The dangerous myth of permanent trauma | George Bonanno: Full Interview

Key Concepts

Potential Trauma: Events that are not inherently traumatic but have the potential to cause trauma depending on the individual's response.
Resilience: The capacity to endure and continue functioning in a healthy way after experiencing adversity.
Resilience Trajectory: The pattern of stable, healthy functioning following a potentially traumatic event, observed in the majority of people.
Recovery Pattern: A pattern where individuals experience significant distress after an event but gradually return to normative functioning over time.
Delayed Pattern: A pattern where individuals initially struggle and then gradually worsen, requiring professional help.
Chronic Distress/Symptomatology: A pattern of prolonged and severe suffering following an event.
Resilience Blind Spot: The tendency to underestimate the duration of negative emotions following a large-scale disaster due to social contagion and difficulty imagining emotions as ephemeral.
Fight or Flight Response: The body's immediate physiological reaction to a perceived threat, involving increased heart rate, blood flow to extremities, and heightened senses.
Cortisol: A stress hormone that plays a role in the body's stress response and can lead to epigenetic changes in brain structures.
Fragmented Memories: The tendency to recall only bits and pieces of information from traumatic events, which is adaptive for survival but can be reinterpreted over time.
Flexibility Mindset: A set of core beliefs that enable adaptive coping, including optimism, confidence in coping (coping self-efficacy), and challenge orientation.
Flexibility Sequence: A three-step process for adaptive coping: contact sensitivity (identifying the specific problem), repertoire (choosing a strategy), and feedback (monitoring effectiveness and adjusting).
Fallacy of Uniform Efficacy: The misconception that certain coping strategies are always good or always bad, when in reality, their effectiveness is situation-dependent.
Coping Ugly: The idea that even seemingly maladaptive strategies can be adaptive in specific, challenging situations.
Continuing Bonds: The concept that individuals can maintain a psychological connection with deceased loved ones, transforming the nature of the bond.
Trauma Dumping: The phenomenon of sharing traumatic experiences on social media platforms, often for attention or engagement.
Shell Shock: An early term used to describe psychological distress in soldiers during World War I.
Bereavement: The process of coping with the death of a loved one.

Overcoming Trauma with George Bonanno: Chapter One: The Human Capacity for Resilience

Debunking Trauma Myths

George Bonanno, a professor of clinical psychology at Columbia University and author of "The End of Trauma: How the New Science of Resilience is Changing How We Think About PTSD," challenges common misconceptions about trauma. He identifies three interrelated myths:

Anything difficult or unpleasant can cause trauma. Bonanno argues that events are "potentially traumatic," and not all difficult experiences lead to trauma.
Traumatic events always cause lasting emotional damage. This is contested by the prevalence of resilience.
Hidden traumas exist and continue to harm us unknowingly. Bonanno questions the scientific basis for such hidden traumas.

He emphasizes that trauma and PTSD are not inherent natural phenomena to be discovered but rather concepts that have been constructed and defined. This perspective shifts the focus from an essentialist view of trauma to an inquiry into why some individuals develop PTSD while others do not.

The Emergence of Resilience Research

Bonanno began studying resilience around 1991. At the time, resilience was primarily understood in the context of children facing chronic adversity or individuals in war zones. The prevailing assumption was that acute, intense, and focused events (potentially traumatic events) were too overwhelming for most people to handle, similar to grief.

Bonanno's research, which demonstrated that a significant number of people are resilient to these events, was initially met with indifference or skepticism from the clinical community, who believed his methods were flawed or his findings were simply incorrect. His colleagues were even hesitant to use the word "resilience" due to its provocative nature.

Personal Experience with Potential Trauma

Bonanno shares a personal anecdote from his youth. At 17, he left a difficult home environment and, at 19, found himself in Central Arizona near an Apache Reservation. He decided to camp by the Salt River, ignoring warning signs of flash floods. During the night, heavy rain caused the river to rise dramatically, flooding his campsite and forcing him to climb to a precarious ledge. He recounts the panic and the realization that he could have drowned. Years later, while studying trauma, he remembered this event and other potentially traumatic experiences he had navigated without developing PTSD, realizing that these events, while disturbing, were not necessarily traumas.

