Bring together a group of oncology professionals, and almost inevitably, talk will turn to the stress and distress of doing this work that we have chosen. The hours, the intensity, the constant confrontation with mortality, the responsibility, the emotional interactions with patients and families, the conflict, the drama, the crises.
Because our work environment embraces a “chronic state of crisis," we experience a steady stream of pain and loss -- that of our patients and their loved ones as well as our own. How can it be, under these conditions, that we are able to maintain our commitment to our patients, to their families, and to our colleagues? How are we able to continue investing in relationships, in future planning, to connect and to care through it all?
There are many pieces to the complex puzzle of how we make sense of our experiences and maintain our motivation to work and to live fully in the face of so much pain; one piece of that puzzle may have to do with post-traumatic growth.
Post-traumatic growth is personal growth that emerges in the aftermath of trauma. Dr. Lawrence Calhoun and Dr. Richard Tedeschi of the University of North Carolina Charlotte are pioneers in the establishment and research of this phenomenon. What they and other researchers at their institution and in the mental health arena are developing is a deeper understanding of the resilience that we demonstrate in the face of serious trauma.
Beyond the notion of simply surviving, post-traumatic growth theory suggests that some people, when faced with a crisis, will not only emerge whole, but will grow and develop emotionally, intellectually, and/or spiritually.
While post-traumatic growth doesn’t protect us from suffering trauma or loss, for those who experience it, it is a meaningful, positive outcome of otherwise painful and often overwhelming experiences. This kind of growth may be experienced as a deepening of important relationships and connections. It may be found in a deepening of one’s sense of spirituality. For some, it will come in the form of a “wake-up call” or a motivation to focus on the moment, to appreciate this life and the good in it.
One patient with whom I worked called it his “cup of awe,” and he “drank deeply from it daily, knowing that life is finite and precious.” For others, this growth will take the form of the development of greater confidence in their own internal strength and an opening of the mind to possibilities not previously considered or never taken seriously. Some experience this growth in “aha” moments; others find it develops in a slow and steady way.
While we most often think of post-traumatic growth in terms of our patients and their families, it strikes me that, in my conversations with fellow oncology professionals over the years, these kinds of experiences are typically the foundation for longevity in practice. We continue to invest in our work, in our patients and their families; we continue to care in part because our connections and experiences, sad and hard as they may often be, are also a significant factor in our most profound growth and development.
What we don’t know is why some people experience it and others do not -- a question for future research! What seems likely is that safe and supportive opportunities for discussing trauma (in our case, our daily work) may help us to consolidate our feelings and thoughts so that this kind of growth can be consistently nurtured and, in turn, become part of an important feedback loop that helps us to stay fresh and motivated in our work.