The landscape of military mental health has long been dominated by discussions of Post-Traumatic Stress Disorder (PTSD), its devastating effects, and various treatment approaches. However, there’s another side to the trauma story that receives far less attention in clinical settings – Post-Traumatic Growth (PTG). Whilst PTSD focuses on the negative psychological aftermath of trauma, PTG represents the positive psychological changes that can emerge from the struggle with highly challenging circumstances. Here are seven surprising facts about PTG that many military psychiatrists rarely discuss with their patients.
Contrary to what many might assume, research shows that moderate levels of PTG are remarkably common amongst military personnel. A systematic review of 21 studies found that military and ex-military personnel consistently reported moderate levels of post-traumatic growth, with Post-Traumatic Growth Inventory scores ranging from 32.60 to 59.07. Importantly, research involving UK military personnel deployed to Iraq or Afghanistan found that approximately 30.8% of male personnel and 34.8% of female personnel reported moderate to large PTG.
What’s particularly striking is that these findings suggest positive psychological change following trauma is not an exceptional occurrence, but rather a natural human capacity that emerges in a significant portion of those who face adversity. The prevalence challenges the predominant clinical focus on pathology and dysfunction.
One of the most surprising discoveries in trauma research is that PTG and PTSD are not mutually exclusive conditions. Individuals can simultaneously experience the distressing symptoms of PTSD whilst also developing positive changes associated with growth. This challenges the binary thinking that often characterises mental health discussions in military settings.
Research has revealed a complex curvilinear relationship between PTSD and PTG. Veterans with moderate levels of PTSD symptoms often report the highest levels of post-traumatic growth, suggesting that some degree of psychological struggle may actually be necessary for growth to occur. This paradoxical finding indicates that the presence of PTSD symptoms doesn’t preclude the possibility of positive transformation.
Neuroscience research has uncovered fascinating evidence that PTG involves measurable changes in brain structure and function. Studies using neuroimaging techniques have shown that individuals experiencing PTG demonstrate increased grey matter volume in the dorsolateral prefrontal cortex (DLPFC). This brain region plays a crucial role in emotional regulation, cognitive control, and resilience.
The neuroplasticity underlying PTG represents the brain’s remarkable capacity to rewire itself following trauma. These structural changes aren’t just correlational – they appear to be mechanistically linked to the cognitive and emotional processes that facilitate growth. The dorsolateral prefrontal cortex changes are particularly associated with the “relating to others” component of PTG, which involves developing deeper connections and empathy.
Whilst combat exposure is typically discussed in terms of its potential to cause psychological harm, research reveals a more nuanced picture. Multiple studies have found positive associations between combat exposure and post-traumatic growth. Active duty military personnel, who face repeated exposure to potentially traumatic events, may actually be better equipped to develop coping skills that facilitate positive change.
This finding suggests that individuals may gradually build tolerance to stress and trauma through repeated exposure, developing sophisticated coping mechanisms in the process. The military context, with its emphasis on unit cohesion and shared experiences, may provide a unique environment where collective narratives of adversity can be transformed into stories of growth and resilience.
The role of military leadership in either facilitating or hindering post-traumatic growth is profound, yet rarely discussed in clinical contexts. Research demonstrates that supportive leadership is associated with lower self-stigma and greater likelihood of seeking help for mental health concerns. Conversely, destructive leadership experiences increase internalised mental health stigma, which can significantly impede both help-seeking behaviour and growth processes.
The influence of leadership extends beyond immediate support – it shapes the entire cultural environment in which trauma recovery occurs. Leaders who create psychologically safe environments where vulnerability is not perceived as weakness may inadvertently foster conditions more conducive to post-traumatic growth.
Emerging research suggests that interventions specifically designed to facilitate post-traumatic growth may offer advantages over traditional PTSD treatments. Studies have found that PTG is associated with better mental health outcomes, positive health behaviours, and reduced alcohol and cigarette use. The growth-oriented approach focuses on identifying and nurturing positive changes rather than solely addressing symptoms and dysfunction.
Therapeutic approaches that facilitate PTG often emphasise cognitive processing, narrative reconstruction, and meaning-making. These interventions help individuals develop new perspectives on their experiences, recognise personal strengths they didn’t know they possessed, and discover new possibilities for their lives. This contrasts sharply with traditional treatments that primarily focus on symptom reduction.
Perhaps the most concerning revelation is that the current military mental health system, with its emphasis on pathology and dysfunction, may actually inhibit post-traumatic growth. The persistent stigma surrounding mental health in military settings prevents many personnel from seeking help. Research indicates that up to 52-74% of individuals with mental disorders do not seek help, with military personnel ranking mental health stigma as a much greater barrier than civilian populations.
The focus on diagnostic categories and symptom-based treatments may overlook the potential for positive transformation. Recent UK data shows that whilst PTSD rates appear relatively low at 0.2% of serving personnel, this figure doesn’t account for the significant delay in diagnosis or the reluctance to report symptoms due to career concerns. Meanwhile, rates of PTSD and common mental disorders have been rising, with probable PTSD increasing from 4% in 2004/2006 to 9% in recent studies.
