Ade O’Malley, young survivor of stroke and senior clinical neuropsychologist Dr Jamie Berry chat about Ade’s experience of post traumatic growth after his stroke.
They cover:
- What is a traumatic event?
- What is post traumatic growth?
- The five areas of post traumatic growth
- Ade’s stroke journey, including becoming a parent shortly after his stroke and returning to work in a different field.
- Ade’s love of horticulture and orchids
- Can post traumatic growth be cultivated?
Transcript
Adrian: What are the, sort of, four or five pillars of post-traumatic growth?
Jamie: So one is an enhanced appreciation of life where a person generally has a sense of gratitude and appreciation for what life holds.
An increased perception of personal strength. So that requires a person to draw deep on their character strengths and enhance some of them perhaps.
There's the identification of new possibilities in life. Which fit in your story, was a necessary requirement because you had to look at new ways of working, new ways of navigating your environment and so on.
Improved relationships with others, and a sense of connectedness with others.
Spiritual growth is an aspect of post-traumatic growth as well.
So they're, they're the five domains that are generally included in this constructed post-traumatic growth.
And if you do the post-traumatic growth questionnaire, it will give you a score across those five domains.
Adrian: Can a person like ... will a person perhaps not get all five? They'll cherry pick, but still experience growth even if they only got, you know, spirituality and strength, for example.
That's still going to be better than none at all.
Jamie: Correct. Yeah, that's right. So you don't have to have all five, but usually two or three would be the minimum for someone to be experiencing post-traumatic growth.
Adrian: And once you've got it, my understanding is you can't shake it off.
Jamie: Yeah. I mean, why would you want to shake it off?
Adrian: Yeah.
Jamie: It's part of you. It actually becomes part of your character or it's intimately at least related to your character.
Adrian: And can you cultivate it? Can you get more? Or is enough enough?
Jamie: Yeah, it's a really good question. And I get asked that quite a bit, particularly when I give presentations about it.
I don't know that we've got a perfect science for how to cultivate post-traumatic growth. I suppose, seeking those things. So, reflecting on one's life situation and thinking about whether there are any possibilities for growth as a result of this generally negative thing that's happened.
So reflecting on what's happened in the most positive way. And that necessarily requires some future oriented thinking because as in your story, you were forecasting, what, 15, 20 years into the future at least, and you were imagining the life that you could have in spite of what's happened.
And you had to come to terms with the vision of how life would have been if what happened didn't happen, if you hadn't had the stroke.
And you had to resolve that in some way, you had to process it and make meaning of it. And I think that's probably. I know it's very vague and very general. But that would be my suggestion about how to best cultivate it. Process it deeply, look into the future, look for a meaningful life. Imagine the most meaningful life you can have, and then work backwards from there.
Adrian: Ruminate.
Jamie: Yeah. Interesting that you mentioned that. Rumination is interesting because it's usually used in a negative sense where people go over and over something, usually something that bothers them more or a problem or something like that.
Rumination serves a purpose, and the purpose is to solve a problem. So I would say yes, ruminate so long as you're solving a problem and not just going over ...
Adrian: This sucks. This sucks. This sucks.
Jamie: That's right.
Adrian: Okay. And I mean, I still clearly remember when you first mentioned we were in a, we'd exchanged emails, we had spoken on the phone, but we were in a room together doing training about brain injury and you were presenting the clinical and 20 minutes into the presentation you said and Adrian here is a good example of post-traumatic growth.
And I thought, what the hell is that? And I'm looking on my phone, looking at it, and I read those things and I you know, those underlying concepts. And I just I was reflecting "Oh, yeah, I get that." I could clearly draw upon my personal strength.
So I'm a warm, friendly guy, but I realise as a result of what's happened to me that I am as hard as granite.
Jamie: Yeah.
Adrian: Something, whatever happened, you know, a meteor comes through the roof right now. I'm on an aeroplane and it's crashing. Whatever. I know that everyone around me will be going to hell in a handbasket, but I know that I'll be doing higher order thinking and I'll be really okay with myself.
And I think that inner strength, certainly in terms of people who've had a stroke, I would wish that for anybody if I could pick or choose because stroke is going to throw challenges constantly.
You know, if you're going to be living a life, if you've had a stroke when you're young, 30, 40, 50 years of living with a shitty situation, having that recognition that you are a tough M.O.F.O, is a good thing to have.
