Post-Traumatic Growth: 3 Things We Can All Learn from First Responders

We all experience trauma over our lifetimes — the loss of a loved one, a bad injury or medical scare, a violent attack, a natural disaster. For most of us, fortunately, these incidents are few and far between. But for first responders, trauma is a way of life. For example, it's estimated law enforcement officers will experience 188 critical events over their career, vastly more than the average person.

All this takes a toll. Post-traumatic stress disorder (PTSD) is over-represented in first responder populations. Various studies have found 33% of correctional officers have at least one symptom of PTSD, 35% of police officers suffer from PTSD, and 20% of firefighters will pass the diagnostic threshold for PTSD at some point in their career (as compared to 7% in the general population).

But as the public safety industry has increased its focus on mental health over the past 20 years, another phenomenon has emerged. Some first responders react very differently to the trauma they observe or live through. Rather than post-traumatic stress, these individuals experience something we have come to call post-traumatic growth. And we can all learn a lot from their experiences.

1. Tragedy doesn't have to be emotionally devastating.

What is post-traumatic growth? Researchers Richard Tedeschi, PhD, and Lawrence Calhoun, PhD, define post-traumatic growth as the idea that experiencing tragedy, suffering or other crises can lead people to positive psychological change. These changes can occur in the perception of self, relationships with others, and the person's life philosophy. Although studies vary widely, it's believed post-traumatic growth occurs in somewhere between 30-90% of individuals who have had traumatic experiences.

As a clinical psychologist who has worked with first responders for decades, I have seen post-traumatic growth occur frequently. It's common for first responders who have experienced trauma to realize they are stronger than they knew. They may have increased empathy for others who suffer, leading to less isolation and more connectedness with others. Moving through a crisis can also provoke a change in life priorities, resulting in greater appreciation for what one has and being less likely to take things for granted.

These changes contrast with what we often associate with post-traumatic stress — people who are tortured by memories, feel survivor's guilt, and turn to negative coping mechanisms to combat their pain. Instead, those experiencing post-traumatic growth may feel more alive, motivated and fulfilled.

2. We can cultivate post-traumatic growth.

People experiencing post-traumatic growth sometimes feel confused — why are they doing well, even thriving, while other people experiencing the same event are struggling and suffering? This can be especially prominent in first responders, where we sometimes observe widely varying reactions to the same incident, making one-size-fits-all approaches potentially problematic.

In truth, there is an element of chance associated with post-traumatic growth; we can't always predict who will experience it and under what conditions. But we absolutely can take steps to cultivate it — both before and after a critical incident.

Prior to a traumatic experience, we can socialize the idea. Simply reframing the conversation can help us see trauma as a normal part of life and encourage us to turn to others for support when we experience it. If we talk not just about the stress and anxiety and depression we may face, but also about how such experiences can make us better, we may be better positioned to react with hope rather than despair.

In addition, our inherent motivations for living play an important role. In one study, individuals who listed "family" as their only reason for living had the lowest post-traumatic growth scores. Those who listed "helping others" had the highest, and this inherent motivation, so common in first responders, may underpin the ability to grow through exposure to numerous critical incidents.

A small study of 113 law enforcement officers working in the New Orleans area after Hurricane Katrina brought many of these elements together: Among police officers in the study who experienced a greater magnitude of stressful life changes, those high in gratitude, satisfaction with life, and social support experienced stronger post-traumatic growth. While we can't control the traumatic experiences we will be exposed to, we can certainly cultivate close relationships and develop a gratitude practice.

Additional strategies are helpful after a traumatic experience. A 2019 study of 226 firefighters in Korea identified how "deliberate rumination" — purposely thinking about their experiences and trying to describe how the experience had benefited them — enhanced post-traumatic growth. Meditation, yoga and exercise have also been reported to reduce traumatic stress.

Finally, it's essential to have resources at the ready. In my work with public safety agencies, we strive to provide trusted, completely confidential resources accessible 24/7 so that first responders know how to get help when they're ready. For individuals outside of public safety, that might mean identifying a trusted clinician you can call if things get overwhelming or knowing the number of your employer's Employee Assistance Plan.

It's important to note that while we can train ourselves to promote growth from trauma, it's not all under our control. We must not expect anyone to experience post-traumatic growth or put pressure on them to do so. And frequently, people experience both post-traumatic stress and growth.

3. Post-traumatic growth doesn't mean exposure to trauma is good.

If you're thinking all this sounds a lot like the old saying, "Whatever doesn't kill us makes us stronger," a word of caution is in order. Yes, post-traumatic growth can create a positive from a negative. But we all process trauma differently over time. Minimizing someone else's experiences, chalking it up to "life" or urging someone to "suck it up and move on" can have disastrous consequences. Normalizing treatment for trauma is very different than normalizing the trauma itself. Post-traumatic growth is often facilitated through support, not by leaving individuals on their own to figure things out.

Post-traumatic growth requires the ability to pause, reflect and heal. That's something we owe our first responders — and ourselves.