In psychology, post-traumatic growth (PTG) is positive psychological change experienced as a result of struggling with highly challenging, highly stressful life circumstances.Tedeshi, R.G., & Calhoun, L.G. (2004). Posttraumatic Growth: Conceptual Foundation and Empirical Evidence. Philadelphia, PA: Lawrence Erlbaum Associates. These circumstances represent significant challenges to the adaptive resources of the individual, and pose significant challenges to the individual's way of understanding the world and their place in it. Post-traumatic growth involves "life-changing" psychological shifts in thinking and relating to the world and the self, that contribute to a personal process of change, that is deeply meaningful.
Individuals who experience post-traumatic growth often report changes across the following five areas: appreciation of life; relating to others; personal strength; new possibilities; and spiritual, existential or philosophical change.
These changes allow these individuals to give meaning to their traumatic experience in order to better understand themselves, allowing them to appreciate all aspects of their lives, stronger relationships allow them to increase empathy while personal strength becomes resilience as well and spiritual experiences or philosophy help them incorporate new core beliefs. These five areas allow these individuals to grow and find meaning in different but interconnecting sources.Tedeschi, R. G., & Calhoun, L. G. (1996). The Posttraumatic Growth Inventory: measuring the positive legacy of trauma. Journal of traumatic stress, 9(3), 455–471. https://doi.org/10.1007/BF02103658
Global context and history The general understanding that suffering and distress can potentially yield positive change is thousands of years old. For example, some of the early ideas and writing of the ancient Hebrews, Greeks, and early Christians, as well as some of the teachings of Hinduism, Buddhism, IslamTedeschi, R.G., & Calhoun, L.G. (1995). Trauma and Transformation: Growing in the Aftermath of Suffering. Thousand Oaks, CA: Sage. and the Baháʼí FaithAbdu'l-Bahá on Suffering and Tests, Baháʼí International Community, accessed Jul 14 2013. contain elements of the potentially transformative power of suffering. Attempts to understand and discover the meaning of human suffering represent a central theme of much philosophical inquiry and appear in the works of novelists, dramatists and poets.
Traditional psychology's equivalent to thriving is psychological resilience, which is reaching the previous level of functioning before a trauma, stressor, or challenge. The difference between resilience and thriving is the recovery point – thriving goes above and beyond resilience, and involves finding benefits within challenges.
The term "post-traumatic growth" was coined by psychologists Richard Tedeschi and Lawrence Calhoun at the University of North Carolina at Charlotte.Michaela Haas, "Bouncing Forward: Transforming Bad Breaks into Breakthroughs," Atria/Enliven, 2015 According to Tedeschi, as many as 89% of survivors report at least one aspect of post-traumatic growth, such as a renewed appreciation for life.
Variants of the idea have included Crystal Park's proposed stress related growth model, which highlighted the derived sense of meaning in the context of adjusting to challenging and stressful situations, and Joseph and Linley's proposed adversarial growth model, which linked growth with psychological wellbeing. According to the adversarial growth model, whenever an individual is experiencing a challenging situation, they can either integrate the traumatic experience into their current belief system and worldviews or they can modify their beliefs based on their current experiences. If the individual positively accommodates the trauma-related information and assimilates prior beliefs, psychological growth can occur following adversity.
Development of post-traumatic growth
Relationship between trauma, PTG, and other outcomes Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences. While the idea that positive change may occur following trauma may seem paradoxical, it is common and well documented. However, not everyone who experiences a traumatic event will necessarily develop post-traumatic growth. This is because growth does not occur as a direct result of trauma; rather, it is the individual's struggle with the new reality in the aftermath of trauma that is crucial in determining the extent to which post-traumatic growth occurs.
While PTG often leads individuals to live in ways that are fulfilling and meaningful, the presence of PTG and distress are not mutually exclusive. Experiencing trauma is typically associated with distress and loss, and PTG does not change this. PTG and negative trauma related outcomes (e.g. PTSD) often coexist. Encouragingly, reports of growth experiences in the aftermath of traumatic events far outnumber reports of psychiatric disorders.
Creating post-traumatic growth Post-traumatic growth occurs with the attempts to adapt to highly negative sets of circumstances that can engender high levels of psychological distress such as major life crises, which typically engender unpleasant psychological reactions. Such experiences often alter or renew one's core relationships or concepts, leading to PTG.
