Stressing the positive after trauma

Can trauma be good for us? Can a truly distressing and devastating life episode actually be a powerful force for growth? It does seem to be a counterintuitive argument but an Irish professor of psychology – and a leading expert in the study of the effects of trauma – is receiving a lot of attention for the idea that traumatic events can, if handled correctly, be the triggers for positive change.

"This is not about 'looking on the bright side' or some ridiculous idea of treating a serious illness or similar as a 'gift'," says Prof Stephen Joseph. In his current book, What Doesn't Kill Us – The New Psychology of Post-traumatic Growth , he argues, with no little skill, for a new definition of post-traumatic stress disorder, one that allows an understanding of how personal growth can occur even in the midst of severe distress.

Traumatic life events – which include serious illness, divorce, bereavement, violent assault, as well as involvement in acts of natural disasters/terrorist events – have a psychological hangover long after any physical damage may have healed.

“People who have suffered from these events report persistent nightmares, upsetting thoughts, avoidance of anything that reminds them of the event. Even a particular song playing on the radio or the sound of a car back-firing can greatly upset people if it triggers some awful memory of the event,” Joseph says.

Post-traumatic stress disorder (PTSD) was recognised by the American Psychiatric Association in the 1980s as an umbrella term for the understanding of the lingering mental after-effects of a traumatic episode.

“PTSD has become has become a very widespread diagnosis but over 20 years of research into the field, I have become increasingly aware of the amount of subjects who while displaying symptoms of PTSD also report how they have become better people since the damaging event,” Joseph says. “What I’ve been finding, and consistently so, is that people don’t have a disorder in terms of an illness or a brain dysfunction. What they are experiencing is a normal and natural reaction to a devastating episode in their lives. It is similar in a sense to the grieving process.

“My argument is that there is too much focus on the negative effects of PTSD, whereas if handled properly, PTSD can help people reorder their lives, become more compassionate, give them a new sense of priorities and help form new relationships and strengthen existing ones. In some cases, there can even be a new relish for life that simply wasn’t there before and people can become stronger as a result of what happened to them.”

Joseph, from Belfast, was part of the team of psychiatrists in the early 1990s who were employed by lawyers acting for the survivors of the Herald of Free Enterprise . When the passenger ship sank in the North Sea in 1987, almost 200 passengers lost their lives as 300 survivors watched helplessly as family members died.

In interviewing the survivors, he was surprised to find that almost 50 per cent of them – despite still being traumatised by what they had gone through – reported that their lives were now actually better than they had been before the event.

“In fact 70 per cent of the survivors reported some sense of ‘positive growth’ in that they felt they had become stronger, more resilient, were a lot less materialistic than before and now attached more value to their relationships with family and friends,” he says.

Intrigued by these seemingly contradictory findings, he researched further.

In his book he talks about meeting an ex-RUC officer, Michael Patterson, who was blown up by an IRA bomb, losing both his arms and receiving horrific injuries to his legs. Patterson suffered from PTSD – he was unable to talk about the event and had constant nightmares – but after therapy, he went back to college to earn two doctoral degrees. He now works in Belfast as a clinical psychologist with a unique insight into how to cope with trauma. In 2008, he was awarded an OBE.

While Joseph does refer to a “trauma industry”, he is careful to balance his argument. “The amount of studies and interviews with survivors I’ve carried out over the years show that the diagnosis of PTSD can be a self-fulfilling prophesy, in that it can negatively shape people’s expectations of having any form of ‘normal’ life after a traumatic episode. My point is, we need to look at PTSD in a different way and we need to help people shape their own recovery.

“As much emphasis needs to be placed on the idea of post-traumatic growth. I’ve heard people say ‘my cancer diagnosis was the best thing that ever happened to me’, which may sound a strange and extreme opinion to many, but these people are referring to how they reordered their lives and their relationships in the wake of such a devastating event.”

A professor of psychology at the University of Northampton and co-director of the Centre for Trauma, Resilience and Growth in the same city, Joseph has spent the last 20 years studying and researching why and how some people really struggle in the aftermath of trauma, while others use it to build a better life.

"It still surprises to me to find that people, generally, are a more resilient to traumatic events that one would think – and all the studies carried out in the aftermath of 9/11, the London 7/7 bombings and the Madrid train station bombings bear this out."

He adds: “My belief is that when trauma happens it shatters the assumptions we all have about the world.

“People basically believe that the world is more or less a just place but when something dreadful happens to them – a cancer diagnosis, for example – those assumptions are profoundly shattered and there is need to rebuild our view not just of the world but of ourselves.

“The expression I keep hearing in this regard is ‘I am wiser now’ and almost all report increased feelings of compassion.

“It is important to understand that no amount of wishful thinking will help with post-traumatic stress,” Joseph adds.

“Those symptoms you experience will not go away if you stick a smile on your face, they will persist depending on the severity of the trauma but they can be managed.”

What Doesn' t Kill Us: The New Psychology of Post-traumatic Growth , by Prof Stephen Joseph. whatdoesntkillus.com
Prof Joseph's blog is at psychologytoday. com/experts/stephen-joseph-phd