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Is Posttraumatic Growth the opposite of Posttraumatic Stress Disorder?

Most people experience some form of trauma in their lifetime – a painful divorce, physical or psychological abuse, sexual assault, the death of a loved one, serious injury and illness, witnessing acts of terrorism, combat exposure and so much more. Currently, the COVID-19 pandemic is a massive source of traumatic stress for many around the world. Trauma can be defined as any stressful event that overwhelms a person’s ability to cope. Trauma is often subjective – what may feel traumatic for one person is not necessarily traumatic for another, so two people can experience the same event and respond quite differently. It’s useful to note that not all individuals experience mental health disorders after trauma, in fact, some may experience what researchers call Posttraumatic Growth (PTG). As a coach who specialises in Posttraumatic Growth Coaching, I am often asked if PTG is the opposite of Posttraumatic Stress Disorder (PTSD). The accurate answer is no. So, let me explain further.

PTSD is a term for an anxiety disorder that often results from an experience of severe trauma. Symptoms of PTSD include fear, helplessness, horror, re-experiencing the event, nightmares, triggers associated with the event and increased stress responses. The symptoms of PTSD can have a significant impact on a person’s day-to-day life. PTG, on the other hand, is positive psychological changes people experience as a result of highly stressful or traumatic events. PTG is both a process and an outcome resulting directly from the trauma or struggle that the person has experienced. The process of PTG can lead to an increase in personal strength, improved relationships, meaning and purpose, a renewed appreciation of life and spiritual and existential change.

It’s important to note that PTG extends beyond pre-trauma functioning i.e. it’s not just bouncing back but rather a profound growth way beyond pre-trauma levels. PTG often starts with a sense of overwhelming distress, a “shattering of assumptions” and intrusive thoughts of the trauma. But PTG, unlike PTSD, takes on a different trajectory from here. There is an internal reflection of the trauma, which creates new meaning for the individual and shifts perspectives on the various domains in his or her life. Social support is also a key ingredient in developing PTG.

Extensive research conducted over the years have shown that PTG is not the opposite of PTSD, in fact, they are two separate responses and that placing them on two ends of a spectrum is superficial given the intricacies of how people respond to trauma. Research has shown:

  • People who experience symptoms of PTSD also report PTG-like changes simultaneously. This has been documented in multiple studies conducted by Dr Katie Devine and colleagues.

  • People who have recovered from PTSD have also shown not to depict or report any signs of PTG.

  • Therefore PTG and PTSD are two separate responses that can occur within the same person simultaneously and that experience of distress can, in fact, promote the development of growth.

  • In a meta-analysis conducted by researchers Shakespeare-Finch and Lurie-Beck in 2014 to clarify the relationship between PTG and PTSD symptoms, they concluded that both constructs are positively and linearly correlated showing that they are not on opposite ends of a single dimension.

  • In the same study, they also demonstrated a stronger curvilinear relationship between PTG and PTSD symptoms.

Although PTG has been conceptualised as positive, an individual who experiences a traumatic event is driven by the same set of factors that leads to PTSD – guilt, rumination and so on. The difference between the two is that a person on the path to PTG weaves in the trauma, "shattered assumptions" and experiences into his life as part of his new reality. Unlike PTSD, they move on from rumination with experiences accommodated positively resulting in the individual’s growth and transformation. However, experiencing PTG does not diminish the pain that accompanies the trauma.

As individuals and communities we are currently witnessing such a turbulent time with the coronavirus pandemic. Ever since the virus hit us we’ve witnessed lockdowns, an unprecedented number of deaths, job losses, the shrinking global economy and the toll this traumatic event is taking on the mental health of many. In a survey conducted by the mental health charity MIND in the U.K. it was discovered that over 60% of adults felt that they’re mental health got worse over the lockdown. 55% of individuals, especially young adults without any previous experience of mental health problems have also seen a decline in their mental health with disorders such as anxiety, paranoia, depression and PTSD on the rise.

As a mental health professional, I wanted to come out here today on the blog and continue to create awareness on topics that are so relevant today. As individuals and communities, we can never go back to exactly how life was like before the coronavirus pandemic hit us. The old normal no longer exists. However, we can recover, grow and find meaning in many areas of our lives. I want to reiterate that experiencing some levels of distress is a very normal part of the process, not only for healing and recovery but also for PTG. If there’s one research-based, well-validated tip I can give you today it’s this: Social support and social networks play a massive role in the process to help survivors recover and develop PTG. So please don’t suffer in silence. Reach out and ask for help. My friends stay safe and stay well.

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