What doesn’t kill you makes you stronger…

…or so the saying goes. And yet for many people, a traumatic event leaves them feeling weaker, somehow less than they were and believing that life has changed for the worse.

The media is full of stories and examples of “permanently damaged” lives. A popular view is that Post Traumatic Stress Disorder cannot be “cured” and that individuals can only learn coping strategies to deal with it. This is also based on the assumption that the individual will seek help and advice in the first instance, many don’t!

Most people in the security, close protection and emergency services are familiar with the damaging impact of psychological trauma – maybe they’ve seen or read about people experiencing flashbacks, personality changes, ongoing fear and nightmares. But how many have heard of Post Traumatic Growth? It’s not something that is often talked about but is a very real phenomenon:

Post Traumatic Growth (PTG) describes the range of positive changes experienced by people as a result of their struggle with a severe life challenge or a traumatic event.

You may be aware of people who have survived a life-threatening illness describing how life is more precious, more vibrant and colourful, and how they wake up each day with a new direction and purpose. Well, this same phenomenon is found in survivors of other major crises and traumatic events and there is increasing research to back up the clinical experience of people like myself who see this regularly in our work.

I’ve talked about resilience in previous articles and the ability to bounce back from traumatic events but PTG takes this to a new level. Individuals don’t just bounce back but actually reach a higher level of functioning than before.

I have to say here though that there is nothing positive about experiencing a traumatic event. It can feel as though life, as it was, has been totally smashed up. All the assumptions we make about ourselves and the world are suddenly questioned. However, it is the rebuilding of life after the event that offers the opportunity for new strength and growth.

PTG is generally seen in 5 areas of life:

1) Relating to others
Many people report that their close personal relationships have improved. They are able to be more open and emotionally intimate with loved ones. Whereas a common feature of the initial Traumatic Stress reaction is a withdrawal from others and a gradual disconnection from relationships, PTG leads to stronger connections with those who really matter.

There is also more empathy and compassion towards other people who are experiencing difficulties.

2) New possibilities
In the early days and weeks after a traumatic event, individuals may avoid situations and have reduced tolerance of change and challenges. As they make sense of what happened, many completely reassess their life and find themselves moving in new directions or having a greater sense of purpose. This can mean expecting more from life and breaking free from situations that are less than fulfilling.

3) Personal strength
It’s ironic that people (who felt vulnerable or helpless due to the traumatic event or due to their initial reaction to it) emerge from their struggle feeling significantly stronger. There may be the belief that “if I can get through that I can get through anything.” Sometimes it’s only when we really test our limits that we accept our true strength.

I think it’s enriched how I feel now. Because I’ve never ever, at this moment in time, I’ve never felt quite this strong for a lot of years (Paul, police officer)

4) Spiritual (life beliefs) change
Whereas the aftermath of a traumatic event often leads to a loss of faith and shattering of sustaining beliefs, PTG can go on to leave people feeling more spiritually connected or positively changing their philosophical attitude and beliefs about life.

5) A deeper appreciation of life
When life has been in chaos or at risk of ending, even much later, the world can still feel dangerous and uncertain and individuals may have a negative or cynical outlook. However, as they achieve recovery and PTG, there is often a deep appreciation for life. Even small things can bring pleasure – the natural world, the smell of coffee, birdsong, a child’s smile. There can be a real shift in perspective on what is important.

I understand who I am and it’s made me the person I am today with the different experiences I’ve had. It keeps me alive, emotionally, it makes me grateful for who I am, what I have and where I am, I’m grateful to be here, and there are times when suddenly I’ll get a reflection on something and I’ll look around and I’ll think, some of you people don’t know how lucky you are (Matthew, ex-Royal Marine)

PTG does not mean the absence of suffering or the complete disappearance of distress so it’s not about having no reaction or a minimal reaction to an event. In fact, the more severe the initial reaction is the more there may be potential for Post Traumatic Growth.

Contrary to media stereotypes, PTG is far more common than Post Traumatic Stress Disorder with estimates of between 30 to 70% of survivors experiencing at least one aspect of PTG. However, Richard Tedeschi, a prominent researcher in the field, cautions that not everyone achieves PTG “In the wake of trauma, people become more aware of the futility in life and that unsettles some while it focuses others. This is the paradox of growth: people become more vulnerable, yet stronger.”

More research is needed to determine the factors that make PTG more likely but equally, we need to change our expectations for recovery. Many people access trauma psychotherapy and leave once their symptoms are manageable. From my perspective, this is incomplete treatment based on an assumption that “this is as good as it can possibly get”.  Sadly, some mental health professionals may share this view!

However, PTG does not occur just because someone has experienced a traumatic event. It is the resulting efforts to reconstruct a new reality that will be the main factor in PTG. If you expect and work towards, Post Traumatic Growth instead of just controlling Traumatic Stress reactions then you are more likely to ultimately achieve it.

It’s made me more compassionate, more understanding, and although it probably doesn’t sound it, more humble! It’s taught me not to be blinkered on my judgement because we are all different. For every action, there is a positive reaction and yeah, I actually do view it quite positively because I’ve been to the dark side and I’ve come out (Charlie, ex British Army)

By: Dr Liz Royle, KR Trauma Support

Reference: Tedeschi, R.G. & Calhoun, L. (2004) “Posttraumatic growth: Conceptual foundations and empirical evidence.” Psychological Inquiry, 15:1-18