And yeah, I love that idea of I don't come across particularly macho, you know, I'm not going to, you know, talk about the footy or whatever, but you place me in an awkward situation and I know that I'll be okay.
Jamie: Yeah.
Adrian: I think inner strength is a great thing to have.
Jamie: Absolutely. And for you that probably pre-existed the stroke did it?
Adrian: I don't know. I mean, I think as a teenager watching my dad die, you know, he had a series of brain tumors and finally decided after the third not to have more surgery because at this point, he wasn't, you know, medical science was not prolonging life.
They were just keeping, you know, staving off death. And that. You know. So at 17, I watched Dad die and I closed his eyes.
Two days later, I was doing, you know, I buried him. And then the day after that, I started the HSC with a hangover.
So I don't know that I ever thought about post-traumatic growth in reflecting back on watching Dad die, but I certainly I think that probably set me up without reflecting on it for further on down the track.
Jamie: Yeah.
Adrian: Once stroke happened and then, you know, you introduced the concept. I reflected on that and that interconnectedness. I love the interconnectedness that you get from it also of my situation is not your situation, but we have a commonality. So we have a connection. And I love connection now.
I mean, I'm the youngest of nine kids, so I'm used to, as, you know, studies around birth order. When you get to me, you're adept at dealing with people from 8 to 88 because you're exposed from a very young age to lots of people.
So I had that to draw upon. But then you've got that interconnectedness of not quite the same situation, but similarity. So I can kind of walk in your shoes a bit, but you can kind of walk in my shoes a bit.
And I think I think again, stroke brings that out in people. Which are, you know, I don't know anybody. I have no friends that have disability. I'm not a ... I'm in that community but it's not my community.
My community is you and I going bushwalking or, you know, going to an orchid show or whatever. It's not disability. So you can kind of dabble in it and not but, you know, you're not bullshitting, I guess.
Jamie: Yeah, I wonder whether you know, your positioning in the family and your early life exposure to lots of different people from different walks of life and different ages. I wonder whether a certain flexibility emerges from that life experience that may or may not be relevant to post-traumatic growth, but may be relevant to sort of problem solving. We do know that problem solving is affected by cognitive flexibility.
And if you can fairly rapidly shift your perspective or shift your direction when a problem occurs, such as a meteorite coming through the roof, well, you're going to be a good problem solver.
And to some extent, I wonder now whether problem solving might be part of that, the whole post-traumatic growth experience. Right?
Because it's about looking for new ways to do old things or and that includes defining who you are and what your next 20, 30, 50, 70 years is going to look like.
So I'm just sort of riffing here on some ideas. And this is not based on any sort of empirical studies I've read, but I do wonder whether that's an important part of it. And your story would be a really good example of that, again.
Adrian: It's like a Teflon coating.
Jamie: Yeah.
Adrian: Okay, life, bring it on. And it is that, you know, I've been through this and I remember, I told you. When it appeared that I'd had another stroke and this you describe that as very high order thinking. I was left in a in a room in a wheelchair waiting for an MRI with no windows, no social worker, or a psychologist to help me process it. And I was just like, okay.
And I just wanted to lie in the fetal position and ball my eyes out. Because it certainly appeared, my blood pressure was through the roof. I was hemiplegic.
I'd had another stroke. My neurologist thought I'd had another stroke. And I remember sitting there going, okay, well, you've been through this and you've rehabilitated, so you know you can do that again.
It's fortunately, it's your right side again. So at least you've got your left side again. And I was just lining up my ducks. I was lining up my ducks.
Okay, so you know what to do for rehab. It's your right side. I'd told Konnie, don't call anyone. I would rather have answers and give people answers rather than because when you're one of nine kids, you know, you make a phone call, Ade's in hospital. It looks like he's had another stroke.
Lots of movement happens. But I just wanted to get answers and proceed on the basis of, okay, you've had another stroke, now you can lie on the floor in the fetal position and ball your eyes out.
Jamie: Right.
Adrian: But I pulled myself together and I clearly remember, literally and figuratively put myself together and went, okay, let's go have an MRI and not cry.
And it is that intestinal fortitude to pull yourself together, which I just think thank God for that, if I'm honest, because. Oh, thank Buddha. Thank whoever.
