When trauma occurs, it is human nature to try and make sense of it.

Working in oncology, I see every day how traumatic a diagnosis of cancer can be. It causes emotional and physical upheaval and can be financially devastating. As a therapist, I counsel various people who have experienced different types of trauma, which run the gamut from rape, to the death of a loved one, and to the infidelity of a spouse. Although the traumas are vastly different, it always strikes me how the emotions that follow each of these traumas are extremely similar and how people deal with the emotions in a very similar way. Basically, they struggle to accommodate it into their lives. Some do it seamlessly, but some suffer extreme reactions such as Post Traumatic Stress Disorder (PTSD), severe anxiety or depression. The common thread is that they are trying to understand why this trauma occurred and how they can continue living their lives in some semblance of normalcy. I had a conversation with one of my patients who had finished his cancer treatments and was doing well. Unfortunately, his father had just been diagnosed with cancer and he was struggling to find meaning in it all. He anguished over the fact that his 89 year old father, who had worked hard his whole life, had to end his life with having to deal with cancer. He did not know what to do for his father who had, at that point, become depressed. Then he asked me, Is trauma ever a good thing? I mean, should we want trauma to hit us so we can learn some type of lesson? He went on to tell a story about how his father taught him to swim. He was tossed into the pool and his father watched from the side as he flapped his arms and legs trying to keep his little face above the water. He remembered feeling absolute terror until he finally figured out how to tread the water. He admitted that he learned to swim pretty quickly, but then asked if experiencing trauma is a good way to really learn things. I answered thusly, No, trauma is not a good thing. None of us would ever invite trauma into our lives; however, good can most certainly come from a trauma should one befall us, but only if we allow it. We went on to talk about how, because of his own experience with cancer, he was now equipped with the knowledge that he could impart to his father to help him through his own treatment journey. Had he not experienced cancer himself and had he not done the introspection and reflections that ensued after his diagnosis, he may not have been as prepared for what his father was about to face. The wisdom that he gained from his own experience would now benefit his father. He found tremendous comfort in that. This whole concept of learning from pain reminds me of 2 Corinthians 13:4. This version of the text is from the Complete Jewish Bible (parentheses added by me for clarification), "Praised be God, Father of our Lord Yeshua the Messiah (Jesus Christ), compassionate Father, God of all encouragement and comfort; who encourages us in all our trials so that we can encourage others in whatever trials they may be undergoing with the encouragement we ourselves have received from God." This verse discusses how God allows us to go through difficulties so that we can then help others enduring the same or similar difficulties. Another example of suffering comes from the Old Testament through Job. Job suffered tremendous loss and his faith was tested. Those around him judged and questioned why he suffered so. Ultimately, Job regained that which he had lost and more, but not as a direct reward. He had to learn that suffering happens and the rewards came because of his own character. Good came of Jobs life because he accepted that suffering happened without blame. He allowed it all to be turned for his good. In the Judeo/Christian religions, we see over and over how trauma can be used to mold us into the person who God wants us to become. If one can understand that trauma can befall us whether we

deserve it or not, one can most certainly allow it to teach oneself the lessons one needs to learn. Every religious philosophy assigns meaning to the trials we suffer. My friend Mindy is a practicing Buddhist. She has endured a few traumas in her life. When I asked her to tell me, as a Buddhist, how she makes sense of trauma, she offered me her thoughts and this quote from Pema Chodron, If someone shoots an arrow into your heart, it is fruitless to stand there and yell at the person. It would be much better to turn your attention to the fact that there is an arrow in your heart The following are Mindys own words, For me, a lay Buddhist, dealing with trauma is
perhaps the highest test of my walking the eightfold path and the most intensive exercise in compassion. For me or anyone at the moment of trauma and for some time afterward there is suffering. The root of the suffering stems from my own attachments to whatever has been lost or damaged, but if I am to move out of the pain and suffering, then I must start by taking right action. This is best done for me by practicing right mindfulness. This is for me the first step and the hardest step in dealing with a trauma. I have to learn to stop searching for a blame center and even harder I have to stop wishing the loss had never occurred in the first place. All is impermanent and I must cut the attachment to my old reality. This is a time of meditation, breathing and accessing my new reality. This is a time of renewal of my commitment to the eightfold path and to my practice of compassion; compassion for those who have also felt loss, compassion to those who caused my suffering due to their own brokenness and hardest of all compassion for me. I think the compassion for myself is hardest because like it or not I will stumble. Once again, we see meaning come from trauma,

as Mindy uses the pain and suffering as a way to open the mind, to herself and to others, to help her gain a sense of empathy for another and as a way to gain wisdom for herself. The Islamic religion considers suffering to be an inevitable human experience. According to the Quran, suffering is used by Allah in many ways and for many reasons. Suffering can be merely the effect of an action. It can be used by Allah to punish the wicked. It can be used as a test for some to learn patience or other important lessons that benefit ones community. It is also used to tests ones sense of charity towards others. It can be used to test ones faith. Ultimately, the goal is to pass the tests so that eternal life will be one of paradise and not damnation, but just as important, one looks to find ways of turning the suffering into useful lessons that benefit both the individual and his or her community. I was fortunate enough to have an interesting exchange with a Muslim gentleman by the name of Omar Rashed, an alumnus of Rutgers University and the University of Michigan, Ann Arbor, where he earned his masters degree in social work. According to Omar, The same way that we
discuss a fine sword being tempered by fire - the katana is historically the best sword because of the intense heat that forged it - the trial is what makes someone as strong as they are, and it is, therefore, not bad. It is not suffering, but is rather a part of process of connecting with God. This idea is confirmed in the Holy Qur'an, Chapter 57, Verses 22-23: No evil befalls on the earth nor in your own souls, but it is in a book [of deeds] before We bring it into existence ... So that you may not grieve for what has escaped you, nor be exultant at what He has given you. Here we see that the meaning of the suffering is found as one

