Question

For this week's discussion board post... Consider post-traumatic growth in the individual described in the case study.

Please answer the following:

1. What are the personal characteristics of this individual and the characteristics of their trauma that you are thinking about in terms of assessing how they will respond/are responding to the trauma?
2. What is post-traumatic growth?
3. How likely do you think this individual is to experience posttraumatic growth, and why?
4. As a counselor, how would you work with this individual to foster their posttraumatic growth?

Case: Tina This is a 31-year old Japanese American woman has been hospitalized two times in the past six months for depression and suicidality, complicated by bursts of energy consistent with Type Il manic-depression illness and hearing voices telling her to kill herself. She is a successful attorney with 5 years of experience in a large firm specializing in family law, and has been married for 8 years to a journalist. The couple has two children, a 7 year-old boy and a 2 year-old girl. Tina grew up in an intact family, upper middle socioeconomic status (SES) family that she describes as healthy and loving, with two older brothers to whom she feels close. Tina was a star student and athlete, devoted to gymnastics until she had a serious accident at a meet. During her recovery, she revealed that her coach had been sexually molesting her since she was 6 years old. Her parents filed charges, and the coach was fired and sentenced to a probation after a very public trial in which Tina testified against him-unfortunately, other girls on the team accused her of "making up the story" and, in turn, they and their parents ostracized Tina and her parents. Tina views these events as catalysts for becoming an attorney and for her chosen area of specialization. Apart from several months of family therapy at the time of the trial and a brief experimentation with marijuana as a teenager, she denied having any treatment or psychiatric history or potentially problematic substance use until she experienced postpartum depression following her daughter's birth. In the intervening 2 years Tina has experienced escalating symptoms of dysphoria, culminating in the severe recent affective and potentially psychotic symptoms and suicidality, as well as medically unexplained severe exhaustion and blackouts, in which Tina's husband describes her as markedly different. She has also returned to the use of marijuana to cope and to keep her calm. (Courtois & Ford, 2009, p. 4) Source: Courtois, C. A. & Ford, J.D. (2009). Treating complex traumatic stress disorders: Scientific foundations and therapeutic models. New York NY: Guilford Press.

Answer 1

The personal characteristics of Tina:

• 31 y/o
• Female
• Profession: Laywer
• Married with 2 children
• Japanese American
• SES: Middle class
• Healthy and Loving Family
• Became a lawyer due to her experiences with her coach and peers
• Family Therapy and Marijuana
• No psychiatric illness / Substance Abuse till after giving birth

Characteristics of her trauma:

• Hospitalized twice for Depression and Suicidality
• Type 2 Manic Depression
• Sexual Molestation (age 6) by her gymnastics coach who was fired after she filed a case against him
• Accused by her peers for making up the story about their coach
• Post partum depression
• Dysphoria
• Affective,Psychotic, Suicidal
• Severe sudden exhaustion and blackouts
• Refered to as different by her husband
• Still uses marijuana to calm herself

Post-Traumatic Growth:

It is the ability to accept situations that cannot be changed. PTG  is crucial for adapting to traumatic life events. Also called "_{acceptance coping}", it determines coming to terms with a reality that is a significant predictor of post-traumatic growth. Another term used for PTG is Benefit finding , it is defined as positive psychological change experienced as a result of adversity and other challenges in order to rise to a higher level of functioning.

Tina is very likely to experience post traumatic growth as she experienced sexual abuse as a very young child and managed to find strength by finding her way into becoming a lawyer. Lawyers are required to serve justice to their clients in dire need and Tina managed to become one as she was motivated by her experiences to do so for other people who may have been through similar experiences as herself. Helping victims of abuse and other issues may be a coping mechanism placed by her to keep her going in life,to overcome her past trauma in a different way that serves her as well. Using her trauma as a catalyst to become a successful lawyer shows that Tina has already been resilient in the past and is very much capable to find strength as a much more mature woman who is a mother,wife and a successful lawyer. Her pregnancy may have produced her brain chemistry (of the trauma experience) to change and revisit the sexual abuse and other such experiences but Tina will be able to once again find her grounding moments perhaps through her family and children who love her.

To foster her traumatic growth I would:

• Focus on solving nervous system body issues first with medications as needed.(with the help of psychiatry).
• Increase her insight, awareness and also focus on her intentions as well as her focused attention that she may be struggling with on a daily basis. These could be done using meditation techniques and maybe even tools like art therapy for her to explain her meaning in her suffering.
• Her relationships- I would make sure that she finds ways to cope by using her direct support system be it her husband and children or parents and close peers and friends.
• Apart from these points above I would also make sure that her family is psychoeducated about her trauma and triggers and how they can help her immensely with small things like creating family activities for bonding time. It is proven that maintaining and looking for help in support systems socially may help trauma patients find themselves again in small if not big ways. They may feel a sense of togetherness and find themselves as a part of their tribe which may be their family. Being a part of something like a social group is a factor that prevents people from being sad,lonely and depressed. Perhaps Tina will be able to find solace in her tribe.

Solve her physical issues first if they require medications to ease her troubles from a more physical perspective. After making sure that she isn't debilitated by her physical disturbances too much I would introduce psychotherapy and address how she sees her world. Rather than minizing her trauma it would be better to focus on how she can shift her manic,suicidal and depressive thoughts to feeling/thoughts that are more about being in the present with mindful awareness. Helping her find her meaning in her suffering and also finding creative new ways that she thinks will help reduce her distress instead of focusing her energy and attention on it. Using CBT nad DBT techniques could also be useful.