International Journal of Psychosocial Rehabilitation
Hope and Meaning During Times of Tragedy and Loss:
Appreciating the Influence of Meaning in the Aftermath of Trauma
Vis J & Brownlee, K. (2008). Hope and Meaning During Times of Tragedy and Loss: Appreciating the Influence
of Meaning in the Aftermath of Trauma. International Journal of Psychosocial Rehabilitation. 13(1), 39-49
Dr. Keith Brownlee,
Many theories dealing with the impact of trauma focus on long term traumatic experiences, such as childhood sexual and physical abuse, or they focus on large-scale traumatic events such as war, plane crashes, school shootings, and other significant events that attract media attention (Bell, 1995; Herman, 1992; McCann & Pearlman, 1990; Mitchell & Everly, 1994; Terr, 1983; van der Kolk, McFarlane & Weisaeth, 1996). The theories and models developed to contribute to our understanding of how to assist victims of large-scale traumatic events do also provide direction for responding to individuals such as Susan. However, while this information is significant, and has assisted in adding to the knowledge concerning trauma, the attention to individual, short term (acute) trauma events such as Susan’s is equally important.
Personal testimonies such as Susan’s have led to the professional literature recognizing that trauma is a multifaceted phenomenon. The research on trauma has also supported the position that people who have been exposed to trauma experience a variety of after-effects (Courtois, 1988; Herman, 1992; LeDoux, 1994; McCann & Pearlman, 1990; Neimeyer & Stewart, 1996; Schultz, 1998). This information has extended our understanding beyond traditionally accepted views of trauma and introduced new possibilities for trauma management. It has served to highlight how each individual’s response, understanding, or truth regarding the traumatic event is unique. Thus, practitioners have been challenged to consider interventions that support this uniqueness in ways that offered multiple views of a traumatic incident (Franklin, 1995; Hoffman, 1990; McCann & Pearlman, 1990; Neimeyer & Stewart, 1996).
The purpose of this paper is to explore recent research and ideas about trauma recovery, and to identify key concepts that influence memory, mood, behaviour and, ultimately, post-trauma management. The case is made that acute trauma involves an integrated process, which incorporates physiological, sensory, and socially constructed experiences. The paper begins with a summary of the literature defining traumatic events followed by an examination of recent research on memory and a discussion of the integrated model of memory formation. It is argued that these emerging ideas about memory formation support a post-modern perspective of trauma and challenge traditional conceptions of how to best respond therapeutically to trauma. In conclusion, this paper will present a therapeutic approach to trauma that not only incorporates the complexity and individuality that a trauma experience entails, but also one that provides possibilities to move beyond the tragedy of the traumatic experience. It is an approach that challenges individuals and therapists alike to see trauma as more than tragedy, loss, and victimization and to include hope and personal strength.
How Trauma has Been Defined
Throughout history, there have been numerous accounts and descriptions of events and circumstances related to trauma (Keane, Marshall, & Taft, 2006). The majority of recorded and researched events in areas of trauma have either been linked to times of war (Archibald & Tuddenham, 1965; Frankl, 1984; Horowitz & Solomon, 1975; Kutchins & Kirk, 1997) or connected to the trauma associated with child abuse (Courtois, 1988; Herman, 1992; McCann & Pearlman, 1990; van der Kolk et al., 1996). Although the research and theoretical knowledge in these two areas have increased our awareness of and response to trauma victims, a situation has emerged whereby attention has been concentrated on the similarities of trauma experiences while tending to overshadow the differences between these experiences. Consequently, trauma has been defined broadly to encompass the variety of circumstances (Kutchins & Kirk, 1997; McCann & Pearlman, 1990).
McCann and Pearlman (1990), for example, define an experience as traumatic, “if it (1) is sudden, unexpected, or non normative, (2) exceeds the individual’s perceived ability to meet its demands, and (3) disrupts the individual’s frame of reference and other central psychological needs and related schemas” (p.10). The most frequently used definition of trauma is post traumatic stress disorder, or PTSD. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, 2000) describes a broad range of events that have been experienced directly, witnessed or even learned about as likely to be traumatic such as, “actual or threatened death or serious injury, or other threat to one’s physical integrity” (p. 467). The DSM-IV-TR focus is on the characteristic symptom response rather than on the event itself. These symptoms may include reactions of intense fear, helplessness or horror that are persistent and which are associated with further reactions such as increased arousal, temper outbursts, difficulties falling asleep and numbing and avoidance of stimuli associated with the event.
