Personal Transformation Posttraumatic Growth And Gerotranscendence

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DOI: 10.1177/0022167813492388 published online 2 July 2013Journal of Humanistic Psychology

Tzipi WeissGerotranscendence

Personal Transformation: Posttraumatic Growth and

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Article

Personal Transformation: Posttraumatic Growth and Gerotranscendence

Tzipi Weiss1

AbstractThis article connects two rich but distinct literatures on personal transformation and well-being that can benefit from cross-fertilization. It explores the intersection of posttraumatic growth (PTG), a model of positive changes following traumatic events, and gerotranscendence, a theory of positive changes related to aging. The two conceptualizations of positive change are compared on multiple dimensions. These include the philosophical base, domains, trigger, mechanism, and correlates of change, as well as the connection of change with wisdom and life satisfaction. The analysis reveals many similarities between the two paths to personal transformation with the key difference being the trigger for growth. Whereas PTG connects growth to traumatic events, gerotranscendence connects the growth to normative later life experiences. The similarities identified imply that PTG could be viewed as part of normative adult development and as an accelerator of gerotranscendence. The analysis also indicates that transformation in normative development is likely fueled in part by stressful losses and existential suffering. The article suggests that PTG and gerotranscendence may be viewed as two facets of the universal human striving toward self-transcendence or emancipatory knowledge. The critical role of the sociocultural context in personal transformation is also highlighted. Implications for future research and practice are discussed.

1Long Island University Post, Brookville, NY, USA

Corresponding Author:Tzipi Weiss, Department of Social Work, Long Island University Post, 720 Northern Boulevard, Brookville, NY 11548, USA. Email: [email protected]

492388 JHPXXX10.1177/0022167813492388Journal of Humanistic PsychologyWeissresearch-article2013

2 Journal of Humanistic Psychology XX(X)

Keywordsposttraumatic growth, gerotranscendence, human development, trauma, aging, personal transformation

When interviewed about her illness experience, the author Marilyn French, who survived deadly esophageal cancer in middle age, said that cancer did wonders for her (Freely, 1998). It took away her future and allowed her to abandon herself to the small pleasures of the present. She found great appre-ciation for life so that living through a day was as exciting as a walk through an art gallery. When 75-year-old Mary was interviewed about her aging expe-rience, she reported that she came to rejoice in the small things in life (Hyse & Tornstam, 2009). She no longer needed extravagant travel to faraway exotic places to appreciate life. She found a trip to the grocery store a most exciting experience.

The personal transformation tales of Marilyn and Mary suggest that there are some similarities between the positive changes that may follow trauma and those that may come with aging. Such similarities have not yet been explored, and they provide an opportunity to shed light on the phenomenon of personal transformation, defined as changes in mental structures and worldview that lead to increased wisdom and well-being (Tedeschi & Calhoun, 2012). Wilber (2006) highlighted that the study of personal trans-formation is in its infancy when he suggested, As for transformation itself: how and why individuals grow, develop, and transform is one of the great mysteries of human psychology. The truth is, nobody knows (p. 87). Personal transformation has been described in the literature of trauma and crisis (e.g., Joseph & Linley, 2008a; Weiss & Berger, 2010a) as well as in the literature of aging (e.g., Sheldon & Kasser, 2001). This article is an attempt to begin integrating these two rich but distinct literatures concerned with understand-ing and promoting psychosocial well-being.

The positive changes in the aftermath of a struggle with traumatic or highly stressful events have been well conceptualized by the posttraumatic growth (PTG) model, which identifies three broad domains of change: perception of self, relationships with others, and ones philosophy of life (Calhoun & Tedeschi, 1998; Tedeschi & Calhoun, 2004). The positive changes associated with aging have been well conceptualized by the theory of gerotranscendence, which identifies three similar dimensions of change: self, social relationships, and worldview (Tornstam, 2005). This article will review the PTG and gero-transcendence literatures and explore the implications of one for the other and for open questions regarding personal transformation. These questions include

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the extent to which crisis-related transformation is related to processes of nor-mative development, the role of existential suffering in personal transformation related to aging, and the conditions that facilitate transformation. Juxtaposing two pieces of the puzzle of personal transformation could also point the way toward a conceptual synthesis. The article will include a brief introduction of PTG and gerotranscendence, a comparison of the approaches in terms of their basic assumptions about positive change, and a discussion of the implications for theory, practice, and research.

