Moving Through PTSD to Post-Traumatic Growth

The saying that “you only need to be six months ahead of your clients” has been challenging for mental health providers over the last year. We’ve found ourselves catapulted into the trifold trauma of the COVID-19 global pandemic, surging racial conflict, and media-amplified skepticism about our government—all at the same time as our clients.

When we treat trauma, we teach our clients to soothe their nervous systems by grounding themselves in the present moment. But we aren’t usually asked to do that while living through the same trauma as our clients in real time.  

Trauma treatment also helps clients distinguish between realistic fears of a present threat and trauma-induced emotional reactions. But what constitutes a “realistic fear” when the enemies of the past year have been invisible, undefinable, and seemingly endless? How do we as clinicians maintain distance from our clients’ experiences, while we stand in the midst of our own (probably different) interpretations of those same events? 

Reconciling Disparities in Our Experiences

Despite the prospect of society reopening, we’ll still need to find ways to effectively cope with the differences between our lived experiences—clients and clinicians alike. As reopening gets closer, it’s likely that the disparities between us will increase, not decrease.

In the midst of the COVID pandemic, we’ve done our best to adapt by simply embracing what was right in front of us. And as a result, we suspended our longing for the way things used to be. 

But as we get closer to the end of the pandemic and can fully engage with our friends and peers in person again, these suppressed desires will be released from the deep-freeze called “making the best of things.” At that time, the profound disparity in our experiences will be thrown into high relief. A parent expressing gratitude for how their child has thrived will inadvertently shame another parent whose child is failing in school. A couple’s wedding invitation will hold up a painful mirror to the twelve-year marriage that finally succumbed to the fault lines exacerbated beyond repair, and so on. 

Instead of the longed-for and much anticipated relief from pandemic isolation, these affronts may bring disappointment, resentment, judgment, or shame. Just when we’re hoping most for connection, these feelings will effectively deepen and prolong our trauma. 

Post-Traumatic Stress vs. Post-Traumatic Growth

In the coming months, we’ll need to find a way to process our anxiety, anger, powerlessness, and grief without losing hope—and also a way to embrace that hope without stuffing away our negative emotions. To do this successfully, clinicians will need to hold the two phenomena of post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG) as equally valuable. If we do this, we’ll be able to successfully lead our clients—and ourselves—through the transition from social isolation to reopening. 

PTSD occurs in the wake of a threatening event or events that rob us of our agency and our means of escape. When we lack sufficient resources to process those events, we fail to integrate our trauma into our understanding of the world as safe enough, predictable enough, or fair enough.

Looking at trauma in this way, we can appreciate the many ways in which the pandemic and concurrent societal developments have been traumatic, and how people with insufficient internal or external resources will be at risk of developing PTSD as a result.

Less widely known—but equally powerful—is the concept of post-traumatic growth, which was first developed in the mid-1990s by psychologists Richard Tedeschi and Lawrence Calhoun. It turns out that not everyone who lives through trauma develops PTSD. So what happens instead?

Research has revealed a rich and transformative encounter with post-traumatic growth in five major domains: relations with others, new possibilities, personal strengths, spirituality, and appreciation of life. An integral part of post-traumatic growth theory is the idea that transformation occurs not in spite of trauma, but as a direct consequence of it. In other words, the growth could not have occurred without the trauma—or at least not in the same way at the same moment. 

Can We Simply Choose Growth?

For some people, choosing to interpret the pandemic through the lens of post-traumatic growth will allow them to appreciate the little influence they have over things they once thought they needed to control. They’ll deepen their connections with the people they value, and shed the relationships they used to hang onto out of fear or guilt. Some will deepen their spiritual connection, finding solace in unexpected places. Or they will form a new perspective on injustice in the world, bringing their values and their actions into greater alignment.

But for others, it may still be an immense struggle to accept and make sense of the many losses they continue to experience—the loss of loved ones, the loss of health, of financial security, and worse. For these people, to focus on post-traumatic growth as a kind of silver lining may land as an invalidation of their experience. This can interrupt their grieving, which is an essential stage in the integration of trauma on the path toward humility, acceptance, gratitude, and freedom. 

A Dialectical Frame of Mind

One way to hold space for our disparate experiences is to recognize that seemingly contradictory ideas can be true at the same time. In doing so, we can help our clients and ourselves remember that the deepest pain from unfathomable loss can coexist with the awe of unexpected blessings—and everything in between.

I would encourage us all to remember that many of our silver linings have occurred not in spite of the pain of the past year, but rather because of it—and that much of our collective post-traumatic growth is still to come. If we can do this, we can create space for both the grieving of immense loss and the positive affirmation of change. 

I’ve seen first-hand in my practice how impactful staying rooted in this notion of intentional growth can be. It pushes away nothing and clings to nothing, and frees us up to move forward. I wish the same for you—and for all of us. 

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