“The world breaks everyone, and afterward, some are strong
at the broken places.”
~ Ernest Hemingway

Trauma does not leave people unchanged. Traumatic experience alters us in ways that are excruciating, and often, tenaciously haunting. Trauma makes injury to our sense of the workings of the world. It leaves people stowing unspeakable ordeals that clamour to the foreground as unremittingly as they also check out into protective insensibility. Trauma puts brain, body and self-sense horribly out of kilter. The entire person is affected. On the checkered board of traumatic memory, intrusions ravage whilst evasions confound and petrify. Attachment trauma can render relationships a landmine-territory. The remnants of trauma bring a host of bodily-felt upsets, physiologically-manifest discomforts and neurological re-configurations.

But in the struggle that we face in trauma's aftermath, life's dreadful events can also be transformative and finally, gainful. In discussing posttraumatic growth
, I make prominent the sentiment of the UNC at Charlotte Posttraumatic Growth Research Group (2013), that holding the notion of posttraumatic growth does not imply that the horrendous effects of trauma are taken lightly, or in any way minimized.

The Search for Wisdom and PTG
The idea that traumatic events can ultimately lead to meaningful and life-enhancing change, has been developed and conceptualized as posttraumatic growth (PTG) by Richard Tedeschi and Lawrence Calhoun. Both were psychologists at the University of North Carolina at Charlotte in the mid 90s. They started out by wanting to know: what is it that makes people wise? In search of answers, they interviewed people whom they thought would be wise, about their life experience. In the stories that they heard, what emerged was the theme of remarkable transformation in the aftermath of adversity. 

What's New and Not-So-New about PTG?
Tedeschi talks about posttraumatic growth in this Soaringwords Interview. He points out that although PTG is a novel re-conceptualization in the field of psychology, the notion of suffering as gainful is not at all new. Embedded in many ancient religious traditions is the notion that suffering can be transformed in liberating ways. In Buddhism, for instance, the First Noble Truth is that dukkha - often translated as suffering - is at the heart of human experience. But equally central in Buddhism, is a core belief in our capacity to attain liberation from suffering. 

In the 1950s Carl Rogers introduced to Western Psychology the theme of an innate orientation towards growth. His actualizing tendency viewed all life process as directed towards growth. "Life is an active process, not a passive one", asserted Rogers ("The Foundations of the Person-Centred Approach"). "Whether the stimulus arises from within or without, whether the environment is favorable or unfavorable, the behaviors of an organism can be counted on to be in the direction of maintaining, enhancing, and reproducing itself. This is the very nature of the process we call life. This tendency is operative at all times. Indeed, only the presence or absence of this total directional process enables us to tell whether a given organism is alive or dead" (Rogers, p 2).

Frequency of PTG
When Tedeschi and Calhoun systematically investigated the idea of crisis as gainful, they found that two-thirds of people report growth in the aftermath of trauma. What defines PTG is that it isn't merely about survival and recovery of pre-trauma functioning; the term implies some meaningful shift, or a measure of post-trauma wellbeing that the individual experiences as greater than before. 

PTG vs Resilience
PTG, then, speaks to a level of post-trauma functioning that goes beyond the more traditional concept of resilience. What is very interesting  - and encouraging for people who do not think of themselves as particularly well equipped as copers, is that PTG also occurs in people who are not necessarily particularly resilient. Moore (2014) suggests that more resilient individuals, due perhaps to their established coping skills, might struggle less in the aftermath of trauma, and so correspondingly there might be reduced potential for change. What this implies is that our efforts to engage and grapple with trauma - hard as they be - have at least a fair chance of propagating some new life.

What does PTG look like?
PTG generally falls within five major domains (UNC Charlotte PTG Research Group, 2013)
  • seeing new possibilities and fresh opportunities; 
  • greater connection in relationships; 
  • a sense of oneself as stronger than before (which does not exclude an awareness of vulnerability); 
  • a greater appreciation for life in general; and 
  • changes in the individual's spiritual life - deepening of or changes in spiritual life.
Notwithstanding these general ballparks in which PTG tends to occur, each person's posttraumatic growth journey will be a uniquely felt and treasured re-entry into the land of the more comfortably living. Perhaps the greatest post-trauma acquisition is the capacity to be present to the traumatic experience from an observational vantage point that no longer overwhelms or disables.

Psychiatrist and groundbreaking trauma writer Judith Herman (2001) sees recovery from trauma as a three-stage process, entailing first, creation of safety; followed by a phase of remembrance and mourning, and finally, what she calls reconnection with life. Reconnecting with life could surely take as many forms as life itself, but for at least some people, growth after trauma - or reconnection with life in Herman's terms - includes what she calls a 'survivor mission' - an engagement with social change arising from these individuals' hard-won experiential wisdom (Herman: 2001, 207-211).

Another version of PTG is Joseph Campbell's hero's journey motif. The mythological representation of the way in which our most grueling trials and dark interludes bring ascension to wisdom is perhaps more readily identified with for some, than the conceptual abstractions about growth post-trauma. 

Trauma processes often draw significantly on the creativity of client and therapist. Rich Simons (2014) points to the challenge-breeds-innovation nature of trauma work: "No diagnosis has done more than trauma to spark therapeutic creativity, generate new and innovative treatments, and even transform the way we think about and practice therapy in almost any setting with almost any client. For one thing, we no longer think only in terms of psychotherapy as a largely mind-to-mind exercise between therapist and client. Trauma studies have led the way to incorporating not just brain science into our work with trauma clients, but knowledge about interactions among the body, mind, and—what we now call without too much embarrassment—spirit. In what’s really a revolution in the field, trauma has largely ushered in a truly holistic, integrated way of thinking about all so-called mental disorders. If anything can kill off the last remnants of Cartesian dualism in psychotherapy, it should be this profoundly integrative convergence of what were once thought incompatible streams of knowledge." 

Nobody would ever wish to experience trauma for the sake of growth. But if trauma has been a part of our experience, and the cause of posttraumatic stress, it could be helpful to hold the notion that growth and stress can co-inhabit the wildly unpredictable terrain that we navigate in trauma's aftermath.

Sources

Calhoun, L and Tedeschi, R: "The Foundations of Posttraumatic Growth: New Considerations" (n.d.). Retrieved March 16, 2016, from http://ptgi.uncc.edu/files/2013/01/PTG-New-Considertrns-2004.pdf

Herman, JL: Trauma and Recovery From Domestic Abuse to Political Terror (2001).London: Pandora.

Moore, M: "What is PTG?" (2014). Retrieved March 16, 2016, from http://www.posttraumaticgrowth.com/what-is-ptg/

Rogers, C: "The Foundations of the Person-Centred Approach" (n.d.). Retrieved March 16, 2016, from http://www.elementsuk.com/libraryofarticles/foundations.pdf

Simon, R: Editor's Note in Psychotherapy Networker: Treating Trauma, May/June 2014. Retrieved March 17, 2016, from https://www.psychotherapynetworker.org/magazine/article/105/editors-note

Soaringwords Interview Dr. Richard Tedeschi - Post-Traumatic Growth (PTG). (n.d.). Retrieved March 16, 2016, from https://www.youtube.com/watch?v=_N33ZkQAu1s

UNC Charlotte Posttraumatic Growth Research Group: "What is PTG?" (2013). Retrieved March 16, 2016, from https://ptgi.uncc.edu/what-is-ptg/