03. But, Did You Die?

Hi friends,

Welcome to the third dispatch of How Humans Flourish, a research-informed newsletter on how humans thrive. 

It seems we're off to the races with this publication! From the responses and feedback I received after last week’s letter, I’m humbled by how much mental health impacts so many of us and the people we love. You can read our second newsletter here and our first, inaugural newsletter here. 

As mentioned last week, for the rest of January I’m sharing key insights from Flourishing: A Visionary New Understanding of Happiness and Well-Being, written by Dr. Martin Seligman, the originator of Positive Psychology and Professor of Psychology at University of Pennsylvania. 

Unpacking Dr. Seligman’s work often reminds me of a conversation I had many years ago. After starting talk therapy around the age of 25, I mustered up the courage to have a heart to heart with my step-father, describing the moments I’d felt our relationship did not reflect care or love towards one another. Awkwardness aside, I shared the slights I’d felt over the years, and admitted my goal was to take a step towards having more open and emotionally honest conversations. After pouring out my heart, I watched as he nodded and responded with the utmost sincerity, "Mhm, I hear all that... but, did you die?"

Obviously, I was mortified. 

But years later, I have immense perspective, humor, and even appreciation for his sardonic, Boomer response. The wisdom here is not in the conversation itself, but rather who I had to become because of the dynamic of our relationship. 

It’s not a far reaching assumption to say most reading this letter also carry slights. Or more than slights, have experienced very real trauma (big T and/or little t). The spectrum of possibilities around adversity is dizzying, and here is where Dr. Seligman’s work shines. 

In his own words, “The human species has evolved through millennia of trauma, and far and away the usual response to high adversity is resilience—a relatively brief episode of depression plus anxiety, followed by… a higher level of psychological functioning than before.” (pg. 183) 

This is a fundamental pillar of human flourishing– that most of us can and will move on from hardship, no matter how severe it is. But moreso, when we move on, we have what many cultures of the old would call an elevated consciousness: a renewed appreciation for being alive, a newfound personal strength, a clarity to act on new possibilities, a willingness (and humility) to improve relationships, and a spiritual deepening. And this isn’t to glorify trauma, but rather to acknowledge trauma often sets the stage for growth, and it behooves us to understand the conditions under which such growth is most likely to happen.

It’s also important to note, not all of us respond to adversity in the same way either. According to Dr. Seligman, “individuals who are catastrophizers* (*people prone to intense anxiety and depression) are much more susceptible to PTSD. One study followed 5,410 soldiers through their army careers from 2002 to 2006. Over this five-year period, 395 were diagnosed with PTSD. More than half of them were in the bottom 15 percent of mental and physical health to begin with. This is one of the most reliable—and least quoted—facts in the entire PTSD literature: the people who are in bad shape to begin with are at much greater risk for PTSD than more psychologically fit people, and PTSD can often better be seen as an exacerbation of preexisting symptoms of anxiety and depression than as a first case.” (pg. 184)

When framed this way, the best question to ask ourselves is: how do we shore up our psychological inner worlds? How do we experience what Dr. Seligman calls Post-Traumatic Growth (PTG)?

There are five elements known to contribute to PTG:

1. The first element is to “understand the response to trauma”— to realize it is normal to respond to trauma with shattered beliefs about self, others, and the future. This is not a symptom of post-traumatic stress disorder, nor does it mean something is wrong with the trauma survivor.

2. The second element is anxiety reduction— using science-backed techniques to control intrusive thoughts and images (more on this in another newsletter).

3. The third element is constructive self-disclosure— telling the story of what happened in places that can hold the weight of it.

4. The fourth element is creating a trauma narrative— this narrative might detail “what personal strengths were called upon, how some relationships improved, how spiritual life strengthened,” etc.

5. The fifth element is formulating new, robust life perspectives. These include “exploring new ways to be altruistic, accepting growth without survivor guilt, crafting a new identity as a trauma survivor or a newly compassionate person,” etc. (pg. 189)

There is an obvious hero/ heroine’s arc in these elements… which brings me back to my conversation with my step father.

Our conversation bridged two generational worlds— his of controlling one’s intrusive thoughts (mental toughness), and mine of self-disclosure. Our conversation was also an interesting microcosm of a larger debate happening in popular culture, in particular around the “fragility” of young people and over-sharing (usually on social media). It’s an interesting line in the sand, because regardless of the side you champion, culturally and digitally, self-disclosure is here to stay.

Venture funds like Greylock (supported by titans like LinkedIn’s co-founder Reid Hoffman) and AI Fund (built by former co-founder of Google Brain, Andrew Ng) are particularly interested in technology that stands in the gap between messy self-disclosure and constructive self-disclosure. In fact, on Greylock’s website, they write, “While the past decade in mental health has advanced telehealth-based models, we think the future is in peer-based models. Peer models have demonstrated efficacy with lower dependencies on the healthcare system. As a result, 50 states have recently passed laws in the past few years to require Medicaid to cover peer-based services, which can encompass novel models that might look like social support groups.”

Forward-thinking medical service providers are meeting patients where they are (i.e. therapists going viral on TikTok and accumulating millions of followers), but are not necessarily innovating commercialized models that take individuals or groups through the five step journey that leads to post traumatic growth.

My guess is, a disgruntled academic or behavioral scientist will leave their full-time job to build something that changes the game for millions (if not billions) globally. Perhaps it’ll be Woebot, the AI mental health ally, that has raised over $123M?

One of my favorite poets Joy Harjo muses, “At some point we have to understand that we do not need to carry a story that is unbearable. We can observe the story, which is mental; feel the story, which is physical; let the story go, which is emotional; then forgive the story, which is spiritual, after which we use the materials of it to build a house of knowledge.”

As always, I’m watching and learning the space, excited to see which visionaries will build something that democratizes emotional and mental dexterity, allowing all of us to build our own houses of knowledge.

Until next week, friends.

With gratitude,