Mental health professionals are well aware of the problem of posttraumatic stress disorder (PTSD) in our combat veterans. Estimates vary, but researchers tend to agree that around 10-15 percent of veterans of the recent wars in Iraq and Afghanistan suffer from the disorder. It is estimated that this rate is consistent with previous conflicts as well.
Understandably a tremendous focus has been placed on developing and refining effective interventions for PTSD. Slowly, but surely, studies on prolonged exposure, cognitive processing therapy, and eye movement desensitization and reprocessing, specifically with combat veterans, have hit the pages of psychiatry, psychology and medical journals of all stripes.
These recent wars have also given rise to greater interest in the idea of posttraumatic growth (PTG). Sharing similarities with some principles of psychological resiliency (although resiliency and PTG are not interchangeable notions), the discussion of PTSD is finding its rightful place alongside discussions about the effects of combat trauma.
The Theory of Posttraumatic Growth
The theory of PTG has been popularized and advanced by psychologists Richard Tedeschi and Lawrence Calhoun of the University of North Carolina at Charlotte. Over the past 30 years, Drs. Tedeschi and Calhoun have studied the enigmatic and seemingly contradictory concept that people are able to grow in multiple life areas after experiencing a significant negative event. Their research has shown that people from all walks of life can find greater personal strength, renewed appreciation of life, better relationships, new possibilities and a higher degree of spirituality in the weeks, months and years following a tragedy. And PTG is not just an abstract theory that makes for great conversation in the faculty lounge or at conferences. Drs. Tedeschi and Calhoun have tested their hypotheses with their scale the Posttraumatic Growth Inventory, an instrument that has been used in hundreds of studies.
Support for Posttraumatic Growth in Combat Veterans
In their 2011 article titled “Can We Facilitate Posttraumatic Growth in Combat Veterans?” Dr. Tedeschi and Dr. Richard McNally of Harvard provide evidence that combat veterans can and do indeed experience PTG. They cite multiple studies conducted with former prisoner of war (POW) veterans, a group that has suffered some of the greatest traumas associated with combat and military service. Broadly, the majority of POWs experience growth following their experiences. And in some cases data supports the notion that the more severe a trauma is for a person the greater potential there is for growth. Furthermore, studies looking at multiple war eras (World War II, Vietnam, Persian Gulf) and cultures (United States, Israel) support the presence of PTG.
Facilitating Posttraumatic Growth
The primary model for facilitating PTG is found within Tedeschi’s and Calhoun’s theory and practice of expert companionship (EC). EC is the process in which the clinician takes the role of a consistent and compassionate companion who can convey interest and respect in the trauma survivor’s experiences while helping them identify and nurture positive changes. Although there are slight variations in the delineation of the process, the main tenets include: 1) helping the trauma survivor understand the trauma response; 2) learning methods of emotional regulation; 3) adaptive self-disclosure; 4) writing a new life narrative or story; and creating and fostering a new way of life that protects one’s self against future obstacles. For a more detailed review of these concepts, see Tedeschi & McNally, 2011.
Points to Remember
■ Growth can and does occur after trauma.
■ Some experts believe posttraumatic growth is the norm and not the exception.
■ Combat veterans are exposed to high rates of trauma, but also have some of the highest rates of growth.
■ Expert companionship is the process by which the clinician can help facilitate posttraumatic growth.
Tedeschi, R. G. & McNally, R. J. (2011). Can we facilitate posttraumatic growth in combat
veterans? American Psychologist, 66, 19-24.
*You can learn more about Posttraumatic Growth from the “Posttraumatic Growth Workbook: Coming Through Trauma Wiser, Stronger and More Resilient” written by Drs. Richard Tedeschi and Bret Moore.