You know, there's that spirituality thing. Thank your lucky stars that you can draw upon those reserves for the whatever's next.
Jamie: Yeah.
Adrian: Because sitting in a wheelchair in a soulless, windowless room waiting for an MRI is not a happy place to be.
Jamie: No.
Jamie: So that was quite a remarkable story about discovering that you had that inner strength, that intestinal fortitude, as you'd put it, to get through some pretty significant challenges.
And that's one domain, one sphere, if you like, of post-traumatic growth.
Another one is appreciation of life. How has that resonated for you since you've had the stroke?
Adrian: Looking out a hospital window, it was springtime, and I just wanted to be out there. I've always been a nature boy and as a career I've worked outside, rain, hail or shine, for, you know, 14, 15 years. I love interacting with nature.
It's on the walls. It's in the garden. And stroke, not having a license has shortened my horizons.
So I kind of have a gilded cage here in the backyard where I still get to interact with nature. And I love, I've acquired a reasonable orchid collection, which is good for me to interact and keep my horticultural skills. I get to use my horticultural skills to cultivate and enjoy growing orchids.
I will always think of myself as a horticulturist, even if I ... Screw you stroke. That's what I did and that's what I do. And that's how I think of myself.
And I'm still going to do it and I still get to do it.
Jamie: That's amazing. Is it alright if we go and have a look?
Adrian: Of course.
Jamie: Sounds good.
Jamie: So what does this place mean to you?
Adrian: It means a lot of things, Jamie. It means joy, peace.
It means for me, I still get to practice my horticulture skills because I don't work in a garden, you know, four or five days a week.
It means joy, sorrow, anger, frustration. There's an orchid up the back that after eight years it was going to flower for the first time for me. And two days before the flower opens, I was rather frustrated because an insect ate the flower. I went, oh, well, there's always next year.
And it's that peace. It's, you know, post-traumatic growth means that acceptance, I guess.
But in 12 square meters, I get life lessons that I can take out of this place into the real world. And it makes me a better human.
Jamie: Yeah. Wow. So what are some of those life lessons?
Adrian: Stuffs out of my control.
Jamie: Yeah.
Adrian: I can put all my horticultural skills to use. And plants will thrive. Plants will sulk, plants will die. Plants will flower, plants will not flower. And ultimately, I can do everything within my control, but I have zero control.
And that was the same with my experience, certainly within the hospital. And then moving on from that. The only thing I had control of as an inpatient in hospital, doctors telling me stuff, physiotherapist making me do stuff. The only thing I had control of was what was going on between my ears. And everything else in life, in hospital, in here is out of control.
So I can only control my emotions. So I really screwed my emotions down tight.
Jamie: Yeah.
Adrian: And outwardly projected a guy that was calm and in control and friendly and polite. In hospital I was all those things in a bloody hard place.
But those life lessons, I guess, are a good ... You're in hospital for nine, ten weeks, but then you re-enter the world with disability and you have to process that.
I didn't want to be … I didn't want to be that angry guy that I mentioned before. I don't wanna be an angry guy in here. I wanna be a happy guy in here. It's springtime at the moment.
I mean, how can you ... Ultimately the end game, growing orchids, is to have them flower. And I'm going to be surrounded by thousands of flowers in the next couple of weeks. And that's just unbridled joy. That's just, that's just ...
You and I've talked about, I remember, what is it? Instant dopamine and low level dopamine. There's a lot of low level dopamine going on here.
And right at the moment "ding, ding, ding". It's all just going off, you know, the synapses are firing. It's joyous.
How can you not be happy when you're surrounded by the scent?
I mean, you can describe a flower, but you can't describe the scent. And I think the scent is ... You can take a photo of a flower. But you can't take a photo of a scent.
So I've only got that, you know, 4 to 6 weeks of a year. I just get to come up and go. And that heady smell, you know, makes me dizzy and giddy. And I love it. So you can see the look on my face.
This place here represents a lot of things to me. But unbridled joy, I think is probably the main one.
Jamie: I'm really fascinated by that mixture of emotions you mentioned earlier that you also associate with this place.
So it's unbridled joy for six weeks in the year because you see the fruits of your labour, if you like, and you get to enjoy it in that ephemeral sense, particularly using your olfactory sense.