Defining Trauma and Resilience

Bonanno defines trauma as an event "out of the range of normal human experience," typically violent and/or life-threatening. Archetypal examples include events where one could die, be seriously injured, or endure sexual violation. While some events can be potentially traumatic if imagined as threatening, many unpleasant but life-altering events (like financial crises or relationship endings) are not classified as traumatic because they elicit different reactions and brain processes.

Resilience, on the other hand, is an outcome defined in relation to a specific event. A person is resilient if, after experiencing a potentially traumatic or difficult event, they maintain a stable trajectory of healthy functioning. This doesn't mean they are unaffected; natural stress responses are necessary for coping. Resilience means continuing to function relatively normally, with the capacity to concentrate, focus on tasks, and maintain close relationships.

Patterns of Response to Aversive Events

Bonanno's research has identified several patterns of response to potentially traumatic events:

Resilience Trajectory: The majority of people (around two-thirds) show this pattern, continuing to function relatively normally and healthily after an event.
Recovery Pattern: Individuals experience significant distress and struggle for a longer period (up to a year or more) before gradually returning to normative functioning.
Delayed Pattern: Some individuals initially struggle and then progressively worsen, experiencing increasing symptoms and requiring professional help. This can be due to lingering consequences of the event, ongoing upheaval, or depression about not recovering.
Chronic Distress/Symptomatology: A smaller percentage (less than 10%) experience severe, long-lasting harm and persistent symptoms.

The Resilience Blind Spot

Bonanno coined the term "resilience blind spot" to describe the phenomenon observed during large-scale disasters like 9/11 and the COVID-19 pandemic. In such events, shared anxiety and distress, amplified by media and social contagion, make it difficult for people to believe that their negative emotions will pass. This is linked to "affective forecasting," where it's hard to imagine not feeling a current emotion in the future. The constant exposure to upsetting information creates a "blinder" effect, obscuring the idea that the situation will eventually improve.

The Brain's Stress Response

The brain's response to extreme stress is described as remarkable and multifaceted. Initially, the "fight or flight" response, identified by Walter Cannon, is triggered. Sensory signals are processed by brain structures like the amygdala and hypothalamus, which assess threats. This initiates a cascade of biological responses: increased blood flow to extremities, glucose production, heavier breathing, and pupil dilation. Non-essential functions are temporarily shut down.

Crucially, there's a shift from reflective, thoughtful processing to more immediate, automatic processing. This focuses attention on survival-relevant information, often resulting in fragmented memories that lack broader context. If the threat persists, the hypothalamus signals the adrenal glands to release cortisol. Cortisol can induce epigenetic changes in brain structures, amplifying the stress response. Long-term memory recall is also blocked, as past information is deemed irrelevant for immediate survival.

Cortisol has a natural braking system, with cells having varying affinities for it, leading to a gradual decline in its levels over a couple of hours. This entire process creates an "alternative state of consciousness" focused on immediate survival.

Why Some Develop PTSD and Others Don't

The effectiveness of these stress response processes explains why many people do not develop PTSD. However, for some, these processes may be less effective. Emerging research suggests potential factors like lower resting cortisol levels or a more sensitive "cortisol break" (shutting down the stress response too quickly), possibly influenced by early life experiences and epigenetic factors. The fragmented nature of memories from extreme stress is adaptive for survival, providing generic information for future threats.

Memory Consolidation and Reconsolidation

When we remember something, it's a biological event involving consolidation. Recalling a memory reactivates these systems, and as they are reconsolidated, they are influenced by new experiences. This means memories can change over time. Traumatic memories, often consisting of fragmented pieces, can be reinterpreted. If this reinterpretation involves dwelling on the horror, it can worsen the experience. Conversely, creating distance and remembering events in a more benign way, or as an observer, can be helpful. Research on 9/11 survivors showed that those who recovered had more benign memories, while those who remained traumatized had persistently disturbing memories.

The Utility of the PTSD Diagnosis

While acknowledging that some individuals genuinely suffer from PTSD, Bonanno notes that the diagnosis can be "porous," leading to overdiagnosis. However, for those truly struggling, a diagnosis can be comforting, validating their experience, and guiding them toward appropriate treatments.

Overcoming Trauma with George Bonanno: Chapter Two: Developing Tools to Overcome Trauma

The Resilience Paradox

Bonanno reiterates that the resilience trajectory is a well-established phenomenon, confirmed by over 100 research studies. The persistent question is why most people are resilient and some are not. He debunks the popular myth of a few "magic traits" of highly resilient people. Instead, numerous factors are associated with resilience, but they all have "small effects," meaning they explain only a small portion of who will be resilient. This is the "resilience paradox": we can identify these factors, but they don't reliably predict future resilience.

