witnessing collective trauma serves to allow traumas to be both known and communicated (Goodman, 2012). Bearing witness to communal-level trauma is then an act of social justice. When people bear witness to the narrative of trauma of colonization, such an act can be understood as political activism and can lead to taking control of how such collective traumas are both represented and interested, leading to systemic change (Goodman, 2012). Positive systemic change can be understood as collective growth, made possible through the act of witnessing. Judith Herman (1992), in her book Trauma and Recovery, argues that unlike individual confrontation of trauma that is possible through skilled clinicians, the systematic confrontation of trauma is dependent on a political movement as well. She writes, “In the absence of strong political movements for human rights, the active process of bearing witness inevitably gives way to the active process of forgetting” (p. 9). Bearing witness will never be enough to fully dismantle symptoms of oppression or heal cultural traumas. However, witnessing has deep importance as a broader cultural expression in that it is an integral part of the process of systemic change embedded in collective, intergenerational, and historical traumas. The role of witness makes possible both communal healing from trauma and communal growth. SUMMARY A large part of the expression “I don’t even know what to say” when someone shares trauma in their life story, either directly or indirectly, is rooted in

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a failure to understand trauma, a desire to look away from trauma, and/or a failure to see the importance and power that is part of being a compassionate witness to trauma. As Bessel Van der Kolk (2015) suggests, “Nobody wants to remember trauma. . . . We all want to live in a world that is safe, manageable and predictive and victims of trauma remind us that this is not always the case” (p. 196). Yet, without remembering trauma, loss compounds. An individual and a collective system miss opportunities to create, to explore, to wonder, to love, to grow. A nuanced understanding of trauma and traumatic growth, and the transformational power embedded in the role of being a compassionate witness, allows a person to have access to useful, connecting, healing words in facing human suffering, and hope in the possibility of individual and communal growth moving through trauma. I see you; I see your suffering; the suffering is unjust; you are worthy of love and goodness; you are worthy of protection and care; you are worthy of healing and hope. Witnessing is the work in the paradox: to witness the night, to stay awake in the night, so to witness the bloom too. Witnesses may indeed be silent in their words at purposeful times. But they do so from a place of knowing, not from not knowing about trauma. They do so from a place of awareness, not unawareness or pseudo-awareness of the role of witnessing. Psychologically, spiritually, and culturally, witnesses remain connected to trauma and growth as they observe with deep empathy and relate an expression of interconnectedness, of hope without attachment, and a recognition of the cultural reality of trauma, and sometimes, they reveal the paradox of suffering and growth. The role of witness is an expression of meaning that validates another’s but is not an “othering” experience. As a witness, it is the act of seeing that is of consequence first, not saying. The saying comes from seeing, from witnessing when it comes to trauma and growth: I see you; the Divine sees you; the world sees you; you matter. Witnessing is a deeply relational act that heals wounded attachments to trauma and can even set up a person to grow. The work of the paradox is presented in the act of witnessing. And yet, there is a challenge presented too. We cannot let traumatic growth, the night bloom, be the best one can hope for humanity. This perspective risks encouraging systems of traumatic oppression. If the frame that one holds is that the best one can do is paradox, then growth is both glorified and fettered. While not all trauma is avoidable, systematically, some trauma is: certainly, the traumas that come from ignorance, a belief in and giving power to oppressive systems, a lack of critical awareness of systemic oppression, and a lack of advocacy work—and even trauma that may be perpetuated by glorifying traumatic growth.

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When working with a paradox such as suffering and growth, one cannot allow it to be all one works for. From a systemic perspective, the greater goal in the work of the paradox of trauma, spirituality, and growth, is to move humanity to a place where one can honor traumatic growth and be interested in creating systems that all people can live and love in and that don’t harm anyone at all. The challenge of the paradox is to remember that the best-case goal of the paradox is not for everyone who breaks to grow strong in their broken places (Hemingway, 1929/1995). The best-case goal is not knowing how to compassionately witness and so what to say when someone presents trauma. The best-case goal is not night blooming. The best-case goal of the paradox of trauma, spirituality, and growth is, as it is in traditional trauma work, an end to trauma. Far better than everyone breaking and everyone growing strong in broken places is a world where people are not broken by each other at all.