The argument that there are similarities in the way people experience the effects of trauma is irrefutable; yet, the differences also need to be considered as these differences give rise to the distinctiveness in the experience of trauma. For example, in its simplest terms, war can be seen as an event that pits one side against the other, the other being a non-personal association with “the enemy.” Political forces beyond individuals’ control require them to serve their country, providing a socially constructed meaning or purpose for those who have been “recruited for this task.” Experiencing the trauma with a group of peers significantly impacts the meaning that is derived through conversations with others in the group as all members are exposed to the same level of atrocities and grapple with forming a future outlook (Archibald & Tuddenham, 1965; Golan, 1978; Horowitz & Solomon, 1975; Kutchins & Kirk, 1997; Mott, 1919). Survivors of war related trauma stand in sharp contrast to a childhood abuse survivor, who sustained ongoing trauma at the hands of a knowing perpetrator of the trauma. The child abuse survivor often has no one with whom to share language or experience, and is left alone in silence to manage the trauma with little hope or promise of an end or victory (Courtois, 1988; McCann & Pearlman, 1990; Herman, 1992; van der Kolk et al., 1996). In further contrast, are those individuals who have been exposed to a traumatic event without warning. This type of trauma is sudden, unexplainable, and perhaps even short lived. They may not have any means of understanding why the event happened; experience confusion as to their role in the event; and they may even question the validity of allowing themselves to think about the impact, believing that they should just forget about the whole thing and move on. The presence of these and other contrasting trauma experiences adds weight to the argument that there is a need to account for the differences in trauma experiences.
Research has begun to challenge many established theories of memory formation and retrieval. Memory is now believed to be influenced by a complex set of circumstances before, during and after an event. Memory, as we have come to understand it, can be constructed through our sensory, working, and subjective memory.
McCann and Pearlman (1990) discuss the interconnection between memory and perception. They propose that the verbal, imagery, affective, somatic and interpersonal experiences inform perception and that perception subsequently informs memory. McCann and Pearlman argue that all of these components are necessary for full perception, which then leads to a complete memory. While this information was provided in attempts to understand memory perception for adult survivors of childhood abuse, one could see the potential for connections between this and other trauma circumstances. It could be argued, therefore, that individuals develop a unique sense of a traumatic event, which is vulnerable and susceptible to suggestibility.
Schacter, in his work Searching for Memory (1996), discussed research by Charles Wilkinson (1987), who investigated 102 survivors of a traumatic incident in 1987 in which two skywalks connected to the Hyatt Regency Hotel collapsed. This disaster ended with 114 deaths and more than 200 physical injuries. In his research, Wilkinson discovered that nearly 90 percent of these people said that they had repeated memories of the event. These memories were intrusive and disrupted the daily life functioning of many. Within these memories were associated emotions of sadness, anxiety, depression, and even detachment. Wilkinson reported that since the event nearly one in three experienced “memory difficulties.”
Nearly all scientific research in the area of trauma suggests that trauma events can have long-lasting impact. This impact not only has to do with the event itself, but the emotions these memories induce later. These memories are not only connected to the recall of events, but also influence the interpretation that elicits the emotions and meaning of the event itself. Schacter (1996) suggests that memory of trauma events are not devoid of emotion; in fact, the two may be inseparable and he coined the term “emotionally traumatic memories” to describe this phenomenon. Regardless of the debates defining trauma, there appears to be agreement that overwhelming emotional responses to a traumatic incident disrupt the usual processing of memory and affects emotion and behaviour (Butler, 1996; LeDoux, 1998; Ratey, 2001; Schacter, 1996; 2001).
We no longer view memory as developing in isolation (Koriat, Goldsmith, & Pansky, 2000; Mazzoni, & Vannucci, 2007). Similar to a strand of fabric woven within a sheet of cloth, memory connects and interweaves with other threads such as perception, meaning, emotion, and mood (Richards, Butler, & Gross, 2003). As a result, memory is not a simple video tape playback system of the concrete movements and actions related to a particular event; rather, each movement and action is interpreted, and this interpretation feeds into the emotions associated with the event (Bonanno, Papa, O’Neill, Westphal, & Coifman, 2004; Richards & Gross, 1999; Laney, Campbell, Heuer, & Reisberg, 2004; Levine, 1997; Levine, & Pizarro, 2004).
Research is unearthing significant ties between memory and emotions or mood. Schacter (1996) credits Mark Williams and his colleagues as the first individuals to report that emotions can bias perception and memory. Williams’ research compared two groups, one in which people reported depression type symptoms, and another in which no such symptoms were reported. They found that the group with depressive mood symptoms would focus on generally negative experiences more than their counter parts: “They tend to encode (and therefore retrieve) everyday episodes through a negative filter that confers a kind of repetitive and pervasive drabness on all their experiences” (Ratey, 2001, p.211).
