George Bonanno

10 июля 1987 г. в 08:48

In a landmark 2004 article, clinical psychologist George Bonanno argued for expanding the concept of the stress response. He defined endurance as the ability of people who have experienced a traumatic experience to maintain a relatively stable psychological and physical state. Bonanno studied a lot of research on this topic and came to the conclusion that endurance is a fairly common phenomenon, it is not synonymous with the absence of psychopathologies and it can be achieved in several different ways.

A large number of people who have been through a traumatic event, such as learning about their terminal illness, losing someone close to them, or experiencing sexual abuse, have not only shown amazing stamina, but have also been able to improve their quality of life after this experience. Richard Tedeschi and Lawrence Calhoun called this phenomenon post-traumatic growth.

Research shows that almost 70% of adults have experienced traumatic events at least once in their lives, but only 20% develop PTSD symptoms.

Positive psychological changes that have developed as a result of a collision with difficult life circumstances are manifested as follows:

  • higher life satisfaction;
  • understanding the value of close relationships;
  • more active expression of altruism and empathy;
  • finding new opportunities or goals in life;
  • better understanding of your personal achievements;
  • spiritual development;
  • creative growth

Bonanno's research has shown that psychological resilience is at the core of human responses to grief and trauma. Bonanno's discovery of the ability to recover refutes what has been the status quo assumption about the experience of human grief and trauma in the West since the time of Sigmund Freud almost a century ago. Bonanno's contribution to this field is that he found sustainability through careful research, rather than through anecdotal evidence, theorizing, or a simple but unreliable methodology.

Many of those who have experienced a bereavement, found the opening on Bonanno resilience in the face of potentially traumatic events is controversial. Many therapists and psychiatrists who usually treat patients with a chronic illness can hardly imagine that for most people who have experienced a loss or even an extreme stressful event, such as during September 11 or sexual violence in childhood, treatment is not required. Moreover, unlike the ideas of Freud and his followers and the prevailing popular theories, many people find it difficult to accept laughter as a healthy response. Another difficult concept, especially in the face of a potentially traumatic event when people feel they need help , is the realization that treatment that is otherwise safe can cause harm, causing symptoms they hope to avoid.

Other critics have argued the opposite, that the idea of human resilience is not only not wrong, but so obvious that it is simplistic. Others objected that this might seem simple, but the idea eluded researchers during the century between the works of Freud and Bonanno. The policies and treatment of the last century were based on the false idea that people are not resilient, which is costly in human and monetary terms.

That people are resilient even in the face of extreme stressors or losses contradicts the step-by-step model of grief. Many hardy people don't show grief. So they don't have stages of grief to go through. Before Bonanno, therapists and psychiatrists considered the absence of grief a pathology to be feared, not a healthy outcome.

Resilience has profound implications for people's self-image, especially after a stressful event. This idea is also important for how the therapeutic community thinks about and relates to bereavement. Bonanno's research has shown that universal psychological counseling after potentially traumatic events does more harm than good. Resilience, which is an integral part of the human experience after major stressful events, can also have important implications for public policy, such as how best to treat veterans who have served in military situations, and whether large populations need to be consulted after major stressful events such as tsunamis or riots, or shootings.

Four trajectories of grief and trauma responses

In 2002 and 2004, Bonanno described the four most common trajectories of grief or potential trauma. This study was based on longitudinal data obtained before the loss. In subsequent studies, Bonanno and his colleagues identified the same trajectories after other potentially traumatic events, such as the September 11 terrorist attack in new York and the SARS epidemic in Hong Kong. Contrary to popular assumptions about loss and injury, Bonanno's research may show that resilience is the most common pattern, and delayed responses are rare.

The four trajectories and the percentage of people who tend to fall into each category are summarized and expanded in his book the Other side of sadness: what the new science of bereavement tells us about life after loss. The book also includes graphs of the trajectories.

