Finding benefits in adversity

314 Pages·2011·4.25 MB·English

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Finding benefits in adversity:
Symbolic tools
in adult development
after life disruption
Amber de Rooij
ISBN 978-90-77877-11-1
Rotterdam: Parnassia Bavo Groep, 2012
Cover illustration: Truman finds the beginning of a possible way out after he has encountered
the boundaries of his known world (from The Trumanshow, Peter Weir, 1998). Reproduced
by permission of Paramount Pictures, Hollywood.
© 2012 A. de Rooij. All rights reserved. No part of this publication may be reproduced, stored
in a retrievalsystem, or transmitted, in any form or by any means, electronic, mechanical,
photocopying, recording, or otherwise, without prior permission in writing from the
proprietor.
Printed by Proefschriftmaken.nl, Oisterwijk
Finding benefits in adversity:
Symbolic tools in adult development after life disruption
Voordelen vinden in tegenspoed:
Symbolische gereedschappen als hulpmiddel bij de ontwikkeling van
volwassenen na het doormaken van een ingrijpende levensgebeurtenis
(met een samenvatting in het Nederlands)
Proefschrift
ter verkrijging van de graad van doctor
aan de Universiteit Utrecht
op gezag van de rector magnificus, prof.dr. G.J. van der Zwaan,
ingevolge het besluit van het college voor promoties
in het openbaar te verdedigen
op vrijdag 10 februari 2012
des ochtends te 10.30 uur
door
Amber de Rooij
geboren op 10 april 1956 te Rotterdam
Promotor: Prof.dr. P.G. Heymans
Finding benefits in adversity:
Symbolic tools in adult development after life
disruption
Table of Contents
1. Adversity-induced development: Introduction and Overview 1
1.1 Casus Wesdorp 1
1.2 Meaning-finding and improvement in psychological and physical health-outcomes after the
confrontation with adversity, e.g. major illness 2
1.3 The problem of finding new meaning and self-coherence after the confrontation with adversity 3
1.4 The role of narratives and metaphors in the process of meaning- making and meaning-finding
after the confrontation with adversity 4
1.5 Goals and research questions of the research project 6
2. Symbolic tools facilitating self-transformation after confrontation with adversity:
A theoretical overview 9
2.1 Adversities as catalysts for development 10
2.2 The confrontation with life events: The fried egg model 13
2.3 The role of emotional arousal in personal development 16
2.4 The confrontation with adversity and cognitive generativity 18
2.5 Life narratives 19
2.5.1 Two modes of thought: storytelling and argumentation 19
2.5.2 Basic themes in narratives 20
Intermediate summary and outlook 22
2.6 Symbolic tools facilitating self-transformation after confrontation with adversity 23
2.7 The hero-story or monomyth (Campbell, 1993) 24
2.7.1 The monomyth: the hero-story and the exploration of the unknown 24
2.7.2 The monomyth as the encoding of a life crisis 25
2.8 Orientational metaphors 28
2.8.1 Symbols and metaphors in narratives 28
2.8.2 Universal transformational metaphors as tools in the process of personal development or
transformation 29
2.9 Two modes of storytelling: literature and film 36
2.9.1 The similarities and differences between literature and film 36
2.9.2 Film as a language 37
2.10 The therapeutic value of films 39
2.10.1 The levels in a story 39
2.10.2 The influence of film on the human mind and emotional life 40
2.11 Incantation Theory of Development 42
2.12 The advantage of single case studies in understanding human development 43
Summary and Outlook 43
3. Adversities as catalysts for adult development: Hannah’s process of self-(re)discovery 49
3.1 Adverse life events: the confrontation with major illness 50
3.1.1 Illness as a breach in the life course 50
3.1.2 Illness as a ‘rite de passage’ 50
3.2 Sources of data about Hannah’s life 51
3.2.1 Recruitment of the participant 51
3.2.2 Hannah’s life course in three periods 53
3.2.2.1 Period I: Hannah’s pre-diary life trajectory (age-period 0-38) 53
3.2.2.2 Period II: Hannah’s diary (age period: 38- 45) 54
3.2.2.3 Period III: Hannah’s post-diary period (age period: 45-46) 55
3.3 Background concepts 55
3.3.1 The role of transformational metaphors in a transitional phase of life, e.g. as a result of the
confrontation with a life threatening illness 55
3.3.2 Personal change against the background of narrative structuring of lives 57
3.3.2.1 Illness rhetoric’s 57
3.3.2.2 Life narratives 58
3.3.3 Emotions as guardians of concerns and as signals of concern activation 59
Intermediate summary and outlook 59
3.4 Results 60
3.4.1 Hannah’s life course 60
3.4.2 Hannah’s narratives 63