Conclusion

Years ago, I was asked to present to a group of spiritual directors, religious educators, ministers, and pastoral counselors gathered together to learn about PTG in the context of pastoral and spiritual care. I started my presentation in the way I do many presentations to psychologists, social workers, and counselors. I asked them to take a moment and consider the following question in regards to their professional practice. I asked them the question, “Do you believe in growth?” The question carried with it the intent to guide the group to reflect upon that when in the role of a professional care giver, how what they believe about suffering and growth will directly relate to how they sit with, and so then what they say to, a person in their care who is suffering. In general, I have found that over the years of asking this question, the responses of mental health professionals related to their belief in growth are often a pondering of the varied psychological theories and interventions that guide their practice. Understandably, most often mental health providers notice that they work from disease-model interventions. Considering what is going wrong more than what is going right. So then, the growth-related questions are often a secondary thought, if a thought at all. When I asked the same question to the aforementioned pastoral and spiritual care providers, I imagined that the group would consider the varied theological theories and pastoral interventions that guide their ministries. I imagined the space between theoretical and lived theodicies, or theology in practice might be approached. Yet before such a conversation could be had, one loud, somewhat sarcastic, perhaps somewhat narcissistic, declaration came from the audience; “Well, I certainly hope we do!” The conviction of this care provider was clear. However, the response gave me great pause and it was, in part, the impetus for writing this book. In my many years as a counselor educator and clinician, I have seen how a belief in the possibility of growth is an essential part of trauma work and how the expectation of growth leads to working with people who are suffering in less than helpful ways. As a pastoral care provider, working from an 87

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expectation of growth can create significant blind spots in meeting people in our care. They can cause a caregiver to miss a person entirely. They can lead to a caregiver not knowing what to say when confronted with trauma, or to too quickly saying something that is not helpful at all as it relates to their faith experience as a caregiver and not the person who is suffering. This book suggests that pastoral and spiritual care providers need not give up their religious and spiritual convictions, but they must, too, understand that a caregiver’s faith is not a worthy substitute for a deep understanding of the realities of trauma and the nuanced complexities of the process of PTG. As articulated in this book, to accompany a person well, in times of stress and trauma, a pastoral and spiritual care provider must • be trauma informed, aware of the psycho-neurobiological reality of trauma, the way it is lives in people’s physical bodies, changes people’s brains, and effects people’s capacities to be in relationships; • understand the utility of varied psychological interventions in working with people who are suffering; • see the paradox of trauma and growth that moves beyond a polarity of positive and negative emotions and toward a focus on the interplay between the two; • understand a model for the development of PTG grounded in the loss of one’s assumptions of how the world “ought” to work and the space for the formations of new meaning; • recognize the various interpersonal, intrapersonal, and systemic factors that may encourage or discourage growth; • be aware of how varied religious and spiritual perspectives can be a great strength in the formation of PTG ‌‌‌‌, a hinderance to growth, a way of by-passing true psychological and spiritual growth, or the very cause of trauma itself; and • ground oneself in the role of witness as way of noting the great suffering that is trauma, and when it exists, noting the ways in which a person’s meaning and perspective has changed in positive ways as they have moved through the night. With a deep understanding of the points above, pastoral and spiritual caregivers will recognize that any words a caregiver says in response to a person who shares a story of suffering must not not merely seek to fill space with noise, nor come from a caregiver’s needs related to expecting another’s growth. Silence in the face of witnessing suffering is revealed not necessarily as the absence of knowing what to say. Silence can be at times an intentional and powerful response in the role of witness. But silence can also be not knowing what to say because one is not trauma-informed or because one is

