What We Gain From Pain

We’ve all heard the saying, “What doesn’t kill you makes you stronger.” But is there any truth to this idea? This week, we explore the concept of post-traumatic growth with psychologist Eranda Jayawickreme. He finds that suffering can have benefits — but not necessarily the ones we expect.

Additional Resources

Books:

Redesigning Research on Post-Traumatic Growth: Challenges, Pitfalls, and New Directions, edited by Frank J. Infurna and Eranda Jayawickreme, 2021.

Greatness: Who Makes History and Why, by Dean Keith Simonton, 1994.

Research:

Toward a More Credible Understanding of Post-Traumatic Growth, by Eranda Jayawickreme and Frank J. Infurna, Journal of Personality, 2020.

Past Adversity Protects Against the Numeracy Bias in Compassion, by Daniel Lim and David DeSteno, Emotion, 2020.

Fixing the Growth Illusion: New Directions for Research in Resilience and Posttraumatic Growth, by Frank J. Infurna and Eranda Jayawickreme, Current Directions in Psychological Science, 2019.

Randomized Controlled Trial of SecondStory, an Intervention Targeting Posttraumatic Growth, with Bereaved Adults, by Ann Marie Roepke, et al., Journal of Consulting and Clinical Psychology, 2018.

Hard-Earned Wisdom: Exploratory Processing of Difficult Life Experience is Positively Associated with Wisdom, by Nic M. Weststrate and Judith Glück, Developmental Psychology, 2017.

Suffering and Compassion: The Links Among Adverse Life Experiences, Empathy, Compassion, and Prosocial Behavior, by Daniel Lim and David DeSteno, Emotion, 2016.

Control and the “Good Life”: Primary and Secondary Control as Distinct Indicators of Well-Being, by Erik G. Helzer and Eranda Jayawickreme, Social Psychological and Personality Science, 2015.

Changing for Better or Worse? Posttraumatic Growth Reported by Soldiers Deployed to Iraq, by Iris M. Engelhard, Miriam J. J. Lommen, and Marit Sijbrandij, Clinical Psychological Science, 2014.

Does Self-Reported Posttraumatic Growth Reflect Genuine Positive Change?, by Patricia Frazier,et al., Psychological Science, 2009.

The transcript below may be for an earlier version of this episode. Our transcripts are provided by various partners and may contain errors or deviate slightly from the audio.

Shankar Vedantam: This is Hidden Brain, I'm Shankar Vedantam.Some years ago, I got to talking with an investor. By his own account he was a one-percenter. Like many other successful Americans before him, he had overcome many challenges growing up. Then he told me about the one thing in his life that made him sad; his kids. They were sweet and smart, but they lacked drive. They had led easy lives, he told me. They didn't have the same hunger that had made him successful. I've heard variations of the same story over the years. People who have come through adversity will invariably tell you that their adversity played a central role in their success.

Fox Business host Maria Bartiromo: You're the godfather of technology, you founded this company, you're still thriving and you came from such humble beginnings. Tell me how you did it.

Oracle CEO and cofounder Larry Ellison: Well, I think my favorite line is I had all the disadvantages necessary for success.

JK Rowling: I was jobless, a lone parent and as poor as it is possible to be in modern Britain without being homeless.

Oprah Winfrey: I now know from interviewing over 50,000 people over the years and my own personal experiences, that everything that has happened to you can be used to strengthen you, if you're open to it.

Shankar Vedantam: This idea that hard times make us stronger, has been touted so often and by so many people that we rarely stop to ask ourselves, "Is there any truth to the story?" This week on Hidden Brain, we explore whether adversity is the secret sauce of success.

Eranda Jayawickreme grew up in Sri Lanka while a civil war raged in that country. When he was 21, he moved to the United States to study. Soon after his arrival, Eranda began to notice that Americans had a way of thinking about adversity and suffering that was new to him. It became the start of a lifelong exploration. Today, as a psychologist at Wake Forest University, Eranda is asking a question that is increasingly relevant in many parts of the world. What happens to people as they go through terrible times? And what advice can science give them about the best path forward?

Eranda Jayawickreme, welcome to Hidden Brain.

Eranda Jayawickreme: Thank you so much for having me.

Shankar Vedantam: Eranda, you arrived in the United States shortly before the 9/11 attacks and a few weeks after the attacks, New York's Mayor Rudy Giuliani gave a speech at the United Nations.

Rudy Giuliani: This massive attack was intended to break our spirit. Has not done that. It's made us stronger, more determined and more resolved.

Shankar Vedantam: There was a theme in speeches like this that jumped out at you, Eranda. You felt it reflected a particularly American way of thinking about trauma. What did you hear?

Eranda Jayawickreme: One thing that I remember being struck by was this idea that well, this bad thing has happened, but something good is going to come out of it. That we're absolutely determined that something good is going to come out of it. I remember thinking, "Well, that's interesting," because the first thing you typically want to do is make sure you can manage the impact of that bad thing and maybe in the wake of what's happened, try and return to where you were before or return to a baseline. But this is something different. This is idea that, oh, this terrible thing has happened, but somehow we are going to overcome it and we are going to get to a place that's somehow better than before.

