Exploring post-traumatic growth

By Lori A. Zoellner, Ph.D., Professor, Department of Psychology, University of Washington
Emma K. PeConga, Ph.C., Doctoral Candidate, Department of Psychology, University of Washington
Michele A. Bedard-Gilligan, Associate Professor, Department of Psychiatry and Behavioral Sciences, University of Washington

Who, after a horrific sexual assault, would not wish that the thing that has happened didn’t happen? That, that day or days would disappear from the course of their lives and from their memories? No one chooses to be sexually assaulted. No one chooses to have unrelenting images, vivid nightmares, fear, or grief for days, weeks, months, or years following an assault as many do.

Messages now abound on social media encouraging individuals to “choose” to grow after trauma, a concept called post-traumatic growth: “PTG is about finding strength in the scars. It’s about emerging from the storm with a deeper appreciation for life.” or “…Remember, out of the deepest pain comes the greatest growth.”

But, is it really that simple or even an individual “choice?”

Almost thirty years ago, Tedeschi and Calhoun were credited with introducing the concept of “post-traumatic growth” in the scientific literature. The idea is simple: trauma can be a catalyst for profound personal evolution, from coming to appreciate each day as a gift, loving others more fully, to knowing an inner strength that was never known before.

Yet, real suffering also goes along with post-traumatic growth; one does not exclude the other. In large studies that pool results for tens of thousands of trauma survivors, higher post-traumatic growth is, almost always, associated with higher severity of post-traumatic stress symptoms. There is not a dichotomy between growth and suffering. They are intricately connected, like two sides of the same coin. More often than not, it is a “both/and” not an “either/or” situation. For most, emotional processing after an assault is a dynamic process where growth and suffering can occur simultaneously, where there can be high points of realization, and where there are profound low points of fear and loss. There are days of thriving and days of just getting by.

The danger associated with the term “post-traumatic growth” is that it can easily be misinterpreted as potentially blaming the survivor. This involves a sense of invalidation; feeling judged for continued suffering and feeling solely responsible for one’s outcome. If you are simply able to “#ChooseGrowth,” everything will be okay; and if you are not, you have somehow failed in some way.

It also places societal expectations that individuals can’t live up to, such as the old adage “when life gives you lemons, make lemonade” or the expectation to be the “wise one” who has emerged from the fire or risen from the ashes. Not everyone experiences new self-actualization or gratitude following a sexual assault—this is more than okay!

Importantly, post-traumatic growth is not solely an individual pursuit but one that rather requires us as a society to step in and provide support. Our current conceptualizations of recovery and growth often do not adequately account for this. Quite simply, society needs to stop sexual assault from happening in the first place AND better support people after it happens; we need to be better at giving people the support they need or want. Not everyone needs therapy. But, if needed, there are good evidence-based psychotherapies reducing post-traumatic stress and fostering post-traumatic growth. Yet, it is still often hard to choose to seek help, and, even then, the process can often be frustrating, with limited or delayed access to quality care in some locations. This is, hopefully, changing.

Our social environments critically provide thousands of little and big interactions that shape how someone thinks about a sexual assault. Recovery and growth are determined not just by an individual’s choices, but also by messaging they hear from their communities, our culture, and our society.

No one who is experiencing post-traumatic growth is doing it alone. Post-traumatic growth takes time, happens in surprising ways, is not there all the time, and yet it does occur. No one chooses to be sexually assaulted; and no one is solely responsible on their own for post-traumatic growth. To that end, we encourage all of us to choose compassion not pity, understanding not silence or criticism, and hope for the survivors in our lives.

Our thanks to our partners at the University of Washington for this guest blog.