Hand to Hold's Official Blog: Written by Parents for Parents

Embracing Posttraumatic Growth: Is Growth Possible After Trauma?

 

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Photo credit: Kara Wahlin

I remember certain days in the NICU. Vividly. The tough days: the days one would never even want to speak of. At the time, I quit all of my social media, I stopped responding to calls, emails and texts, and my world shrunk to pumping, going to the hospital, and making decisions with my husband and my babies’ medical teams about what we would do regarding the health and treatment of our sweet boys. Sleep was fleeting and fraught with anxiety.

Everything– everything changed so quickly. What’s more, so many things fell away. So many of the beliefs, values, and perceptions that I had held prior to the experience of this trauma became suddenly rote. They didn’t matter any more. Everything even remotely symbolic suddenly became obviously so, and obviously unimportant. I often wondered what made it possible for my husband and I to be able to get up each day, make our way to the hospital, make educated decisions about treatment, and say our torturous goodbyes to our babies at the end of the day. At that point I realized there was one thing that hadn’t been shut down in my life: the powerful love I had for my sons.

Peace Lily with a twin bloom. Photo credit: Kara Wahlin

Peace lily with a twin bloom. Photo credit: Kara Wahlin

There was a quote from Pema Chodron that became my mantra at the time; it still makes a resurgence in my life now and then: “Only to the extent that we expose ourselves over and over to annihilation can that which is indestructible be found in us.” It resonated with me. Because in watching my sons struggling in the NICU, I felt that only the indestructible aspects of my belief system could survive.

A week after my son William passed away, his twin Elliott needed to have a PDA ligation. NICU parents know that this is a fairly standard NICU procedure, but that morning I remember as my husband and I waited anxiously outside of Elliott’s room while they operated on his heart, our faces empty and pale, attempting to trust that the procedure would go without a hitch; our silence reverberated with fear and vulnerability. My OB/GYN found us and did a tap dance to try and lift our spirits. When they were able to switch Elliott from a ventilator to the CPAP the next morning my tears flowed with my breath– I had never known a deeper gratitude. And for breathing. Elliott’s breathing had improved.

After the NICU, as we assessed what still stood around us, what hadn’t changed dramatically or crumbled in our lives, I wondered how the experience would affect my story, our story, the story of our family. Did this trauma mean that we would become a sad story? Our lives a tragedy? Would our lives forever be shifted into the shadow of grief?

Photo credit: Kara Wahlin

Photo credit: Kara Wahlin

The answer, unexpectedly, was no.

While the NICU experience undoubtedly took away so much of what we had hoped for; while it shifted and transformed so many expectations; while it did introduce me to the concept of true grief and loss, it also, after time, made me feel incredibly stronger. Letting go of the minor things that, prior to the experience, had actually made big differences in my life had a liberating quality to it. I knew, too, that I would no longer spend time attempting to be symbolically “cool” or passive. I knew that I would strive to find gratitude in my daily life, for things that heretofore I had taken for granted. The NICU experience also brought me an empathy with others, a silent acknowledgment that maybe, just maybe, when someone is behaving cruelly, or driving recklessly, or seems just “off”, maybe they are silently facing some kind of an unspeakable personal tragedy. I knew, even before Elliott’s discharge, that I would be spending a good amount of my future career reaching out to help others who found themselves in similar circumstances. And I knew it would feel meaningful.

Richard Tedeschi and Lawrence Calhoun are psychologists at the University of North Carolina who have conducted research on the concept of something called posttraumatic growth. Starting with the study of bereaved parents, they discovered that it was common after a traumatic circumstance for individuals to experience positive personal change. “For many people, a crisis seems to serve as a catalyst for acquiring personal and social resources, a more intense appreciation of their self-worth, increased coping skills, and changes in their life philosophies” (Spielman, V. and Taubman-Ben Ari, O., 2009); in other words, individuals who have gone through trauma oftentimes exhibit positive changes or shifts after processing the experience.

The moon and Venus. Photo credit: Kara Wahlin

The moon and Venus. Photo credit: Kara Wahlin

It’s important to remember that the idea of posttraumatic growth doesn’t imply that any individual who has gone through a traumatic experience actually liked it or found it inspiring. It doesn’t mean that individuals who have been through a trauma wouldn’t trade it or any growth that it brought in a second. It also doesn’t mean that families walk out of the NICU with a suddenly sunny outlook on life, or that if you don’t feel that you changed for the positive that something is somehow “wrong” with you. It means that the NICU trauma has the potential to transform families in a powerful way, much by means of highlighting the true values or beliefs of these individuals, if only for what it’s threatened to take away. Trauma can sometimes change our stories in unexpected ways, and make us grateful for things we never would have noticed in our pre-trauma lives.

