Many people will experience potentially traumatic events in their lifetime, whether it is a severe accident, a life-threatening diagnosis, combat exposure, community violence, or other kinds of abuse or trauma. Past research has focused on the development of mental health problems after a trauma, such as anxiety disorders, post-traumatic stress disorder, or acute stress disorder. However, not all individuals develop mental health problems after a trauma, and some actually may experience what researchers call “post-traumatic growth.”
What is post-traumatic growth?
Post-traumatic growth (PTG) can be defined as positive personal changes that result from the survivor’s struggle to deal with trauma and its psychological consequences1. The process of post-traumatic growth can lead to improved relationships with others, more compassion, openness, appreciation for life, spiritual growth, personal strength, and a renewed sense of possibilities in the world. This personal growth extends beyond pre-trauma functioning. Therefore, PTG it is not merely a bouncing back to the level of functioning prior to the trauma, but rather a sense of positive growth beyond pre-trauma functioning.1-2 Importantly, recent research has highlighted that post-traumatic growth is not the opposite reaction to that of post-traumatic stress; rather these are two separate kinds of responses that can occur within the same person simultaneously, and over time3, and that the experience of distress can actually promote the development of growth.4
How does post-traumatic growth develop?
Post-traumatic growth can be thought of as a meaning-making process, beginning with a sense of overwhelming distress following a traumatic event. This is followed by a “shattering” of the pre-trauma worldview; beliefs about oneself, trustworthiness of others, and the world, no longer feel valid or accurate to the survivor.5 This is a time when survivors naturally feel a lot of distress and will experience intrusive thoughts about the trauma. However, when one is on a trajectory towards PTG, these intrusive thoughts can lead to more intentional reflection about the trauma12. This intentional reflection can lead to a reduction of distress and the generation of new meaning making and perspective about the individuals’ life, relationships, goals, hopes, and values.
What Predicts Post-Traumatic Growth?
It is important to note that post-traumatic growth doesn’t occur in a vacuum. The social support network of the survivor is critical to the process of growth, both in how friends/family/healthcare providers react to the survivor’s disclosure about the trauma, and how they help the survivor generate new meanings, hopes, and values, in the aftermath of the trauma.6,7 In addition, increased social support increases the likelihood of PTG to be reported among survivors of diverse traumas,8,11 and stronger attachments are predictive of higher PTG.9 This suggests that the social support network not only has a key role in helping survivors recover from post-traumatic stress symptoms, but they are also key in helping the survivor cultivate positive growth in the aftermath of a traumatic event.
Research has also found that personality factors and coping style can impact the development of PTG. Individuals who report higher levels of optimism tend to report higher levels of PTG.3,8 Further, active and positive coping strategies, such as positive reappraisal and acceptance are associated with higher post-traumatic growth.3,8,9, 10 Finally, a sense of spirituality and religious coping is associated with the post-traumatic growth.3,8,9,10 It is important to note that post-traumatic growth, and post-traumatic stress, change over time, so any of these factors can have a positive influence on the recovery of a survivor and change their trajectory towards growth, and there is evidence that many people experiencing traumatic stress will experience an increase in PTG over time11.
This research highlights a very important hope; that while individuals will never be able to go back to exactly how they were before a trauma, they can recover, and grow and find meaning in many areas of their lives, and that experiencing some level of distress is a very normal part of the process, not only of recovery, but also of post-traumatic growth. This research also highlights that social support networks have a major role to play in this process to help survivors recover, and develop PTG. Finally, this research highlights that encouraging survivors to utilize active coping strategies may also help with the development of PTG.
