PTG (Post Traumatic Growth) & Positive Psychiatry

Trauma doesn’t just hurt; it reorganizes. It reshapes sleep, memory, attention, stress physiology, trust, identity, and the story you tell yourself about what life allows. That’s why I start from one non-negotiable place: respect for suffering. And I make one crucial distinction that changes how we think about trauma recovery and PTSD treatment, especially for complex PTSD: change is not the same thing as damage.

POST TRAUMATIC GROWTH: We then take on a topic that’s often misused and often feared: post-traumatic growth. I’m not talking about silver linings, forced resilience, or spiritual bypassing. I’m talking about a careful, trauma-informed inquiry into what can become possible after survival, and why “getting back to who you were” can be an unrealistic and painful goal for many people. We walk through the neuroscience of growth after trauma, including the default mode network and meaning making, the salience network and threat-based attention, executive control, and why neuroplasticity needs safety to move in a healing direction.

On the clinical side, I dig into timing, readiness, and language. Growth introduced too early can harm. Growth demanded can shame. Growth framed carelessly can invalidate grief. I share practical ways to listen for readiness, how to invite complexity without imposing meaning, and why growth can coexist with distress. We also talk moral injury, relationships as co-regulation, existential reframing without coercion, and the inner work clinicians need to do to avoid burnout while staying human.

www.JainUplift.com

Transcript

Tempo: 120.0

Rakesh Jain, MD, MPH 0:08

Well, welcome, and thank you for being here. You're listening to another podcast episode called Positive Psychiatry with Rakesh Jan. And this is a space devoted to studying, not necessarily prescribing nor demanding, but carefully examining the possibility of growth after trauma. I'm your host, Rakesh Jan. And before we talk about growth, and before we talk about meaning, strength, or transformation, we need to begin somewhere far more important. And I think we need to begin with respect for suffering. That's a necessary grounding because you know trauma changes people. And that statement alone requires no defense, no citation, no justification. Because trauma changes us, humans, biologically. It alters stress physiology, threat perception, memory, sleep, inflammation, and even the meaning making networks in the human brain. And needless to say, trauma changes people psychologically. It reshapes our identity, our sense of safety, trust, agency, and the stories we tell ourselves about who we are and what the world allows. And you know, I've also seen trauma changes people relationally. It influences things like attachment and boundaries and intimacy. It makes people withdraw, takes away their sense of belonging. And trauma can change people inside out, even existentially. And it can fracture assumptions about fairness and goodness and purpose and even faith. Faith in ourselves, in religion, in spirituality, whatever that might be. Everything I've said so far is not controversial. But what might be controversial and often deeply misunderstood is what we're going to say next. And this is a crucial distinction. Because change is not synonymous with damage, and recovery is not the end point of healing. Yeah, you heard me correctly. Let me say it again. Recovery is not the endpoint of healing. That does not mean trauma is good. It does not mean trauma is necessary. It does not mean trauma should be reframed as a gift, because trauma really is injury. But the truth is, human beings are not inert objects. We are adaptive, meaning-making, relational organisms. And sometimes, oh just sometimes, after survival, something more becomes possible. Not because trauma was good, but because humans are capable of integration and humans are capable of post-traumatic growth, which is the whole point of this conversation. Now, this might be a difficult conversation because the idea of post-traumatic growth often makes people uncomfortable. Because some incorrectly do hear it as invalidating. Others might hear it as minimizing pain. Some might fear that they're not being listened to. Or they might feel that if you didn't grow from your trauma, did you somehow fail? So let me be very clear right from the start. It's in fact not even required. And it certainly does not justify trauma, and it never invalidates suffering. So if growth does not emerge from trauma, nothing has gone wrong. But if growth does emerge, that could be a significant positive. And if growth emerges, that does not erase what was lost. So in today's podcast, we're going to treat growth as a possibility. Okay. The problem with how trauma is often framed is sometimes quite challenging. It's also quite true that our modern ways of thinking about trauma, particularly in the last decade or two, have saved lives and marriages. But the focus is on symptom reduction, on stabilization, on increasing safety. This is all good. This is essential. But too often the implicit message becomes this the goal is to return you to who you were before the trauma. But for many survivors, this goal is not only unrealistic, it's painful. Because trauma doesn't just interrupt life, it changes the reference point of life. So often the deeper questions that emerge are as follows: Who have I become? Who am I now? So this is not a symptom question. This is an identity question, a meaning question, a human question. And that deserves scientific seriousness and definitely not platitudes. So, no, this podcast is not about silver linings, it's not even about forced resilience, and it most certainly isn't about toxic positivity or spiritual bypassing. This