As I read through Upside: The New Science of Post-Traumatic Growth by Jim Rendon, I had plenty of thoughts that didn’t necessarily fit in my official review of the book. The book certainly prompted some thinking and questioning on my part; I always appreciate it when a book stimulates my brain cells. Some of these questions I’m asking probably haven’t been answered by studies yet, so I can’t fault the author for not including things that don’t yet exist! The following are some of those thoughts shared in a rather random order.
- It wasn’t until very late in Upside that a divorce was mentioned among the case studies of those who have undergone trauma. However, I suspect that this representation is not accurate. Chronic illness and PTSD were major contributions toward my divorce, and I know I’m not alone in that. I’d be curious as to what the actual divorce rate is among those who suffer from PTSD as well as what the divorce rate is among those who suffer from PTSD but have come to a place of positive growth. Further questioning would ask how many people saw their divorce as a part of their positive growth (as I definitely do).
- As I read the chapter on family support, I questioned, “What about those who didn’t have family support?” I would like to see a study of how support for patients with cancer compares to those with other illnesses. Because Rendon focused on cancer, he may not be aware that other diseases actually can cause families to abandon loved ones. This certainly was my situation with extended family, and again, it was a contribution to the end of my marriage. In my experience with late disseminated Lyme disease which is legally diagnosed as fibromyalgia and chronic fatigue syndrome, compassion and support was not overwhelming. In many cases, friends and extended family abandoned me and my family unit. One extended family member pointed out to me not so subtly that two other family members with type 1 diabetes and gallstones had REAL health problems (implying that mine were not significant, real and/or valid despite the fact that I was homebound and mostly bedbound at that point).
- While Rendon completely failed to discuss the problems surround childbirth and infant loss as they apply to women, he did devote a chapter to a group of dads who have lost children. This is a rare perspective that is often ignored in our culture, and I appreciate that he shared this reality with the world. Too often, men’s grief is poorly processed and disregarded contributing to the ongoing problem in our society of men who are out of touch with their emotions including grief.
- I felt like the chapter on religion and spirituality was one of the weakest. From what was written, I suspect that the author does not identify with religion or spirituality and may in fact be hostile towards them. I felt like he neglected the major differences between religion and spirituality, for they are two different things. It is very possible to be spiritual without being religious. I also wondered as I read the chapter how many people with PTSD experience a radical change in their beliefs or spirituality. In my life I went from being Catholic to being agnostic to experiencing PTSD and becoming highly spiritual without identifying with any religion (and in fact shunning most of them). I suspect I am not alone in this process of spiritual growth that is a part of personal growth with PTSD. This spiritual growth I experienced is a far different experience than someone becoming more vested in an established religion or turning to their pastor for counseling.
- Rendon argues that support groups are instrumental in the personal growth of individuals because they allow those with PTSD to be with those “who get it.” On one hand this is very true. However, I am curious about the reality of support groups for a wider population. I actually found that the pessimism and negativity of many support groups were pulling me down and were impeding my personal growth. They weren’t “better-informed optimists” as Rendon writes. Instead, they were people filled with unhealthy attitudes, bitterness, and often ignorance. I switched to digest for many online groups to avoid reading the posts of the worst offenders; some groups I left altogether. The two health related in-person groups I tried attending, one for those who had lost a baby and one for those who were chemically sensitive, I quickly left because the energy in them was awful. My better-informed optimism did not fit there. Thus, I would be curious about studies that showed that support groups actually have an ability to hamper personal growth rather than assist it. My experiences show that this is a potential reality.
- I cringed at the idea of 46 pills being a lot as Rendon dramatically presents when discussing a cancer patient. I currently take 14 Western medical pills per day plus 65 pill supplements, seven doses of liquid supplements, and a nebulizer treatment per day. At times my pill total has been well over 100 a day. This is what it has taken to get me functional and to continue to heal. I look forward to dropping back to “only” 46 pills and then the day when I need less than 20 per day to maintain my health. Again, if Rendon had talked to people with other health issues outside of cancer, his perspective would have been broadened and enlightened in many ways.
