1. If Life Gives You Lemons… What Research Can Tell Us About Resilience, Recovery and Growth Following Trauma Craig Hutchison Beyond Trauma Project Manager, Health in Mind

2. 3 Historical Phases of Research 1.Prevalence and consequences of child sexual abuse. How much abuse is there, and what does it do to people? 2.Comparisons between ‘resilient’ and ‘non- resilient’ survivors. Why do some people experience more severe problems than others following abuse? 3.Positive changes reported following trauma. How do people grow or ‘recover’ following trauma? Research from the Positive Psychology movement.

3. Problems of Definition The research literature has tended to define resilience and recovery in negative terms, as the absence of unwanted symptoms (e.g. flashbacks, dissociation, alcohol or substance misuse).

4. Literature on ‘Resilience’ Resilience literature has often compared survivors who demonstrate significant problems with those who don’t, in order to understand factors which may mitigate suffering. Significant factors = Adult responses to abused children Role of Good social support Cognitive Appraisal Spirituality Individual personality factors Relationship to perpetrator(s) Duration and Intrusiveness/Violence of abuse

5. The Experience of Being Criminally Victimized “Being criminally victimized is a disruption of daily routine and a shattering of its taken for granted horizon of social harmony which compels one, despite his resistance, to face his fellow as predator and himself as prey, isolated from any helpful community.” Fischer & Wertz (1979) “…experiences of victimization lead to a crazy, unpredictable world where others have no care for one’s life and constantly stand as threat to it.” Wertz (1985), p.204

6. Joseph & Linley (2006) “ Within the literature, three broad dimensions of growth have been discussed. First, relationships are enhanced in some way … Second, people change their views of themselves in some way … Third, there are reports of changes in life philosophy.” p.1042

7. Woodward & Joseph (2003) INNER DRIVE TOWARDS GROWTH Will to Live (9) VEHICLES OF CHANGE Awakening of Responsibility (18) Love and Nurturing (16) Validation and Acceptance (13) Liberation and Freedom (10) Belonging and Connection (8) Mastery and Control (7) PSYCHOLOGICAL CHANGES Changes in Self-Perception (24) New Perspectives on Life (17) Changes in Relationships (6) TOTAL = 29 participants.

8. Banyard & Williams (2007) Qualitative interviews with 21 women examining definitions of recovery: Recovery as never fully possible – an ongoing process (36%) Recovery as involving change (43%) Women also described recovery as: Acceptance of what happened … Making peace with oneself … Connection with others … Regrouping … Talking about one’s feelings and experiences … Linked to recovery from substance misuse.

9. Banyard & Williams (2007) “You’re always in a form of recovery because you’re always gaining new knowledge about yourself and who you are.” “I don’t think anyone is ever FULLY recovered…I think it’s a lifelong process in which you just, you might find other ways of being able to deal with it.” “I would like to truly believe that I have recovered from that because when I talk about it I don’t cry as much as I used to cry… my shame or my guilt or blaming is not as much as it used to be.” p.285

10. Banyard & Williams (2007) 16 women (76%, N=21) included descriptions of significant ‘turning points’: Relationships with their own children. Spirituality. Remembering the past so as not to return to it. External social supports and environmental opportunities were also important. The researchers discuss the protective role of ‘communal mastery’. (from Hobfall et al, 2002).

11. Grossman, Sorsoli et al (2006) MEANING-MAKING IN MALE CSA SURVIVORS 1.Through Action. (e.g. altruism / helping others, creativity and arts) 2.Through Thought and Reason to Understand the Abuse. Psychological Analysis of the Abuser Understanding the Role of the Self / Self-Blame Socio-cultural Ways of Understanding Understanding through Philosophy 3.Through Developing or Calling on a Sense of Spirituality.

12. Calhoun & Tedeschi model Traumatic events challenge pre-trauma schema by shattering prior goals, beliefs, and ways of managing emotional distress. This shattering leads to ruminative activity as people try to make sense of what has happened and to deal with their emotional reactions to the trauma. In initial stages this ruminative activity is more automatic than deliberate (re-experiencing and avoiding). As adaptation increases, initial ruminative activity shifts towards a more effortful ruminative activity, characterized by narrative development, part of which may be the search for meaning.

13. Joseph, Linley et al (2005) “…our re-analysis of the association between positive change and … intrusion tentatively suggests that positive changes may be related to consciously controllable, ruminative forms of intrusive thinking but not to automatic and uncontrollable intrusive thinking.” p.77

14. Tedeschi (1999) “Crucial in response to trauma is the attempt to find relief from emotional distress, and to address the challenge to … high-order schemas (such as believing that good people will have good fortune) [which] allow us to minimize our sense of vulnerability…Satisfactory adjustment seems to be dependent on developing a way to understand the trauma and its aftermath in personal terms.” p.320

15. Linley & Joseph (2004) Frazier et al (2001) found that sexual assault survivors demonstrated negative changes in beliefs about the goodness of other people and the safety and fairness of the world in parallel with positive changes in philosophy of life and sense of personal strength. Positive changes in areas of self and spirituality were associated with less distress, whereas negative changes in these areas were associated with more distress, as were negative changes in relationships.” p18

16. Viktor Frankl (1905-1997) Existential Therapist Founded Logotherapy Holocaust Survivor – both of his parents and his wife died in concentration camps ‘Will to Meaning’

17. Linley & Joseph (2006) “Calhoun and Tedeschi (1998) suggest that in discussing growth with clients…‘it is important to use words that clearly locate the impetus for growth in the arena of struggle with the event, not the event itself’ (p.366). Personal growth after trauma should be viewed as originating not from the event but from within the person themselves.” p.1048

18. Craig Hutchison MBACP (Accred), UKRC Reg Ind Cllr. Project Manager: Beyond Trauma Health in Mind 40 Shandwick Place EDINBURGH EH2 4RT Tel: 0131 225 8508 Email: craig@health-in-mind.org.uk