Shankar Vedantam: I'm wondering if you can almost summarize this way of thinking in a single line that you see all over social media nowadays, what doesn't kill you makes you stronger.

Eranda Jayawickreme: Exactly and this happened I think, in the last 10 or 15 years or so. This quote, which comes from Frederick Nietzsche, the German philosopher. It's become almost a cultural touchstone. I remember, I think the last few years there've been songs by Kanye West and Kelly Clarkson. There have been memes that go around the internet. It's almost a default attitude towards trauma. When bad things happen, we are going to use this as an opportunity to become better. That to me seems quintessentially American. The idea that we are going to take even the worst opportunities, the worst experiences and make something positive out of them.

Shankar Vedantam: Once Eranda noticed this phenomenon, he started remembering all the times he'd encountered it earlier in his life, particularly in American superhero movies.

Eranda Jayawickreme: When I was growing up in Sri Lanka, when I was a small boy, I remember watching the original Superman movie with Christopher Reeve and Marlon Brando.

Audio from Superman: What's your background? Where do you hail from?

Well, it's kind of hard to explain, actually. See, I'm from, well, pretty far away. Another galaxy, as a matter of fact.

Eranda Jayawickreme: The movie begins with Superman as an infant, leaving the planet Krypton before it's destroyed, traveling to earth, growing up on earth, realizing he has superpowers and then becoming a superhero. When I was young, I just thought, "Oh, this is a cool superhero story." Then once I moved to the US, I realized, well, it's interesting that so many superhero stories, the Batman movies for example, or Spider-Man, tend to follow a very similar plot. The protagonist goes through some type of trauma, adverse event and somehow that event is a catalyst.

Audio from Spiderman Movie: The story of my life is not for the faint of heart. If somebody said it was a happy little tale, if somebody told you I was just your average ordinary guy, not a care in the world, somebody lied.

Eranda Jayawickreme: I think buried in that narrative is this idea that bad things in some cases, can lead to this growth or the development of specific abilities that makes you better off than before and also better off than most other people.

Shankar Vedantam: What I find fascinating of course, is that this way of thinking about suffering is not new in America. In the 1950s books and sermons by the clergyman, Norman Vincent Peale, became enormously influential.

Norman Vincent Peale: The world is full of problems. For what reason? Why do we have so many problems? Why do you have so many problems? There's one answer to that. It is that you will grow strong so that you're more and more capable of handling problems. The only way you make a strong man is through resistance, struggle, pain, frustration, disappointment. This makes men.

Shankar Vedantam: When I listen to that clip from Norman Vincent Peale, he's not just saying that suffering produces growth, he's actually saying suffering exists in your life in order to produce growth.

Eranda Jayawickreme: Right, and that's a very interesting claim, this idea that to some extent in order for you to become the best person you can be, in order for you to grow in character, suffering is necessary. It makes you wonder whether that has something to do with the history of the United States, especially for people who had the freedom to immigrate to the United States. I mean, I think when they came to the US, there was this belief that the US is this land of plenty. There's all this opportunity and it's up to you to make the most of it. To the extent to which you're not able to make the most of it, it's because of something that you are not doing. I wonder whether that cultural belief is consistent with this view that pain and suffering are opportunities for growth, for change.

Shankar Vedantam: Now, this way of thinking about trauma and suffering is arguably no longer purely American. I feel like I've heard this theme now in many other contexts, perhaps because American culture increasingly permeates the whole world. But there are videos on TikTok and WhatsApp that talk about how "generation one" confronted suffering, built its character and pulled itself up by the bootstraps... "Generation two" built on that hard work to create great companies or acquire political power. Then "generation three" squanders it all because those kids grew up in luxury and were not tested by adversity. Do you think it's possible that to some extent, some of this American attitude has now started to rub off on the rest of the world as well? The sense that suffering exists in some ways to allow you to become a better version of yourself?

Eranda Jayawickreme: I think there's something to that. A couple of weeks ago in my graduate personality seminar, I was talking with my students about this narrative that adversity and trauma can lead to positive outcomes. One of my students who is originally from China said, "Well, I do think this narrative is there in other countries as well, including in my country. What's interesting and different though, is that in China, the idea is that adversity and suffering can lead to positive change at the national level, so that the country and the community can benefit." He said there was a clear difference from maybe how Americans would think about the value of adversity and suffering, because they will see it in terms of its value to the individual, its value to personal transformation.

Shankar Vedantam: Very interesting. Now, you noticed this theme of triumph over trauma turning up in the lives of the people you were getting to know in the United States. Tell me about Meredith Russo, who she was and how you became acquainted, Eranda.

Eranda Jayawickreme: Meredith Russo, she was a retired English instructor. She was very kind to me. I housesat for her multiple times, she would allow me to use her house to throw dinner parties for my friends. She was just a very kind, generous, welcoming presence while I was in college as an international student.