is not even a promise of transformation. This is in fact an inquiry. An inquiry that is based on neuroscience and psychology and psychiatry and moral injury research and lived human experience. What we will talk about is the following. Because to introduce a conversation about post-traumatic growth with a patient, timing is really important because safety precedes growth and stabilization precedes exploration. Right? So to be careful about when we introduce the concept of post-traumatic growth to our patients is profoundly important. And the truth of the matter is growth concepts introduced too early in a trauma journey can, in fact, harm. And growth demanded too forcefully can actually silence the individual. And growth framed carelessly can invalidate grief. These are three mistakes we clinicians cannot afford to make. But when growth emerges authentically, it does so after a period of time. It can be quite magical. So if you're a clinician and you're listening with curiosity and not obligation, and you're not being asked to add one more task, then I am inviting you to refine how you listen. But if you're a survivor, nothing in this episode is a demand upon you. You do not owe growth to anyone. Take from this episode what resonates with you and leave the rest. But if you are both, you're both a clinician as well as a survivor, just know please, you're not alone. You're not alone. So let's continue this conversation about post-traumatic growth one more time. We're not looking for trauma in order to grow. But rather, if trauma has occurred, we don't want to waste the opportunity to at least consider the possibility of growth from this experience. I say we change gears a little bit and talk about the neuroscience and psychology of growth after trauma. So now let's do something interesting. Let's begin with the foundational premise. The foundational premise is trauma is not merely a psychological event, it is a biological event too. So trauma alters threat detection systems, stress hormone signaling. It even alters our immune and inflammatory pathways. And my goodness, sleep architecture is decimated. Memory consolidation is abnormal, and attention? What attention? Patients often say. And meaning-making circuits that we will be talking about momentarily are also deeply affected. So post-traumatic growth, which by the way is also known by its acronym PTG in the scientific literature, cannot be understood without understanding how the brain reorganizes itself after threat. Importantly, growth does not mean that the brain returns to normal. It just means that the brain adapts, sometimes in ways that reduce suffering, but sometimes in ways that deepen perspective, and sometimes in ways that increase complexity in a beautiful way. One of the most important psychological insights in trauma research is this. Trauma disrupts core assumptions. Assumptions such as the world is predictable, that people are safe, that effort automatically leads to reward, that I have agency. So trauma doesn't just create fear, it can create literally a moral injury, an injury to how we know the world. And from a biological standpoint, this disruption is reflected in altered coordination between these three brain networks. The first one is the default mode network. The second one is the salience network. And the third one, the executive control network. Growth, post-traumatic growth, when it occurs, represents reconstruction. The brain does not reinstall old assumptions, it in fact builds new ones. I say we ought to talk about the default mode network because it's involved in meaning making. So let's talk briefly about it. And the DMN, which of course is the acronym for default mode network, is active when we are reflecting on ourselves and we are constructing a personal narrative, or thinking about the past or the future, or asking questions of meaning and self-identity. And trauma sadly can fragment the default mode network. And this fragmentation leads to at least the following four: it leads to intrusive memories, a disrupted narrative continuity of life, identity confusion occurs, and rumination. Rumination without integration. Oh gosh, you have seen this countless times in people. Post-traumatic growth appears to involve the reintegration of the default mode network with other networks, particularly those involved in emotional regulation and executive control. So let's put it in simple terms. Growth reflects a shift from what happened to me to what does this mean about who I am now? And this shift isn't just neurological, it's not philosophical, it's in fact both. Now let's talk a little bit about the salience network. This is a brain network system that is responsible for determining what deserves attention. After trauma, neutral cues can become dangerous. Like going to the grocery store can become a catastrophically difficult activity for someone. And the attention span narrows to just the threats. And even novelty, things that one enjoyed before become potentially threatening. And ambiguity feels intolerable. Everything needs to be known for a fact, which of course is not possible in life. Now, all of these are highly adaptive in the short term. But the problem is, as you can well imagine, these on a persistent basis just completely destroy human life. So for growth to occur, the brain must slowly regain the capacity for flexible salience attribution. Now you see, don't you, why the salience network is of such importance to us as we consider the value of post-traumatic growth. It does mean that expanding what the brain can safely attend to in terms of connection, curiosity, possibility, positive value does require the salience network to normalize. Growth requires both. We should also briefly talk about the importance