What Doesn't Kill You Doesn't Always Make You Stronger

The journey towards personal growth and the triumph over life's challenges are deeply ingrained aspirations in human nature.

These pursuits, often written about by me and celebrated in self-help literature and motivational speeches, reflect our innate desire for progress and resilience.

However, the path to self-improvement and overcoming adversity is far more nuanced and complex than popular wisdom often suggests.

This complexity became starkly apparent to me some years ago when I taught meditation and mentored individuals striving to overcome sorrows and difficulties in their lives.

During this time, I learned valuable lessons about the immense difficulty many face when trying to change and overcome deeply rooted issues and traumatic events.

For some, the events in their past were so impactful that suggesting predictable or tired strategies felt not just trite, but potentially harmful.

This realisation challenged my understanding of resilience and personal growth, leading me to seek a more nuanced perspective.

My scepticism towards commonly held beliefs about overcoming adversity was further reinforced when I recently encountered the work of Dr. Paul Conti, a psychiatrist specialising in trauma.

Conti's research offers a sophisticated understanding of how trauma impacts individuals, often in ways that endure long after the initial event. His insights resonated deeply with my experiences, providing a scientific framework for the complexities I had observed in my mentoring work.

His perspective also prompted me to examine more critically the popular sayings and beliefs about resilience that permeate our culture.

The Birth and Spread of a Cultural Mantra

In the realm of popular wisdom, few sayings have achieved the status and widespread acceptance of "What doesn't kill you makes you stronger."

This adage, attributed to Friedrich Nietzsche, has become a cultural touchstone, frequently repeated during times of hardship as a source of comfort and motivation.

It suggests that adversity, regardless of its severity, ultimately promotes personal growth and enhances resilience.

However, as our understanding of psychology, neurobiology, and trauma has evolved, this simplistic view of human resilience has come under scrutiny.

While it's true that some individuals may emerge from challenging experiences with newfound strength, the reality is often more complex and less optimistic than this saying implies.

Nonetheless, the popularity of this phrase has been bolstered by a variety of cultural products.

Kelly Clarkson's hit song "Stronger (What Doesn't Kill You)" topped charts globally in 2011. It has also become a staple in self-help literature, often serving as a motivational tool.

The phrase frequently appears in sports contexts, embodying the ethos of persevering through pain and adversity. Additionally, it is commonly used in military training to instil mental toughness.

The widespread use of this phrase has solidified its position in the collective consciousness, often being accepted without critical examination.

However, its prevalence does not necessarily equate to truth, particularly when considering the intricate nature of trauma and resilience.

"What doesn't kill you makes you stronger" suggests a straightforward connection between confronting challenges and personal growth.

However, the true effects of trauma and chronic stress on individuals are far more complex and often less optimistic.

The Physiological Impact of Trauma and Stress

When a person experiences trauma or chronic stress, their body's stress response system—the hypothalamic-pituitary-adrenal (HPA) axis—becomes activated.

This system releases stress hormones such as cortisol and adrenaline, preparing the body for a "fight or flight" response.

While this mechanism is essential for short-term survival, prolonged or repeated activation can lead to detrimental effects.

Chronic stress can weaken the immune system, making people more susceptible to illnesses. It is associated with an increased risk of hypertension, heart disease, and stroke.

Additionally, stress can lead to various gastrointestinal issues, including ulcers and irritable bowel syndrome.

Furthermore, trauma and chronic stress can alter the structure and function of the brain, particularly in areas related to memory and emotional regulation.

The Myth of Universal Resilience

The notion that adversity universally fosters strength overlooks the reality that we all possess varying levels of resilience.

Several factors influence how we respond to trauma and stress, including genetic predisposition, early life experiences, support systems, and prior trauma.

• Some individuals may be genetically predisposed to be more vulnerable to the effects of stress.

• A person's childhood and early development are critical in shaping their stress response system.

• The presence or absence of social support significantly affects an individual's capacity to cope with adversity.

• Previous traumatic experiences can render a person more susceptible to the negative impacts of subsequent stressors.

