HEALTH: Post-traumatic growth.
While post-traumatic stress disorder is widely acknowledged, much less attention is paid to its counterpart, posttraumatic growth –where people can find their lives transformed for the better after terrible events. By Lindy Alexander.
In the days and months after Victoria’s Black Saturday bushfires in 2009, Rhonda Abotomey felt overwhelmed by the scope and scale of what she had experienced. Abotomey lost three family members in the fires that raged through the state and ultimately killed 173 people.
“I crawled through the rubble and looked for any remnants of what was left,” she says. “I organised for my family’s home to be bulldozed and wound up their business.”
A former corporate accountant, Abotomey was dismayed to learn that because she herself didn’t live within the bushfires zone she wasn’t able to access much of the support that had been made available. “One of the pivotal things that drove me to advocacy was having someone in bureaucracy say I didn’t meet the criteria of being directly affected by Black Saturday,” says Abotomey. “They were telling citizens who had dead family members that we weren’t directly affected. I had the wrong postcode. Yet if my chook shed had burnt I would have been directly affected.”
Spurred on by the desire to make a positive and enduring social difference, Abotomey threw herself into advocacy. She became involved in the Bushfire Bereaved Advisory Group, was a witness for the bushfires royal commission and launched a bushfire recovery initiative.
Almost four years after the fires, Abotomey was talking to Professor Louise Harms from the department of social work at the University of Melbourne when she heard a term that perfectly described some of the trauma reactions she experienced but had no way of articulating. “I was telling Lou about the advocacy I was doing and that despite the horrific things I had been through, I also had some positive experiences,” says Abotomey. “Lou said my experiences sounded like a good example of post-traumatic growth.” Abotomey’s ears pricked up instantly. “It was a light-bulb moment,” she says. “I’d been given so much material about the incapacity that happens from being exposed to trauma, but nothing recognising that a normal part of a trauma reaction is that you can also have growth. Post-traumatic growth is formally recognised, just as post-traumatic stress is, and yet we don’t tell anyone about it.”
Post-traumatic growth was first described by researchers in the mid-1990s. The idea is that experiences after traumatic events can include developing a greater appreciation of life, embracing new possibilities, improvements in personal strength and relating to others, and spiritual growth. “The emerging literature on post-traumatic growth provides a language and a way of thinking about people’s strengths and their capacity to find a new way of living with traumas that have been experienced,” says Harms. “It recognises that alongside the distress and difficulty, there can also be positive transformations.
“I think it’s important to know that many people have experienced post-traumatic growth in some small to extensive way. It should be an anticipated experience after trauma, and one people have social permission to talk about.” Harms emphasises, however, that shining a light on such growth does not negate the distress and disruption trauma causes.
She approached Abotomey as a “citizen scientist” to come together with other interdisciplinary professionals and investigate experiences of posttraumatic growth after Black Saturday. This study was conducted at the same time that Harms was involved as a co-investigator in Beyond Bushfires, a six-year study exploring the impact of Black Saturday and related bushfires on the physical and mental health and wellbeing of community members. The study found that women were more likely to report post-traumatic growth, and that people from medium to highly affected communities and those experiencing greater posttraumatic stress were also more likely to report growth.
“Some researchers have suggested when people are reporting post-traumatic growth, it may be because the trauma experience is still very much alive in their daily life,” says Harms. “Therefore some argue that post-traumatic growth is not a positive sign of trauma, but a sign that a person is still quite traumatised.” If this is the case, talking with people about their experiences may be a good facilitator of recovery. “Rather than focusing on people’s difficulties and post-traumatic stress experiences, by focusing on strengths and positive transformations it may be a preferred conversation for people and a way of talking through a trauma experience.”
For Greg Ireton, manager of the Centre for
Disaster Management and Public Safety at the
University of Melbourne, the kind of conversations Harms is referring to can often successfully be entered through creative practice. “Most of us go through life believing we are in control of what we do and that tomorrow holds the same thing as today,” he says. “When a disaster or trauma occurs, people’s sense of confidence and capability can be shattered. A creative activity such as writing, painting or music can be seen as a distraction initially, but often there’s deep emotional responses that arise and they can be transformative.”
Ireton points to several creative initiatives that emerged after the Black Saturday fires. In Strathewen, a town where 27 people lost their lives, a group of women spent a day a week for 18 months making mosaic letterboxes, often intricately decorated with tributes to the people, animals or property they lost. Another group gathered to knit vibrant woollen chickens for people in various bushfire-affected towns. “These activities, and quite a number of others, transformed the way the community conceptualised themselves, their capacity and their resilience in the future rather than being defined by the tragic impact of the bushfires,” Ireton says.
Ireton’s observations mirror those discovered by Harms and Abotomey, who found that the opportunity for bushfire-affected people to engage in creative, flexible, safe community or group-oriented activities helped in the healing of their continuing post-disaster difficulties.
Abotomey found herself compelled to create. “I started writing and initially it was just for myself to process all the horrendous things that have happened,” she says. “I started writing poetry, and I’m definitely no poet, but it helped put some of my feelings into words. Some of my poetry has ended up in the Melbourne Museum bushfire collection.”
Psychotherapist Liz Scarfe says post-traumatic growth is an opportunity to develop new insights, skills and personal power. “This is how it differs from resilience, which aims only to bounce back to pretrauma levels of functionality and wellbeing,” she explains. “Post-traumatic growth suggests we can do more than bounce back – we can bounce forward and actually increase our pre-trauma baseline levels. It doesn’t just happen, though – certain attitudes and effort are required.”
According to Scarfe, the time and money put in can lead to extraordinary recovery and healing. “People can get to a point where they [mostly] no longer wish the trauma hadn’t happened,” Scarfe says. “Instead they see it as an essential part of making them who they are, and they like who they’ve become.”
This is certainly the case for Anita Bingham, who was 17 when she was working in a cafe at Port Arthur in 1996 when 35 people were killed by Martin Bryant. “The whole day was a nightmare,” Bingham says. “Even now I suffer from post-traumatic stress when I hear a car backfire. For years afterwards vacuuming was a terrifying task because I couldn’t hear if someone was behind me.” The experience highlighted to Bingham that life could be over in an instant.
“After Port Arthur I grabbed life by the horns and travelled and worked all over the world,” she says. “It has definitely made me a stronger person in certain areas of my life. My experience hasn’t stopped me from living. It’s made it hard at times, but it has really motivated me to live life to the fullest.”
Like Bingham, Abotomey’s experience of the growth and decline are inextricably linked. “It’s like a tangled ball of string,” she says. “It’s a whole trauma experience. People can be declining in some parts of their life but flourishing in others that would not have happened if not for that trauma.
“You would never wish it to happen, but given that it has and you can’t change it, I say thank goodness for the growth I have discovered within that mess, because without it I would have been sunk,” she says. “Posttraumatic growth is the hope within the hell.” •