PTG

The idea that suffering has its rewards has been a key element in world mythology and in the Eastern and Western perennial philosophy (Huxley, 1946). It is only in the past two decades that it has also become the focus of theory development and empirical studies in the social sciences. Whereas the pain related to traumatic events is undisputed, there is extensive evidence that in the aftermath of the struggle with the pain, many people also experience positive changes (Calhoun & Tedeschi, 2006; Weiss & Berger, 2010a). Coined by Tedeschi and Calhoun (1995), PTG captures the phenomenon that in the aftermath of an encounter with highly stressful events or life crises, people often perceive themselves and their lives as having improved. This phenomenon is also described by many other terms such as life crises and personal growth (Schaefer & Moos, 1992), stress-related growth (Park, Cohen, & Murch, 1996), transformational coping (Aldwin, 1994), resilience and thriving (OLeary & Ickovics, 1995), and growth from adversity (Linley & Joseph, 2004; Joseph & Linley, 2008a).

In the past two decades, Tedeschi, Calhoun, and their colleagues at the University of North Carolina developed a comprehensive model about the pro-cess of PTG (Calhoun, Cann, & Tedeschi, 2010; Calhoun & Tedeschi, 1998; Tedeschi & Calhoun, 2004). It is an ecological model that assumes that positive outcomes from coping with trauma are a function of event, individual, and social context characteristics. The model suggests that a potentially disruptive event, such as an encounter with serious illness or injury, earthquake, tsunami, war and terrorism, if perceived as a challenge to ones basic beliefs and goals, may trigger the process of growth. They posit that such a seismic event becomes a turning point that creates a break in ones life narrative and divides existence to before and after the emotionally distressing ordeal. Tedeschi and Calhoun assume that the disruptive event sets in motion a process of cogni-tive-emotional processing that involves reassessment of goals and beliefs and reconstruction of basic schemas and life narratives. This process may result in recognition of strengths, resources, and new possibilities, which in turn may


yield acceptance of the changed world, and wisdom reflected in a life narrative that acknowledges the complexity of the world. These changes may ultimately relate to increased well-being and life satisfaction.

The model also indicates that the cognitive-emotional processing involves self-analysis and self-disclosure in a social context and that PTG is related to the degree to which this context provides support, positive models of change, and cultural themes that are consistent with such a change.

Gerotranscendence

Like the transformative potential of suffering, the potential for transforma-tion in old age has been part of world mythology and philosophy, although more so in Eastern traditions than Western ones (Tornstam, 2005). And as has been the case with PTG, the positive changes of aging became the focus of theory development and empirical study in the social sciences in the past two decades. The Swedish sociologist Lars Tornstam coined the term gerotrans-cendence and argued that if we listen to older adults, we might hear them report a positive transformation in old age. The recognition of this growth beyond E. M. Eriksons (1998) last stage of development, the stage of ego integrity, prompted Joan Erikson to add gerotranscendence as the ninth stage in the course of human development.

On the basis of qualitative and quantitative studies conducted in Europe, Tornstam (2005, 2011) developed and tested the grounded theory of gerotran-scendence. It is a social constructionist theory that assumes that in the latter part of life, individuals are challenged to reassess their basic assumptions about existence and their primary values. Tornstam posits that old age pres-ents a challenge to middle age materialistic (e.g., productivity, efficiency, and wealth), individualistic (e.g., fierce independence), and sociability (e.g., the more contact the merrier) values. This challenge can trigger a process of deconstruction and reconstruction of reality that may lead to positive changes in defining the self, relating to others, and connecting to the universe. The theory assumes that the changes of aging occur in the context of the personal life course trajectory and sociocultural forces. Thus, gerotranscendence might be facilitated by life crises or traumatic events and can be impeded by social obstacles such as negative attitudes to transcendental change. The the-ory further specifies the potential that the changes of aging are accompanied by increased wisdom and life satisfaction.

PTG and Gerotranscendence Juxtaposition

In the following section, transformation conceptualized in the context of trauma will be compared with the conceptualization of transformation in the

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context of aging. PTG and gerotranscendence will be compared regarding their assumptions about human growth and positive change. They will be juxtaposed in terms of their philosophical perspectives, the domains of change, the trigger for change, the mechanism involved, correlates of change, and connection with wisdom and life satisfaction (see Table 1). Measurement methods and empirical findings will be included in the discussion.

Philosophical Perspective

Two major assumptions seem to be shared by PTG and gerotranscendence: the salutogenic orientation and a phenomenological lens.

Salutogenic Orientation. Both PTG and gerotranscendence emphasize the need to shift from a deficit-based lens to a strengths-based perspective in under-standing the human condition. This shift is consistent with Antonovskys (1987) salutogenic approach and the more recent developments in positive psychology (Linley & Joseph, 2004). PTG assumes that it is clearly a distor-tion to view trauma only as a source of misery and pathology, ignoring human strengths and the potential for growth. This assumption is in agreement with Jungs suggestion that where you stumble and fall, there you find pure gold (cited in Rohr, 2011, p. 58). Similarly, gerotranscendence proclaims that it is a myth that aging is strictly a miserable descent into illness and loss

Table 1. Posttraumatic Growth and Gerotranscendence: Underlying Assumptions About Change.