Another crucial aspect often overlooked in the "what doesn't kill you" adage is the cumulative nature of stress. Research has demonstrated that the effects of stressful experiences can accumulate over time, a phenomenon known as "allostatic load."

This suggests that, rather than strengthening an individual, repeated exposure to stress can actually heighten vulnerability to both physical and mental health issues.

Dr. Paul Conti's Perspective: Unveiling the Long-Term Effects of Trauma

The aforementioned, Dr. Paul Conti, psychiatrist and author of "Trauma: The Invisible Epidemic," offers valuable insights that challenge the notion that adversity inherently leads to strength.

Conti describes trauma as an "invisible epidemic," emphasising how its effects can be pervasive yet often unrecognised.

He argues that the impact of trauma extends far beyond the immediate aftermath of an event, shaping an individual's perception of the world and their place within it.

This invisible nature of trauma's long-term effects contradicts the simplistic notion that surviving hardship automatically leads to increased strength.

One of Conti's key insights is the "ripple effect" of trauma. He explains that trauma does not only affect the individual who experienced it directly; it can also impact their relationships, work, and even future generations.

For instance, an army veteran struggling with post-traumatic stress disorder (PTSD) may have difficulty maintaining close relationships, which can affect their spouse and children.

A child who experienced neglect might grow up with trust issues, hindering their ability to form healthy attachments in adulthood.

Additionally, an individual who faced workplace harassment may develop anxiety that impedes their career progression.

Dr. Conti, echoing the work of Dr. Bessel van der Kolk, emphasises that trauma is not only stored in the mind but also in the body.

Unresolved trauma can manifest physically through chronic pain with no apparent physical cause, autoimmune disorders triggered or exacerbated by stress, and unexplained fatigue or insomnia.

These physical manifestations of trauma illustrate that, rather than making a person stronger, unresolved trauma can lead to persistent health issues.

Dr. Conti strongly criticises the cultural tendency to glorify "toughing it out" or suppressing emotional responses to trauma.

He suggests that this approach often leads to a delayed onset of symptoms, with trauma manifesting years after the event.

It can also lead to unhealthy coping mechanisms, such as substance abuse or excessive work habits, and may transmit unresolved issues to the next generation, thereby influencing parenting styles.

These outcomes clearly contradict the notion that merely enduring hardship results in strength.

Perhaps most importantly, Dr. Conti emphasises that healing from trauma necessitates active processing and often requires professional assistance.

He provides examples of effective trauma treatments, including Cognitive Processing Therapy (CPT) for reframing experiences, Eye Movement Desensitisation and Reprocessing (EMDR) for processing memories, and mindfulness-based therapies for managing anxiety.

The necessity for these interventions highlights that trauma does not naturally resolve itself or transform into strength without appropriate care and attention.

While Dr. Conti acknowledges that some individuals exhibit remarkable resilience in the face of trauma, he emphasises that this is not a universal outcome.

Factors such as genetics, early life experiences, and access to support systems play crucial roles in determining how an individual responds to trauma.

This variability in outcomes further complicates the blanket statement that "what doesn't kill you makes you stronger."

The Enduring Shadow: Long-Term Consequences of Trauma and Stress

While the adage "what doesn't kill you makes you stronger" implies that overcoming adversity fosters resilience, the reality of trauma and chronic stress often presents a contrasting narrative.

The long-term effects can be extensive and debilitating, influencing numerous facets of an individual's life long after the initial traumatic event or stressful period has concluded.

Mental Health Consequences:

Many trauma survivors experience long-lasting symptoms of PTSD, including intrusive thoughts, nightmares, hyper-vigilance, exaggerated startle responses, emotional numbing, and avoidance behaviours.

These symptoms can persist for years, significantly impacting an individual's quality of life. Trauma and chronic stress are major risk factors for the development of mood disorders.

A study found that 26% of 9/11 survivors experienced depression 5 to 6 years later, and childhood trauma can triple the risk of developing anxiety disorders in adulthood.

Many trauma survivors resort to substances as a means of coping. Up to 59% of individuals with PTSD also meet the criteria for substance use disorder. This dual diagnosis complicates the recovery process and can result in further health and social issues.

