Turning Pain into Fuel for Positive Change

The morning after a birthday party she threw for me fifteen years ago, I woke up in a hospital emergency room to learn that my girlfriend, Laura, was killed in a drunk-driving crash. Although I had no recollection of driving the car, and we’d planned for her to be our designated driver, I was responsible for her death. A year later, I pleaded guilty to negligent homicide and went to jail to serve a short sentence. There, I unexpectedly found the solitude and stillness to consider a future that would honor Laura’s memory.

Laura graduated from college with a degree in psychology a month before the crash. She was planning to apply to social work school to help people with substance-use disorders and the many consequences that often accompany addiction. Through my two-month incarceration and court-ordered drug and alcohol treatment, I got to know many men and women grappling with these issues. I became determined to make meaning from the harm I caused by improving the criminal justice and addiction treatment systems.

When I left jail and started probation, the economy had just crashed. Finding work felt impossible. But six months later, I found a job helping men returning from prison with their own job searches. Over the next decade, I had the privilege of working for a nonprofit law firm doing federal-level advocacy to change laws and regulations that make it harder for people with substance-use disorders and criminal records to rebuild their lives. I led Baltimore’s public health response to the opioid overdose crisis, and I shared some of our city’s strategies with other jurisdictions while working for another nonprofit focused on addiction.

Many of the most passionate and profoundly effective changemakers I worked with along the way arrived at their callings through personal experiences with loss, trauma, or other life-changing adversity. I met countless parents who’d lost children to drug overdoses and found meaning in supporting other families. One of my colleagues witnessed his mother’s killing and worked to end gun and domestic violence. Another friend was exonerated by DNA after spending decades in prison and found purpose in ensuring people returning from prison had access to the support they needed to succeed.

Interested in understanding why some people seemed to thrive while living with such extreme distress, I read the book What Doesn’t Kill Us: The New Psychology of Posttraumatic Growth (Joseph, 2013), my first introduction to posttraumatic growth (PTG) and the world of positive psychology.

PTG and Altruism

PTG, positive changes that may result from experiences of trauma, can lead to greater appreciation of life, an awareness of new possibilities for one’s future, strengthened relationships, increased personal strength, and spiritual growth (Tedeschi & Calhoun, 1996). Trauma experiences, which the PTG research defines more broadly than the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), include “sets of circumstances that represent significant challenges to the adaptive resources of the individual, and that represent significant challenges to individuals’ ways of understanding the world and their place in it” (Tedeschi & Calhoun, 2004, p. 1). Importantly, when it occurs, PTG is often accompanied by substantial distress and pain. It is the real and often quite painful challenges that traumatic experiences pose to the survivor’s assumptive world that unleash the cognitive processes necessary for PTG to occur (Tedeschi & Calhoun, 2004).

One potential outcome of PTG is that survivors adopt altruistic behaviors that make meaning from their experiences. They may develop greater compassion and empathy for other people who are suffering and find that the struggle with trauma leads them to find new purpose in helping (Tedeschi & Calhoun, 2004). Their new purpose might be the pursuit of a survivor mission in which they help others affected by experiences similar to their own, engage in efforts to raise awareness, or take action to prevent future occurrences of the harm they experienced (Herman, 1998). In addition to the psychological benefits that survivors derive from the pursuit of a survivor mission, there is evidence that they may also be more effective at helping people experiencing hardships similar to their own. One study, for example, found higher levels of engagement with their work among police officers who were previously crime victims and mental health professionals who treated patients for disorders they themselves had previously been diagnosed with (Eskreis-Winkler et al., 2014).

Interventions to Cultivate PTG and Altruism

It was ultimately my interest in PTG that led to my determination to enroll in the University of Pennsylvania Master of Applied Positive Psychology (MAPP) program and to start a nonprofit, Trauma Informed, an organization with a mission to raise awareness and understanding about the nature of trauma, improve systems and policies to better recognize and respond to trauma, and empower trauma survivors to experience healing and personal growth (Trauma Informed, 2021). Throughout my year in MAPP, I focused the majority of my assignments on the relationship between constructs and interventions we studied, on the one hand, and the development of PTG, on the other, with a goal of creating a program at Trauma Informed to help survivors cultivate PTG and take action in pursuit of their missions.

