Beyond the Cancer Diagnosis: Dialogue with Taryn Greene, Hosted by Adrian Pogacian

In the new episode of ‘Beyond the Cancer Diagnosis’, Adrian Pogacian brings into focus the concept of Posttraumatic Growth, in an interesting conversation with Dr. Taryn Greene, director of research at Boulder Crest Institute.

Taryn Greene, Ph.D, is the Director of Research at the nationally recognized 501(c)(3) nonprofit, Boulder Crest Foundation, the home of Posttraumatic Growth (PTG) and the global leader in the development, delivery, study, and scale of PTG-based programs. She is a former active-duty Air Force Officer and two-tour veteran of Afghanistan.

As a Health Psychologist she specializes in research and application of psychological processes related to posttraumatic growth, resilience, and thriving in the aftermath of trauma. She has published alongside Dr. Tedeschi and Dr. Moore on the topic of facilitating posttraumatic growth in first responders, military members, and veterans. Taryn has expertise in positive psychology, trauma-informed care, and program evaluation, as well as experience utilizing applied research to investigate the experiences of military, refugee, and immigrant populations overcoming adversity.

Adrian Pogacian, MS Psychology, clinical psychologist with executive education in Psycho-oncology, holding a degree in Global Health Diplomacy from Geneva Graduate Institute. Currently, researcher and associate lecturer with focus on Impact of Cancer Diagnosis on Couples and Families, Communication in Cancer Care and Posttraumatic Growth. His expertise is on Coping with Cancer and managing Fear of Recurrence.

Additionally, Founder of INCKA Psycho-oncology Center, Host of Beyond the Cancer Diagnosis Interview Series as well as Writer and Host Content in Psycho-oncology at OncoDaily.com, co-author of the first Romanian Multimodal Care Guideline in Pediatric Onco-hematology, active contributor to the International Psycho-oncology Society, presently IPOS Fear of Cancer Recurrence SIG member and IPOS Early Career Professionals in Psycho-Oncology Committee founder member.

00:00 Introduction
01:10 Post-Traumatic Growth
04:10 Phases of Post-Traumatic Growth
11:08 Navigating the Growth Journey
13:10 Universal Struggle and Growth
16:16 PTSD and Post-Traumatic Growth
21:07 Integrating Trauma and Growth
23:35 Carrying the Flame of Hope
28:20 Advancing Post-Traumatic Growth
30:20 Conclusion

Adrian Pogacian: Hello everyone, it’s good to see you again to a new edition of Beyond the Cancer Diagnosis interview series. Today we’ll talk a little bit more about the new concept in approaching traumatic events and not so much on issues related to cancer. Therefore, my guest today is Taryn Greene.
Taryn, welcome, nice to have you with us. Thank you for accepting my invitation.

Taryn Greene: Thank you, I’m so excited to be here, Adrian.

Adrian Pogacian: And I would like to first, as a first question, if you could reveal for our audience your activity at the Boulder Crest Foundation and after how you personally define this new concept, new old concept of post-traumatic growth.

Taryn Greene: Absolutely, sure. So the Boulder Crest Foundation, that’s where I’m from and I work at the institute which is part of the Boulder Crest Foundation and we are the home of post-traumatic growth. So we are a non-profit organization that are founded, that is founded on the principles of post-traumatic growth or PTG and we’ll get it, I think, about what PTG is throughout our time together.

But at Boulder Crest, what we really do, our bread and butter is that we offer programs where we have translated the science of post-traumatic growth into training programs for different populations. Our flagship programs are for military members, veterans, and first responders and those are all offered free of cost so folks can come from those different professions which, you know, are professions where people are exposed to potentially traumatic events quite a bit and they can attend our programs and learn more about post-traumatic growth and the idea of how you can grow through these really challenging and traumatic things that we go through.

So that’s a bit about the Boulder Crest Foundation and the Institute and I guess just to say up front, post-traumatic growth is the positive psychological change that can come from going through traumatic experiences and so that is something that’s really near and dear to my heart as I was a military member for about a decade and it was through my experiences in the military, in the Air Force, going over to Afghanistan and being exposed to combat, being exposed to the dangers

And just the realities of war that that was a struggle for me when I got back and I came through that having my own transformation, my own post-traumatic growth experience and got very interested in this whole range of outcomes that happens when people encounter traumatic events and just began studying it and then decided to make that my career.

Adrian Pogacian: People want to overcome these post-traumatic events because not all of us unfortunately don’t want or maybe don’t have all the information about how to overcome these traumatic events in our life and as every new, let’s say, event or a concept, also PTG has some phases. Could you develop each phases of post-traumatic growth?

