“We all re-create ourselves; it’s just that some of us use more imagination than others.” ~ Madonna
Whether we want to or not, we often end up re-creating ourselves after a significant medical diagnosis. Researcher Dr. Kathy Charmaz calls this phenomenon “the loss of self“ after such a diagnosis, a loss experienced while we’re learning to adapt and adjust to this strange new life as a patient. When we try to talk about this painful loss to others who haven’t ever experienced it, most have trouble taking us seriously, or they may want to jolly us out of our current reality.
Yet how we talk about this matters to how we get through it.
Coping with loss or adversity in the past, and more importantly, what we learned growing up about how our own families coped can influence how we approach crisis and setbacks now. Behaviour scientists, like Dr. Sonja Lyubomirsky at the University of California Riverside, for example, assure us:
Life’s turning points do not have to become major crises after all. In fact, our research has found that life events do not have much of an impact on optimism or happiness.
“And as crazy as this might seem, I recognize one true thing: the older we get (except maybe for extreme old age), the better the chances of being able to handle any given catastrophe, entirely due to all those years of experience in successfully handling all kinds of difficult problems, big and small.”(1)
And as I wrote in my book (A Woman’s Guide to Living with Heart Disease, Johns Hopkins University Press, November 2017):
“In my experience with heart disease, I learned to cope with crisis by coping. I learned to adapt to crisis by adapting. I learned to roll with the punches because, like so many of us, I’ve practiced rolling with so many figurative punches during my life.
“It’s not because I needed the crisis to become a better person, not because the diagnosis itself was some kind of a gift, and certainly not because I needed to add meaning to a meaningless existence, but because human beings have a remarkable ability to get used to almost anything in life (both positive and negative).”
Drs. Marshall Duke and Robyn Fivush at Emory University suggest that rolling with the punches may be a learned skill from childhood, informed in part by listening to how our families talk about their own history of rolling with those punches. They summarize three general forms of family story-telling(1):
- Ascending family narrative (things always got better for us)
- Descending family narrative (things always got worse for us)
- Oscillating family narrative (We’ve been up. We’ve been down. We’ve had terrible, painful times but we got through them. We’ve also enjoyed the best of times, but when they didn’t last, we survived no matter what).
Dr. Duke adds:
“In our study of family stories at the Emory University Family Narratives Project funded by the Sloan Foundation, we found that family stories seem to be transferred by mothers and grandmothers more often than not, and that the information is typically passed during family dinners, holidays and celebrations.
“Other studies have indicated that these very same regular family experiences can contribute to the development of a sense of what we have called the intergenerational self.
“And it is this intergenerational self and the personal strength and moral guidance that seem to derive from it that are associated with increased resilience, better adjustment, and improved chances of good clinical and educational outcomes.”
Family stories about past adversity can affect a child’s interpretation of what painful setbacks, disappointments or crises mean. Are they unfair tragedies that should never have happened to us, or are they part of life? Each health crisis essentially becomes part of the oscillating family narrative of the future, and the family stories about how we adapted – or not! – can actually influence other family members.
In other words, how do we want to be remembered by generations of our friends and family?
As my grandbaby Everly Rose grows up, for example, she’ll know that her grandmother had a heart attack in her 50s. Will that storyline in her own family narrative – and especially how her grandmother coped during subsequent years – passed down during years of family dinners, affect what she believes chronic illness is? And when she suffers her own crises or setbacks or personal losses one day as she grows (as we all must), will the family stories she hears about her family today affect her beliefs about her own capacity for resilience?
When we believe that no matter what happens in our family, we are able to handle even the hardest times, it can help us move beyond the initial panic and fear that often feels like it will last forever. It’s also why I like to write about what’s known as the situational depression that’s so often experienced – yet often ignored – by freshly-diagnosed heart patients. If only hospital staff would reassure us before discharge that this kind of depression is common, temporary and almost always treatable, imagine how it could improve our belief that we can and will get through this.
A New York Times article by Bruce Feiler summarized the benefits of an oscillating narrative that stresses resilience:
“The bottom line: create, refine and retell the story of your family’s positive moments and your ability to bounce back from the difficult ones.”
1. S. Lyubomirsky, “The Science of Happiness,” lecture at Pepperdine University, Seaver College, W. David Baird Distinguished Lecture Series, Malibu, California, September 25, 2014.
2. Duke, M.P., Lazarus, A., & Fivush, R. Knowledge of family history as a clinically useful index of psychological well-being and prognosis: A brief report. Psychotherapy Theory, Research, Practice, Training, 45, 268-272. 2008.
Q: What have you learned about resilience from your own family’s discussions about how they have coped with past adversity?
NOTE FROM CAROLYN: I wrote much more about resilience in Chapter 9, “The New Normal”, in my book, “A Woman’s Guide to Living with Heart Disease” . You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use the JHUP code HTWN to save 20% off the list price when you order).
- Why hearing the diagnosis can hurt worse than the heart attack
- The shock – and ironic relief – of hearing a serious diagnosis
- How we adapt after a heart attack depends on what we believe the diagnosis means
- The “loss of self” in chronic illness is what really hurts
- The new country called Heart Disease