Understanding Posttraumatic Growth in Haiti

Print Friendly, PDF & Email

Ainelle Mercado, Marie Valsaint, Skultip (Jill) Sirikantraporn, Grant J. Rich, & Wismick Jean-Charles

Despite being the first nation in the world created as a result of a successful slave revolt and also the first independent nation in Latin America and the Caribbean in 1804, Haiti in recent years has faced numerous problems, including poverty, corruption, unemployment, and most recently, the devastation brought upon by the 2010 earthquake. The 7.0 magnitude earthquake, centered near the capital Port-au-Prince, was one of the most traumatic events that Haiti has ever faced. An estimated 200,000 people died, and hundreds of thousands more were displaced.  Psychological effects of the earthquake included posttraumatic stress symptoms and depressive symptoms (Burnett Jr. & Helm Jr., 2013; Blanc, Rahill, Laconi, & Mouchenik, 2016). Historically, while research has focused on examining the negative results of traumatic events, such as natural disasters, recent efforts have shifted the focus to examining the positive aspects, or rather the strengths, that enable individuals and communities to thrive. This article examines posttraumatic growth (PTG) in Haitian survivors of the earthquake and its implications for trauma recovery among adult Haitians.

Posttraumatic Growth

PTG is a term coined by researchers Tedeschi and Calhoun (1996) and is defined as the positive psychological changes that occur as a result of experiencing trauma (Tedeschi & Calhoun, 1996).  Research indicates that after a traumatic event, it becomes possible for individuals to go through a transformative experience that gives them the adaptive ability to improve their perception or opinion of themselves and others (Calhoun, Cann, & Tedeschi, 2010).  Furthermore, the experience of positive growth occurs in five distinct life domains: personal strength, new possibilities, relating to others, appreciation of life, and spiritual change (Tedeschi & Calhoun, 2004).

Recent research that investigated PTG in Haiti after the earthquake utilized a mixed methods study, including a grounded theory approach, and found themes related to adult Haitians’ maturing perspectives on the roles of external support persons or sources, as well as internal strengths, appreciation for life, perceived happiness, and an increased role of religion (Mercado et al., 2018; Rich, Sirikantraporn, & Jean-Charles, 2018). These studies found that changes in interpersonal relations occurred through the increased desire to help people in need, as well as a greater focus on being “kinder to people in life.” Indeed, this finding is consistent with previous research, which indicates that individuals that report PTG often express having an increased sense of compassion for others (Lindstron, Cann, Calhoun, & Tedeschi, 2013). Hence, they experience more meaningful relationships with other people (Lindstron, Cann, Calhoun, & Tedeschi, 2013; Prati & Pietrantoni, 2009).

Research also indicates that individuals that report PTG become more aware of their own personal strengths and gain a greater appreciation of life (Janoff-Bulman, 2004; Tedeschi & Calhoun, 2004). For Haitian survivors of the earthquake, personal strength is gained through self-acceptance, overcoming adversities, and the understanding that one can continue to move forward in life despite traumatic experiences (Mercado et al., 2018). With personal strength comes greater appreciation of life, as survivors become more grateful and thankful for what they currently have in their lives. Indeed, they report “not taking life for granted” and “living life in the moment to the fullest” (Mercado et al., 2018). Moreover, for Haitian survivors of the earthquake, a greater appreciation of life contributes to their happiness. In fact, some expressed that due to their experience of trauma, they gained a greater sense of peace and freedom, which contributes significantly to their ability to enjoy life and live life happily. (Mercado et al., 2018).

Furthermore, individuals that report PTG report experiencing spiritual growth, which contributes to a greater sense of purpose and meaning in life (Shaw, Joseph, & Linley, 2007; Tedeschi & Calhoun, 2004). For Haitian survivors of the earthquake, the role of religion is reported to significantly contribute to trauma recovery (Mercado et al., 2018; O’Grady et al, 2012). Indeed, survivors reported that recovery is gained through the belief in God and through prayers. Additionally, recovery is believed to be strengthened through the understanding that religion or spirituality allows one to not feel “alone” in the experience of great adversity (Mercado et al., 2018).

Implications for Trauma Recovery

Among factors that contribute to PTG, religious and spiritual beliefs have been shown to play a prominent role in reaction to traumatic events (Wilson & Boden, 2008). Indeed, religion and spirituality can provide an extensive variety of potential benefits including a sense of meaning and purpose in life, a sense of harmony and inner peace, and faith that one is being cared for and looked after by a higher power (Gall, Kristjansson, Charbonneau, & Florack, 2009).