Sources
1. Tedeschi, R. G., & Calhoun, L. G. (1995). Trauma & transformation: Growing in the aftermath of suffering. Thousand Oaks, CA, US: Sage Publications, Inc. doi:10.4135/9781483326931
2. Triplett, K. N., Tedeschi, R. G., Cann, A., Calhoun, L. G., & Reeve, C. L. (2012). Posttraumatic growth, meaning in life, and life satisfaction in response to trauma. Psychological Trauma: Theory, Research, Practice, And Policy, 4(4), 400-410. doi:10.1037/a0024204
3. Shand, L. K., Cowlishaw, S., Brooker, J. E., Burney, S., & Ricciardelli, L. A. (2015). Correlates of post‐traumatic stress symptoms and growth in cancer patients: A systematic review and meta‐analysis. Psycho-Oncology, 24(6), 624-634. doi:10.1002/pon.3719
4. Marotta-Walters, S., Choi, J., & Shaine, M. D. (2015). Posttraumatic growth among combat veterans: A proposed developmental pathway. Psychological Trauma: Theory, Research, Practice, And Policy, 7(4), 356-363. doi:10.1037/tra0000030
5. Danhauer, S. C., Russell, G. B., Tedeschi, R. G., Jesse, M. T., Vishnevsky, T., Daley, K., & … Powell, B. L. (2013). A longitudinal investigation of posttraumatic growth in adult patients undergoing treatment for acute leukemia. Journal of Clinical Psychology in Medical Settings, 20(1), 13-24. doi:10.1007/s10880-012-9304-5
6. Jeffreys, M. D., Leibowitz, R. Q., Finley, E., & Arar, N. (2010). Trauma disclosure to health care professionals by veterans: Clinical implications. Military Medicine, 175(10), 719-724. doi:10.7205/MILMED-D-10-00054
7. Lindstrom, C. M., Cann, A., Calhoun, L. G., & Tedeschi, R. G. (2013). The relationship of core belief challenge, rumination, disclosure, and sociocultural elements to posttraumatic growth. Psychological Trauma: Theory, Research, Practice, and Policy, 5(1), 50-55. doi:10.1037/a0022030
8. Wang, Y., Wang, H., Wang, J., Wu, J., & Liu, X. (2013). Prevalence and predictors of posttraumatic growth in accidentally injured patients. Journal Of Clinical Psychology In Medical Settings, 20(1), 3-12. doi:10.1007/s10880-012-9315-2
9. Schmidt, S. D., Blank, T. O., Bellizzi, K. M., & Park, C. L. (2012). The relationship of coping strategies, social support, and attachment style with posttraumatic growth in cancer survivors. Journal of Health Psychology, 17(7), 1033-1040. doi:10.1177/1359105311429203
10. Ogińska-Bulik, N., & Kobylarczyk, M. (2015). Relation between resiliency and post-traumatic growth in a group of paramedics: The mediating role of coping strategies. International Journal of Occupational Medicine and Environmental Health, 28(4), 707-719. doi:10.13075/ijomeh.1896.00323
11. Danhauer, S. C., Russell, G., Case, L. D., Sohl, S. J., Tedeschi, R. G., Addington, E. L., & … Avis, N. E. (2015). Trajectories of posttraumatic growth and associated characteristics in women with breast cancer. Annals of Behavioral Medicine, 49(5), 650-659. doi:10.1007/s12160-015-9696-1
12. Taku, K., Cann, A., Tedeschi, R. G., & Calhoun, L. G. (2009). Intrusive versus deliberate rumination in posttraumatic growth across US and Japanese samples. Anxiety, Stress & Coping: An International Journal, 22(2), 129-136. doi:10.1080/10615800802317841
Sarah Krill Williston is a PhD Candidate in the Roemer lab at the University of Massachusetts Boston. Sarah’s research primarily focuses on developing strategies to increase mental health literacy and reduce mental health stigma, to empower individuals to more effectively seek evidence-based mental health care for anxiety and trauma-related disorders. In addition, Sarah’s clinical interests include providing evidenced-based treatments (primarily CBT, ABBT) to individuals with mood, anxiety and trauma-related disorders, with a particular interest in working with military families, active duty service members, and veterans.
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