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Psychological “Growth” through War and Disease: Sometimes It’s Just a Cruel Delusion

The views expressed are those of the author and are not necessarily those of Scientific American.

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A week ago, The New York Times magazine ran an article on what psychologists call “posttraumatic growth.” An experience that can purportedly occur subsequent to severe life trauma, it might be best titled “The Oprah Moment” for non-clinicians. It entails an arduous life experience—combat, cancer—that, once confronted, is said to engender psychological transformation that affords a more mature or positive perspective on things.

The article was a good piece, focusing on soldiers whose lives had been transformed by confronting adversity and it detailed the U.S. Army’s efforts to foster resilience and growth. Well-reported, it included the requisite caveats in the form of quotes by experts in the field who questioned whether enough evidence exists, beyond the talk shows, to characterize it as worthy of an entry in the DSM.

The history of posttraumatic growth, though, comes replete with a few blemishes that the Times missed. It turns out that people who contend they have begun to take time to smell the roses may actually be descending into a psychological abyss with sometimes bizarre and potentially tragic manifestations.

A paper that appeared in Applied Psychology in 2007 reviewed the results of studies conducted in New York following the Sept. 11 attack and in Israel during the Al Asqa Intifada and found that those who reported growth experiences were actually more liable to suffer psychological distress.

“We’ve probably got 20,000 people that we’ve studied on posttraumatic growth, mainly in the Middle East in Israel and Palestine,” said Stevan Hobfoll of Rush University Medical Center in an interview I conducted with him in November of 2010 for a feature I was writing at the time on psychological resilience, a conversation that ultimately ended up unused on my hard disk because resilience, I learned, may even be construed as the opposite of posttraumatic growth. (It would have made a nice sidebar for the resilience story. But, as often happens, no space…until now.)

Hobfoll and colleagues found that most of those in their studies who said they were engaged in a period of personal growth after witnessing the violence of the Intifada were deluding themselves. “They do report growth, they do report that they think they’re doing better,” Hobfoll said. “And then when we checked them on their depression and PTSD, they were actually doing worse.”

Even more disturbing was how “growth” had apparently reshaped their attitudes. “We also have a very uncomfortable finding that those people who report more traumatic growth are more vicious in how they want to kill the enemy and more rejecting of others and more authoritarian.” (“rigid, right-wing, support of violence and ethnocentrism,” as the researchers characterized their findings in one study of Israel and the territories.)

The Oprah mantra of strength through hardship is commonplace following a traumatic event but only materializes if the victim actually initiates some meaningful action to effect change, the investigators found. Simply saying “my life has changed forever” doesn’t cut it.

Hobfoll illustrated that point from his own experience by telling me about a friend who had provided assurances that he had “seen the light” after a heart attack that led to quintuple bypass surgery. “Another friend of mine and I take off work to go visit him when he gets out of the hospital and he’s not there when we get there, he’s late. And he comes in with the two cell phones going, one in each ear. His adult daughter is leaving in a huff because she’s been there three days to see her almost-dying father and he hasn’t given her a minute. So he gives us the one-finger sign to say he’ll just be a minute and 20 minutes later he gets back to us and says: ‘I’m a changed man.’”

Growth is possible after potentially traumatic experiences, Hobfoll said, if the perception of it is coupled with specifc actions. Michael J. Fox as Parkinson’s spokesman and philanthropist has demonstrated as much. Victor Frankl, the psychiatrist who survived Auschwitz and helped pioneer the concept of psychological growth after hardship, wrote of “right action and right conduct” that, in the camps, translated into mutual aid that one prisoner would lend another at peril to himself.

Another way the “What doesn’t kill you…” meme can turn toxic stems from the unreasonable expectations it puts on the patient. When people have undergone trauma, just getting to the next day may be enough,” Hobfoll said. “If clinicians and even the media start setting up that you have to grow from that experience, that really can be a burden and that can be an overwhelming burden, when you start feeling guilty that I’m just making it to work and  continuing to be a parent to my kids and coaching the kids’ soccer team and they’re telling me that’s not enough and that I have to have grown and all I really want to do is get through this. ”

Oprah narratives are probably best discarded at the door of the trauma specialist’s office.