In their research, Tedeschi and Calhoun found that it was actually more common for individuals who had been through a trauma to experience PTG (posttraumatic growth) than the pathological symptoms of traumatic stress (Tedeschi, R. & Calhoun, L., 2004). What was striking when I started to research PTG, was that many of the studies were centered around NICU parents, for the very fact that it is common for NICU parents, specifically, to experience growth after going through this trauma (Barr, P., 2011; Spielman, V. & Taubman-Ben Ari, O., 2009). It made me curious as to whether there might be others out there who had a similar experience to me: that for them, too, the NICU acted as a crucible, burning away unnecessary anger or resentment, highlighting the things that to them, truly mattered, and making the parenting experience of our incredibly resilient babies an entirely different thing, and tinted with an entirely different hue, than we expected.

Did you experience growth after the NICU? Were there any valuable changes or shifts that you felt in your perception after having gone through it? After the grief, did anything salvageable surface that changed or fortified your ideas about the world around you?

References:

Barr, P. (2011). Posttraumatic Growth in Parents of Infants Hospitalized in a Neonatal Intensive Care Unit. Journal of Loss and Trauma, 16, 117-134.

Chodron, P. (2000). When Things Fall Apart: Heart Advice for Difficult Times. Shambhala Publications.

Spielman, V. & Taubman-Ben Ari, O. (2009). Parental Self-Efficacy and Stress-Related Growth in the Transition to Parenthood: A Comparison between Parents of Pre- and Full-Term Babies. Health & Social Work, 34(3), 201-212.

Tedeschi, R. & Calhoun, L. (2004). Posttraumatic Growth: Conceptual Foundations and Empirical Evidence. Psychological Inquiry, 15(1), 1-18.

Kara Wahlin About Kara Wahlin

Kara (CA) is a marriage and family therapist/art therapist located in southern California. Since the preterm birth of her twin sons Elliott and William at 26 weeks and the loss of William at six days old, she's made it her mission to try and use her skills as a therapist to reach out to help, empower, and nurture other families going through the NICU experience. She loves art, exploring, literature, music and doing wild and wooly projects with her son and husband. You can learn more about her on her website, NICUHealing, as well as her personal website. You can follow her on Facebook or Twitter.

Comments

  1. To answer your guestion of the NICU stay causing growth in my view of the world around me – yes. My 26 week twin granddaughters spent 96 days in the NICU and I was there every day along with my daughter and the days he was not at work, my son-in-law. Like you, all forms of life before their birth changed during the NICU days. Since their release, 19 months ago, my daily eperiences have been inspired in a positive way because of their tenacity to survive against the odds. The anger and feeling of unjustness of watching their daily struggel of the NICU has been replaced by a sense of daily excitement and appreciation of each day. The twins faught so hard to live and I have learned to appreciate the beauty in every day, as they do.

  2. Interesting. I think I’ve experienced both, if that’s possible–PTSD and Posttraumatic Growth.

    • Thanks Kathy. It *is* possible to experience PTG as well as PTSD– in fact, some studies suggest that the harder the experience is for an individual, the more likely it is that they will experience growth through it. Thanks for commenting!

  3. Great read. My 32-weeker has been home for three months (and is 4 months old actual), and I’m working through some PTSD in my everyday life. I really hadn’t thought about post-traumatic growth until your post, but it’s gotten me thinking about the ways in which I’ve changed and grown stronger by my experiences with preeclampsia and my son’s month in the NICU.

    He is my first child, so it’s impossible to say what kind of mother I “might” have been had we experienced a normal pregnancy and delivery. But now, as this mother — his mother — I am more vocal, more positive, more embracing of opportunities, and more willing to listen to and learn from others. I have learned not to take life for granted and have become more compassionate and empathetic, I think, especially to other parents and those experiencing trauma and loss.

    I think that my ability to see any good from the situation is a sign of personal growth . . . and I hope that I will be able to reflect more kindly on the situation and myself later on.

    • Hi Meg, thank you so much for commenting. What you’ve said is truly beautiful, and I’m happy that the post prompted some thoughts of what your resistance to the NICU trauma brought to yours and your family’s lives, even despite the hardship it brought (and perhaps still brings). Thank you for posting here!