The four trajectories:

Strength

"The Ability of adults in normal circumstances who are exposed to an isolated and potentially very disruptive event, such as the death of a close relative or a violent or life-threatening situation, to maintain relatively stable, healthy levels of psychological and physical functioning, as well as "the ability to generate experiences and positive emotions".

Recovery

When "normal functioning temporarily gives way to threshold or sub-threshold psychopathology (for example, symptoms of depression or post-traumatic stress disorder ( PTSD)), usually for a period of at least several months, and then gradually returns to the level preceding the event."

Chronic dysfunction

Prolonged suffering and inability to function, usually lasting several years or longer.

Delayed grief or trauma

When the habituation seems normal, but after a few months, the distress and symptoms increase. Researchers have found no evidence of delayed grief, but delayed trauma appears to be a real phenomenon.

How to deal with the ugly

Bonanno coined the phrase "coping with ugliness" to describe how he discovered that grief and coping with grief take different forms. Behaviors that might normally be unhealthy can be helpful during times of stress, such as self-interest bias.

Scientific study of grief

Prior to Bonanno's work, the prevailing idea was that grief could not be quantified or studied scientifically. Bonanno argued early on that the scientific study of grief was possible.

The pre-Bonanno attitude to this area can be described by Tom Golden, a well-known bereavement specialist who specializes in men's grief. In 1997, he said: "People who are grieving think researchers are full of shit, and part of me says: "I'm with you." We don't have the tools to measure it yet, we don't have a grief meter. We need to develop a sense of ignorance."

"I think that's a ridiculous statement," Bonanno said hotly in 1997 in response to Tom Golden's remark. "You can measure grief. People want to use a magical, mystical perspective, but it is very dangerous to assume that they have access to a sacred realm that is inaccessible to research, relying only on their own observations, feelings and thoughts - things that are very unreliable." He argued that such clinical criticism is the result of a simplistic attachment to the life stories of individual patients. "Most often I hear criticism: "Your research is very bad, because I have a patient who feels this and that." Well, I've studied hundreds of people."

Research methodology

Bonanno has conducted multicultural research on grief and trauma, including research in Nanjing, China; among war survivors in Bosnia and Herzegovina and in Israel. He has conducted multi-dimensional research on emotion regulation, stressful life events, and resilience and adaptation among College students; research on the emotions and well-being of survivors of childhood sexual abuse (in collaboration with researchers); and several recent studies on resilience and adaptation to the aftermath of the September 11 terrorist attacks in new York (funded by the National science Foundation).

Areas of bereavement and trauma research often rely on simple measures, such as self-report questionnaires. Self-reporting measures are simple and inexpensive, but they are unreliable for several reasons. For the areas of grief and trauma, self-assessment indicators depend on how the subject feels at the time of answering the questionnaire. If the subject feels bad while answering the questionnaire, they will remember the loss as more devastating. If the subject feels good when completing the questionnaire, they will report that the loss was easier to bear. This subjectivity can change quickly.

Recognizing that no simple measure can be accurate, one of the hallmarks of Bonanno's research methodology is the simultaneous use of multiple independent measures. This ensures consistent validity of any conclusions. For example, his research often simultaneously uses, among other things, skin temperature, heart rate, facial coding system or "FACS", first developed by Paul Eckman, studies of an empty chair, longitudinal measurements over several months or years, cortisol, a doctor and a friend. Reports and tests of the Scab.

He is also known for developing new research methods, such as measuring ambivalence and the "empty chair" study with researcher Nigel Field.

Conclusions Of James W. Pennebaker's well-supported data directly contradicts Bonanno's claims about the harmful effects of restoring a bad experience. One possible explanation and attempt to reconcile this apparent contradiction is the method of recovering or analyzing bad memories. Pennabaker is known for his pioneering work in writing therapy. Perhaps there is something in the letter that is not expressive crying in public, for example, that helps rather than harms the person's result. Writing can help maintain the social connections that are crucial to achieving good results after a loss.

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