Posttraumatic Growth: Myths & Facts about "Bouncing Forward" after Adversity

When faced with trauma, mental health influencers often "therapy speak" people into becoming more resilient and growing from such a challenge. This narrative, however, encourages people to internalize the message that adversity should always lead to growth or that trauma is a prerequisite for growth. In the psychological lexicon, this positive outcome, or "bouncing forward" following adversity, is called posttraumatic growth or an overlapping concept, benefit-finding and growth (Lechner et al., 2009). While benefit-finding and growth captures more of the lifestyle, behavior, and perceptual changes, posttraumatic growth tends to refer to the transformative changes occurring at a cognitive level, i.e., how one becomes wiser (Lechner et al., 2009). People who experience posttraumatic growth describe it in one or more of the following ways (Hefferon et al., 2009):

• Reappraisal of one’s life and restructuring of previous priorities
• Revaluation and changing of life goals
• Learning new skills, going back to school, and achieving new things
• New appreciation of past and present life
• New appreciation of one’s own strengths
• Ability to relinquish control over life and relax, or gain more control over life
• A sense of humility and humbleness after one has reached out and asked for help
• Strengthened relationships and increased closeness to family and friends
• Greater compassion or altruism
• Heightened sense of the preciousness and fragility of life
• Changes in life philosophies and discovering new meaning and purpose in one’s life
• Healthier lifestyle changes and “listening to one’s own body”
• Taking responsibility for one’s health
• Increased sense of self-reliance
• Keener awareness of one’s own vulnerability
• New openness to spiritual or religious experiences

To illustrate the concept of posttraumatic growth, consider an individual who has suffered from a recent heart attack. This individual is more apt to adopt a healthy lifestyle in terms of diet, physical activity, and balancing work and personal life. Benefit-finding and growth following adversities is associated with lower levels of distress, higher self-esteem, less anxiety, greater life satisfaction, and more optimistic estimates of future life (see Lechner et al., 2009). However, not everyone may feel positive or experience growth following a trauma. It is hypothesized that people with very low levels of distress and those with very high levels of distress may not be able to find meaning in their suffering (Lechner et al., 2006). This may be because the lack of motivation in people with very low levels of distress and preoccupation with the current stressor in people with very high levels of distress precludes them from experiencing a transformative experience. Research also suggests that women tend to experience higher levels of posttraumatic growth than do men, possibly due to greater use of emotion-focused coping (as opposed to problem-focused coping in men) (Linley & Joseph, 2004).

When people report that a crisis has made them stronger, should this be accepted at face value? It has been suggested that true posttraumatic growth following a crisis is reflected by the positive changes that individuals judge as significant and that are not overshadowed or dwarfed by any negative changes (Wortman, 2004). For example, if a person reports one positive change but is also experiencing significant depression that is impacting their daily life, then would this be considered posttraumatic growth? The pioneers behind the concept of posttraumatic growth themselves state that posttraumatic growth may lead to a more fulfilling and meaningful life, but it will not necessarily lead to a decrease in levels of distress or an increase in the levels of happiness (Tedeschi et al., 2015). In fact, continuing personal distress and growth often coexist, and such a paradox is verbalized by individuals who have experienced traumatic life events by statements such as, "I am more vulnerable, yet stronger" (Tedeschi & Calhoun, 2004). Moreover, research has suggested that an individual’s ability to perceive benefit after a negative event predicts better posttraumatic growth, and this ability in turn depends on traits such as optimism, openness to new experiences, and hardiness (McMillen et al., 1997). 

In summary, posttraumatic growth or “bouncing forward” as some popular books on resilience like to call it, is not an all-or-nothing psychological construct. The growth emerges from the struggle with coping, not from trauma itself and, how one copes, is dependent on several variables. At the same time, trauma is not necessary for growth, and posttraumatic growth is neither universal nor inevitable (Tedeschi & Calhoun, 2004). 

To learn more about evidence-based self-management techniques that promote mental health and well-being, check out Dr. Duggal's Author Page.

HARPREET S. DUGGAL, MD, FAPA

REFERENCES

Hefferon, K., Grealy, M., & Mutrie, N. (2009). Post-traumatic growth and life threatening physical illness: a systematic review of the qualitative literature. British Journal of Health Psychology, 14, 343-378.

Lechner, S. C., Carver, C. S., Antoni, M. H., Weaver, K. E., & Phillips, K. M. (2006). Curvilinear associations between benefit finding and psychosocial adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 74(5), 828-840.

Lechner, S. C., Howard, T., & Affleck, G. (2009). Benefit-finding and growth. In S. J. Lopez & C. R. Snyder (Eds.), The oxford handbook of positive psychology (2nd ed.) (pp. 633-640). New York, NY: Oxford University Press.

Linley, P. A., & Joseph, S. (2004). Positive change following trauma and adversity: A review. J(1), 11-21.  
ournal of Traumatic Stress, 17
McMillen, J. C., Smith, E. M., & Fisher, R. H. (1997). Perceived benefit and mental health after three years of disaster. Journal of Consulting and Clinical Psychology, 65(5), 733-739.

Tedeschi, R. G., & Calhoun, L. (2004). Posttraumatic growth: A new perspective on Psychotraumatology. Psychiatric Times, 21(4).

Tedeschi, R. G., Calhoun, L. G., & Groleau, J. M. (2015). Clinical applications of posttraumatic growth. In S. Joseph (Ed.), Positive Psychology in Practice (2nd ed.) (pp. 503-518). Hoboken, NJ: John Wiley & Sons, Inc.

Wortman, C. B. (2004). Posttraumatic growth: progress and problems. Psychological Inquiry, 15(1), 81-90.