by Leigh Sales
‘My biggest fear now is that I have to go through this again. What’s next? Because I know unless I die next, I’m going to lose someone that I love, and the thought of that pain on top of the pain I already carry from Matt feels terrifying. But what do you do then? Do you stop loving people? Of course not. That’s why we’re here, to love people and to give of ourselves. So I just try and keep myself as open as possible.’
This reminds me of what Stuart Diver said about realising that there is enough love to carry on, that it’s boundless.
‘I think of the way we can make space in our hearts to love people – you have one child and you think, I could never love another child the way I love my firstborn. Then you have another child and you’re like, Oh, I do love them. It’s the same and different, because they’re a different person. Somehow your heart can expand to carry love for many people. Maybe it’s the same with pain. We can carry so much more than we think we can, whether that is love or pain. The pain is love. It’s just the manifestation of the sad side of losing someone, as opposed to them being with you.’
There is something beautiful about sitting and listening to Hannah. What she says is deeply insightful. And although we have spoken about such sad things, the atmosphere in the room isn’t sad at all. The room feels full of life. Hannah positively pulses with it. It’s very attractive, almost magnetic. It’s hard to describe but it is as if she is drawn very sharply. I don’t know Hannah, we are not friends, and yet we’ve had a conversation as intimate and real as any I’ve had in my life.
‘I understand now that happiness isn’t some goal that we’re working towards,’ she says near the end of our talk, ‘it’s just in the daily living of life.’
‘It’s that we just had a cup of tea and a nice pastry,’ I say.
‘Exactly. It’s just appreciating the small moments. Sitting with you, having this conversation, is really lovely. So it’s finding happiness in the day-to-day.’
Hannah has not drastically changed her life since losing Matt. She lives in the same home, the one they shared. She is still a writer. Superficially, it looks like the same life except without Matt in it. But look more closely and things are not the same at all. After her intense period of grief, Hannah did not return to being the Hannah who was with Matt. That person is gone forever.
‘I’m so changed. I’m so different. I feel like I’ve sort of had a layer of skin removed. I’m still me, I still hold the same values. But I’m able to live my life now in a very different way. I just find peace and beauty in the smallest moments now,’ she says. ‘I find myself feeling less afraid of life, rather than more afraid, which is strange, given what we have faced as a family and what we now know can happen at any moment. It’s as if surviving the hardest thing – the greatest pain – frees me to live more courageously. You can crumble and give up. Or you can keep living and loving. I choose the latter.’
I’m so glad that I met Hannah. I wish I had met Matt too. There’s something in his face that makes me think we could have been great friends, talking about books over a glass of wine. I feel something almost like envy for Matt and Hannah’s life, until I mentally shake myself. What is the point of envying Matt and Hannah? Hannah doesn’t even have that life anymore. I admire her so much for not allowing that loss to break her, for working so hard to get through it.
The positive changes that Hannah experienced in her outlook on life amidst her grief are an example of what is called posttraumatic growth. Traditionally, psychologists have studied the negative impacts of trauma and bereavement, the ways in which people are left broken and troubled, and the focus has been on how to return to so-called ‘normal’ functioning. In the past three decades, though, researchers have asked, What if people don’t return to normal, what if they develop enhanced functioning instead? The term ‘posttraumatic growth’ was coined by two American academics, Lawrence Calhoun and Richard Tedeschi, who defined it as the aspects of positive, personal change a person may experience alongside intense suffering after a major life trauma.
The quest to find purpose in suffering is nothing new; suffering is as old as humanity, and efforts to explain it go back just as far. The Bible is full of examples of God using trials and tribulations to teach and test his servants. The most famous is the Old Testament story of Job, an upstanding and successful man who is felled by a series of disasters, including the loss of his wealth, his children and his health. Job struggles to understand why he is blighted and eventually learns that God will sustain him through both the triumphs and tragedies of life.
The world’s greatest secular literature also frequently involves a life-changing event that transforms a person. In Tolstoy’s The Death of Ivan Ilyich, Ivan is stricken by a crippling illness, and as he’s dying, a kind servant helps him see that he’s lived selfishly rather than with compassion and empathy. In Dickens’ A Christmas Carol, the cold and mean-spirited Ebenezer Scrooge is visited by ghosts, and after a glimpse of his own future gravestone, miraculously becomes a warm and generous man. Hollywood too has long deployed this theme, from Born on the Fourth of July, in which Tom Cruise’s bitter, paralysed war veteran finds meaning in joining the anti-war movement, to It’s a Wonderful Life, in which a suicidal Jimmy Stewart discovers that life really is worth living after glimpsing how things would have turned out in his home town of Bedford Falls had he never lived at all.
It was only comparatively recently that this concept leapt from the arts to the sciences and psychologists began to drill into what triggers personal transformation after a life-changing event. They looked at such questions as why some people alter their world views but others don’t. How traumatic does the trigger event have to be? What are the ways in which people grow, and does this change last? Is the nature of the event linked to the type of growth? And what sort of counselling can help facilitate long-term positive outcomes beyond basic coping and adaptation?