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using spirituality to bypass the painful reality of trauma in the narrative they are asked to witness. To commit one’s professional life to pastoral and spiritual care means being open to turning toward and walking with people who are suffering. Human suffering often evokes existential questions that hold religious and spiritual themes. However, if we believe that religion or spirituality alone can heal trauma and lead to growth, we are dangerously wrong. Religion and spirituality can be powerful forces to cope with stressful life experiences, to keep people alive and guide them through a night. For some religion and spirituality reveal themselves to be the most powerful force in times of suffering. And for some people, religion and spirituality block people from engaging the paradox of trauma and growth, or worse still, cause stress and trauma. Even when active in a person’s life in the most positive of ways, religious and spiritual practice should never alone be asked to heal trauma. And yet sometimes many deeply religious and spiritual people ask this of faith. In this world where trauma grows more ubiquitous, the need for skilled pastoral and spiritual care givers who are trauma-informed, who understand psychological and spiritual development and their integration, and who can believe in the possibility of the paradox of trauma and growth without demanding it, is ever more necessary. Caregivers who can accompany people in the night, stay awake in the night, notice a night bloom and the power it has to form a person’s life with deeper meaning and wisdom may be as rare as witnessing a cereus cacti bloom. Yet, with commitment to becoming trauma-informed, to a deep and nuanced understanding of PTG, and the complex relationship that religion and spirituality has with growth, the ability of pastoral and spiritual care providers to notice night blooming may certainly grow. Witnessing such a paradox has deep implications for living a more meaningful life for the one who is being cared for and the caregiver alike.

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Index

abuse: physical, 20–21; sexual, 67–68 Aceh conflict, 65 active coping styles, 41 adaptive coping styles, 30, 41–42 Adaptive Information Processing Model, 15 adrenaline, 44 adversarial growth, xi adverse childhood experiences, 33 aggression, spiritual, xiii agreeableness, 40, 41 Ainsworth, Mary, 10–12 American Psychological Association, 22 amygdala, 7–8 anxiety, 26, 30 appraisal, principle of, 26 ARMs. See authentic relational moments assumptive world, 10–14 Atheism, 58 attachment theory, 11–12 authentic relational moments (ARMs), 79 “bad” emotional states, 25 baseline level of functioning, 17 basic life assumptions, 13 Baumeister, Roy, 48 Beauregard, Mario, 54

behaviorists, on personality, 40 belonging, sense of, 30, 48 Benet-Martínez, Veronica, 40 blooming, 37. See also night blooming The Body Keeps the Score (Van der Kolk), 4 Bowlby, John, 10 brain, trauma and, 4–5, 7–10 breast cancer patients, 42 Buddhism, 19, 54, 58, 63, 76, 81 Calhoun, Lawrence, xi Cataldo, Lisa, 4 categorical thinking, 74 Catholic Church, 67–68, 76, 80 CED. See Cognitive-Emotional Development cereus cactus, xiv, 37 character strengths, 64–66 childhood trauma, early, 9, 11–13 children: adverse childhood experiences, 33; corporal punishment of, 20–21; enlightened helper and, 78; infants, 10–12, 29; meaning for, 29; of parents with schizophrenia, 33; resilience of, 33–34; social support for, 47 Christian witnessing, 80 chronic trauma, 5 105

106

Index

cognitive behavioral therapy, 43 cognitive dissonance, 20 Cognitive-Emotional Development (CED), 70 collective trauma, xi, 82–83 communal trauma, 82–83 compassion, xv compassionate witness, 78, 83 complementarity, principle of, 26 complex trauma, 5–7 conscientiousness, 40, 41 consciousness, witness, 80–81 coping: with distress, 60–63; religious, 60–61; social support and, 47; strategies for stress, 44; styles, 30, 41–43 2 Corinthians 1:5–6, 59 corporal punishment, 20–21 cortisol, 44 Costa, P., 40 courage, as virtue, 63 co-valence, principle of, 26 COVID-19 pandemic, 41, 60 critical positivity ratio, 74 Cultural Influences on Mental Health Model, 49 culture and culture-related experiences: for night blooming, 49–51; witnessing and, 81–83 DCT. See Developmental Counseling and Therapy Model death, 19–20 depression, 30, 53 Developmental Counseling and Therapy Model (DCT), 70 Dezutter, J., 29 Dharma, 58 Diagnostic and Statistical Manual of Mental Disorders (DSM III), 5 disease-model interventions, 87 disengagement, 9 Disorders of Extreme Stress Not Otherwise Specified or (PTSD/ DESNOS), 6

