The ‘building blocks’ of
Positive Psychological Change
David Blore
Accredited CBT, Consultant Accredited EMDR
Doctoral researcher University of Birmingham
Visiting Lecturer Teesside University
Chester & NE Wales BABCP: 8th April 2011
1
EXERCISE 2

List all the personal or other attributes/ qualities that, in your
personal opinion, would contribute – or detract from – PPC
e.g. (the following are not necessarily correct!!)
• Being female
• Being happy
• Having more than £1000 in the bank
2
The fractal nature of
PPC
3
A few of the components of PPC
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Traumatic event
Sociodemographic factors
Personality factors
Self efficacy
Hardiness and toughness
Self esteem
Resilience
Sense of coherence
Coping
Locus of control
Religiosity
Emotions generally
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Blame
Forgiveness
Hope
Optimism
Attributional style
Cognitive appraisal
Wisdom
Paradox
Social comparison
Supportive others
Existential issues
Flow
4
Traumatic event

Research results were generally confusing and PPC:
• “…may not be a function of event type per se. It is more likely that it is the
characteristics of the subjective experience of the event… that influences
adversarial growth.” (Linley & Joseph 2004a, p.15)

Mothers of bereaved children showed greatest PPC, whilst husband’s
of women with breast cancer showed the least (Linley & Joseph 2004b p.14; Weiss 2002;
Polantinsky & Esprey 2000)
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threat and harm was indicative of PPC (Linley & Joseph 2004b, pp15-6), BUT:
–
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“…there does not appear to be a consistently positive linear relation between degree of
trauma and growth.” (Ibid, p.15)
“Curvilinear” relationship with traumatic event type, i.e. mid range
trauma resulting in the most PPC and mild and severe trauma
producing less PPC (Fontana & Rosenheck 1998; Schnurr et al 1993) but not clear what
constitutes mild, mid and severe trauma
5
Sociodemographic factors

Being female was more associated with PPC than being male, although
evidence was ‘mixed’
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There were confusing results in relation to age and that generally
mature, younger people are more likely to report PPC, whilst older
people in “temporal proximity to one’s own death”
Davis et al 1998)

(Linley & Joseph 2004b;
reported less PPC
Higher levels of education and income were associated with PPC
6
Personality factors
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The ‘Big Five’ personality factors, (extraversion, openness to
experience, agreeableness, conscientiousness and neuroticism)
(Gross 2005, pp.742-3)

All were positively associated with PPC with the exception of
neuroticism (Linley & Joseph 2004b p.16)
7
Self efficacy
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A strong sense of self-efficacy will lead individuals to exert effort to master
coping challenges, the success of which, likelihood of further success (Tedeschi
& Calhoun 1995) thus a self-fulfilling prophecy
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Knowing that one has control through coping, and can freely choose whether or
not to use it, is very empowering. Bandura (1988) argues that this available
choice produces a sense of being in command, and hence internalises the locus
of control

