Memories of traumatic experiences are at the very heart of posttraumatic stress disorder (PTSD; American Psychiatric Association, 2013). People with PTSD are haunted by memories of traumatic past events; these memories intrude in daily life, reappear in dreams or in flashbacks, and cause people to avoid reminders of those events. The memories harm sufferers’ sense of their own competence, safety, and capacity for joy. In the present study, we examined such memories in a sample of people at a particularly high risk for PTSD—namely, military veterans, who often face traumatic experiences like watching their fellow service members perish in combat. We were curious about how veterans narrate their most stressful military experiences and whether their particular styles of narration were associated with their posttraumatic stress (PTS) symptoms. We discovered that certain narrative themes are associated with veterans’ PTS symptoms and well-being.
In an attempt to pinpoint what features of trauma memories are critical in the development of PTSD, over the past 25 years researchers have examined the narratives that people develop about their traumatic memories (Crespo & Fernández-Lansac, 2016; O’Kearney & Perrott, 2006). Unfortunately, although this research has successfully pinpointed some common features of trauma narratives, the studies have yielded largely inconclusive findings. We believe that one reason these earlier studies may have not found clear patterns in PTSD patients’ trauma narratives is that the studies have failed to consider these narratives as stories with their own particular themes, structures, and narrative arcs. There is a rich narrative tradition within the field of personality psychology that argues that the way that people reflect back on and draw meaning from their most important memories is a core aspect of their personalities (McAdams & McLean, 2013).
In the present study, we drew from this narrative personality tradition to study the narratives of 154 U.S. military veterans. We asked the veterans to write narratives about two military experiences—one highly stressful experience and one experience that had been significant to them in some way. In a little over half of the highly stressful narratives, the veterans described experiences involving direct or indirect exposure to actual or threatened death, serious injury, or sexual violence.
Two aspects of the narratives turned out to be related to the veterans’ self-reported PTS symptoms: namely, whether the veterans’ articulated a sense of growth from the events, and whether they expressed a sense of agency, or mastery, during the events. Growth refers to the extent to which people tell their life stories in terms of positive changes they experienced as a result of past life events, including the development of new self-insights, positive goals, or life lessons (McLean et al., 2020). Agency reflects the extent to which narrators are able to affect their lives by developing a sense of initiative, mastery, or control over their life experiences (McLean et al., 2020). For example, one veteran expressing high growth and high agency in his highly stressful narrative wrote about successfully helping to save fellow soldiers after a helicopter crash: “I think I chose this experience because it reminds me how slender the thread of life is and how suddenly life can be ended . . . I have had numerous brushes with death and it reminds me to live life daily.” For the narratives about highly stressful experiences (but not significant ones), expressions of greater growth and greater agency predicted lower symptoms of PTS, depression and anxiety, and impairment. Several other narrative processing dimensions were not associated with the veterans’ PTS symptoms: the extent to which the narratives expressed satisfying connections with others (communion); the overall affective tone of the narratives from negative to positive; and the structural coherence in terms of clarity about time/place, temporal ordering, and overarching theme.
These findings demonstrate the importance for veterans of reflecting back on distressing military events in productive ways that highlight avenues for self-growth and for mastery, control, and initiative. Narratives characterized by high levels of growth and agency may serve as a protective force against common maladaptive behaviors associated with PTS symptoms such as ruminating about how the event could have gone differently, avoiding thoughts of the event entirely, or developing negative views of the self or of the world. It may be possible for therapists working with patients with PTSD to help them think about ways that they grew following their traumatic experiences, rather than trying to eliminate their negative thoughts about the event or paint their thoughts in a positive (but not growth-oriented) light. Even if patients experienced a loss of control during traumatic military experiences, it may be possible to help them find ways of narrating their lives in more agentic terms in the present through the process of therapy. Our findings suggest that it may be the meaning that people create in their narratives about their traumatic experiences that is crucial for their recovery.
Reference Article
Tappenden, P. C., Shiner, R. L., & Mo, F. (2021). Narrating life in the military: Links between veterans’ narrative processing of service experiences and their posttraumatic stress symptoms and well-being. Journal of Traumatic Stress, 1– 14. https://doi.org/10.1002/jts.22738
Discussion Questions
- How are trauma memories involved in the symptoms of PTSD?
- What narrative processing dimensions were associated with PTS symptoms in this sample of veterans?
- How might clinicians attempt to address narrative processing of traumatic experiences in treatment for people suffering from PTSD?
About the Author
Rebecca L. Shiner, PhD is Charles A. Dana Professor of Psychology at Colgate University, where she has taught since 1999. She received her PhD in Clinical Psychology from the University of Minnesota. Her research centers on personality development in children, adolescents, and young adults, including stability and change in personality and the influence of personality on positive life outcomes and the emergence of psychological disorders, especially personality disorders. Dr. Shiner can be contacted at rshiner@colgate.edu, and she can be found on Twitter at @ShinerRebecca.
References Cited
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Crespo, M., & Fernández-Lansac, V. (2016). Memory and narrative of traumatic events: A literature review. Psychological Trauma: Theory, Research, Practice, and Policy, 8, 149-156.
McAdams, D. P., & McLean, K. C. (2013). Narrative identity. Current Directions in Psychological Science, 22, 233-238.
McLean, K. C., Syed, M., Pasupathi, M., Adler, J. M., Dunlop, W. L., Drustrup, D., Fivush, R., Graci, M. E.,
Lilgendahl, J. P., Lodi-Smith, J., McAdams, D. P., & McCoy, T. P. (2020). The empirical structure of narrative identity: The initial Big Three. Journal of Personality and Social Psychology, 119, 920-944.
O’Kearney, R., & Perrott, K. (2006). Trauma narratives in posttraumatic stress disorder: A review. Journal of Traumatic Stress, 19, 81-93.