The End of Trauma: How the New Science of Resilience Is Changing How We Think About PTSD ★★★★☆

• Format: 336 pages, Hardcover
• Published: September 7, 2021, by Basic Books
• ISBN9781541674363 (ISBN10: 1541674367)
• ASIN1541674367
• LanguageEnglish

I heard of this book by George Bonanno on the Hidden Brain podcast. He challenges the widely perceived notion that all trauma causes PTSD in all people. While not diminishing actual trauma victims who suffer post-traumatic stress, he emphasizes through research that not all such stress leads to a disorder. For one, PTSD is surprisingly uncommon considering the multiple traumatic incidents many of us face in today's world, and people are also unexpectedly resilient and tend to cope not easily yet satisfactorily eventually. So what gives?

I found his arguments convincing because he advocates for a resiliency mindset, which is similar to a growth mindset that I've worked in and researched. He lays down three essential factors that foster a resiliency mindset through a coping process that kickstart the flexibility sequence:

1. Optimism about the future,
2. Confidence in our ability to cope, and
3. a willingness to think about a threat as a challenge.

He makes a case by narrating several cases where a person has undergone a severe trauma, ranging from being in one of the towers on 9/11 to being part of a horrific road accident that led to amputation, to a mugging in a park at night. These three characteristics, not necessarily in any particular order and not always to the same degree, define resilient individuals. Hence, we see people who emerged from the horrors of the Holocaust (think Elie Wiesel) go on to live long, productive lives. Of course, it leaves a mark, but not always for the worse.

The book serves as a valuable instruction manual for coping with today's world. I've always considered myself a pissed off optimist. Yes, I'm angry, but I'm also confident that eventually the future will be better. It won't be easy or even linear. Things will get bad, then slightly better, and then worse before eventually emerging in a new reality that's better than our past. That belief is the first step in gaining confidence in our ability to cope.

Millions of people have lived under fascism and brutal regimes, but many of them coped. They kept trudging along in the hope that things would be better. Finally, it's not just about believing in the inevitability of change for the better but also about treating threats as a challenge rather than an overwhelming force that leaves you feeling helpless.

Of course, the book isn't perfect. It's less about the 'end of trauma' and more about 'dealing with trauma so that you aren't left scarred for life'. Also, not all types of trauma are the same. A child being sexually abused by their parent is infinitely graver than other forms of trauma that we experience in our day-to-day lives. However, they too survive. It's more about not being a slave to the effects of trauma but giving it time and working through it with the right frame of thinking. As the cliche says, life goes on.

Notable Highlights

The flexibility mindset is essentially a conviction that we will be able to adapt ourselves to the challenge at hand, that we will do whatever is needed to move forward. At the core of the mindset are three interrelated beliefs: optimism about the future, confidence in our ability to cope, and a willingness to think about a threat as a challenge.

Neither trauma nor PTSD is a static, immutable category. They are dynamic states with fuzzy boundaries that unfold and change over time.

Trauma severity and trauma outcome are correlated. But when two things are correlated at a rate greater than chance, this tells us only that when one happens, the other is also likely to happen. It doesn’t mean they always co-occur, or even that they necessarily co-occur most of the time.

Context sensitivity builds on this process by focusing much more specifically on the details, on the particular contextual nuances and demands we face. In essence, in this step we ask ourselves, “What is happening to me?” “What is the problem?” and “What do I need to do to get past it?”

Reappraisal can be an effective strategy, but it doesn’t work as well when emotions are extreme or intense as it does in less intense contexts, and people prefer it less often. A different strategy, such as distraction, tends to be more effective in reducing intense emotions, at least in the short term.

In fact, in one study we found that depressed people with intact context-sensitivity skills were more likely to improve over time than those with only minimal context sensitivity. The former were more likely to show a recovery trajectory, while the latter were more likely to experience depression for an extended period of time.

When we are overwhelmed by stress, our resources are already depleted, and it’s often hard to think clearly. A less taxing approach, and one that would engender a wider learning experience, would be to practice and enhance the capacity for flexibility in the course of normal daily life, when we are not overcome by stress.

The resilience trajectory is in evidence, I proposed, when people in otherwise normal circumstances are exposed to an isolated and potentially highly disruptive event, but nonetheless maintain “a stable trajectory of healthy functioning across time”

The key point is that the more strategies we are able to engage in effectively, even if we use them only sparingly, the more options we have for meeting the demands of a specific situation.

I’ve used the word “resilience” throughout this book to describe a pattern of continued good mental health after potential trauma, or, more precisely, a stable trajectory of healthy functioning across time. Flexibility is not resilience. Flexibility is the process we use to adapt ourselves to traumatic stress so that we can find our way to resilience.

These are supplemental highlights made by other readers.