For some who've endured life-changing trauma, the experience can yield something surprising: positive personal growth.
Research shows that these people develop a greater appreciation of life, closeness with others, optimism about new possibilities, increased sense of personal strength, and spiritual changes. Studies estimate that about half of people affected by trauma go on to experience what's known as post-traumatic growth.
Now, a major survey conducted in the last year suggests that's happening to people who've felt traumatic stress related to the COVID-19 pandemic.
Research published Thursday in JAMA Open Network found post-traumatic growth in more than 40 percent of 3,000 people surveyed. Led by Dr. Robert H. Pietrzak, professor of psychiatry at Yale School of Medicine, the researchers asked the thousands of military veterans a series of questions about personal changes they'd experienced during the pandemic, like if they appreciated life more, became closer with friends and loved ones, developed a better understanding of "spiritual matters," and felt capable of doing "better things" with their life.
Respondents who screened positive for symptoms of COVID-19 related post-traumatic stress disorder were more likely than those who didn't to say they'd experienced the full range of changes associated with post-traumatic growth. The finding, which aligns with previous research into veterans' mental health, didn't surprise Pietrzak, who is also director of the Translational Psychiatric Epidemiology at the Department of Veterans Affairs National Center for PTSD.
"Growth is facilitated by struggle," he said. "You need to have some degree of these traumatic symptoms to have the growth."
"You need to have some degree of these traumatic symptoms to have the growth."
This process is much different than using pandemic lockdowns to optimize one's productivity or personality by setting ambitious goals. Nor are the people who didn't experience positive changes failures. It's also not meant to excuse or justify societal failures during the pandemic by emphasizing the importance of post-traumatic growth over the government's responsibility to prevent deaths, illness, unemployment, and other types of trauma.
Instead, Pietrzak says that experiencing symptoms of PTSD associated with the pandemic may prompt "reflective processing" that in turn leads to positive psychological changes. Typically, people who undergo the transformation have intrusive, uncomfortable thoughts, but over time develop the skills to approach them in an organized manner, with a greater sense of control. Others may ruminate unpredictably or try to avoid the negative thoughts altogether, strategies that can ultimately worsen how they feel.
People who experience growth can still feel distraught, but they find ways to confront trauma and move forward. Techniques like creating a narrative of the experience, sharing feelings about it, and learning how to regulate emotions can help. Pietrzak says post-traumatic growth is often spurred by strong emotional support, including psychotherapy. Research also associates post-traumatic growth with personality traits like extroversion, openness to new experiences, the wisdom that comes with age, and the ability to seek silver linings in otherwise stressful situations.
"We don't want to say this is rainbows and sunshine... these things can coexist," says Pietrzak, describing the dual experiences of trauma and growth. He likens post-traumatic growth to a "psychological shield" that can help protect people in future traumatic events.
Prior to the pandemic, Pietrzak had already been surveying a large group of veterans about their traumatic experiences and decided to ask them about post-traumatic growth in the context of COVID-19. In the newly published survey, people screened positive for post-traumatic symptoms based on their answers to questions about dealing with "repeated, disturbing, and unwanted memories" of the pandemic, avoidance of reminders of COVID-19, feeling jumpy or easily startled, and possessing strong negative beliefs about themselves, others, or the world.
The researchers also measured and adjusted for survey participants' risk factors for trauma, including COVID infection for themselves or a loved one, media consumption, social isolation, and financial and relationship difficulties.
Mary C. Waters, the John L. Loeb Professor of Sociology at Harvard University, said the study was well designed. Waters, who is the lead investigator of a study of Hurricane Katrina survivors over time and wasn't involved in this research, described Pietrzak's findings as similar to other studies of post-traumatic growth, including her own.
Though some have worried that the pandemic would worsen the suicide rate in the U.S. and abroad, Pietrzak and his co-authors found an association between post-traumatic growth and decreased suicidal thinking. Participants who said their appreciation for life increased and their social relationships had improved also saw a significant reduction in their odds of contemplating suicide.
"This study highlights that trauma can lead to greater engagement and connection, two contributors to preventing suicide," Dr. Jill Harkavy-Friedman, a clinical psychologist and vice president of research at the American Foundation for Suicide Prevention, wrote in an email. Harkavy-Friedman wasn't involved in the study. "While trauma is painful, it is also an opportunity for growth and change."
Preliminary surveys from other researchers also hint at the potential for post-traumatic growth in the wake of the COVID-19 pandemic. A small survey conducted by American researchers and published last month in the Journal of Health Psychology revealed a link between "benefit-finding," or reevaluating negative experiences in a positive light, and post-traumatic growth.
A survey of New Zealanders, published recently in PLOS ONE, a peer-reviewed scientific journal, found that two-thirds of the respondents identified "silver linings" in the early stages of the pandemic, including increased kindness and neighborliness, improved personal relationships, and time to reflect on what was important to them. The authors were careful to note that the government's decision to financially support people during the pandemic may have reduced survey participants' feelings of distress.
Chinese researchers surveyed more than 400 people about aspects of post-traumatic growth related to the pandemic and found that the concept of "emotional creativity" — the ability to experience and express emotions — played a key role in fostering positive personality changes.
Pietrzak said it's important to understand that such changes don't mark a tidy conclusion to a person's experience with trauma.
"Post-traumatic growth is not an end but a process," he said.
If you want to talk to someone or are experiencing suicidal thoughts, Crisis Text Line provides free, confidential support 24/7. Text CRISIS to 741741 to be connected to a crisis counselor. Contact the NAMI HelpLine at 1-800-950-NAMI, Monday through Friday from 10:00 a.m. – 8:00 p.m. ET, or email [email protected]. Here is a list of international resources.
Related Video: How to use your COVID vaccine guilt to fight for health equity
Topics Health Mental Health Social Good COVID-19