Taryn Greene: Sure, absolutely and that’s so true that if you don’t know about it, sometimes it can be challenging to reach for the growth experience when you’re going through traumatic, you know, post-traumatic situations and dealing with a lot of the distress and anxiety and things that come with that.

So we do understand these kind of phases that happen for people that eventually do end up leading to post-traumatic growth and so because we understand the process of post-traumatic growth, we call it a process and also it’s an outcome because I think we’ll talk about the domains a little bit too, the areas where people experience growth more of an outcome kind of focused conversation

but yes, to focus in on the process that happens and the phases of post-traumatic growth is a really important piece of the conversations so that folks can understand what they’re looking for and how to help each other recognizing where somebody might be in the process of post-traumatic growth and all of this occurs within the context of expert companionship.

So this idea that when we are facing the struggle in the aftermath of trauma, sometimes it’s really hard to recognize what’s happening in ourselves and so these what we call expert companions are folks who can meet us where we are and help create an environment of trust and openness and help us approach what’s happening in ourselves with curiosity. That is a critical element for getting through these phases. We do kind of have to have that kind of connection in our life I think to be able to successfully navigate these phases.

So the first phase and these don’t happen necessarily in order for folks but I will go through them kind of numbered one through five. The first phase is education and that’s about people learning about the idea that struggle is universal because a big piece of trauma in the aftermath of it is feeling very alone and often not being accepting of our struggle and wondering why we’re struggling so hard.

So a big part of the education phase is to come to the understanding that many of us almost all of us are going to struggle when faced with events like this and that that struggle is universal but also there is value in the struggle though we would not wish for this type of event to happen in our life.

Often people do come through the other side of it and and find that transformative process has occurred which can be surprising and shocking and also there are some gifts that happen in the process. So that’s what the education phase is about and like I said having expert companions who come in into our sphere as we navigate this can help immensely in helping us to make those those connections about the universal nature of struggle and some of the value in struggling. The second phase regulation is you know fairly typical of any kind of therapeutic intervention and just is just something that is helpful when we’re struggling in life.

It’s about calming our body, calming our mind. A hallmark of PTSD and and struggling with trauma is intrusive thinking and not being able to turn your mind away from what has happened. So we do need to help people get some regulation practices in place whether it be through breathing, mindfulness, connecting with nature and other kinds of practices so that we can create some space for folks to begin to process what’s happened maybe even take some rest a little respite from thinking about what’s happened.

So regulation is a big part of the process for post-traumatic growth. The third piece is disclosure and that’s about you know sharing and starting to be able to disclose and share what about what’s happened about not only what has happened what the event was but how it’s impacted us which can sometimes be hard to accept hard to recognize like we talked about in the beginning and so being able to share it helps us to begin to piece together the story in a way that can incorporate growth.

It can make some space for integrating the trauma if you will and being able to see more holistically how this trauma fits into the broader life narrative and so that leads to the fourth phase which is story and the story phase is when we’re really seeing people integrate the trauma. They’re grappling with those questions about who am I?

Why am I here? What does this all mean for me? What am I supposed to do now?
And as those questions sort of are are being grappled with there there could be some acceptance in the process and some getting almost to the other side or maybe feeling a little more rooted down in even a new path finding reconnection with a path that was felt lost or with people that you didn’t feel connected with before that that’s part of the story phase and then and then the last piece of that of this is service.

So we often see that as people go through this process they begin to identify as a person who can give back right like I went through this and now I want to help others who are going through this and it doesn’t even necessarily have to be the same type of trauma but just that you want to help others to struggle well and then that comes full circle to the trauma survivor then learning to be an expert companion to others who struggle.

Adrian Pogacian: And in addition with these phases can we argue that this is a road for let’s say every patient or maybe client that want to overcome its fears its traumatic events? I think that’s a wonderful idea. In the sense that each patient has a road and starting with awareness with maybe prevention education so these phases might be his or her own road to overcome.

Taryn Greene: Yeah absolutely and people get stuck in different places different phases can be more challenging depending on individual differences or context or you know whether you have a social support network where there are folks who are walking alongside you as companions or not. If you have a pre-existing you know conditions of anxiety or depression those can be some of those things can can make you know complicated and make it you can get a little bit stuck in different areas.

So I would say it’s an individual journey but we do find that generally people when they are given the training and the folks who come to us at Boulder Crest Foundation are struggling and we give them the training.

We give them the training about these five phases and we have built-in expert companionship and they do very well. They learn the phases and they experience the phases and we study our participants for between 90 and 180 days when they leave and we have found that folks generally do experience post-traumatic growth and and they do well in the aftermath of trauma.

Adrian Pogacian: You mentioned how many days?

Taryn Greene: We have studied people between 90 and 180 days after post post leaving our programming and you can find our outcome studies on our website.