I remember when she told me about her illness and I went to visit her almost immediately. She simply said, "Well, I have cancer, the prognosis isn't good, but I'm going to take it day by day." Then she went on to talk about how part of what she was experiencing after her diagnosis were people talking about how she was going to fight the cancer like a warrior, that she was going to defeat it. It was really important to take the right attitude about fighting cancer. She thought, "Well, it seems like a lot of stress to think about cancer as something to be vanquished. I have it, I'm going to manage the best I can. I probably don't have a lot of time left, but I'm going to focus on what's important."

It seemed like this idea of being a warrior, about somehow overcoming and maybe even growing from defeating cancer, it struck her as almost... I'm trying to find the right word here. It struck her as almost unnecessary and she didn't like the fact that people were encouraging her to take this more almost warrior-like position towards the illness.

Shankar Vedantam: Yeah, people are telling her, "You're going to come out stronger than before," or, "There's a reason this is happening." And for the person who's actually suffering from the cancer, it now feels like they not only have to deal with the cancer, but they have to deal now with the expectations that they've been bequeathed a gift to actually become some kind of superior person, some kind of superhero.

Eranda Jayawickreme: Exactly. I think it is especially strange to be given that type of advice, that this is a gift, this is an opportunity, when you are still thinking about the emotional response that you have when you're given the news. That it seems very quick to move from, "oh, you have this very serious situation," to "oh, but this is an opportunity that you can learn from," or "this is an opportunity where you can grow your character, become the best possible version of yourself."

Shankar Vedantam: By this point you were studying to become a psychologist at the University of Pennsylvania, you were in grad school and you discovered that the triumphing over adversity trope, the superhero trope was not only dominant in American popular culture, but it was a booming area in psychological research. Can you tell me about the idea of post traumatic growth? What does that mean and how is that connected with this larger cultural trope?

Eranda Jayawickreme: Post traumatic growth refers to this idea that people can experience positive psychological changes as a result of going through stressful life experiences. Research in post traumatic growth started taking off in the mid 1990s. A lot of the early research in post traumatic growth, I think, was based on interviews that clinicians were doing with clients who had gone through trauma, gone through adversity, and they were trying to categorize the types of benefits these clients would report in their clinical interviews. In the last 20 years, work and research and interest in post traumatic growth has exploded. I can tell you that in the last six months, I think I've seen at least three papers looking at post traumatic growth in the wake of COVID and I'm sure there are quite a few more that are in the pipeline.

Shankar Vedantam: Even as some clinicians were telling patients that traumatic events could lead to growth, other researchers said, "Hang on. Are people reporting growth because they've grown or are they saying so because the superhero trope is so dominant in the culture?" Eranda cites a paper by the researcher, Patricia Fraser.

Eranda Jayawickreme: I was a graduate student when I had started becoming interested in looking at post traumatic growth. I remember reading this paper when it came out and it was a very elegant, simple paper. It was a short term, longinalstudy, it was a study that tracked a large number of undergraduate students over a few months. And it asked them whether they experienced a major stressful event and then they were asked, "Okay, as a result of the stressful event, how much have you changed because of the trauma?" It turns out that this question, how much do you think you've changed because of the trauma, is the way most measures of post traumatic growth asks about change.

This paper made me realize that even though most theories about post traumatic growth were talking about post traumatic growth in terms of personal transformation, the measures of post traumatic growth were actually looking at something different, which was the perception of change. And what they found was that while people who had experienced real change had better quality mental health, the people who reported perceiving high levels of change as a result of experiencing the trauma or the adverse event, actually reported higher levels of mental distress.

Shankar Vedantam: From the point of view of someone who was now just looking at this larger, American cultural trope, what I'm going to now call the superhero trope, that bad things produce extraordinary qualities to come out inside you, is it fair to say that this study in some ways was pointing to the fact that if you subscribe very strongly to this belief, this superhero trope belief, but didn't naturally have the changes in your life, not only was this not good, but it could actually be bad?

Eranda Jayawickreme: I think that's right. What was happening was that people were having these beliefs about benefits or growth in experience as a way to cope with the traumatic event they had gone through. In some ways, having these beliefs was potentially serving the role of making them think about their event in a more manageable way, maybe make them establish a greater sense of control over the event. I think one lesson from the Fraser paper is that this coping strategy of perceiving growth didn't seem like a particularly effective one, at least for this sample.

Shankar Vedantam: Now there was another study, this one conducted with soldiers deployed to Iraq. Can you tell me what that paper found, Eranda?

Eranda Jayawickreme: Yeah, this is a paper that looked at soldiers in the Netherlands that were deployed to Iraq. What was nice about this paper is that it tracked people, I think across 15 months. This paper explicitly looked to the question of whether perceiving growth served as an adaptive coping strategy. What they found was that perceived growth actually predicted increased impairment in terms of PTSD symptoms.

