Saturday, April 03, 2010

Is There Anything 'Good' About Traumatic and/or Intense Life Experiences?


Studies suggest posttraumatic growth can be a significant, positive outcome of surviving and even thriving following a traumatic event. Controversial in some quarters, at this juncture the data shows such life experiences may be character-building:

That which does not kill us makes us stronger. — Friedrich Nietzsche

In contrast to Nietzsche’s well-known quote, life-threatening experiences may lead to psychiatric conditions such as posttraumatic stress disorder (PTSD; Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). Furthermore, greater exposure is usually linked to more severe symptoms (Brewin, Andrews, & Valentine, 2000). Psychopathology nevertheless occurs only among a minority of those exposed to such events, leaving open the possibility of other outcomes, including benefits (Bonanno, 2004). Tedeschi and Calhoun (1995) identified the positive psychological changes that can occur following a potentially traumatic event as posttraumatic growth: improved relationships with others, openness to new possibilities, greater appreciation of life, enhanced personal strength, and spiritual development. ...

How are strengths of character related to growth following trauma? A retrospective Web-based study of 1,739 adults found small, but positive associations among the number of potentially traumatic events experienced and a number of cognitive and interpersonal character strengths. It was concluded that growth following trauma may entail the strengthening of character.

Source: "Strengths of character and posttraumatic growth," Journal of Traumatic Stress, Volume 21 Issue 2, Pages 214 - 217

In educational interest, article(s) quoted from extensively.

Post-traumatic growth, however, isn't the same as resiliency. In fact, it appears to be the exact opposite:

The present results based on two large samples of survivors of war and terror show an inverse relationship between growth and resilience. The findings support the contention that resilience conceptualized and measured by a lack of PTSD following adversity is inversely associated with posttraumatic growth (Tedeschi & Calhoun, 2004; Westphal & Bonanno, 2007). These findings appear to be intriguing, as resilience and posttraumatic growth are both salutogenic outcomes and so intuitively should be positively related. Scrutiny of the empirical literature, however, shows that these findings are consistent with research showing a link between vulnerability (PTSD) and posttraumatic growth (Tedeschi & Calhoun, 1996). There may be at least two possible explanations of these findings. Resilience refers to a broad cluster of personal characteristics that facilitate the ability to manage despite trauma. These characteristics include hardiness, optimism, self-enhancement, repressive coping, positive affect, and a sense of coherence (Agaibi&Wilson, 2005; Bonanno, 2004; Tedeschi & Calhoun, 2004). Collectively, these characteristics permit such people to emerge from trauma with less psychological wounds and relatively unchanged.

Unlike resilience, growth represents a change for the better following adversity (Tedeschi & Calhoun, 1996). Accordingly, posttraumatic growth only occurs if trauma has been upsetting enough to drive the survivor to (positive) meaning-making of the negative event. Resilience may make a person less likely to perceive threat to self or world views. Thus, more resilient people are more able to mitigate the impact of the event. Accordingly, if growth is the need to find meaning to a traumatic event (Tedeschi & Calhoun, 1996, 2004), resilient people are less likely to engage in the meaning-making behaviors (Bonanno, Wortman, & Nesse, 2004) that are associated with growth because they are unlikely to struggle with the implications of the trauma.

Source: "Examining the relationship between resilience and posttraumatic growth," Journal of Traumatic Stress, Volume 22 Issue 4, Pages 282 - 286

Mentioned above, meaning-making appears to be an important element of posttraumatic growth:

Support has been thoroughly documented for some aspects of the meaning-making model. In particular, it is clear that meaning-making attempts and meanings made are reported by most individuals facing highly stressful events. In fact, it seems logical that some sort of cognitive readjustment or meaning-making process must occur following experiences of events that are greatly discrepant with one’s larger beliefs, plans, and desires. Summarizing evidence on meaning making, which she referred to as ruminative thinking, Filipp (1999) concluded, “In victims of life crises and trauma, the transformation of objective reality into their ‘interpretive realities’ can only be accomplished by ruminative thinking” (p. 71). Whether assimilative processes constitute meaning making is not universally agreed upon (e.g., Bonanno et al., 2002; Davis et al., 2000), but assimilation and accommodation together are common.

Literature also solidly supports the notion that appraised meanings of violation are related to distress, whether these violations are appraised directly (e.g., Park, 2008b) or indirectly (e.g., as appraisals of threat or loss; Aldwin, 2007). In addition, the quality of the meaning-making attempts and the meanings made is at least as important as the quantity. For example, evidence is accumulating from various research areas that meaning making and meanings made that involve blame and negative evaluations typically lead to poorer outcomes and that those involving nonjudgmental reflection lead to better adjustment (see Gortner et al., 2006; Treynor et al., 2003; Watkins, 2008).

Source: "Making sense of the meaning literature: An integrative review of meaning making and its effects on adjustment to stressful life events," Psychological Bulletin, Vol. 136(2), March 2010, pp. 257-301

If meaning (rather than blame or negative evaluations) can be forged from the suffering, an inner strength may be summoned. This personal and posttraumatic growth may in turn lead survivors to be more understanding of and even altruistic toward others:

The concept of altruism points to action motivated by caring and the unselfish desire to benefit others (Batson, 1991; Leeds, 1963). Altruistic action can result in good feelings for the actor, but this is a byproduct, not the primary motivation for action. ...

The proximal influences and motivations for helping by people who have suffered, such as awareness of others’ need, perspective taking, empathy, and prosocial value orientation might be the same as in the case of altruism that develops through positive socialization. However, once the psychological changes take place that we suggest are necessary to shift from a defensive orientation to concern about others, a person’s own suffering can become a source of especially pronounced awareness of human suffering, empathy with others in need, and feelings of responsibility for their welfare, resulting in strong commitment to helping. For example, perspective taking leads a person to understand another’s state, their thoughts and feelings, but does not inevitably lead to empathy. However, perspective taking by people who have suffered may give rise to deeper understanding of someone’s actual or potential suffering (Staub, 1979), and in turn to empathy or sympathy that enhances helping.

Source: "Altruism born of suffering: The roots of caring and helping after victimization and other trauma," American Journal of Orthopsychiatry. Vol. 78(3), July 2008, pp. 267-280

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