3.4.3.1 Hannah’s illness rhetoric 63
3.4.3.2 Hannah’s life narrative 64
3.4.4 How does Hannah’s near-death experience compare with other experiences? 66
3.4.4.1 Hannah’s outstanding experience (OE) on day 0030 66
3.4.4.2 The place of Hannah’s NDE amidst other life events 69
3.4.5 Does Hannah uses transformational metaphors and if so which ones? 72
3.4.6 Hannah’s emotional life 74
Discussion 79
4. Nicole’s quest, after life disruption 83
4.1 Conceptual background for the analysis of changes in Nicole’s view on life 83
4.1.1 Emotions as the primary meaning making system and as a barometer for change 83
4.1.2 Contextualized selves 84
4.1.3 The determination of the narrative preference of a person 85
4.1.4 Transformational metaphors in the life story 85
4.1.5 The study of a one years episode in Nicole’s life 85
4.2 Nicole’s struggle to find direction in her life 87
4.2.1 Method 87
4.2.1.1 Recruitment of the participant 87
4.2.1.2 Description of the participant 88
4.2.1.3 Design and data collection 89
4.3 Results 93
4.3.1 The course of Nicole’s feelings over a period of nearly a year 94
4.3.2 Nicole’s contextual selves 109
4.3.3 Nicole’s vision towards problems of life 118
4.3.4 Transformational metaphors in Nicole’s self-description 120
4.3.5 Does occurrence of these transformational metaphors coincide with lasting changes in
emotional patterns? 123
Discussion 130
5. The construction of a tool to sensitize and guide event-disoriented people toward
more self-coherence and personal development 137
5.1 The use of social forces in inspiring people to map their own life experiences onto a
transformational symbolic structure 138
5.1.1 The advantages of a group- intervention 138
5.1.2 The one-day OVK-meeting as a ritual 139
5.2 The creation of a developmental nexus based on Incantation Theory of Development 141
Intermediate summary and outlook 145
5.3 Description of the operational details of the OVK-Program 146
Some concluding remarks 151
6. Stimulating the meaning-making process in patients with facial nerve paresis:
Effectiveness of a film-mediated intervention in improving their outlook on life 153
6.1 Introduction 153
6.2.1 Facial nerve paresis and its consequences as a source of life breach 156
6.2.2 A facial nerve paresis as a breach with regard to the perceived moral order 157
6.2.3 Enhancing the meaning-making process. An application in patients with consequences of
facial nerve paresis 157
6.2.4 Plan of reporting 157
6.2.5 Research questions in detail 160
6.3 Methods 161
6.3.1 Design of the OVK-investigation 161
6.3.2 Participants and the OVK-intervention procedure 162
6.3.3 Measures 164
6.4 Results 165
6.4.1 Description of OVK-participants 165
6.4.1.1 The biographical background and patient characteristics of participants 165
6.4.1.2 Personality characteristics of participants 168
6.4.1.3 Experience of subjective health and mental state of participants 169
6.4.1.4 Posttraumatic growth 174
6.4.1.5 Equivalence of the two groups on background characteristics 175
6.4.2 Immediate outcomes of participation in the OVK-meeting 176
6.4.2.1 The OVK-meeting as a social interaction ritual in the sense of Collins’ IR Theory 177
6.4.2.2 The OVK-meeting as an ‘outstanding’ ritual compared with ‘normal’ daily rituals 180
6.4.2.2.1 Presence of ritual ingredients 182
6.4.2.2.2 Presence of ritual outcomes 184
6.4.2.2.3 Effects of participation in the OVK-meeting on inspiration and positive moods 185
6.4.2.3 Intra- individual differences in the waiting-list control group 188
6.4.2.4 Do participants show, on average, a rather high degree of emotional arousal during the
OVK-meeting? 189
6.4.2.5 Conclusions on developmental context created in the OVK-meeting 193
6.4.2.6 Has participation in the OVK-meeting improved the outlook on life of participants? 194
6.4.2.6.1 Perception of the future in the experimental group (group 1) after participation in the
OVK-day compared with the perception of the future of the waiting-list control group
(group 2) after having experienced a normal (i.e. pre-OVK)day 195
6.4.2.6.2 Changes in perception of the future pre- and after participation in OVK 197
6.5 Description of consequences of participation in the OVK-meeting 198
6.5.1 Description of participants’ trauma-stories 198
6.5.1.1 The writing task 198
6.5.1.2 Relevant methods of text analysis 199
6.5.1.3 Results 200
6.5.2. Evaluative opinions of participants about the OVK-meeting 203
6.5.3 Post-hoc evidence for the process initiated by the OVK-meeting 207
6.5.3.1 The rationale 207
6.5.3.2 Variables and their measurement 208
