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3 Dec

Shifting Perspectives: Confusion as The New Norm Part I – Tragic Optimism, Post-Traumatic Growth, and Grief

In conversations with clients, friends, and colleagues, and in the materials I have read from numerous mental health sources, the word “surreal” is often used to describe the feeling of this time when we are living through the COVID-19 pandemic. At times, it feels as if we are living someone else’s life – in someone else’s body. This sense comes and goes depending on what is happening at the moment. You can have the sensation that this is not real – and then settle into the reality of living your life and then something else may happen that brings back the surreal feeling. This is where I begin the discussion of shifting perspectives.

 

Here are ways in which the current situation and its challenges for all of us have been described:

We are living through a time of fear and disruption of daily life that most of us have never experienced. When we are facing threats to our health, our safety, and financial security, and also dealing with the impact of social isolation and a massive disruption of normal routines of daily life, our minds and bodies respond in powerful ways… When we no longer feel in control and in charge of ourselves, on top of our limited control of the world around us, we become more prone to changes in mood. – Excerpted from Yale Child Study Center:“Understanding & Coping with Reactions in a Pandemic”

Feelings of anxiety, helplessness and grief are rising as people face an increasingly uncertain future — and nearly everyone has been touched by loss. A nationally representative poll conducted by the Kaiser Family Foundation [in early April 2020] finds that nearly half of all Americans — 45 percent — feel that the coronavirus has negatively affected their mental health. – Excerpted from The New York Times: “On Coronavirus Lockdown? Look for Meaning, Not Happiness”

Yes, and we’re feeling a number of different griefs. We feel the world has changed, and it has. We know this is temporary, but it doesn’t feel that way, and we realize things will be different… The loss of normalcy; the fear of economic toll; the loss of connection. This is hitting us and we’re grieving… Our primitive mind knows something bad is happening, but you can’t see it. This breaks our sense of safety. – Excerpted from Harvard Business Review: “That Discomfort You’re Feeling Is Grief”

In preparing for this essay, I took the liberty of asking some students, colleagues, and friends about their reactions at different points throughout the pandemic. Here are four quotes from reflections on the current reality:

“How am I doing? I don’t really know. Mostly I think I’m doing OK. I’m much less anxious than I was when this began. But there are times I feel overwhelmingly sad and times when I feel tired and depleted. At the same time, I’m grateful for everything that is good in my life and that is a lot. My state of being, thoughts, and feelings are in constant flux. The only constant is gratitude.”

“I go back and forth from a sense of perspective/balance, to anxiety/feeling down; time is different – before it had edges, boundaries, now it feels more like taffy, flows mostly without daily pressure, but moments of anxiety, despair, and fear when trying to see through the uncertainty of how things will go and anticipate the future. Will I ever be able to go back to things I was doing in the outside world that gave me a sense of purpose and pleasure?”

“In general, I do not see myself as a particularly resilient person. Getting through tough times with grit and grace is not my forte. I’m not stoic. So, I’m surprised that the past six weeks have been relatively easy for me. I’ve felt centered. In part, I think it’s because the “shelter in place” order suits my basic introversion and love of home. I know, however, that I would feel otherwise if I did not have “the work.” Of course, my sense of well-being and gratitude occasionally wanes. It’s replaced by fatigue, which morphs into envy and self-pity. It’s not pretty. I’m more vulnerable to lows when I’m overworked. Rather than respecting my limits, I trample on them.”

“Most of the time, I’m reasonably steady, though over the course of the past 6-7 weeks, the trend has been toward greater weariness. Within that, there are brief, but intense, periods of darkness that feel very absolute, during which my experience of self is very painful.”

As far as why my state of being changes: Often, I think it happens when I experience self-neglect – when it feels like no one, including me, is showing interest in how I’m doing. More recently, I’ve had it happen seemingly out of the blue. More adaptive coping mechanisms – like exercise, meditation, etc. – sometimes help, but at other times, I just have to ride it out.”

I would say that for most of us – our personal experiences, one way or another, are reflected in these brief quotes. They certainly speak to me.

When researchers and clinicians look at who copes well in crisis, and even grows through it, it is not those who push away and distract from their feelings; it’s not those who focus on pursuing happiness to feel better; it’s those who cultivate an attitude of tragic optimism.