A model of PTG
Calhoun and Tedeschi (2006) outline their updated model of post-traumatic growth in Handbook of Post-traumatic Growth: Research and Practice. Most importantly, this model includes:
Characteristics of the Person and of the Challenging Circumstances Management of Emotional Distress Rumination Self-Disclosure Sociocultural Influences Narrative Development Life Wisdom
Promotive factors Various factors have been identified as associated the development of PTG. In 2011 Iversen and Christiansen and Elklit suggested that predictors of growth have different effects on PTG on micro-, meso-, and macro level, and a positive predictor of growth on one level can be a negative predictor of growth on another level. This might explain some of the inconsistent research results within the area.
Trauma types: Characteristics of the traumatic event may contribute to the development or inhibition of PTG. For example, for PTG to come about, the severity of the traumatic experience must be enough to threaten one's preexisting understanding the world or their personal narrative. However, extremely severe trauma exposure may overwhelm one's ability to comprehend and grow from the experience. Experiencing Multiple Sources of Trauma is also considered promotive of PTG. While gender roles did not reliably predict PTG, they are indicative of the type of trauma that an individual experiences. Women tend to experience victimization on a more individual and interpersonal level (e.g. sexual victimization) while men tend to experience more systemic and collective traumas (e.g. military and combat). Given that group dynamics appear to play a predictive role in post-traumatic growth, it can be argued that the type of exposure may indirectly predict growth in men (Lilly 2012).
Responding to the traumatic experience: The different ways in which a person may process or engage after a traumatic experience may influence whether PTG comes about. The presence of rumination, sharing negative emotions, positive coping strategies (e.g. spirituality), event centrality, resilience, and growth actions are associated with increased PTG.
Many individuals ruminate extensively about a traumatic experience after it has occurred. In this context, rumination is not necessarily negative and can mean the same thing as cognitive engagement. When this occurs, the individual is investing mental resources into understanding and making sense of their experience. People typically participate in this way to comprehend and explain their experience (Why? How?) and to discover how their experience factors into their perceptions and plans (What does this mean? What now?). While neither is entirely bad, deliberate rather than intrusive rumination can be the most effective at producing growth.
The use of different coping strategies to adjust to a stressor may also influence the development of PTG. As Richard G. Tedeschi and other post-traumatic growth researchers have found, the ability to accept situations that cannot be changed is crucial for adapting to traumatic life events. They call it "acceptance coping", and have determined that coming to terms with reality is a significant predictor of post-traumatic growth.Michaela Haas, Bouncing Forward:Transforming Bad Breaks into Breakthroughs, Atria/Enliven, 2015, It is also alleged, though currently under further investigation, that opportunity for emotional disclosure can lead to post-traumatic growth though did not significantly reduce post-traumatic stress symptomology.
The individual's characteristics: Some personality traits have been found to be associated with increased PTG. These traits include openness, agreeableness, altruistic behaviors, extraversion, conscientiousness, sense of coherence (SOC), sense of purpose, hopefulness, and low neuroticism are associated with PTG. Despite being otherwise undesirable, narcissism is also associated with PTG. These traits may increase an individual's capacity to adapt to traumas, leading to growth.
Social support: Social support has been found to be a mediator of PTG. Not only are high levels of pre-exposure social support associated with growth, but there is some neurobiological evidence to support the idea that support will modulate a pathological response to stress in the hypothalamic-pituitary-adrenocortical (HPA) pathway in the brain (Ozbay 2007). It also benefits a person to have supportive others that can aid in post-traumatic growth by providing a way to craft narratives about the changes that have occurred, and by offering perspectives that can be integrated into schema change. These relationships help develop narratives; narratives of trauma and survival are always important in post-traumatic growth because they forces survivors to confront questions of meaning and how answers to those questions can be reconstructed.
Religion and Spirituality: Spirituality has been shown to highly correlate with post-traumatic growth and in fact, many of the most deeply spiritual beliefs are a result of trauma exposure.
Other variables: Age: Post-traumatic growth has been studied in children to a lesser extent. A review by Meyerson and colleagues found various relations between social and psychological factors and post-traumatic growth in children and adolescents, but concluded that fundamental questions about its value and function remain.
Interdisciplinary connections
Personality psychology and PTG Historically, personality traits have been depicted as being stable following the age of 30. Since 1994, research findings suggested that personality traits can change in response to life transition events during middle and late adulthood. Life transition events may be related to work, relationships, or health. Moderate amounts of stress were associated with improvements in the traits of mastery and toughness. Individuals experiencing moderate amounts of stress were found to be more confident about their abilities and had a better sense of control over their lives. Further, moderate amounts of stress were also associated with better resilience, which can be defined as successful recovery to baseline following stress. An individual who experienced moderate amounts of stressful events was more likely to develop coping skills, seek support from their environment, and experience more confidence in their ability to overcome adversity.
Post-traumatic growth and personality psychology