11 Nov Life after COVID-19: Making space for growth
In this time of grief, the theory of post-traumatic growth suggests people can emerge from trauma even stronger
In the traditional Japanese art of kintsugi, artisans fill the cracks in broken pottery with gold or silver, transforming damaged pieces into something more beautiful than they were when new. Post-traumatic growth is like kintsugi for the mind.
Developed in the 1990s by psychologists Richard Tedeschi, PhD, and Lawrence Calhoun, PhD, the theory of post-traumatic growth suggests that people can emerge from trauma or adversity having achieved positive personal growth. It’s a comforting idea in the best of times. But it holds particular appeal as we live through a pandemic that’s upending lives for people around the globe.
Growing from trauma isn’t unusual, says Tedeschi, now a professor emeritus at the University of North Carolina Charlotte and chair of the Boulder Crest Institute for Posttraumatic Growth in Bluemont, Virginia. “Studies support the notion that post-traumatic growth is common and universal across cultures,” he says. “We’re talking about a transformation—a challenge to people’s core beliefs that causes them to become different than they were before.”
And the COVID-19 pandemic may have the ingredients to foster such growth. “We’re still in the middle of this situation, and we don’t know yet what might happen—but there will be serious challenges to people’s lives,” Tedeschi says. While those effects may be devastating, it’s possible to emerge from such adversity for the better, he adds. “For some people, this event may be a shock to their core belief system. When that’s the case, it has the potential to result in significant positive changes.”
Resilience vs. post-traumatic growth
Research across a variety of disasters has shown that there are different trajectories for recovery, says Erika Felix, PhD, a psychologist at the University of California, Santa Barbara, who treats and studies trauma survivors. Some people need time to recover from a trauma before returning to normal functioning. A portion of people experience negative mental health impacts that become chronic, but the majority of people bounce back from a trauma pretty quickly, she says. “Most people will be resilient and return to their previous level of functioning.”
Resilience and post-traumatic growth are not the same thing, however. In fact, people who bounce back quickly from a setback aren’t the ones likely to experience positive growth, Tedeschi explains. Rather, people who experience post-traumatic growth are those who endure some cognitive and emotional struggle and then emerge changed on the other side.
This experience is measured by Tedeschi and Calhoun’s Posttraumatic Growth Inventory (PTGI) (Journal of Traumatic Stress, Vol. 9, No. 3, 1996), which evaluates growth in five areas: appreciation of life, relating to others, personal strength, recognizing new possibilities and spiritual change. It’s not necessary or even typical to show change in all five areas, Tedeschi says. But growth in even one or two of those realms “can have a profound effect on a person’s life,” he says.
Some psychologists say the evidence for post-traumatic growth isn’t yet as robust as it could be. For example, Patricia Frazier, PhD, at the University of Minnesota, and colleagues followed undergraduates before and after a trauma. They found that participants’ self-reported perceived growth didn’t align with actual growth as measured by the PTGI. And while actual growth was related to positive coping, perceived growth was not, suggesting the construct may not fully reflect the way people are transformed by trauma (Psychological Science, Vol. 20, No. 7, 2009).
But other evidence suggests that people do grow from trauma. A 2018 book by Tedeschi and colleagues summarizes more than 700 studies related to post-traumatic growth, including Tedeschi’s own research and work from other scientists (“Posttraumatic Growth: Theory, Research, and Applications,” Routledge, 2018). “When you look at how people respond to traumatic events, post-traumatic growth seems to be fairly common,” he says.
Planting the seeds for positive change
Post-traumatic growth isn’t something psychologists can prescribe or create, Tedeschi says. But they can facilitate it. “We see it as a natural tendency that we can watch for and encourage, without trying to make people feel pressured or that they’re failures if they don’t achieve this growth,” Tedeschi explains.
Most evidence-based trauma treatments provide a “manualized approach” to alleviating stress and symptoms such as anxiety, Tedeschi says. The post-traumatic growth framework he uses is an integrated approach that includes elements of cognitive-behavioral therapy, along with other aspects that emphasize personal growth. “It has elements of narrative and existential aspects, too, because traumas often present people with existential questions about what’s important in life.”
One way to help clients see the possibilities for growth is to be an “expert companion” during their struggle, he says. “That’s someone who accompanies their trauma, listens carefully to their story and learns from them about what has happened in their lives. By being that kind of expert, people start to open up and look at the possibilities in their lives more thoroughly.”
Yet post-traumatic growth isn’t something that can be rushed, and it often takes a long time to come to fruition. “As a clinician, you can plant the seeds that may germinate later,” Tedeschi says.
As we emerge from the COVID-19 crisis, clinicians and their clients may have opportunities to help those seeds begin to sprout. “This situation presents a challenge to people’s lives, and some people will be able to emerge from this for the better,” Tedeschi says.
One doesn’t necessarily need to experience trauma and existential struggle to learn from this crisis, however. For many people, the pandemic is shining a light on the things that are most important. “We might be making more time for things we find meaningful, simplifying our lives and making time for being connected in our relationships,” Felix says. “A stressor like this makes all of us think: What does this slowdown mean for our lives? We might be fundamentally changed in some ways that are beneficial.”