6.5.3.3 Results relating process-indicators and longer-term outcome 211
6.5.3.4 Conclusion with regard to the process 212
Overview of results 213
7. Reflections 219
7.1 The purpose of the project 219
7.2 Perspectives 221
7.2.1 Psychological research on metaphors 221
7.2.1.1 Consequences of the occurrence of transformational metaphors in the self-story of a
person with respect to perception of the self 221
7.2.1.2 The effect of transformational metaphors on the anticipated life course 221
7.2.2 Religious or spiritual traditions as repositories of ‘useful’ (transformational) metaphors 223
7.2.3.1 Other (psychological) theories concerned with meaning-making and/or coping with
trauma after an incisive life event 224
7.2.3.2 The posttraumatic growth approach within psychology 226
7.3.1 Psychotherapeutic approaches which may be useful for people who have problems with
respect to overcoming life events 226
7.3.1 Acceptance and Commitment Theory 226
7.3.2 Film assisted supportive interventions 227
7.4 The educational value of ‘inoculation’ with film-based life metaphors 229
7.5 Concluding comments 230
References 231
Appendices 249
Summary 285
Samenvatting 293
Acknowledgements 301
Curriculum Vitae 303
Chapter 1
Adversity-induced adult development: Introduction and
Overview
1.1. The case of Rob Wesdorp
In general, life crises or traumatic life events are considered as stressful, endangering
individual well-being and as a result blockingan individual’s development. Examples of these
events are the confrontation with a life threatening disease, the loss of a loved one, a severe
burn-out, coping with medical illness of a child, or the confrontation with burglary. How,
then, can it be that some people apparently benefit from life crises, even to a degree that they
experience (positive) personal development? An example:
The Dutch oncologist Rob Wesdorp, who became a victim of non-Hodgkin disease, describes in the Dutch
television program Vinger aan de Pols (1996) that he has become a “searcher for other values” instead of a
“researcher”. He sees his illness in essence as “something very positive” and “as a possibility to increase my
self-knowledge and to live in more harmony with myself.”
A closer look at this case shows that it contains three elements: a) the experience threatens the
normal life order of the person and is therefore undesirable, b) the person nevertheless reports
that he (or she) “got better”, and c) the experience has resulted in a quest for meaning and
values.
Highly challenging life events can produce a variety of negative and unpleasant reactions
(Rubonis & Bickman, 1991; Wortman & Silver, 2001). The pattern of negative reactions will
vary from person to person, but negative elements are likely to be observed in distressing
emotions, troubling cognitions, physical complaints, a moderate increase in physical illness,
and a small increase in the possibility of significant psychiatric disorder (Calhoun and
Tedeschi, 1999). A common feature of the confrontation with (severe) adversity is that
traumatic life events (threaten to) shatter the fundamental assumptions about self and world,
inviting persons to rebuild these assumptions (Janoff-Bulman, 2004), or force the person to
adjust their ‘theory’ about self and world (Heymans, 2002). Although this process is often
experienced as undesirable, it in fact reflects a move towards a greater coherence in one’s
organisation of experiences, as any resolution of a crisis must ultimately involve a new (and
more adaptive) way of being in the world (Kegan, 1996).
Rob Wesdorp emphasizes that the confrontation with his illness has led to increased self-
knowledge and that he has learned to live in more harmony with himself. The general
understanding that suffering and distress can be possible sources of positive change is ancient
(Tedeschi and Calhoun, 2004). Personal development as a result of the confrontation with
suffering has been described in several paradigms, for instance in religious scriptures (e.g. the
Story of Job, one of the Wisdom Books in the Old Testament), world literature (e.g. Tolstoy:
My Confession), existential philosophy (Kierkegaard, 1983 Nietzsche, 1955 ) and existential
psychology (e.g Caplan, 1964; Dohrenwend, 1978; Frankl, 1963; Maslow, 1954; Yalom,
1980). However, it was not until the 1980s and more strongly the 1990s that systematic
scholarly interest emerged, specifically focused on the possibility of growth from the struggle
with trauma (Tedeschi and Calhoun, 2004). Tedeschi and Calhoun introduced the concept of
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