Change assumption Posttraumatic growth Gerotranscendence

Philosophical base Salutogenic: trauma/growth Salutogenic: aging/growth Phenomenological:

survivors voicePhenomenological:

elders voiceDomains Perception of self Dimension of self Relating to others Dimension of social relation Philosophy of life Cosmic dimensionTrigger Trauma-related existential

crisisAging-related developmental

tasksMechanism Cognitive-emotional

processing of lossDeconstruction and

reconstruction of realityCorrelates Crisis event characteristics Life crises Sociocultural context Sociocultural context Personality and coping Wisdom/well-being /

life-satisfactionPositively related Positively related


(Tornstam, 2005). Such a myth ignores individuals potential for growth and development throughout their lives, to their last breath. Gerotranscendence is inspired by Jungs assumption that the most significant personal growth occurs in the second half of life, and that aging is a falling upward and onward, into a broader and deeper world (cited in Rohr, 2011, p. 153).

Phenomenological Lens. A phenomenological lens, focusing on the subjective experience of trauma or aging and giving voice to the people involved in the experience played a pivotal role in the development of the PTG and gerotran-scendence conceptualizations. Calhoun and Tedeschi are clinicians as well as academic scholars, and their work is based on reports of positive changes by bereaved individuals and other survivors of traumatic events. Similarly, Torn-stam developed his conceptualization of aging while listening to reflections of older adults about their experiences (Hyse & Tornstam, 2009; Tornstam, 2005). He strongly cautioned gerontologists against imposing their own value-laden theories on elders.

Domains of Positive Change

Both PTG and gerotranscendence assume growth in primarily three domains: self, relationships, and worldview. These domains have been identified on the basis of broad literature reviews as well as qualitative and quantitative empir-ical studies. In reviewing the literature for the development of the PTG model, Tedeschi and Calhoun (1995) specified positive changes in perception of self, relating to others, and philosophy of life. On the basis of this concep-tualization, Tedeschi and Calhoun (1996) developed a 21-item survey instru-ment, the Posttraumatic Growth Inventory (PTGI), which yielded five empirical factors. Changes in self were reflected in the factors of New Possibilities and Personal Strengths, changes in relationships were reflected in the Relations to Others factor, and changes in philosophy of life were reflected in the Appreciation of Life and Spiritual Change factors. Cann, Calhoun, Tedeschi, Taku, et al. (2010) recently published a short version (10 items) of the PTGI that duplicated the original five factors.

Based on qualitative studies, Tornstam (1996, 1997) identified the self, relationships, and cosmic dimensions of gerotranscendence. Tornstam (2005) also developed a 10-item survey instrument that yielded three factors. Changes in self were reflected in the Coherence factor (2 items), changes in relationships were reflected in the Solitude factor (3 items) and changes in cosmic view were reflected in the Cosmic Transcendence factor (5 items). A comparison of the content of each domain in PTG and gerotranscendence follows.

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Self. In PTG, changes relate to the development of a complex view of self, involving increased sense of strengths, self-efficacy, and self-reliance cou-pled with increased recognition of ones vulnerability and acceptance of indi-vidual limits. Changes in self also refer to new possibilities and a new path in life (Tedeschi, Park, & Calhoun, 1998). Items on the PTGI include I discov-ered that Im stronger than I thought I was (Personal Strengths) and I devel-oped new interests (New Possibilities). In gerotranscendence, changes in self relate to self-confrontation (recognizing new good and bad aspects of self), decrease in self-centeredness, body transcendence (decreased interest in the physical self), self-transcendence (moving from egoism to altruism, genera-tivity) and ego integrity (finding meaning as the fragments of life acquire wholeness). In the gerotranscendence measure, however, the self dimension is reduced to the two items of the Coherence scale: The life I have lived has coherence and meaning and (the negative of) My life feels chaotic and dis-rupted. As Hyse and Tornstam (2009) note, when one views ones life path from the top of the mountain, one can make sense of roads taken and not taken and acknowledge ones strengths and weaknesses.

Relationships. In PTG, there is a sense of deepening of relationships with oth-ers and greater appreciation of these deep relationships. As one experiences greater sense of personal strengths and vulnerability, one shows greater readi-ness to receive support from others and respond to people with empathy and compassion as well as act altruistically. Items on the PTGI include I have a greater sense of closeness with others and I learned a great deal about how wonderful people are. In gerotranscendence, this dimension includes changed meaning and importance of relationships (one becomes more selective, focusing on meaningful relationships and periods of solitude), understanding of role-playing (noting the difference between self and roles), emancipated innocence (freedom from social conventions), modern asceticism (freedom from the encumbrance of superfluous possessions), and everyday wisdom (reluctance to give advice, transcendence of right/wrong duality, broadmind-edness, and tolerance). In the survey instrument, the relationship dimension is reflected in the three items of the Solitude scale: I like to be by myself better than being with others, (the negative of) I like meetings with new people, and Being at peace and philosophizing by myself is important for my well-being. Thus, in gerotranscendence as well as PTG, changes involve greater appre-ciation of meaningful relationships characterized by authentic and supportive interactions and lack of interest in inconsequential contacts.

