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What Is Post-Traumatic Growth?

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I’m no expert. I may be a recent grad school graduate, having completed my master’s degree in clinical mental health counseling at CACREP-accredited Messiah College Graduate School, but I’m not the authority on post-traumatic stress disorder (PTSD) or post-traumatic growth (PTG).

• What is PTSD?

Here’s what I do know: I know what it’s like to experience significant trauma. In fact, I was sexually molested at the age of 4 by a male perpetrator and spent years reeling from the after effects of childhood sexual abuse (CSA). Coming out of my CSA experience, I found there were two clear pathways toward recovery and healing: one which focused on the symptoms of my abuse, and one which identified and utilized assets and resiliency factors.

It’s entirely possible I grew up with PTSD symptoms and remained undiagnosed. Regardless, I’m still here today, and somehow, I’m thriving. Thriving occurs when an individual faces barriers, such as trauma, neglect or abuse, and despite these negative factors, finds a way to overcome them in a way which has a positive outcome. I found my way through the trauma, the pain and the unwanted flashes of memory of my abuse. With little help from others and the furthest-from-ideal home life situations, I found a way to bounce back, grow and find resiliency. I learned to get back up when aspects of my life felt more like I was being crushed under someone’s foot. An Eastern adage states: fall down seven times, get up eight. If I could find a way through the obstacles I faced with my own trauma, I think you can find a way through your symptoms, too.

As a recent graduate from grad school, I’m learning plenty of new things. I never knew there was such a thing as PTG, but there is. We’ve all heard about PTSD, since many of our family members have at least someone in the military, or who have experienced trauma from the events of 9/11, or who have lived through one of several hurricanes or other weather-related natural disasters. Post-traumatic growth (PTG) is a relatively new diagnosis similar to PTSD, yet focused on assets and resiliency, rather than on symptoms of trauma. I don’t mean to minimize the very real experience that is the reality of a PTSD survivor. However, I don’t believe it is healthy for the survivor to accept their PTSD status permanently or indefinitely until it redefines their identity. It doesn’t have to become permanent.

Healing and recovery are possible. Growth is possible. If that is true, then PTG is an option for the survivor of PTSD to work toward. PTSD may be a starting point, but it doesn’t have to be an endpoint or a death sentence. PTG utilizes mindfulness and resiliency to support recovery in a way that moves a survivor away from just managing recurring symptoms of PTSD.

But here’s the problem with PTSD: it often focuses solely on the symptoms of the trauma — the after effects — and these can eventually define the survivor. The goal of a diagnosis is to identify a mental health need, to develop a treatment plan and
therapeutic goals, and to work toward those goals. The ultimate goal is to be discharged from treatment because you have attained your goals or have made sufficient progress in healing from your trauma. When an individual is diagnosed with PTSD, it’s often like a sentence for permanent victimhood. The diagnosis can change your identity, it can prevent you from moving on, and it can limit your ability to find a way out. Or at least, it has the potential for these negative outcomes.

I’ve never been diagnosed with PTSD, but I’ve experienced some of the after effects. These may include: reliving or experiencing the trauma over again through flashbacks or nightmares. These experiences can be so vivid that they include visuals, smells and the sensation of touch. Those who have these vivid experiences of reliving past events might witness things that are not actually happening and then startle awake from being in a hyper-alert or hyper-vigilant state of mind and realize those events did not actually happen. PTSD survivors often have gaps in their long-term memory as a result of a break down in the system that records the memory.

This is due to the impact of the fight-or-flight response intersecting with the recording of the long-term memory. Two parts of the brain are responsible for recording memory: the hippocampus and the amygdala. The hippocampus records the video of a memory — who was present and when the memory occurred along the timeline of an individual. The amygdala records the sensory aspects of a memory, including everything the individual sees, hears, smells, tastes and touches within a memory. When both parts work correctly, a long-term memory is recorded and stored in the brain. When this process is disrupted by trauma, the fight-or-flight response is activated and the brain is unable to record the memory, essentially creating a broken computer file which the brain can’t easily open. The fight-or-flight response has four F’s: fight, flight, freeze (there are two of these: brain freeze and numbing) and fawn. When the individual has a freeze response, they are essentially unplugging the amygdala, and thus gaps in memory occur. These can be restored with the help of a trained clinician who understands how to restore these “broken files.”

PTG focuses more upon mindfulness and resiliency. Thus, an individual recovering from trauma learns to remain in the present moment without judgment, rather than having a flight/freeze response which typically causes them to run away from the problem, rather than stay present and bounce back from the effects of the problem.

Imagine a line with a focal point in the center which stands for the trauma you’ve experienced. If you were to move to the left, let’s say this can be described as a negative outcome. If you were to move toward the right, let’s say that is a positive outcome. Moving left of the trauma brings you to post-traumatic stress symptoms (PTSS). These symptoms often have distress as a key component. Moving further along this continuum away from the trauma brings you to PTSD. But these negative outcomes do not have to be the only way out from the trauma.

Moving to the right, away from the trauma, you come to PTG. Post-traumatic growth is an amazing paradox. The individual with PTG has both distress, just like PTSS on the opposing side, but as a result of a cognitive change, literally a transformation, after processing the after-effects of the trauma, which leads the individual toward PTG. The components of PTG include: new possibilities, relating to others, personal strength, appreciation for life and spiritual change. Along the positive side of the continuum, PTG is only the first step leading to resiliency. Resiliency is often where true growth happens, with long-term positive effects no longer led by distress or reliving the trauma as an outcome. Mindfulness can also be a positive factor of PTG, allowing an individual to remain present to distress and learn from it in an objective way.

We may live in a negative-focused, glass-half-empty, bad news is good news culture. Rarely do we hear about the possibility of goodness, growth and resiliency as outcomes to problems, let alone trauma. Now you know. Tell a friend. And when you’re tempted to make a joke about the very real trauma someone has experienced, first walk a mile in their shoes, then see if they’re doing the best they can with the resources they have and swallow that thought if it doesn’t encourage that person toward a positive outcome.

Perhaps you’ll be the next one to experience an unexpected trauma in your life, and you’ll be glad to know there are options that don’t involve remaining a victim, or a public punching bag, or a bully’s favorite sport. Please remember, you can seek out the possibility of PTG or resiliency as an outcome.

Getty image via Warren Wong

Originally published: July 19, 2018
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