Sometimes, Trauma Can Have Positive Outcomes
"I regarded every minute I was alive as a gift...I vowed to survive."
Post-traumatic growth is defined as a positive psychological change experienced from adversity to rise to a higher level of functioning. In faith and spiritual traditions throughout almost all of the human existence, there is a consensus that suffering can yield positive change and growth, and almost everyone can agree that you don't grow much when your life is easy.
The other day, I stumbled upon an article written by Jim Rendon in the NYTimes about how some soldiers grow positively form their wartime trauma. The article begins with the story of Sgt. Jeffrey Beltran, who suffered a mild traumatic brain injury in an I.E.D. attack in Iraq in 2005. After the explosion, he had 14 surgical operations performed the next year. He was on several medications. His brain injury was severe enough that his short-term memory was no longer reliable - Beltran had to obsessively check planners and post-it notes to jog his memory
The army deployed him again a couple years later helping NGOs (nongovernmental organizations) clear minefields. He saw a farmer blown up and a close friend and fellow soldier killed. Despite the stress and trauma, he stayed in the army, as his father and grandfather had done before him.
Beltran started noticing changes due to his hardships, and these hardships changed him for the better. "This whole experience has helped me to be more open, more flexible... I am branching out to activities that I was once uncomfortable with." In the meantime, Beltran took numerous rigorous exams pursuing a promotion, and took online courses towards a bachelor's degree in criminal justice. He rediscovered his spirituality, remarried, and reconnected with his parents. To this day, he carries the pictures of the explosion to "remind himself of what he overcame."
The foremost psychological researchers behind post-traumatic growth are two professors at University of North Carolina, Charlotte: Richard Tedeschi and Lawrence Calhoun. "I thought, Who do I want to know the most about, distressed or violent or crazy people? Instead, I want to know about wise people. Perhaps I'll learn something myself." First, the two researchers interviewed survivors of severe injuries, and then they interviewed widows and widowers.
Almost everyone said the same thing: they deeply wish their sufferings didn't happen, but the experience changed them for the better. The five areas that people most generally report positive change are as follows: the found a new appreciation for life, they found new possibilities for themselves, their spiritual lives improved, their relationships grew stronger, and they felt more personal strength. Paradoxically, post-traumatic growth happens while it co-exists with PTSD.
Since after the Vietnam War, Rendon argues, the attention has been on PTSD. In 2011, the Department of Veteran Affairs spent $5 billion on mental-health services. In 2010, the Army gave PTSD diagnoses to over 10,000 troops. But only a few studies have asked soldiers about the positive changes they experienced, and the results have been very surprising. A 1980 study on aviators captured during the Vietnam War found that 61 percent benefited psychologically from their experience in captivity. Most of these aviators said their faith grew stronger and they enjoyed life more. They appreciated other people more, and most surprisingly, the aviators treated the most harshly in captivity were the ones who reported the most positive change. "Perhaps it was no more than the desire to give meaning to a horrible time in their lives," Rendon notes as a rational explanation.
Rendon once met Tedeschi and the latter noted that only a "seismic event" can lead to post-traumatic growth. A seismic event is one that "causes you to question your fundamental assumptions about the world." Survivors of trauma this severe confront a variety of existential questions that the majority of people don't need to answer. For survivors, the growth does not come from the event itself; it rarely does. It comes from the rumination afterwards, the struggle to make sense of what happened. "Don't just rebuild the same crappy building you had before. Why not build something better?"
The Army now has a resilience program called Comprehensive Soldier Fitness, which intends to help soldiers become more resilient and recognize how traumas in combat can change them for the better. The program was brought to fruition by Brig. Gen. Rhonda Cornum, a physician and former prisoner of war. Her helicopter was shot down in a rescue mission, and she was held a prisoner for eight days. "I regarded every minute I was alive as a gift...I vowed to survive." Very few people would consider being in a position like Cornum's as lucky, but, she laughed at this note, and said: "If you don't do that, why would you ever proceed with anything?"
As a physician, she started to empathize more with her patients because she was one. She came grew closer to her family and became a better leader. Later, she wanted to develop a psychological training program for the Army, and met with famous positive psychologist, Martin Seligman to start the Comprehensive Soldier Fitness program. Seligman had a theory that if soldiers could be taught to approach a situation as Cornum did - "with gratitude for being alive rather than distress at being taken prisoner," they would gain resilience. A fundamental part of the program, too, is not to evaluate an event as good or bad, but solely neutral. The reaction to the event is more important. Soldiers are also asked to write down three good things that happened on a day. Whether Seligman's interventions actually apply to the extremely harsh realities of war have yet to be seen. These interventions are often aimed at healthy people, not soldiers faced with tragedy and atrocity.
But one thing that is clear is this: our view of trauma is growing much more complicated. According to Rendon, the perspective used to be "you either got P.T.S.D. or you were fine." Researchers today often acknowledge that it's normal to lose sleep, be devastated by guilt and fear, and have problems in general. With only a small percentage of exceptions, the majority of people that suffer trauma recover and grow as they suffer. "We bend, we break, we repair and rebuild, and often we grow, changing for the better in ways we never would have if we had not suffered."
There is the obvious caveat, too: the exceptions. Not everyone comes out of a trauma changed for the better. Sometimes a dependence on drugs as treatment "might even stifle growth." But Pamela Fisher, a director of primary care mental health at the Oklahoma City VA Home, encourages doctors to get their patients to "work through the pain, to see it as a motivation." It is a touchy idea and subject, and timing is critical. Doctors should not talk to patients about growth before they have even completed therapy, so there's a balance between a great idea in post-traumatic growth and making sure it is done right.
And then there's also the question of whether post-traumatic growth factually exists. Every person questioned in these surveys is self-reporting their growth and change through their traumas. Friends and spouses might not even notice anything, and "in the wake of trauma, people might tell themselves they changed for the better, if only as a way of making sense of a senseless tragedy." Growth and resilience often aren't measurable, and Howard Tennen, a professor at the University of Connecticut, if it's not measurable, then it cannot be promoted.
But isn't the fact that these patients think and believe they've grown and transformed because of their traumatic experiences a victory in itself? Aren't the patient themselves the final judges for whether they themselves are growing? Tedeschi, for one, promotes his own work and observations. Almost all psychological research relies on memory, and even if these growth experiences are illusions and placebos, Tedeschi contends that "I don't think you can dismiss it. People can have profound personal experiences that directly change their perception and philosophy." Rendon ends the article with a quote from Sgt. Beltran, who doesn't label himself as a PTSD veteran, but a post-traumatic-growth veteran. "I am a person looking forward," he says.
Although Rendon's article is one that applies to the trauma of war veterans, trauma isn't a phenomenon exclusive to those at wars. I have my own traumas, as have many of my friends, and I can say first hand that I believe, with the utmost confidence, that I have grown substantially as a result of my traumas. I became a Christian because of how I owned certain events in my childhood. I found friends and relationships for life. I feel like I'm the luckiest person alive all the time. I still feel consumed by the pain of events that have shaken the core of my foundations, a lot. But I don't want to waste that pain. It is fuel to keep moving forward, like Sgt. Beltran and Brid. Gen. Cornum, and I'm lucky enough to still be standing and able to do so.
