Feature
Cite thisApple Monitor 2016
Collier, L. (2016, November). Growth after trauma. Monitor on Psychology, 47(10). http://www.apa.org/monitor/2016/11/growth-trauma
As Kay Wilson struggled to make her way through a Jerusalem forest after being repeatedly stabbed by a Palestinian terrorist, she distracted herself from her agony by playing the song 'Somewhere Over the Rainbow' in her mind, composing a new piano arrangement while she fought for breath and forced herself to put one bare foot in front of the other. Peerless guitars serial numbers.
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Wilson, then 46, had been working as a tour guide when, on Dec. 18, 2010, she and a friend were ambushed by terrorists. Wilson witnessed her friend's murder and was herself viciously stabbed with a machete, ultimately playing dead as her attacker plunged his knife into her chest a final time.
Matt Wilson - The Monitor-Life. McAllen native emerging as young Hollywood storyteller A. Colleen DeGuzman - The Monitor-February 27, 2021 0. One evening in 2016 when Gabriela.
She eventually recovered from her severe physical wounds and is healing from her psychological trauma. She now speaks to global audiences about her survival, hoping to 'dispel hatred, whether toward Arabs or Jews.'
The work 'helps me make meaning out of something so senseless,' says Wilson, who is also writing a book about her experiences.
After the attack, Wilson had flashbacks and deep survivor's guilt. But like many people who have survived trauma, she has found positive change as well—a new appreciation for life, a newfound sense of personal strength and a new focus on helping others.
Post-traumatic growth (PTG) is a theory that explains this kind of transformation following trauma. It was developed by psychologists Richard Tedeschi, PhD, and Lawrence Calhoun, PhD, in the mid-1990s, and holds that people who endure psychological struggle following adversity can often see positive growth afterward.
'People develop new understandings of themselves, the world they live in, how to relate to other people, the kind of future they might have and a better understanding of how to live life,' says Tedeschi.
How can clinicians use PTG theory to help patients? How has new research helped refine understanding of it? Here's a look at developments in the field.
Signs of post-traumatic growth
PTG can be confused with resilience, but the two are different constructs (see 'The post-traumatic growth inventory' below).
'PTG is sometimes considered synonymous with resilience because becoming more resilient as a result of struggle with trauma can be an example of PTG—but PTG is different from resilience, says Kanako Taku, PhD, associate professor of psychology at Oakland University, who has both researched PTG and experienced it as a survivor of the 1995 Kobe earthquake in Japan.
'Resiliency is the personal attribute or ability to bounce back,' says Taku. PTG, on the other hand, refers to what can happen when someone who has difficulty bouncing back experiences a traumatic event that challenges his or her core beliefs, endures psychological struggle (even a mental illness such as post-traumatic stress disorder), and then ultimately finds a sense of personal growth. It's a process that 'takes a lot of time, energy and struggle,' Taku says.
Someone who is already resilient when trauma occurs won't experience PTG because a resilient person isn't rocked to the core by an event and doesn't have to seek a new belief system, explains Tedeschi. Less resilient people, on the other hand, may go through distress and confusion as they try to understand why this terrible thing happened to them and what it means for their world view.
To evaluate whether and to what extent someone has achieved growth after a trauma, psychologists use a variety of self-report scales. One that was developed by Tedeschi and Calhoun is the Post-Traumatic Growth Inventory (PTGI) (Journal of Traumatic Stress, 1996). It looks for positive responses in five areas:
- Appreciation of life.
- Relationships with others.
- New possibilities in life.
- Personal strength.
- Spiritual change.
Fie titan manual 380 cal. The scale is being revised to add new items that will expand the 'spiritual change' domain, says Tedeschi. This is being done 'to incorporate more existential themes that should resonate with those who are more secular' as well as reflect cross-cultural differences in perceptions of spirituality.
A predisposition for growth?
How many people experience PTG? Tedeschi prefers not to put a hard number on it.
'It all depends on the trauma, the circumstances, the timing of the measurement … [and] on how you define growth using the PTGI, looking at total score, means, factors or individual items,' he says. However, he estimates that about one-half to two-thirds of people show PTG.
Some PTG researchers have tried to corroborate self-reported growth by questioning friends and family members about whether growth 'sticks.'
'We are getting more studies that show that PTG is generally stable over time, with a few people showing increases and a few showing decreases,' Tedeschi says. 'It is now up to us to learn what is going on with those who change over time, but the evidence is for stability in general, and also corroboration by others.'