Physical Health Impacts:

Chronic stress and trauma can have lasting effects on heart health. A study of Holocaust survivors revealed that they experienced higher rates of hypertension and heart disease decades after their traumatic experiences.

The persistent activation of the stress response can result in chronic inflammation, which is a significant risk factor for heart disease.

Trauma and stress can disrupt the immune system's regulation. Research indicates that individuals with PTSD are at a higher risk of developing autoimmune diseases, such as rheumatoid arthritis and psoriasis.

Furthermore, childhood trauma is linked to a 100% increased risk of developing autoimmune diseases in adulthood.

Chronic stress can contribute to premature ageing at the cellular level. Research has shown that trauma survivors frequently possess shorter telomeres, which serve as a marker for cellular ageing. This accelerated ageing process may result in the earlier onset of age-related diseases.

Cognitive and Neurological Effects:

Trauma can impair cognitive function, with many survivors reporting difficulties in short-term memory and concentration. These issues may persist even in the absence of full-blown PTSD.

Neuroimaging studies have revealed long-term changes in brain structure following trauma, including a reduced volume in the hippocampus—a region crucial for memory formation—and hyperactivity in the amygdala, which leads to heightened fear responses.

Social and Relational Impacts:

Trauma can profoundly impact an individual's ability to establish and sustain relationships. Survivors of trauma often experience trust issues and a fear of intimacy, which can result in social isolation and feelings of loneliness.

The long-term consequences of trauma can also influence career paths, as difficulties with concentration and stress management may lead to diminished work performance.

Additionally, symptoms of PTSD, such as hyper-vigilance, can render certain work environments challenging or even unmanageable.

The effects of trauma can extend beyond the individual. Children of trauma survivors may be at a higher risk of developing mental health issues, and parenting styles can be influenced, potentially perpetuating cycles of trauma.

Trauma and stress have significant economic impacts, including increased healthcare costs, reduced workplace productivity, and potential income loss due to work limitations.

The Perilous Path: The Dangers of Glorifying Suffering

The adage "what doesn't kill you makes you stronger" reflects a broader cultural tendency to glorify suffering and resilience. While resilience is undoubtedly a valuable trait, the uncritical celebration of overcoming adversity can lead to serious negative consequences.

Emphasising the strength gained through suffering can trivialise the genuine pain and long-term effects of trauma.

This mindset may discourage people from seeking the help they need. The notion that one should always emerge stronger from adversity can lead to blaming trauma survivors who struggle with lasting consequences.

It implies that if they haven't become "stronger," they have somehow failed.

Glorifying the ability to endure hardship can normalise oppressive or abusive situations, hindering essential social change.

The belief that suffering leads to strength might encourage unnecessary risk-taking or the endurance of harmful circumstances in the pursuit of personal growth.

Focusing on resilience in the face of trauma may divert attention from efforts to prevent traumatic experiences in the first place.

The expectation of resilience can impose additional stress on trauma survivors. Individuals may feel pressured to conceal their struggles, resulting in emotional suppression and increased psychological distress.

The belief that one should be able to overcome trauma independently may hinder or prevent individuals from seeking professional help. Those who do not feel they have become "stronger" may experience feelings of inadequacy or shame.

Instead of glorifying suffering, a more constructive approach would acknowledge the diverse responses to trauma, recognising that individuals react in various ways, all of which are valid.

It would promote early intervention, encouraging individuals to seek help promptly rather than endure suffering in silence.

This approach would emphasise the significance of social and professional support in the healing process. While celebrating resilience, it would also strive to prevent unnecessary suffering and trauma.

The Silver Lining: Opportunities for Growth Through Adversity

Understanding the impacts of trauma and stress is vital, but it's also important to acknowledge that overcoming challenges can lead to personal growth and increased resilience.

This concept, known as post-traumatic growth (PTG), offers a more nuanced perspective on the adage, "what doesn't kill you makes you stronger."

PTG refers to the positive psychological changes that individuals may experience as a result of grappling with highly challenging life circumstances.

It is important to note that PTG does not negate the distress or negative effects of trauma; rather, it can coexist alongside them.