Even non depressed people report that sad moods tend to feed on themselves: when you feel sad, it somehow seems all too easy to think negative thoughts and remember painful experiences. Psychologists have a name for this common experience: mood-congruent retrieval. Experiments have shown that sad moods make it easier to remember negative experiences, like failure and rejection, whereas happy moods make it easier to remember pleasant experiences, like success and acceptance (Schacter, 1996, p. 211).
Thus, mood is believed to have the capacity to elicit a memory, and subsequently a memory can elicit a mood. When emotionally charged memories, such as those associated with trauma are evoked, “mood” has the capacity to influence the memory as negative, overwhelming, and unmanageable. It can be concluded, therefore, that how trauma has been perceived, how an individual makes meaning of the event, and how he or she processes the physiological and sensory aftermath of the trauma has a great impact on how an individual will navigate the trauma process. Given the significance of meaning formation during trauma recovery, it is vital that meaning exploration be a part of effective intervention.
More recently, a third therapeutic intervention has been proposed that draws upon the current research on memory and emotions and includes the phenomenon of meaning associated with the trauma event. Meaning, or the construction of meaning making of the traumatic event, has the potential to shape our perception of the event, and subsequently influence memory, emotions, and behaviour (McCann & Pearlman, 1990; Neimeyer & Stewart, 1996). Taking the opportunity to create a space for the importance of meaning through the process of developing a narrative provides a previously unexplored, but newly emerging, interventive approach to PTSD.
Neimeyer & Stewart (1996) explore an additional concept to trauma impact that includes the story, narrative, or belief about the role which an individual places him or herself in during and following the traumatic event. This theory adds to the complexity involved with trauma: it includes not only the trauma event itself, but the incidents following the event and incorporates the idea of people having many different selves.
As an essential part of the person, the traumatic self constrains the other possible selves. That is, as long as the traumatic self exists in its original form, the cognitive, perceptual, and emotional processes invoked during its creation place limits on psychological processes available to the pre morbid selves (Klion & Pfenninger, in press). The narrative, meaning-making processes of the former selves become more like those of the traumatic self. Subjectively, a trauma victim may feel as if “I’m not the person I once was (Neimeyer & Stewart, 1996).
These authors conclude that roles such as “victim,” “injured,” and/or “incapable” influence the recovery process. They believe that meanings or stories that individuals develop about themselves has an impact upon their ability to move beyond the trauma experience and see themselves as something other than a trauma survivor.
Although Neimeyer and Stewart offer valuable research and information regarding the importance of meaning, as it relates to an individual’s sense of self and how this effects an individual post trauma, the significance of meaning post trauma appears to encompass more than just self image brought on by self reflection. Rather, the formation of meaning appears to be influenced by a variety of factors, and can encompass a variety of concerns, including, but not limited to self image.
Traumatic memories are difficult to study due to the “profoundly upsetting emotional experiences” that are often associated with PTSD (LeDoux, 1998; Ratey, 2001; Schacter, 1996). However, van der Kolk and Fisler (1995) report findings that suggest that support the idea that trauma memories are very susceptible to narrative influences. In a study of 46 subjects who were diagnosed with PTSD, van der Kolk and Fisler found that the narrative of the trauma event evolved over time. Although the sensory recall, stored as sensory fragments, may have existed since the trauma event, the narrative developed later. The authors observed their subjects constructing a narrative that explained what happened to them as they became more aware of more elements of the trauma experience, either through conversations with others, sensory experiences, or other influencing factors. The authors speculated that this “weaving of a narrative out of the disparate sensory elements of an experience is probably not dissimilar from how people construct a narrative under ordinary circumstances” (p.12). Although van der Kolk & Fisler use the term narrative as a verbal account of the description of the trauma events, their findings support the notion that memory is processed through verbal recollections, stories, and the meanings associated with them.
When people receive sensory input, they generally automatically synthesize this incoming information into narrative form, without conscious awareness of the processes that translate sensory impressions into a personal story. Our research shows that traumatic experiences initially are imprinted as sensations or feeling states that are not immediately transcribed into personal narratives, in contrast with the way people seem to process ordinary information. This failure of information processing on a symbolic level, in which it is categorized and integrated with other experiences, is at the very core of the pathology of PTSD (van der Kolk & Fisler, 1995, p.13).