Shankar Vedantam: In other words, the soldiers who perceived that they had grown as a result of adversity were actually more likely than other soldiers to experience symptoms of PTSD. The belief was supposed to be helping, but it led to worse outcomes. Yet the idea that people who experience trauma would benefit from their trauma proved irresistible. Increasingly this trope has been actively recommended to patients as a path to recovery.

Eranda Jayawickreme: Around 10 or 15 years ago there was a lot of interest in trying to promote these beliefs about post traumatic growth among cancer patients, because there was this belief that maybe growth could help them improve their quality of life. This led to this pretty acrimonious debate where you had researchers advocating for post traumatic growth, talking about the potential benefits of growth. The fact that large proportions of people report high levels of growth. Then you had detractors saying we haven't properly distinguished between perceived growth and post traumatic growth and the existing evidence suggests that growth understood as perceived change doesn't have a meaningful impact on the quality of life or the longevity of cancer patients.

This speaks to one of the challenges of doing this type of research in the context of a culture that really validates this superhero trope or this idea that adversity can lead to these positive outcomes. I think it's easier for people to accept research that speaks to their own preexisting beliefs. I think what happened with post traumatic growth research was that people were willing to jump ahead and make strong claims about the evidence before the right kind of evidence could be procured.

Shankar Vedantam: Eranda started to wonder, "Does the post traumatic growth narrative give people hope and inspiration, or does it demand that people suffering trauma not only survive it, but show evidence they have come out stronger on the other side?"

When we come back, Eranda contrasts what he was seeing in the United States with his own experience of dealing with conflict in Sri Lanka. You're listening to Hidden Brain, I'm Shankar Vedantam.

This is Hidden Brain, I'm Shankar Vedantam.American culture insists that hard times can make us into better, more successful people. "What doesn't kill us makes us stronger." After moving to the United States to study psychology, Eranda Jayawickreme began to ask if this popular trope was doing more harm than good. He had a reference point: his own experience growing up in Sri Lanka. Through much of the 1980s and '90s, the minority Tamil population of Sri Lanka and the Sinhalese majority were locked in a brutal civil war. Tens of thousands of people were killed. The conflict featured terrible acts of cruelty on all sides. Eranda, you were a kid in Sri Lanka when the civil war unfolded, how much were you allowed to see as a child?

Eranda Jayawickreme: My everyday experience as a nine and 10 year old going around Colombo, which is where we lived, was seeing the bodies of people who had been abducted, tortured, killed and left on the side of the street. Looking back on that, one thing that I'm struck by is just the extent to which I thought that was normal. I had no comparison. I just thought, "Oh, we don't get to go to school." All this stuff is happening around us, but I just didn't think too much about it. I think that set the stage for a pretty high degree of normalization of extreme violence. I think for many people who grew up in Sri Lanka in the '80s and '90s, that was very much the norm.

I grew up in a relatively affluent middle class household so we were spared many of the terrible atrocities that were committed, both in the insurrection and the civil war. But this attitude of, well, a bomb might go off when you're on the bus, you have to be careful if you see someone suspicious, these types of behaviors and these types of beliefs just became normalized. We moved to Kandy when we were, I think, 14 years old and in 1998 I think, when the Tamil tigers blew up the Temple of the Tooth, this major Buddhist shrine in Kandy. We were a couple of miles away from the blast. I remember our house shook when the bomb went off and the moment the bomb went off, I thought, "Oh, something's happened."

I think it was interesting that I felt comfortable traveling out to the city center that afternoon to see my friends and to see what was happening. I remember visiting a friend who lived close to the temple and all the windows in his house had been blown through, but it felt weirdly mundane because of the degree to which we had become accustomed to the type of violence that we saw going on in Sri Lanka at that time.

Shankar Vedantam: I mean, it's astonishing that your parents simply let you out of the house. I mean, there was a bomb blast that went off two miles away and a few hours later you were traipsing out to a friend's house. I mean, that's astonishing.

Eranda Jayawickreme: I think looking back, it might be that we made a decision that, well, the bomb's already happened. Chances are something's not going to happen again, so we felt comfortable going out. I will also say, and it was true that there was a degree of difference between what people in Kandy and Colombo were experiencing and what people in the north and east of the country were experiencing, people who were actually caught up in the civil war. I think there was a sense in which maybe implicitly or explicitly, we believed that compared to other people, this wasn't too bad, at least we weren't living in a war zone.

Shankar Vedantam: We talked earlier about how you moved to the United States shortly before the 9/11 attacks. When the attacks happened, you noticed something about your own reaction to the attacks. What did you notice, Eranda?

Eranda Jayawickreme: I remember this very vividly. I was in class that morning when they announced that the first plane had hit the World Trade Center and I think because at that point people thought it was still an accident, we continued with class. Then it was after my first class of the day that it became clear that this was actually a coordinated attack. People were in shock and they canceled classes the rest of the day. They set up TV sets and they gave out food. My first thought was, "Well, this is bad, but it also weirdly feels like home." My thought was, "Oh, this is bad," but I don't think it struck me just how bad it would've felt to other people around me.

