My first experience with posttraumatic growth was in the form of a pink and purple butterfly, drawn by a pediatric client I’d been working with due to child sexual abuse. It was their last day after working hard over the past months to heal and we drew good-bye cards together while focusing on celebrating this termination. The butterfly reminded me of hope and possibility. I wasn’t familiar with the concept of posttraumatic growth back then, but I was buoyed by my client’s palpable sense of empowerment as I watched them skip down the hall after saying good-bye. In the many years since, I’ve been awed by people’s ability to make meaning of their traumatic experiences and use that as a base to develop a fresh perspective on life, share their stories to support others as they heal and sometimes even make real change for the better.
The Concept of Posttraumatic Growth
The concept of Posttraumatic Growth (PTG) was developed in the 1990’s by Richard G. Tedeschi, Ph.D and Lawrence G. Calhoun, Ph.D, both psychologists and professors of psychology at UNC Charlotte. PTG is defined as “positive psychological changes experienced as a result of the struggle with trauma or highly challenging situations.” Dr. Debi Silber, psychologist and founder of the Post-Betrayal Transformation Institute, states “the crisis can be the death of a loved one, disease, natural disaster, or devastation of some kind like abuse or betrayal.” She goes on to further describe PTG as “a psychological earthquake, where your world is now divided between before it happened, and after it happened. It’s a defining moment that changes life as you’ve known it.”
The positive psychological changes that occur in the aftermath of experiencing a “psychological earthquake” go far beyond the typical self-improvement project. According to Tedeschi and Calhoun, there are five domains of PTG and experiencing a change in just one of them may be a sign of PTG:
- Appreciation of life
- Relationships with others
- New possibilities in life
- Personal strength
- Spiritual change
How Resilience Plays a Role in Posttraumatic Growth
It would seem the concepts of PTG and resilience are interchangeable as they both indicate positive change in the aftermath of trauma but they’re actually two different ideas. Resilience, as defined by the American Psychological Association is “the process of adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress.” It’s the ability to hang in there and endure while experiencing significant life challenges but doesn’t necessarily mean someone will undergo the profound life changes that occur when experiencing posttraumatic growth.
If resilience is what helps us maintain who we are while experiencing trauma, post-traumatic growth occurs when who we are has been fundamentally changed for the better. While survivors don’t need to have experienced PTG to be considered resilient, resilience has the unique ability to carry us to the “after,” opening up the door toward healing and possible posttraumatic growth.
Current Research on Posttraumatic Growth
In 2018, Tedeschi and Calhoun, along with other researchers, conducted an updated literature review on posttraumatic growth and found that PTG has been the subject of countless studies since the mid-1990’s. Their updated review showed more than half of those who experience a traumatic event are likely to attain posttraumatic growth and that people under the age of 60 were more likely to reap this benefit. This research also found that women were more likely to experience PTG than their male counterparts.
Other research has sought to answer questions related to models of treatment and effective interventions that may increase the likelihood that someone will experience PTG. Steps that people can take to work toward PTG are:
- Recognizing your strengths in order to identify qualities that may support you in healing.
- Learning emotional regulation skills in order to cope when experiencing distress.
- Processing the traumatic event and its impact with a trauma-informed therapist who is trained in evidence-based models of treatment such as Trauma-Focused Cognitive Behavioral Therapy.
It’s important to be mindful that posttraumatic growth does not happen quickly. In my experience as a trauma therapist, the work is often slow-going. It requires patience on the part of client and clinician because doing too much, too soon can lead to overwhelming clients and treatment may become too painful to continue. Using a centralized platform that houses client information, such as Casebook, can be an effective measurement tool to track progress over time as well as determining the pacing of treatment. Having the data readily available in real time also reassures clients they are doing the hard work of healing.
Using software such as Casebook can also be an effective tool to coordinate care for clients who may be involved with additional collateral services such as case management, child protective services or medication management. Helpful information, such as a client’s identifiable strengths, can be easily communicated, allowing providers to make use of this important information as they engage in all the stages of clinical work.
The path to posttraumatic growth is not an easy one for clients or clinicians but strategies such as using Casebook, doing the necessary research and obtaining training in evidenced-based models of trauma therapy can make this journey doable. With time and effective treatment, you’ll find that whether they’re a pink and purple butterfly skipping down the hall or a source of support for other survivors, the person who walked into your office won’t be the same one leaving when the work is done.
