Abstract
This book brings a timely contribution to a field with a recent clinical development, but with a nonempirical wisdom literature as long as humankind. While the posttraumatic growth attracted predominantly psychological research with concluding implications for practice, this book aims at bringing these clinical implication to its core.
The book is structured in nine chapters, which go from the history of the field and its contra arguments, to the cognitive processing of trauma, the role of positive emotions, personality, relationships, and an exploratory look into faith and religious coping. Generally, chapters open by accessible theoretical overviews. Clinical applications/implications are then presented in ways that draw from the evidence-based research on posttraumatic growth. Each chapter ends with “a Quote to Remember” and “Clinical Cornerstones of the Chapter.” Finally, a suggested reading list helps interested readers to go further into the issue discussed.
The first chapter traces the theoretical grounds of posttraumatic growth. Readers find out that the term, coined in mid-1990s is rooted in three sources: (1) existential psychology which considers that difficult life events are intrinsic to human existence; (2) Carl Rogers’ person-centered approach, holding that humans are genuinely motivated to grow; and (3) the positive psychology which shifted the frame from a traditional focus on “what is going wrong,” toward “what is going right.”
The second chapter enters into the middle of the controversy on whether the experience of posttraumatic growth is genuine or mere illusionary. The authors do not avoid examining some really intriguing questions: Do people posses the capacity to accurately judge how they change? Could it be that posttraumatic growth is a simple return to a pretrauma level of functioning or be confounded with denial, cognitive avoidance, or defensive mechanisms? How to accurately measure growth? It is argued that clinicians’ search for assessing whether growth is indeed, “objective change” needs to weight the risks for them going beyond the therapeutic role when becoming “truth-seekers.”
The third chapter looks into facilitating posttraumatic growth through meaning making, a process not yet covered by evidence-based research. It is argued that this process involves the integration of loss through reinterpretation and restructuring of life narrative, a reappraisal of personal identity, and ultimately, the capacity to find new meaning in the life posttrauma. A brief section looks into the oral narrative techniques and journal writing as ways for assisting clients in their reconstruction of meaning.
The fourth chapter looks into cognitive processing, which refers to the reconstruction of basic, prior assumptions about world that have been shaken by the trauma. It presents the clinical evidence of the different types of ruminations (deliberate/intrusive, positive/negative, voluntary/involuntary) as related to their timing in the cognitive processing.
The fifth chapter examines the relation between growth and positive emotions, in particular the pretrauma dispositions (such as optimism). It calls for a balanced clinical perspective that is also sensitive to the negative emotions, such as fear or anger. The sixth chapter explores the evidence on the relationship between posttraumatic growth and each of the five personality domains (neuroticism, extraversion, openness, agreeableness, and consciousness). The seventh chapter moves toward considering the role of social relationships in posttraumatic growth and encourages clinicians to look also into occurrences of the so-called negative social support.
The eighth chapter examines the role of forgiveness in posttraumatic growth, by drawing to recent and limited exploratory research. It is argued that the relation between forgiveness and growth is contentious, that forgiveness may not be necessarily for growth to occur, but may be essential for some very religious populations.
Chapter 9 looks into faith, suffering, and religious coping, calling clinicians to be sensitive to the different ways their clients rely on their particular faith as a source of meaning. Particularly relevant is the notion that the way people access religion may cause more harm than good and that important is not what faith clients rely to, but how they experience spirituality. The Epilogue is explicitly addressing practitioners with both a dense summary of the main findings and a synthesis of skills and approaches needed for a mindful and patient clinical work.
Mary Beth Werdel and Robert J. Wicks take a venture into an elusive and at times, contested terrain, where finding solid evidence is not easy. The topic itself implies operating with terms which are diffuse and may escape measurement or even a sensible consensus over their definition (e.g., “meaning making,” “forgiveness”). Even so, the authors remain professionals truthful to their goals in a field where there is more said than written.
Overall, the book is valuable for relying on the highest level of evidence available in an area where systematic research started to accumulate only recently and where the evaluation of long-term outcomes is scant. Consequently, the guiding provided to clinicians cannot be but cautious, aware at both the professional and human limitations involved. Thus, a cross cutting theme is that posttraumatic growth is about possibility for some.
In nearly 200 pages, the book attempts to cover a wide array of issues. It provides the sufficient level of detail for clinicians starting now to discover the field of posttraumatic growth or to consolidate their practice based on the latest research. The book is engaging: It uses an accessible language, with well-placed citations from clients working to overcome negative life events or from inspiring thinkers.
However, the book carries an unsolved tension between what the clinical practice aims at and how to get there. Those seeking “hands on” examples on how to facilitate posttraumatic growth may want to see more situations from actual practice. For instance, the book is exceptional in passing the message that clinicians need to offer clients “a culture that believes in the possibility of growth” (p. 30). However, at times, the persuaded reader may be left with insufficient tools to actually engage in such work. A second edition might benefit from more input coming from actual practice.
The book engages very rarely in discussing how culture influences the posttraumatic growth. This would have been necessary for informing culturally sensitive practices. On the other hand, the volume has to deal with an inbuilt limitation: much of the research informing it has been produced in Western countries and with nonminority groups.
The book is centered on individuals experiencing posttraumatic growth, with the close ones being seen as sources of support. In a second edition, the authors may want to broader the approach by including clinical interventions for families as systems. Also, a more considerate examination of secondary stress or vicarious posttraumatic stress disorder may be warranted.
Overall, the book is highly commended for instilling a set of principles for considerate clinical interventions and for enabling practitioners to grasp the theoretical underpinnings of posttraumatic growth. It inspires a deep sense of humanism, has a profound ethical vision, is nonpatronizing, and genuinely respectful for human dignity. The authors made a remarkable and much needed shift from authority knowledge, toward a shared search for growth, which highly recommend the book.