Key aspects of post-traumatic growth include increased personal strength, as some individuals report feeling more capable of handling challenges after surviving a traumatic event.

Trauma can sometimes prompt the exploration of new life paths or opportunities that were previously unconsidered.

Some survivors experience deeper connections with others and a greater appreciation for their support networks.

A traumatic experience can lead to a renewed sense of gratitude and a shift in life priorities.

Additionally, some individuals report deepened spiritual beliefs or a stronger sense of meaning in life following trauma.

Several factors can influence whether an individual experiences personal growth following adversity.

• Strong social support is essential in facilitating this growth.

• Active, problem-focused coping strategies are more likely to result in growth compared to avoidant strategies.

• Traits such as optimism and openness to experience may predispose individuals to achieve growth.

Interestingly, moderate levels of trauma exposure are more closely associated with growth than either very low or very high levels.

Growth often necessitates time and reflection to effectively process the traumatic experience.

It is essential to emphasise that post-traumatic growth is not a universal or guaranteed outcome of trauma. It does not occur for everyone, and its presence does not diminish the very real and often long-lasting negative effects of trauma.

Moreover, the expectation of growth should never be used to minimise the suffering of trauma survivors or to pressure them into "getting over it."

Redefining Success: Cath Bishop's perspective in "The Long Win"

Cath Bishop, a former British Olympic rower and diplomat, presents a refreshing perspective on adversity and success in her book "The Long Win."

Her insights serve as a compelling counterargument to the mentality of "what doesn't kill you makes you stronger”, in the realms of elite sports and high-performance environments.

Bishop critiques the conventional narrative that equates struggle and hardship with success and strength. She argues that this mindset can be counterproductive and even detrimental.

The focus on overcoming immediate challenges may lead to a neglect of long-term well-being and development. Continuously pushing through adversity without sufficient support or recovery time heightens the risk of burnout and mental health issues.

Defining success solely through the lens of overcoming hardship overlooks other essential aspects of personal and professional growth.

Instead of glorifying struggle, Bishop advocates for a more nuanced and sustainable approach.

She emphasises collaboration over competition, focusing on teamwork and mutual support rather than individual battles against adversity.

Bishop prioritises continuous learning and personal development over simply overcoming obstacles. She recognises that physical and mental well-being are essential for long-term success and resilience.

Additionally, Bishop expands the definition of success beyond merely winning or overcoming hardship to include personal fulfilment and a positive impact on others.

Bishop's insights extend beyond the realm of elite sports. In various sectors, from business to education, her approach emphasises the importance of long-term, sustainable performance over short-term victories achieved at any cost.

She acknowledges and values diverse pathways to success, not solely those characterised by extreme adversity. Bishop advocates for a transformation in organisational cultures, shifting the focus from glorifying struggle to fostering well-being and collaborative growth.

Redefining Resilience and Success in the Face of Adversity

The bottom line is, the reality of how trauma and chronic stress affect individuals is more complex and often less optimistic than “what doesn’t kill you makes you stronger” suggests.

Moving forward, it is essential to acknowledge the various ways individuals respond to trauma and stress.

We should advocate for early intervention and professional support for those who have experienced trauma, while also prioritising the prevention of unnecessary suffering and trauma whenever possible.

Establishing compassionate environments that facilitate healing without imposing expectations of resilience is vital. We should adopt a holistic perspective on success that emphasises sustainable growth, collaboration, and overall well-being.

By reframing our understanding of adversity and strength, we can foster a more empathetic society that recognises the complexity of human experiences.

This approach not only supports individuals who have faced trauma but also promotes a more realistic and healthy perspective on resilience for everyone.

Ultimately, while some challenges may indeed foster growth, it is time to retire the blanket statement that "what doesn't kill you makes you stronger."

Instead, let's adopt a balanced view recognising both the potential for growth and the lasting effects of trauma and stress on lives.

By transcending the simplistic belief that adversity invariably leads to strength, we pave the way for a more nuanced, empathetic, and ultimately more constructive approach to navigating life's challenges.

"Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, 'I will try again tomorrow.'" Mary Anne Radmacher