The Truth about Posttraumatic Growth After Loss

Understanding Grief / Understanding Grief : Eleanor Haley

For further articles on these topics:

Litsa and I have long had a bee in our bonnet over the rhetoric around grief self-help.  Not all grief self-help of course, but specifically that which puts forth the notion that, with the proper perspective, a person's grief will become a vehicle for "transformation" "renewal" "self-discovery" or "metamorphosis".  Although I can't claim that these ideas are patently untrue, I can say that they are often misleading.

In truth, growth and transformation are not attained by simply setting one's mind to it.  More importantly, one may feel they have experienced growth in their grief, yet still feel intense pain over the loss. It's important to talk about the true nature of posttraumatic growth so people understand that it's not an easy path out of or around pain. On the contrary, it is only through confronting and struggling with pain, that such growth and transformation can exist.

What is posttraumatic growth (PTG) exactly?

Prominent PTG researchers Tedeschi and Calhoun (2004) define posttraumatic growth as...

"...positive psychological change experienced as a result of the struggle with highly challenging life circumstances."

What are highly challenging life circumstances?  Going back to our discussion of trauma, we are reminded that there's a lot of subjectivity when it comes to traumatic and challenging experiences.  For example, something that seems immensely troubling to me - like the loss of a job, death of a pet, or divorce - might be far less disturbing to someone else.  Generally speaking, an event might be considered highly challenging when it threatens a person's understanding of the world and his or her ability to function within it.

The type of hardship that leads to PTG is always significant, meaning it comes with an immense about of pain and distress. Rarely, if ever, does the experience of growth lead to a sense of preference for the trauma having happened.  Many of you have experienced the death of a loved one and, as I'm sure you can attest, you'd trade all the growth in the world to have your loved one back.  Experiencing PTG is of little consolation in grief, and I suspect this is why sentiments that aim to comfort through promises of transformation and self-discovery often fall flat.  

Posttraumatic growth does not nullify or lessen grief and so you should not look to it as an end point to pain.  Instead, PTG should be conceptualized as something that co-exists with distress or, more specifically, something that only exists because of distress and subsequent coping. Posttraumatic growth evolves from the same processes people use to cope with grief.  So, in effect, posttraumatic growth is an unexpected, but beautiful, byproduct of pain.

It should be noted that, although humans have long understood their capacity to experience PTG, research on this psychological phenomena is relatively recent and evolving.

It's also important to note...

Not everyone experiences PTG:

Posttraumatic growth is not a given.  For various reasons, not everyone who has been through a trauma will experience notable PTG.  Although research indicates that instances of PTG far outnumber reports of psychiatric disorder like PTSD, depression, or anxiety, many people will have significant and ongoing difficulty coping with their losses and many will ultimately feel they have experienced little to no growth as a result of their highly challenging experiences.

PTG is not the same as resilience:

The term resilience is often used is relation to grief, so it's important to draw the distinction between this concept and PTG.  Resilience typically refers to an ability to withstand hardship and remain psychologically healthy despite adversity.  PTG goes beyond maintaining baseline functioning (i.e. resillience) and refers to improvement in one's ability to function and adapt.

Screen Shot 2016-02-02 at 3.12.04 PM

How does posttraumatic growth occur?

Even if a detailed description of posttraumatic growth were within the scope of this article, I am by far not the best person to explain it.  If you have a mind for research articles, you can head here and I will also link to a few other resources related to PTG at the end of the post. Although this concept is complex, I'd like to make a few basic points about the process of PTG.

The type of event:

A wide range of experiences have been documented as resulting in PTG.  Generally speaking, events that lead to PTG are those that shake a person's fundamental understanding of themselves, others and the world; specifically with regards to predictability, purpose, justness, benevolence, and safety.  So in order for posttraumatic growth to occur, a trauma must be significant enough to destroy a person's foundation because only then can he or she put it back together in a way that feels enlightened, deeper, and enriched.

