Your Best Life: Turning Posttraumatic Stress Into Posttraumatic Growth

Posttraumatic stress disorder (PTSD) is a term that seems to appear more and more lately. PTSD is a lasting emotional response to a traumatic event, characterized by increased levels of fear, helplessness, and horror [11]. PTSD can be severe, leaving many who experience it incapable of living peaceful and fulfilling lives. We, as orthopaedic surgeons, are likely to see many patients with this condition, as it’s common for those who have experienced polytrauma [10].

Fortunately, many patients with PTSD manage to overcome it and emerge stronger and more resilient. This “posttraumatic growth” is real and can enable those who have experienced catastrophic events to reach heightened levels of spiritual and emotional enrichment. First described by Tedeschi and Calhoun [8], posttraumatic growth manifests as an increased appreciation for life and the forging of more meaningful relationships, especially with those who experienced similar traumas. In addition, many patients who experience posttraumatic growth learn to cultivate unique inner strength, reassemble priorities, and fortify religious beliefs and spirituality.

Research suggests that those who emerge from trauma stronger tend to be optimists who view setbacks as fleeting challenges that can be modified [6]. And, importantly, the optimism and skills to potentiate posttraumatic growth can be learned and prepare us all to better cope with difficult events.

There is No Growth in Comfort

Challenges, trials, and suffering can be real drivers of growth that prompt us to re-examine our beliefs. We can choose to deny the trauma and avoid all forms of conflict, but a conflict-free life is a life bereft of growth. Sidestepping pain eliminates any impetus to change; facing hardship head-on opens us to its potentially positive effects [4]. Likewise, we improve as surgeons when we tackle challenging procedures and acknowledge the surgical errors that we made. The real “masters” dedicate themselves to learning from their mistakes. Thus, failure and the trauma of surgical errors become our friends, serving as catalysts for real and sustainable growth—if we allow them to.

Adopt a Growth Mindset

Retired Brigadier Gen. Rhonda Cornum MD, PhD, was serving as an Army flight surgeon in 1991 when her helicopter was shot down in Iraq [3]. With two broken arms and a gunshot wound to the back, she was taken prisoner by Iraqi forces and endured unspeakable hardships. Despite this, she exhibited extraordinary resilience. She later said she was committed to “grow in the face of adversity and (to) get back up if you get knocked down”[5]. General Cornum viewed the horrors of captivation as a challenge to overcome, stating: “It's not the event that causes the reaction—it's what you think or believe about that event. You always have to find something positive in any crummy situation because the crummy event has occurred anyway”[5].

When major challenges appear (and they will), we have to ask, “How can I grow from this?” A growth mindset dictates that we are not defined by our conditions and circumstances; we can always develop new skills, beliefs, and behaviors. In other words, dedication and hard work far surpass intelligence and talent in crafting the life we desire [2].

After her captivity, Dr. Cornum recognized that like physical fitness, psychological fitness can be improved with training. Her passion for soldier wellness in addition to her leadership skills catapulted her to the role of Director of the Comprehensive Soldier Fitness Program (CSF), an intense curriculum designed to mentally equip combat soldiers for battle [1]. CSF is predicated on building on personal strengths and employs Seligman’s cornerstones of positive psychology: fostering positive emotions, engagement with life, building positive relationships, finding meaning, and nurturing achievement [7]. By using the science of positive psychology in addition to cognitive-behavioral and social problem-solving skills, CSF has helped many warriors avert full-blown PTSD and experience quantum personal growth [1].

Look for the Gift

Even the direst of misfortunes holds a gift, if we know to look for it. Scores of testimonies from individuals who experienced the most severe injuries often convey gratitude for their personal loss. This attests to the inner growth that is possible.

A close friend of mine is a motivational speaker and amputee. He is thankful for his disability because it has greatly increased his faith in God and enabled him to serve as a source of hope for others who are disabled. He maintains that his amputation has allowed him to connect to audiences far more powerfully than he ever had before.

My Twin Brother’s Death

When my identical twin, Mike, passed away in 2022, I experienced a genuine and profound trauma that led to a seismic shift in my personal beliefs and behaviors. After languishing in pain and sorrow for months, I decided to honor my brother by pressing on and making positive contributions to the world. I examined my life and looked for opportunities to grow. In time, I experienced the five pillars of posttraumatic growth [9] firsthand:

1. Cultivation of personal strength: I committed to taking one day at a time and not obsessing over the past. I discovered inner reserves that I was not aware of and became more present at work much faster than I anticipated. This left me with a quiet confidence that I didn’t have before.

2. Appreciation of life: I no longer take my life for granted and appreciate each day as a true gift. Having been spared the cancer that my brother endured, I regard each day as precious.

3. Enhanced relationships: Sharing my loss with my wife and children has only made us closer. My loss prompted me to cherish and attend to the loved ones that remain in my life. I also put more effort into maintaining my personal friendships.

4. Transformation of beliefs: My pain moved me to change my dysfunctional beliefs in order to cope with my loss and maintain some semblance of energy. I jettisoned to the best of my ability the demons of perfectionism and approval addiction, since there was simply no more room in my emotional bank account for additional suffering.

5. Spiritual growth: The trauma of losing an identical twin led to an urgent search for meaning. I found answers in my faith and have since cultivated a deeper relationship with God. I devote more time to prayer each day and attend church services more frequently and with more reverence.

I am happy to say that nearly 3 years after the loss of my brother, I am experiencing a deep peace that eluded me for years. The rejection of maladaptive thinking—such as perfectionism—has enabled me to perform my best surgeries and produce my best scientific research. My marriage has never been better, and our family has never been closer. All this growth was ignited by misfortune.

Tomorrow, Try This:

• When faced with unusual hardship, recognize the call to grow and not to despair.

• In every event, look for the gift. What may appear as a dire misfortune is actually a challenge that can lead to the shedding of dysfunctional beliefs and practices.

• Read and learn more about positive psychology in order to build on existing strengths. You will become far better equipped to embrace the major challenges that life will undoubtedly throw your way [7].