Harlene Anderson (1997) and Kenneth Gergen (1999) argue that, from a social constructionist point of view, occurrences such as depression, personality disorders, and anxiety attacks are not, in fact, problematic in and of themselves. Rather, the meaning and language that we use to conceptualize our understanding of people’s behaviour develops a problem. Within this context they believe that language, dialogical interactions, and even therapy are ways in which language can be used to explore alternative truths to the traditional empirical view of problems. They propose an alternative therapeutic approach in which cause and effect realities are replaced with the challenge that the cause and effect reality is but one truth, with the emphasis being placed on the constructed meanings by which we make our way through life.
When people think and/or talk about trauma, the initial constructed narrative about the event is about loss, suffering, inability to manage, never being able to recover from the loss. Although these narratives are true for the majority of trauma survivors, they represent but one truth. Additional narratives, looking beyond the trauma act itself, invite individuals to incorporate meaning that includes appreciation of care of others that may have been shown during the trauma event, appreciation for relationships, a chance to take what they have experienced to make a difference in their lives and how they interact with others. Of course, it is important to recognize the losses and impact that trauma may induce, and what may be experienced or learned as an outcome of the trauma experience would never make the trauma event worthwhile. But the fact that the story continues beyond the trauma events provides hope and an alterative view to suffering that trauma often entails.
A more recent example of the power
of alternative narratives can be most significantly seen following the
Here the major emphasis is on expanding the number of voices bearing on the problematic situation. The aim is not to locate “the solution”, or “the new story” but to generate a range of new options. With many voices at hand the deep puzzlement which the clients’ beings into therapy are replaced by a plethora of possible actions. For some therapists there is also a secondary hope: when one is exposed to many “views of the matter”, the grounds are laid for developing a consciousness of construction. One finds that “the truth of the matter,” is but “a truth”. This kind of consciousness may have the liberating implications described in the previous chapters (p.174).
Tedeschi and Calhoun (1995), in their work on post-traumatic growth, argue that for too long research has focused on negative after-effects of trauma and has minimized individual’s ability to move past the trauma event with positive after-effects. They suggest that research needs to focus on how people move through the “process” of post-traumatic growth, believing that this understanding will offer new effective interventions in the area of trauma.
If Susan had been offered a therapeutic approach that explored how she felt about these experiences it may have risked perpetuating Susan’s emotional reactions. Ratey (2001) and van der Kolk & Fisler (1995) support this view, noting in their research that talking about the event or the feelings about the event, once a constructed narrative has been established, does little to resolve the occurrence of flashbacks or relief from the intrusive memories. For Susan, the socially constructed narrative that she was a bad mother would only be reconfirmed if therapy continued to focus on Shawn’s death and her feelings concerning it.
Before entering into therapy Susan had already developed a strong sense of meaning not only about the trauma associated with Shawn’s death, but her sense of self and what it would mean to live life without her son. Counselling began with Susan being asked to recount the events of the day of her son’s death. Susan was able to recall the events in detail. This process allowed for the connection of the verbal, imagery, sensory, effective, and interpersonal experiences connected to the formation of memory as discussed by McCann & Pearlman (1990). Once there was a sense that the connections were in place, Susan was then asked to think about and discuss how she has changed as a result of this trauma and what if anything has stayed the same. These questions allowed Susan to engage in conversations whereby a conscious narrative could include the possibility of shifting her established story about the event. Building on this framework, Susan was asked to elaborate on her current narrative surrounding Shawn’s death connected to meaning. It was through this conversation, using the concept of poly-vocality (Gergen, 1999), that Susan was able to discover that by continuing to focus on Shawn’s death she had forgotten about his life. She discovered that all of her conversations with anyone, following his death, related to the suicide in one form or another. Shawn’s memory was alive only in the description of his death. She realized that Shawn was not being remembered for the life he had and the joy he gave and experienced, but that this meaning or alternative truth was being overshadowed by the negative narrative of the suicide.
By the third and forth sessions, prompted by the possibility to explore meaning beyond Shawn’s death, (Tranter & Vis, 1997), Susan began to recall stories that focused on Shawn’s life. Susan was able to discuss times when she was able to witness Shawn in laughter, having fun, and would recall how being with him brought joy to her life. Growing on this experience of alternate meaning, Susan began to be more aware of others in her life, who since Shawn’s death, wanted to find a way to pay tribute to Shawn for his athletics and friendship. Previously, Susan was unable to focus on this part of Shawn’s life, as her meaning was completely shrouded in his death. Susan was able to put away the police and autopsy reports and think about how she could use this energy to re-establish relationships with the rest of her children, knowing full well how important these relationships had become for her. Discussions around the family table expanded to include recollections of Shawn that were more than the outcome of his death.
The traumatic incident of Shawn’s death was a reality that could not be changed. Having Shawn alive would certainly have outweighed any positive outcome Susan experienced through the pain of his death. Yet, she had a choice to remain in the narratives of suicide and self blame, or envision new narratives that could allow for Shawn’s death to mean more than just loss.