There appear to be two traits that make some more likely to experience PTG, says Tedeschi: openness to experience and extraversion. That's because people who are more open are more likely to reconsider their belief systems, says Tedeschi, and extroverts are more likely to be more active in response to trauma and seek out connections with others.
Women also tend to report more growth than men, says Tedeschi, but the difference is relatively small.
Age also can be a factor, with children under 8 less likely to have the cognitive capacity to experience PTG, while those in late adolescence and early adulthood—who may already be trying to determine their world view—are more open to the type of change that such growth reflects, says Tedeschi.
There also may be genetic underpinnings for PTG, but researchers are just beginning to tease this out. In a 2014 study in the Journal of Affective Disorders, for example, Harvard social and psychiatric epidemiologist Erin Dunn, ScD, and a team of researchers examined data previously collected from over 200 Hurricane Katrina survivors and found that variants in the gene RGS2 significantly interacted with levels of exposure to the hurricane to predict PTG. RGS2 is linked to fear-related disorders, such as post-traumatic stress disorder, panic disorder and anxiety.
Dunn calls the results 'very interesting' but notes that 'we have to be somewhat cautious in interpreting it because we were unable to find a similar sample to replicate that finding.'
Sarah Lowe, PhD, of Montclair State University, who worked with Dunn on the research, says one difficulty with gene studies for PTG is the concept's complexity. 'If you look at what predicts PTG, it is often psychological stress and dysfunction—but also more positive personality traits like optimism and future orientation, which you'd expect would have a very different genetic basis,' she says.
Theory into practice
Is it possible to prepare people for PTG, to pave the way should tragedy or trauma strike? Yes, says Tedeschi, noting that psychologists can 'allow people to understand that this may be a possibility for themselves' and is a 'fairly normal process' if and when trauma occurs.
More often, though, therapists will become involved not before adversity has occurred, but afterward. In this context, they can introduce PTG concepts but need to take care doing so.
H'Sien Hayward, PhD, cautions that therapists should not 'jump right into the possibility of growth,' which she says can 'often be construed as minimizing someone's pain and suffering and minimizing the impact of the loss.'
Hayward, who works with veterans at VA Long Beach Medical Center in Long Beach, California, knows about such growth firsthand: She was paralyzed in a car accident when she was 16, ending a competitive athletic career. She overcame that trauma through the help of supportive family and friends, went on to study social psychology at Harvard and has traveled to more than 42 countries, often on humanitarian missions providing counseling and other support to trauma victims. Today, she credits the accident for increasing her strength of character 'exponentially' by forcing her to overcome challenges. She also appreciates life and relationships with others—including the near-daily support in the small tasks of daily living that she gets from friends and strangers alike: 'those interactions warm my heart.'
Yet Hayward is careful not to preach the potential for upside to her patients before they are ready. Instead, she waits for them to express 'some positive reaction to the event.'
She also helps patients discover what's meaningful in their lives and then helps them schedule activities involving these interests, such as spending more time with family members or doing volunteer work.
Tedeschi says sometimes traditional therapy for trauma patients gives people short-fix solutions to help them resume daily functions, such as sleep or work, but may not provide them with a way of living 'beyond just getting by .. We've got to attend to their experience of life and how meaningful, satisfied and fulfilling it is.'
One veterans' care facility that takes a nontraditional, PTG approach to trauma treatment is Boulder Crest Retreat in Bluemont, Virginia. The private, donor-supported institute provides free, weeklong nonclinical exercises and activities for vets seeking recovery from combat stress. The treatment is led primarily by veterans who have themselves gone through trauma and achieved growth. Vets are encouraged to deal with past traumas while also discovering their underlying strengths, as well as forging connections with others and ultimately finding ways to give back.
After the intensive program, vets are followed for 18 months with regular Skype check-ins.
Kevin Sakaki, a former Marine and intelligence/special operations veteran, entered Boulder Crest's Warrior program last September and found it transformative. He's noticed such changes in himself as better communication with his family, less anger ('Things don't get to me as much'), a deeper appreciation of 'the little things,' more generosity and a stronger connection to other people.
Tedeschi is among the psychologists studying the Boulder Crest program's efficacy as part of a research grant funded by the Marcus Foundation.
He hopes that as vets go through the process at Boulder Crest, they 'develop new principles for living that involve altruistic behavior, having a mission in life and purpose that goes beyond oneself, so that trauma is transformed into something that's useful not only for oneself but for others.'
The post-traumatic growth inventory
To evaluate whether and to what extent someone has achieved growth after a trauma, psychologists look for positive responses in five areas.
