Bret A. Moore Psy.D., ABPP

The Camouflage Couch

Posttraumatic Growth: Shifting from Dysfunction to Evolution

It is time to move beyond just treating PTSD and focus on potential growth.

Posted Mar 27, 2018

March 20th marked the 15th anniversary of the U.S. invasion of Iraq. Although only a fraction of American service members remain deployed to Iraq today, the residual effects of combat permeate many of our communities.

As a nation we opened our communal arms to the men and women as they returned home from Iraq.  Main Street parades were held and memorials were constructed. However, a darker side of this time began to show and still remains. It's the presence of the psychological effects of war, the most notable being post-traumatic stress disorder - simply referred to as PTSD.

PTSD has a long and sordid history with war.  After witnessing countless soldiers suffering from fatigue, heart palpitations, and shortness of breath, Civil War doctor Jacob Mendes Da Costa labeled soldiers as suffering from "Soldier's Heart".  What was believed to a be a cardiovascular condition was in fact anxiety. 

The term "battle fatigue" was the dominate label during World War II. And although the medical community's understanding of the psychological consequences of combat was greater at this time, many military leaders incorrectly and callously labeled struggling soldiers as cowards.

It wasn't until the Vietnam War that researchers truly began to classify and categorize the many shared psychological symptoms of combat veterans. Consequently, the term PTSD made its way into the Diagnostic and Statistical Manual of Mental Disorders (DSM), the publication often referred to as the "psychiatric bible."

Today, 15 years into the longest period of war in our nation's history, we're still trying to understand PTSD. The prevalence rate in post-9/11 veterans hasn't changed from that of their predecessors from earlier conflicts, which has been reported to be as high as 30% in certain groups.

Our treatments haven't changed that much either. Talk-therapy and medications are the dominate interventions for our combat veterans. And unfortunately it's estimated that only about half of veterans who need treatment actually seek it. And of those who initiate treatment only a modest portion actually finish and achieve remission.

One hundred and fifty years after Soldier's Heart, it's time to rethink our approach to PTSD. Let's get away from the medical model that reduces our combat veterans to a set of symptoms and start harnessing their inner strength and turn their struggles into new possibilities, purpose, and meaning.

This novel concept is called "posttraumatic growth," or "PTG". PTG supports the notion that our most difficult experiences can make us stronger. Instead of just thinking in terms of recovery from traumatic events, we should also help combat veterans use their experiences to grow and become stronger, healthier, and better versions of themselves.

Many experts in psychology and psychiatry believe that PTG can be cultivated in veterans. In fact, over 30 years of research by psychologists Richard Tedeschi and Lawrence Calhoun, the fathers of modern-day PTG, establishes a strong foundation for this belief.

We don't believe that facilitating PTG in veterans should replace current treatments.  Talk-therapy and medication are effective for a subset of combat veterans struggling with PTSD. We do believe that leveraging veterans' inner strength in order to help them explore new possibilities for psychological, relational, and spiritual growth is imperative.  In other words, we must help them focus on what they have gained from their combat experiences versus what they have lost.

Bret A. Moore, Psy.D., is a former Army psychologist, veteran of the Iraq War and writer. He's the co-author of "The Posttraumatic Growth Workbook.”  

Ken Falke is a retired Navy Master Chief. He's chairman and founder of both the Boulder Crest Retreat for Military and Veteran Wellness and the EOD Warrior Foundation and co-author of "Struggle Well".

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