The necessity of grief:

Through coping with death and grief, one learns lessons about themselves, the world, and others.  By facing the reality of trauma and loss, a person may discover flaws in their previous assumptions and the need to refine their beliefs and understanding accordingly.  In contrast, when one does not face their experiences, perhaps through avoidance or other maladaptive coping, they are less likely to find ways to create meaningful narratives around their trauma and more likely to experience negative psychological outcomes.

You know this already, grief exposes you to a reality you never knew existed. Through the grit and persistence required to survive and make sense of the senseless, you find new strength and meaning. Without this struggle - the sadness, anger, despair, meaninglessness, and fear - growth would never occur.  The domains of PTG (detailed below) are all paradoxes to loss....because you understand life is precious, you treasure it more...because you know what it means to feel vulnerable, you've learned how to be strong...because you've lost someone you love, you treasure others more...and so on.  Although the pain of these losses remain, in time you discover what comes next.

Support and disclosure:

Positive social support can aid in facilitating PTG by providing an outlet for disclosure of trauma related memories, thoughts, and emotions.  This type of personal interaction opens the door for support and feedback from others and stimulates dialectical thinking about the meaning of one's experiences. It has been found that, in addition to disclosure in the context of one-on-one interaction and support groups, written disclosure is also helpful in facilitating PTG.  Sadly, support systems that discourage disclosure and emotional expression are linked to poorer outcomes such as depression.

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What does posttraumatic growth look like?

Tedeschi and Calhoun (1996) outlined the 5 major domains of postraumatic growth. As someone who has experienced a highly challenging event, you may be able to identify with one or more of these growth domains.

1.  Greater appreciation of life and/or changed sense of priorities:  

Growth in this area might mean you...

  • Have a greater sense of appreciation for what you have
  • Experience a shift in priorities
  • Redefine what you consider "important"
  • Have a greater appreciation for the "small things" in life

2.  More intimate, deeper, or warmer relationships with other:  

We'll admit that we focus a lot on the bad and the ugly of support systems after a death, but the truth is that many people have really wonderful grief-related personal interactions.  Growth in this area might be experienced if you...

  • Feel a greater sense of compassion for others
  • Experience compassion from others
  • Are able to focus on the relationships that truly matter and ignore those that are harmful or unhelpful
  • Feel the experience has helped you to "find out who your friends are"
  • Realize the need to cherish your relationships

3.  A sense of increased (or discovered) personal strength:  

Many people have the sense that if they've survived the death of a close loved one, they handle anything. Growth in this area might be experienced as...

  • Greater sense of self control and emotional balance
  • An enhanced ability to cope and adapt
  • A greater sense of perspective during times of hardship
  • Increased feelings of independence and confidence

4.  Openness to new possibilities in life:  

Often the realization of vulnerability and the discovery of new strength and perspective can lead people to make new or more meaningful decisions regarding their path in life.

5.  Spiritual growth:  

Whether you fancied yourself a religious person at the time of the trauma, struggling with existential and spiritual questions can often lead to a deeper, more refined sense of belief and understanding.

For more information on posttraumatic growth, check out the following resources:

Upside: The New Science of Post-Traumatic Growth

What Doesn't Kill Us via Psychology Today

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26 Comments on "The Truth about Posttraumatic Growth After Loss"

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  1. michael  October 6, 2020 at 10:58 pm Reply

    I know this is an old article, but it’s still the first thing I found about post-traumatic growth that wasn’t an academic paper. I’m glad I found it.

    My closest friend lost her battle with depression six months ago, and I don’t feel like the same person I was before. I’ve been feeling confused about some of these changes; positive changes to my priorities, self-discipline, empathy and urge to connect with people. I feel guilty about the idea that anything positive could come out of this awful thing.

    Like the article says, these changes don’t negate the overwhelming grief, pain, anger or guilt.
    Like the article and other commenter(s) mention, the idea that post traumatic growth would be an encouragement to people grieving a loss is just so tone-deaf. Right up there with “everything happens for a reason”.