The reason for this paradox is that situations vary greatly, and the cost-benefit of any strategy depends on the context. Even seemingly beneficial coping mechanisms only work sometimes. Therefore, individuals must constantly assess the current situation and determine the best strategy for that specific moment.

Adaptive Flexibility and the Flexibility Mindset

Bonanno introduces "adaptive flexibility" as a set of skills most people possess and that are highly learnable. However, possessing these skills isn't enough; they must be actively used, which requires motivation and a belief in one's ability to cope. This belief, the conviction that one will eventually get through a difficult situation, is termed the "flexibility mindset."

The flexibility mindset comprises three core beliefs:

Optimism: A belief that the future will be okay, even if the present is difficult.
Confidence of Coping (Coping Self-Efficacy): A belief in one's ability to manage challenges, recognizing that most people have some coping mechanisms.
Challenge Orientation (Challenge Appraisal): Shifting focus from the threat itself to what needs to be done to overcome it. This involves assessing the threat but then moving towards problem-solving.

The Flexibility Sequence: A Three-Step Process

Bonanno outlines a three-step "flexibility sequence" derived from his research:

Contact Sensitivity: This involves pausing when upset to reflect on the specific problem at hand. Instead of viewing the problem broadly ("this is ruining my life"), it's about identifying the immediate issue ("I'm not sleeping well," "I get anxious in this specific place"). The goal is to break down overwhelming problems into manageable pieces.
Repertoire: Once a clear problem is identified, the individual chooses a strategy from their personal "repertoire" of known coping mechanisms. This is likened to opening a toolbox and selecting the most appropriate tool for the current situation.
Feedback: This simple yet crucial step involves monitoring the effectiveness of the chosen strategy. If it doesn't work, people often give up, believing they cannot cope. However, the flexibility sequence dictates returning to the repertoire step and trying a different strategy. This trial-and-error process may need to be repeated multiple times. If many strategies fail, it might be necessary to revisit the contact sensitivity step and redefine the problem.

This sequence teaches individuals about their own mastery and agency, empowering them to actively work through challenges rather than passively letting events happen. It also allows for learning and expanding one's repertoire of coping tools over time.

The Fallacy of Uniform Efficacy

Bonanno critiques the "fallacy of uniform efficacy," the idea that certain strategies are universally good or bad. He argues that even "unhealthy" strategies can be adaptive in specific contexts (e.g., impulsive actions to get through a crisis), while "healthy" strategies like mindfulness or social support may not always be effective for every problem. The key is situational appropriateness, embodying the sentiment of John Lennon's "Whatever gets you through the night."

He uses emotional suppression as an example. While often seen as maladaptive, it can be crucial in situations requiring focus, such as parents suppressing their fear to protect their children or soldiers needing to remain concentrated in combat. Conversely, suppressing emotions can be detrimental when their information is needed.

Applying Flexibility to Past Trauma

The concepts of adaptive flexibility and the flexibility mindset are also applicable to past traumatic events that continue to cause harm. Instead of viewing the event as a monolithic, unsolvable problem, individuals can apply the flexibility sequence:

Contact Sensitivity: Identify a specific, current problem related to the past event (e.g., avoiding social situations due to fear of flashbacks).
Repertoire: Develop strategies to address that specific problem (e.g., confiding in trusted friends as "safe houses").
Feedback: Monitor the effectiveness of these strategies and adjust as needed.

This gradual, step-by-step approach, involving trial and error and paying attention to feedback, allows individuals to regain agency and expand their capacity to navigate life.

Self-Talk as a Tool

Self-talk, the internal dialogue we have with ourselves, can be a powerful tool for reinforcing flexibility. Positive self-talk can be used to:

Flexibility Mindset: Phrases like "It's gonna be okay," "I have some tools to work with this" (optimism), "I have some tools. I know how to cope" (confidence of coping), and "Okay, this sucks. What do I need to do to get through this?" (challenge appraisal).
Flexibility Sequence: Questions like "What's happening now? What do I need to do?" (contact sensitivity) and "What tools do I have in my toolbox?" (repertoire).