of neuroplasticity, because for post-traumatic growth, neuroplasticity is a necessity, though it's not sufficient by itself. It might be tempting to say something as you know simple as growth happens because of neuroplasticity. Well, that's true, but that's an incomplete statement because neuroplasticity simply means the brain can change. Neuroplasticity does not tell us what changed, in what direction. Trauma can produce, you know, sadly, neuroplasticity, but in the wrong direction. Hypervigilance, avoidance, numbing. That's neuroplasticity too. It's just in the wrong direction. So what we're looking for is growth-driven neuroplasticity that elevates relational safety, increased positive meaning making, increased emotional integration, and a sense of greater agency in life. Because plasticity without safety just often deepens psychopathology. We're not looking for that. Now we will talk about emotional processing and growth, because a crucial finding in post-traumatic growth research is this. Growth is not emotional suppression. In fact, to the contrary, in fact, attempts to avoid emotion often correlate with less growth. So growth is more likely when individuals are able to tolerate emotional complexity and are able to experience grief without being overwhelmed, and are able to hold ambivalence in their mind and can reflect without dissociating. Now you see, right, why offering post-traumatic growth interventions too early, too quickly would in fact not be a wise move. Now, neurobiologically, this would reflect improved coordination between the limbic system, the prefrontal modulation, and of course enhanced awareness. So growth is not emotional positivity, it's beyond that. It's elevation in emotional capacity. Now I think we really should spend some time talking about rumination, because rumination is a double-edged sword. Now we often treat rumination as pathological, but brain trauma research distinguishes between two things, intrusive rumination and deliberate rumination. Let's talk about the components of each of them. So intrusive rumination is repetitive, it's involuntary, it's distressing, and it is threat-driven. On the other hand, deliberate rumination is reflective, it's meaning-oriented, and quite importantly, it's exploratory in nature. Post-traumatic growth is associated in individuals with a gradual shift from intrusive to deliberate rumination. But this shift is not forced. It emerges over time, very often with support from us clinicians. So interrupting intrusive rumination is essential, but eliminating reflective rumination can completely stall integration. Now, why don't we talk about the role of relationships in brain change? Relationships the patient has with everybody, but also with their therapist, their prescriber. Because no discussion of growth is complete without having a discussion on relationships. Because the human nervous systems are co-regulated, and safety is learned in connection, isn't it? And meaning is often constructed relationally. So people often define themselves and their roles as husband or wife or partner or parent or as a child. And supportive relationships buffer stress physiology, they facilitate, well, emotional processing and cognitive flexibility, and they scaffold identity reconstruction. Reconstruction because trauma took that away. So isolation, even in the absence of danger, narrows the possibilities for our patients. So part of post-traumatic growth interventions are certainly improvement in relational capacity and increased socialization. You know what else is quite crucial is spiritual and existential reframing. Because one domain of post-traumatic growth, in fact, does involve spiritual and existential reframing of life. Now, none of this requires religion. A person can be an atheist, agnostic, or religious. None of that matters. Because an exploration of this particular concept alters priorities and deepens engagement with meaning, expands moral awareness, even increases humility and can help redefine purpose. And neurobiologically, this may involve, you know, things like reduced egocentric bias. Because what trauma often does is makes an individual narrow their worldview to themselves and their pain and their fear. This is very adaptive early on, but late on, in the latter part of their recovery, this can be quite problematic. Be cautious here, clinicians, my fellow clinicians, because you don't want to offer a spiritual reframing. What you want to take is the humanistic and spiritual meaning the individual already possesses and expand on that. Please do be careful, otherwise, it can come across as coercive. One of the more misunderstood things about post-traumatic growth research is that post-traumatic growth often coexists with ongoing distress. People often say it's one or the other. You have to be completely recovered before you move on to growth. But that's a deep misunderstanding, not one that you and I wish to have. They expect growth is going to replace suffering, but in reality, growth replacement. Growth can exist with suffering at the same time. Though with greater and greater growth, the level of suffering from the individual is diminished. So a person may feel deeper gratitude and deeper grief at the same time. That is totally a thing. They can have increased strength and vulnerability at exactly the same time. Both of those are beautiful values and virtues. They can also have clearer values in life and ongoing sadness about their losses or their trauma. Let's not see that coexistence of post-traumatic stress symptoms and post-traumatic growth symptoms that occur at the same time as pathology. They're not that in fact is integration. Now, science does not say, science does not say that growth is universal or we can force it