Can Trauma Improve Psychological Health?

Traumatic events are not necessarily traumatizing. In fact, traumatic events are usually not traumatizing. Most people suffer no enduring psychological consequences from them, even after events as horrific as the 9/11 terrorist attacks or a mass shooting. After decades of confusion about our capacity to cope with acute stress, we now know—based on study after study—that people have a robust and likely inherent capacity to cope effectively with trauma.

The Complex and Sometimes Paradoxical Effects of Trauma

My purpose here is not to review the evidence for resilience to trauma (see here for that). Instead, I want to suggest an even more radical idea: That trauma can—sometimes and for some people—have beneficial effects. Yes, beneficial effects.

My colleagues, Heather Littleton and Amie Grills, and I had an extremely rare opportunity to test this possibility in a study of 368 female survivors of the Virginia Tech campus tragedy in 2007, the second most deadly civilian shooting in US history. It was rare because students’ functioning (depression and anxiety symptoms) had been assessed before the shootings (as the result of an unrelated study) and again at 2, 6, and 12 months after. This allowed us to precisely gauge the impact of the shootings on their psychological health.

We expected to find a range of psychological responses to the tragedy, and we did. Most (about 60 percent) were resilient, with no statistically discernible uptick in distress after the shootings. On the other hand, about 20 percent of survivors saw large increases in anxiety or depression that continued to increase for 12 months—a reaction consistent with potential posttraumatic stress disorder. Given the typical prevalence of resilience and the indisputable potential of such events to generate distress, these findings were unremarkable.

What was remarkable was a group of survivors whose psychological health improved. This group had high levels of depression and anxiety before the shooting and substantially less anxiety and depression after the shootings. About 15 percent of the sample, in fact, saw substantial and statistically significant improvement in psychological functioning.

Social Relationships Can Be Strengthened after Traumatic Events

Why would some people improve? We hypothesized that people who felt isolated, anxious, and depressed before a traumatic event would benefit from a well-documented phenomenon: The power of acute stress to strengthen our relationships, particularly with close others. The UCLA psychologist Shelley Taylor has described this as “tend-and-befriend.” Indeed, for more than half a century, historians and sociologists have documented this phenomenon, variously describing the aftermath of mass trauma as a “post-disaster utopia,” a “city of comrades,” and “a democracy of distress.”

This is exactly what we found. Psychologically improved survivors reported a substantial increase in the belief that friends and family would be available if needed. They were more likely to report gains in intimacy with friends or family, and to perceive an increased sense, for example, that “I can count on my friends when things go wrong” and “I can talk about my problems with my family.” Remarkably, their social ties continued to strengthen for a full year after the shootings. As expected, the group with potential posttraumatic stress disorder reported no increase—and even a slight decline—in their perceptions of support from others.

“The Remedial Influences of Pure, Natural Human Relationships”

The trauma appeared to improve their relationships. And this in turn may well have improved their psychological functioning. Indeed, close and active social relationships are essential to well-being and happiness. Not surprisingly, then, psychological distress is exquisitely responsive to the quality of our relationships: The perceived absence of supportive relationships is one of the strongest predictors of posttraumatic stress disorder, a devastating and potentially chronic illness. All of this points to a fundamental and often overlooked reservoir of healing: what the novelist George Eliot once described as “the remedial influences of pure, natural human relations.”


Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59, 20-28. doi:10.1037/0003-066X.59.1.20

Bonanno, G. A., Galea, S., Bucciarelli, A., & Vlahov, D. (2006). Psychological resilience after disaster: New York City in the aftermath of the September 11th terrorist attack. Psychological Science, 17, 181-186.

Mancini, A. D., Littleton, H. L., & Grills, A. E. (2016). Can people benefit from acute stress? Social support, psychological improvement, and resilience after the Virginia Tech Campus Shootings. Clinical Psychological Science, 4, 401-417. doi:10.1177/2167702615601001

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