The silver lining: research on personal growth after trauma

Research on stressful life events like receiving a terminal diagnosis or the impact of losing a job has focused primarily on the negative psychological effects of such events.  However, clinicians and researchers began to realize that many of their patients were reporting positive changes after experiencing adversity. Interviews with cancer patients and other samples found, as a surprise to many mental health professionals, that many people saw a “silver lining on the dark cloud”  to their life difficulties. From war and terrorism, to the loss of a loved one, to a heart attack, many people report positive life changes after the event. Since the late 1980s there has been a growth of research in this area and investigation into the long term benefits of such thought processes.
The positive changes people report generally fall into the categories:changes in views of self, relationships with others, priorities and goals, health behaviors, and coping skills such as improved problem solving ability.

Several different terms are used to describe finding the “silver lining” after a stressful event, such as benefit finding, post-traumatic growth, meaning making, and discovery of meaning.

Impact on health

Findings from several studies have suggested that finding benefit can actually impact physical health outcomes. One foundational study by Affleck, Tennen, Croog, and Levine (1987) interviewed 287 men about their perceptions of positive life change after recently experiencing a first heart attack. They followed them for 8 years. Men who had described finding benefits from their heart attack experience within two months of their first attack were less likely to have another attack in the following years and had lower levels of morbidity 8 years later.

For another example of this type of work in a sample of HIV positive men, see  Bower, Kemeny, Taylor, and Fahey (1998).

Debates in the literature

Many current questions remain in the literature, such as: Are these positive changes real? And if so, what type of clinical interventions would encourage them? Could they just be positive illusions for self preservation? If a person reports one positive change but is also experiencing significant depression and PTSD symptomotology, does this still count as growth? When people say they’ve seen a positive change, is that just some socially desirable thing? Couldn’t it just be defensive coping? Reporting bias because you want to see yourself on an upward trajectory? Just motivated illusions?