Susan looked at life very differently following her son’s death, she interacted differently with others. Through this experience, Susan appreciated her relationships more and described Shawn’s death as an experience that changed how relationships worked within her family. Taking this tragic experience to mean more than pain and suffering, self blame, and focusing on how Shawn died, required an opening through which other narratives could emerge. Narratives such as valuing Shawn’s life, their relationship, and the memories of happy times allowed for new perceptions of the event, which allowed for alternative emotions and shaped new memories. In essence, this is about finding hope and meaning through times of tragedy and loss.
Psychiatric Association (2000). Diagnostic
and statistical manual of mental disorders. Fourth Edition, Text
H. (1997). Conversation, language and
possibilities: A post-modern approach to therapy.
Archibald, H. & Tuddenham, R. D. (1965). Persistent stress reactions after combat. Archives of General Psychiatry, 12, 475-481.
Bonano, G. A., Papa, A., O’Neill, K., Westphal, M., & Coifman, K. (2004). The importance of being flexible: The ability to enhance and suppress emotional expressions predicts long-term adjustments. Psychological Science, 15, 482-487.
C. A. (1988). Healing the incest wound:
Adult survivors in therapy.
V. E. (1984). Man’s search for meaning.
Franklin, C. (1995). Expanding the vision of the social constructionist debates: Creating relevance for practitioners. Families in Society: The Journal of Contemporary Human Services, 76(7), 395-405.
K. J. (1999). An invitation to social construction.
N. (1978) Treatment in crisis situations.
J. L. (1992). Trauma and recovery.
Hoffman, L. (1990). Constructing realities: An art of lenses. Family Process, 29, 1-12.
M. J., & Solomon, G. F. (1975). Prediction of delayed stress
Koriat, A., Goldsmith, M., & Pansky, A. (2000). Toward a psychology of memory accuracy. Annual Review of Psychology, 51, 481-537.
H., & Kirk, S. A. (1997). Making us
crazy. DSM: The psychiatric bible and the creation of mental disorders.
Laney, C., Campbell, H. V., Heuer, F., & Reisberg, D. (2004). Memory for thematically arousing events. Memory & Cognition, 32, 1149–1159.
LeDoux, J. E. (1994). Emotion, memory and the brain. Scientific American, 270(6), 50-57.
J. E. (1998). The emotional brain: The mysterious underpinnings of emotional
Levine, L. J. (1997). Reconstructing memory for emotions. Journal of Experimental Psychology: General, 126, 165-177.
Levine, L. J. & Pizarro, D. A. (2004) Emotion and memory research: A grumpy overview. Social Cognition, 22(5), 530-554.
Mazzoni, G. & Vannucci, M. (2007) Hindsight bias, the misinformation effect, and false autobiographical memories. Social Cognition 25(1), 203-220.
L., Pearlman, L., (1990). Psychological trauma
and the adult survivor: Theory, therapy and transformation.
Mitchell, J. T. & Everly, G. S.
(1994). Preventing work-related post-traumatic stress: The critical
debriefing (CISD). In G. S. Everly, Jr., & J. M. Lating (Eds.), Psychotraumatology: Key papers and core concepts in
post traumatic stress (pp. 267-280).
F. W. (1919). War neuroses and shell
Neimeyer, R. A., & Stewart, A. E., (1996). Trauma, healing and the narrative emplotment of loss. Families in Society: The Journal of Contemporary Human Services, 77, 360-375.
J. (2001). A user’s guide to the brain:
Perception, attention, and the four theaters of the brain.
Richards, J. M., & Gross, J. J. (1999). Composure at any cost? The cognitive consequences of emotion suppression. Personality and Social Psychology Bulletin, 25, 1033–1044.
D. L. (1996). Searching for memory: The
brain, the mind and the past.
D. L. (2001). The seven sins of memory,
how the mind forgets and remembers.
M. L. (1998). Awakening intuition.
G., & Calhoun, L. G. (1995). Trauma and transformation: Growing
aftermath of suffering.
Terr, L., (1983). Chowchilla revisited: The effects of psychic trauma four years after a school bus kidnapping. American Journal of Psychiatry, 140, 1543-1550.
D. & Vis, J. (1997). Flexibility, sensitivity and timing: A
trauma debriefing model for the north. In K. Brownlee, R. Delaney,
Graham (Eds.), Strategies for northern
social work practice (pp. 187-216).
der Kolk, B., & Fisler, R. (1995). Dissociation and the fragmentary
of traumatic memories: Overview and exploratory study. Journal of Traumatic Stress, 8(4),