Posttraumatic Growth: Shifting From Loss to Gain

This year marked the 20th anniversary of the U.S. invasion of Iraq. Although only a relatively small number of American service members remain deployed to Iraq today, the residual effects of combat continue to permeate many of our communities.

As a nation, we opened our communal arms to the men and women as they returned home from Iraq. Main Street parades were held, and memorials were constructed. However, a darker side of this time began to show and still remains. It's the presence of the psychological effects of war, the most notable being posttraumatic stress disorder—simply referred to as PTSD.

PTSD has a long and sordid history with war. After witnessing countless soldiers suffering from fatigue, heart palpitations, and shortness of breath, Civil War doctor Jacob Mendes Da Costa labeled soldiers as suffering from "Soldier's Heart." What was believed to be a cardiovascular condition was, in fact, anxiety.

The term "battle fatigue" was the dominant label during World War II. And although the medical community's understanding of the psychological consequences of combat was greater at this time, many military leaders incorrectly and callously labeled struggling soldiers as cowards.

It wasn't until the Vietnam War that researchers truly began to classify and categorize the many shared psychological symptoms of combat veterans. Consequently, the term PTSD made its way into the Diagnostic and Statistical Manual of Mental Disorders (DSM), the publication often referred to as the "psychiatric bible."

Today, 20 years into the longest period of conflict in our nation's history, we're still trying to understand PTSD. The prevalence rate in post-9/11 veterans hasn't changed from that of their predecessors from earlier conflicts, which has been reported to be as high as 30 percent in certain groups.

Our treatments haven't changed that much either. Talk therapy and medications are the dominant interventions for our combat veterans. And, unfortunately, it's estimated that only about half of veterans who need treatment actually seek it. And, of those who initiate treatment, only a modest portion actually finish and achieve remission.

One hundred fifty years after "Soldier's Heart," it's time to rethink our approach to PTSD. Let's get away from the medical model that reduces our combat veterans to a set of symptoms and start harnessing their inner strength and turn their struggles into new possibilities, purpose, and meaning.

This novel concept is called "posttraumatic growth," or "PTG." PTG supports the notion that our most difficult experiences can make us stronger. Instead of just thinking in terms of recovery from traumatic events, we should also help combat veterans use their experiences to grow and become stronger, healthier, and better versions of themselves.

Many experts in psychology and psychiatry believe that PTG can be cultivated in veterans. In fact, more than 30 years of research by psychologists Richard Tedeschi and Lawrence Calhoun, the fathers of modern-day PTG, establishes a strong foundation for this belief.

We don't believe that facilitating PTG in veterans should necessarily replace current treatments. Talk therapy and medication are effective for a subset of combat veterans struggling with PTSD. We do believe, however, that leveraging veterans' inner strength to help them explore new possibilities for psychological, relational, and spiritual growth is imperative. In other words, we must help them focus on what they have gained from their combat experiences versus what they have lost.