Monday, August 27, 2012

The Emerging Field of Post-traumatic Growth

Richard G. Tedeschi and Lawrence G. Calhoun, from UNC Charlotte, are the principle architects of the emerging field of "post-traumatic growth." It's actually not a new idea - they've been working on this for a couple of decades now - but it seems to be getting more attention and recognition over the past five years or so.

Here is their definition of what PTG is, and is not:
What is posttraumatic growth? It is positive change experienced as a result of the struggle with a major life crisis or a traumatic event. Although we coined the term posttraumatic growth, the idea that human beings can be changed by their encounters with life challenges, sometimes in radically positive ways, is not new. The theme is present in ancient spiritual and religious traditions, literature, and philosophy. What is reasonably new is the systematic study of this phenomenon by psychologists, social workers, counselors, and scholars in other traditions of clinical practice and scientific investigation.

What forms does posttraumatic growth take? Posttraumatic growth tends to occur in five general areas. Sometimes people who must face major life crises develop a sense that new opportunities have emerged from the struggle, opening up possibilities that were not present before. A second area is a change in relationships with others. Some people experience closer relationships with some specific people, and they can also experience an increased sense of connection to others who suffer. A third area of possible change is an increased sense of one’s own strength – “if I lived through that, I can face anything”. A fourth aspect of posttraumatic growth experienced by some people is a greater appreciation for life in general. The fifth area involves the spiritual or religious domain. Some individuals experience a deepening of their spiritual lives, however, this deepening can also involve a significant change in one’s belief system.

Some Clarifications
Most of us, when we face very difficult losses or great suffering, will have a variety of highly distressing psychological reactions. Just because individuals experience growth does not mean that they will not suffer. Distress is typical when we face traumatic events.

We most definitely are not implying that traumatic events are good – they are not. But for many of us, life crises are inevitable and we are not given the choice between suffering and growth on the one hand, and no suffering and no change, on the other.

Posttraumatic growth is not universal. It is not uncommon, but neither does everybody who faces a traumatic event experience growth.

Our hope is that you never face a major loss or crisis, but most of us eventually do, and perhaps you may also experience an encounter with posttraumatic growth.
Several of their papers are available free online through their website. I highly recommend Posttraumatic Growth: Conceptual Foundations and Empirical Evidence (Psychological Inquiry, 2004) as a good introduction to their work and the research supporting it.

Calhoun and Tedeschi have also published a handful of books for those who want a more in-depth, clinically useful understanding of PTG: The Handbook of Posttraumatic Growth: Research and Practice (2006, as editors), Facilitating Posttraumatic Growth: A Clinician's Guide (1999), and Posttraumatic Growth: Positive Changes in the Aftermath of Crisis (1998).

For now, here is a brief overview of the basic ideas by at Pick the Brain.

Post-traumatic Growth: What Research Says About Why Some Grow While Others Break In The Face of Adversity

Have you ever heard of inspiring stories where people rise to impossible challenges and triumph? I’ve always wondered what gave them the resilience few others possess.

Lindsay Fox, Australia’s 10th richest person, grew up with an abusive father. So did Christina Aguilera (celebrity), Tina Turner (celebrity), Gloria Steinem (writer), Billy Hudson (entrepreneur & Professor), Maya Angelou (author and poet) and of course, the most famous example, Oprah Winfrey.

Yet we hear very little of what psychologists call “posttraumatic growth”. For example, a casual survey by Martin Seligman from the University of Pennsylvania, found that only 10% of his respondents are aware of the term. What is more widely known (97%) is its evil twin: post-traumatic disorder.

And that, he said, is the first problem: if you are aware only of the bad consequences of adversity, you’ll assume that’s where you are headed. This is why most people live life to avoid traumas.

When an awful event does happen – some of which, of course, are inevitable – they’ll actually talk themselves into depression. It is, after all, the only reaction you know of.

What more people need to be aware of is that growth, or at least resilience, is actually the normal reaction. If you experience anger, bitterness, grief and/or bursts into tears when something awful happens, that doesn’t mean you’re “going under”.

It just means you’re human.

7 More Factors of Posttraumatic Growth

Recognizing the growth potential of adversity is but one factor of posttraumatic growth. A number of research studies have since been conducted and here are 6 more factors that may explain why some grow while others break:

1. Spirituality
A study published in 2008 by psychologists O’Rourke, Tallman and Altmaier found that spirituality is highly correlated with posttraumatic growth. There are a few “common sense” explanations, but your guess is as good as mine.

So they did a follow up study and found that forgiveness predicted posttraumatic growth. Want to grow out of a trauma? Let go revenge and hatred.

2. Social Support
Those who suffer alone are more likely to break, researchers have found. But unfortunately, males tend to grieve alone in an effort to hide vulnerability – making them less likely to grow after a trauma.

Those who surround themselves with supportive people, on the other hand, are more likely to come out stronger when an adversity hits. And if you think only friends and families can do that for you, think again.

Support from those who have had your experience can be just as helpful – even if those people are strangers. Back in the day, this takes the form of bereavement groups. Today, it can be a Facebook group or an online community.

3. Opportunity For Emotional Disclosure
A peculiar thing pops out when you read stories about those who thrive after an abuse. Almost always, there’s someone in their life they can talk to. For Oprah, it was her mother (who was also being abused by her husband). For others, it was a sibling, a neighbour or a best friend.

As it turns out, the opportunity for emotional disclosure is a huge factor in post-traumatic growth. Being able to “let it out”, matters big time.

But here’s the surprising finding that comes out of the studies: you don’t even need another person for emotional disclosure. You can write in a diary or talk into a recorder. And all you need is 30 minutes a day.

4. Narrative Changes
Whether you grow or you break after an adversity depends largely on how you view it. For example, if you think being fired is a rite of passage to your destiny, you’ll naturally feel better about it.

The people around you are the most common source of such narrative changes. When people are facing an adversity, they are usually too busy to see another point of view – it takes a third party to point it out.

Other common sources of narrative changes: books. For example, if you read about how Colonel Sanders failed to sell his chicken recipe for years, it can make you feel better about losing your job. Who needs those greedy jerks, right?

5. Take Decisive Actions
People who take decisive actions are more likely to grow out of trauma. Decisive action means they do something about their situation.

For example, disaster survivors who become actively involved in rebuilding the community are more likely to grow out of the experience than those who wallow on their losses. This is also true for cancer survivors who begin to live a healthier lifestyle and the unemployed who starts his/her own business.

So what’s the decisive action to take when you lose someone close? Grieve! There’s this unspoken expectation in the society about grief: people should recover after a certain period of time, men shouldn’t cry, you should keep it private, etc.

These expectations often prevent decisive actions and thus lower the likelihood of posttraumatic growth.

6. Avoid Substance Abuse
Last but not least, avoid substance abuse at all cost post trauma. Substance abuse is not restricted to illegal drugs, alcohol or otherwise obviously harmful substances. It can be something as simple as sugar.

Contrary to popular belief, eating ice cream after a break up doesn’t lift you out of depression. If anything, it keeps you in.

There are a couple of reasons why: not only does sugar uses up mood enhancing B vitamins, it also drains your body of chromium, which is crucial in keep your blood sugar level stable. A crash in your blood sugar level would make you feel… well, depressed.

And if you can’t FEEL good, you simply can’t grow.

Andrianes Pinantoan is part of the team behind Open Colleges. When not working, he can be found on Cerebral Hacks, where he blogs about psychology and neuroscience.

Photo credit: ‘Flower in Asphalt’ by Big Stock

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