1. Physical activity and Posttraumatic growth Chichester Centre of Applied Sport and Exercise Sciences (CCASES) Chichester University June 25 th, 2014 Dr. Kate Hefferon, PhD Programme Leader- MSc. Applied Positive Psychology Head of the Posttraumatic Growth Research Unit University of East London London, UK

3. Outline  Physical activity and well-being  Post-traumatic Growth (PTG)  Corporeal Posttraumatic Growth  Conclusions and questions

4. Physical activity and Wellbeing  Physical activity is a ‘stellar’ method of intervening to promote well-being (Hefferon & Mutrie, 2012)  Reduces the risk of developing several diseases  Produces both hedonic and eudaimonic experiences of well-being including: positive emotions, self esteem, body image, cognitive functioning, psychological well being, posttraumatic growth, flow, purpose in life, etc.  Mens sana in corpore sano: Healthy body = healthy mind (Somatopsychic Principle)  Build psychological and emotional strength via the building of physical strength (Faulkner, Hefferon & Mutrie, In press)

5. Psychological Resilience “the flexibility in response to changing situational demands, and the ability to bounce back from negative emotional experiences” (Tugade, Fredrickson, & Barrett, 2004b, p. 1169) Recovery, resistance and reconfiguration (Lepore & Revenson, 2006)

9. Posttraumatic growth (PTG) “It is through this process of struggling with adversity that changes may arise that propels the individual to a higher level of functioning than which existed prior to the event.” (Linley & Joseph, 2004, p. 11) 40-70% experience some positive benefits from trauma Focus is not to advocate suffering as a situation worth striving for, but rather to examine the phenomenon in which suffering and grief can co-exist with enlightenment and growth (Linley and Joseph, 2004)

10. 1) Perceived changes in self  Becoming stronger  More confident  New awareness of a possible self authentic self  A ‘better self’  Deeper  More open  More empathetic  More creative  More alive  More mature  More humanitarian  More special  More humble (Tedeschi & Calhoun, 1995, p. 456).

11. 2) Improved relationships  Closer relationships with family and/or friends  Neighbours  Fellow trauma survivors  Strangers  Find out who “True friends” are

12. 3) Changing life philosophy/ increased existential awareness  Reflection of mortality  Meaning and purpose in life  Finding reasons/making meaning from the trauma  ‘Vulnerability’ and ‘the shortness of time’ ‘Once you worry about whether you are going to die, nothing else seems quite as significant to worry about’ (Kennedy, Tellegen, Kennedy, & Havernick, 1976)

13. 4) Changed priorities  How and with whom they decided to spend their day  Appearance  Nature  Monetary goods  Health  New appreciation of life (calling it a ‘gift’)  The ‘here and now’  Simple things  Time  Change life goals  Learn new skills  Go back to school

14. 5) Enhanced spiritual beliefs  Increased spirituality  Return to faith  Spiritual practices  Praying  Attending church  Gratitude to God  Strengthening of faith  Bereavement  Importance and existence differs across culture (Tedeschi et al., 2010)

15. Example of growth “And it’s…and I feel my life’s better ! I know it sounds crazy (laughs), but I feel the quality of my life is better because (sniffles) I’ve prioritized (sniffles) and I know what matters.” Brenda, Cancer survivor

16. Benefits of PTG Improved Physical FunctioningImproved Psychological FunctioningReduced substance misuse Reduced distress, anxiety and depression Improved quality of life

17. PTG GenderAge Coping styles SESEducation Trauma severity Personality traits Time since trauma Social support Rumination

18. Physical activity and PTG  Physical activity and sport in facilitation and as an outcome of posttraumatic growth  Breast cancer patients  Spinal cord injury  Paralympians  Severe and enduring mental health service users  Acquired disability  Very new research area  Predominantly qualitative research

19.  Breast cancer patients  Exercise intervention during chemotherapy  Women attributed much of their process and outcomes of PTG to the experience of participating in the exercise programme during rehabilitation  Physical Activity as BOTH a facilitator and an outcome