It was only later that evening, there was an interfaith memorial service that I went for and there were professors who were there and they were crying, they were sobbing because there were seniors who had graduated that spring, who had gone to work on Wall Street, who had gone to work at the World Trade Center and they didn't know where they were. They tried to contact them. They were beside themselves with grief. I remember thinking at that moment, "Something's wrong here. I feel like I'm having a response to this attack that doesn't seem right."

Shankar Vedantam: I mean, you were almost responding with a sense of detachment to this terrible thing that was happening around you.

Eranda Jayawickreme: Exactly and it also speaks to the fact that time is that what seemed relatively normal to me, as someone who grew up in Sri Lanka, was something that I was realizing was not normal to many other people, at least for people who lived in this part of the world.

Shankar Vedantam: After he became a psychologist, Eranda started to ask himself whether his own response to the trauma of the Sri Lankan civil war revealed inner growth. When he looked at himself honestly, he didn't see growth. He saw hardening, desensitization, even indifference. Now, you could argue if you like Norman Vincent Peale, that hardness is growth. But was apathy in the face of suffering, really a sign that trauma had made him a better person? When Eranda returned to Sri Lanka to do research on post traumatic growth, he interviewed other people who had been traumatized by the civil war. He saw lots of people who were like himself or worse.

Eranda Jayawickreme: It makes no sense to talk to them about what happened to you last week, or what was a terrible thing that's impacted your life? Because these people have undergone multiple traumas of all types. One thing that struck home for me in those interviews is that unlike in the United States, most Sri Lankans don't want to talk at length about their experiences, about their trauma. There's no investigation into what this means for who am I as a person or where I can grow from it, or change from it or what lesson I can take from it.

All the conversations that I had with people are very matter of fact. If I pushed them on the experiences they had, they would just list them one after another and that would be it. The extent to which it was clear their day to day function had been impacted by trauma varied. There were some people who did come across as very resilient and very positive, despite the adversities they had gone through. Not too many, maybe one or two. But there were many people who you could tell were just struggling to function day to day.

There was one person who came to speak to us because that person was hoping that I could help her find her son. That was a heartbreaking discussion to have. It was clear she was struggling, it was clear that she could barely function in daily life, but she came to a meeting because she was hoping that talking to me about her son would maybe open up a new possibility that he could be found.

Shankar Vedantam: So you weren't satisfied with the approach that you were seeing in Sri Lanka, avoidance that left people isolated in their pain. But you also weren't satisfied with the American approach, this Pollyanna-ish optimism that told people that tragedy would make them better versions of themselves. So you started to examine if there was a third way and you began to look for answers, not just in science, but in philosophy and theology. Why did you do that Eranda, and what did you find?

Eranda Jayawickreme: My first thought was, "Okay, to the extent to which adversity can lead to change, in what domains would you expect to see change?" In looking at the literature and philosophy, looking at different religious traditions, looking at theology, one idea I had was that well, it might be that to the extent to which these different traditions talk about suffering, how to deal with it, how to move past it, there might be valuable insights that could come from these different traditions.

In the last few years, there have been many people who have argued that a fundamental role of religion isn't to tell you a story about creation, or to tell you a story about why you should be a moral or a good person. The fundamental role of religion is to help us understand why there's suffering and trauma in the world. Why do the people that we love get sick and leave us at some point? Why do we suffer unavoidable pain, undeserved suffering? These are fundamental existential questions that we can't immediately answer rationally. So my thought was that looking at different religions, looking at theology, looking at different philosophical traditions to try to explain the role and value of suffering and adversity, these traditions might give us a better understanding of where we could see change.

In the Buddhist tradition there's this idea that it's important to understand that life is fundamentally about suffering. And once you accept that core truth about life, it opens up the possibility for you to attain specific virtues, like compassion that would enable you to lead a good life. Similarly, in the Christian tradition, one lesson that suffering can provide us is that we are vulnerable creatures, that we need other people, that we're fundamentally interdependent. That insight is a valuable lesson that suffering can teach you.

Shankar Vedantam: So you began your own research on the role of adversity in promoting this character development, and you became alert to an emerging body of research within psychology that was demonstrating the potential for suffering to lead to things like compassion or wisdom or creativity. For example, you found the work of the psychologists, David DeSteno and Daniel Lim who had examined empirically how adversity affected people's capacity for compassion. Tell me what they found, Eranda.

Eranda Jayawickreme: They assessed adversity through a checklist where people were asked across your whole life, tell us what major stressful life events you have experienced. What they found was that if you look to the relationship between the number of adverse life events people reported in their lifetime and the expression of compassion, they found that people who had experienced high levels of cumulative lifetime adversity were more compassionate. They were more willing to engage in prosocial behavior. They also found that to the extent to which you have experienced higher levels of cumulative lifetime adversity, you are less prone to be overwhelmed by the number of people who are suffering.