The evidence overwhelmingly suggests that post-traumatic growth represents a genuine and significant phenomenon that deserves equal attention alongside traditional approaches to trauma treatment. The neurobiological changes, the prevalence among military populations, and the potential for improved outcomes all point to PTG as a valuable framework for understanding human resilience.
However, this doesn’t mean replacing traditional PTSD treatments. Rather, it suggests integrating growth-oriented approaches with conventional care. Clinicians can help military personnel recognise that trauma doesn’t have to define them solely through its negative effects – it can also become a catalyst for profound positive change.
The five domains of post-traumatic growth – relating to others, new possibilities, personal strength, spiritual change, and appreciation of life – offer concrete areas where positive change can be identified and nurtured. Military mental health professionals who acknowledge and explore these possibilities with their patients may find they’re not just treating illness, but facilitating genuine transformation.
Understanding PTG doesn’t minimise the very real suffering associated with PTSD. Instead, it offers hope that even in the darkest circumstances, the human capacity for growth and positive change remains intact. For military personnel who have sacrificed so much in service to their country, this perspective acknowledges not just their wounds, but their remarkable potential for healing and growth.
The time has come for military mental health care to embrace a more complete understanding of trauma’s aftermath – one that honours both the pain and the possibility of human experience. Only by doing so can we provide the comprehensive support that our service members truly deserve.
I needed focus I needed something to fill my time, well maybe not fill my time but something to focus on like a target, a needed to get back my drive.
I started to help VIA ‘Veterans In Action’ and found something that I could do, use the old skills that I learnt in the army and more since I left which I did not register I had.
I had been missing that motivation to do something that I wanted to do and gain that level of self-gratification and achievement.
Everybody has a skill set, but it’s the motivation to use it we can lose, VIA have various projects on the go all the time, hopefully I have found my niche to help them and myself to gain personal gratification by being a member of a team again and a job well done.
After discussions I realised that it’s this which advances my mental well-being and my ongoing fight against depression and the feeling of worthlessness.
I have woken up, helping hand in hand with fellow soldiers suffering from labelled disorders finding strength from weakness, realising what helps them generally does helps me, the recognition has been an awakening.”
Ian ‘Chalky’ White former 17th/21st Lancers and B Sqn 22 SAS
Veterans In Action have been filming our expeditions for many years for our YouTube Channel, Veterans Expeditions Overland, and through this experience of not only running the expeditions but also capturing footage that enables veterans who have taken part in a place of reference to recapture how they felt by taking part.
The Veterans In Focus project enables veterans to learn new skills and record not only the expeditions we run but also the day-to-day work on all projects connecting them all together so everyone feels involved in all aspects of the work we do.
VIA take a long-term approach to helping veterans who suffer to enable them to grow within a project working alongside their peers. All this can be achieved within this project which can be ongoing and would allow veterans to learn new skills or to pass on skills learned during their time in the services
Some of the outcomes of the project are a sense of purpose, regaining confidence and working in an environment alongside other veterans where they can instantly feel relaxed, chilled-out, secure, and safe.
Veterans can work at their own pace, stop thinking negatively, concentrate, learn new skills, be part of building something, and most importantly where problems are understood this will positively impact mood and stress levels.
For those involved in the project, they can also get involved on an expedition HERE
I became involved with VIA in 2010 after my life took a turn for the worse and was invited along to do some fundraising with them. This helped me no end and in time my life got back on track. I completed a Union Flag Walk with them from Cape Wrath to Land’s End which again helped as walking and talking with other veterans with similar stories was a great help in understanding how I was feeling. I gained control of my life again.
In 2019, I took part in an overland expedition travelling through the Spanish Pyrenees and whilst away my life took a turn for the worse again due to family problems back in the UK. On my return I had to start again and rebuild and focus on the future and with the help of Veterans In Action I got back on track and took control.
I now own and run my own courier business.
Mark Colman former Royal Engineers
To date, we have travelled 25,000 miles travelling through 30 different countries and some of them several times both on overland expeditions for humanitarian aid through the pandemic and more recently supplying medical humanitarian aid to Ukraine.
It is important to note that to take part in one of our overland expeditions we insist that veterans get involved in the BUILD IT part of the project. The reason for this is part of the Post Traumatic Growth process which is our method for helping veterans so that veterans can grow within a team of their peers, learning new skills and relearning old skill sets that may have been forgotten after service.
Leading up to an expedition involves expedition training which will include off-road driving, navigation, camp setups, camp cooking and daily maintenance, something most veterans will understand from their time in the services.
It would be unfair for any individual to turn up on the day of an expedition who hadn’t previously been involved as everyone else would have been working together over a long period of time so due to the very nature of the mental health problems of those we take out on expedition turning up on day 1 for any individual could become very difficult to find where they fit in no matter how welcoming everyone was.
It is the involvement long-term on building the vehicles that enable veterans to grow that gets them to a place where they fully enjoy all aspects of the expedition experience starting from the minute that an overland expedition sets off.