Editorial note: This piece is drawn from a qualitative study conducted in 2019 exploring psychoanalytic responses to meaning and mortality in the context of terminal illness. The findings are here woven into reflections on burnout, trauma, and therapeutic practice.
Traumatic growth
Part of the series: Surviving Hyperreality
In 2019, I conducted a study exploring and evaluating psychotherapeutic encounters which centred around questions of existential meaning in the context of terminal illness. I was interested in what happens when death moves into the immediate landscape, and finitude is no longer theoretical but lived. One theme that was revealed powerfully from this work was the concurrent emergence, or restructuring of ‘trauma’ and ‘growth’. Against the backdrop of terminal illness the familiar notion of post-traumatic growth, where healing occurs and life begins anew after the rupture was impossible. You might assume that, given such a stark outlook, patients would collapse into inertia or grief. And indeed, this was sometimes present in the findings. However, what repeatedly overshadowed it was a more subtle, less spoken of phenomenon: a type of ‘growth’ that happens within trauma. Growth that occurs while the trauma is still active, unresolved, ongoing.
Defining Growth
When I speak of ‘growth’ here I am not referring to any form of recovery or development in the linear way. I am conceptualising growth as libido in the Freudian sense, the excess of energy that propels us forward and insists on movement, even in the midst of pain. Far from tidy and not easily measurable, this is the messy dynamic motion of life that brushes against jouissance. It is not growth as healing, but as the psychic momentum that we cannot stop. A force embedded into and exploited by our cultural notions of ‘development’ ‘progress’ and ‘recovery’.
Cultural Framing
This notion feels particularly relevant to life today where identity has become a product and healing is marketed as a subscription. Day to day we are surviving within a system that is itself traumatising. Unlike acute traumatic events which can be understood through their links to a place in time, the trauma here is persistent, structural. Neoliberalism suggests, by its very nature, that there is no end that is not total — no conceivable outside. And yet, within this saturation, people are still ‘growing’, still transforming. The tangled, often painful process of movement itself asks us to reconsider what survival, meaning, and becoming really look like in the thick of things.
Reconsidering “Post”
We often think of trauma as something we survive, something we recover from, something that is — crucially — behind us. We speak of post-traumatic growth, of life after the rupture, as if the work of becoming only begins once the storm has passed. But perhaps this is a fiction we tell ourselves to make trauma more palatable. In practice, the story is messier. Growth doesn’t wait politely for trauma to be over. Trauma and growth can co-exist, and can even fold into each other in real time. We are often growing right from the roots of the wound. This is traumatic growth: not a life after the event, but a life blooming awkwardly from within it.
From the clinic to the collective
This concept emerged vividly in therapeutic work with clients facing death, but it translates just as sharply to the slow, grinding trauma of everyday life — life within neoliberal capitalism, where we are constantly stretched beyond our limits, where rest is framed as laziness and selfhood is something to be optimised.
Living in the Eye of the Storm
The idea that trauma is finished before we begin to grow is seductive because it offers a sense of sequence, of narrative resolution. But many of us live in situations where the storm doesn’t pass. The trauma isn’t over. The body doesn’t relax. Far from being rare, trauma is universal, everyone suffers in their own way. And in childhood, it is from the unique imprint of these early uneasy experiences that we assume our subjective position and expression. Many people decide to come into psychoanalysis when they feel trapped in or oppressed by the reverberations of this seemingly inescapable trauma. Maybe it’s a harmful relationship that keeps resurfacing or a relationship with food that feels inescapable. “The patient does not remember anything of what he has forgotten and repressed, but he acts it out. He reproduces it not as a memory, but as an action’ – Freud 1914 And psychoanalysis certainly can be a helpful place to think about all this internal stuff and to open up possibilities of shifting our position in relation to it. Opportunities that might look like growth. Or even transformation.
Internal/External Trauma
This ‘internal’ trauma is one thing by itself but we must also consider the nature of the trauma we undergo simply by continuing to exist. Of course it’s impossible to tell quite where one type of ‘internal’ trauma ends and the ’external’ trauma starts, they are dovetailed together, intermingled and in a constant negotiation with one another. Yet one feature of late capitalism stands out: its sheer too muchness . We are swimming in a semiosphere of productivity, self-surveillance, limitless stuff and endless ‘improvement.’ Here the trauma is ambient — not the sharp cut of a single event but the saturation of systemic pressure. And yet ‘growth’ still happens right here, under the weight of it. This is an expression on a macro level of the findings of my study into meaning and terminal illness, where an immersion into trauma acts as a catalyst.
Therapeutic Questions
In the therapeutic space, this presents a particular question: how do we reconceptualise growth when the client is still living inside the conditions that hurt them? How do we work with meaning when the pain will never become historic? In the study’s findings, therapists working with terminally ill clients repeatedly spoke about a strange intensification — a kind of aliveness that emerged not after the trauma, but during it. One participant described a client who had, in a sense, never been alive until she knew she was dying. There’s something quietly radical in this: that trauma does not simply shatter us; it can also pull us into life with a startling, unbearable clarity. It is not that suffering is good, or that growth redeems pain. It is that sometimes, trauma brings us so painfully close to the edges of ourselves that something new insists on forming.
The Neoliberal Trauma Loop
If we apply this frame to life under capitalism, we might recognise that we are also undergoing a ‘strange intensification’. Life demands our obedience to speed, to growth, to excellence – even, absurdly, in the midst of collapse such as the covid pandemic and the climate crisis. The burnout epidemic is perhaps not simply the after-effect of too much work; it is the signature of traumatic growth in process; peoples relentless stretching, surviving, and sometimes transforming within a system that will not release them. There is a strange kind of honesty in capitalism. It’s clear here that we don’t get the luxury of recovery. The trauma is persistent. And yet, we change. We grow. But this growth is laced with exhaustion, sometimes with bitterness. It is not a clean, redemptive arc; it is a fraught negotiation between survival and becoming.
The Unfinished
Psychoanalysis can remind us of the ways in which we can utilize this space. For we can accompany people in the unfinished, however painful, without seeking to mend or fix. The analytic act is a radically defiant one. It resists, at all costs, the false promise that things will make sense later. It insists we stay instead with what is still unresolved: and often unresolvable. One therapist in the study spoke about the therapeutic discourse as being a kind of vessel; something that holds and transmits experience without needing to ‘solve’ it. In this way, therapy can privilege traumatic growth: not as something to flee from, nor as something fixable, but rather as both an opportunity and an essential quality of being. In the grip of systems that constantly insist we demand more of ourselves and that we achieve it in a way that is somehow faster, better, more efficient: it might be a quietly subversive act not to run towards achievement but to ask what it is that you actually want— to grow messily, traumatically, here, now, backed into an invisible corner by a system that refuses to flinch.
Amy Finn is a psychoanalytic psychotherapist and writer based in the west of Ireland. She works to expand access to analysis and foster dialogue between psychoanalysis, literature, philosophy, and the arts. She is the founder of NEST, a psychoanalytic space – www.nestpsychotherapy.org.