This is called the numeracy bias. The idea is that when you see one person suffering, you feel like, "Oh, I can do something for that person." But when you hear that a whole country has a refugee crisis, you tend not to get involved because you feel like, "Well, this is overwhelming. I don't think I can do anything about this, so I'm not going to engage."

It turns out that people who have experienced a high level of lifetime adversity are immune to this bias. One implication from these studies is that there is something about experiencing different types of adverse events that seems to increase your empathy towards other people, that seems to make you more sensitive to the needs of others.

Shankar Vedantam: In other words, suffering and trauma don't always produce growth. When they do, that growth is unlikely to follow the arc of your standard superhero movie. Instead of getting tougher, growth may take the form of increased compassion and empathy. There are caveats, however. Trauma can also decrease empathy and compassion. Remember how Eranda responded to the 9/11 attacks. It turns out trauma alone usually does not produce wisdom and compassion. A lot comes down to how you process trauma, how you reflect on your own suffering. One study along these lines was conducted by the psychologist Judith Gluck and Nic Westrate.

Eranda Jayawickreme: Yes, Judith's been doing research on wisdom for many years now and Nic Westrate led a project with her, looking at what predicts whether someone experiences changes in wellbeing in the wake of adverse life events. They found that how you thought about the event was a critical factor in determining whether you subsequently experienced changes in wisdom and changes in wellbeing. Specifically, Nick and Judith looked at this construct called exploratory processing, or the extent to which you reflect on the event. You try and think, "Okay, what does this event mean to me? How do I make sense of this? How can I use this event as an opportunity for me to do something different with my life?"

In a study that they ran a few years ago, they found that to the extent to which people engage in that type of self-reflection, those people are much more likely to increase in wisdom and increase in wellbeing after going through a changing life event.

Shankar Vedantam: Setbacks and adversity do not magically produce growth and build character. Trauma is just as likely to cause us to turn away from others and become embittered.

When we come back, how to cultivate character strengths following setbacks and adversity. You're listening to Hidden Brain, I'm Shankar Vedantam.

This is Hidden Brain, I'm Shankar Vedantam. Eranda Jayawickreme is a psychologist at Wake Forest University. He studies how we respond to hardships. He explores how suffering can provide a platform for cultivating character strengths like compassion, wisdom, and resourcefulness.

Eranda, you've long been inspired by Viktor Frankl, the Holocaust survivor who wrote "Man's Search for Meaning." Can you tell our listeners what the book is about and how it's spoken to you?

Eranda Jayawickreme: Yeah, I remember reading Viktor Frankl as a sophomore in college. I remember even back then being struck by the message of the book. The book is about the experience that Viktor Frankl had in a concentration camp during the Second World War. Specifically, it was about his experience, how he was able to maintain a sense of control over his life, despite the complete lack of control he had from an objective standpoint. One of the core lessons of that book is even when you have no control over your environment, you can still exert some degree of control over your reaction to the environment. Especially in contexts where you feel like there's nothing you can do to make the situation better, believing that well, at least I can control my own reaction to the situation, I think gives you some degree of agency. That allows you to both maintain an adequate level of wellbeing in the moment, and also maintain some degree of hope to think that, "Well, things are terrible now, but at least there's a possibility for things to be better in the future."

Shankar Vedantam: Psychological research has begun to build on testimonies like this, this idea that we can choose our own responses to adversity. This research makes a distinction between what's called primary control and secondary control. What are those two modes of control, Eranda?

Eranda Jayawickreme: Primary control is what I think most people, at least most Americans, would think of as control or agency. It's when you use your own actions to modify or change the environment. Secondary control is when you can't change the environment, or maybe for example, the health diagnosis you just can't change objectively. In those cases, the focus of control is not on the environment, but on your own thoughts. While primary control involves changing the environment, secondary control involves changing your own reaction to the environment.

Shankar Vedantam: There's been a lot of work that looks at the difference between these two approaches in a study that you conducted with Erik Helzer. You assessed how much people exercise this control over the external world versus control over the internal world and then you measured how satisfied they were with their lives. Can you describe the study for me and what you found, Eranda?

Eranda Jayawickreme: We had this idea that primary, secondary control work together to promote wellbeing. In the literature, there's an assumption that primary control is what's most important and that you fall back on secondary control when you don't have an option, with the hope that in the future you can then revert back to primary control.

Our perspective was that, well, no, maybe we use these different control strategies as tools to deal with different types of challenges in our world. So we ran a study to look at the unique impact each of these control strategies had on wellbeing and we found that these two strategies independently predicted wellbeing. Primary control or control over environment tended to be associated with high levels of positive emotions, whereas secondary control had this relationship with life satisfaction. They're both varied tools that we can use to promote our wellbeing in daily life.

Shankar Vedantam: So in other words, it is absolutely the case that trying to limit the traumas that affect us, changing the external world, obviously that does help, that does produce positive outcomes. It is also the case that changing our response to those traumatic events, that independently can also promote our wellbeing.