upon individuals like prescribing, you know, something. Nor does growth predict that a person will fully recover from PTSD. Growth, in fact, PTG, in fact, does not follow a predictable timeline. So yeah, let's be careful. The science here is nuanced, and our language must be nuanced as well. So far, just to recap, what we have learned together is a deeper understanding of how trauma alters brain networks, how meaning-making systems reorganize themselves, and why safety and relationships matter biologically, psychologically, socially. And this is crucial, folks. Don't let this get away from you. That post-traumatic growth is complex, it's nonlinear, and it can coexist, coexist with post-traumatic stress symptoms. So science in the service of humanity is what we're looking for. We're not looking for certainty, we're looking for curiosity. We clinicians face a really important question. Really, it's a quiet internal question when we're talking about growth. The question is, is it even appropriate to talk about growth with a patient who has experienced a life-altering traumatic situation? Well, there's no checklist that answers this question reliably. But having said that, we clinicians must develop attunement to timing, readiness, language, and the power dynamics. So post-traumatic growth is not something we introduce because just because we believe in it. We do so because it can be a remarkably positive thing in the journey of someone who is recovering from a serious or any type of traumatic issue. So how do we assess for readiness without asking for it directly? Obviously, a bad mistake would be to ask a patient, have you experienced any growth from this trauma? Can you imagine if this question is asked too early, how it would feel to the patient, it might even feel shaming. So instead, we look for readiness indirectly, not through interrogation. So a sign that a patient might be approaching readiness to have a conversation about post-traumatic growth is when a patient's self-narrative is becoming more and more coherent, and that their emotional flooding during recounting is diminished from the acute time period after the event happened. Perhaps our patient is even experiencing and talking about curiosity about self-change. And there's emerging agency and language. So somebody might say things like, and I'll give you some examples, I'm not the same person anymore. Or they might say, I see things differently now. Something has shifted in me. They might perhaps even allude to something like this. I don't know what this means yet, but and these are invitations, I think, from our patients that they are ready for a deeper conversation. And what we ought to, of course, keep in mind is that the language we use should be designed to open, not obviously language that closes conversation. And language is not neutral and trauma work. Our words are really important. What words we say or don't say, how we say it. Ah, all of those are profoundly important. Examples to avoid, let's talk about that, is something like you had the trauma to help you become stronger. Oh gosh, you can imagine how poorly that'll be received by anybody. Or to say things like this, everything happens for a reason. It's also not appropriate to too early say, you grown so much from this, or something as potentially painful as at least something good came out of it. Because these statements impose meaning and they collapse complexity and often silence grief. Now, let's contrast that with language that opens space. I'll give you some examples. Do you see how inviting that comment is? We could also say things like, I hear both your pain, and that something new is emerging. We could say things like, there may be more than one truth here. Or we don't have to yet name this, but let's observe it. Those can be very powerful invitations to an individual who's emerging into post-traumatic growth. We should also never forget that as clinicians, we do hold power, and our interpretations can carry a lot of weight, even when unintended. I have seen patients who, 30 years after I have seen them, they will tell me what I told them. Then I of course have no memory of it, but for them, they do. So as a clinician, we do hold power. We should be cautious about how we use it, how we use language. So think about this. Think about when we might want to be particularly gentle, when we have survivors of abuse, or patients who have a history of being invalidated by family or friends, perhaps even individuals from marginalized groups, and those who've suffered from moral injury. Here, ethical work requires a real radical respect for the patient's autonomy. So let's not treat growth just as a treatment goal, but one of the one of the pillars of helping someone who has experienced a lot of trauma and in fact are suffering from post-traumatic stress disorder or even complex PTSD. What we want to do is offer them the opportunity to have even that aspect of the recovery process grow with them. The clinical goals always remain the same. We want to offer our patients safety and stabilization, and of course, improved functioning in everything they touch personal relationships, work, the relationship itself, and of course a greater range of emotional processing abilities and agency. We should also learn the art of working with ambivalence. So post-traumatic growth clinicians are really people who understand that. Because patients might say things like, I hate this trauma has changed me. But it did. I wished it had never happened to me. And it did. I feel stronger. But you know what? I resent that. Did I really need to experience trauma to be tougher? See, this is ambivalence. It's not resistance, it's ambivalence. This is a sophisticated way the brain is thinking. So we clinicians