Source: Wikimedia Commons

Gary Stix About the Author: Gary Stix, a senior editor, commissions, writes, and edits features, news articles and Web blogs for SCIENTIFIC AMERICAN. His area of coverage is neuroscience. He also has frequently been the issue or section editor for special issues or reports on topics ranging from nanotechnology to obesity. He has worked for more than 20 years at SCIENTIFIC AMERICAN, following three years as a science journalist at IEEE Spectrum, the flagship publication for the Institute of Electrical and Electronics Engineers. He has an undergraduate degree in journalism from New York University. With his wife, Miriam Lacob, he wrote a general primer on technology called Who Gives a Gigabyte? Follow on Twitter @@gstix1.

The views expressed are those of the author and are not necessarily those of Scientific American.

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  1. 1. luaprelkniw 5:03 pm 04/1/2012

    My personal experience with mental illness bears out the contentions in this article. Thank you Mr. Stix, for telling the other side of the “what doesn’t kill me makes me stronger” myth.

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  2. 2. jtdwyer 7:39 pm 04/1/2012

    While the author somewhat strangely relies on the anecdotes of several psychologists proclaiming expertise in this subject based on their research, I can only say that the author and his sources seem to have no real experiences on which they can base their viewpoints.

    Regarding the research conducted using “probably… 20,000 people that we’ve studied on posttraumatic growth, mainly in the Middle East in Israel and Palestine” – I suggest that those subjects remain in a continuous traumatic state.

    Myself having survived one tour of duty in Viet Nam, I would not likely have developed any new perspective on my approach to living had I permanently remained in a combat environment.

    It is the escape from threatening conditions that affords individuals an opportunity to change their life using knowledge gained through their most difficult experiences. Those who continue to suffer from those experiences are not capable of applying that new found knowledge to revise their life goals and objectives.

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  3. 3. Archimedes 12:47 am 04/2/2012

    George Washington, Theodore Roosevelt, many of the Kings of England and Kings and nobles of many nations were combat veterans and had witnessed combat. Subsequent to the same, they matured intellectually, ethically, and emotionally. They were said to be ennobled as Henry V stated in his speech prior to the Battle of Agincourt (or Crecy) .As Aristotle stated, “Courage” is one of the hallmarks of men. My personal opinion is that certain individuals are dramatically changed intellectually, emotionally, and ethically by being placed in the combat environment. The same dramatic combat environmental clues trigger dormant genes which dramatically change the individual and mature him intellectually, emotionally, and ethically. The same are, as a consequence, distinctly more mature and developed intellectually, emotionally, and ethically than those who can not and/or will not experience combat.
    Our “bourgoise” norms envelop the psychiatric community and demand that they rationalize persecution of those who are thus “different” than they are.
    In the not too distant past, this combat elite were the “aristocrats” which both protected and dominated the “others”. Todays “bourgoise” majority fears them as a result as a mouse fears a cat and reacts, like cowards and bullys towards them.

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  4. 4. Geopelia 9:08 am 04/2/2012

    (For Archimedes)
    Living through a war as a civilian is also a maturing experience. In World War Two most of the population of south eastern Britain, especially London, were the targets of bombing, V1 and V2 weapons.
    There was no defence from the V2 rockets, and no warning that one was coming. Any minute could be one’s last.
    But people just carried on and ignored them.
    (Yes, I was there).

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  5. 5. jtdwyer 1:00 pm 04/2/2012

    BTW, having never watched an Oprah program I have no idea what you’re referring to there, except perhaps an attempt to discredit through association the idea that difficult life experiences can be character-building. That concept has been firmly established for generations and did not originate with any Oprah ‘mantra’.

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  6. 6. EyesWideOpen 2:54 pm 04/2/2012

    You may be right. If adversity is such a character builder, such a spiritual lift, then why have generations of people throughout the war torn Middle East sinking deeper into the mire of violence and degradation of every human value held dear by the so-called “civilized world”? Answer me that, Oprah? These people should be like the Dalai Lama, and the Middle East should be filled with luminaries of world peace after over 2,000 years of adversity and strife!

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  7. 7. Raghuvanshi1 12:54 am 04/3/2012

    I think those who suffered from psychological trauma from childhood they cannot cure. Research done by Joseph LeDoux wrote in his book The Emotional Brain.In these kind of trauma fear of death so deeply inserted in psyche of patient,that cannot cure by psychoanalysis or any medicine. He to sustain it lifelong,only he can sublime it in art science on any other creative work.May be in old age when brain`s energy became weak there may improvement occurs in behavior of patient but completely cure from this disease is impossible. This I am writing with my personal experiences because I suffered most terribly from this diseases in childhood,with the help of self-psychoanalysis I found out how this trauma arises in my brain and how and why I suffered by this trauma, I wrote many books and articles on this subject and till I am searching real meaning of this kind of suffering

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