War is one of the greatest evils. The outcomes and destruction it brings traumatise everyone and leave no one indifferent. Meanwhile, can something good happen after trauma? What can we do amid the ongoing war? We discussed this issue with Dr Richard Tedeschi, a psychologist who coined the term ‘posttraumatic growth’ with Lawrence Calhoun in 1995. At the moment, Richard Tedeschi is an honorary professor of psychology at the University of North Carolina and the executive director of the Boulder Crest Institute at the Boulder Crest Foundation, an institution considered the ‘home’ of posttraumatic growth research. On 4 August this year, Dr Tedeschi gave an interview on posttraumatic growth for a Ukrainian audience.
In the beginning, posttraumatic growth (PTG) does not differ from posttraumatic stress disorder (PTSD). Both PTG and PTSD occur after trauma – some events turn people’s world upside down, affecting the very foundation of what they believe in. After that, it’s very difficult to move on with one’s life, especially if one does not have a clear vision, a transparent path into the future that has been destroyed and doesn’t make sense anymore. And this leads to the emergence of anxiety and symptoms associated with PTSD.
PTG emerges when people experience a challenge to their core belief system. And because that system is challenged or shattered, we must reconstruct it. We must devise a way to move forward with a new, better and more accurate understanding of our lives and how to live them. What happens in the aftermath of trauma is a struggle. But in that struggle, people tend to reconstruct a belief system that they later use to move forward and find something of value even though all those terrible things have happened. During this process, people often experience a transformation of their true selves.
There are five different ways for people to experience growth. One way is to feel a greater sense of personal strength. People feel like if they’ve already handled whatever they’ve gone through, they can handle anything. The second way is a greater sense of appreciating life. A third method is the new possibilities. That is, there are things in life they may no longer be able to do because of what has happened, yet some people seek new pathways and directions, discovering new opportunities. The fourth way is introducing changes to interpersonal relationships. Some people reveal that their relationships have become deeper and more meaningful; they’ve experienced a closer connection with others and felt more compassion and empathy. And then, finally, there is a spiritual existential change where people grapple with the big philosophical questions about life. Why continue living, given what has happened? What is the point of all? What is my purpose? What is meaningful and valuable about my own life?
People are more likely to experience PTG if they understand it is possible. One of the most important thoughts I want to share is this: if you have to experience the suffering, terror, and horrors of the war, it does not mean that you are defeated or that there is something wrong with you; it does not necessarily mean that you’re going to be lost or damaged. “What I am saying is, yes, it will be difficult. You will suffer. But it’s not going to be meaningless suffering. And it doesn’t mean this sacrifices your life’s complexity, even if you physically survived the war. There’s still more to life than that. So when people hear about PTG, it’s important for them to understand that I am not claiming this to be an easy thing; I am not just being optimistic or convincing people that experiencing problems is not natural. Not at all. All of this is a struggle. That’s what we call it: keep fighting, ‘struggle well’ (“Struggle Well” is one of the Boulder Crest programmes and a book title).
Growth brings resilience. You have to go through some changes. A greater strength can come out of those changes. What’s happening in Ukraine is a response of people in this country, many of whom have already experienced posttraumatic growth through various traumas they’ve been through. And they draw on that. Now they know how to face future traumas with a better understanding of their own strength; they know how to appreciate life, treat other people with meaning and purpose, what opportunities they see in it, and how creative they can be in responding to all of this. And just because one is living through trauma, it doesn’t mean that one can’t experience PTG. A person affected doesn’t have to wait until it’s all over. In some ways, traumas are never all over. People remember them. Traumas never entirely leave our memory.
Posttraumatic growth is both an outcome and a process. It is a way of living, not an achievement. People learn how to live in a meaningful, purposeful, and valuable way. This learning process continues every day. You can’t say, “I’ve figured this out, and I don’t have to think about that anymore”, no. You continue reflecting on this and learn that healing is a continuous process. This way, we can see PTG as a result reflected through changes people experience. Those changes continue to show in how they live their lives, carry on with their routine, and perceive their future.
Boulder Crest Foundation is called the home of PTG. “This organisation’s distinctive, unique feature is that its programs are based on PTG approaches and are conducted according to the ‘peer-to-peer’ principle. The Warrior PATHH Program (Progressive and Alternative Training for Helping Heroes), our original program for veterans, is one of them. It’s a seven-day program where participants meet in small groups and learn about PTG and how to facilitate it. After that, participants stay in touch with us for another three months. We have a phone app that they can use to learn more and stay connected with us and each other. This app allows them to receive the proper support throughout all this time.