In Haiti, religion – which includes Catholicism, Vodou, and Protestantism – plays a vital role in all areas of life. It not only gives Haitians a sense of purpose in life, but it also provides a sense of utility, comfort, belonging, structure, and discipline (Corten, 2000; Hurbon, 2004). Vodou, in particular, is often regarded as a health care system among those that practice it. Indeed, it promotes healing practices, disease prevention, and personal well-being (Augustin, 1999). Vodou also provides information on how to promote, prevent, and treat health problems, through disease theories, treatment interventions, and behavioral prescriptions that are consistent with other widespread explanatory models (Vornarx, 2008). Aside from Vodou, many Haitians also practice Catholicism or Protestantism, which help promote emotional and psychological well-being (Kirmayer, 2010). In fact, over half of Haitians are Catholic, about one-fourth to one-third are Protestant, and a number of Haitians combine some elements of Vodou with their practice of Christianity.

For Haitians, religion can help diminish despair and create hope in difficult circumstances. As such, spiritual leaders can be allies to mental health professionals working to help individuals recover from trauma, as they are able to gain the confidence of communities more quickly than mental health professionals that are coming into the community. When mental health professionals engage with key spiritual leaders, the collaborative relationship that is built can be utilized to improve community responses to disasters and therefore assist in trauma recovery (Aten et al., 2014). Indeed, when this type of collaborative relationship has been established, spiritual leaders are more willing to act as facilitators and refer community members for mental health treatment as well as encourage them to adhere to recommended treatments (Aten, 2004). Engaging spiritual leaders also provides mental health professionals the opportunity to gain important knowledge from them regarding cultural contexts as well as the specific dynamics of members of their faith community (O’Grady et al., 2012). This could subsequently allow mental health professionals and spiritual leaders alike to create trauma recovery approaches that are both community-specific and culturally sensitive (Aten et al., 2014; O’Grady et al., 2012). Once mental health professionals have established relationships with spiritual leaders and their communities, they will have a greater opportunity to provide therapeutic services, including interventions that could facilitate the process of PTG, to survivors.

References

Aten, J.D. (2004). Improving understanding and collaboration between campus ministers and college counseling center personnel. Journal of College Counseling, 7, 90-96.

Aten, J.D., O’Grady, K.A., Milstein, G., Boan, D., & Schruba, A. (2014). Spiritually oriented disaster psychology. Spirituality in Clinical Practice, 1(1), 20-28.

Augustin, J. (1999). Le vodou libérateur: Et si le vodou était une valeur!–. Montréal: Tanboula.

Blanc, J., Rahill, G.J., Laconi, S., & Mouchenik, Y. (2016). Religious belief, PTSD, depression and resilience in survivors of the 2010 Haiti earthquake. Journal of Affective Disorders, 190, 697-703.

Burnett Jr., H.J. & Helm Jr., H.W. (2013). Relationship between posttraumatic stress disorder, resilience, and religious orientation and practices among university student earthquake survivors in Haiti. International Journal of Emergency Mental Health and Human Resilience, 15(2), 97-104.

Calhoun, L. G., Cann, A., & Tedeschi, R. G. (2010). The posttraumatic growth model: Sociocultural considerations. In T. Weiss & R. Berger (Eds.), Posttraumatic growth and culturally competent practice: Lessons learned from around the globe (pp. 1-14). Hoboken, NJ, US: John Wiley & Sons Inc.

Corten, A. (2000). Diabolisation et Mal Politique. Haïti: misère, religion et politique. Montréal: les Éditions CIDIHCA.

Gall, T. L., Kristjansson, E., Charbonneau, C., & Florack, P. (2009). A longitudinal study on the role of spirituality in response to the diagnosis and treatment of breast cancer. Journal of Behavioral Medicine, 32, 174–186. doi:10.1007/s10865-008-9182-3

Hurbon, L. (2004). Religions et lien social: l’Église et l’État moderne en Haïti. Paris, Éditions du Cerf.

Janoff-Bulman, R. (2004). Posttraumatic growth: Three explanatory models. Psychological Inquiry, 15(1), 30-34.

Kirmayer, L. J. (2010). Culture and mental health in Haiti: A literature review. Department of Mental Health and Substance Abuse. http://www.who.int/mental_health/emergencies/culture_mental_health_haiti_eng.   pdf

Lindstrom, C.M., Cann, A., Calhoun, L.G., & Tedeschi, R.G. (2013). The relationship of core belief challenge, rumination, disclosure, and sociocultural elements to posttraumatic growth. Psychological Trauma: Theory, Research, Practice, and Policy, 5(1), 50-55.