    Anyway, I am really glad to have read this. Grief is such a lonely feeling, and I find it comforting when I read something that reflects my own experience, and know that other people have felt the way I’m feeling.

  2. Ruth E. Field, LCSW  March 2, 2018 at 8:48 pm Reply

    As a bereaved mother, author, and psychotherapist, this is an important conversation. Your article is right-on in every way, especially in the caveat that not everyone experiences PTG. For me, it was enough to know it’s possible. That was the hope I could cling to when there was nothing else to hope for. I couldn’t hope for my son to come back, for life to ever be the same, or that I would ever stop missing him. But I could hope to make my life more meaningful through this traumatic loss — even though I will always wish his sudden, accidental death never happened. This is the dialectic challenge: experiencing a shattering reality while also entertaining the possibility of something new and meaningful evolving from it.

  3. Ruth E. Field, LCSW  March 2, 2018 at 8:48 pm Reply

    As a bereaved mother, author, and psychotherapist, this is an important conversation. Your article is right-on in every way, especially in the caveat that not everyone experiences PTG. For me, it was enough to know it’s possible. That was the hope I could cling to when there was nothing else to hope for. I couldn’t hope for my son to come back, for life to ever be the same, or that I would ever stop missing him. But I could hope to make my life more meaningful through this traumatic loss — even though I will always wish his sudden, accidental death never happened. This is the dialectic challenge: experiencing a shattering reality while also entertaining the possibility of something new and meaningful evolving from it.

  4. Luanne Mclaughlin  January 27, 2017 at 1:58 am Reply

    Thank you. Amazing. When i needed you most

  5. Amber  January 18, 2017 at 9:47 pm Reply

    I’m dealing with PTG right now after the unexpected loss of my beloved dog and working with a counselor through it. Thanks for a great article as usual.

  6. andelina  October 10, 2016 at 2:03 am Reply

    PTG really results on growth. Together with the Lord, He has given me beauty for the ashes

  7. Cathy Davis  September 29, 2016 at 11:11 am Reply

    I lost my husband 10 months ago and don’t understand some of my own feelings. May I also follow your blog.

  8. Lisa Kusen  July 13, 2016 at 8:46 am Reply

    My husband suddenly and unexpectedly died at home. I would like to follow this blog

    • Eleanor  July 14, 2016 at 3:48 pm Reply

      Hey Lisa, would you like us to subscribe you?

  9. Anonymous  February 25, 2016 at 3:09 am Reply

    I don’t feel like I’ll ever be able to GET out of the post-traumatic event, I don’t feel like anybody will LET us get beyond it. Not with people bringing up new things every damn year, and that’s what’s been happening for 15 years now, this year’s feature being the news to just let GO from Guantanamo the people who helped kill him by paying for the planes operation, which is what they call it – and having solid evidence of it beFORE they were tortured.

    It’s just that if people are always introducing more SECONDARY junk like this I don’t see how the families of Sep-11 victims are supposed to feel like there’s been any earthly justice for the “people” who did it. The ones who ACTUALLY carried out the plan all died within half a second, not 8 to 10 minutes like it took him to die, and now the people who helped pay for it are treated like they’re poor little victims when they’ve never been any such thing, nor have they felt even a twinge or remorse or guilt for what they’ve done.

    How is one supposed to transform grief to something good under those circumstances? The only thing I can think to do is process yet again this miscarriage of justice and then go on until the next damn thing occurs. I can’t imagine what else could occur but I haven’t been able to do that since 2008 and I’ve been met with all kinds of new things I had to process, including the news of an official Senate Torture Report 2 weeks before Christmas last year and the proof of actual torture a year before that. That should probably have no effect on my grief, at least I thought so, but my feelings betrayed me and I had a reaction anyway.

