What Doesn't Kill Us

The new psychology of posttraumatic growth

Changing How We Think About Psychological Trauma

Trauma is not an illness

The possibility of posttraumatic growth has become one of the most exciting topics in modern clinical psychology and psychotherapy.

Many commentators have talked about how trauma can be a catalyst to positive psychological change. Often, people's philosophies of life change; perhaps becoming wiser, less materialistic, or more able to live in the present. Their sense of self changes too; perhaps becoming more patient, compassionate or grateful. And people's relationships change; perhaps with a new depth of quality, the ability to make time for others, or becoming more giving.

Certainly, the study of posttraumatic growth is fascinating.

But what I find so compelling about this topic, and what most commentators haven't spotted yet, is that posttraumatic growth turns on its head how we think about psychological trauma.

For the last thirty years, the idea of posttraumatic stress disorder (PTSD) has been the big idea in the field of psychological trauma. But PTSD has increasingly come under fire by its critics.

Critics point to how PTSD has become scientifically meaningless. Psychiatric classification demands that a line is drawn that separates people into two groups: those without the disorder and those with the disorder. The question is where to draw that line.

Since the diagnosis of PTSD was formally introduced in 1980 the line has moved twice - in a manner some authors have referred to as bracket creep - so that the diagnosis of PTSD is now much more common than it would have been thirty years ago.

But not only is it more common, it has also become evident that it is widely used to describe what might previously have been viewed as normal human distress. This can't continue without devaluing the idea of PTSD.

The challenge therefore is for the next edition of the Diagnostic and Statistical Manual (DSM) to demonstrate when these normal processes of posttraumatic stress become disordered, so that the term PTSD is used clearly to describe dysfunction of some mental mechanism.

And it becomes increasingly clear that for most people trauma is simply not an illness.

For many years humanistic psychologists have argued against the illness ideology in psychology with little success. But now it is also becoming obvious to the wider audience that what is needed is a new non-pathological understanding of the normal processes that trauma triggers.

This is the cutting edge of posttraumatic growth research and theory. It is why I think posttraumatic growth is one of the most important topics in contemporary psychology. Posttraumatic growth shows that what we need is neither a negative psychology, nor a positive psychology, but an integrative psychology that understands that trauma and transformation, suffering and joy, go hand in hand.

To find out more about criticisms of PTSD, see:

Boone, K. N. (2011). The Paradox of PTSD. The Wilson Quarterly, Volume xxxv, Number 4.

For information on posttraumatic growth research, see: 

Joseph, S., and Butler, L. D. (2010). Positive changes following adversity. National Centre for PTSD Research Quarterly (Summer). Free to download at: http://www.ptsd.va.gov/professional/newsletters/research-quarterly/V21N3.pdf

 

 For more: http://www.profstephenjoseph.com

 

 

Stephen Joseph, Ph.D., is a professor of psychology, health, and social care at the University of Nottingham, UK, and author of What Doesn't Kill Us.

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