Posttraumatic Growth

There can be positive change after adversity.

By Adena Bank Lees, LCSW

For those who have experienced trauma, it is common to feel like life will never be the same again. As evidenced by a growing body of research, though, humans have the ability to not only “bounce back” from trauma, but to yield a positive life on the other side of a traumatic experience. Those who study and practice in the field of mental health refer to this as posttraumatic growth (PTG), defined as positive psychological change experienced as a result of adversity and other challenges in order to rise to a higher level of functioning.

About Posttraumatic Growth

The general concept that trauma can lead to positive change is a common theme that has appeared in religious and philosophical teachings for thousands of years, but it wasn’t until the mid-1990s that the term posttraumatic growth was coined by psychologists Richard Tedeschi and Lawrence Calhoun.

Tedeschi and Calhoun posit that PTG tends to occur in five general areas:

  1. Appreciation of life
  2. Relationship with others
  3. New possibilities in life
  4. Personal strength
  5. Spiritual change

These five factors make up the general themes of the Posttraumatic Growth Inventory (PTGI), a 21-item assessment tool developed by Tedeschi and Calhoun to determine an individual’s progress in reconstructing their perceptions of self, others, and the meaning of events while they are coping with the aftermath of trauma. PTG does not discount those who struggle with posttraumatic stress. It does, however, offer a new lens through which an individual can explore themselves in the shadows of trauma.

Experiential Methods Can Encourage Posttraumatic Growth
As practitioners, we must meet our clients where they are at and not minimize their suffering by jumping to practical solutions. Most often, our assistance is sought after a traumatic event has occurred, so we need to take great care in introducing PTG concepts. Therapy – especially when experiential learning methods are employed – can help people see that things like these are true for them:

  • I discovered that I’m stronger than I thought I was.
  • I know better that I can handle difficulties.
  • I changed my priorities about what is important in life.

Experiential learning allows healing to take place in “real time” – we do not talk about something, we actually engage in it.

Take Christine (35 years old), for example, who was sexually abused from ages 8-13. Christine felt alone and did not trust others when she entered therapy. In several psychodrama group therapy sessions, Christine experienced group members’ support through their standing behind her with hands on her shoulders. She allowed hugs when crying or frightened. Group members contacted her between sessions to see how she was doing. At the close of the 12-week commitment, Christine reported, “because my group members were here for me and supported me when I was crying and in pain, I am more trusting that I can count on others in difficult times.” She continued with the group and strengthened the relationship aspect along with other aspects of PTG.

According to Dr. Kate Hudgins, co-founder of the Therapeutic Spiral Model, “Posttraumatic Stress Disorder is not a terminal illness. It can be treated with experiential methods such as those from the Therapeutic Spiral Model of psychodrama, which addresses trauma in action. As clients build up the strength to face their trauma, they realize that they can emerge victorious into PTG.”

Therapist, author, and lecturer Rokelle Lerner recommends using story writing as an experiential strategy to identify, clarify and solidify posttraumatic growth: “Every time we describe our life’s events, we are both providing and discovering underlying patterns of meaning. It is the meaning we make of our experience that shapes how we feel, think, and respond.” Lerner offers the following outline for writing one’s story:

  • Once upon a time… (wounding)
  • And when he/she grew up… (present)
  • The story changed when… (vision)

At the very least, we can help clients understand that posttraumatic growth is a normal process that can be a possibility for them.

 

References

Tedeshi, R.G., & Calhoun, L.G. (2004). Posttraumatic Growth: Conceptual Foundation and Empirical Evidence. Philadelphia, PA: Lawrence Erlbaum Associates.

Tedeschi, R. G., & Calhoun, L.G. (1996). The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9, 455-471.

Tedeschi, R.,et al, (2018). Post Traumatic Growth: Theory, Research and Applications. New York, NY: Routledge.

Article originally posted on Psychologytoday.com

 

Adena Bank Lees, LCSW, is a counselor, speaker, author, and consultant, providing fresh perspective on traumatic stress, addiction treatment and recovery. Her specialty is childhood sexual abuse, and in particular, Covert Emotional Incest. She is a Licensed Clinical Social Worker, Licensed Independent Substance Abuse Counselor, Board Certified Expert in Traumatic Stress ®, and a Certified Practitioner of Psychodrama. She is the author of Covert Emotional Incest: The Hidden Sexual Abuse, A Story of Hope and Healing, as well as 12 Healing Steps for Adult Survivors of Childhood Sexual Abuse; A Practical Guide.

Spectrograms in India: Increasing Cultural Competency through the Third TSM Psychodrama Safety Structure

by Steven Durost, PhD, AL

 

Scarves on the floor and saris wrapped around participants.  96 degree heat drying sweat as it comes of the body and fans providing more noise than relief.  This day is the fourth day of a seven day stretch of TSI Psychodrama workshops presentations.  Yesterday, we completed yesterday a three day workshop in Bangalore and then directly after flew an hour to Coimbatore where we slept and woke to be starting today.