This internal dialogue, framed as questions, helps focus the mind and guides behavior.

Challenging the Fragility Narrative

Bonanno expresses concern about a cultural trend that emphasizes human fragility, often fueled by the internet's focus on danger and a burgeoning industry that profits from this narrative. He believes this trend is detrimental and that the concept of flexibility empowers individuals by placing them back in control. He advocates for reminding ourselves of our inherent strength, drawing on past experiences of overcoming adversity. This is akin to Carol Dweck's "growth mindset," where challenges are seen as opportunities for learning and development, rather than fixed indicators of personal inadequacy. Resilience, he concludes, is not fixed but an outcome achieved through effort and adaptation.

Overcoming Trauma with George Bonanno: Chapter Three: The History of Post-Traumatic Stress Disorder

The Ubiquity of Trauma in the Modern Era

Bonanno questions whether life is inherently more traumatic now than in the past, suggesting that the increased focus on trauma is a more significant factor. He attributes this heightened focus to two primary drivers:

Evolutionary Wiring: Our brains are predisposed to detect danger and immediate threats for survival.
The Internet and Attention Economy: The internet, driven by a need to capture attention for advertising revenue, amplifies threatening content. This includes news of disasters, depictions of suffering, and "trauma dumping" on platforms like TikTok. This constant exposure to danger, coupled with the difficulty of looking away (doom scrolling), leads to a perception of the world as increasingly dangerous and our own failings as a result of this harm.

Historical Absence of Trauma Discourse

Curiously, historical literature shows a striking absence of references to trauma symptoms akin to PTSD. While grief and mourning are well-documented (e.g., in Homer's Iliad and Odyssey), accounts of soldiers experiencing nightmares or psychological harm from combat are rare until the late 19th century.

19th Century: The term "traumatic neurosis" emerged, attributed to a German physician.
World War I: The concept of "shell shock" gained traction, though it was often met with disbelief, and soldiers claiming it could be accused of cowardice and even shot ("shot at dawn").
World War II: Similar psychological disturbances in soldiers were observed, but a clear understanding or terminology remained elusive.

The Advent of PTSD in 1980

The formal designation of PTSD as a disorder in 1980, largely in the aftermath of the Vietnam War, marked a significant shift. Prior mental health manuals often attributed trauma-related symptoms to individual weakness or deficits. The Vietnam War, with its guerrilla warfare, unpopularity, and the draft, led to widespread psychological distress among soldiers. Many self-medicated due to a lack of support and societal condemnation. This context finally prompted the recognition of PTSD as a diagnosable condition to facilitate treatment.

Samuel Pepys and the 17th Century

Bonanno presents the diaries of Samuel Pepys, a 17th-century aristocrat, as compelling evidence that trauma symptoms existed long before the formal diagnosis of PTSD. Pepys documented his experience during the Great Fire of London in 1666, describing the horrific sights, sounds, and his own fear. Months later, he recorded experiencing nightmares and an inability to sleep due to fear of fire, symptoms consistent with PTSD. Crucially, Pepys was confused by these symptoms, indicating a lack of societal understanding or acknowledgment of such reactions. This suggests that while people experienced trauma symptoms, they were often unspoken, unknown, and unacknowledged.

Overcoming Trauma with George Bonanno: Chapter Four: The Psychology of Grief

Challenging Antiquated Grief Models

Upon completing his PhD, George Bonanno shifted his research focus to bereavement, initially with little interest. However, he was "amazed" by the antiquated nature of the existing literature, which he likened to 19th-century writings. The prevailing assumption was that grief was universally debilitating, requiring clinical intervention for almost everyone. The research methods were also considered outdated.

Bonanno's Research on Bereavement

Bonanno took a position at the University of California, San Francisco, to study how people cope with the death of a spouse. His approach, described as "common sense," involved applying modern research methods to a broad sample of individuals who had lost a spouse, rather than just those seeking treatment. He used techniques like coding facial expressions, psychophysiological experiments, and text analysis, tracking participants over time.

His findings consistently revealed that the majority of people cope well with loss, demonstrating resilience. This was a surprising but foundational discovery that shaped his subsequent research career, extending into trauma studies.