1: Appreciation of life
2: Relationships with others
3: New possibilities in life
4: Personal strength
5: Spiritual change
Source: Richard Tedeschi, PhD, and Lawrence Calhoun, PhD, Journal of Traumatic Stress, 1996
Cover Story
Cite this Weir, K. (2016, December). Policing in black & white. Monitor on Psychology, 47(11). http://www.apa.org/monitor/2016/12/cover-policing
Ic3d 5 5 6 qt. 'Do you believe police are implicitly biased against black people?' When NBC newsman Lester Holt asked Hillary Clinton this question in the first presidential debate, it was a sure sign the science of implicit bias had jumped from the psychology journals into the public consciousness—and that racial bias in law enforcement has entered the national dialogue.
There's evidence of racial disparities at many levels of law enforcement, from traffic stops to drug-related arrests to use of force. But the roots of those disparities aren't always clear. Experts point to systemic problems as well as the implicit (largely unconscious) biases mentioned in the debate. To be sure, those biases aren't unique to police. But in matters of criminal justice, implicit bias can have life-altering implications.
Social media has turned a spotlight on cases of racial discrimination. As the list of black citizens killed by nonblack officers grows, tensions between black communities and police are running high. 'It's a nuanced problem but people continue to take a polarized view,' says Jack Glaser, PhD, a social psychologist at the University of California, Berkeley. 'It's not productive to demonize police.'
Glaser says police departments are eager for solutions that will reduce racial disparities. 'Police chiefs know what the stakes are,' he says. Policymakers, too, are keen to take action. In October, for instance, the New Jersey attorney general issued a directive requiring mandatory classes in racial bias for police officers in the state. Psychologists, meanwhile, have the skills to understand discrimination and point to evidence-based solutions. 'This is an area that's worth a lot of investment in research, and important for psychologists to think about,' Glaser says.
Evidence of inequality
With more than 15,000 law enforcement agencies across the country operating at the federal, state and local levels, there is no 'typical' police department. Still, evidence for racial disparities is growing. Most of those data focus on the treatment of black civilians by white officers. In an analysis of national police-shootings data from 2011–14, for example, Cody T. Ross, a doctoral student in anthropology at the University of California, Davis, concluded there is 'evidence of a significant bias in the killing of unarmed black Americans relative to unarmed white Americans.' The probability of being black, unarmed and shot by police is about 3.5 times the probability of being white, unarmed and shot by police, he found (PLOS One, 2015).
Other studies conflict with that finding. Harvard University economist Roland G. Fryer Jr., PhD, examined more than 1,000 shootings in 10 major police departments and found no racial differences in officer-involved shootings. Fryer did, however, find that black civilians are more likely to experience other types of force, including being handcuffed without arrest, pepper-sprayed or pushed to the ground by an officer (National Bureau of Economic Research, 2016).
Those disparities don't seem to arise from the fact that black Americans are more likely to commit crimes. Supporting this point is research by Phillip Atiba Goff, PhD, a social psychologist at the University of California, Los Angeles, co-founder of the Center for Policing Equity. Goff, Glaser and colleagues reviewed data from 12 police departments and found that black residents were more often subjected to police force than white residents, even after adjusting for whether the person had been arrested for violent crimes (Center for Policing Equity, 2016).
Other data show that black people are also more likely to be stopped by police. Stanford University social psychologist Jennifer Eberhardt, PhD, and colleagues analyzed data from the police department in Oakland, California, and found that while black residents make up 28 percent of the Oakland population, they accounted for 60 percent of police stops. What's more, black men were four times more likely than white men to be searched during a traffic stop, even though officers were no more likely to recover contraband when searching black suspects (Stanford SPARQ, 2016).
And in Falcon Heights, Minnesota, where cafeteria worker Philando Castile was fatally shot by a nonblack officer in July after being pulled over for a broken taillight, statistics released by the local St. Anthony Police Department showed that about 7 percent of residents in the area are black, but they account for 47 percent of arrests.
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The police officer's dilemma
Many factors can account for the differences in treatment at the hands of police. In some jurisdictions, explicit prejudice still occurs, says John Dovidio, PhD, a social psychologist at Yale University who studies both implicit and explicit prejudice. Many police departments and officers take a paramilitary approach to law and order, and sometimes adopt an 'us-versus- them' attitude toward black communities, he says. 'There can be a lot of dehumanization that occurs in the conversations people have, and that's explicit.'
In many cases, however, the biases come from unconscious or unintentional beliefs. 'A large proportion of white Americans have these [implicit] biases, and it's hard to expect police officers to be any different,' Dovidio says.
