Join senior clinical neuropsychologist Dr Jamie Berry as he presents to Ade O’Malley, young survivor of stroke on post traumatic growth.

Dr Berry covers:

  • What is a traumatic event, including trauma statistics
  • What is post traumatic growth?
  • The five areas of post traumatic growth
  • The difference between post traumatic growth, resilience and happiness
  • Why does post traumatic growth occur?

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Transcript

Jamie: So welcome to my world, Adrian. In our previous conversation, we mentioned trauma in the context of defining post-traumatic growth.

So what's a traumatic event?

It's essentially an event that threatens the integrity of an individual. And the DSM defines trauma as exposure to actual or threatened death, serious injury or sexual violence.

The person might encounter trauma in being exposed to war, sudden and unexpected death of loved ones, natural disasters, threatened or actual physical assaults, threatened or actual sexual assaults, serious accidents and being diagnosed with a life-threatening illness such as stroke.

There are some trauma statistics you might find interesting. 57 to 75% of Australians will actually experience a potentially traumatic event at some point in their lives. So the majority. PTSD is characterised by enduring symptoms of intrusive memories of the event, avoidance of all of the reminders of the event, a negative thoughts or feelings and changes in arousal or reactivity.

So that's post-traumatic stress disorder. And it's estimated that 12% of Australians will experience PTSD in their lifetime. The one year prevalence is about 6% in Australia. And approximately 20% of people who are exposed to a traumatic event experienced PTSD.

So there's some statistics about trauma.

Now your question when we had our discussion was what is post-traumatic growth? And that is most commonly defined as positive psychological change experienced as the result of the struggle with highly challenging life circumstances.

This is the definition that was offered by Tedeschi and Calhoun, who developed the PTG literature.

There are some other definitions and similar concepts. Another definition is the success with which individuals cope or strengthen their perceptions of self, others and the meaning of events after a traumatic event. And some of the other terms or concepts that overlap with or are sometimes synonymously used with post-traumatic growth are adversarial growth, benefit finding and stress related growth.

Importantly, post-traumatic growth is to be distinguished from resilience.

We often use the term resilience within a mental health context and in everyday language. And what resilience means is basically bouncing back to your baseline after you've experienced some adversity or challenge.

Post-traumatic growth is different in that the person bounces back to a higher level compared to their baseline.

And a very common saying that's often cited in this respect is that which doesn't kill me makes me stronger by Nietzsche.

Adrian: But Jamie, we're not talking about being happier. We're not talking about happiness, per se, are we? It's different.

Jamie: It's very different to happiness. One can experience post-traumatic growth independent of their levels of happiness. It's more about developing a sense of purpose, meaning and autonomy in life.

So consider the person who's lost his or her child to leukemia. Very sad experience, obviously. And because of that experience, they've become committed to helping other children with leukemia or parents of children with leukemia. They set up a charity. And they help develop awareness and raise funds for this worthy cause.

Now, that person won't necessarily say that they feel happier as a result of what they've been through, but they will often report a stronger sense of purpose and meaning as a result of the event.

They've re-evaluated their life where their life trajectory was, and they've made a significant change and look for new opportunities in this case.

So the positive changes, the new found meaning and the clarity of life priorities would be considered forms of growth, even if the person's not reporting feeling happier or more satisfied with life.

So you asked about the five areas of post-traumatic growth. They are an enhanced appreciation of life, increased perception of personal strengths, identification of new possibilities for one's life, spiritual growth and improved relations with others.

Why does post-traumatic growth occur?

One reason is people are intrinsically motivated towards growth. We all aim to grow. If you ... If I cite one of the more popular and well founded theories in psychology, which is self-determination theory, we all strive for competence, connection and autonomy.

And competence is about growing, learning new things, being productive, being helpful, being able to be of service.

So we're all intrinsically motivated for that.

When someone experiences a traumatic event, their world shatters. It ... Their world views are questioned and they need to, in a sense, pick up the pieces and reassemble their model of the world.

And so if a person is intrinsically motivated to grow and their world shatters around them, that obviously leads to this third element, which is reconstructing the world and the model of the world.

And this requires the person to make meaning of things. Often in different ways to their understanding prior to the traumatic event.

Adrian: So I grew up in the country. I know cows ruminate. But why are we talking about rumination? I think it's an interesting idea.

Jamie: Yeah, rumination probably deserves more research than it's attracted to date. Rumination is the idea of mulling over concepts, ideas, what's happened, what's to happen.

So people can ruminate about what's happened in the past. But people can also ruminate about what they're concerned about in the future.

And rumination is a really important part of the process of making sense or making meaning of things. So rumination about a traumatic event involves thinking about how and why the event occurred, and it's accompanied by high levels of distress, often at least in the early stages, and it can be characterised by intrusive thoughts.

So thoughts you don't want to have at that particular time or intrusive memories and counterfactual thinking about how the incident could have been avoided.

Now, this is very common for people who have experienced trauma. Now at a more general level. We ruminate to solve problems. And the problem here to solve is my world has shattered.

How can I make sense of what's happened? So Todeschi and Calhoun have proposed that rumination is one of the mechanisms that facilitates post-traumatic growth.

Another one is deriving meaning from the event. So an individual starts to derive meaning from the trauma by contemplating why it happened and what can be learned from the experience.

And then thirdly, social support. Other people, particularly those who have experienced similar circumstances themselves, will be able to help survivors make sense of the events and devise new narratives to tell different stories about how and why they got to that point.

Adrian: And so passive rumination, not good.  But active rumination, actively engaging and thinking about these circumstances is going to be helpful in the long run?

Jamie: I would say active and helpful rumination. There is unhelpful rumination. There is a form of rumination where a person gets stuck in a loop in a repeat pattern, and by definition there's no problem solving going on there.

Person's getting stuck. And that could be due to a flexibility issue or a habit of thinking.

So I would say active, helpful or positive rumination, I suppose, is the way out.

Adrian: So for me it was I'm in hospital, I need to get out of hospital. I need to learn to walk, I need to problem solve. And I was, I suppose, ruminating on not what was but what is and working, dealing with the consequences rather than mulling over why has this happened?

Jamie: Yep. Yep. Precisely. So you went straight into problem solving mode and obviously that ultimately helped.

So thanks for joining me in my world for a little moment Adrian. I hope you've taken some notes and that you find that helpful.

Adrian: Thank you for having me. Is there going to be a test Jamie?

Jamie: Of course.