  10. Julia  February 5, 2016 at 5:21 pm Reply

    I’m so grateful that I found this site. I’ve experienced multiple losses and 5 surgeries in the past 4 years. I’m also grieving my loss of health. Throughout that period of time, I have experienced friends walking away because I am unable to do so many things, lack of support from my family (family mantra…we do not show our feelings), struggling with PTSD with a therapist who doesn’t believe it’s real (diagnosed twice for different events, and I’m caring for my 98 year old father. I’m exhausted and having a hard time going on. Does anyone have any suggests on how to incorporate these multiple stressors in my life into a semblance of a healthy life? Any suggestions would be appreciated. Than you in advance for your help.

    • Clare  June 24, 2019 at 10:52 pm Reply

      Verrrrry late reply, Julia. But I hope you sacked your therapist and found someone better! I hope you’ve been able to make small changes over the past few years, and that on reflection they have mounted to something meaningful and hopeful. Take care.

  11. Roselyn  February 4, 2016 at 7:37 pm Reply

    I don’t think it was not helpful. It did not fit me where I am and felt pressure – self inflicted- to grow through this . I cannot wrap my head around that right now.
    I read all you post along with so much else trying to find a way to cope.
    Although not everything helps, it is important to share what we learn, feel, and live through this experience . This hell of a life that I did not anticipate.
    Again thank you

  12. Stacy Maddux  February 4, 2016 at 7:14 pm Reply

    Roselyn, I hear the pain in your words which come from the heart. I too hope Litsa’s closing words of her reply are true for you. She wrote, “The tricky thing in grief is that nothing applies to everyone, because grief is so unique for each of us. I’m sorry this post was not helpful to you, hopefully you have found others on our site that are.”

    Although I had been thinking of making changes in my professional life, the death of my mother caused a dramatic turn that I never would have predicted. Yes, I wish she were here to share in the new world I’ve entered, but I feel it is her strength and my father’s spirit which continue to take me on the trip through the second half of my life.

  13. Roselyn  February 4, 2016 at 9:17 am Reply

    yes, and as I wrote later , it is information which is always helpful. At times it feels foreign and others it is right on.
    I cannot imagine getting there, however as I know life is unpredictable and I may. It feels like pressure to get there at this point- one year later which I know is crazy !!! and I know it may be self inflicted. I have worked for years on myself, for myself and for my son, and others. Now I have regressed into this deep sadness and longing for death as comfort. Hope is tough, the hope I have and pray for is to see my son again
    Thank you

  14. Cathleen  February 3, 2016 at 3:37 pm Reply

    “Rainbow Bridge” My brother…Mother and Son are waiting for me to join them. “Never stand at my resting place.” I am not there…

  15. Chaplain Regan Saoirse  February 3, 2016 at 8:47 am Reply

    Thanks for your perspectives and for sharing education that desperately is needed. This morning I just read an op-ed piece on the importance of distinguishing PTSD and moral injury for soldiers. I think there is something similar for those recovering from lost relationships. When there is no reconciliation or ability to make amends for wrongs we may have caused against persons who are dead or gone, there is a deeper spiritual rift that troubles us differently and heals differently than a traumatic experience. Here’s the piece. And I highly recommend following Soul Repair Center at Brite Divinity School on fb.

  16. Tracy Russell  February 3, 2016 at 7:03 am Reply

    This is a great article. Although I do see growth in myself in certain aspects ie can now spend a little time with my friends etc I have other negatives in my life. I am extremely clumsy (always causing myself stupid injuries), short tempered and unable to cope with every day stresses. I suffer from bad anxiety too. I was telling someone the other day that I lost my Dad just over a year ago when in actual fact it’s closer to 18 months. 18 months! I feel like it happened yesterday. So yes, I have experienced growth in some areas but it has come at a price. Hopefully the counsellor I have arranged to see can help with this. I sometimes feel myself slipping in to something I’m not sure I could come out of.

