Do we really know if adversity makes us stronger?
Clockwise from top left: Netflix’s comedy The Unbreakable Kimmy Schmidt; musical artist Kanye West; philosopher Friedrich Nietzsche; singer Kelly Clarkson; and civil rights leaders Martin Luther King Jr., Mahatma Gandhi, and Nelson Mandela.
Wake Forest University. September 27, 2022.
I remember greatly enjoying the Netflix comedy Unbreakable Kimmy Schmidt when it came out a few years ago. Part of the reason why I enjoyed the show so much is that it tells the story of an irrepressible young woman, played by Ellie Kemper, who survived a 15 year-imprisonment by a cult and begins a new life in New York with resilience and optimism. One scene in the first series has stayed with me since I first binge-watched the series. In the third episode, Kimmy asks a senile World War II veteran: “Do you think going through something like that, a war or whatever, makes you a better person, or deep down does it just make you bitter and angry?”
My research program on the possible benefits of adversity is in part a considered response to that question. In many ways, it also reflects a core concern of existential thought: How do we respond to the fact that suffering (and ultimately death) are part and parcel of life? Is ill-being the only outcome we can expect following tragedy and trauma? Can enduring significant failure and adversity in fact enhance our life in meaningful ways?
Many people’s intuition on the question suggests that perhaps there are benefits to adversity. This intuition was shared by St. Paul, who wrote that “suffering produces endurance, and endurance produces character, and character produces hope” (Romans 5: 3-5). Moreover, “That which doesn’t kill me makes me stronger” is ubiquitous enough a meme that you could attribute it to Kanye West, Kelly Clarkson or (originally) the German philosopher Friedrich Nietzsche. In addition, we admire people who are seen to have triumphed over adversity in achieving laudable moral goals. For example, icons such as Nelson Mandela, Mahatma Gandhi, and Martin Luther King are known as much for their life struggles as they are for their heroism.
What is posttraumatic growth?
While others have explored the idea of gaining strength through adversity, the psychologists Richard Tedeschi and Lawrence Calhoun (1996) coined the term posttraumatic growth to capture the positive psychological changes they had witnessed as clinical psychologists among their patients who were coming to terms with traumatic life events. They found that people often reported experiencing positive changes since these events occurred. For example, people reported feeling better connected to the people around them and taking more pleasure in the small things in life (Tedeschi & Calhoun, 2004).
Many researchers agree that the positive transformations in beliefs and behavior can manifest in at least five forms:
Improved relations with others,
Identification of new possibilities for one’s life,
Increased perception of personal strength,
Spiritual growth, and
Enhanced appreciation of life
Since Tedeschi and Calhoun’s (1996) initial work led to the development of a scale measuring posttraumatic growth, there has been a marked interest in the study of the construct and its presumed associated mental and physical health benefits. Current research indicates that posttraumatic growth is widely reported. In fact, longitudinal research indicates that the phenomenon is fairly common, with 58-83% of survivors reporting positive change in at least some domains of their lives (Jayawickreme & Blackie, 2014).
Theories of posttraumatic growth view the experienced trauma as the catalyst for fostering lasting personal growth. For example, Tedeschi and Calhoun (2004) note: “The individual has not only survived, but has experienced changes that are viewed as important and that go beyond what was the previous status quo. Posttraumatic growth is not simply a return to baseline—it is an experience of improvement that for some persons is deeply profound” (p. 4). Similarly, Joseph and Linley’s (2008) organismic valuing theory posits that trauma can cause positive changes in “issues of meaning, personality schemas, and relationships” (p. 33).
What does the research tell us about posttraumatic growth?
Over the past several decades, the field has accumulated a large and growing body of research focusing on posttraumatic growth. Hundreds and hundreds of academic papers have examined the construct of posttraumatic growth (Boals, Jayawickreme, & Park, 2022). There have also been popular books that have focused on “the new science of posttraumatic growth” (Rendon, 2015) arguing that people’s intuitions about growth are actually supported by science.
However, I’ve spent the last 10 years making the case that the question of whether adversity can lead to enduring positive change across the lifespan has not been addressed conclusively, even if you perceive vivid examples of posttraumatic growth in your own and other people’s lives.
