Is There an Upside to Tragedy?
Yes, say psychologists. It's called post-traumatic growth.
Photo: Claire Benoist
At 16, my nephew, Kent—an engaging, energetic Indiana kid—was taken by a wildfire-fast leukemia. The cancer spread with such ferocity, he died within 24 hours of being diagnosed—and probably, the doctors speculated, mere months from the time it took hold. In those boggy, quicksand weeks that followed, as we rummaged numbly for explanations—how was he able to run a five-minute mile just two weeks before? why didn't we know?—other disturbing questions looped through my mind: How would my sister, Pam, survive? Would she ever be the same?
By now, eight years later, I have answers. Pam is not the same. She's stronger, more sure of herself, more spontaneous and open to new experiences and even quicker to laugh. Not that she hasn't struggled. For years she was struck by disorienting panic attacks, and there are still days when she's stopped in her tracks by grief. Even so, she has used her sadness as a springboard. The year after Kent died, she and her husband held a 5K race in his honor; since then, the annual event has raised more than $250,000 for the Leukemia & Lymphoma Society.
Watching Pam's evolution has been deeply moving, and, as it turns out, there's a name for it: post-traumatic growth (PTG), a term coined by Richard Tedeschi, PhD, a professor of psychology at the University of North Carolina at Charlotte, and his colleague, Lawrence Calhoun, PhD. Dozens of studies have shown that trauma survivors can change in profound ways. And it goes well beyond resilience, or bouncing back from adversity. "With post-traumatic growth, a person who has faced difficult challenges doesn't just return to baseline, which is what happens with resilience," explains Tedeschi. "They change in fundamental, sometimes dramatic, ways."
The fact that science has only recently turned its attention to PTG says less about the true experience of trauma than it does about the field of psychology, which has focused more on trauma's harmful outcomes, like post-traumatic stress disorder, a condition that afflicts just 7 to 8 percent of Americans. "In healthcare, we've always been more interested in identifying dysfunction than superior functioning," says Jack Tsai, PhD, assistant professor of psychiatry at Yale School of Medicine, who has studied PTG in veterans. "Only in the last few decades have we begun redefining health as not just the absence of disease but also the promotion of well-being."
Researchers have documented PTG in combat soldiers, people who've been disabled by accidents or illness and survivors of everything from earthquakes to violent crime, and a clearer image of what triggers PTG has emerged. "Growth results from an active, engaged process of dealing with a stressor—not the stressor itself," says Suzanne Danhauer, PhD, an associate professor in the department of social sciences and health policy at Wake Forest School of Medicine, who coauthored a PTG study on leukemia patients.
In that study, participants who went through a period of deliberate rumination, in which they thought deeply about their experience and how best to find a way forward, were more likely to rebound to a better place. After trauma, many people go through a phase of wallowing or obsessing—and some get stuck there or, just as stunting, avoid thinking about their pain at all. Those who grow often have a mind-set that psychologist David Feldman, PhD, coauthor of Supersurvivors: The Surprising Link Between Suffering and Success, calls grounded hope. "Trauma survivors who experience PTG acknowledge their own sadness, suffering, anger and grief, and are realistic about what happened to them," says Feldman. "But in the midst of their pain, they're able to ask: 'Given where I am in my life, how can I build the best future possible?'"
Perhaps one of the most surprising findings about PTG is that you may not have to adopt a grin-and-bear-it attitude to inspire growth—a welcome finding given that it can feel almost offensive when someone tells you to see the glass as half full after a traumatic episode. In one study on women with breast cancer, pessimists were as likely to experience PTG as optimists—and in another report, those who felt more depressed after their diagnoses were more likely to say they had made positive changes up to two years later compared with those who found the ordeal less trying. And those changes can completely reshape one's existence.
"Some people deviate radically from their previous path and, on the way, convert the worst thing that happened to them into the best," says Feldman. Jim Rendon, author of the forthcoming book Upside: The New Science of Post-Traumatic Growth, interviewed a woman who told him that, given a choice to rewrite history and not get into the car that crashed, paralyzing her 20 years ago, she wouldn't change a thing. "This woman has a profound understanding of her experience and how it changed her," says Rendon. "She feels her life is more meaningful now than it would have been if the accident hadn't happened."