  17. Roselyb  February 2, 2016 at 10:57 pm Reply

    Yes. The suggestion of PTG is nauseating and cruel at this time
    I cannot see it being helpful except anecdotal
    It’s not any benefit as one commenter stated.
    You have no idea

    • Litsa  February 4, 2016 at 7:57 am Reply

      Rosyln, as Eleanor mentioned in the post, we specifically wrote this article because we ourselves, as grievers, were also frustrated and often infuriated when people would talk about ‘transformation’, grief ‘making you a better person’ etc. I have had moments of wanting to punch people when they have made comments like that 🙂 That said, PTG is a thing and there are many grievers who ultimately connect with it in certain ways (some in small ways, others in large ways). The fact that I did not connect with it in my own grief is actually part of the reason we find it so important to talk about and understand, because some others relate to it very deeply while others don’t at all. It may not apply to you at this time, it may not apply to you ever. But one of our goals is to educate about the things that give us insight into our own grief, and the grief of others, even the things that we don’t personally connect with. You’re right, I have no idea of your experience. You have no idea of mine. The goal here is to share as much as we possibly can with the hope that some things will resonate with some people, other things will resonate with others. The tricky thing in grief is that nothing applies to everyone, because grief is so unique for each of us. I’m sorry this post was not helpful to you, hopefully you have found others on our site that are.

  18. Cheryl Bailey  February 2, 2016 at 10:00 pm Reply

    What a well written post. As a therapist specializing in grief and trauma, I am very aware of how some people do experience posttraumatic growth while others are do not. We need to be particularly careful what we say to those who have recently experienced a great loss. To even speak of posttraumatic growth to them may feel like it is minimizing their pain or that they should “look for the gift” when they are not in any place to even conceive of such a thing. There was an article by Tim Lawrence on his “The Adversity Within” website called “Everything Doesn’t Happen For a Reason” that went viral recently. I read it to the grief group I was facilitating and they loved it. People love to say to grieving people “there must have been a reason why ……. happened.” Not helpful. The mind looks to make sense of what happened, but we still must experience the grief and express it. In time we find a way to tell the story and if lucky, we may experience posttraumatic growth. Keep up the great posts!

  19. Cathryn  February 2, 2016 at 5:15 pm Reply

    What a great synthesis of the possible different outcomes as the result of a grief experience. Important you mentioned about the necessity of grief. No getting around grief, but there are benefits. Ok. Especially liked the discussion on the importance of support and disclosure. How sad that these types of opportunities are hard to find. Could you be more specific about the type of written disclosure that is helpful? Thank you for continuing to provide such valuable support and education about grief. I appreciate all your hard work.

  20. Yam Kahol  February 2, 2016 at 5:07 pm Reply

    Eleanor – I’m loving your articles and podcast recently! Hits the spot!
    Thank you 🙂

  21. Kelly  February 2, 2016 at 4:48 pm Reply

    You guys are such experts at addressing very complex and often contradictory responses to grief with perfect sensitivity. It is hard to think of how grief can co-exist with something that changes you in a way that can be defined as growth, but it can. I think the important point that you made was the lessons learned, if in fact there are any…are not a cure for grief but a result of it. For me, it was this out of nowhere creativity, doing art and taking pictures that ended up being coping mechanisms that have opened up a whole new path. Compassion has taken up a bigger place in my heart in a way that I never really understood being compassionate before humbling loss. You are right…no one would rejoice in even the most positive changes, if he/she could have avoided loss. For me, I think my loved ones are looking down on me, sometimes sadly, when they see me crying, and sometimes clapping and smiling to see me doing new things and having been changed in ways that they have played a part in. When I think of the changes in my life since I lost my husband, mother and father somewhat recently, I think of them as on the journey, as part of something we are almost doing together, it that doesn’t sound too strange.

  22. Anne Marie Higgins  February 2, 2016 at 4:32 pm Reply

    I wrote about PTG in my memoir, Dancing In Two Realms: A Love Story Beyond Death. I experienced it myself in many ways after my husband died and have seen other widowed people move forward in many of the ways you have written about. Other than being an author, I am a nurse practitioner and family therapist and have also seen people who could not move forward after trauma. It’s a difficult thing to witness. As always, your articles are interesting, informative and helpful to so many. Thank you Eleanor and Litza.

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