The result of that research and work with fellow MAPP alums, Kimberly Dickman (C’22), Devon Still (C’22), and KC White (C’22) is the TI EMPOWERS (Expanding Meaning, Purpose, Optimism, Well-being, Emotion, Relationships, and Strength) curriculum. The eight-session curriculum teaches survivors to reimagine their trauma narrative to focus on resilience, strength, growth, and the role of social support. It encourages them to adopt healthy coping mechanisms and other well-being-enhancing practices. It teaches them to cultivate positive emotional experiences, hope, and optimism. It equips them to change harmful thinking patterns and engage in deliberate rumination about the meaning of their experiences. And it empowers them to identify role models and develop self-efficacy and skills for the pursuit of their missions. We believe the combination of supporting well-being, cultivating PTG, and increasing self-efficacy may be a magical formula for launching people into meaningful endeavors that help them to flourish and make a positive contribution in the world.

Earlier this year, when Richard Tedeschi presented to the MAPP community about his work at Boulder Crest, he talked about the importance of expert companions with lived experiences of trauma to accompany other survivors on their journey to PTG (R. Tedeschi, personal communication, February 4, 2023). He talked about the importance of changing narratives and explained that he and his Boulder Crest colleagues considered their participants to be students not patients or clients. In Tedeschi’s telling, informing their students about trauma and PTG was a form of treatment (R. Tedeschi, personal communication, February 4, 2023). During his discussion, we saw a number of parallels with the curriculum we’d been developing, confirming for us that we were on the right track.

We received a 2023 MAPP Grant to advance development of the curriculum and launch an online, asynchronous course for anyone who wants to explore how painful experiences from their past can fuel the meaningful pursuit of positive change in themselves and their communities. We also plan to offer the curriculum as a cohort-based webinar series and as a retreat program where survivors will receive the added benefit of connection and interaction. Ultimately, we hope to use the curriculum as the foundation for a year-long fellowship during which participants also receive coaching and ongoing assistance to advance their survivor missions. We are grateful to the MAPP community for supporting what we believe will be a life-changing program that ripples out through communities benefited by the altruistic endeavors of the people we serve.

Looking Outward in the Aftermath

Difficult experiences that challenge our most basic assumptions about the world and our place in it can cause high levels of distress while also catalyzing positive changes in our relationships, priorities, spiritual life, and self-appraisals of strength. When these changes prompt us to look outward and act for the benefit of others, not only might we experience greater well-being ourselves, but also, we have the potential to make a huge difference for others.

References

Eskreis-Winkler, L., Shulman, E. P., & Duckworth, A. L. (2014). Survivor mission: Do those who survive have a drive to thrive at work? The Journal of Positive Psychology, 9(3), 209–218. https://doi.org/10.1080/17439760.2014.888579

Herman, J. L. (1998). Recovery from psychological trauma. Psychiatry and Clinical Neurosciences, 52(S1), S98–S103. https://doi.org/10.1046/j.1440-1819.1998.0520s5S145.x

Joseph, S. (2013). What Doesn’t Kill Us: The New Psychology of Posttraumatic Growth. Basic Books.

Tedeschi, R. G., & Calhoun, L. G. (1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455–471. https://doi.org/10.1002/jts.2490090305

Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1–18. https://doi.org/10.1207/s15327965pli1501_01

Trauma Informed. (2021). About Us. https://www.traumapolicy.org/about

About the author | Mark O’Brien (C’22) is a leading advocate and change-maker in trauma, substance use, and criminal justice. He’s the founder and executive director of Trauma Informed, where he designs and leads programs to support trauma survivors and improve the way organizations respond to trauma; founding partner of Springlake Solutions LLC, where he provides strategic consulting to mission-driven organizations working in behavioral health and public safety; adjunct professor of political science at Towson University; and an assistant instructor at the University of Pennsylvania Positive Psychology Center. His book, Crashing: I Love You. Forgive Me, delivers an unflinching examination of grief, mercy, and the fractured path from loss to meaning.