It’s important to note that posttraumatic growth does not occur instead of grief and pain, it’s simply the accidental by-product of an experience that nobody would want in the first place. Hannah would relinquish every insight she’s gained since Matt’s death in exchange for his return.
There have been dozens of studies on the phenomenon of posttraumatic growth. In a survey in 2001, data was collected from almost two hundred survivors of sexual assault via a rape crisis centre. The women ranged in age from sixteen to fifty-two and about half of them had been assaulted by strangers. The participants were asked about positive as well as negative changes to their lives and those changes were assessed in four key areas – self, relationships, life philosophy and empathy. Just two weeks after their attack, most women reported some positive personal change, such as increased empathy, and over months, there was a realisation of their own strength and resilience. The women also reported negative effects, of course, such as the sense that they were less safe in the world, but over the two years of the study, the positive impacts became stronger and the negative feelings less powerful, although there was variability among the women depending on their personalities and the nature of their attack.
In another study, in 2004, 162 breast cancer survivors were monitored for a year and a half after their diagnosis. The mean age was forty-nine years and most had undergone a lumpectomy or a radical mastectomy. Most also reported positive psychological changes, and the number of improvements increased over the course of the study. Those who experienced the most personal growth were the ones who had actively thought about their diagnosis, ruminated on its meaning for their lives and discussed it with others. Some of the benefits the women reported were closer relationships with family and friends, appreciating their lives more, recognising their own positive qualities, becoming more spiritual, and realising that new possibilities were open to them.
More fascinating research emerged in the aftermath of the Westray Mine explosion in Canada in 1992. This killed twenty-six miners and was an enormous international news story at the time. Eight years after the disa
ster, researchers interviewed fifty-two family members of the dead miners, including parents, siblings, spouses and adult children. The findings grouped the participants into three clusters. Half of them were in the cluster labelled ‘Rebuilt Selves’. They had found ways to make sense of their loss, they’d learned something about themselves, and taken comfort from the fact that the tragedy had changed public policy, so that a similar disaster was less likely to happen in future. The next largest group was tagged ‘No Meaning, No Growth’. These were people who said they had not found meaning in their loss. They felt that their views about life had changed for the negative and that nothing good had come from the explosion.
The smallest group was called ‘Minimal Threat, Minimal Growth’ and it included people who agreed with the second group in thinking that nothing good had come from Westray, but nonetheless felt that their philosophy of life had not changed, either for better or worse. One participant summed up that group’s view by saying, ‘I’m not a person who thinks there is a reason for everything that happens, I think it was just meant to be.’
The Westray study is particularly interesting because it illustrates the range of ways in which people process tragedy over time, although easily the most common outcome was an experience of posttraumatic growth alongside the loss and bereavement.
There are too many studies to list in detail here but during the past three decades, experts have forensically catalogued how people have changed in the aftermath of events as varied as terrorist attacks, earthquakes, the loss of children, plane crashes, sexual assaults, paralysis caused by accidents, the birth of children with profound disabilities, cancer diagnoses, combat service, and even a shipwreck. The collected data from these studies shows that anywhere from 30 to 80 per cent of people experience posttraumatic growth.
That figure appears in numerous articles and books on the subject, and I must admit, it surprised me, because my opinion about how trauma affects people is mostly formed by daily immersion in the news. The media reporting on post-traumatic stress (a disorder characterised by flashbacks, depression and an inability to function) has become so prevalent that I assumed that any person who experienced a shocking life event would have a high chance of developing PTSD. The reality is that only about 10 per cent of people who suffer extreme trauma will develop PTSD.
Of course, that rate is higher in occupations that deal with tragedy day after day, such as police officers, paramedics and soldiers. Constant exposure to catastrophe has a cumulative effect and so the risk of PTSD is magnified. People in those jobs are trained to process what they see and are offered counselling to help mitigate the effects, not always successfully. But the good news is that if you’re the victim of one terrible, isolated event, then once the initial trauma subsides, you have a drastically higher chance of experiencing posttraumatic growth than of developing PTSD.
These studies also demonstrate that the types of positive change people experience after adversity are many and diverse. They can be small (‘I now notice the everyday beauty around me’) or epic (‘I changed careers and left my marriage’). Calhoun and Tedeschi, having crunched all the available qualitative data, came up with five distinct categories of likely personal transformation: increased inner strength, an openness to new possibilities, closer relationships, an enhanced appreciation for life, and a stronger sense of spirituality.
Along with the types of change people are liable to see, researchers are also learning what makes people more likely or less likely to experience posttraumatic growth. By far the most important condition for growth is that the event itself has to be cataclysmic. It can’t be a simple brush with death, like a car accident in which you break your arm. To spur growth, it must be seismic; it must shake you to your core and cause you to fundamentally rethink everything you believe. The higher the level of stress caused by the event, the greater the potential for change.