distal influences, 50 distress, 28, 30; coping with, 60–63; night blooming and, 44–46 Divine Responsibility, 59 DNA, 12 Dōgen, 76 doubt, 72 DSM 5-TR, 5, 6 DSM III. See Diagnostic and Statistical Manual of Mental Disorders dualistic thinking, 74, 75 early childhood trauma, 9, 11–13 Ecstasy (MDMA), 16 EFTT. See emotion focused therapy for trauma EMDR. See eye movement desensitization and reprocessing emotional experience, sharing, 47 emotional states, 25, 75 emotion focused therapy for trauma (EFTT), 15–16 emotions: negative and positive, xiv, 21, 22–25, 74–75; regulation of, 8 Encounter Theodicy, 58 enlightened helper/witness, 78 epigenetics, 12 eudaimonic well-being, 31–32 evolution, principle of, 26 exercises: grounding, 3; “Strange Situation,” 11, 12 exiles, 15, 78 Existential Psychotherapy (Yalom), 26, 76 extroversion, 40 eye movement desensitization and reprocessing (EMDR), 15 family cohesion, 33 family stability, 33 fertilization, 37 FFM. See Five Factor Model fight-flight response, 8, 44 firefighters, 15, 78 Five Factor Model (FFM), 40, 41–42

Index

flight responses, 9 flourishing, 74 flowering plants, 45 Foa, Edna, 14 forgiveness, 65–66 For Your Own Good (Miller), 21 Four Noble Truths, in Buddhism, 63 Fredrickson, Barbara, 23, 74 Freud, Sigmund, 53 front-line health care workers, 41 frozen responses, 9 Garmezy, Norman, 33 German Nazis, 1 global meaning, 27–28, 45 Goleman, Daniel, 8 “good” emotional states, 25 gratitude, 65–66 Greece, 41 grief, traumatic, xiii A Grief Observed (Lewis), 30 grounding exercises, 3 growth: adversarial, xi; positive, 28; spiritual, 20; stress-related, xi; traumatic, 2. See also posttraumatic growth; specific topics happiness, 22–23, 53 health care workers, front-line, 41 heart rate variability, 16 Hefferon, Kate, 32 Hegel, Georg Wilhelm Friedrich, 26 helplessness, x Herman, Judith, 2, 5, 83 hijacking, of brain by amygdala, 8 Hinduism, 58, 63 hippocampus, 8 historical trauma, 50, 81 Historical Trauma—Posttraumatic Growth (HT-PTG) framework, 50 holy texts, 58 hope, 64 hormones, stress, 9, 44 The House on Pooh Corner (Milne), 46

107

HT-PTG. See Historical Trauma— Posttraumatic Growth framework Hugo, Victor, 34–35 human narrative, 23 humility, as virtue, 64 hypothalamus, 44 “I don’t even know what to say,” ix–x, 84 IFS. See internal family systems therapy imaginal exposure, 14 infants, 10–12, 29 interdisciplinary conversations, xiii intergenerational trauma, 12, 81 interior singlet, 15 internal family systems (IFS) therapy, 15, 79 International Statistical Classification of Diseases and Related Health Problems, 6 interventions: disease-model interventions, 87; trauma, 14–16; witnessing as, 77–79 in vivo exposure, 14 Iraq wars, 41 Islam, 54, 58 Ivtzan, I., 25–26 Janoff-Bulman, R., 13, 57 Japan, 67 Jesus, story of, 58 Job, story of, 58 Johns Hopkins University, 11 Joseph, Stephen, xi, 32, 57 Joy, Melanie, 83 Judaism, 54 justice, as virtue, 64 karma, unfolding of, 63 Kierkegaard, Soren, 62 knowledge: Limited Knowledge Theodicy, 59; as virtue, 63 koan, 76 languishing, 74

108

Index

Lao Tzu, 76 Levine, Peter, 16, 28, 77 Lewis, C. S., 30–31 LGBTQ community, religious trauma against, 68 life assumptions, basic, 13 Limited Knowledge Theodicy, 59 Linley, Alex, xi living in the moment, 20 Lomas, Tim, 25–26 loneliness, x Losada, M. F., 74 maladaptive coping styles, 30, 43 managers, 15, 78 Marcel, Gabriel, 63 McCrae, R. R., 40 MDMA. See methylenedioxy-methamphetamine meaning: absence of, 30; global, 27–28, 45; importance of, xi; making, 26–28, 56–60; religion as framework for, 55; situational, 27–28; spirituality as framework for, 55; suffering and, 56–60; well-being and, 29–30; wisdom and, 29 Meaning Making Model, 27–28 “Meaning Making Model of Coping” (Park), xiv medial prefrontal cortex (middle brain), 8, 9 meditation, 16 memory, 7, 9, 44 metanoia, 72 methylenedioxy-methamphetamine (MDMA), 16 middle brain (medial prefrontal cortex), 8, 9 Middle Way, 81 military veterans, 41 Miller, Alice, 21, 78 Milne, A. A., 46 motivational interviewing, 68–70 Muhammad (Prophet), 58

