Post Traumatic Growth

That which does not kill us makes us stronger. ~Friedrich Nietzsche

The normal response to trauma is resilience and growth. Some people develop PTSD, or post traumatic stress disorder in response to trauma. Most people do not. Depression, suicide, anxiety, and PTSD are ways some people “break down” after an adverse event. Most people are resilient. After going through a tough time for awhile following the trauma, they bounce back – usually within a few months. Some people have a really tough time following the trauma. After a year or so, they not only bounce back to where they were before the trauma, they experience post traumatic growth where they are even stronger than before. Their life has more value, meaning and purpose than it did before.

In one sense, it’s good that the public is educated about PTSD and trauma symptoms. A lot of people are helped because they recognize the symptoms and know to get help. The downside of this knowledge is this. What if a person has a traumatic event, and begins to think, “Now my whole life is ruined, and I’ll never recover?” That knowledge becomes self fulfilling, and can lead to worsening symptoms; even create symptoms that might not have occurred.

Knowing that it’s normal to cry or feel depressed or experience some anxiety after a traumatic event, a person will more likely experience resilience and growth. Likewise, if a person knows that many people experience growth and opportunity after a trauma, he or she is more likely to be aware of and prepared for growth opportunities when they present. On the contrary, believing that his life is ruined and he is permanently damaged, keeps him debilitated and unresponsive when opportunities do present.

Depression, suicide, anxiety and PTSD affect one fifth of the soldiers returning from Iraq and Afghanistan.These conditions do not affect the remaining four fifths of the soldiers. While there may be some biological and genetic differences in those who develop PTSD and those who do not, for the most part resilience, our ability to bounce back, is learned. Often it is learned from past adverse events. Confidence that one can overcome adversity comes from past experiences of having overcome adversity.

Army Basic Training used to be thought of as a way of weeding out those who were not physically and mentally strong. Drill Sergeants stood screaming nose to nose with new recruits, calling them numb nuts and piss ants, and ordering 20 push ups for un-shined boots. The astute recruit thanked the drill sergeant and asked for more push ups. When a recruit completed Basic Training, he or she was certified “Army Strong.”

Now, due to increased rates of suicide, PTSD, divorce and substance abuse, drill sergeants are receiving resiliency training and teaching resiliency skills to new recruits. Many soldiers are on their third or fourth deployment and the stress of these extended periods away from family and in combat situations over a period of ten years is taking a toll. Seasoned soldiers and their family members are also taking resiliency training classes to help them prepare for and cope with repeated deployments. Every soldier is now receiving resiliency training.

It is hoped that resiliency training will prevent some soldiers and their families from developing problems and help them recover if problems do arise. There is currently no evidence that the training will increase resilience or prevent symptoms. When the training is complete, it will be known whether resiliency or mental toughness can be taught in a classroom, and whether resiliency training can prevent or reduce trauma symptoms. Similar types of training have been used in parenting classes and in schools.We may now be better able to assess their effectiveness in preventing and reducing trauma symptoms related to childhood trauma. The findings may also have implications for corporate training in resiliency.

The training is based on the life long work of Dr. Martin Seligman, father of positive psychology and author of Flourish, a book about well being. He modified his work to meet the specific needs of the military. Dr Seligman identifies the building blocks of resilience and growth as PERMA, an acronym for positive emotions, engagement, relationships, meaning and accomplishment. The hallmark of Dr. Seligman’s work is that too much attention has been paid in clinical training for mental health practitioners on identifying and correcting a problem – what is wrong – rather than identifying and building on strengths, or what is right.

The training also includes some cognitive behavioral concepts that reinforce the idea that it is not so much what happens; but our thoughts about what happens, that lead to our emotional and behavioral reactions to adversity. Some common thinking traps are identified and corrected. For example, the thinking trap of “always, always, always” leads to believing that a problem is unchangeable and that one is helpless to do anything about it. Being able to identify what can and cannot be controlled and taking control of what can be controlled are alternatives to a helpless response of doing nothing and believing that a painful experience will last forever.

The resiliency training program has been implemented under the direction of Brigadier General Rhonda Cornum, a flight surgeon whose helicopter was shot down over Iraq. When she awoke and learned that she was still alive, she perceived her situation as positive compared with her original belief that she would surely die. While held captive for eight days she was sexually molested repeatedly by her captors. She refused to be defeated or “haunted” by her experience. In the video link below, General Cornum describes how important it is to have resiliency skills before they are needed, and that these skills can be learned.