In the breast cancer study I described, the younger participants were more likely to experience higher levels of posttraumatic growth. The researchers concluded that this is because a breast cancer diagnosis is more unusual in younger women, and also more threatening and therefore more distressing. A younger woman may not have yet married or had children. She may be more concerned about her chance to do that after she’s had breast surgery or chemotherapy. She may have small children and fear they’ll be left without a mother. She may feel terror at the prospect of dying young and missing out on most of an average life span. This is not to say that older women don’t also experience great stress, but that younger women suffer more, and therefore report greater growth.
There is also evidence that active contemplation correlates with growth, particularly writing or speaking about the trauma (as Hannah did with her ‘overwrought’ journals). In some cases, the emotions experienced are so strong that it’s hard for the brain to process what occurred unless the victim actively wrestles to make meaning of it. Putting their feelings into words forces the person to clarify those feelings. And speaking with others who’ve been through something similar – social support – is another factor associated with high potential for growth, as Walter learned from the Dunblane fathers.
But while you may be able to control your social interactions and choose whether or not to talk about what happened to you, you can’t control your gender, your past life experience or your personality, all of which also influence the likelihood of posttraumatic growth. Women experience growth more often than men do, probably because they’re more likely to discuss their feelings with others. If you’ve had a life largely free from violence and sadness, that will also help: you’ll be more likely to regard a sudden disaster as an aberration in the way the world works.
There are still many questions for researchers in this area: does positive growth dissipate over the long term as memory of the trauma fades? How influential in promoting growth is what happens in the first twenty-four hours after a disaster? The study of posttraumatic growth is important because if we understand the factors that cause and inhibit it, we can then change the way we behave towards victims – in the immediate aftermath on the part of police and the media; in the medium term for lawyers, court workers, psychologists and counsellors; and in the long term for schools, churches and families.
Hannah was fortunate that within a day of losing Matt, she met somebody who knew something about posttraumatic growth. This amazing guide set her on a path towards positive transformation and not collapse.
That guide was the woman Hannah met at the morgue when she identified Matt’s body and whom she later saw for counselling. Her name is Wendy Liu. And within moments of meeting Wendy myself, I can see why Hannah found her so reassuring. She’s around forty, petite, with short dark hair and a friendly face. Wendy speaks softly and resonantly, like a well-trained actor. There is indeed, as Hannah noted, something about her presence that makes you feel she’s in control and that you can relax. She has an air of dignified competence. If I ever have to go to the morgue to identify the body of someone I love – and I very much hope to never test this theory – Wendy Liu is pretty much exactly who I would want to have with me.
We meet one morning in her office in the building above the morgue. Wendy’s official title is Forensic Counsellor, New South Wales Department of Forensic Medicine. The department deals with up to four thousand deaths each year – everything from violent homicides to unexpected fatalities in hospital – and four other people perform a similar role to Wendy (including Jane Mowll, the woman who helped Juliet Darling). That means Wendy personally deals with hundreds of grieving families every year. She has seen corpses in every imaginable state: decomposed, beaten up, ravaged by cancer, savaged by animals, even pristine and bearing no signs of injury or illness. She has seen the lifeless faces of the young and the old, the rich and the poor, the beloved and the unmourned. It makes an impact.
‘I’m aware of all the different kinds of ways I might die,’ she tells me. ‘I’m aware that my death and the death of those I love cou
ld be quick or not, horrific or not. But I also try really hard to be here, living in the moment.’
Wendy describes her current role as the ‘interface’ between the families and the forensics. Every day, she helps people prepare to face the reality of what happened to their loved ones. She may have to talk to them about the need for an autopsy or help them understand preliminary results. She often has to explain how the Coroner’s Court works and why an inquest is necessary. She frequently accompanies stricken relatives to viewings.
Before this job, she was a palliative-care social worker. ‘Was there something that attracted you to it? Or was it an accident?’
‘It felt like an accident at the time, but it wasn’t,’ she says. ‘I was a social work student. I turned up for an interview for my fourth-year field placement. At the end of that interview, my team manager offered me one of two choices: Would you like to work in medical rehabilitation or palliative care?’
Wendy didn’t know what palliative care was, and the interviewer explained that it involved helping people at the end of their lives, when there’s no curative treatment. Something about that clicked with Wendy.
‘My dad died when I was young and the culture in my family was to shut it down. He died of cancer when I was seven, a very short illness, and then we didn’t talk about him again,’ Wendy tells me. ‘What I’ve linked it to since is that I want to be part of a conversation with people, if they wish, around dying and death, and for that to be okay to talk about.’
From the first autopsy Wendy attended, it was not revulsion or fear that she felt: it was amazement and appreciation.
‘Our bodies are phenomenal machines. I remember thinking: What a beautiful sight, the richness, the boldness of the colours, like a beautiful sunrise. I think part of life is appreciating the miracle of our bodies. I don’t have a faith, but there is something intrinsically incredible about how we are put together and how we die,’ she says.