connects with God. Omar continued, The idea of pain, suffering, etc. as a tool to bring us closer to God
is also indicated in another place in the Holy Qur'an: Chapter 67, verse 2: [God is He] Who created death and life that He may try you - which of you is best in deeds.

The idea is that suffering and life struggles, loss and gain, are all geared towards passing the test"- with passing defined as connecting with God and loving God, while not allowing temporary losses or gains to make us change in our love for God."

Meaning can also be found through secular and humanistic means as well. Atheists do not believe in God or in a higher power; however, they have a moral code just as those of us who believe in God have a moral code. They also strive to find meaning in suffering. They channel their pain into community service. They express their pain through works of visual and creative art. They may contribute to scientific breakthroughs as a result of having experienced the trauma of losing a loved one to a devastating illness. Basically, those of us who believe in God or in a higher power do not corner the market in learning, growing, evolving and practicing compassion, empathy and kindness. It is a human characteristic to search for meaning. That desire to find meaning is true for both the religious and non-religious. No matter what your religious belief or your personal philosophy, traumas in this life may not make sense, but we can make sense of them and find meaning in the pain we suffer as a result of the trauma. We do not always suffer trials because we did something wrong or we are being punished. We may never know the reason, but good can certainly come of trauma. We may use it to draw closer to God or to a higher power. We can be refined like silver, making us better versions of ourselves. Best of all, we gain wisdom and compassion, which enables us to help others who are experiencing the same trial. My breast cancer support group is a prime example and a living illustration of wisdom through trials being imparted upon others. I have seen women transformed through their breast cancer treatment journey and the transformation is almost always one of evolution. They all would rather not have gotten breast cancer, but since they did, they all made a decision along the way to not let the trauma or suffering define them. They instead drew from inner strength they never knew they had and pressed forward to learn about life and what really matters. They learned about love and friendship, they learned about themselves and what they have to offer. Could they have learned all of these things had they not had to endure suffering? Perhaps they could have, but perhaps not. To illustrate this, one of my ladies, as I affectionately call the members of the network, named Heather Hirst, shared the following thoughts with me, I compare hearing the word
Cancer come out of your doctors mouth as the equivalent of being punched in the stomach while somebody else kicks you in the shin. There is this moment of uncertainty- where you hear the words and the actions but your brain isnt processing them correctly. I remember going through phases- first I was stunned, then I thought I was going to die, then I cried a lot and then I was really angry. I was angry that our family was facing uncertainty and knew a tough road ahead of us was coming but people are abusing drugs and committing suicide and laughing upon the gift of life. Overall, I was scared, like a terrified monster that was lurking under my bed, only this monster was cancer and it was coming to get me. She went on to say the

following about finding meaning in her journey, I feel that Cancer has given me the clarity to live a
better life. I see the value in what life has to offer and no longer get stuck on the little things that used to bother me. I dont let things mentally fester anymore. I also believe that Cancer has allowed me to love better and stronger and see people for who they truly are. I am no longer afraid to ask for help or admit that

I am not the superwoman I once wanted people to believe I was. Its just like the lyrics to that Tim McGraw song Live like you were dying. I am not sad for this diagnosis- I am firm in my commitment to embrace life- some days are harder than others. Heather has not let cancer defeat or define her, but rather,

she has evolved into a person who has become an inspiration to so many, including me. Anyone who has endured a trauma probably wished that it had never happened at one point or another. Perhaps we wish we could have had the improvements or positive changes in our lives without having to have endured the pain. Some find it difficult to emerge from the pain. Sometimes it takes others to take their hand and guide them out of the wilderness. Some find their faith tested to the point of extreme doubt. If you are one, please ask yourself these questions. How strong would my faith actually be if it was never tested? Without suffering, how would there be strong and wise people to guide me out of the wilderness in my own time of need? Logic would dictate that life would be better or easier without having to deal with pain or trauma, but would it? Maybe I am just trying to make sense out of something that does not make sense. Perhaps there are those who would believe that life is random and things happen for no apparent reason. Others may believe trauma happens to punish people. That may be true in some cases because I believe we reap what we sow; however, even in those cases, the pain can be turned for good as one learns from his or her mistakes and he or she allows that pain to mold him or her into a better version of him or herself. Searching for meaning is natural and sometimes difficult to do, but if we allow ourselves to learn, if we are teachable, we can allow pain and suffering to shape us into the person we are meant to be. If we are really fortunate, we can become a guide in the wilderness to others. That may be the most important purpose trauma serves in this life. With Love, Abigale S. Hassel, MSW, LCSW, OSW-C Oncology Social Worker