  4. I wonder if there is a time frame you need to pass once getting out of the NICU before you can realize if you’ve grown from it. We’ve been home with my son for 4 months. There are times when I still feel like I’m in the middle of the NICU tornado (subsequent doctors visits and special care needed), and other times I feel like we’re moving forward and “getting there”. I sure hope there is growth for my family. I am forever changed by the experience, I want some of that change to be positive. I’m so thankful for groups and articles about NICU stays because it reminds me that I’m not alone. Thank you

    • Hi Victoria~ thank you so much for your comment; you bring up such an important point that the struggle of the NICU is not happily wrapped in a bow at discharge. It can be hard to see the light at the end of the tunnel, because the tunnel is SO long; sometimes a lifetime long (or, to use another analogy, a new normal). It is so hard.

      It sounds like you’re making a space for reflection for yourself by reaching out to online groups and reading articles, which is so important. You are not alone. Talking with others, reflecting, and adopting (as best as you can) an attitude of gentleness and compassion with yourself are all healing practices that might help uncover your strengths– or make them more visible to you. I can tell simply by reading your comment you are incredibly strong. Thank you so much for sharing here!

  5. Kimberly Burke says:

    Hi Kara-wonderful read thanks! I still deal with both. My ID twin girls are 28 weekers that weighed 1.8 lbs each at birth. We are fortunate as one had many “events” while in the NICU and the other faired better but both are with us today. They are now 2 and 1/2 and happy and healthy. They do have significant delays though (not walking or talking). Our days consist of numerous therapies and many Dr appts at times. I tend to be overprotective to the 100th degree and still have a lot of anxiety. I also thought after leaving the NICU and once they were off oxygen and heart monitors at home, everything would move forward and they would catch up and things would be fine. As mentioned above, I feel as though things got tougher and when milestones were not achieved a whole other kind of anxiety took over. However, I have become a parent mentor for The Tiny Miracles Foundation in Connecticut and go to our local hospital to support and speak with parents of other preemies. Some days it brings me back to our NICU days (and those days can be tough) but mostly now I’m just so happy to help and support other parents. On another note I’m so sorry about William. I bet he is so proud of you and all the support you give to other moms and dads out there and I’m sure he keeps a close watch over Elliot. Thanks again.

    • Hi Kimberly~ Thank you so much for your comment and speaking to your experience with your sweet girls. I really appreciate that you’ve talked about the duality of the whole experience; that the struggle and its pain is very real, and it doesn’t end with discharge from the NICU. In fact, at times, the pain or anxiety can transform and intensify, even along with any growth or insight it might bring.

      It reminds me of that notion often conveyed in art and philosophy– that it’s only through struggling that we find our strengths. The 13th century Persian poet Rumi had a quote that your comment brought up for me: “The wound is the place where the light enters you.”
      The light may be entering, but the wound is still a wound, and it cannot be forgotten.

      Thank you so much for sharing here~ and thank you so much for your kind words for my family; it meant a lot to me to read your words! Take care~

  6. Kimberly Burke says:

    Thank you Kara! I was really touched by the Rumi quote…it actually brought tears to my eyes. I’m going to use that now. It really spoke to me. 🙂

  7. Georgia Relman says:

    While we do experience a post traumatic growth, be very careful about labeling yourself as having PTSD. In my experience it is just another way of perpetuating the outdated stereotype of the vulnerable child syndrome (VCS). Dr. Shaw (one of the psychologists and authors on PTSD in mothers of children born preterm) writes how mothers of preemies have PTSD, thereby altering their parenting style in a way that creates delays in self-regulation in the children (once again blaming the mother).
    Our daughter, who is a 25 weeker, just started high school and is doing great, yet I still get comments by those familiar with Dr. Shaws work (usually child psychologists), on how I must have PTSD because our daughter has anxiety. Be careful of labels.

  8. My twins are still in the NICU, and I can tell you that I am profoundly grateful for so many things that I didn’t even notice before this experience. I’ve noticed how much more I enjoy spending time with my toddler, for instance. As if every moment we’re together is a blessing not to be squandered.

    The exact thing you described, being more tolerant of other’s bad behavior is really something I’ve felt too. You just don’t know what they’ve gone through that day, month or year.

    I absolutely agree, that PTG is very possible.

  9. I have planned to go back to University next year to study teaching and childhood education so that I can help others through these pivotal first early years. My ex 33-weeker is now 16 months and we had not only a month in NICU/SCN but also severe reflux, food allergies, chronic constipation, tongue and lip ties and obstructive sleep apnoea. It’s not over, we are still on the roller coaster and I’m eagerly awaiting the moment that I can get off. I know I’ve experienced PTG and I am going to experience the grief and loss more fully once I can stop being so vigilant. This is another wonderful article

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  1. […] illness of a child. And while it has not been widely reported in medical literature, we know posttraumatic growth is possible for NICU graduate parents as well. It should be noted this posttraumatic growth does not typically happen for many years, and is […]

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