Head Strong

How Psychology is Revolutionizing War

Trauma, Adversity, Pathology, and Resilience

Thoughts on the full spectrum of response to adversity.

A few years ago, I spoke to a group of army leaders, all of whom were preparing to deploy to Iraq for a combat tour.  By this point in the war, almost all of these officers and senior enlisted personnel had been deployed at least once, and had experienced first-hand the challenges and horrors of combat.  Knowing I was a psychologist, I am sure they expected to hear me expound on posttraumatic stress disorder (PTSD) and other combat-stress related pathologies.  Instead, the theme of my talk that day was on the full range of psychological responses that soldiers experience during and after combat, ranging from pathology, to resilience, to personal growth.

The response to my talk was overwhelming.  About half way through my comments, the commanding general interrupted me to offer his support for research I was planning on the effects of combat on soldier performance and adjustment, and directed the brigade surgeon to assist me in any way needed.  After the talk, many soldiers wanted to talk to me individually about their own combat experiences.  They had experienced the trauma and adversity of war first hand, but their personal narratives were more ones of resilience and growth, versus pathology.  Many had indeed suffered from their experiences, but they also saw themselves as emerging from their combat tours as stronger and more adaptable. This theme of resilience and growth spoke to their own personal narratives of combat.

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It is not surprising that these soldiers were surprised to hear me talk about resilience and growth.  Psychology has focused on pathology for over 100 years. Moreover, the media and press also focus on “newsworthy” phenomena like PTSD, depression, and suicide, more so than on positive reactions to stress and adversity. At the height of the war, it was common to pick up a newspaper and read about the putative PTSD epidemic, and to repeatedly see stories on PTSD on television or online news sources. 

The positive psychology movement has begun to expand the scope of legitimate psychological inquiry to include resilience and personal growth, but the pathology focus still predominates.  In Head Strong, I point out that a literature search revealed 24,004 references to PTSD, compared to just 1,064 to posttraumatic growth (PTG).  I did this search about 18 months ago, as I was writing Chapter 5 (“Tough Hearts: Building Resilience Soldiers”).  Moments ago, I repeated the search and found in the intervening months an additional 4,518 “hits” for PTSD, and only 443 for PTG.  This is rather interesting, because this shows a greater rate of increase in PTG studies (42%) than in PTSD studies (19%).  There is hope!

Expanding the focus of psychological research to include resilience and growth is significant for several reasons.  All of us – military or civilian – will likely experience trauma and adversity in our lives.  You may witness a deadly vehicle accident, be the victim of a violent crime, suffer the unexpected death of a loved one, or contract a potentially fatal disease. For some people, their jobs expose them to trauma.  Law enforcement personnel, first responders, and the military must respond to and deal effectively in dangerous and threatening situations on a regular basis.  The lessons learned by military psychologists who study resilience and growth in response to trauma and adversity will provide us all with the tools we need to respond more adaptively if and when we face trying circumstances in life.

The emerging science of resilience and growth is also important because it provides us with an alternative narrative to pathology for those instances when our wellbeing is threatened.  There is a strong pathology narrative in the military and, I suspect, among the civilian population.  A few years ago I surveyed 100 West Point cadets and found that 80 percent felt they had a “good understanding” of PTSD.  In contrast, 78% of these future Army officers had not even heard of PTG.  Sadly, the majority believed they would experience PTSD when exposed to combat later in their careers.

This concept of the narrative is important because it may influence how one frames his or her personal experience with trauma and adversity. Most psychologists recognize that it is normal for people to experience disturbed sleep, intrusive memories, and dissociative reactions following trauma.  In many ways, these initial responses may be adaptive to the extent they help the individual avoid similar future experiences. Soldiers with a strong pathology narrative may quickly label these very normal reactions to trauma as pathology, perhaps increasing the chances they will later present with diagnosable PTSD.  In contrast, someone with a resilience and growth narrative may be able to recognize their initial adverse reactions as part of a normal sequel of reactions to trauma, ones that later will subside and be replaced by a resilient or even a growth response.

My own research affirms that soldiers experience personal growth following combat.  In one study, I surveyed over 100 army officers who had just returned from combat deployments. When asked to rate what personal character strengths increased or decreased as a result of their combat experiences, they indicated the greatest growth in teamwork, bravery, capacity to love and be loved, and honesty.  Along with other studies reviewed in Head Strong, this suggests that resilience and growth may be a far more typical response to trauma and adversity than is pathology.

A supporting, but admittedly anecdotal observation supports this contention.  About half of my faculty colleagues at West Point are young officers, all of whom have deployed to combat, most two or more times.  When they finally arrive at West Point for a three year tour, there is a noticeable spike in their fertility rate.  The number of children born is really quite remarkable.  I suspect these combat veterans view creating the next generation as a highly meaningful and positive way of expressing their increased sense of capacity to love and be loved.  Demographers will be quick to remind us of the post-World War II baby boom.

The impact of war on our psychological adjustment is complex.  Young people join the military with diverse backgrounds and skills.  Some may be vulnerable to stress-related pathology, and others may have the emotional and social tools needed for a robust and positive response to their experiences.  Perhaps the noted Civil War officer Joshua Laurence Chamberlain said it best, when he observed “War is for the participants a test of character. It makes bad men worse and good men better.”  It is up to psychology to develop a more precise understanding of just what enables us to respond successfully to the inevitable challenges we all, military or civilian, must face in the course of our lives.

Note:  The views expressed herein are those of the author and do not reflect the position of the United States Military Academy, the Department of the Army, or the Department of Defense.

Michael D. Matthews, Ph.D., is Professor of Engineering Psychology at the United States Military Academy and author of Head Strong: How Psychology is Revolutionizing War.

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