Implicit biases are attitudes or stereotypes that can influence our beliefs, actions and decisions, even though we're not consciously aware of them and don't express those beliefs verbally to ourselves or others. One of the most well-demonstrated types of implicit bias is the unconscious association between black individuals and crime. That association can influence an officer's behavior, even if he or she doesn't hold or express explicitly racist beliefs.
Goff describes implicit bias as a kind of identity trap. 'They're situations that trap us into behaving in ways that are not consistent with our values,' he says.
Joshua Correll, PhD, a psychologist at the University of Colorado, has explored one facet of implicit racial bias in a series of laboratory studies since 2000. He developed and tested a paradigm known as 'the police officer's dilemma,' using a first-person-shooter video game. Participants are presented with images of young men, white and black, holding either guns or innocuous objects such as cellphones or soda cans. The goal is to shoot armed targets but not unarmed targets.
The researchers found that participants shoot armed targets more often and more quickly if they're black rather than white, and refrain from shooting more often when the target is white. The most common mistakes are shooting an unarmed black target and failing to shoot an armed white target (Journal of Personality and Social Psychology, 2002).
But experiments with police officers show a more complex pattern. Similar to community participants, officers showed evidence of bias in their reaction times, more quickly reacting to armed black targets and unarmed white targets—in other words, targets that aligned with racial stereotypes. But those biases evident in their reaction times did not translate to their ultimate decision to shoot or not shoot (Journal of Personality and Social Psychology, 2007). Still, that's only part of the story. In later work, Correll found special unit officers who regularly interact with minority gang members were more likely to exhibit racial bias in their decision to shoot. When officers' training and experiences confirm racial stereotypes, those biases appear to hold more sway over their behavior (Personality and Social Psychology Bulletin, 2013).
Bad habits
While research points to some patterns in implicit bias, we still have a lot to learn about the ways that biases influence people's decisions and behavior in the real world, says David M. Corey, PhD, a police psychologist and founding president of the American Board of Police and Public Safety Psychology. 'Yes, implicit bias can affect us. The more important questions are, which persons are affected, and under what conditions?'
Yet while those questions remain unanswered, many police departments and policymakers have skipped ahead to a different one: What can be done to reduce implicit bias? 'The police officers I've worked with are looking for effective ways to reduce implicit or unintended bias, and they welcome advice based on psychological evidence, not politics,' says Corey.
Under pressure from the public, many police departments have implemented implicit bias workshops and trainings. That could be premature, says Corey. 'We feel like we have to do something, but sometimes the action we take proves to be merely window dressing,' he says. 'My worry is that could cause a police agency to think they're doing enough, or that the monies being spent will prohibit spending for other areas, including research.'
That hasn't stopped some departments from moving forward, however—a step that concerns Glaser and others who think evidence should come before implementation. 'There are contractors that provide [implicit bias training], but there's zero evidence that what they do has an impact,' Glaser says. 'We don't know how to lastingly change implicit biases, particularly those as robust and prevalent as race and crime—and not for lack of trying.'
Recently, psychologist Calvin K. Lai, PhD, at Harvard University, and colleagues tested nine different interventions designed to reduce implicit racial biases. Some interventions aimed to introduce participants to exemplary individuals that ran counter to traditional stereotypes, for example. Other strategies included priming participants to consider multicultural attitudes, or teaching participants strategies to create implementation intentions (such as repeating to themselves, 'If I see a black face, I will respond by thinking ‘good.'). In two studies with more than 6,300 participants, all of the interventions reduced implicit prejudice in the short term. But none of those changes lasted more than a couple of days following the intervention—and in some cases, the effects vanished within a few hours (Journal of Experimental Psychology, 2016). 'Implicit associations are habits of mind,' Dovidio says. 'And habits are really hard to change.'
That's not to say there's no value in training officers. But rather than trying to eliminate their unintentional biases, it might be more fruitful to stack the deck so that officers are less likely to act on those biases. 'Character is a weak predictor of behavior, but situations are strong predictors of behaviors,' Goff says. And changing situations can be more feasible than changing ingrained stereotypes.
Imagine, for example, officers chasing a perpetrator after a crime has occurred. 'As they chase the person, it's building up their adrenaline. All of the biases they have come together like a perfect storm,' Dovidio says—a storm that can lead to excessive force. To circumvent that possibility, he says, some police departments have implemented a policy that the officer who chases a suspect should not be the one to initiate subsequent steps, such as booking the suspect or leading the interrogation. 'You try to build in structures and procedures that help overcome the tendencies,' he explains.