Stephen Joseph, PhD, a psychology professor at the University of Nottingham, says he's heard the same thing from patients. Many trauma survivors more than just accept what happened to them: "They feel it made them better human beings than they would ever have been without it. And it made them wiser and willing to take the risk of being more fully alive."
By now, eight years later, I have answers. Pam is not the same. She's stronger, more sure of herself, more spontaneous and open to new experiences and even quicker to laugh. Not that she hasn't struggled. For years she was struck by disorienting panic attacks, and there are still days when she's stopped in her tracks by grief. Even so, she has used her sadness as a springboard. The year after Kent died, she and her husband held a 5K race in his honor; since then, the annual event has raised more than $250,000 for the Leukemia & Lymphoma Society.
Watching Pam's evolution has been deeply moving, and, as it turns out, there's a name for it: post-traumatic growth (PTG), a term coined by Richard Tedeschi, PhD, a professor of psychology at the University of North Carolina at Charlotte, and his colleague, Lawrence Calhoun, PhD. Dozens of studies have shown that trauma survivors can change in profound ways. And it goes well beyond resilience, or bouncing back from adversity. "With post-traumatic growth, a person who has faced difficult challenges doesn't just return to baseline, which is what happens with resilience," explains Tedeschi. "They change in fundamental, sometimes dramatic, ways."
The fact that science has only recently turned its attention to PTG says less about the true experience of trauma than it does about the field of psychology, which has focused more on trauma's harmful outcomes, like post-traumatic stress disorder, a condition that afflicts just 7 to 8 percent of Americans. "In healthcare, we've always been more interested in identifying dysfunction than superior functioning," says Jack Tsai, PhD, assistant professor of psychiatry at Yale School of Medicine, who has studied PTG in veterans. "Only in the last few decades have we begun redefining health as not just the absence of disease but also the promotion of well-being."
Researchers have documented PTG in combat soldiers, people who've been disabled by accidents or illness and survivors of everything from earthquakes to violent crime, and a clearer image of what triggers PTG has emerged. "Growth results from an active, engaged process of dealing with a stressor—not the stressor itself," says Suzanne Danhauer, PhD, an associate professor in the department of social sciences and health policy at Wake Forest School of Medicine, who coauthored a PTG study on leukemia patients.
In that study, participants who went through a period of deliberate rumination, in which they thought deeply about their experience and how best to find a way forward, were more likely to rebound to a better place. After trauma, many people go through a phase of wallowing or obsessing—and some get stuck there or, just as stunting, avoid thinking about their pain at all. Those who grow often have a mind-set that psychologist David Feldman, PhD, coauthor of Supersurvivors: The Surprising Link Between Suffering and Success, calls grounded hope. "Trauma survivors who experience PTG acknowledge their own sadness, suffering, anger and grief, and are realistic about what happened to them," says Feldman. "But in the midst of their pain, they're able to ask: 'Given where I am in my life, how can I build the best future possible?'"
Perhaps one of the most surprising findings about PTG is that you may not have to adopt a grin-and-bear-it attitude to inspire growth—a welcome finding given that it can feel almost offensive when someone tells you to see the glass as half full after a traumatic episode. In one study on women with breast cancer, pessimists were as likely to experience PTG as optimists—and in another report, those who felt more depressed after their diagnoses were more likely to say they had made positive changes up to two years later compared with those who found the ordeal less trying. And those changes can completely reshape one's existence.
"Some people deviate radically from their previous path and, on the way, convert the worst thing that happened to them into the best," says Feldman. Jim Rendon, author of the forthcoming book Upside: The New Science of Post-Traumatic Growth, interviewed a woman who told him that, given a choice to rewrite history and not get into the car that crashed, paralyzing her 20 years ago, she wouldn't change a thing. "This woman has a profound understanding of her experience and how it changed her," says Rendon. "She feels her life is more meaningful now than it would have been if the accident hadn't happened."
Stephen Joseph, PhD, a psychology professor at the University of Nottingham, says he's heard the same thing from patients. Many trauma survivors more than just accept what happened to them: "They feel it made them better human beings than they would ever have been without it. And it made them wiser and willing to take the risk of being more fully alive."
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