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Hippocrates said, “Healing is a matter of time, but it is sometimes also a matter of opportunity.”

Trauma does not have to mean defeat. It can be a perfect opportunity for growth and can be used as a catalyst to move lives forward in unexpected ways. This concept actually has a name, Posttraumatic Growth (PTG).

According to the Posttraumatic Growth Research Group for the Department of Psychology at the University of North Carolina Charlotte, PTG is defined as “positive change experienced as a result of the struggle with a major life crisis or a traumatic event.” 1 PTG is measured scientifically by the Posttraumatic Growth Inventory (PTGI) which measures five (5) areas of life that indicate mental health and appropriate lifespan growth.

1. Relating to Others
2. New Possibilities
3. Personal Strength
4. Spiritual Change
5. Appreciation for Life
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Traumatic events can occur in a split second or over an extended period of time. According to the American Psychological Association, “Most people will experience trauma at some point in their lives, and as a result, some will experience debilitating symptoms that interfere with daily life. The good news is, research has shown that psychological interventions can help prevent this long-term, chronic psychological consequences.” 2 An individual’s internal coping mechanisms, life skills, and external support system are factors related to health and growth after a traumatic event. This article is intended to introduce you to the concept of Post-Traumatic Growth (PTG) and provide hope and positive empowerment to those who have suffered traumatic events.

UNC Charlotte’s Posttraumatic Growth Research Group answers the question, “What is posttraumatic growth? It is positive change experienced as a result of the struggle with a major life crisis or a traumatic event. Although we coined the term posttraumatic growth, the idea that human beings can be changed by their encounters with life challenges, sometimes in radically positive ways, is not new. The theme is present in ancient spiritual and religious traditions, literature, and philosophy. What is reasonably new is the systematic study of this phenomenon by psychologists, social workers, counselors, and scholars in other traditions of clinical practice and scientific investigation.”3

 

PTG refers to multiples levels of trauma and “has been researched in a hugely diverse set of traumatic events from divorce and death to natural disasters and terrorist attacks (Haidt, 2006) [3]. The literature on PTG shows that even though the causes of PTG are vast, the benefits reported fall into three categories.”

1. Finding personal strength and abilities.
2. Improving positive relationships.
3. Positive change in priorities and philosophies.

Literature and research are “mixed when it comes to explaining the link between PTG and wellbeing.” Three main hypotheses have been put forward.

PTG leads to positive life changes, and this improves wellbeing.
PTG does lead to life changes but this is stressful and so leads to lowered wellbeing.

PTG is a coping strategy, and its effectiveness as a coping strategy mediates the relationship between PTG and wellbeing.
Research is inconclusive as to which hypothesis is accurate and so further work is required.” 4

An article published in the Journal of Trauma Stress describes the assessment tool used to evaluate and determine an individual’s level of growth after trauma. The Posttraumatic Growth Inventory: measuring the positive legacy of trauma, details areas of assessment for positive life changes and personal growth, utilizing trauma as a catalyst to achieve a more meaningful life.

The Posttraumatic Growth Inventory (PTGI) is an instrument for assessing positive outcomes reported by persons who have experienced traumatic events.

The PTGI consists of a 21-Item Scale which includes factors of:

  • New Possibilities
  • Relating to Others
  • Personal Strength
  • Spiritual Change
  • Appreciation of Life

“Women tend to report more benefits than do men, and persons who have experienced traumatic events report more positive change than do persons who have not experienced extraordinary events. The Posttraumatic Growth Inventory is modestly related to optimism and extraversion. The scale appears to have utility in determining how successful individuals, coping with the aftermath of trauma, are in reconstructing or strengthening their perceptions of self, others, and the meaning of events.”5

A study published in the August 2015 issue of the Canadian Medical Association Journal found that an optimistic attitude can do wonders for patients’ recovery. Researchers reviewed 16 studies that looked at patients’ attitudes toward health that spanned over 30 years and looked at the patients’ attitudes after medical procedures and surgery.