should in fact normalize this complexity, not resolve it. We should be things, you know, statements like this can actually be very helpful. We can tell our patients both can be true at the same time. You can be very angry, yet have grown from this experience. You don't have to choose one interpretation over the other. Both could be equally true. So this ambivalence allows growth to breathe without feeling pressure. Now, moral injury is occurring more and more and more in modern day society. So when trauma involves betrayal or injustice or ethical violations, meaning making becomes very dangerous. So clinicians in such situations, instead of offering their interpretation, could ask these three questions. Question one, what values feel more important now? Question number two could be, what feels unacceptable to you after this? Do you see how open-ended these two questions are? And the third is, what lines in life feel clearer to you? And these are really beautiful questions because they pass no judgment. They reveal curiosity on part of us clinicians, and that can lead to great, great help for the patient. Now, so far we have talked about patients, but it's impossible to talk about post-traumatic growth unless we talk about ourselves, our own inner work. And we rarely acknowledge the truth here, do we? That we clinicians often want growth not just for our patients, but for ourselves. And often working with patients with post-traumatic stress leads to us becoming harmed in the process. We have to be honest about that. It's sometimes very hard to carry these burdens. But because growth offers hope and because it counterbalances despair, I think we ought to be talking about ourselves too. And we must examine our own beings. How comfortable or uncomfortable are we with suffering? Do we want suffering to quickly disappear so that we can reduce our own discomfort? Or are we patient? Do we desire a narrative resolution immediately, right off the bat? Or are we patient about that? And how about this fear of helplessness that appropriately affects us clinicians when a patient is sitting in front of us suffering? Can I be someone who can pause and allow things to unfold at their own time? So I think we ought to turn the lens inwards as well. Don't you think that's the right way to go? And you know, we face a lot of cumulative exposure and moral injuries and grief and exhaustion, sometimes even loss of meaning. You and I have seen a lot of burnout, haven't we? Which I think is a kind of post-traumatic stress. Now you see why post-traumatic growth is something really important to us as well. So for clinicians, growth might look like the following: we might have clearer boundaries, deeper humility. We might redefine our purpose as clinicians, we might become passionate advocates. All of these are possibilities. So post-traumatic growth is not working harder, it's often working differently. So a clinical case reflection, I want you to consider two clinicians seeing the same survivor. One might say things like, you are incredibly resilient. Look how much you have grown. The other might say something like, something about this experience seems to have changed how you hold your life without taking away the pain. Do you see the second approach leaves one with more space to experience the full breadth of human experience, which is a combination of pain as well as growth? So growth is invited, folks. It's never imposed. Timing is everything. The language we use must be soft, approachable. And if the individual is not yet receptive, it's okay to leave it hanging in the room. And to appreciate that distress and growth can coexist. In fact, they often coexist. If growth does not appear, please don't feel that you have failed the patient or the patient has failed themselves. But if growth does appear, it must be protected from oversimplification. Trauma cannot be rewritten as, oh my God, I'm so glad this happened to me. That's a false narrative. That's not post-traumatic growth. That's denial. So now we move on to the final part of our conversation, which is integration and living forward and, of course, sustaining growth for our patients. We will talk about what post-traumatic growth is and it's not, and we've talked about the science behind it, but we also talked about the traits we clinicians can develop that can be very helpful to our patients. We are now going to talk about another very important concept I've learned the hard way over the last few decades, which is a process of integration and growth unfolds over time. Because in reality, growth is never a single event. People don't go from at 12.05, I was in the throes of post-traumatic stress, and at 12.06, I was warmly embraced by post-traumatic growth. Oh no, that doesn't happen at all, nor should it. So integration means that the traumatic event no longer dominates self-identity and doesn't dictate every interpretation. And a person is no longer consumed by the psychological distress. Now, none of this means that the memory is erased. Oh no. It just means a larger story has emerged. A full story, an entire story has emerged. Because with post-traumatic growth, that story is bigger, more complex, and of course far more useful to the individual. Because many survivors struggle with an unspoken fear that I will never live fully again. Just look at the way I was betrayed before. It'll never happen again. That's what we want to help individuals recover from. And for them to remember, growth does not mean forgetting. I'll give you an example. After a spouse has passed away, the surviving spouse often feels that they must be sad continuously. They must be traumatized continuously. Otherwise, the love that they experienced for their spouse wasn't real. And see, that's the role