“…survivors begin to have an impact on their environment, they perceive some
small measure of self-efficacy and control in a world that is not wholly random.”
(Janoff-Bulman 1992, p.143)
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…therefore coping; locus of control; action; and self-efficacy, are all interlinked
when it comes to the successful management of NPC and, potentially,
subsequent PPC
8
Hardiness and toughness
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Hardiness > plant biology > ability to resist adverse growing conditions
such as frost. Toughness > materials science > ability to resist
fracturing when stressed.
– Considered psychologically interchangeable (Golby & Sheard 2004)
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The H personality (Kobasa 1979; Kobasa et al 1985), consists of:
– Commitment: characterised by curiosity and active involvement in taskrelated behaviours
– Control: individuals who believe that they can influence matters
– Challenge: an expectation that life will set challenges which will stimulate
personal development
9
Hardiness and toughness
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H associated with PPC (Waysman et al 2001)
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Hardy people are thought to develop optimistic appraisals and meaning
as well as a willingness to learn from the traumatic event and to
incorporate them into a life plan (Kobasa 1979)
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Hardy men appraised tasks as threatening, responded with
negative and positive affect and physiological arousal than those
hardy (Wiebe 1991). The effect was marked amongst women
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H > psychiatric symptomatology and self-esteem Younkin (1992)
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H > acts as a buffer against stress Tedeschi & Calhoun (1995)
10
Self esteem
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Higher levels of self-esteem in combination with optimism is
widely associated with higher levels of PPC
(e.g. Joseph et al 1993; McMillen et al 1995; Tedeschi & Calhoun 1995; Abraído-Lanza et al 1998; Linley &
Joseph (2004b)
11
Resilience
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3 forms of resilience > metaphor of a ‘tree in the wind’
(Lepore &
Revenson 2006, p.25-7)
– Resistance resilience
– Recovery resilience
– Reconfiguration resilience
12
Resilience
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Resistance resilience:
– ‘Tree’ stands still in the face of a howling gale (Lepore & Revenson 2006, p.25)
– Frequently seen as unhealthy (Bonanno 2004, and Wortman & Silver 1989)
– Has resulted in treatments that led to breaching resistant clients’ defences
(Lepore & Revenson 2006)
13
Resilience
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Recovery resilience:
– ‘Tree’ bends to accommodate the wind and once the wind stops blowing
– ‘Tree’ retains its original shape > same concept as psychological
homeostasis (Selye 1956) but (Bonanno 2004) says not, whilst (Garmezy 1991); Lazarus
1993 and Masten & Reed 2002) that it is
– How quickly the ‘Tree’ returns to its normal position is also unclear with
Bonanno (2004) arguing recovery needs to be immediate, or even that the Tree
should not bend at all – suggestive more of resistance resilience
– Even a slow return to the normal position is better than no recovery Lepore &
Revenson (2006) > recovery resilience perceived as normal and resistance
resilience as abnormal. Both may be normal (Wortman & Silver 1989)
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Resilience
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Reconfiguration resilience
– ‘Tree’ changes its shape to accommodate the prevailing gales
– Seen as fundamentally different to the other forms of resilience
Lepore &
Revenson (2006)
– Logically however, a reconfigured tree growing with the prevailing gales
would result in highly adaptive growing provided the prevailing gales did not
change direction! If it did, the reconfigured ‘tree’ would become a highly
vulnerable, resistant, ‘tree’
15
Sense of coherence (Antonovsky 1989)
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Comprehensibility:
– An ability to make sense of the incomprehensible
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Manageability:
– The ability to manage, cope with, or bear, life’s challenges
– The opposite has parallels to an external locus of control, e.g.
traumatic events seek individual’s out and victimise them
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Meaningfulness:
– Considered by Antonovsky to be the most important component of
the triad because without it, comprehensibility is unstable.
16
Sense of coherence
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Use of SOC (Tedeschi & Calhoun 1995, p.59) extended to describe the
categories of coping responses that followed a traumatic
experience:
“…to achieve a sense of coherence, there are four crucial spheres
that must be seen as meaningful: inner feelings; interpersonal
relationships; one’s major activity; and existential issues such as
death, failure, conflict, and isolation…” (Ibid, p.53)

Plausible too that a SOC interchangeable with PPC
– Might explain why Linley & Joseph (2004b) concluded,
unequivocally > SOC not associated with PPC (?conjecture
because they did not explain their reasoning)
17
Coping
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Emotion-focussed coping (Maercker & Langner 2001) including emotional social
support associated with PPC
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Positive and negative religious coping
(e.g. Pargament, Smith et al 1998; and
Pargament, Koenig et al 2000)
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Problem-focussed coping (e.g. Armeli et al 2001; Evers et al 2001; Maercker & Langner 2001)
as well as acceptance, positive reinterpretation and positive religious
coping
18
Locus of control
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Internal LoC > taking decisive actions for social change (Gore & Rotter 1963)
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After struggle to cope with trauma iLoC > catalysts for social change
e.g. Simon Weston (Weston 2003)
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Interactive nature of an internal LoC (Baylis 2004):
“An internal locus of control has long been regarded as a key factor
creating resilience in the face of extreme adversity” (Werner & Smith 1982 p.211)

