March 27, 2015 at 6:33 AM
The concept of post-traumatic growth has been around since long before the term was coined. For example, people have long proclaimed, “What doesn’t kill you makes you stronger.” The thing is, sometimes it does, and sometimes it doesn’t. And when it doesn’t, the point of trauma-focused therapy is to help those who have been wounded by their experiences to heal and come out stronger. In other words, when post-traumatic growth doesn’t happen naturally, we try to induce it.
The processing of trauma or loss has long been regarded as a primary method of personal growth (e.g., Cassem, 1975). My favorite take on this is Jungian, and my favorite exemplar is Joseph Campbell’s (1949) classic, The Hero With a Thousand Faces. Campbell surveyed numerous cultures’ coming-of-age rituals, as well as myths and fairy tales, to formulate the quest of the hero as a model of growth via facing and processing one’s fears, traumas and/or losses.
The quest of the hero’s basic structure is as follows:
- Base line, or “once upon a time,” when everything is normal.
- The call to action, in which normal doesn’t work anymore. Because now (for example), the old parents can no longer feed their growing children; or there’s a dragon in town, wreaking havoc.
- Gathering of resources to enable the hero – who typically starts out as someone decidedly not heroic – to face the challenge.
- Death and rebirth. The hero utilizes her resources, faces death (or some equivalent fate such as enchantment), and comes through. In the process of overcoming the challenge, the hero becomes transformed, for example from child to adult, or wounded to whole.
- Re-entry, in which the hero returns home, but in a new role or higher level as per the growth/transformation that has been achieved.
I used to teach therapists this model using the example of the beloved (1939) movie version of The Wizard of Oz (Baum, 1900). The once upon a time of hard-scrabble farm life is disrupted by the call: the wicked Myra Gulch who plans to have Dorothy’s dog killed. Dorothy runs away, and (one thing leading to another) finds that she must face and kill the wicked witch in order to be able to return home. Along the way she gathers essential resources, including wisdom (the Scarecrow), compassion (the Tin Woodman), and courage (the Cowardly Lion), not to mention her own intuition or unconscious (that’s her dog Toto). She uses all of these (companions, or qualities) to face and vanquish the witch. She returns home with a new level of maturity and appreciation for her family and her black-and-white life.
It was fun to use The Wizard of Oz as a teaching tool, but over time I found the need for a story that did more, that taught the details of the trauma-informed therapy approach. So I developed a fairy tale that did that, as summarized here.
This story starts out with a life-as-usual once upon a time, and yes, a dragon for the call; the dragon also represents the trauma or loss event. The kingdom’s dragon-reactive fear and dysfunction represent the post-traumatic stress symptoms. Then the story moves from pathology to therapy.
The hero is just some guy, who happens to be in love with the princess, who happens to be willing to marry whoever slays the dragon; this represents the therapy focus on motivational work, guiding the client to identify and embrace treatment-related personal goals. In quest of the hero terms, the arrival of the dragon is part of the call, and the guy’s love for the princess – who will only marry him if – is the rest of it.
The residents of this dragon-blighted kingdom are rooting for this guy, so they help him prepare for the big fight. First they find him a safe, protected place to work out; this represents the therapy focus on stabilization. Then they provide a personal trainer to support him in becoming dragon-fighting-ready; this represents the therapy focus on self-management and coping skills, as well as the quest stage of gathering resources.
He does face, fight, and slay the dragon; in therapy that’s trauma resolution work, and in quest, the death and rebirth. Okay, he does get to marry the princess, and the kingdom residents are proud of having helped; in the quest this is returning home at a higher level.
But it doesn’t end there. The people in the kingdom don’t want any more dragon incursions, so they take various measures such as planting apple orchards to block the easy way in; this represents the therapy focus on teaching clients to anticipate future challenges, which can then be avoided or coped with (i.e., relapse prevention). Then the kingdom holds an annual mock dragon-slaying contest, which keeps the contestants in dragon-fighting shape in case another dragon ever does come; this represents the therapy focus on harm reduction.
This is the summary, not the actual story; it’s told much better in the books (Greenwald, 2005, 2007, 2009, 2013; Greenwald & Baden, 2007) and training programs. Our fairy tale model of trauma-informed treatment has served us well as a training tool as well as a research-supported treatment approach. And it all came out of Joseph Campbell’s quest of the hero as a model for post-traumatic growth.
Baum, H. (1900). The wonderful wizard of Oz. Chicago: George M. Hill Company.
Campbell, J. (1949). The hero with a thousand faces. Princeton, NJ: Princeton University Press.
Cassem, N. H. (1975). Bereavement as indispensable for growth. In B. Schoenberg, I. Gerber, A. Wiener, A. H. Kutscher, D. Piretz, & A. C. Carr (Eds.), Bereavement: Its psycho-social aspects (pp. 9–17). New York: Columbia University Press.
Greenwald, R. (2005). Child trauma handbook: A guide for helping trauma-exposed children and adolescents. New York: Haworth.
Greenwald, R. (2007). EMDR within a phase model of trauma-informed treatment. New York: Haworth.
Greenwald, R. (2009). Treating problem behaviors: A trauma-informed approach. New York: Routledge.
Greenwald, R. (2013). Progressive counting within a phase model of trauma-informed treatment. New York: Routledge.
Greenwald, R., & Baden, K. J. (2007). A fairy tale. [Comic book.] Northampton, MA: Trauma Institute & Child Trauma Institute.
The Wizard of Oz [Motion picture]. (1939). Metro-Goldwyn-Meyer.
Please add a comment
does this have application to grief work?
what about anxiety?
how does this treatment approach work with people for whom Christian faith is an integral part of their lives?
- most of these problems come, at least in large part, from upsetting experiences that have not yet been fully processed; and
- the fairy tale model incorporates most other treatment activities that therapists are already doing, such as guiding clients to focus on their goals, teaching coping skills, etc.
Whether or not the therapy client is a person of faith, the same treatment approach applies. People are people, and if they are emotionally wounded, they deserve healing. Some therapy clients of faith do bring in faith-related concepts or resources to support their healing path. There is room for that in this treatment approach.