Grief vs. Trauma

While Bonanno sometimes uses "potentially traumatic event" to encompass loss, he emphasizes that grief and trauma are fundamentally different:

Potentially Traumatic Event: An intense, life-threatening event that triggers emergency reactions and forces a re-evaluation of life.
Death of a Loved One (Grief): This signals to the brain that one's understanding of the world, particularly regarding relationships, is no longer accurate. It introduces an existential threat by confronting the impermanence of life.

Both are challenging, but they elicit different reactions, brain activity, and long-term processes.

The Functionality of Sadness and Withdrawal

During grief, sadness is a highly functional emotion. Unlike the arousal associated with trauma, sadness leads to a slowing down of the system, a decrease in heart rate, and a withdrawal from the external world into one's internal thoughts. This inward focus is adaptive because deeply attached individuals become part of our identity. When such a person dies, the brain is confused and needs to recalibrate to a world where that person is no longer physically present but can still exist in our minds.

Moving Beyond the Five Stages of Grief

Bonanno strongly refutes the prevalent "five stages of grief" model (denial, anger, bargaining, depression, acceptance). He states there is "really no evidence" that people grieve in this sequential manner. Most bereaved individuals exhibit a resilient trajectory, functioning and moving forward early on, making a sequential five-stage process unlikely. The five stages were originally proposed by Elisabeth Kübler-Ross for individuals facing their own death and were later misapplied to bereavement.

This model can be harmful, leading people to feel inadequate if they don't follow the stages or if they experience positive emotions prematurely. Bonanno highlights the absurdity of a 1960s spinal cord injury literature chapter suggesting doctors should induce depression in patients to facilitate recovery through the stages.

Quasi-Hallucinations and Brain Recalibration

Bereaved individuals often report "quasi-hallucinations," such as seeing or hearing the deceased loved one. This occurs because the brain is still operating on the assumption that the person is alive. The brain, as a prediction machine, needs to recalibrate to a new reality. This process involves deep internal reflection to understand the person's life and what can be carried forward.

Condensing and Idealizing Memories

During grief, we condense what we knew of the deceased into a form we can carry forward. This often involves a degree of idealization, "rounding off the rough spots" and focusing on positive aspects, though negative memories are not necessarily forgotten. Mourning ceremonies serve a similar function by facilitating storytelling, which condenses memories and helps carry forward an idealized version of the deceased.

The Oscillatory Nature of Grieving

Sadness, while functional for inward reflection, makes individuals vulnerable to external dangers. Bonanno proposes an "oscillatory way of grieving," where individuals move between inward reflection (sadness) and outward engagement with the world and others. This back-and-forth movement is adaptive.

Laughter and Social Connection in Grief

Research shows that even while crying, bereaved individuals can experience genuine laughter and smiling when recalling funny stories. This oscillation between sadness and positive emotion, often facilitated by social connection, is crucial. Laughter is contagious and can provide comfort to both the griever and those around them.

Anger in Bereavement

Anger can arise during bereavement when individuals feel the pain is someone's fault (medical establishment, self, or even the deceased). While useful for expressing pent-up feelings, excessive or constant anger becomes maladaptive, as it indicates a lack of situational awareness, similar to other strategies used too frequently.

Coping with Prolonged Grief

For individuals who continue to suffer intensely for years after a loss, various approaches can help:

Conversations with the Deceased: Talking through thoughts and feelings, including anger or guilt, can foster connection and release.
Engaging with the World: Getting out and exercising can improve functioning and a sense of aliveness.
Reviewing the Deceased's Meaning: Understanding what the person meant and finding ways to develop those aspects of one's own life in their absence.
Cognitive Behavioral Approaches: Focusing on how one conceptualizes and explains the loss, challenging erroneous beliefs (e.g., self-blame).
Exposure Therapy: Telling the entire story of the loss from beginning to end, which helps process fragmented memories and reframe one's role in the narrative.

Continuing Bonds and Transforming Relationships

Bonanno supports the concept of "continuing bonds," where individuals maintain a psychological connection with deceased loved ones. This bond transforms from a physical presence to a mental one. He is comfortable with this, suggesting that we are free to engage with this idea as we wish.

He offers personal examples, such as having mental conversations with his deceased father to discuss past issues and seek fatherly advice. He also mentions Paul McCartney's perspective that his late wife Linda would have wanted him to move on, not suffer. This involves thinking about what the deceased would have wanted for us, using their memories to guide our present and future. This process allows for a continued relationship with the deceased, fully aware that they are no longer alive in the physical world.