Post Traumatic Growth: How To Grow From Trauma

A secondary mental health pandemic is being left in the wake of the COVID-19 pandemic. Public health experts fear that prolonged periods of uncertainty, stress, and grief will leave many with post traumatic stress disorder. This episode explores Post Traumatic Growth, a process of facilitating personal growth after trauma. An interview with Dr. Tedeschi, one of the founders of the concept, explores how to apply this concept to pandemic-related trauma and discusses the scope of the mental health crisis that is developing.  

Episode Transcript

Anita Kirti (00:01):

So it's been about eight months since we started social distancing and quarantining, at least most of us. It's just now occurring to me that people who are depressed, like I am, are so much more prepared for this pandemic than anybody else. I mean, think about it. I can hibernate for up to 18 hours a day, sit in front of Netflix and not move for days on end and not meeting people is not even a problem. I did not want to talk to them anyway. So I'm kind of living the dream, I guess. No, but really it's actually the complete opposite. People with mental health disease actually are doing a lot worse than those who don't have it, which perfectly segues us into what we're talking about today.

Anita Kirti (00:42):

We are going to discuss the effect on mental health this pandemic has had and a way to use this stress to actually improve ourselves. And it's something called post-traumatic growth. So stick around if you want to learn how to take the experience of 2020 and turn it into a way to improve yourself. This is The World We Inherit and I'm your host, Anita Kirti. Thanks for listening.

Anita Kirti (01:13):

So before we get started into post-traumatic growth, I kind of wanted to go over how mental health has been affected. And there's just so many different components that people are feeling, like stress and isolation, paranoia, anxiety, uncertainty, and this is not spread evenly in the population. It is disproportionately affecting black and Hispanic people, older adults, people in lower socioeconomic groups and healthcare workers too. So different groups of people are experiencing significant stressors. Like the black community actually had to, on top of the pandemic, had to also deal with the conversation that happened around the Black Lives Matter movement. And the Asian community had to deal with, especially in the United States, had to deal with a lot of xenophobia, which only compounded their own stress. And last but not least, healthcare workers are dealing with all kinds of things. Like I can personally say the shortcomings of the public health system and people's noncompliance to public health infection control measures, increased workload, just a whole lot of things.

Anita Kirti (02:16):

And unfortunately we weren't really prepared at all, not just in the US but across the world, was not prepared for the mental health fallout that would happen as a result of the pandemic. There was, and continues to be a major lack of psychiatric help in more than half of the countries around the world. There's only 1 psychiatrist per 100,000 people. And in lower and middle income countries between 76 and 85% of people with mental health disorders don't receive any kind of treatment. And both of those statistics are from the World Health Organization. And as far as prevalence of mental health goes, about 450 million people suffer from a mental health disorder. And that actually puts mental health as one of the leading causes of ill health and disability in the world. There's actually a metric for those in public health call years lived with disability.

Anita Kirti (03:08):

So the number of years in total that have been lost to disability across a population and the leading cause of the global years lived with disability. So the disorders that have the greatest number of years lost to disability is neuropsychiatric disorders. And these statistics are from the World Health Organization. So compounded on top of poor mental health systems, we get this pandemic that is expected to leave a devastating effect on people's mental health overall. They say that for every one person that dies, there is an average of about nine people that are in bereavement.

Anita Kirti (03:44):

So in the US itself, if there are 214,000 people dead, as of mid October, there are about 2 million people bereaving someone's death. And a paper written from the Department of Psychiatry at NYU recently stated that their central concern for what is to happen in the aftermath of the pandemic is that the distress is so prolonged that it will actually result in major depressive disorder and post traumatic stress disorder. And the CDC also echoed the same idea after they did a study from April to July of 2020. They found that about 35% of the population is suffering from anxiety and depression, which is likely to lead to increased rates of post traumatic stress disorder.

Anita Kirti (04:31):

So that kind of leads us into what we're going to talk about today, which is post-traumatic growth. So just to kind of give you an idea of what post-traumatic growth is. It's a term that was coined by two psychologists, Dr. Richard Tedeschi and Dr. Lawrence Calhoun in the mid 1990s. And it refers to the positive change that occurs in the aftermath of struggling with a major life crisis or traumatic event. This is not a direct opposite of post-traumatic stress disorder. It's its own concept. It's not that you either get post-traumatic stress disorder or post-traumatic growth. It's possible to be both experiencing negative effects of trauma. And also later on experience post-traumatic growth.

Anita Kirti (05:13):

So that's a little bit of a primer of what post-traumatic growth is, but luckily enough, I won't have to explain all of the ins and outs to you because I was lucky enough to get a hold of Dr. Tedeschi, one of the people who founded this concept, who very graciously agreed to speak with me. So I'm going to stop talking and play that interview right now.

Anita Kirti (05:34):

This is Dr. Rich Tedeschi who's a professor of psychology at the University of North Carolina at Charlotte, and is a licensed psychologist specializing in bereavement and trauma. He is one of the developers of an area of research called post-traumatic growth, which examines personal transformations in the aftermath of traumatic life events. Welcome to the podcast, Dr. Tedeschi.