Although posttraumatic growth is widely reported, it is unclear whether these changes represent lasting and genuine transformation. Perhaps the most noteworthy problems with the measurement of posttraumatic growth are inconsistencies in the instrumentation used, an over-reliance on self-reported change, and a lack of longitudinal studies with baseline data collected prior to the event (Ford, Tennen, & Albert, 2008). More specifically, the cross-sectional and retrospective nature of posttraumatic growth measurement has led some researchers to remain unconvinced that these self-reported changes represent lasting and genuine transformation, as argued by Tedeschi and Calhoun (2004). Instead, they may reflect an ability to find silver linings in otherwise devastating circumstances (Tennen & Affleck, 2002; McFarland & Alvaro, 2000), particularly when primed to go looking for them by a questionnaire.
Most of the alternative explanations for posttraumatic growth can be grouped together under the following themes: 1) self-enhancement, 2) an “active coping” effort, 3) the violation of post-event recovery expectations, and finally 4) personality characteristics and cultural scripts. Let’s consider each of these, in turn.
1. Is it really just self-esteem maintenance?
According to the self-enhancement perspective, posttraumatic growth reflects a reappraisal of the situation to reduce the individual’s sense of victimization and maintain self-esteem.
Shelley E. Taylor (1983) argued that threatening and stressful life events challenge an individual’s sense of self-esteem, sense of personal control, and optimism about the future. Based on her research with female cancer patients, she proposed that people rely on cognitive reappraisal strategies that allow them to restore and enhance their self-esteem, perception of control, and optimism. For example, an individual may compare themselves to others who are less fortunate or inflate their chances of recovery.
Taylor argued such “positive illusions” protect the individual from the initial threat and may eventually allow them to accept their situation (Taylor, Kemeny, Reed, Bower, & Gruenewald, 2000; Taylor & Armor, 1996). Many other studies have obtained data consistent with that idea. For example, McFarland and Alvaro (2000) employed an experimental approach and observed that self-enhancement strategies function through the derogation of pre-event attributes that are relevant to the dimensions of personal growth.
Relatedly, some researchers have argued that the posttraumatic growth literature has proclaimed that people have grown, without sufficiently considering the potential negative changes that might also occur following adverse life events. It is possible that the positive changes these individuals identify actually represent defensive illusions – an attempt to convince themselves and others that they are coping well and have even found something good from their struggles (Wortman, 2004).
2. Is it really just an “active coping” process?
The erosion that caused the Kalaloch Tree Root Cave at Olympic National Park, USA represents a traumatic adversity to the old sitka spruce there. Yet, the tree survived it—earning it the nickname “The Tree of Life.” But has the spruce changed for the better (posttraumatic growth), or is it just dealing with a past stressor and coping with its new environment?
Similarly, perceived posttraumatic growth may represent an active coping strategy in the process of coming to terms with a stressful and challenging event.
Tennen and Affleck (2002) assert that the process of searching for benefits and actively reminding oneself of these benefits is akin to an “active coping” strategy. There are definitely similarities between some of the classic emotional coping strategies proposed by Folkman and Lazarus (1988) and the outcomes that presumably reflect posttraumatic growth. For example, finding faith, discovering what is important in life, and feeling stronger are all classic emotional coping strategies that are present in measures of posttraumatic growth. It has also been posited that reports of posttraumatic growth represent more avoidant and defensive coping strategies for people low in hope and optimism, and more adaptive strategies for those higher in these resources (Stanton & Low, 2004).
3. Is it really just motivated dissonance reduction?
Conversely, others have claimed that reports of posttraumatic growth represent a survivor’s attempt to understand why they survived and are functioning better than would be typically expected. People may expect that stressful or traumatic events would have a severely negative impact. And yet the reality of their everyday experiences may be noticeably different—they may have subsequently adapted and adjusted rather well by comparison. The dissonance between the expectation and the reality can be disconcerting (Festinger, 1957), which can motivate people to look for additional information that can help explain the difference between the two. Thus, these “expectation violation” accounts argue people may be motivated to invent stories of personal growth to explain the dissonance between the common expectations and their current level of adjustment (Tennen & Affleck, 2002).
