Post-traumatic Growth Among Service Members: Are Negative Outcomes the Only Outcomes?

service members walking with guns
Photo by Lance Cpl. Timothy Shoemaker
By Lauren Restivo, M.S.
November 13, 2017

Research on traumatic stress in the military tends to focus on negative stress reactions that service members can experience. But many service members affected by trauma also share nuanced stories of loss and struggle that result in unexpected opportunities for personal growth. Posttraumatic growth (PTG), a term coined by Richard Tedeschi and Lawrence Calhoun, is defined as the positive change experienced as a result of the struggle with a major life crisis. The concept of PTG challenges the common assumption that tragedy only results in negative outcomes.

This first blog in a two-part series will provide an overview of PTG and its relevance to military populations. The second blog will discuss therapeutic considerations and strategies for clinicians who work with service members seeking treatment for trauma.                                                

Process and Domains of Post-traumatic Growth

PTG occurs when a primarily adverse event also results in a positive outcome. Traumatic events disrupt an individual’s well-being and often present challenges to his or her basic assumptions and beliefs about the world and his or her place in it. For example, those who have faith in humanity and believe that the world is generally a safe place may question these beliefs after experiencing harm caused by war. Traumatic events often prompt individuals to reconsider basic assumptions and develop new perspectives and beliefs; for some, this arduous coping process can also result in growth. PTG is both an outcome and a process, such that it does not occur purely because of the existence of the traumatic event; rather it is the struggle with the traumatic experience that fosters positive growth.

Research with trauma survivors who have experienced military combat, sexual assault, bereavement, cancer, and HIV found that PTG most commonly occurs within five domains of growth as measured by the Post-traumatic Growth Inventory (PTGI):

  1. Appreciation of life

  2. Improved relationships

  3. Greater sense of personal strength

  4. New possibilities and opportunities (e.g., new interests, hobbies, passions)

  5. Spiritual change or development (e.g., new purpose in life, perspective of mortality, deeper sense of spirituality)

PTG in the Military

Service members can be exposed to high levels of stress and potentially traumatic events, whether in operational or combat roles. While it’s recognized that mental health outcomes such as posttraumatic stress disorder (PTSD) and other stressor-related disorders can occur from trauma, it’s also beneficial to educate service members and providers about PTG. It’s important for military personnel to understand that responses to trauma, even maladaptive ones, are normal, but growth can and does occur for some people. In fact, studies have found support for the existence of PTG among military populations, with rates ranging from 59.4 percent among U.S. veterans who reported at least one potentially traumatic event from 2011 to 2013 to 72 percent among veterans exposed to combat exposure from Operations Enduring Freedom and Iraqi Freedom.

Certain factors have been found to be positively correlated with higher levels of PTG:

Processing trauma takes time and can be a painful process, and service members should be reminded that experiencing stress after a trauma is normal and is not a reflection on their capabilities or character. The possibility of PTG provides some reassurance that despite the adversity and challenges, military personnel can benefit and grow from their experiences. 

Stay tuned for the second part of this blog series which will discuss PTG clinical considerations for providers.

Ms. Lauren Restivo is a contracted health systems specialist at the Psychological Health Center of Excellence. She has a master’s degree in criminal justice with a specialty in victimology and substance abuse.


The views expressed in Clinician's Corner blogs are solely those of the author and do not necessarily reflect the opinion of the Psychological Health Center of Excellence or Department of Defense.


Comments

  • Good article. Good observations. I've been living this process for years now. We don't usually spell them out in that way. I feel that it all starts with the social support. We often cocoon but family needs to help with the breakdown of the outer shells. We need a counter balance to the horrors of what was seen or experienced. Family is key. will read the second part.

  • I really enjoyed this article. It hits home to me on so many levels. Can't wait for part II!

  • Thank you so much for posting this article! I think that many civilian therapists don't realize the strength it takes for one to be a service member of either the military or law enforcement, and sometimes their approach to PTSD and related trauma disorders is to "infantilize" (overly comfort and negate the strength and development) of veterans and service members. Further, our high performances and dedication to excellence is often pathologized as either a personality disorder or perfectionism; in essence, you have to have high attention to detail to survive and to protect your fellow soldiers and service personnel. Sometimes therapists offer advice on career opportunities that don't meet the desires of veterans, such as suggesting that they take a very non-stressful job instead of one that truly is interesting to them and offers the same challenges that underscore their strengths as when they were in the service. I wished that more therapists would understand that in both the civilian world and otherwise. Many of my veteran friends refuse to seek treatment because they don't want to be (1) misdiagnosed, and (2) babied, which are often the laments I've heard from many of my brothers and sisters who have served. Some actually have been provided with awesome treatments, and they've went on to fulfill meaningful careers in science, medicine, law enforcement, etc., despite their histories of PTSD. Some have histories of childhood traumatic experiences on top of service-connected trauma experiences, and that should be recognized as well - especially in terms of strengths. Some of the veterans I've spoken to with multiple forms of trauma throughout their childhood and adulthood have also experienced PTG and went on to pursue very competitive and challenging careers, despite their history of PTSD and other related symptoms. It is important for clinicians not to undermine the talents, strengths, and intelligence of those who served.

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