Frankly, I like the heat. I have been traveling in India for almost two weeks prior to the workshops and I have been cold.  The temperatures in New Delhi drop fast from 70 to 40 degrees when the sun goes down.  Finally a place I can feel my toes.

Karen Drucker and I stand before our second group of 18 curious and eager participants.  They have all been in psychodrama training for several years under the tutelage of Jochen Becker.  Jochen lives in Germany and has devoted one month out of every three to develop psychodramatists in India.  His years of devotion have paid off in a group of trainees who have skills and a rich understanding of psychodrama.

Karen and I work through the safety structures with spontaneity aimed at building the group sociometry.  We are eager to deepen our understanding of Indian culture and people.  We are aware that we are unaware of our blind spots. So, part as training and part to build our cultural competency, we ask the participants to break into three groups and to develop spectrogram criteria that will help us understand what is important to them.  What do they want us to know about them selves and their world?

Karen and I were struck by the criteria they created and how much it revealed about India and the what was important to the participants.  Here are the criteria we put into action and some of the things we learned about Indian culture.

 

Education Level

The first spectrogram criteria was to “put yourself along the line in relation to the amount of education you have.”  The placement of the participants showed they were a highly educated group with PhDs, accountant, leaders and counselors.  They said that there is a great pressure in India to be educated. In some cases, one person is educated in order that they can then support the family back home.  I asked if there is a lot of shame around the amount of education one has.  I was told there is a great amount of shame if one has not achieved well in school. A woman who is educated can get a better husband and command a larger dowry.  However, there is a doubled edge sword because a woman cannot be more educated than her husband.  “A woman can be educated but only just enough.”  One participant stated she defied her parents and became more educated than they thought was proper.  The depth of this criteria provided a rich understanding of a topic we would not have explored or if we had we would not have done so in the same way.

 

Personal Space

The next criteria was “at home I have little physical space for myself to I have a lot of physical space for self in my house.”  The participants were spread evenly over the line with some saying they have very little personal space at home and needed to go to work or school to have space that is their’s.  And, other participants saying they had a good amount of space.  Discussion about why this was an important criteria followed as participants express that the idea of personal space is different in India…with people on buses and trains pushed up against or purposely pushing against you.  Someone suggested the criteria might have a follow up of “who would want more space versus who is content with the space they have.” Then someone mentioned that asking for more was considered wrong when growing up, so the criteria would be hard to answer because it would work against cultural upbringing.  Others suggested that participants expand on “what do you have in that personal space at home” and “what are spaces outside home where you have space.” And there was one even more interesting criteria being “how much emotional space do you have in this moment?”

 

Feminine and Masculine

The next criteria opened up many possibilities for exploration.  “In this moment, I feel feminine and at the other end in this moment I feel masculine.”  Again the line was balanced out with the majority of the participants more or less in the middle.  All three men were in the middle stating they felt equally in touch with their masculine and feminine sides.  Three women were fully at the masculine end stating they were feeling very pro-active/action-centered/making something happen in their beings.  This criteria’s richness has another level as the god Shiva is sometimes portrayed as half man and half woman.  This portrayal is when Shiva and his wife Parvati are spliced together…showing male and female energy equally.

 

Geographic Area

One other criteria that emerged from the groups is more of a locogram in which participants would stand in positions representing North, South, East and West India.  From these places, participants could talk/show the diversity of cultures in India based on regions.  We were told that each area is different, with different festivals, food, politics, language, landscapes and uniqueness.  Much cultural abundance could be found in this locogram.

Education level, personal space, the masculine and feminine internal connection and geographic area as diverse cultural identity were the criteria that the participants felt gave Karen and I a deeper understanding of the lives they are living.  There was so much to unpack in what they offered and insight into their culture.  Without asking the participants to come up with their own criteria, we would have imposed our own criteria and never had the luxury of unpacking cultural differences that lay in our blind spots.  In the planning for the workshop, we brainstormed spectrogram ideas to attend to social issues, political differences, cultural defenses/values, conflicts and interests.  However, we did not come close to the topics they felt important.  The learning for me is about providing opportunity within the safety structures for groups to have their own time to explore and build the sociometry they feel is important to let them have time to “show” who they are and how they are connected.  I learned more about Indian culture in that 45 minutes than in the two prior weeks of travel, multiple tours and cultural events.  With thought and care, the third TSM safety structure can be used to deepen cultural competency, create human connection and expand the positive impact of a workshop.

A drum sits in the middle of scarves at the end of the last day.  Art pieces depicting the autonomous healing center have been created, shared and integrated.  The end of my time in India is approaching.  I know I will miss the heat.  And, because our hearts were open to each other, I will miss the people from this workshop too.

Dr Steve