Extreme degree of LoC (Tedeschi & Calhoun 1995, p.45) could > traumatic events
being harder to cope with than when beliefs are more moderate (Perloff
1983; Swindle et al 1988)
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iLoC tend to resist influence from others (Crowne & Liverant 1963) whilst
aversive events actually produce attempts to reassert control (Blore &
Holmshaw 2009; Thompson 1981)
19
Religiosity
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‘Spiritual development’ (e.g. Pargament et al 1990)
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Cynicism and becoming less religious (Schwartzberg & Janoff-Bulman 1991)
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Strengthening religious beliefs (e.g. Calhoun, Tedeschi & Lincourt 1992)
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A mixture of weakening and then strengthening (Tedeschi & Calhoun 1995, p.38)
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Strengthening of religious beliefs may serve a variety of purposes
including gaining a sense of control, comfort and meaning as well as
feeding back into the perceived changes in relationships with others –
in this case with God (Pargament et al 1990)
20
Religiosity
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Associated with PPC (Linley & Joseph 2004b, p.16) :
– Religious activities
– Intrinsic (i.e. to the person) religiousness
– Positive religious coping
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Religious beliefs can fend off everything
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“Sacred canopy”
(Berger 1967)
(Calhoun et al 1992)
protects against chaos which is:
“…only adaptive when it leads to positive affect and the confidence to
engage in new behaviours to test one’s limits and to maximise the
possibilities of one’s success.” (Tedeschi & Calhoun 1995, p.73 see also Janoff-Bulman
1989b, p.169)

Search for meaning (Viktor Frankl 1959/2004)
21
Emotions generally
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Positive affect “consistently positively associated…” with PPC
(Linley &
Joseph 2004b, p.16)
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Negative affect > negatively associated:
– Depression (Frazier et al 2001; Updegraff et al 2002)
– Anxiety (Best et al 2001)
– Associated with pre-incident mental health problems (Linley & Joseph 2004b)
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PTSD was negatively associated early after trauma, but not at one year
post event (Ibid)
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Time, in relation to affect, important because expression of emotion can
be beneficial in the early aftermath, but can be counterproductive later
Tedeschi & Calhoun (1995, p.66)
– Complicated by other factors including perceived controllability
1992), and cultural and gender differences
(Wasch & Kirsch
22
Blame and forgiveness

Blame negatively associated with PPC:
– illustrates the Effect of “clumsy leading questions asked by police
officers” (Purves 2001, p105) at the scene of an RTA

Logically the antonym, of blame, forgiveness, should be
associated with PPC, however:
– F is notable omission from both Linley & Joseph (2004b) and Tedeschi
& Calhoun (1995), although it is covered at length by Fincham &
Kashdan (2004) in relation to positive psychology generally - rather
than specifically psychological trauma
– ‘Complete’ or ‘incomplete’ forgiveness (Zechmeister & Romero 2002; Levenson et
al 2006 see also Campaign for Forgiveness Research: www.forgiving.org )
23
Hope and optimism
“…the traditional view of health turns out to be flawed…
optimism and pessimism affect health itself, almost as clearly as
do physical factors”
(Seligman (1990/2006, p.14 – from the chapter ‘Two Ways of Looking at Life’).
24
Hope and optimism

H > emotionally based, O >more cognitive Seligman (1990/2006)
 H depends on lack of permanence and specificity :
– “Finding temporary and specific causes for misfortune is the art of hope:
temporary causes limit helplessness in time, and specific causes limit
helplessness to the original (traumatic event).” (Ibid p.48)