20. Physical activity: “Savior” during difficult time Healthy distraction Normalized activity Purpose and structure Active coping Expertise of instructors Safe place Camaraderie and positive support

21. Physical activity as an outcome of PTG The somatopsychic Principle Reconnection to body Transference of skills New health behavoiurs Responsibility for own health Body as a barometer

22.  5-year follow up of physical activity intervention  70% of those who serendipitously reported PTG were in the original exercise intervention  Suggests “window of opportunity” (teachable moment) (Mutrie et al., 2012; Hefferon, 2012; Hefferon et al., 2013; Murphy et al., in press)

23. Main ThemeSubtheme Gone off trackLoss of physical self Loss of confident self Endeavour Social re-integrationFree to ‘Be’ Class constituentsWayne Evoke power Main ThemeSubtheme Praise of classA focused challenge Healthy escape Camaraderie WayneSuperstar status Proxy Efficacy Wayne's gym Path to MetamorphosisLost and found Somato-psychic principle in practice Heightened awareness of health

24. Paralympians (Kampan, 2013; Kampman and Hefferon, 2014;) Sport Fundamental route to experiencing (PTG) Platform for recovery Provided camaraderie and achievement Base for new identity as an athlete Team as a resource Safe environment Learn new skills Share practical ideas Promoted a sense of equality Body in facilitating PTG

25. Reconnection to the body (Hefferon, Grealy & Mutrie, 2009; 2010)  In traumas where the body has been damaged or altered, the body has been found to be: 1) A vital component to the process and outcomes of PTG 2) Integral component to their self identity (influencing PTG facilitation)  Participants discuss visceral experiences not mentioned in current tools  They can experience dramatic changes to their body which can make them feel a sense of betrayal by their body (as the transgressor)  PTG can be experienced via the renegotiation of this corporeal relationship NEW BODY Fear of new body Systematic decline in functioning Reconnection to body Achievement of PTG

26. Body-related traumatic event (illness, injury) Person-Pre trauma Corporeal Awareness Fear of New body (Vengeful, loss of control) Systematic decline in functioning (Alienation of body from the self) Reconnection to body New relationship with body Listen to body Non-taken-for granted body The body is used as a facilitator and as an outcome of PTG Increased awareness of health Health behaviour changes (Exercise and diet, cessation of negative health behaviors) Assumptive beliefsTaken-for-granted body Preliminary Model of Corporeal Posttraumatic growth (Hefferon, 2013) Sport and Physical activity

27. Current Projects  Posttraumatic Growth Research Unit (UEL)  PTG and acquired disability within Paralympians  PTG and acquired disability within leisure sports  Passion, peak performance and PTG (Olympic and Paralympic sports) (English Institute of Sport)  PTG and Wheelchair Basketball (London)  PTG interventions (E-mpower)  Corporeal Posttraumatic Growth Scale development

28.  Physical activity can be utlised to increase both physical and psychological well being  Posttraumatic growth is the phenomenon of surpassing previous levels of functioning than which existed before a traumatic event occurred  Research into Sport, Physical activity and PTG is a rapidly expanding area  There is a need for further multi-method evaluations of these links  Ultimately, there is a need for a more corporeal approach to PTG following trauma Conclusions and Considerations

29.  www.katehefferon.com www.katehefferon.com  Posttraumatic Growth Research Unithttp://www.uel.ac.uk/psychology/research/PTGunit/http://www.uel.ac.uk/psychology/research/PTGunit/  Hefferon, K. (2013). Positive Psychology and the Body: The somatopsychic side to flourishing. London: Open University Press.  Joseph, S. (2011). What Doesn't Kill Us Makes Us Stronger: The New Psychology of Posttraumatic Growth. Basic Books.  Centre for Trauma, Resilience and Growth (CTRG) Nottingham University http://www.nottinghamshirehealthcare.nhs.uk/our-services/local- services/specialist-services/prescribed-services/trauma/  University of Toronto Faculty of Kinesiology and Physical Education http://physical.utoronto.ca/FacultyAndResearch/Research_Areas.aspx Resources

30. k.hefferon@uel.ac.uk www.katehefferon.com @katehefferon Thank you