Eranda Jayawickreme: Exactly and it can do so in a number of different ways. It can do so by helping us accept the change that's happening in our lives. Doing so also gives us a sense of agency control, we don't feel overwhelmed by the event. We don't feel like this event has somehow taken over our sense of self, it has made us lose our sense of control over our lives and it makes the event more manageable.

Shankar Vedantam: There was a time in your own life Eranda, where you had to lean on your own capacity to exert secondary control. In other words, to exert control over your own reactions, not the external world. Can you tell me about what happened in Sri Lanka in 2004? You were enrolled in college at the time and the events that were unfolding were taking place thousands of miles away. Walk me through what happened.

Eranda Jayawickreme: I remember, I think it was Christmas in 2004 and at some point during the night I got a message from my father saying that there had been a tsunami that hit Sri Lanka. I remember that morning waking up and watching the news and seeing these terrible scenes of people being swept through city centers by these waves of water. And it felt overwhelming because over the next few days, all these stories came out of the number of people who had been killed, the level of devastation on the Eastern coast, on the Southern coast. There was a train that was traveling down from Colombo to the south of the country and the wave that came from the tsunami engulfed the train and pulled it into the sea and then washed it back up ashore. Many of these people on that train were lost.

There were all these terrible stories that were coming out and I felt completely helpless. I was worried about my parents. Thankfully, they were not impacted that badly by the tsunami. I was worried about the impact this would have on the friends I had there, the people in the country. And there wasn't anything I could do because I was a college student in his final year in Lancaster, Pennsylvania. I remember thinking, "Well, I can't do anything to fix it." I just had to figure out how to manage with the fact that this terrible thing has happened and accept the fact that I can't do anything about it right now.

I will say that relying on secondary control at that point in time helped facilitate a more primary control response in the spring. Because in the spring of that year, I worked with some friends of mine to raise funds for people impacted by the tsunami. It ended up becoming one of the most meaningful experiences in my college career. This is why I think these different control strategies can be so helpful because depending on where you are at the moment, depending on what you can and can't do in the moment, selectively utilizing these different strategies can be very helpful. I do think in the case of the tsunami, I was able to get to a place in the spring where I was then able to exert primary control and do something that hopefully was helpful to people in Sri Lanka.

Shankar Vedantam: Another practice that's supported by your research is engaging in reflection on what we really care about and whether we're actually living out our values. Why would this be valuable and how would it work, Eranda?

Eranda Jayawickreme: Over the last few years, I've been working with colleagues on developing interventions to help people manage and recover from different types of adversity. One insight that we include in our interventions, these are ideas that are taken from other practices like acceptance and commitment therapy, is the idea that one of the challenges when we are faced by adversity or struggle or suffering, is that it prevents us, dealing with the impact of that event, prevents us from living our lives the way we want to. Or living our lives in light of the values that we care about.

One thing that we are trying to do in these interventions we're developing is to highlight for people who are taking part in this intervention, the importance of their own values. Despite the fact they're going through challenges, despite the fact that there might be events outside their control that they're experiencing, what's important to them, what matters to them, and then how can they commit to behaviors that are consistent with those values? Because the idea is that even though you may be struggling or might be dealing with various challenges in the wake of adversity or in the wake of suffering, that you can somehow separate out that struggle from who you are as a person, and understand that you are not purely defined by your struggles. That you are also someone who has values and that you can still commit to that life despite the fact that you are simultaneously managing all these challenges that come from dealing with diversity.

Shankar Vedantam: I'm struck by the fact though that in some ways, this is a very different model than saying trauma and adversity make us into better versions of ourselves. This is really saying trauma and adversity help us discover who we really always were on the inside.

Eranda Jayawickreme: I think that's exactly right. I think one problem with current research in post traumatic growth is the term itself. There are two assumptions baked into the phrase post traumatic growth. One is that trauma is needed for you to grow, but also that you are going to become a better person. That is a much more simplistic understanding of what happens to you when you experience a major life event that I think is the case for most people.

I think it's quite likely that people can become more compassionate. They can develop greater insight into their own lives. They can commit to their values again. But we should be sensitive enough not to say that that means that the trauma or the adversity was worth it. Someone could become compassionate, someone could become wiser, someone could commit to living their values and still experience significant challenges in their mental health or in other domains of their life.

Shankar Vedantam: Eranda found that his own life reflected what he was finding in his research. The more he reflected on his values, the more he found himself connecting his own experiences growing up with those of people in other contexts. One moment of epiphany came when news broke in 2019 of attacks on two mosques in New Zealand.

Eranda Jayawickreme: I ended up staying up to four or five in the morning and watching the events unfold in real time. I had this strong, visceral reaction when I heard about this gunman who had gone into a mosque and was indiscriminately killing all these people. My thought was that, "Oh, if there was someone like that that decided to attack in North Carolina." It was one of the first times where it became clear to me that my identity, being an American immigrant of South Asian origin, who in this context could be caught up in an event like that.