Worldview. In PTG, individuals report a changed philosophy of life, value clarification, and changed priorities. In the aftermath of trauma, people focus


on greater appreciation of life and living in the moment. Changes in world-view also include finding life meaningful and orderly and conversion into, or deepening of, spiritual beliefs (Tedeschi & Calhoun, 1995). Spirituality is defined as a greater sense of somehow being connected to something tran-scendent (Tedeschi et al., 1998, p. 14). PTGI items include I have a greater appreciation for the value of my own life (Appreciation of Life) and I have a better understanding of spiritual matters (Spiritual Change). In gerotranscen-dence, one achieves a new understanding of fundamental, existential ques-tions of life. The changed worldview represents a paradigm shift from materialism/rationalism to cosmic transcendence, which includes shifts in time perception and childhood connection (transcendence of borders between past and present), connection to earlier generations (being part of the stream of life), transcendence of the dichotomy of life and death, embrace of the mystery in life, and finding joy in everyday experience (Hyse & Tornstam, 2009; Tornstam, 1997). The gerotranscendence measure assesses this dimen-sion with items such as I feel connected to the entire universe and sometimes I feel like I live in the past and the present simultaneously. Thus, both PTG and gerotranscendence changes include a spiritual component denoting greater awareness that each of us is an inseparable part of the universal unity of being (Cloninger, 2008, p. 7), and a sense of joy in being, as illustrated in the opening paragraph of this article. The comments of Marilyn and Mary illustrate recognition of the great lesson from the true mystics . . . that the sacred is in the ordinary, that it is to be found in ones daily life . . . and that to travel may be a flight from confronting the sacred (Maslow, 1971, pp. 348-349).

The Trigger for Change

Whereas in PTG change is triggered by an encounter with a stressor event at any point in the life course, in gerotranscendence growth is spurred by aging-related life experiences. PTG posits that a traumatic event represents a potential disruption to assumptive world beliefs defined as a broad set of fundamental beliefs that include, for example, how we believe people will behave, how events should unfold, and our ability to influence events (Cann, Calhoun, Tedeschi, Kilmer, et al., 2010, p. 19). Recently, PTG study has been enhanced by the development of the Core Beliefs Inventory (CBI), which allows quanti-fication of the degree to which an event was disruptive to ones worldview and challenged basic assumptions (Cann, Calhoun, Tedeschi, Kilmer, et al., 2010). Items are related to beliefs about: the fairness and controllability of events, the motives for other peoples thoughts and behaviors, the individuals own strengths and weaknesses, and the source of meaning in life.

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Thus, in PTG, change is triggered by an event that involves such profound losses that it challenges or shatters ones basic beliefs and sends one into an existential crisis with the realization that old ways of seeing the self, others, and the world are no longer applicable. For example, when a woman diagnosed with cancer enters a hospital, is stripped of her clothes, cannot fulfill her roles of worker and parent, and is forced to ask who am I, she may feel that she is falling into an abyss. This experience of descent into the hellish kingdom of the sick might be the fall that leads to transformation. PTG clearly assumes that the trigger for transformation includes intense emotional distress.

In gerotranscendence, growth is triggered by the experiences of normal living from adulthood to death that pose challenges to individuals percep-tion of self, relating to others, and worldviews (Tornstam, 2005). As some people reach later years, they find it difficult to navigate life through a middle-age worldview reflecting materialistic values. Tornstam adopts Jungs view that whereas in the first part of life the developmental tasks we face involve getting acquainted with and being socialized into society, including conform-ing to its dominant values, in the second part we are challenged to get to bet-ter know ourselves and the collective unconscious with its universal wisdom. Or, as Rohr (2011) suggests, in the first half of life people build their career and home life. As they reach midlife and move toward old age, they are chal-lenged to reexamine the material base they established to look for deeper meaning and fuller purpose. Thus, in gerotranscendence the potential triggers for growth are related to the natural human progression toward maturation and wisdom, and such triggers are not necessarily accompanied by intense emotional distress.