Creating protocols and checklists for various law-enforcement situations can also help remove bias from the equation, adds Tom Tyler, PhD, a professor of law and psychology at Yale Law School. Federal authorities, for example, use such checklists when deciding whether to search airline travelers for drugs: Did the person use an alias? Did they pay for their tickets with cash? Are they using evasive movements? So far, checklists haven't been rolled out for everyday street stops, Tyler says, though such protocols could help reduce bias when officers decide whether to search a suspect or pull over a driver. 'In ambiguous situations, people are more likely to act on bias,' Tyler says. 'If you have a script to follow, that's more objective.'
Implementing protocols to circumvent bias could be helpful in the short term. Looking ahead, changing hiring practices could be an effective way to reduce racial disparities, says Corey, whose research focuses on selecting new officers. His research explores the cognitive characteristics that make a person more likely to resist the automatic effects of implicit bias.
For example, he points to research by B. Keith Payne, PhD, at Ohio State University, who found that people with poor executive control were more likely to express automatic race biases as behavior discrimination (Journal of Personality and Social Psychology, 2005). By hiring police candidates who already possess qualities such as greater executive control, Corey says, 'we can select police officers less likely to require cognitive reshaping.'
Rebuilding community
Reducing and circumventing bias is one way to chip away at the disparities in how police treat black civilians. Another is to focus on the positive. Many departments are taking a fresh look at community policing, in which police and community members collaborate to rebuild trust and build safer neighborhoods.
Experts say efforts to reach across racial lines to build ties with community members could help to reduce disparities. Community policing efforts might include town meetings, polls and surveys, sitting down with interest groups and foot patrols to increase an officer's interactions with the neighborhood.
It's hardly a radical concept. 'In the past, an officer used to walk a beat. They'd get out of their car, get to know people,' says Dovidio. 'When you don't have those personal experiences, you tend to treat people in a homogeneous way.'
But over the last several decades that policing style has fallen out of favor as police have taken a hard line on minor offenses in an effort to reduce crime rates. 'Policing in last 30 years in America has focused on a mission of crime control,' says Tyler. Departments began adopting procedures such as New York City's controversial 'stop-and-frisk' program, which encouraged officers to stop pedestrians and search them for weapons and contraband. Columbia University statistician Andrew Gelman, PhD, and colleagues reported that the program had the effect of disproportionately targeting black and Hispanic citizens, even after controlling for race-specific crime rates in the various precincts (Journal of the American Statistical Association, 2007).
Critics say such programs drive a wedge between police and community members, eroding trust. That lack of trust could be particularly problematic when layered on top of implicit racial stereotypes. 'Effective policing requires the cooperation of the community. If the community doesn't trust you, they won't give you info to help you do your job,' says Dovidio. 'If you can create a sense of being on the same team, having the same goals, it makes policing more effective.'
Writing on the wall
As citizens continue to demand change, police departments increasingly understand the importance of taking action, says Tyler. 'I think many see the writing on the wall. It's in their interest to get ahead of the curve to prepare and reduce the likelihood of these politically damaging events.'
Major police departments such as Chicago and New York City are making efforts to take action based on evidence, he says. And the Department of Justice recently issued a final report from the President's Task Force on 21st Century Policing that drew from research including the psychological literature, he says. 'On the highest level, national leaders in policing are making an effort to do things based in research,' Tyler says.
As such efforts continue, psychologists can help by studying disparities, developing new interventions and testing what works in the real world.
Glaser, for instance, is a co-investigator on the National Justice Database, a project at the Center for Policing Equity with funding from the National Science Foundation. The project team is studying use-of-force data to identify the variations in policies, practices and culture that could predict excessive force. 'Data analysis doesn't solve problems on its own, but it helps to point to solutions,' he says.
Dovidio adds that to be most effective, psychologists might take a hard look at their preconceived ideas about law enforcement. 'If more psychologists understood how policing operates and the challenges that police face, we could do a lot in terms of creating partnerships for effective training and applications of psychological theory,' he says.
For more on police and African-American shootings, go the APA Public Interest blog 'Psychology Benefits Society,' https://psychologybenefits.org, and search for 'police.'
Further reading
- Racial Bias in Policing: Why We Know Less Than We Should
Goff, P.A., & Kahn, K.B. Social Issues and Policy Review, 2012 - Final Report of the President's Task Force on 21st Century Policing
2015 - Implicit Bias and Policing
Spencer, K.B., Charbonneau, A.K., & Glaser, J. Social and Personality Psychology Compass, 2016