But to enjoy that six weeks of the year takes a lot of grit, a lot of hard work, a lot of persistence and perseverance and challenges and disappointments and all the rest of it.
And I wonder now whether your horticultural background and knowing that fact of life for plants, which is you can't control everything, you can't control the weather, you can't control a lot of external factors. All you can control is give these plants the best environment, the best support necessary to achieve the best possible outcome.
Even though you realise that the best possible outcome won't always be achieved. And I wonder whether that is interwoven in your character and whether that in some way has actually helped, helped you foster some post-traumatic growth.
Adrian: Cultivation.
Jamie: Yeah, Yeah, exactly.
Adrian: As I cultivate them, I cultivate me, you reckon. Yeh, possibly. I've never really thought about it that way. I mean, I look at, you're a scientist, I look at this unemotionally.
But the end result is purely emotion. It's a scientific process. You know, feed them this at this time. Water them, you know, more in summer. Give them as much life as you can. And all that sort of stuff.
So give them optimal opportunity to do what they want.
Jamie: Yes.
Adrian: Is all higher order thinking. The end result is "Yay, yay." Lots of brain chemicals going "Happy, happy. Joy, joy".
So yeah, that's an interesting, interesting ... I'm gonna have to ponder that now.
Jamie: Well, it's not dissimilar to the story you were telling me earlier, which is, you know, you'd had another stroke or thought you'd had another stroke.
All you felt like doing was curling into a ball and crying. But you pulled yourself together to to say, okay, what do I need to do here? What are the next steps?
And that's similar to, you know, that's very thoughtful, very rational, so that you could have ultimately an emotional experience.
And in the context of post-traumatic growth, the emotional experience is living a meaningful life. Living a good life. Being happy. Being authentically happy.
And that requires cultivation, requires work, it requires dedication. It requires strength and commitment.
And yeah, I think it's not too much of a stretch of the analogy of this world pretty much being a microcosm for the world of the, the person, the soul, the psyche.
Adrian: It's interesting, we haven't really touched on happiness, but I love to be happy.
Jamie: Yeah.
Adrian: I could be really unhappy because at 34 I had a stroke and lost, you know, opportunity etc. etc.
But I'm fundamentally motivated by happiness. And you talked about authentic happiness and I'm not bullshitting it.
Yeah, it's ... I love to be happy regardless of, of, you know, stuff happens externally, that again, happiness is totally within.
You know, I've got the keys to it. I can be the driver. So it's that sense of control that planning that we sort of touched on without ... I mean, yesterday was the 16th anniversary of my stroke and yesterday wasn't a great day.
But I'm allowed to have one day a year where things are, you know, are a little bit rough around the edges. I want to be happy the other 364 days of the year. And that takes effort.
Jamie: Yeah.
Adrian: And post-traumatic growth for me is the driver of that. Post-traumatic growth makes me happy.
Growth on this makes me happy. Growth within myself makes me happy. Seeing growth in other people makes me happy.
And I just think it's a lovely idea. And I think you, as I said, you know, when I was there Googling, looking up at you and Googling, I thought it was a gift. You gave me a gift.
And I think what I hope we achieve is that we give people a gift also.
Because I think it's a good thing to have. It's a good thing to cultivate. It's a good thing to have more of. And as we've touched on, once you've got it, you can't shake it off. You know, I'm going to be this guy for the rest of my life and I wouldn't want to be anybody else.
Jamie: That's lovely. Well, I'm deepening my own knowledge anecdotally through your story about the power and the importance of trying to cultivate post-traumatic growth after a traumatic experience, and I think you're still one of the best examples of that that I've ever come across.
And it's just nice to, to see the connections and see how the rest of your world and outlook and interests kind of weigh in on that post-traumatic growth process. And I think it's wonderful and thanks for sharing it.
Adrian: I'm not going to give you a hug, but it's lovely hearing from a friend who also has a clinical background to say that.
I mean, that's like, you know, literally there's goose bumps here, Dave. I've got goose bumps, man. To be an exemplar of something be it an orchid grower or whatever, is not a bad place to be and somebody's gotta do it. Well, you know, sure, I'm going to put my hand up and, you know, the Commonwealth Games are on and I'm a gold medalist in post-traumatic growth.
Cool. Thank you.
Jamie: You're very welcome. We're done.