Mechanism of Change

Detailed models exist regarding the development of PTG (Calhoun et al., 2010), whereas the dynamics of the change process are less clear in gerotran-scendence. PTG is assumed to be the potential product of rumination, the cognitive-emotional processing of the existential crisis triggered by a highly stressful event. As described above, the growth process is set in motion by the traumatic experience challenging existing ways of thinking and being, mak-ing goals unattainable, disrupting the personal narrative, and forcing indi-viduals to examine their identity and life purpose. In the posttraumatic struggle, one gets an opportunity to engage with the existential questions of who am I and what am I here for as well as step out of the automatic ways of functioning into which he or she had been conditioned. In the after-math of a traumatic event, one may become aware of a real life, which is always a much deeper river, hidden beneath the appearances (Rohr, p. 19).


The PTG model assumes that initially the rumination is mostly automatic, experienced as intrusive thoughts about the painful event and its catastrophic impact. This rumination may trigger self-analysis in the form of writing and praying as well as self-disclosure through talking and sharing the traumatic experience. Later, the rumination becomes more deliberate and constructive. One is pondering ways of being. One reevaluates basic assumptions about life in a search for new schemas and meaningful ways to revise the life narrative.

PTG research has been advanced by the development of an event-related rumination scale with six items for intrusive rumination, assessing the degree to which individuals experienced uncontrolled preoccupation with thoughts and images of the traumatic event, and six items for deliberate rumination, assessing the degree to which individuals thought about ways to make sense of the event, the positives in the struggle, and the meaning and purpose of life (Calhoun, Calhoun, Cann, Tedeschi, & McMillan, 2000; Cann et al., 2011). It is from the engagement in deliberate reflections, often triggered by intrusive rumination, that one might emerge with a more authentic self, deeper rela-tionships, and a more spiritual worldview.

Gerotranscendence posits that the personal transformation related to aging is the potential product of a process of deconstruction and reconstruction of reality, similar to the one described in Zen Buddhism, allowing for self-transcendence and a paradigm shift from a rational/materialistic to a cosmic transcendent worldview (Tornstam, 1994, 2005). In Zen Buddhism, a meta-cognitive shift into a nonlinear perception of time and dissolution of the rigid boundaries between self and others is the product of meditative practices (Levenson, Aldwin, & Cupertino, 2001). The metacognitive shift requires commitment to a process of self-observation, identification of the growth-inhibiting reactions based on greed/attachment, anger/aversion and igno-rance/self-deception, and cultivation of freedom from these obstacles. Tornstam (2005) does not specify such mechanisms, but he does indicate that gerotranscendence includes self-confrontation and the willingness to engage in discovering ones virtues as well as ones shadows and that developing ego integrity is related to tranquility and solitude. Tornstam also cited evidence that the cognitive processes involved in life review or reminiscence work are correlated with the changes of gerotranscendence.

It appears that both PTG and gerotranscendence are related to changes that come from stepping back from the immediacy of events and acquiring a broader perspective (Tedeschi et al., 1998). This process has been the topic of philosophical and spiritual teachings for millennia. In both PTG and gerotranscendence, one confronts the inadequacy of core beliefs or con-structions of the ego. And as Rohr (2011) suggests, it is when the ego is

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most deconstructed that we can hear things anew and begin some honest reconstruction (p. xxxiv). He further reminds us that transformation is often more about unlearning than learning (p. x) and that to go forward there is always something that needs to be let go of, moved beyond, given up (p. xxxv). It is important to note that the PTG and gerotranscendence concep-tualizations both posit that the mechanism of change is not related to defen-sive processes generating illusive perceptions but cognitive processes that produce a restructuring of ones approach to life.

Change Correlates: Crisis Event Characteristics

PTG is, by definition, growth related to the struggle with the aftermath of a crisis or trauma. Tedeschi and Calhoun (2004) have emphasized that the event has to be of a high magnitude of disruption; they use the metaphor of a seismic event that induces a significant subjective perception of loss and dis-tress. Tornstam (2005) also links gerotranscendence to what he calls an incident-impact factor, meaning exposure to life crises or traumatic events. Tornstam defines life crises as upheavals that challenge or question the foundation of ones conception of reality (p. 72). Tornstam found that such events tend to increase all three gerotranscendence dimensions already in young and middle adulthood but tend to lose their impact on the cosmic dimension in old age. These findings suggest that there is a potential connec-tion between PTG and gerotranscendence. Based on narrative analysis of reports of individuals demonstrating gerotranscendence, Hyse and Tornstam (2009) explicitly stated that positively handled crises and turning points in a life course . . . paved the way for certain reevaluations and reconsiderations that may be prerequisites for the development of gerotranscendence (p. 2). Verbraak (2000) also found that nearly all his study participants attributed the changes of gerotranscendence to reflection about a traumatic event such as death of a spouse or immigration.

Change Correlates: Sociocultural Context

PTG is conceptualized as a universal phenomenon that may have cultural variations and its development is conceptualized as related to different aspects of the social context surrounding the individual (Calhoun et al., 2010). Gerotranscendence appears to be conceptualized as a universal phe-nomenon, the development of which is either facilitated or inhibited by what Tornstam (2005) calls social-matrix factors.

