Chronic Illness and Post-Traumatic Growth
Finding light in the darkness.
Posted Nov 14, 2019
“The wound is the place where the Light enters you.” —Rumi
I’ve had the opportunity this month to speak to patients, clinicians, and graduate-level social work students about my therapeutic work with people living with chronic illness. I love getting out into the community to share my experience and learn from others. It’s validating to be reminded that we exist in great numbers—both those of us who live with chronic illness and those invested in improving our quality of life. I never fail to be awed and humbled by the sheer grit I observe in people affected by illness.
This month’s blog post is about the ways that living with chronic illness can produce resilience, compassion, and self-efficacy. Nobody would consider illness a desirable occurrence, but the ways that people bear illness can create meaningful gains that resonate personally, relationally, and societally.
Post-traumatic growth is “a process whereby individuals show positive personal growth after experiencing a significant life-altering event or circumstance” (Zeligman et al., 2018). Tedeschi and Calhoun (1996) first defined and operationalized this concept, noting that, in addition to experiencing negative effects of trauma, “people exposed to even the most traumatic events may perceive at least some good emerging from their struggle.” Tedeschi and Calhoun (1996) identified five domains in which post-traumatic growth occurs. We’ll look at each of these in turn in the context of the experiences of people living with chronic illness.
1. Relating to Others
People coping with trauma “discover both the worst and best in others” (Tedeschi, Calhoun, & Groleau, 2014). While those of us who live with chronic illness have almost certainly been disappointed by the friends who go radio silent when we are struggling, we also likely have been surprised and moved by the people who have rallied to our side. We experience first-hand the lifeline that comes in the form of generosity, compassion, and support of others.
The relationships that sustain us during illness may may cause us to become more comfortable with vulnerability and intimacy. We may see in a new way that our relationships matter profoundly, and act in ways that strengthen and deepen those ties.
2. New Possibilities
When illness pushes us to accept that “what is” is different than what we may wish for, we start looking for potentialities in what remains of our abilities (Tedeschi & Calhoun, 1996). We are not who we were, and so we look for new ways to redefine ourselves and our purpose. When our energy is limited, we seek to accomplish what is important to us and cast aside what is not. Of necessity, we live a life reflecting our values, eliminating many of the “shoulds” we may have adhered to prior to illness.
3. Personal Strength
People living with chronic illness often discover we are stronger than we imagined (Tedeschi & Calhoun, 1996). We develop a sense of pride in facing the challenges chronic illness presents, living the paradox, “I am vulnerable, yet stronger” (Tedeschi, Calhoun, & Groleau, 2014).
4. Spiritual Change
People living with chronic illness grapple with existential questions regarding suffering, mortality and the meaning of life. Our philosophies of life are often deeply developed and personally satisfying (Tedeschi, Calhoun, & Groleau, 2014).
5. Appreciation of Life
Those of us who live with chronic illness often are profoundly aware of the importance of life’s “small moments.” We tend not to take for granted pleasurable experiences, “experiencing life at a deeper level of awareness”(Tedeschi, Calhoun, & Groleau, 2014).
Conditions Needed to Experience Post-Traumatic Growth
I want to emphasize that chronic illness is a terrible burden. It destroys much and causes great suffering. It’s not that chronic illness creates growth; it’s that the struggle with suffering offers the opportunity for growth. That said, most of us would prefer to not have that opportunity.
Some people reading this article will recognize themselves in my description of post-traumatic growth; others will not recognize themselves and perhaps feel worse. Tesdeschi, Calhoun, and Groleau (2014) state that “the presence of a social environment that explicitly addresses and encourages growth may be an important factor in promoting post-traumatic growth.” This growth-facilitating environment needs to address trauma symptoms of emotional dysregulation; it needs to create a holding environment in which grief, anger and fear can be felt and worked through; and it needs to encourage cognitive processing of traumatic events. If you despair of experiencing post-traumatic growth, I encourage you to seek therapy with a professional who is committed to providing a space that offers these qualities.
What Strengths Do You See in Yourself?
Growth through struggling with suffering is a lifelong process, not a a one-time achievement. There will always be days when we feel hopeless, angry, and isolated. We can honor those feelings while also trying to find the places where the light enters.
A recent qualitative study interviewed people with chronic illness about the strengths they’ve observed in themselves as they live with illness (Kristjansdottir et al., 2018). Participants cited qualities including persistence, compassion to others and self, courage, and insight. I invite you to take a few moments and write down the strengths that you observe in yourself. If you’d like, please share your findings in the comments section.
Kristjansdottir, O.B., Stenberg, U., Mierkovic, J., Krogseth, T., Ljosa, T.M., Stange, K.C., & Ruland, C.M. (2018). Personal strengths reported by people with chronic illness: A qualitative study. Health Expectations, 21, 787-795.
Tedeschi, R.G. & Calhoun, L.G. (1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455-471.
Tedeschi, R.G., Calhoun, L.G., & Groleau, J.M. (2015). Clinical applications of posttraumatic growth. In S. Joseph (Ed.), Positive psychology in practice: Promoting human flourishing in work, health, education and everyday life. (pp. 503-518). Hoboken, NJ: Wiley.
Zeligman, M., Varney, M., Grad, R.I., & Huffstead, M. (2018). Posttraumatic growth in individuals with chronic illness: The role of social support and meaning making. Journal of Counseling and Development, 96, 53-63.