narrative cohesion, lack of, 9 Nazis, 1 need-to-belong theory, 48 negative coping styles, 61–62 negative emotions, xiv, 21, 22–25, 74–75 neuroticism, 40 New Testament, 58 Niederland, William, 4 Night (Wiesel), 1, 57 night blooming, xiv, 18, 37–39, 73–75; culture and culture-related experiences for, 49–51; distress and, 44–46; paradoxes as transformation, 76; personality and, 39–43; social connections and, 46–49; spiritual change and, 66–67; summary, 51. See also witnessing Ninety-Three (Hugo), 34 non-dualistic thinking, 75 Nowen, Henri, xi Old Testament, 58 O’Leary, Denyse, 54 On Becoming a Person (Rogers), 76 open-ended questions, 23 openness, 40–42 optimism, 41–43 organized religion, 54 Ortega-Williams, Anna, 50, 82 othering, 83 Overcoming Theodicy, 59 Ozer, Daniel, 40 Paivio, S. C., 15–16 Park, Crystal, xi, xiv, 27 Pascual-Leone, A., 15–16 patriarchy, religious, 68 PE. See prolonged exposure therapy personality, night blooming and, 39–43 personal protective equipment (PPE), 41 Pew Foundation, 54 Pew Research, 60 phenomenological reasoning, 25 physical abuse, of children, 20–21

Index

physical death, 19–20 Piaget, Jean, 70 Piglet (character), 46, 48 plants, 37, 45 pleasure, 32 pollination, 37 positive coping styles, 61 positive emotions, xiv, 21, 22–24, 25, 74–75 positive growth, 28 positive psychology, xiv, 21, 22–24, 82 positive psychology 2.0 (second wave positive psychology), xiv, 21, 24–26, 35, 43, 75 positive social relationships, 11 posttraumatic growth (PTG), x–xi, xii, 2, 44–45; cereus cactus as metaphor for, xiv, 37; eudaimonic well-being and, 32; FFM and, 40; meaning making and, 26–28; optimism and, 42–43; place for, 17–18; religion and, 56–66; resilience and, 34; spiritual change and, 66–67; spirituality and, 56–66 Posttraumatic Growth Indicator (PTGI), 66 posttraumatic stress disorder (PTSD), 5, 6, 59 PPE. See personal protective equipment prayer, 62 Prayer of St. Francis, 76 prefrontal cortex, 7 Project Competence (study), 33 prolonged exposure (PE) therapy, 14 Providence Theodicy, 59 proximal influences, 50 Psalm 18:28, xii psychoanalytic theory, on personality, 40 psychological variables, 53 psychological well-being, 31 PTG. See posttraumatic growth PTGI. See Posttraumatic Growth Indicator PTSD. See posttraumatic stress disorder

109

PTSD/DESNOS. See Disorders of Extreme Stress Not Otherwise Specified punishment, corporal, 20–21 Quran, 58 Ram Dass, xi, 80 Random Theodicy, 59 Reaching Out (Nowen), xi relationships, 10; positive, 11; social connections, 46–49 religion, xiv–xv, 53, 89; defining, 54–56; PTG and, 56–66; summary, 71–72; as trauma, 67–68 religious coping, 60–63 resilience, ability to build, 32–34 Retribution Theodicy, 59 Rogers, Carl, 76 Rumi, 19 Sartre, Jean Paul, xii SBNR. See Spiritual But Not Religious schizophrenia, children of parents with, 33 Schwartz, Richard, 15, 78 second wave positive psychology (SWPP), xiv, 21, 24–26, 35, 43, 75 self-compassion, 64, 66 self-pollinators, 37 Seligman, Martin, 22 sexual abuse, within Catholic Church, 67–68 Shapiro, Francine, 15 shared humanity, 83 Shattered Assumptions (JanoffBulman), 13, 57 Shaw, George Bernard, 19 simplicity, trading wisdom for, 29–31 situational meaning, 27–28 Smith, Ruth, 33 social-cognitive theory, on personality, 40 social connections, night blooming and, 46–49