Dr. Richard Tedeschi (05:57):

Thank you very much.

Anita Kirti (06:00):

Let's just get right into it. Can you give us a brief introduction of what post-traumatic growth is?

Dr. Richard Tedeschi (06:07):

It's the positive changes that people report after a struggle in the aftermath of traumatic life events.

Anita Kirti (06:15):

So are there certain types of changes that they see or components that they notice after going through post-traumatic growth?

Dr. Richard Tedeschi (06:22):

Yes. We found that there are five different areas of growth that people tend to report. One is improved relationships with others. Another is a appreciation of life and the change in their priorities for what's important in life. Another is the recognition of their personal strengths. A fourth is recognizing that they have new opportunities or possibilities in their life that opens up as a result of what they've been through. And the final one is a spiritual or existential change and development.

Anita Kirti (07:02):

So we're kind of talking about this in the context of the pandemic that everyone's experiencing. So would you say because everyone is going through what is a pretty traumatic event for a lot of people, that we would all experience post-traumatic growth?

Dr. Richard Tedeschi (07:18):

Well, not everybody experiences post-traumatic growth, and certainly there are a lot of individual differences in this. And despite the fact that we're all going through the pandemic together in certain ways, everybody's in different situations and circumstances. So it's hard to generalize about that. Someone said to me one time, we're all in the same storm, but we're actually in different boats.

Anita Kirti (07:43):

I like that. So what are some things people can do that could put them on the path of post-traumatic growth?

Dr. Richard Tedeschi (07:51):

Well, one thing that's important is to just be aware that these possibilities exist. A second thing is to find people to talk to about what you're going through. People who are, we tend to call expert companions, people who are really expert at being in relationship with you while you're going through something. And being able to understand your point of view, empathize with you and kind of help you develop a new perspective on what may be possible in the future.

Anita Kirti (08:23):

There are certain, restrictions that we have now with quarantining and being in the pandemic. So are there some tips that you would have for people that they could do every day?

Dr. Richard Tedeschi (08:33):

Well, it's hard to find the expert companion when you're quarantined, but luckily, there may be some people that you're comfortable with seeing at a social distance or whatnot. And then of course, beyond that, you've got all the internet connections you can make use of and social media. So don't be afraid to be in contact with people. One thing that I think is happened with some people I've talked to is that they've reached back into relationships that have kind of gone stale maybe, or they just neglected for a while. And re-established some relationships because a lot of people are lonely out there. And when you hear from someone like that, it's usually a pretty good thing.

Anita Kirti (09:21):

In your professional opinion, do you see that there's a developing mental health crisis, kind of like a secondary to the pandemic?

Dr. Richard Tedeschi (09:30):

I think that's really important. Of course, there are a lot of people who are in workplaces where there's a lot of stress and trauma and demand, especially healthcare workers. But also other people who are just trying to keep things going, in places like the grocery stores and other establishments where it's really important for people to have access to their work. And so there's a lot of demand on people in terms of trying to get things done while still being worried about their own health or trying to take care of kids at home who are in school that's virtual and just trying to make sure they have daycare, which is pretty much closed down in a lot of places. And they have to scramble to figure out who's going to take care of their kids while they try to work.

Dr. Richard Tedeschi (10:30):

I mean, there's all these stressors that make it really hard on a lot of different kinds of people. So stress generates mental health problems in a lot of circumstances. And another thing is people in quarantine or who are working from home a lot are with family members a lot more than they're used to, which can be difficult, but there's also an opportunity there to maybe improve those relationships.

Anita Kirti (10:58):

Yeah. I'm home after like ... I just graduated from college and I was planning to move out, but that really didn't happen. So I totally get what that means. During the summer, and even till now, we're having the Black Lives Matter movement really picking up. So it has been really traumatic for the black community and the election that's coming up. A lot of people are feeling stress from that. Is there a point that there's so much stress that post-traumatic growth just can't happen?

Dr. Richard Tedeschi (11:27):

Yes. We see a kind of a curvilinear relationship between stress and growth, meaning that if the stress is overwhelming and people just are beyond their basic levels of coping, you're going to be in pretty tough circumstance to recognize any positive things coming your way. Or we're making moves in that direction. And on the other hand, on the other end of the curve, if there isn't much stress, there isn't any reason to change. So we don't see much growth when there isn't much happening. So on either end of the spectrum, you see less growth, but the sort of the middle range where things are stressful, but not overwhelming, that's when we can see some change.

Anita Kirti (12:14):

Last question. Do you think that the US is equipped as far as the healthcare system to be able to cope with this amount of stress that's happening to the general public?

Dr. Richard Tedeschi (12:26):

Not very well I'm afraid. I don't think our mental health system is very well funded, integrated, respected. I think there's a lot of difficulty that we have as a country in meeting the mental health needs of people. And it's just not accessible to a lot of people and there's still a stigma about seeking help. So there's all sorts of problems. And I think one of the things that can come out of this is as a society, we can start to rethink a lot of different things about how we operate and rethinking the mental health system will be one area that I think we need to pay attention to.

