Can Trauma Lead to Both Distress and Growth?

What you need to know

• Trauma can lead to both negative outcomes (posttraumatic stress symptoms) and positive changes (posttraumatic growth)
• Key factors predicting growth after trauma include disruption of core beliefs, seeing the event as central to one’s identity, deliberate reflection, and helpful disclosure to others
• Unhelpful disclosure experiences and seeing the event as central to identity were the strongest predictors of posttraumatic stress symptoms

Understanding Trauma’s Complex Impact

Experiencing a traumatic event can shake a person to their core, disrupting their fundamental beliefs about themselves and the world. While trauma is often associated with distress and symptoms like anxiety, flashbacks, and hypervigilance, research shows that many survivors also report positive changes and personal growth arising from their struggle with highly challenging life circumstances.

This phenomenon, known as posttraumatic growth (PTG), involves positive psychological changes in areas like relationships, personal strength, appreciation for life, new possibilities, and spiritual/existential matters. PTG doesn’t mean trauma wasn’t distressing - rather, growth often coexists with ongoing distress as people rebuild their lives and sense of self.

To better understand the factors that contribute to both positive and negative outcomes after trauma, researchers tested a theoretical model of posttraumatic growth alongside measures of posttraumatic stress symptoms. Their findings shed light on the complex cognitive and social processes involved in adapting to trauma.

Key Factors in Posttraumatic Growth

The study found several important predictors of posttraumatic growth:

Disruption of Core Beliefs

When trauma severely challenges or shatters a person’s fundamental assumptions about the world (e.g. that the world is generally safe and predictable), it sets the stage for growth. Having to rebuild one’s worldview creates an opportunity for positive change.

Event Centrality

To what degree does a person see the traumatic event as a core part of their identity and life story? Higher event centrality was associated with both growth and distress.

Deliberate Rumination

Initially after trauma, intrusive thoughts and memories are common. Over time, more deliberate reflection on the event’s meaning and implications predicted greater growth.

Helpful Disclosure

Talking about the trauma in a way that felt helpful and supportive was the strongest predictor of posttraumatic growth. This likely aids in processing the experience and constructing a meaningful narrative.

Factors Predicting Posttraumatic Stress

While some predictors overlapped, others were unique to posttraumatic stress symptoms:

Unhelpful Disclosure

Negative experiences in disclosing about the trauma (e.g. feeling misunderstood or judged) were strongly associated with more severe posttraumatic stress symptoms.

Event Centrality

Seeing the trauma as central to one’s identity predicted both growth and symptoms, highlighting how this can be a double-edged sword.

Intrusive Rumination

Unlike deliberate reflection, intrusive and uncontrolled thoughts about the trauma were linked to greater distress.

The Process of Growth After Trauma

These findings support a model of posttraumatic growth that unfolds through several stages:

1. A highly challenging event disrupts core beliefs about the self and world

2. The person sees this event as central to their identity and life narrative

3. They experience both intrusive and deliberate thoughts about the trauma

4. Deliberate reflection helps process the experience

5. Helpful disclosure to others aids in meaning-making and narrative development

6. Core beliefs are rebuilt in a way that incorporates the reality of trauma but also allows for positive change and growth

This process isn’t linear, and growth often occurs alongside ongoing distress. The degree of growth versus distress likely depends on factors like the nature and severity of the trauma, personal characteristics, and environmental supports.

Clinical Implications

These findings have several important implications for therapists and counselors working with trauma survivors:

• Recognize that positive change and ongoing distress often coexist after trauma. Focusing solely on symptom reduction may miss opportunities to foster growth.

• Understand that having one’s core beliefs severely challenged is psychologically painful, but also creates an opening for positive change. Help clients navigate this difficult process.

• Encourage deliberate reflection on the trauma’s meaning and implications, while being mindful that intrusive thoughts may increase distress.

• Create a safe, empathic space for helpful disclosure. Be aware that negative disclosure experiences can exacerbate posttraumatic stress.

• Help clients construct a coherent narrative that incorporates the trauma into their broader life story, while also envisioning new possibilities.

• Recognize that seeing the trauma as central to one’s identity can promote both growth and distress. Help clients find a balanced perspective.

Conclusions

• Trauma can lead to both significant distress and positive personal changes
• Core belief disruption, event centrality, deliberate rumination, and helpful disclosure are key factors in posttraumatic growth
• Unhelpful disclosure experiences and high event centrality are strongly linked to posttraumatic stress symptoms
• Growth and distress often coexist as people rebuild their lives after trauma
• Clinicians should create opportunities for helpful disclosure and meaning-making while being sensitive to ongoing distress

By understanding the complex cognitive and social processes involved in adapting to trauma, mental health professionals can better support survivors’ recovery and growth. While the path is rarely easy, many people are able to derive meaning and positive change from their struggle with trauma’s aftermath.