We’ve recently started a program called Struggle Well, which was developed for emergency service workers, such as law enforcement officers, firefighters, and emergency medical personnel. This is a program where people don’t come to our Boulder Crest campuses; instead, we travel to meet them, introduce the PTG concept, and present ways to manage the traumas these people have experienced. The whole idea of the Struggle Well program is not just helping these individual first responders, but we are changing the culture of those departments through our programming.
Both programs are delivered by peers. The peer-to-peer approach works better because the veterans help the veterans. They understand each other, trust each other, and speak the same language. Trust and connection are the key elements of these programs. We maximise the outcome using a peer-to-peer approach, trust, and connection, which allows people to do the challenging work. People may feel emotionally drained, intimidated or embarrassed. After all, it can be frightening to reveal one’s experiences to others. This is particularly the case with communities, where people have been used to hiding their suffering and trying to go through it alone. “Opening up and discussing this openly with their peers is quite challenging. So, having peers encourage those affected and understand them is a much more productive way to achieve results than me trying to do this on my own”.
There are four healing factors. These are four “P”: place, people, program and philosophy. You’ve probably noticed that the sites we bring people for Warrior Path are beautiful places in rural settings; this way, we demonstrate our respect for the people coming to the programs. Remarkable people are part of our team. And then, there’s the program, and we have it all mapped out and laid it out. Also, there is a philosophy based on posttraumatic growth. We believe that people have value amid their suffering and their symptoms, their misery and loss, their doubts about themselves, and all of those things brought by the trauma; we believe that there are values still in human beings that we must reach and promote again.
There are just not enough mental health specialists to handle all the trauma and suffering that’s going on now in Ukraine. You can’t develop enough mental health services to reach out to everyone with individual psychotherapy. I’m not saying individual psychotherapy is wrong or bad; I do it every day, and it’s beneficial. But if we look at it within the context of what is going on in Ukraine or what’s happening in the United States, you must have a larger number of people involved in the case. That’s one reason. Secondly, as I mentioned, peers tend to understand traumatic events better because of their own experiences. And this is a step forward through trust and connection that comes from that shared experience when people say, oh, you get it, you understand me; you’ve been through a similar experience yourself. That definitely helps the process in a very crucial, meaningful way.
In Ukraine, everyone has an excellent opportunity to participate in this healing process. We call it expert companionship. It’s more important to offer people companionship that’s deep and trustworthy than to provide them with techniques that you find in therapy. The relationship is the most crucial healing component; we can offer that to people without being educated and trained as psychologists. So we’ve got something here supporting the idea: a peer-to-peer approach. And that’s what we find to be the case. And many different people can be expert companions, such as teachers, physicians, community organisers, neighbours, and family members. Anybody can learn how to approach people who are going through trauma, listen to them, learn from them, and respect them. And that goes a long way in healing the wounds. I think what is going to be needed in Ukraine is the kind of approach to war trauma when people are helping each other; when everyone is peer-to-peer on this.
Being an expert companion means a personal responsibility. Making Ukrainian victory closer means not only supporting soldiers but also strengthening the civilian population. Everybody in Ukraine is responsible for taking care of their neighbour and community. It is a patriotic matter. In everyday life, treat each other with respect, and remember that each person is fighting the war. Build your relationship with people, keeping the PTG in mind.
You can’t enforce posttraumatic growth in another person, so don’t feel responsible for that. You can be an expert companion. So what do you do? You listen. You learn about that person’s experience. You look for places of value, places of change, the roots. Observe things that could grow into something, and let people know you see these positive things in them. Now, the problem, of course, is that growth takes time. Some people need more patience. They want things to change quickly. So, if you want to become an expert companion, being patient is part of the process.
You can’t be an expert companion without feeling people. Sometimes, listening to people and learning about survivors’ trauma can be genuinely distressing and deeply disturbing. And that’s why people have talked about vicarious traumatisation. But we’ve also spoken about vicarious posttraumatic growth. I truly believe that if you talk to any of our guides and ask them about helping other people, they will all say: “I’m helping other people, but I’ve been helped a lot”.
Services are an important part of sustaining the posttraumatic growth process. Because it keeps you connected with people and keeps you empathic, those relationships allow you to see your own strength and learn how to live life in a meaningful way. This opens up new possibilities, allowing you to do things you never thought you could do. All those areas of posttraumatic growth you see evolve from caring for others. It has to go beyond just feeling good about yourself.
I pay close attention to what Ukrainians are going through and see the strength of people in this country. I see how there’s a response to this concept of posttraumatic growth, and I think once the war is over, this will allow you to sustain yourselves long-term because you must feel that all this misery, loss, death, and destruction weren’t for nothing. There is hope and growth.
While trauma is inevitable in our lives, there is a hope that the fruits of its impact can be meaningful and essential for your personal growth and the deepening of your identity, as well as for the nation as a whole.