of post-traumatic growth, is to offer them greater possibilities that your loss is real. It'll always be real. But there's also the possibility that you can find meaning and purpose in your relationship and past and future relationships and with your own self that in some ways, that in some ways respecting the memory of someone who has passed away is to find purpose and joy in life again. This is all something to be introduced gently and at the right time. And we should also remember post-traumatic growth is never non-linear. It doesn't go from one to two to three to four at a regular pace. No, post-traumatic growth is not linear. It's not even a stable trajectory. But it is something that deepens over time, sometimes plateaus, sometimes recedes a little bit, and then it can re-emerge later in different forms. That is the typical trajectory of post-traumatic growth. It's a capacity that ebbs and flows. But in a fair number of people, particularly if they're offered guidance and support, the overall trajectory is in the correct direction, in a direction that is more adaptive for the individual. Identity after trauma is often deeply fractured. People often say after trauma, I no longer recognize myself. I don't know who I am anymore. It feels like a part of me is stuck. I don't exactly know what to do. And post-traumatic growth does not require us to become a new self. Oh no, we never want to let go of the past. But we don't want to be stuck in the past either. Flexibility is a great tool to have both our painful past, but also to have a more hopeful future. And this meaning making should happen without grand narratives. So one of the dangers that I would like to alert you to in post-traumatic growth work is pulling towards grand meanings, like things like this was God's plan all the time. That shuts down conversation. It sweeps away purpose. It's too definitive an answer, does not allow for the individual to look for real growth, which comes in small steps. Smaller, clearer priorities come when post-traumatic growth is organic, guided by a clinician, perhaps. Because what happens is a quieter sense of what matters. So, clinicians, we should resist pushing too hard towards these destiny narratives or cosmic explanations or redemptive arcs. No, I think what should allow for all the experiences to emerge and to be part of the individual. Even though it may seem like day-to-day changes are small, they can in fact be quite profound in the long run. We are not looking for speed, we're looking for sustainability. And of course, we're looking for the direction of the growth to be in a positive arc. Okay, let's see. What else should we talk about? Well, perhaps we should talk about when growth does not appear. If the individual who had trauma and had sleep difficulties or anger problems or depression or heart racing or whatever, nightmares perhaps. If that's all gone, you know what? That in itself is a worthy goal. So if you don't detect any arrival of post-traumatic growth, and the individual isn't particularly open to a conversation on that, you know what? Nothing got lost. Some people just do not experience post-traumatic growth from a significant trauma. That's okay. What they may have is acceptance. What they may have is stability. What they may have is something important called relief. These outcomes are not lesser. No, no, no. So it's okay. It's okay. So sustaining this post-traumatic growth without pressure from us clinicians is what we want. We don't want the patient to feel that they gotta perform a certain way, or that we have certain expectations, or we're comparing them to others, like saying, Well, my other patients who return from war after a year or two, they are morally so strong. No, that would be comparison and could come across as a lot of moral pressure. Instead, the way we generate and foster post-traumatic growth is gently offering guidance when it's appropriate. We offer relational safety, that's really a big deal. We're flexible, and of course, we create a situation where the patient themselves feels that they have permission to change. That's where things really happen. So we clinicians ourselves should, you know, move forward. As I said before, this is hard work, folks. Meaning often gets eroded. Often early career clinicians, bright-eyed, bushy-tailed, want to take on the world, but after the world has understandably been rough on them, cynicism can creep in. So yeah, we do need to be very thoughtful about ourselves too. And to think about your post-traumatic growth or your own growth is not a sign of weakness. It is in fact a sign that you are a wonderful humanistic clinician who makes sure that you're taking care of yourself as well as you're taking care of others. So as we close out this conversation, let me just reflect on a few things. Trauma absolutely leaves marks on our psychology, our sociology, and as we've talked about earlier, on our biology. And some of these wounds are visible, most are invisible. Many are lifelong. And post-traumatic growth is not designed to erase those marks. It just allows them to be held with a larger life, not a perfect life, but a larger, a well-lived life. So thanks so much for being on this journey with me to talk about post-traumatic growth. And trauma itself doesn't make people stronger, but if trauma were to occur, were to occur, and it as you know, happens far too often, at least honoring the person's pain and suffering with the possibility of post-traumatic growth, to me, appears to be the highest calling of any clinician. Thank you, folks. This is an episode of Positive Psychiatry with Rakesh Jan. I was just so glad to be with you to talk about this very important topic. Goodbye for now, and I look forward to seeing you on the next one.