- Coping responses such as dissociation can be double-edged; they stunt the development of healthy emotion regulation over time.
- Experiencing trauma often forestalls the development of a positive self-concept.
- For some, having a mental illness can lead to determination to understand the root of those problems and explore past trauma.
What does the healing journey from serious mental illness involve?
This was the central question of a study led by Xiafei Wang, now of Syracuse University, and her collaborators. More specifically, they were interested in recovery journeys through the lens of trauma and post-traumatic growth. Since people with serious psychological conditions are more likely to have trauma histories in which they experience events that overwhelm their resources to cope, Wang and her team sought to explore the role of trauma and post-traumatic growth in triggering, developing, and healing from serious mental health conditions.
To pursue this exploration, the researchers began by recruiting participants who had been diagnosed with a serious mental illness, including schizophrenia, bipolar disorder, and/or major depressive disorders; individuals who had been prescribed psychotropic medications but had been off of them for at least a year; individuals who met the criteria for recovery; and individuals with a trauma history.
From there, the investigators asked the participants to tell their “stories” about life before and after they were diagnosed, how they coped with the illness, what resources they used to recover, and their current mental health. The participants’ stories were then analyzed and coded.
The results were striking. The investigators found eight components that participants cited as part of their healing journey. The findings of the study are outlined below.
1. Affect dysregulation.
The participants reported that trauma made affect regulation difficult. In response, many used repression and dissociation as survival strategies to cope with their painful feelings. However, this was a double-edged sword, because this approach also stunted the development of healthy emotion regulation over time.
One participant shared: "All my belief systems and my perceptions had become very fluid. It was so intense, and I couldn’t get to sleep. All of my repressed stuff from childhood and earlier in my life just started flooding up into my consciousness, and then I just felt really overwhelmed."
2. Distorted self and other concepts; relationship difficulties.
Trauma also led to having distorted views of oneself and of others, including feeling unlovable and unworthy, feeling rejected, and having difficulties with trust and closeness in relationships.
A participant expressed: "Because of my own childhood, I had a hard time trusting anybody. I had good friends, and they did help. I was just careful what I disclosed to them. And I would take their help as much as I could, based on what I would actually share."
Trauma can shatter the assumption of a meaningful world, with person-outcome contingencies (i.e., the belief that events don’t occur randomly, and that there is a connection between a person and what happens to them). For some participants, this lack of meaning led to feeling that they had no control, were powerless, didn't have a life purpose, and had a foreshortened view of the future.
4. Existential fears.
Some of the participants’ traumas were due to witnessing the death of family members. The experience led to the fear of “annihilation” and the impermanent nature of life. Bearing witness to death was also linked to self-harm and mood swings.
A participant reflected: “I had agitated depression just after the death of my mother because I’d had a fairly traumatic childhood and relationship with her."
5. Self-acceptance: embracing emotions and changing perceptions of symptoms.
Transformation for some participants began with seeing their symptoms in a new light—they were not as out of control, negative, or meaningless as they once believed. Rather, participants began to feel more control over their symptoms, which in turn cultivated self-empowerment.
6. Self-exploration: connecting with past trauma.
For some people in this study, having a mental illness was the turning point that led to their healing journeys, and their determination to understand the root of their mental health problems. While the struggle was painful, it ultimately led to an exploration of their traumas, and the symptoms to which they gave rise. But it was making the connection between the past trauma and their current mental health symptoms that allowed them to develop healthier coping and reintegrate their fractured selves.
7. Self-worth: redefining self-concept and self-other relationships.
Experiencing trauma often forestalled the development of a positive self-concept, leading to various psychological challenges. Yet some participants also developed a greater sense of self-worth, which was central to their recovery and transformation.
One participant expressed: "What did I lose? I lost my sense of self, my self-esteem, and my self-worth. What did I recover? Me. I recovered me—myself. The more I recovered myself, and the stronger I came, the more I realized that the answers that everybody seeks are within us."
8. Self-fulfillment: serving others, community, and humanity.
Post-traumatic growth encouraged some participants to commit themselves to taking care of others, engaging in community service, and advocating for social justice. This transformation, the authors note, went beyond the healing of the individual. Rather, self-fulfillment was found in improving the lives of others and humanity at large.
Facebook/LinkedIn image: STEKLO/Shutterstock
Xiafei Wang, Mo Yee Lee & Nancy Yates (2018): From past trauma to post- traumatic growth: the role of self in participants with serious mental illnesses, Social Work in Mental Health, DOI: 10.1080/15332985.2018.1517401