4. Is it really just personality and cultural scripts?
Finally, posttraumatic growth has been explained as the expression of relevant personality characteristics and cultural scripts.
The narrative approach to posttraumatic growth, proposed by Pals and McAdams (2004), can be more broadly construed as an individual difference perspective of personal change. According to Dan McAdams (1994), personality is defined by three parallel levels: dispositional traits, personal concerns, and life narratives. He argues that while specific traits remain stable across adulthood, personal concerns are sensitive to change due to situational circumstances. There are particular narratives that may follow changes in an individual’s personal concerns that make posttraumatic growth more or less likely. A redemptive narrative is characterized by a move from a negative life scene to a positive life scene, whereas a contamination narrative is characterized by a move from a positive life scene to a negative life scene (McAdams, Reynolds, Lewis, Patten, & Bowman, 2001). According to this perspective, posttraumatic growth may be an expression of this redemptive narrative and therefore more likely to occur in individuals with the psychological resources necessary to generate this narrative.
Relatedly, the notion that one can grow from suffering is central to many works of philosophy, literature, and theology, and therefore is likely to be part of an implicit theory of change that many people hold. As such, people may simply report posttraumatic growth due to the activation of this culturally “scripted” expectation (Splevins, Cohen, Bowley, & Joseph, 2010; Tennen & Affleck, 2002).
We don’t really know! A field hampered by poor methodology
As described above, the methods currently in use to assess posttraumatic growth allow many alternative explanations to the notion that people experience actual changes in growth-relevant domains. Additionally, questionnaires intending to measure posttraumatic growth often require participants to engage in a mentally complex procedure. Participants must attempt the following 5 steps for each item on these sorts of questionnaires:
Deduce their current standing on the dimension,
Recall their prior standing on the dimension before the event had occurred,
Compare these standings,
Calculate the degree of change, and
Evaluate how much of the change was due to the traumatic event.
Use of these scales therefore assumes that people can accurately detect and report change in their status over time.
But, as personality research has found, perceived change usually has a low or no association with actual change (Robins, Noftle, Trzesniewski, & Roberts, 2005; Herbst, McCrae, Costa, Feaganes, and Siegler, 2000; Henry, Moffit, Caspi, Langley, & Silva, 1994). For example, Robins et al. (2005) assessed the personality of 290 college students six times over the course of four years, and at the end of the 4 years asked participants to rate how much they believed their personality had changed. The correlation between measured personality change and participants’ perceived change was modest (around .2). This suggests that perceptions of change have rather low validity as assessments of “actual” change.
A further limitation of existing posttraumatic growth measures—such as the posttraumatic growth inventory (PTGI)— is that they often do not provide a balanced picture of the positive and negative changes that people have experienced. Indeed, the PTGI remains the most widely used measure in posttraumatic growth research. But, as is the case with the PTGI, it’s common that no questions on such measures allow for the reporting of negative experiences. This increases the likelihood of positive response bias (Tomich & Helgeson, 2004) and thus of overtly positive reports of growth (Park & Lechner, 2006). One solution to this problem is to include items that allow for reporting both positive and negative responses to trauma (for one example, see Boals & Schuler, 2019).
What do we know for certain? Three data-based patterns
At this point, it would be beneficial to pause and evaluate the evidence for posttraumatic growth, and take stock of what the field has learned, for certain, from its research.
Data patterns show, for certain, that after traumatic events: (1) people readily report perceiving change, (2) actual change is associated with health; and (3) retrospective perception of growth appears to be a stable individual difference.
First, we know for certain that people readily report perceiving change following traumatic life events (Linley & Joseph, 2004), at least when asked to think about it directly. As discussed earlier, research has demonstrated that self-reports of posttraumatic growth are fairly common. This is not trivial. If people believe they have changed (and if these beliefs are not an artifact of limitations in assessment strategy), this phenomenon is then worthy of greater study.
Second, there is some evidence that “actual” posttraumatic growth, if measured with a valid measurement tool, may predict improved psychological and physical health. Frazier et al. (2009) directly measured students’ actual standing on posttraumatic growth-relevant domains before and after a trauma occurred, as well as their retrospective reports of how they had changed since the event. While actual growth assessed prospectively using students’ standings on posttraumatic growth before and after the traumatic event was associated with lower distress levels, retrospective reports were associated with positive coping strategies. Thus, “perceived growth” is potentially associated with some functional value in that it predicted more effective coping, and that actual positive personality change is of clinical significance.