There is empirical evidence that PTG is a universal phenomenon with culture-specific manifestations (Weiss & Berger, 2010a). For example, Taku


(2010) argued that in Japanese culture, growth on the dimension of self of PTG might be expressed as increased recognition of ones weaknesses, whereas among Westerners, growth on this dimension is expressed as increased recognition of ones strengths. In contrast, Tornstam (2005) assumes that gerotranscendence is intrinsic and culture free (p. 39), with no need for empirical testing of cross-cultural variations. For example, he rein-terprets Gutmanns (1976) findings that across cultures younger men project active mastery with competitive and aggressive themes, whereas older men demonstrate passive or magical mastery with solidarity and harmony. Tornstam sees these not as new coping strategies developed within ones stable worldview but as universal developmental changes indicative of quali-tative differences and a paradigm shift.

However, both PTG and gerotranscendence are conceptualized as subject to social-environmental influences. The PTG model further differentiates between a distal aspect of the contextual influence, which is related to broad cultural themes and values, and a proximate aspect, related to contact with people who may offer social support or serve as role models (Calhoun et al., 2010).

Distal Sociocultural Influence. The PTG model emphasizes that cultural values and beliefs affect many aspects of the struggle with traumatic events, includ-ing what is perceived as stressful, which stressful life events are likely to befall individuals and how they cope with them, as well as how one is trans-formed by the struggle (Weiss & Berger, 2010b, p. 189). For example, sociocultural influences affect the likelihood that in the struggle with stress-ful events, individuals will engage in rumination about spiritual/religious topics and will report PTG on the spiritual change dimension (Calhoun et al., 2010). Indeed, there is evidence that in predominantly atheistic Australia, survivors are less likely to use religious coping in processing trauma and report less PTG on the spiritual/religious factor of the PTGI than on other factors (Shakespeare-Finch & Morris, 2010). Similar findings were reported in other mostly secular societies such as East Germany and the Netherlands (Weiss & Berger, 2010b). The development of gerotranscendence is also affected by cultural beliefs and values. Tornstam (2005) argues that gerotran-scendence is more likely to proceed freely if it is not met with sociocultural obstacles such as the lack of mythical narratives of positive aging or the exis-tence of cultural values that privilege materialism and denigrate transcen-dence. Because gerotranscendence is closer to dominant values in Eastern cultures, as is evident, for example, in the Japanese emphasis on humility and solitude, it is more likely to thrive in such contexts (Tornstam, 2005). On the basis of a qualitative study, Ahmadi Lewin (2001) suggested that the secular and individualistic qualities of modern society might delay the development of gerotranscendence.

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Proximate Sociocultural Influence. The PTG model also posits that perceptions of growth are related to survivors interactions with the people in their imme-diate social environment. Calhoun et al. (2010) posit that individuals who had been affected by trauma yearn for self-disclosure and dialogue and thus PTG is related to the degree to which the proximate social context is responsive to such yearning. The proximate context can provide emotional support for affect regulation and role models of schema change. There is indeed broad empirical evidence that social support in the form of emotional comfort and modeling of growth from adversity are correlates of PTG in many places around the globe (Weiss & Berger, 2010b). Although gerotranscendence does not include a conceptualization of the role of proximate social context, Torn-stam (2005) found that social connection proxies such as being married and having children are related to gerotranscendence.

Change Correlates: Individual Characteristics

The PTG model specifies that pretrauma personal characteristics influence the degree to which individuals are likely to develop PTG (Calhoun et al., 2010). Individual qualities such as openness to experience, which affect the likelihood of engaging in the cognitive-emotional processing that yields PTG, are hypothesized to affect the level of PTG achieved (Calhoun & Tedeschi, 1998, 2006). Tornstam does not specify differences in personal characteristics (with the exception of age) as conceptual correlates of gero-transcendence. However, empirical studies (discussed below) did identify individual characteristics that are related to the level of gerotranscendence reported.

Age, a critical variable in the development of gerotranscendence, is not theoretically connected to PTG, and growth from adversity is conceptually possible beyond childhood anywhere in the life course. Empirical findings regarding the connection between PTG and older age are inconsistent. For example, in surveying the connection between age and PTG among cancer survivors, Stanton, Bower, and Low (2006) found that most studies reported nonsignificant relationships between age and PTG, with several actually finding an inverse relationship. Only the study (Kurtz, Wyatt, & Kurtz, 1995) that had a particularly broad age range (22-92 years) found a positive connec-tion between age and PTG. Kurtz et al. found that participants aged 50 to 79 reported the highest level of positive changes in philosophical/spiritual views. As expected, Tornstam (2005) found evidence that all three dimensions of gerotranscendence increase with age, with the trajectory beginning already in young adulthood. However, age effects differed by gender and gerotranscen-dence dimension. In men, the age variable was twice as strong as exposure to


crises (e.g., death of a love one) in explaining the variance in the cosmic dimension of gerotranscendence, but for women, age and crises had similar explanatory power. He interpreted the finding as a possible indication that crises are more important for womens spiritual growth than for mens.