Anita Kirti (13:02):

And as like an anecdotal thing, I'm actually a health care worker. And I notice that every time we have a stressful event, like we heard about the Breonna Taylor developments or things like that, that we have more patients come in with more complaints of joint pains and body pains and fatigue. And that's obviously very anecdotal, but it feels like other doctors who aren't equipped to handle mental health issues are actually seeing them and they're just unable to diagnose depression or anxiety or things like that. Is that something that happens commonly?

Dr. Richard Tedeschi (13:37):

Sure. Yeah. These things also show up as somatic complaints of various kinds and that's perhaps what you're seeing in some of those circumstances. Absolutely.

Anita Kirti (13:48):

Well, thank you for taking some time to talk to me and letting us in on what all of this is about, and hopefully that'll help some people be able to map their own journey out of this pandemic. So thank you so much for being on the podcast.

Dr. Richard Tedeschi (14:02):

You're very welcome. And I just want to say in ending that if people want to know more about this topic, a good place to go to is a organization I've worked for called The Boulder Crest Foundation. So if you go to bouldercrest.org, we have post-traumatic growth based programs that are developed for veterans and first responders in particular. There's also a lot of information there about not only our programs, but the post-traumatic growth concept and how we apply it.

Anita Kirti (14:30):

Absolutely. I'll go ahead and link that in the description so it'll be easy to access for everyone. So that will be really helpful.

Dr. Richard Tedeschi (14:36):

Thank you very much.

Anita Kirti (14:48):

So I want to share more of Dr. Tedeschi's with you and go over some of the big takeaways of post-traumatic growth and how to facilitate it in your own life. So just to really drive this home, it's the cognitive exercise and process of working through trauma that leads to post-traumatic growth. It's not something that just kind of automatically happens. So I want to go through some ideas of how you can facilitate post-traumatic growth.

Anita Kirti (15:16):

Number one, you need to educate yourself. Trauma is essentially a disruption of core belief systems. So these are the ideas that you had had prior to a life-changing event like this pandemic that you believe to be true, but are now being challenged. I think some of the common ones right now are we used to believe that we were guaranteed safety from infectious disease. Especially if you're in a developed country, you almost feel in control and immune to the natural world. And by this pandemic occurring, we challenge those assumptions and it creates a lot of anxiousness and repetitive thinking like, will we ever go back to normal? And when is this going to end? So the first step is knowing that that's what trauma is.

Anita Kirti (16:02):

Number two, emotional regulation. Being able to manage your negative emotions is the second foundational thing you need to have to be able to facilitate post-traumatic growth. So things like anger and anxiety and stress, knowing how to control those emotions. Ways in which you can do that is shifting focus to positive things. And yes, 2020 sucks. But there are some positive things that we have to look to like the number of public health and science experts that are working on a vaccine, something that historically people have not had, or how much we know about preventing infection, or look to historical public health successes, like finding treatments for HIV and eradicating smallpox. Those are all things that give you hope and promise.

Anita Kirti (16:51):

A second thing to do is physical or meditative exercise. These are very commonly talked about and for good reason. They're really helpful in regulating emotions. Shifting our emotional scope kind of pushes us away from brooding and into more reflective rumination. So one, understand trauma. Two, emotionally regulate.

Anita Kirti (17:13):

Number three is disclosure. So finding someone that you can talk to about what's happening, how you feel about it, their effects, and this was mentioned in one of the tips that Dr. Tedeschi gave in the interview about finding an expert companion.

Anita Kirti (17:28):

And that brings us to number four, narrative development. This is where you create a narrative about your life, where the trauma itself is the turning point. So what your life was like before, what it was like afterwards. Things to consider about how to create that narrative would be like, what opportunities have come from this pandemic? Or how have my worldviews and assumptions changed? And looking to the people around you that have experienced trauma or stress and how they construct their own narratives is a good place to start. And the purpose of all of this is to give you direction and meaning for the future.

Anita Kirti (18:07):

So that brings us to number five, service. It's a way to find meaning in the tragedy that's happened. And personally, I feel like focusing on others makes your own problems feel manageable and I feel less attached and honestly, just a lot less self-pity.

Anita Kirti (18:24):

As a quick recap, that was one, educate yourself on trauma. Two, try to regulate your emotions. Three, disclose what's happening to you. Four, create a narrative. And five, service.

Anita Kirti (18:42):

So those are just some ways that you can help facilitate post-traumatic growth. Obviously this is, if you're up to it, you're not doing it wrong if you're not going to do this, or if you don't feel like you're ready for it. Everyone goes about this very differently. So just making it through is also just as amazing.

Anita Kirti (18:59):

Oh, and one last thing. So if you're kind of wondering where you fall, as far as post-traumatic growth, there is something called the post-traumatic growth inventory. It's a questionnaire that will give you an idea as to areas that you can improve on and that could be really helpful for you if you'd like. So I'm going to go ahead and link that in the description of the podcast, as well as other helpful links that Dr. Tedeschi had mentioned, and some of his research that goes even more in depth into post-traumatic growth. So I hope this helps you and you use those resources. Let's just try to get through 2020. This is The World We Inherit and I am your host, Anita Kirti. Thanks for listening.

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