Donald Cole, the article’s author from the Institute for Work & Health in Toronto, reports, “In each case the better a patient’s expectations about how they would do after surgery or some health procedure, the better they did. Across a wide range of clinical conditions, from lower back pain to heart surgery, patients who felt they would do well in recovery, did. Patients who were scared or pessimistic about their recovery did not recover as quickly as the optimists or as well.” 6

Dr. Nancy Snyderman, Medical Correspondent for ABC News, reported on this study saying, “The review says that the power of positive thinking is real. This mind-body connection that we have been toying with for the past couple of decades really does have hard science behind it. You can’t blame people for their diseases, but how you go through your life with the grit and determination to make it through, that you do have control over and that makes a difference.“7

Cannabis has shown the ability to facilitate systematic balance and strengthen “this Mind-Body connection,” while assisting patients to feel more optimistic about creating healthy lives through positive growth. During the Cannabis Health Summit, Cannabis Health Index author Uwe Blesching, Ph.D. explained that Cannabis sets the stage for deeper healing by producing a relaxation response, modulating the endocannabinoid system, altering the state of consciousness, and increasing emotional authenticity and positivity. 8

The goal of Nursing is to assist in increasing health and well-being through individualized patient care.

This goal leads to the question: What is health?

According to Merriam Webster’s dictionary, “Health is the condition of being sound in body, mind, or spirit; especially: freedom from physical disease or pain.” However, it is possible, even when not in optimum health, to begin “feeling” healthier & happier now. In the words of Terry Waite, who survived four years in solitary confinement, chained, beaten and subject to mock execution, ‘Suffering is universal: you attempt to subvert it so that it does not have a destructive, negative effect. You turn it around so that it becomes a creative, positive force.’ 9

Could cannabis be used as a tool to assist patients by serving as a Gateway to Health and a Pathway for Growth?

Health is defined as the condition of being sound in body, mind, or spirit.

BODY- Physically, the Endocannabinoid System is known as the homeostasis or balancing system of the human body. Health can be increased through Life Balance, and if disease, inflammation, or Endocannabinoid deficiencies are present, Cannabis can begin to balance the body systems to assist in obtaining physical homeostasis.

MIND- Mentally, Cannabis can assist with stress reduction and relaxation. CB1 Receptors (CBR1) located in the brain are associated with the limbic system involving motivation & emotional behaviors. The hippocampus, also part of the limbic system is responsible for mood, emotions, and memory. Research has identified the limbic system as the central area of the brain involving laughter. It’s said that laughter is the best medicine, perhaps cannabis is the best medicine to tickle the limbic system and make laughter easier. Positive thinking, uplifting self-talk, and laughter are good coping skills to develop. It could be suggested that the Endocannabinoid system and the cannabis plant are both naturally designed to support mental well-being and assist humans in the quest for personal growth and happiness.

SPIRIT- Spiritually, the feeling of love and gratitude are fast routes to experiencing happiness and well-being. “Thank you,” “I’m grateful,” “I am blessed beyond measure.” The list of things to be thankful for could be endless. Take a moment now to think of one thing you are grateful for. Focus on the thoughts and feelings generated. This simple gratitude exercise can generate good feelings of peace, ease, and well-being. If an individual chooses to sit in a state of gratitude long enough, their mood will likely shift into a happier and calmer state of being. Cannabis can assist patients to calm the mind, sit in retrospective thought, and with gratitude as the intention, experiences of spiritual health and growth become the result.
Cannabinoid therapeutics may aid in PTG by supporting physical health with balance & homeostasis, mental health with a greater ability to cope, and spiritual health by allowing the energy of gratitude and peace to be generated and expressed from the inside out.

The mind, body, and spiritual connections are addressed and utilized by the PTGI to measure posttraumatic growth in human beings. Could a theory be developed that the health of one’s endocannabinoid (eCB) system has an impact relating to PTG?

The journal article entitled, Elevated brain cannabinoid CB1 receptor availability in post-traumatic stress disorder: a positron emission tomography study, was published in the September 2013 issue of Molecular Psychiatry reports, “Three biomarkers examined collectively—OMAR VT, anandamide, and cortisol—correctly classified nearly 85% of PTSD cases. These results suggest that abnormal CB1 receptor-mediated anandamide signaling is implicated in the etiology of PTSD, and provide a promising neurobiological model to develop novel, evidence-based pharmacotherapies for this disorder.” 10

Could Cannabinoid Therapeutics address underlying biochemical imbalances and assist individuals in experiencing greater PTG?