Although neither PTG nor gerotranscendence link growth conceptually with gender, there is some empirical evidence that it is a correlate of per-sonal growth in both instances of growth. In PTG, women tend to score higher in overall growth. For example, a recent meta-analysis of 70 studies by Vishnevsky, Cann, Calhoun, Tedeschi, and Demakis (2010) found that women reported more PTG than men in published and unpublished studies (effect size was small to moderate). In gerotranscendence, women were found (Tornstam, 2005) to score higher than men on the cosmic dimension.

Socioeconomic status, education, and occupation as correlates of PTG have been studied in multiple sociocultural contexts from accident survivors in China (Wang, Wang, Wang, Wu, & Liu, 2012) to earthquake survivors in Turkey (Kili, 2010). Results have been mixed, partly because these vari-ables may be confounded with other individual variables such as ethnicity and use of spiritual coping (e.g., Berger & Weiss, 2006). Gerotranscendence, on the other hand, has been slightly correlated with higher income and mate-rial resources as well as civil service occupation in studies conducted in Scandinavian countries (Atchley, 2011; Tornstam, 2005).

The personal qualities and coping styles found associated with PTG in the context of diverse stressor events and cultures include optimism, openness to experience, active coping, and spiritual coping (Calhoun & Tedeschi, 2006; Weiss & Berger, 2010b). Similarly, Tornstam (2005) and colleagues (Hyse & Tornstam, 2009) found personal qualities such as optimism about problem resolution, openness to reinterpretations and reevaluations of life experi-ences, and active coping to be related to gerotranscendence. Using narrative analysis, Tornstam and colleagues identified a typology of older adults nar-rative styles. Individuals with higher gerotranscendence tended to narrate their lives as a hurdle race, engaging in mythical thinking and viewing themselves as fighters who overcame major difficulties. This type of mythi-cal thinking, related to the universal myth of the hero, has also been impli-cated in PTG (Weiss, 2005). It could be argued that mythical thinking pulls one into deep time (Rohr, 2011; Weiss, 2005), enabling a spiritual transfor-mation in time perspective and mythic consciousness, in both PTG and gerotranscendence. Thus, Hyse and Tornstam (2009) suggest, Could it be the case that achievement of a high degree of gerotranscendence is reserved for those who have lived life as a hurdle race? This question is still waiting to be answered (p. 25).

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Change and Wisdom, Well-Being, and Life Satisfaction

The personal transformation in both PTG and gerotranscendence is posited to lead to wisdom. There seems to be some agreement that although wisdom is not incompatible with young and middle adulthood, its development usually requires more extensive life experience (Baltes, Gluck & Kunzmann, 2002; Baltes, Staudinger, Maercker, & Smith, 1995). Tedeschi et al. (1998) sug-gested that what people learn from their life experiences, at any age, is what allows them to develop wisdom. And it was Tedeschis original interest in wisdom that led him to the focus on PTG and the possibility that rumination in the aftermath of a traumatic event might yield growth as well as wisdom. The PTG model assumes that the positive changes following adversity, cou-pled with acceptance of the changed world, may yield wisdom as recognition of the complexity of life, which may result in higher levels of well-being and life satisfaction (Calhoun et al., 2010). Not much empirical work has been done on the connection between PTG and wisdom, and the results regarding the connection between PTG and well-being/life satisfaction are mixed. For example, in a meta-analysis of PTG/benefit finding, Helgeson, Reynolds, and Tomich (2006) found that PTG was related to less depression and more posi-tive well-being but unrelated to anxiety and quality of life.

Gerotranscendence assumes that in old age, individuals may reach the final stage in the natural progression toward wisdom and that this wisdom is associated with improved life satisfaction (Tornstam, 1997, 2005). According to Tornstam, the worldview shift from materialism to cosmic transcendence that characterizes gerotranscendence is the hallmark of wisdom. This view is consistent with Levenson et al.s (2001) assertion that transcending the ego is a necessary step in the development of wisdom. Tornstam (2005) also suggests that gerotranscendence is related to a greater sense of satisfaction with life. There is some empirical evidence from qualitative data that among Turkish people, those high in gerotranscendence were also high in life satis-faction. However, there were older adults who were low in gerotranscen-dence and high in life satisfaction, indicating that gerotranscendence is not the only pathway to this end (Thomas, 2001).