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H encompasses not only expectancy that desired goals can be achieved but to
imagine how they can be achieved (e.g. Tennen & Affleck 1998).
O linked “superficially” with control factors such as LoC and self-efficacy Tedeschi
& Calhoun (1995) and stress optimism:
– “…focuses directly on how events will turn out rather than who controls
them or how well one can perform acts that may affect them.” (Ibid, p.47, see
also Scheier & Carver 1992)
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Optimists:
– Use coping strategies > active and problem focussed + willing to prioritise
effective problem solving (Linley & Joseph 2004b)
– Are less anxious, hostile, depressed, self-conscious, and vulnerable than
pessimists (Tedeschi et al 1993)
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Hope and optimism
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O is not necessary for PPC (Bellizzi & Blank 2006) – at least for women with breast
cancer, which supports the other two studies on the same traumatic event (Boyers
2001 and Sears, et al 2003) as well as:
– “…the relationship between optimism and perceptions of growth are
relatively low…” (Tedeschi & Calhoun 1995, p47)
– Conclusion being PPC “cannot therefore be simply optimism” (Ibid, p.48)
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O is related to subjective well-being post trauma (Holmes 2005)
O positively associated with PPC (Millam 2004; Feigel 2004 and Linley & Joseph
2004b)
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Conclusion seems to be that H and O is related to PPC:
– “…we also rejoice in our sufferings, because we know that suffering
produces perseverance, perseverance, character; and character, hope. And
hope does not disappoint us…” (Romans 5v3-5, New International Version)
26
Attributional style
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AS (Heider 1958) are viewed as a retrospective factor rather than a
predictor of future direction.
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AS was not identified in Linley & Joseph’s (2004b) meta-analysis as a factor in
PPC, but speculation is that AS is likely to be a factor, as:
– “…it may be more useful to help survivors gain control over future events
rather than focus on… attributions about why the (traumatic) event
occurred… attributional style has been conceptualised as either being
pessimistic… or optimistic… (the latter) might be important in determining
how people respond to stress.” (Joseph (1999, p. 61)
27
Cognitive appraisal

Positive associations between the various components of cognitive
processing (e.g. ruminations, intrusions and avoidance), and PPC (Linley
& Joseph 2004b, p.16)
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Components lead to meaningfulness, or more specifically new
meaningfulness (Janoff-Bulman 1992) and to Joseph & Linley’s concept of
association or accommodation (Joseph & Linley 2005; Payne et al 2007).

When (not ‘if’) meaning is found it is nearly always positive
(Tedeschi &
Calhoun 1995, p.72)

The OVT concept of accommodation and assimilation suggests only
accommodation leads to PPC (Joseph & Linley’s 2005) - if meaning is not found
and the traumatic material is assimilated into existing models of the
world, then PPC does not occur
28
Wisdom and paradox

Linley & Joseph (2004b) do not list wisdom as a form of PPC
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Tedeschi & Calhoun (1995, p.86) see wisdom as a process leading to PPC:
– “Western culture tends to consider wisdom an individual difference variable,
and that wisdom is not considered an automatic concomitant of aging or
experience. Rather, some individuals, through their experiences, become
wise.” (Tedeschi, Park & Calhoun 1998, p.15)
– Thus wisdom as a PPC variable may be culturally bound

Wisdom can also permit a new philosophy of life to develop
(e.g. Janoff-
Bulman 1989a)
– “A common theme… is that after a period of spiritual or existential
quest, individuals often report that their philosophies of life are
more fully developed, satisfying, and meaningful to them…
because existential or spiritual issues have become more salient
and less abstract.” (Tedeschi & Calhoun 2004a, p.407)
29
Wisdom and paradox

Wisdom and paradox are clearly linked, the latter being a
phenomena that individuals are very likely to encounter at some
stage with PPC (Tedeschi & Calhoun 2004a, pp406-7).

Due to inherent belief that ‘only bad results from bad’. Thus
paradox is only paradox because of the perspective that one
starts with.
Presumably if one started with the belief ‘good comes from bad’
then there would be no paradox.

– Would no paradox be paradoxical?
30
Paradox

Something unpleasant gives rise to something positive
(Tedeschi & Calhoun
2004a)
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“Losses have produced something of value”
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‘Being stronger’ as a result of a traumatic experience that exposed
one’s vulnerability, appears to be common (Thomas, et al 1991).