I will say, looking back on that, that did mark a shift in how I started to think about myself and my reaction to the Christchurch attack really highlighted the fact that this feels like something that could be done to me. This is something that I feel at some level, I felt I was being impacted by even though I don't have a direct connection. But I had this visceral sense that what was happening to them could potentially in a different world, in different circumstances happen to me.

Shankar Vedantam: And that's very different than your reaction to 9/11, which was to some extent a reaction of detachment or a reaction even if this doesn't really affect me or this does not concern me.

Eranda Jayawickreme: Exactly. This highlights, I think an important lesson about how we deal with adversity, how we deal with trauma. I don't doubt that the sense of detachment, the sense of normalizing trauma and adversity can be useful when you are in that context. But it also comes with costs, especially when you don't live in that context anymore. I think thinking back over my life, since coming to the US, I'm struck by how as I've gained more distance from my life in Sri Lanka, I've become more aware of just how ubiquitous this normalization was. I understand the benefits of it from a mental health perspective, but I also see the cost.

Shankar Vedantam: There is one other domain where trauma can produce growth. Again, this growth looks very different than the “what doesn't kill you makes you stronger” trope. The psychologist Dean Simonton has explored the correlation between the experience of setbacks, adversity and being an outsider and creativity.

Eranda Jayawickreme: I think the key idea here, and I think this is something that Simonton has written about is that to the extent to which people experience any type of unusual or unexpected event that pushes people to experience the world from a non-normal perspective, that enables these people to think about the world from the margins. And to the extent to which you experience unusual events, unexpected events, that enables you to be open to different ways of thinking about the world and understanding human experience.

Shankar Vedantam: I mean, I'm thinking about how extraordinary art often seems to emerge out of suffering. When you look at the gorgeous paintings of Vincent van Gogh for example, or the music of Beethoven, do you hear echoes in those artists of your own research and findings?

Eranda Jayawickreme: Going back to this Buddhist idea, that fundamental characteristic of life is suffering, that part of what it means to be human is to find a way to confront and manage our experience of suffering and adversity. That view, I think, comes out very strongly in the work of certain artists like Frida Kahlo and Vincent van Gogh.

Shankar Vedantam: I mean, I'm thinking about Beethoven, who wrote some of his most famous music when he was completely deaf. That just seems extraordinary and it's a different kind of superhero trope. It's not developing some new skill, but really doubling down on what it is that you have inside of you.

Eranda Jayawickreme: I think that's exactly right. Vincent van Gogh produced great artwork and lived in considerable psychological pain. Frida Kahlo produced great artwork and lived in considerable physical pain. Beethoven produced this wonderful music as he was going deaf. As an appreciative of art, I might be inclined to say, "Well, yes, he suffered, many of these great artists suffered, but look what they give us." I think my inclination might be to focus on the artwork, on what was produced as a result of that experience.

I think it's an interesting philosophical question, whether the production of art is worth the pain and suffering. I think one of the challenges with thinking about the changes we experience while in adversity purely in positive terms or in negative terms, I think obscures the fact that we can have a complex reaction to adversity. It can lead to positive and negative outcomes simultaneously.

I think as long as we're honest about that and we're honest about the fact that yes, under some circumstances people can grow more compassionate or they can increase their creativity, but also, that is accompanied by other changes that may not be as positive. Maybe you will continue to struggle with your mental health or you might experience negative changes in other domains.

I think going forward, especially because the cultural narrative around post traumatic growth is so strong, this idea especially in the United States and increasingly in other parts of the world, that bad events are an opportunity for growth, maybe taking a slightly more humble view and saying, "Well, adversity and struggle are bad things," those events are clear events that we would not want to wish on other people. At the same time, they can change people in different ways and some of those changes can be positive, some of them can be negative. I think it's important for us to look at all those changes together before we make claims about whether someone's life is better overall compared to before the event.

Shankar Vedantam: Eranda Jayawickreme is a psychologist at Wake Forest University. Eranda, thank you for joining me today on Hidden Brain.

Eranda Jayawickreme: Thank you so much for having me.

Shankar Vedantam: Hidden Brain is produced by Hidden Brain Media. Our audio production team includes Brigid McCarthy, Annie Murphy Paul, Kristin Wong, Laura Kwerel, Ryan Katz, Autumn Barnes, and Andrew Chadwick. Tara Boyle is our executive producer. I'm Hidden Brain's executive editor.

Our unsung heroes this week are Matt Ozug, Elena Burnett, Patrick Wood and Ian Bior at NPR. In March, NPR's All Things Considered began a weekly series featuring stories from our podcast, My Unsung Hero. Matt, Elena, Patrick, and Ian have all played an important role in making each step of that collaboration go smoothly. From the radio stories to articles for the web and social media posts, there are a lot of moving pieces in a weekly project like this, and we're so grateful for their collegiality and attention to detail.

If you like our work and want to support it, please visit support.hiddenbrain.org. Again, that's support.hiddenbrain.org. I'm Shankar Vedantam, see you soon.


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