What hardships can be considered a traumatic experience, how do such events affect one’s life, and can there be any benefit to living through such a destabilizing occurrence? Read on to find out about trauma, post-trauma, and post-traumatic growth.
According to the American Psychiatric Association (APA), post-traumatic stress disorder (PTSD) is a mental health disorder caused by exposure to a severely stressful or traumatic event. It was originally recognized by the APA in 1980, in its third edition of the Diagnostic and Statistical Manual (DSM-III).
PTSD was first listed within the anxiety disorders family, until in 2013, the APA separated it into its own group, called the trauma and stressor-related disorders family. A central reason for its removal was evidence that PTSD induced a number of additional feelings other than anxiety, including shame, guilt, and anger.
The trauma and stressors family is presently the only disorders family not to be linked by a common theme, such as depression or psychosis. PTSD is made an even more unusual mental health disorder, as its definition necessitates that a concrete experience that had to have taken place for it to be considered.
To warrant a PTSD diagnosis, an individual must have undergone an event so destabilizing and horrendous as to understandably be the reason for their disorder.
When looking to define such an experience, the APA has chosen to list only three types of experiences as potentially traumatic:
These events can be experienced:
Despite criticism over the exclusivity of the above list of recognized traumas, the APA has maintained its position. The reasoning behind it is said to be that a more inclusive definition of PTSD would essentially rob it of its meaning: if, for example, viewers shaken by television coverage of a terror attack would be given a PTSD diagnosis, they would be put on par with the survivors who actually escaped with their lives from the same attack.
A PTSD diagnosis includes several other symptoms, beyond the occurrence of a traumatic event. They are:
PTSD prevalence among adults in the US is 3.5%, with females being more likely to develop the condition than males, as well as more likely to experience PTSD for longer periods of time. This is, in part, attributed to females being more at risk of experiencing interpersonal violence.
Since PTSD symptomatology is extremely distressing, it very often requires the support of trained professionals who specialize in its treatment. PTSD treatment options include medication (notably antidepressants), psychotherapy (such as cognitive-behavioral therapy and psychodynamics), and medical device treatments.
The American Psychological Association (also shortened to APA) has presented a post-traumatic growth definition, describing it as a theoretical framework, explaining how individuals who have been through adversity manage to develop in positive and meaningful ways from what was, at the time, a terrible experience. Survivors of a terror attack, for example, may decide to devote their lives following the attack to spreading love, acceptance and understanding—even toward the group whose members had caused their own suffering.
Reframing one’s trauma, through post-traumatic growth, allows the individual to appreciate their own strength, and take back their sense of control. The pain they had gone through may have altered their life, but their change of perspective does not definitively have to consign them to a life of post-trauma. Rather, post-traumatic growth inspires the individual to acknowledge their pain and decide what to do with the lessons it has forced them to learn.
The American Psychological Association has acknowledged an assessment tool, called the Post-Traumatic Growth Inventory (or PTGI), which takes stock of the different life spheres that can be affected by post-traumatic growth. They are:
Post-traumatic growth has been estimated to occur among half-to-two-thirds of those who develop PTSD. Women are more likely to develop post-traumatic growth than men, though the difference between the two genders is rather small.
Post-traumatic growth has also been moderately related to a predisposition toward optimism, openness to experience, and extraversion. Together, these traits tend to steer individuals toward reevaluating their belief systems, while encouraging them to form connections with others, and be more proactive in their daily lives.
Post-traumatic growth is often used synonymously with another term relating to trauma—resilience. The two, however, represent different responses to adversity, and can even be considered complementary to one another.
Resilience refers to preliminary constitutional strength, so that an individual who is resilient would be more likely to experience an extremely destabilizing event without developing, without developing post-trauma.
Post-traumatic growth, on the other hand, occurs when someone who does develop PTSD is able to emerge from it with a new sense of personal development, and meaning. It is from this point that they may become resilient—to future, destabilizing events. And so, resilience and post-traumatic growth should not be considered one and the same, but rather two ultimately beneficial ways, in which individuals might respond to trauma.
Researchers are now examining whether post-traumatic growth can be encouraged, both before and after a traumatic event has taken place.
When working with populations who may be more at risk of facing a traumatic experience, there is a role for helping them consider the potential to grow out of the pain of a terrible circumstance, and that this is not only normal, but attainable.
Most often, though, post-traumatic growth is discussed after a terrible event has occurred. In these cases, it is advised not to force the patient to think about the possibility of growth before they are ready. Rather, it is important to allow them to grieve, and go through the pain and destabilization that come with PTSD. Only when the patient themselves begins contemplating any positivity that has resulted from their traumatic experience.