You’ve heard those stories about people who “against all odds” have overcome challenging and negative experiences to achieve success in life. These types of stories are everywhere: Prince William and Prince Harry who had to grieve their mother’s death in the public eye in 1997; Jennifer Hudson’s recovery after grieving the murders of her mother, brother, and nephew in 2008; Jackie Kennedy Onassis after her husband’s assassination in 1963 as depicted in the new biopic Jackie, or Bindi Irwin who shared she developed anxiety after her father’s unexpected death in 2006. Countless patients diagnosed with Post Traumatic Stress Disorder (PTSD) are benefiting from new research on their paths to recovery. You likely have people in your own life who have risen above tragedy.
But, how do they do it? Is it just luck, or is there science behind it?
In my practice as a psychotherapist, I have seen many patients overcome negative experiences and it isn't by chance. There is a growing body of research that suggests there are distinct qualities and factors that can help a person recover from a negative, and even traumatic, event to experience positive psychological growth. As it happens, even for those with PTSD, negative events don’t have to define the rest of one's life negatively.
Researchers call this positive change despite undergoing a negative or traumatic experience “post-traumatic growth.” The Post-Traumatic Research Group at UNC Charlotte describes post-traumatic growth as “positive change experienced as a result of the struggle with a major life crisis or traumatic event.” According to a systematic review of 39 studies by the National Center for PTSD, positive change is reported in 30 to 70 percent of survivors of various traumatic events. Additionally, people who report positive changes after a traumatic event are less likely to report experiencing post-traumatic stress after six months.
Researchers at UNC Charlotte have found that post-traumatic growth most often occurs in five distinct areas: a sense of new opportunities, closer relationships (including a renewed sense of connection with others, especially those who have suffered in a similar way), increased sense of one’s own strength, a greater appreciation for life in general, and deepening or significant change in one’s spiritual or religious beliefs.
How does this positive change happen? Researchers have discovered a couple leads.
For starters, positive growth doesn’t happen overnight. This type of positive growth after a tragedy typically happens over time and the timeline is different for everyone. The researchers at UNC Charlotte emphasize that experiencing distress following a traumatic event is typical. Pushing for growth before a person is ready can be detrimental and increase the distress a person is already experiencing. I often have patients who have lost a loved one and tell me that, a year later, they think they “should be over” grief.
Recovering from a traumatic experience takes time and can’t have a deadline. Instead, it’s important that those suffering work toward growth when they are ready and at a pace that’s comfortable for them. For example, research on young adults who experienced post-traumatic growth after a childhood illness found that those individuals who had recovered from their illness reported greater growth than those who reported that they were still coping with their illness. Coping with a serious illness can significantly impact a person from a psychological perspective. For example, facing the possibility of a permanent disability or undergoing a complex surgery and invasive treatments can be traumatic. Researchers theorize that not having to focus on treatment and disease maintenance can help facilitate reflection and growth.
The National Center for PTSD cautions that one common misunderstanding over post-traumatic growth is the expectation that people who report experiencing positive changes shouldn’t feel any distress at all. The researchers clarify that instead, positive change relates to psychological well-being, not emotional well-being. That is, a person may continue to experience emotional distress while also reporting growing psychologically (autonomy, mastery, personal growth, positive relationships, self-acceptance, and purpose in life). For example, even though someone who was involved in a major car accident may still experience emotional distress when they get into a car, they can still experience psychological growth by driving again instead of avoiding cars altogether. This speaks to the reality that a person can experience growth and distress at the same time. Because positive growth doesn’t negate the tragedy or erase it, the scars are still there, but that doesn’t mean growth hasn’t happened.
In my work with clients who have experienced some kind of trauma, they learn to carry the trauma with them without letting it define them. For example, a client (identifying information has been changed) who experienced a traumatic loss of a loved one, can now speak about the experience and how she has become braver, more self-assured, and driven to obtain her goals than before the tragedy. She still experiences sadness and anxiety sometimes due to the trauma but she also reports experiencing significant growth. A common mantra of people overcoming the pain of trauma is "you can't go under it, and you can't go over it; you must go through it."
Researchers have also found that there are common strengths that promote resilience when experiencing stress. These include being able to maintain a positive perspective, benefiting from increased family support, having increased appreciation for life, and developing empathy for others. Other common factors that have been shown to support increased posttraumatic growth, as reported by the Naval Center for Combat and Operational Stress Control (NCCOSC), include extraversion, openness to new experiences, and agreeableness wh ich are three of the Big Five Personality traits (you can take a quiz here). Although this data is focused on those in combat situations, experiencing trauma, whether in a combat zone or as a civilian, has common factors. Other factors include possessing more effective coping skills and being more likely to seek support. Note that this doesn’t mean that, if a person don’t have these traits, they will never bounce back. It simply means that having these strengths can help fuel the process of harnessing the negative to turn it into a positive.
Additionally, NCCOSC research found that our thinking patterns play a crucial role in post-traumatic growth. For example, research found that participants who prayed for “calm and focus” also showed the highest positive correlation to post-traumatic growth. These participants were also more likely to use meditation and reflection to promote the meaning-making process. Reflecting on the experience to try to make meaning out of it promotes growth.
On the other hand, merely going over the trauma again and again is not helpful. There is also some evidence that hope plays an important role in promoting post-traumatic growth. For example, the NCCOSC cited research that found that individuals who experienced trauma as a child expressed less hope as adults and reported less growth after trauma.
An interview from Humans of New York an online photography project featuring portraits and short profiles of people in New York and beyond, offers a great example of how powerful the way we think can be:
“This isn’t the first time I’ve owned a flower shop. I owned another store twenty years ago, but it went bankrupt. I was devastated. I’d just gotten divorced. I felt like a complete failure. For months I couldn’t even drive down the street where the shop had been. But one day a friend told me that I’d been looking at it all wrong. He told me: ‘You’re focused too much on the closing. Think of all the years that the shop was open. Think of all the jobs you provided, the flowers that you sold, and all the people that you served. You were open for twenty years. It was happening. And just because it didn’t happen forever, doesn’t mean it wasn’t valuable.’”
Focusing on her shop closing, bankruptcy, and divorce could keep this woman from growing but by focusing on the good that she did while she had the shop allowed her to hope and move forward.
Despite this hopeful research, some health professionals are calling for more nuanced research into post-traumatic growth, given that the research is mixed. For example, research cited by the National Center for PTSD found that looking for benefits resulting from a traumatic event was related to lower levels of depression and higher levels of well-being, but was also related to increased severity of intrusive thoughts and avoiding post-traumatic experiences. The NCCOSC notes that much of the research on posttraumatic growth is still inconclusive and warrants further investigation.
While there is still more research to be done on how people can harness negative experiences and turn them into opportunities for growth, what we know thus far is promising. It takes courage to face the trauma but I have seen, in my own practice, clients recover from experiences ranging from the loss of a loved one, a serious medical diagnosis, sexual assault, and witnessing harm done to others. People with challenging pasts don’t have to let their negative experiences hold them back. With time, the help of a professional, like a therapist, and reflection, most people have a chance at positive growth.
Photo Credit: Elissa Voss