Third, nascent research investigating the long-term stability of posttraumatic growth suggests that retrospectively assessed posttraumatic growth may in fact reflect a stable individual difference. Contrary to what Tedeschi and Calhoun’s (2004) theory proposed, posttraumatic growth reports remain stable over time, rather than gradually increasing. Even prior research by Thompson (1985) and Affleck et al. (1987) failed to find significant increases in self-reports of posttraumatic growth, either one or eight years following the event. Self-reported perceived posttraumatic growth may thus be best understood as an individual difference trait that could be related to how people personally interpret life transitions and challenges (Cantor & Kihlstrom, 1987; Bauer & Bonanno, 2001). While such individual differences may be interesting, at the moment it does very little to help us verify or better understand posttraumatic growth itself.
Renewing the science of posttraumatic growth
In light of the many methodological limitations, and the relatively little we know for certain as a result, I have joined some of my colleagues in arguing that it would perhaps be better to “start over” by employing better methods that are able to more directly test the theoretical questions regarding posttraumatic growth (Jayawickreme & Infurna, 2021). I believe that psychologists have much to gain by studying posttraumatic growth in a more rigorous manner.
Improved research on the possibilities for growth following adversity may lead to greater clarity about the mechanisms underlying personality malleability and stability. Traditionally, personality was understood to exhibit high levels of stability over the lifespan. Yet, while trait stability over the lifespan is indeed high (Terracciano, Costa, & McCrae, 2006), recent research has shown that personality can and does change in response to certain life transitions—including those related to work, health and relationships (Roberts & Mroczek, 2008). It could be that specific types of adversity and specific characteristics of adverse events may lead to personality change, and future research can focus on specific adverse life events that could potentially lead to changes in personality.
Moreover, it is unlikely that everyone who experiences a given traumatic event will respond to it in the same manner. Indeed, not everyone responds to normal/benign events in the same way, and substantial heterogeneity exists in mean-level changes in personality (Johnson, Hicks, McGue, & Iacono, 2007; Roberts & DelVecchio, 2000). More closely examining those individuals who experience real changes following adversity, compared to those who do not experience real changes following the same or similar adversity, represents an exciting area for future research.
Examining these questions with methodological and theoretical clarity would also afford a deeper understanding of one of the most pressing question in existential philosophy: How do people find purpose and value in suffering and struggle?
Further reading:
This essay is adapted from a number of my academic papers on post-traumatic growth, in particular Jayawickreme & Blackie (2014) and Jayawickreme & Blackie (2016).
Jayawickreme, E, & Infurna, F. J. (2021). Toward a More Credible Understanding of Post-Traumatic Growth. Journal of Personality, 89, 5– 8.
Jayawickreme, E., & Blackie, L. E. R. (2016). Can We Trust Current Findings on Posttraumatic Growth? In: Exploring the Psychological Benefits of Hardship. SpringerBriefs in Psychology. Springer.
Eranda Jayawickreme is the Harold W. Tribble Professor of Psychology and Senior Research Fellow at the Program for Leadership and Character at Wake Forest University. He is a personality psychologist whose work focuses on post-traumatic growth, moral personality, personality dynamics, and well-being—research topics that are at the core of existential psychology. His research has focused on addressing three of the overarching existential questions: 1. How do people experience post-traumatic growth? 2. What does it mean to possess “good character?” and 3. What does it mean to live a life of meaning and purpose? He’s approached those questions in three lines of research. His research has been supported by multiple grants from the John Templeton Foundation, Templeton Religion Trust, Templeton World Charity Foundation, European Association for Personality Psychology, and the Asia Foundation/USAID. He has published 3 books and over 100 scholarly publications. His awards include the 2023 Early Career Contributions Award from the International Society for the Science of Existential Psychology, the 2018 Faculty Excellence in Research Award from Wake Forest, and the 2015 Rising Star award from the Association for Psychological Science. He is currently co-editor of Social Psychological and Personality Science and an associate editor for the Journal of Personality and Social Psychology: PPID.