Adrian Pogacian: Okay you mentioned about the domains or field in which people can grow following trauma and you mentioned for example your case as a former military. Which other fields or domain do you think are appropriate to try or at least get in touch with this new concept of PTG? Cancer survival shifts this is for sure.

Taryn Greene: Absolutely.

Adrian Pogacian: Other fields?

Taryn Greene: Absolutely. I mean yes and so struggle like I said is universal and and I think that post-traumatic growth has been going on since the dawn of time and and people have been you know traversing challenging and traumatic events in their lives in their lives since forever. So yes I think this concept is available to everyone and and like you said getting the information out about it is a key piece but people often do in fact I came to the experience of post-traumatic growth myself without knowing what it was.

So it occurs even when you don’t necessarily have the language for it which is which is really powerful.

Adrian Pogacian: Many times in our life we are doing things like instinctively and yes what you are doing at the foundation and this concept of post-traumatic growth it’s something difficult in a way because you are addressing to everyone in general in the cases of short therapies for example they are addressing punctual to this kind of patients or to this kind of clients.

Some therapies for example to couples others to families so the the fact that the post-traumatic growth it’s a it’s a field that cover and open to everyone it is a difficult task and it is also struggle it’s a struggle on both on both parts also for patients but also for you because I’m thinking now as a clinician that statistically or you are you have a lot of data to process so it is not an easy task to do it and therefore I congratulate you for for everything that you’ve done so far in in this field and you mentioned earlier about PTSD in the field of psych oncology for example and also in others.

I noticed that there are experts and moreover patients that misunderstand the concept of post-traumatic stress disorder with post-traumatic growth sometimes combine those two issues sometimes mix them wrong. Can you give us the same explanation or where it’s the limitation between PTSD and PTG?

Taryn Greene: Absolutely and that’s such a great point that there are a lot of related concepts and so I’d be interested to hear about your work with with the cancer patients and and how that comes up for you.

So to answer your question in terms of PTSD and PTG what we find is that typically people when they think about trauma these days which is it’s kind of a modern thing right that we’re thinking about when the word trauma comes up we think PTSD and that is partly because of this the field of psychology you know having a large amount of research and practice around treating mental disorders and and over the past many decades understanding what disorders are the introduction of the diagnostic statistic manual of mental disorders

And so which is which is really important that we understand when things go wrong for people what that means but in reality the people who qualify for a PTSD diagnosis it’s actually a minority and the the fact is that most people are going to go through a traumatic event what we call a potentially traumatic event in their lifetime and the majority of people who go through a potentially traumatic event are going to be able to adapt or they’re going to struggle and then figure out how to bounce back or struggle deeply and then experience post-traumatic growth

So they’re not the same thing although the distress that can be part of post-traumatic stress disorder or PTSD can certainly be part of the experience of post-traumatic growth they you know you you can’t have a post-traumatic growth experience without that distress part because the catalyst for post-traumatic growth is the experience where you encounter one of these potentially traumatic events and it basically creates the equivalent of a psychological earthquake for you in that process your core beliefs the system of core beliefs that you’ve built across your lifetime are called into question and that’s extremely painful and that is where a lot of the symptomology that’s part of PTSD comes from

So I would say PTSD is a really important concept for us to understand especially folks like yourself who are in the room with patients and and need to be able to recognize when the distress reaches a point of severity that a diagnosis could be helpful and that’s only a piece of the larger range of reactions that people have to potentially traumatic events and PTSD can certainly accompany post-traumatic growth or even give way to over time the post-traumatic growth experience which is what we see that over time folks will shift towards post-traumatic growth when given the opportunity to move through these five phases

Adrian Pogacian: So stress it’s like a trigger to understand for post-traumatic growth you talk and we are talking in this interview about trauma traumatic events traumatic experience in Romania my country for example nowadays every psychologist it’s talking about trauma

So if you have a trauma in your childhood this explain everything you are going through when you are an adult which of course from a professional point of view it’s a mistake and I want you to ask you and to let’s say encourage the specialist not to focus only on trauma or traumatic events because trauma and traumatic event is just a part of let’s say bigger pictures and I will kindly ask you to recommend specialists to see and to think outside the box

Taryn Greene: Absolutely I think that’s very much in line with the phases we’re talking about the process we’re talking about which is centered on helping folks to make sense of the trauma that has happened and then that we’re integrated there you know that we need to be able to get to a place where the trauma is a milestone on the very long path of life and that we can understand the impact that it had on us

but it doesn’t have hold of us anymore right and and that’s that’s where the work comes in of helping folks to disclose helping them to sort out what to believe about what happened how to understand it the impact