PTG paradoxically “does not necessarily yield less emotional distress”
(Tedeschi & Calhoun 2004a, p.407). In other words once ‘good’ is recognised, then
‘good’ occurs, but the fact that ‘bad’ continues is thus paradoxical.
However, it may also suggests that NPC and PPC are in some way
inter-related – a concept central to OVT (Joseph & Linley 2005).
(Ibid, p.406)
31
Social comparison

2 types of comparison with others: upward and downward social
comparison (Tedeschi & Calhoun 1995, p.65-6)

‘Upward social comparison’ describes the conclusion “that one is worse
off than others” in similar circumstances (Ibid).
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‘Downward social comparison’, describes “others who are coping less
well” in similar circumstances (Ibid).

The suggestion is that downward social comparison is compared with
better outcomes, but whether this relates to PPC or more effective
reducing of NPC is not clear
32
Supportive others

Satisfaction with social support was associated with PPC (Linley & Joseph
2004b) but confusingly, support generally wasn’t (Ibid p.16) …
 … probably because friends and family have an existing relationship
with the traumatised individual pre-traumatic event (Tedeschi & Calhoun 1995,
p.95) unlike ‘similar others’ and professionals
– Poorly functioning families generate additional stress because of a lack of
both communication and understanding (Coyne et al 1988)
– Anxieties of families is a factor (Tedeschi & Calhoun 1995, p.96)
– If good relationships can be maintained or improved, PPC possible (Ibid, p.94)
– +ve effects on relationships, and thus PPC can result from shared
understanding post-trauma (Patterson 1989)
– ‘Depth of caring’ is associated with PPC (Zenmore & Shepel 1989)
– Both parties in a relationship will feel better if supportive listening, empathy
and encouragement are forthcoming (Notarius & Herrick 1988)
33
Existential issues

An ‘increased appreciation in existence’ (Malinek, Hoyt & Patterson 1979)

Quality of life is negatively associated with PPC (Linley & Joseph 2004b)

An ‘improved perspective on life’ (Affleck, Tennen & Gershman 1985)
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‘No longer taking life for granted’ and ‘living life to the fullest’
(Joseph,
Williams & Yule 1993)

‘Renewed appreciation’ for simple moments in life and taken-forgranted relationships (Miles & Crandall 1983)

Cruciality of the moment or ‘reckoning time’, ‘life at a crossroads’ (Tedeschi
& Calhoun 1988)
34
Flow

Flow: The psychology of optimal experience, Csíkszentmihályi (1990) also
considers the role of flow in the “transformation of tragedies” (pp193-8)

Flow was evident because a traumatised individual develops “…very
clear goals while reducing contradictory and inessential choices” (p.193)

The book describes numerous people who, having experienced a
traumatic event have set out on a quest to ‘find themselves’…
35
Flow
…particularly poignant is the story of Reyad, who, described his
experiences of the 1967 war against the Israelis after which:
“…I decided to leave Egypt and start hitchhiking toward Europe. Ever
since I have been living with my mind concentrated within myself. It has
not been just a trip, it has been a search for identity. Every man has
something to discover within himself… I believe destiny rules life, and it
makes no sense to struggle too hard… if I do not earn anything today it
does not matter. It means that this happens to be my fate. Next day I
may earn 100 million – or get a terminal illness. Like Jesus Christ said,
what does it benefit to man if he gains the entire world, but loses
himself?” (Csíkszentmihályi 1975, pp196-7)
36
Overview

So we can’t even agree what to call PPC

We know, yet we don’t know, what PPC is:
“The more we know about (PPC), the more we know that we do not
know very much.” (Calhoun & Tedeschi, 1998 p.215)

We don’t have a complete consensus of what PPC consists of
– Meta analysis (Linley & Joseph 2004b) of 39 studies on PPC contained
disagreement on core ingredients of PPC:
“…It is unlikely that (PPC) will be substantially explained by one or
even several factors” (Ibid, p.19)
37