The trauma of any kind can trigger systematic inflammation or chemical responses within the body. Inflammation or body system imbalances, if left unaddressed may lead to chronic conditions, including clinical Endocannabinoid deficiency. It is common medical practice for healthcare providers when patients present with endogenous deficiencies (B12, Calcium, Vitamin D, or Iron) to supplement the deficiency with an exogenous replacement to assist body system mechanisms and functions for optimum health. Phytocannabinoids found in Cannabis, provide an excellent source of exogenous cannabinoids to supplement the Endocannabinoid system when addressing conditions related to oxidative stress, inflammation, or Endocannabinoid Deficiency. 11

Dr. Ethan Russo’s work and letter entitled, Clinical Endocannabinoid Deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome, and other treatment-resistant conditions?, concludes by stating, “Migraine, fibromyalgia, IBS and related conditions display common clinical, biochemical and pathophysiological patterns that suggest an underlying clinical Endocannabinoid Deficiency that may be suitably treated with cannabinoid medicines.” 12

Dr. Russo is also quoted saying, “Cannabis is the single most versatile herbal remedy and the most useful plant on Earth. No other single plant contains as wide a range of medically active herbal constituents.” This parallels with Hippocrates who stated, “Healing is a matter of time, but it is sometimes also a matter of opportunity.” Healthcare providers and patients deserve the opportunity to utilize all medications, plants, tools, methodologies, and skills to assist in the promotion of health, well-being, and posttraumatic growth.

Through awareness, assessment, and guidance related to PTG, medical professionals have an opportunity to assist patients in reaching their greatest potential for health and wellbeing. Trauma does not have to mean defeat. In fact, many times the most beautiful opportunities for growth can only be obtained as a result of growing through trauma. In her memoir, A lotus grows in the mud; Goldie Hawn wrote, “The lotus is the most beautiful flower, whose petals open one by one. But it will only grow in the mud. To grow and gain wisdom, first, you must have the mud — the obstacles of life and its suffering. The mud speaks of the common ground that humans share, no matter what our stations in life. Whether we have it all or we have nothing, we are all faced with the same obstacles: sadness, loss, illness, dying and death. If we are to strive as human beings to gain more wisdom, more kindness, and more compassion, we must have the intention to grow as a lotus and open each petal one by one. ” 13

Source References

 

  1. Posttraumatic Growth Research Group. Department of Psychology, University of North Carolina Charlotte. Retrieved from website June 7, 2016, https://ptgi.uncc.edu/what-is-ptg/
  2. American Psychological Association. The Effects of Trauma Do Not Have to Last a Lifetime. Retrieved from website May 2016. http://www.apa.org/research/action/ptsd.aspx
  3. Posttraumatic Growth Research Group. Department of Psychology, University of North Carolina Charlotte. Retrieved from website June 7, 2016, https://ptgi.uncc.edu/what-is-ptg/
  4. Positive Psychology, UK. Post Traumatic Growth. Retrieved from website May 2016. http://www.positivepsychology.org.uk/pp-theory/post-traumatic-growth/105-post-traumatic-growth.html
  5. Journal Trauma Stress. 1996 Jul;9(3):455-71.The Posttraumatic Growth Inventory: measuring the positive legacy of trauma. Tedeschi RG, Calhoun LG. http://www.ncbi.nlm.nih.gov/pubmed/8827649
  6. Positive Thinking, Faster Recovery. ABC News. Retrieved Jan 2016. http://abcnews.go.com/Health/story?id=117317&page=1
  7. Positive Thinking, Faster Recovery. ABC News. Retrieved Jan 2016. http://abcnews.go.com/Health/story?id=117317&page=1
  8. Cannabis Health Index. Uwe Bleshing, Ph.D. http://cannabishealthindex.com/talks/
  9. Psychology Today. Stephen Joseph, Ph.D. What doesn’t kill us? Posttraumatic Growth, the subversion of suffering. https://www.psychologytoday.com/blog/what-doesnt-kill-us/201402/posttraumatic-growth
  10. Molecular Psychiatry. Sept 2013. Neumeister A., et al. Elevated brain cannabinoid CB1 receptor availability in post-traumatic stress disorder: a positron emission tomography study. http://www.ncbi.nlm.nih.gov/pubmed/23670490
  11. US Patent on Cannabinoids. http://www.google.com/patents/US6630507
  12. Neuro Endocrinol Lett. 2008 Apr;29(2):192-200. Russo, EB. Clinical Endocannabinoid Deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? http://www.ncbi.nlm.nih.gov/pubmed/18404144
  13. A Lotus Grows In The Mud. Author Goldie Hawn and Wendy Holden.
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