That it’s had on us and and some of the changes that have occurred in our life because of what happened we often see that folks for trauma for folks trauma can be kind of a turning point so you they might speak of their life in this kind of before after way before my trauma before before this happened after this happened and that’s okay I think but we do have to kind of lean towards this forward looking being focused on what are where are we going from here how are we going to make sense of this how can we begin to move forward in a way that doesn’t avoid what’s happened but integrates it

Adrian Pogacian: You mentioned and we talked a lot about about the struggle and we struggle for a purpose we struggle to overcome fear we struggle to go forward but we struggle because we believe in hope and in psychology and in oncology um often patients and doctors and clinicians have different views of what hope is in the case of post-traumatic growth from your opinion and experience how you define hope in these circumstances

Taryn Greene: I imagine the cancer area of work is a place where that candle that flame of hope is especially important sometimes what I like to say about hope is that sometimes you know that people lose hope that is a piece that happens of in traumatic situations and and losing a focus on hope losing it can it can feel like you’ve lost it and that you’re never going to find it again

And so I like to say you know as expert companions sometimes we have to kind of carry that flame of hope for other people and in terms of of what is that what is hope so traditionally hope has been defined in in the psychological literature as more of a kind of goal-centered concept where folks have identified goals and are able to kind of identify pathways of getting there and able to access motivation to move towards those goals again we’re talking about looking forward

Which is very much a part of the post-traumatic growth process you can kind of see how they relate in that way but there’s a newer conceptualization of hope which is just a really beautiful conceptualization and that’s it’s this goal transcendent hope and it’s the idea that hope is possible even in situations where the desired outcomes and goals seem unattainable and unlock unlikely or even impossible and this feels like it is a salient definition of hope maybe for cancer folks going through cancer diagnosis

and and going through that process and so it’s called persevering hope and it includes thinking thoughts like I will keep trying I will not give up and I’m motivated to wait for a successful outcome which if you can think of the post-traumatic growth process that we’ve talked about that feels it’s like hand in hand with what we’re talking about right and and the losing of the hope probably happens during that core belief challenge when the traumatic event calls into questions your core beliefs and then you’re just everything is kind of blank and you’re in shock right

but people find once the shock subsides you get some of that education piece going some regulation that what can be really surprising is those gifts that are actually part of the process of moving through your post-traumatic growth process that weren’t initially apparent because of the shock that happened

And we like to say um at boulder cross the treasure you seek lies in the that you fear to enter and so a lot of times what we’re uncovering through those phases and through the process is that new sense of identity or renewed sense of identity renewed sense of purpose and this renewed connection with hope

and I would say that the research does show that hope and post-traumatic growth are correlated and most people that I speak to who are involved with our programs like our our peer support guides who are leading participants through the five phases and through the experience of our training they they are so connected to the concept of hope it is so critical to the experience of post-traumatic growth

Adrian Pogacian: Very very interesting and profound explanation of hope and as a foundation of moving forward especially in traumatic events like a cancer diagnosis and also others since we are coming to the end of the interview I would like to ask you if you can share with us which are the future plans of your foundation and how you personally see the future of post-traumatic growth in a world with such new concepts and new therapies and new theories so we are living now tremendous times of new ideas each day so um how you see PTHD in the future and your future plan

Taryn Greene: Yeah absolutely so at the institute um at the boulder cross foundation we I’m the director of research there and I work with Dr. Richard Tedeschi and Dr. Brett Moore so they they you know we affectionately call Dr. Tedeschi the godfather of post-traumatic growth science and Brett his colleague who has also pioneered so much of the literature around this topic so the three of us at the institute are very committed to ensuring that the research continues to uncover even more about the post-traumatic growth process and that we continue to make that available to researchers clinicians but not just those folks but to everybody

so the institute is part of the larger boulder crust foundation where we’re already offering training programs like I said in the beginning for military veterans and first responders and we just launched this year our first ever program for everybody for anybody post-traumatic growth in practice and you can find that on our website that’s just for um for anybody who wants to experience uh the phases in more depth and learn more about it we also have tons of educational resources on our website we’ve created a library of sorts a resource center on the boulder crust website at bouldercrust.org

where you can go and find uh the information about post-traumatic growth for different audiences so I think for the future we’re going to continue to get the research pieces in place that we can continue to study and uncover deeper all of the concepts of part of the process and the outcomes of PTG we’re going to continue providing trainings and we’re going to continue to partner with folks who are interested in this topic and want to get the word out and implement post-traumatic growth training or techniques into the work that you do.

Adrian Pogacian: Thank you very much for this wonderful conversation good luck in your research good luck in your future plans and hopefully we’ll see each other with results in the future and good luck in your activity thank you very much for being today with us and have a nice day.

Taryn Greene: Thank you Adrian I’m looking forward to working with you too and talking to you more about the work that you’re doing.