Post Traumatic Growth: putting the theory into practice 

Post Traumatic Growth

Just how can the theory of Post Traumatic Growth be put into practice? What are the processes that make it work?  And what lessons does it have for the post-Covid health and care sectors?   

In my last blog I spoke about the idea that, however bad things become in our lives, there is always a ‘gift’ or an ‘opportunity for growth’, if only we can find a way to find it. As I said then, this has the potential to be seen as dismissive of our natural reactions to deeply disturbing, even life threatening, events. However, if applied with care and sensitivity, we can find routes through our trauma, and start to process what we’ve been through. Done well, we can then emerge better, stronger, and more complete human beings. 

The idea of Post Traumatic Growth (PTG) was developed by Richard Tedeschi and Lawrence Calhoun in the USA, while working with service personnel and first responders.  It’s a way of approaching an individual’s unique experiences of trauma and helping them to explore their reactions to those events. Through a set of processes, they learn to re-examine not just the events themselves (though those matter, of course) but how they can be assessed and absorbed in such a way that the individual can make sense of what may at first appear totally senseless, and, therefore, begin the process of re-building their lives. 

There are five steps which Tedeschi has identified which facilitate this development. Though often presented in diagrammatic form as a circular process, the steps are not necessarily linear in their application. No two individuals will start the process in the same place, but the key phases do help us to both map that journey and assess where someone might be on their route to, as Tedeschi  puts it, ‘learning to live life well’. 

So what are those steps? 

The Five Phases of Post Traumatic Growth      

Education

Trauma not just shatters lives, but it shatters beliefs. Our view of the world is completely altered. Understanding this, and what our reactions are to these fundamental changes to our understanding of how the world ‘operates’, is an essential first step. Wherever we start from, whatever our feelings, we need to know that these reactions are valid and rational reactions to what we have been through. 

Emotional Regulation

Having understood our reactions, we now need to start to manage them. There will be negative feelings, ranging from anxiety to guilt and anger. These are perfectly natural feelings, but the way we understand and control them can vary. PTG often uses exercise, meditation and ways to share feelings with others in similar situations.         

Disclosure

Talking about what happened is an important first step, but talking about just how this has changed us, what new insights, however negative these may be, is more important than dwelling on the events that caused the trauma in the first place. How does it make you feel, is more important in both the short-term and long-term than re-tracing the actual events themselves.     

Narrative Development  

Having explored the feelings and emotions unlocked by examining events, the next stage is to move forward by asking just what happens next? What might be your new priorities in life? A change of job or lifestyle? 

Service/Sharing

Tedeschi puts a great emphasis on using the experience you have gained through this process to help others. This doesn’t mean setting up a new charity, though, of course, it could, but even small steps to support others, being open and engaging in the simplest ways, can lead to finding new meanings and purposes post trauma. 

Domains of Growth 

People who have been through these five processes in response to their trauma often find that they experience other changes in their lives as a result. Tedeschi calls these new changes ‘domains of growth’. As the name suggests, these are positive but significant shifts in the way we view both our own lives and how we interact with others around us. These ‘domains’ are an opportunity to explore what matters to us as we emerge from the process of learning to understand the way in which trauma has fundamentally changed the way we once viewed our world.  

The domains allow us to reconsider how we can now live our lives by looking forward, examining the choices we’d like to make, and the actions we’d like to pursue. For each of the domains Tedeschi identifies I’ve set out some questions to consider. These are designed to help as you think about each stage of this ongoing process, and the impact which the five processes are likely to have as you shape what is, to all intents and purposes, a new way of viewing your post-traumatic life.        

Appreciation of Life. People often find a new set of priorities that matter, even a new purpose to their lives. 

Ask yourself:

• What’s changed for me about what’s important in my life?
• What do I want to make more of a focus in my life?
• What do I appreciate about my life that I wasn’t aware of before?

Relationships with Others. There is a greater appreciation of the part played by those around us and the part others play in our own inner wellbeing.  

Ask yourself:

• What do I know now about who loves and cares for me and who do I love and care for? 
• What relationships do I now want to nurture and give attention to?
• What are the qualities in relationships that I really appreciate and value?

New Possibilities in Life.  The development of new interests and directions in life. Trying new things and finding a renewed purpose in all aspects of life. 

Ask yourself:

• What might be possible now that I didn’t think of before?
• What experiences and activities are really important to me now
• In what areas of my life do I see new possibilities, and how can I take a small step towards them?

Personal Strengths. Many people report an improved mental strength. A new optimism in what life can be and hold for you.  

Ask yourself:

• What can I appreciate about myself in how I have got through this? 
• What strengths and qualities do I see in myself that I wasn’t aware of before?
• In what ways might I proactively use a newly recognised strength to move forward?

Spiritual Changes. Not necessarily a greater connection and appreciation of formal religious practice, but a deeper sense of ‘spiritual’ wellbeing and wholeness.   

Ask yourself:

• What is starting to emerge about my experiences that feel meaningful? 
• What about my experience connects me to others and/or a sense of unity?
• What stands out for me now about my values and what’s important about how I live my life?

Where do we go from here? 

None of this comes easy. If we define trauma as an event which challenges every aspect and understanding of life we formerly held, then these events will be different for different individuals. Equally the changes we each experience will also be different in scope and depth. For some these will be transformative, for others even the smallest change will feel profound in its impact. 

The vital thing is that there are ways to help every individual to cope with events which may at first seem so disruptive of their lives that they will never be able to cope with the aftermath. But as the above shows, with care and understanding we can find ways to not just enable them to cope with their trauma, but to come through it and live even more fulfilled lives then they did before.  

Agree? Disagree? Even want to find out more? I’d love to hear from you. Only by and through debate and discussion can we deliver the best solutions to help those who have been so much in recent years.  We need to understand what they have each been through, but also to find ways which allow them to gain insights into their experiences, and find ways to use those insights to make sense of what they’ve been through – and start to change their lives for the better. As I’ve suggested above, it’s a start. I’d like to think that start begins right here.