The term was coined by Viktor Frankl, a Holocaust survivor and psychiatrist from Vienna, who authored the book “Man’s Search for Meaning” and developed the school of psychotherapy called Logotherapy. “Tragic optimism is the ability to maintain hope and find meaning in life, despite its inescapable pain, loss, and suffering.”

I would add to this definition the undeniable reality that pain, loss, suffering, and difficulty are a part of life for all of us. It is also true that life is rich with the potential for meaning, joy, fulfillment, spiritual expression, and human connection.

In general, resilient people have intensely negative reactions to trauma, just like those people who have a hard time coping. They experience despair and stress and acknowledge the horror of what’s happening like anybody else. But even in the darkest of places, they see glimmers of light, and this ultimately sustains them.

But even more than helping them cope, adopting the spirit of tragic optimism enables people to actually grow through adversity.

Psychologists now know that only a small percentage of people actually develop Post-Traumatic Stress Disorder (PTSD) after trauma, while, on average, from one-half to two-thirds of trauma survivors exhibit what is known as Post-Traumatic Growth. “It’s not the adversity itself that leads to growth. It’s how people respond to it.” According to the psychologists Tedeschi and Calhoun of the University of North Carolina, who coined the term “Post-Traumatic Growth” in the 1990s, “the people who grow after a crisis spend a lot of time trying to make sense of what happened and understanding how it changed them.” In other words, they search for, and find, positive meaning.

Frankl called it “the human capacity to creatively turn life’s negative aspects into something positive or constructive.”

Here is a list of attributes that characterize Post Traumatic Growth:

  • Appreciation of life
  • Relationships with others
  • New possibilities in life
  • Personal strength
  • Spiritual change

What contributes to Post-Traumatic Growth (PTG) – who is capable of this process of reconstructing meaning in the face of suffering? Tedeschi and Calhoun have described two qualities that contribute to the potential for the development of PTG.

One quality is described as “openness to experience.” This is the quality of trying to understand one’s experience and achieving self-awareness. Another term for this quality in psychology is the “self-reflective function,” which is the awareness of self that contributes to the awareness of others. This is a core quality of psychological well-being.

The second quality is described as “extraversion,” which is seeking connection to others. The drive for social connection is built into our basic human functioning.

Both of these attributes – openness to the awareness and exploration of one’s experience and extraversion – are influenced by the impact of qualitative family dynamics on child development and the impact of parenting on a child’s experience of self-acceptance and validation. The quality of family dynamics and the quality of attachment in parent-child relationships has been shown through extensive research to contribute to resilience in adult children.

Mental health literature talks about anxiety, fear, and emotional reactions that need to be managed in order to cope as well as possible with the crisis of the pandemic. Excessive anxiety and fear contribute to ineffective coping and debilitating emotional, cognitive, and behavioral reactions.

In general, I have read less in the mental health posts crowding my inbox about sadness, feeling down, and grief. David Kessler, the co-author with Elizabeth Kubler-Ross of the book, “On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss,” and author of his own book entitled “Finding Meaning: The Sixth Stage of Grief,” has pointed out that the discomfort that many of us feel is also about grief. At the very least we have all lost the normalcy of our lives while many have experienced the loss of loved ones, loss of connection, loss of employment, and loss of financial security.

The six stages of grief, as defined by Kubler-Ross and Kessler, are:

  1. Denial
  2. Anger
  3. Bargaining
  4. Sadness
  5. Acceptance
  6. Meaning

Kessler, presented the first five stages of grief as related to the pandemic in the following terms:

“There’s denial, which we said a lot of early on: This virus won’t affect us.

There’s anger: You’re making me stay home and taking away my activities.

There’s bargaining: Okay, if I social distance for two weeks everything will be better, right?

There’s sadness: I don’t know when this will end.    

And finally, there’s acceptance: This is happening; I have to figure out how to proceed.”

What about the sixth stage of grief? What is the process of finding meaning during a pandemic? We know that finding meaning is part of coping, resilience, and personal growth. Meaning is elusive in these times and we each come to terms with the current reality in our own way. Feeling lost in emotional reactivity or triggered by past traumatic experiences may make finding meaning elusive – but if we can be open to our experience and regulate our emotions, meaning is within reach.

Bea Hollander-Goldfein, PhD, LMFT, is a staff therapist at our University City Office and Director of the Transcending Trauma Project; she currently sees clients via online therapy. To set-up an appointment, you can reach her at bhollander@councilforrelationships.org or 215-382-6680 ext. 3118.

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