- Rendon has an implicit (and very valid in my opinion) judgment of how deficient psychological treatment is for soldiers and vets with PTSD. He also notes how others involved in other traumas also received very little or no psychotherapy as part of their recovery processes. It would be great to see what the studies show about why this happens other than the lack of funding for mental health care that is an endemic problem in our nation.
- I appreciated the way Rendon approached the topic of “gratitude as a way of life.” As I’ve noted in another blog post, gratitude is the only way I got through many days when my illness was at its worst. I think most people who have not undergone a major trauma understand what gratitude really is and what it can do for us.
- The chapter on activity and exercise as healing was very frustrating to me. I think this is a concept that is fairly well understood in our society as almost all less-than-informed healthcare practitioners I have worked with over the years have pushed exercise as one of the main solutions to healing. However, there is an important distinction between using exercise during a time of hellish illness and using it after one has regained significant health. Rendon discusses women who have survived breast cancer and now row together; he mentions but does not dwell on the fact that they could not have done this kind of activity when they were in the worst phases of their treatment. That distinction is very important for those undergoing health trauma because the overwhelming pressure to exercise when they are too sick to do so can be very emotionally defeating. As someone whose Lyme disease has caused chronic fatigue syndrome, I have had to deal with the conflict that exercise can actually cause more damage than good a great deal of the time, and our society does not seem to understand that because it is so pro-exercise as the cure to all that ails you.
- I really loved that Rendon stressed the importance of not pushing post-traumatic growth on those with PTSD. This book would have been devastating to read in the worst years of my illness; I was not ready to hear its message. I definitely would not give the book to someone who was at a point when they were at rock bottom. The lesson of “bitter blessings” is one that each person has to come to individually on their own time.
- When discussing one person who has survived brain cancer, Rendon reveals the very unhealthy brave face platitudes that are a very problematic part of emotional health in our society. However, Rendon doesn't expand on the problem that "the brave face" ideology creates in relation to PTSD. Rendon writes, “[The patient with brain cancer] maintained a brave face, but beneath it all he was terrified. ‘He never once said, “This really sucks,”’ said [his best friend]. ‘But you could see it in his eyes, you could see him thinking, Holy heck what am I going to do?’” Society expects those with chronic illness to hide behind those brave faces. They’re expected not to show the pain they’re in or the suffering they’re enduring. If they do show that illness, that fear, that pain, that loss, then they risk losing those around them who are unwilling or unable to deal with the realities of health challenges including the possibility of death. This only contributes to the issues surrounding PTSD when one is expected to put on a brave face but is actually falling apart inside.
- I would be curious to see studies about those who manage to achieve positive post-traumatic growth without most of the key items that Rendon cites as contributory factors. I am someone who is lacking in extended family support. I was isolated and alone because of my chemical sensitivities. I was the person whom others looked at and said, “It doesn’t get much worse than that.” Yet somehow I have grown in ways I never would have believed possible. I wonder how other characteristics such as personality and intelligence factor in for those whom growth seemed to be unlikely to happen even according to the standards Rendon establishes.
- Finally, in the last paragraphs of Upside, Rendon writes, “And given that they came so close to death, that they lost so many things they once took for granted, they understand on a much deeper level, in a much more informed way, what it means to be alive.” This association of PTSD with facing death is a flawed one, and it’s something that contributes to a large portion of people enduring PTSD not seeking appropriate help in my opinion. Our society erroneously interprets PTSD to mean former soldiers or those whose lives were endangered. Yet as Rendon demonstrates throughout the book, for many people, PTSD does not result from a life threatening event. I would have added a clause to this sentence about how “some have come so close to death.”
(I do have another upcoming blog post motivated by Upside that I will link to once it publishes.)
© 2015 Elizabeth Galen, Ph.D., Green Heart Guidance, LLC