Luthar, S.S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work.

Mercado, M.A., Seward, D., Valsaint, M., Sirikantraporn, S., Rich, G., & Jean-Charles, W. (2018, August). Posttraumatic growth in Haiti: A mixed methods study.Poster session presented at the meeting of the American Psychological Association, San Francisco, CA.

O’Grady, K.A., Rollison, D.G., Hanna, T.S., Schreiber-Pan, H., Ruiz, M.A. (2012). Earthquake in Haiti: Relationship with the sacred in times of trauma. Journal of Psychology & Theology, 40 (4), 289-301.

Prati, G. & Pietrantoni, L. (2009). Optimism, social support, and coping strategies as factors contributing to PTG: A meta-analysis. Journal of Loss and Trauma, 14, 364–388.

Rich, G. J., Sirikantraporn, S., & Jean-Charles, W. (2018). The concept of Posttraumatic growth in an adult sample from Port-au-Prince, Haiti: A mixed-methods study. In Rich, G.J., &

Sirikantraporn, S. (Eds.), Human Strengths and Resilience: Cross-cultural, developmental, and international perspectives(pp. 21-38). Maryland: Lexington Books.

Shaw, A., Joseph, S., Linley, P.A. (2007). Religion, spirituality, and posttraumatic growth: A systematic review. Mental Health, Religion & Culture, 8 (1), 1-11.

Tedeschi, R. G., & Calhoun, L. G. (1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9, 455-471.

Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence.Psychological Inquiry, 15, 1-18.

Vonarx, N. (2008). Le Vodou haïtien comme système de soins, nouvelle lecture. In: J. Hainard, P. Mathez & O. Schinz (eds.), Vodou (pp. 177-197), Geneva: Infolio, Musée d’ethnographie de Genève.

Wilson, J. T. & Boden, J. M. (2008). The effects of personality, social support and religiosity on post- traumatic growth. Australasian Journal of Disaster and Trauma Studies, 2008 (1), 1–19.

Ainelle Mercado, MA is currently a 3rdyear graduate student at the California School of Professional Psychology at Alliant International University in San Diego, working towards her doctorate in Clinical Psychology. She received her B.S. in Neuroscience at the University of California Los Angeles and her M.A. in Counseling Psychology with a focus on Marriage and Family Therapy at National University. Her research interests are in trauma and posttraumatic growth. Her clinical experience includes conducting psychological assessments and working in community mental health settings, residential treatment facilities, and public schools with children, adolescents, and families that experienced trauma.

Marie Valsaint, MA earned her B.A. in Psychology and Sociology at Florida Atlantic University. Marie is currently a graduate student at Alliant International University (CSPP), San Diego with the goal of becoming a multicultural (clinical) psychologist. She is currently working on developing a website (haitiansthrive.com) dedicated to providing mental health resources for the Haitian community. The website will also address some of the barriers (e.g. stigma) which may impact accessing treatment. Ms. Valsaint is also a member of the Haitian Bridge Alliance, Inc., which is dedicated to supporting Haitian Immigrants in the state of California in becoming self-sufficient.

Skultip (Jill) Sirikantraporn, PsyD is a licensed psychologist in California and New York with research interests in trauma and resilience in the context of cross-cultural and international psychology. She obtained her doctoral degree in clinical psychology from Antioch University Seattle. She is a founding faculty at Fulbright University Vietnam. She has taught multicultural competence development, qualitative methods of research, and intellectual assessment. Jill has a passion for working with individuals from various cultural groups, honoring their unique ways of healing and growing, especially after major life crises. She is a registered yoga instructor and uses holistic, mind-body integration as part of therapy and self-healing.

Grant J. Rich, PhD received his Ph.D. in Psychology: Human Development from the University of Chicago. He is senior editor of Pathfinders in International Psychology (2015) and has three additional coedited books for 2017-2018: “Internationalizing the Teaching of Psychology”, “Human Strengths and Resilience: Developmental, Cross-Cultural, and International Perspectives”, and “Teaching Psychology Around the World”. A Fellow of the American Psychological Association, the Society for the Teaching of Psychology, and the Society for Media Psychology and Technology, Dr. Rich has taught at institutions around the globe, recently in Alaska, Cambodia, and India. He is a National Board Member of the NCBTMB.

Wismick Jean-Charles, PhD, Haitian priest, is the current vice president of the University of Notre Dame, in Haiti. He received his doctorate in psychology from Fordham University, New York.