Most people know about post-traumatic stress disorder (PTSD).  They’ve read an article or blog post or heard a podcast about how people are struggling to cope after a traumatic event.  However, there’s another story to be told.  Transformed by Trauma: Stories of Posttraumatic Growth tells those stories.  It explains how trauma can harm us and how we can also grow from it – sometimes both at the same time.

Primer on Post Traumatic Stress Disorder (PTSD)

While everyone may know about PTSD, that doesn’t mean that everyone understands how it works and what to do about it.  James Pennebaker in Opening Up explains that PTSD may be the inability to process a traumatic event.  In other words, it’s not what happened, it’s how we’re able to process – or not process – what happened.  Normally, as we sleep, we reprocess the day’s events, filing them away for future use.

Robert Sapolsky in Why Zebras Don’t Get Ulcers explains how sleep, and particularly the ability to get into the rapid eye movement (REM) stage of sleep, is critical to integrating our experiences into a coherent story for storage into long-term memory.  Any disruption of this process prevents the memories from being properly stored and can either make them relatively permanently inaccessible or require processing again.  Those items that are the most emotionally charged are likely to need to be processed again until the processing can complete successfully.

In traumatic events, it’s possible that the integration work of the event itself can trigger the failure to complete REM sleep.  The event may be sufficiently emotionally activating that an individual is awoken by the physiological response to the integration process.  This disrupts the process and requires that it happen again – and again.  Many PTSD suffers find that flashbacks of situations occur both while awake and while dreaming.  These flashbacks may indicate that the traumatic experience was never fully processed.  To alleviate the challenges associated with PTSD, it may be that the key is to find ways to make it possible to process the traumatic event.  (See The Body Keeps the Score for more about techniques for processing.)

Richard Lazarus in Emotion and Adaptation explains that what happens in our world is less about what it is objectively and more about how we appraise what happened.  This perspective makes it possible for PTSD suffers to change the perspective on a trauma to the point where it doesn’t emotionally activate so strongly that the event can’t be processed effectively.  The short version is that by changing the meaning – the appraisal – it’s possible to substantially reduce the emotional and therefore physiological activation associated with an event.

Consider a veteran who inadvertently kills a child during a combat situation.  The fact is not itself emotionally charged.  What’s emotionally charged is the feelings that it was wrong and that it should (and could) have been prevented – or the identification of the child as someone related to the veteran for whom the veteran would grieve.

In the first condition, because it is assessed to be preventable, the conclusion is that the person is to blame and therefore not a good person.  This sets up an inner conflict with the ego, and this conflict creates activation.  (See Change or Die and How We Know What Isn’t So for more on our ego.)

In the second condition, the identification of the child as someone for whom the veteran would feel loss, activates the grief associated with that loss.  The key is, of course, to decouple the identification, but this is substantially easier said than done.

In either condition, finding ways to stabilize the individual’s sense of self and general sense of calm can make it possible to process the events over time.  In fact, the process of developing the skills necessary to cope with PTSD may be the kernel for the development of posttraumatic growth.

Finding Posttraumatic Growth (PTG)

Posttraumatic growth (PTG) isn’t the opposite of PTSD; in fact, you can have trouble integrating an event into your world and at the same time experience the characteristic reorganization of values that accompanies PTG.  PTG is, at its heart, a renewed or changed sense of meaning and purpose.  People find that the traumas they’ve survived have caused them to experience the world differently and value things differently.

There are five areas for growth because of this new view of the world:

• Personal Strength
• Relationships with Others
• New Possibilities
• Appreciation for Life
• Spiritual and Existential Change

Sometimes, the trauma that you experience virtually forces you to see things differently.  Sometimes the one change brings a ripple effect of others that must be seen differently to come into alignment with reality.

For instance, the death of a son or daughter forces parents to recognize that they cannot always protect their children.  There’s a choice to be made in these cases: one choice is to find ways to accept the new reality and move towards creating situations of greater support and safety for them.  Conversely, it’s possible to become consumed by the specific situation that caused the death.  It can be that you see the world differently and at the same time can’t fully process the event.

In many more cases, the perspective change from the trauma is more subtle and less “required.”  It’s in these cases when the capacity to grow is most important.  Antifragile explains that growth comes from repeated strains that are of the right kind, at the right time, and to the right degree.  The greater degree to which you’re conditioned to reevaluate your perspective of the world and your values, the more readily you’ll adopt the sub-required perspective shifts that can be learned from trauma.

Victimhood

It’s one thing to have been a victim and another to feel like a victim.  It’s the difference between what has happened and how we view ourselves and the world.  One is a history lesson, and the other is a future prediction.  One of the keys to gaining PTG is to release the feelings of being a victim and find a way to accept the previous reality while also accepting that it’s not necessarily a reality for the future.  It’s not easy to decide to move out of “victimhood.”  It’s an easy place to get into but difficult to gain the courage to leave – but leaving it is important.

Leaving victimhood behind is a lot about changing your perception of yourself and your capabilities.  You can’t change the past, but you don’t have to stay there either.  Though it’s not simple or easy, it’s possible to redefine situations as growth experiences, and that opens the possibility to develop a new strength.

Distress

Experiencing PTG or coming to the other side of a traumatic event is no guarantee that there won’t be further traumatic events.  However, the goal isn’t to eliminate the traumatic events in the world that you cannot control.  The goal is to develop a set of coping strategies that prevent you from remaining in acute distress.  Whether these strategies involve asking others for help or tapping newly developed skills, the objective is to confront distress and find a way to become Transformed by Trauma – in a positive way.