110

Index

social relatedness, 46 social support, 46–47 somatic experiencing, 16 Sōtō sect, 76 Soul-Building Theodicy, 58, 59 “spare the rod, spoil the child,” 20 spiritual aggression, xiii spiritual and existential change, 67 The Spiritual Brain (Beauregard and O’Leary), 54 Spiritual But Not Religious (SBNR), 54–55 spiritual bypassing, 68–70 spiritual change, 66–67 spiritual context, witnessing as, 80–81 spiritual growth, 20 spirituality, 53, 89; defining, 54–56; PTG and, 56–66; summary, 71–72. See also specific topics “Strange Situation” exercise, 11, 12 stress, 4; accumulating, ix; brain scans for, 5; PTSD, 5, 6, 14–16, 59; responses, 44; trauma versus, 6–7, 44. See also specific topics stress hormones, 9, 44 stress-related growth, xi suffering, x, xv, 89; meaning making in, 56–60; spiritual growth, 20 Suffering God Theodicy, 59 suicide, risk of, 48 SWPP. See second wave positive psychology Tao Te Ching (Lao Tzu), 76 technological disasters, 1 Tedeschi, Richard, xi temperance, as virtue, 64 theodicy, 58–59 Thich Nhat Hanh, xi Thomas Aquinas, 59 trait theorists, on personality, 40 transcendence, 53, 55; as virtue, 64 trauma: accumulating, ix; assumptive world and, 10–14; brain and, 4–5, 7–10; chronic, 5; collective, xi,

82–83; communal, 82–83; complex, 5–7; defining, 4–7; early childhood, 9, 11–13; EFTT, 15–16; historical, 50, 81; intergenerational, 12, 81; interventions, 14–16; religion as, 67–68; stress versus, 6–7, 44. See also specific topics Trauma and Recovery (Herman), 5, 83 trauma-informed, becoming, 3 trauma-informed care, 2 traumatic grief, xiii traumatic growth, 2 Tripitaka, 58 Turkey, 67 Unorthodox Theodicy, 59 Upbuilding Discourses in Various Spirits (Kierkegaard), 62 Van der Kolk, Bessel, 4, 9, 16, 84 veterans, 41 Views of Suffering Scale (VOSS), 58 virtues, developing and deepening, 63–66 VOSS. See Views of Suffering Scale Weingarten, Kaeth, 83 well-being: limiting definition of, 31–32; meaning and, 29–30; nature of, 26 Welwood, John, 68 Werner, Emmy, 33 What Doesn’t Kill You (Joseph), 57 When Nietzsche Wept (Yalom), 27 Wiesel, Elie, 1, 57 Winnie the Pooh (character), 46 wisdom: pleasure and, 32; trading for simplicity, 29–31; as virtue, 63 witness consciousness, 80–81 witnessing, xv–xvi, 76; as cultural expression and transformation, 81–83; as psychological intervention, 77–79; as spiritual context, 80–81; summary, 84–85 women, religious trauma against, 68

Index

World Health Organization, 6

youth, 19. See also children

Yalom, Irving, 26–27, 76 yoga, 16

Zen Buddhism, 19, 76

111

About the Author

Dr. Mary Beth Werdel is an associate professor of pastoral care and counseling at Fordham University in New York, working at the intersection of mental health and spiritual care. She is also a licensed professional counselor with more than two decades of experience working with individuals and families. Her work focuses on the connection of spirituality and well-being in times of loss, stress, and trauma in the context of professional counseling, pastoral care, and professional ministry. She has lectured at research conferences, continuing education seminars, and public academic events. She is the author of three books: The Resilient Clinician, 2nd edition (Oxford, 2023) and A Primer on Posttraumatic Growth: An Introduction and Guide (Wiley, 2012), both co-authored with Robert J. Wicks, as well as As Faith Matures: Beyond the Sunday God (Ligouri Press, 2012).‌‌‌‌

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