Page 235 - Creating Spiritual and Psychological Resilience

204 Creating Spiritual and Psychological Resilence

Despite optimistic views of adaptation, even survivors in the “those who
made it” category (Danieli, 1985) still experience difficulties related to their
traumatic past, suggesting that the overly optimistic views may describe
defense rather than effective coping. In fact, it is within this category of
postvictimization adaptational styles that relies on denial of the trauma
and its effects as a primary defense that we observe the highest rates of
suicide among survivors as well as their children (Danieli, 1998).
The findings that survivors have areas of vulnerability and resilience is
no longer paradoxical when viewed within a multidimensional (TCMI)
framework for multiple levels of posttraumatic adaptation. And tracing a
history of multiple traumata along the time dimension at different stages
of development reveals that, while for many people time heals ills, for
traumatized people time may not heal but may magnify their response to
further trauma across the full span of adult development, particularly in
times of even normal transition and old age (Danieli, 1994a, 1994b) and
may carry intergenerational implications.
The aging process inevitably entails losses, forcing the elderly to confront
considerable stress. Recent evidence from both Holocaust survivors and
combat veterans clearly support the vulnerability perspective. Schnurr (1991)
reviewed and Cassiday and Lyons (1992) examined reactivation of posttrau-
matic reactions among American veterans. They reported that life events, such
as retirement, children leaving home, death of a loved one, and other stressful
events, served as triggers that accelerated and unmasked latent PTSD.
With survivors, it is especially hard to draw conclusions based on out-
ward appearances. Survivors often display external markers of success
(i.e., occupational achievement or establishing families) that in truth rep-
resent survival strategies. Clearly, these accomplishments may facilitate
adaptation and produce feelings of fulfillment in many survivors. Thus,
the external attainment represents significant adaptive achievement in
their lives. However, there are also other facets of adaptation that are
largely internal and intrapsychic. If clinicians and researchers do not
look for these adaptational impairments, they can easily miss them in
the presence of evidence that survivors mastered the external challenges
encountered after their traumata. This may be a particular problem with
aging survivors because the elderly often underreport psychic distress
(Rapp et al., 1988).
Conversely, a focus on pathology can lead professionals to overlook the
survivor’s strengths—the clinician’s major therapeutic allies. With a mul-
tidimensional framework for the multiple levels of posttraumatic adapta-
tion, the fact that survivors have areas of vulnerability and resilience is no