Dr. Val Farmer
Rural Mental Health & Family Relationships

Out Of The Rubble And The Tears

September 24, 2001

At the time I am writing this column it has been four days since the unspeakable horror of loss of life and innocence from a terrorist assault on our country. Our collective sense of security has been violated. Our values and freedoms have been assaulted. Our assumptions about our world lie in a heap of rubble in New York City.

We endeavor to clear away the debris and try to understand what has happened to us and make sense of the senseless. It is a struggle that takes time. For those directly affected by a loss of a loved one, the grief and pain will last a lifetime. I wish with all my heart that it hadn't happened. I wish with all my heart that I didn’t have to write about this subject.

I contacted psychologists Lawrence Calhoun at the University of North Carolina at Charlotte and Sharon Smith at Georgia State University in Atlanta. Calhoun, along with his colleague Richard Tedeschi , wrote "Facilitating Posttraumatic Growth: A Clinician’s Guide" published by Lawrence Erlbaum Associates, 1999. Smith’s research shows four key dimensions for positive coping and posttraumatic growth.

Overall social support. In her research Smith found that "received" social support was a key factor in positive coping after a crisis. These are the concrete acts received after a trauma. Little things can and do make a huge difference. It is specific support such as donations of money and volunteering of time and skills that mean the most. Support from strangers in the form of blood donations, notes or financial aid is also important. All support, whether it comes from family, friends, or strangers or in the form of information or tangible or emotional support, contributes to a positive adjustment after a tragedy.

Positive religious coping. A second robust factor in posttraumatic growth is turning to religious beliefs and practices to derive meaning and consolation from tragic events. People who have experienced major trauma identify their turning to their religion and God as a means of strengthening themselves to get through the suffering.

Severity of trauma. Smith also found that the more severe the trauma - injury, threat to life, helplessness, horror and intense fear - the more it was positively associated with personal growth after a trauma. However, one severe event is enough to spur change and growth. A series of traumatic events doesn’t necessarily add to the experience of posttraumatic growth.

Stuff happens. A final dimension of positive coping was the assumption that tragic events can and do happen randomly. This means that the victim doesn’t take the events as a personal attack and feel singled out for misfortune.

How to help others - and yourself. Calhoun wants people to be open to the "possibility" that struggling with something horrific can eventually lead to positive growth for some people. Even when research shows that trauma induces personal growth, most people would trade "all this growth crap" in a heartbeat to have their loved one back or to have not had the event happen at all. Seismic events like the terrorist attack on innocent lives are beyond comprehension and destroy our understanding of the world and our place in it.

A second point Calhoun makes is that significant growth from trauma doesn’t occur in the absence of concurrent pain or suffering. We may be wiser, different, or even stronger but we also continue to miss the people we lose, feel anxious, depressed and are filled with grief that doesn’t end. The skyline is not the same and never will be.

Calhoun is respectful of people’s inherent pace of change and coping. Friends, family and even helping professionals can create an environment where change can take place but that is about it. Too much intrusion can be a bad thing. Above all, do no harm.

Calhoun recommends comforting, soothing and helping victims keep their head above water. Compassionate actions and sympathy are more meaningful than trying to facilitate coping. Victims need to set the agenda for what they need or the help they want.

Saying prayers on behalf of victims, remembering their loss when the immediacy is gone, and other small acts of compassion help victims feel cared about, remembered and that they are connected to a caring community. It restores their faith in humanity. Calhoun suggests that doing a compassionate act whether it is local or directly aiding the victims helps ourselves cope with our own trauma.

Communal support. Collective grieving as a community or as a nation is helpful. Days of prayer and mourning , and memorials bring us together. As a society we grieve and are traumatized. We all hurt. We need each other. During times of crisis, the media does us a great service. We see. We feel. We learn. We share. We hear stories of heroism and survival. We take heart.

Information helps. There is a reason we stayed glued to our radios and televisions. We learn "who" and "why" and "how."

The government actions are helpful. The firefighters and law enforcement officers put themselves in harm’s way and protect us. Our investigators find the facts that help us make sense of the world. Our military protects us and roots out those who intend us harm. Our leaders inspire us and bring us together.

Thank God we are Americans and share a common bond. Good people the world over rally to our side. The sight of Russian people, our former sworn enemies, sharing our sorrow and placing flowers at the American Embassy touches us deeply.

Out of the rubble and tears are the beginnings of posttraumatic growth.