Implications for Theory, Practice, and Research

It is evident from the juxtaposition of growth from adversity and growth with old age that the two phenomena have much in common. PTG and gerotrans-cendence are both based on salutogenic and phenomenological perspectives and posit growth in perceptions of self, relationships to others, and philo-sophical/spiritual worldview. Both involve active engagement in a process of


revising ones life narrative, meaning, and goals. Both conceptualizations recognize the possible role of the social context as a facilitator or inhibitor of growth, and both suggest that the growth might be connected with wisdom, well-being, and increased life satisfaction. As expected, the main difference between PTG and gerotranscendence appears to be the primary trigger for transformation. PTG connects the growth to traumatic events and the cognitive-emotional processing of the aftermath of these events, whereas gerotranscen-dence emphasizes normative later life experiences that are deconstructed and reconstructed. So what can we learn from the intersection of these two path-ways to personal transformation?

First, PTG could be conceptualized as part of normative adults develop-ment toward self-transcendence and an accelerator of gerotranscendence. Second, transformation in normative adult development is likely fueled in part by stressful losses and existential suffering. As Aldwin and Levenson (2004) argued, an explicit developmental perspective is missing from the conceptualization of PTG. They also argued that stress is an engine of human growth that needs acknowledgement in conceptualizing adult development.

The PTG model does not directly address the question of whether growth through struggle with intense psychological pain and loss is normative or qualitatively different from personality development along the life span. Joseph and Linley (2008b) argued that the latter is often assumed. However, Joseph and Linley explicitly theorize that PTG (at the individual level) is about normal personality development. They also emphasize that any time along the life course, people may encounter traumatic events and that the stress and positive changes that ensue are not dichotomous concepts related to pathology and health but natural parts of human development. In concep-tualizing PTG, they adopt a Rogerian assumption that people are intrinsi-cally motivated to grow and, if allowed, make organismic value choices that lead to fully actualizing ones potential. They posit that the trauma-related processes may, to a greater or lesser extent, be continuations or amplifica-tions of more normative life span developmental trajectories (p. 341).

Furthermore, the intersection of PTG and gerotranscendence might indi-cate that it would be more productive to conceptualize adversity-related per-sonal growth as going beyond Joseph and Linleys (2008a) self-actualization and culminating in self-transcendence, the last rung added by Viktor Frankl (2000) to Maslows hierarchy. PTG would manifest the push to actualize human potential and move toward self-transcendence as a developmental tra-jectory that can be accelerated by traumatic experiences, those beyond the expected crises in a particular life stage. Thus, PTG can be viewed as an accelerator of gerotranscendence, allowing the young to glimpse at what the

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Jungian analyst James Hollis describes as knowledge that the world is more magical, less predictable, more autonomous, less controllable, more varied, less simple, more infinite, less knowable, more wonderfully troubling than we could have imagined being able to tolerate when we were young (quoted in Rohr, 2011, p. 25).

Similarly, Levenson and Crumpler (1996) argued that adult development is aimed at emancipatory knowledge: liberation from biological and social conditioning. Thus, it can be argued that PTG, like gerotranscendence, is a reflection of a larger purposive developmental trajectory with liberation as its ultimate goal (Levenson, Jennings, Aldwin, & Shiraishi, 2005, p. 128). PTG would be viewed as a reflection of the natural human tendency to grow toward a higher level of consciousness defined by Cloninger (2008) as ever increasing awareness leading to recognition of cosmic coherence . . . which is also called the universal unity of being (p. 3).

PTG as a change in consciousness appears in anecdotal accounts. Tedeschi (cited in Rendon, 2012) reports the case of a military man whose helicopter was downed over Vietnam. While falling amidst gunfire, the man experi-enced a sense of peace and connection to everything around, including enemy soldiers. It was the reflection about this experience and the adoption of this worldview that signified his PTG. Similarly, Jill Bolte Taylor (2009), who suffered a massive stroke, describes PTG related to the experience of this sense of universal connection and the dissolution of the boundaries that make us feel separate from our world. It is interesting to note that these descriptions of shifts in consciousness resemble the breaks in the incessant brain chatter implicated in meditative practices associated with spiritual experiences. Indeed, Levenson et al. (2005) found evidence that self-transcendence is related to meditation, which indicates that the relationship of PTG and medi-tation needs further exploration.

The PTG/gerotranscendence intersection also implies the need to recog-nize the role of loss in normative adult development. Levenson et al. (2005) argued that the processes by which development occurs in adulthood are seldom addressed (p. 129). Levenson et al. (2001), in their liberative model, connect adult development with a struggle with loss as well as the loss of illusions in the face of trauma. And like gerotranscendence, they posit that the goal of development is the liberation from the socially constructed false self and related illusions allowing connection to ones true nature. They empha-size that in the aftermath of loss, adults can transcend the illusion of the self by experiencing the nonseparation of the ego from the fundamental ground of being. Moody (2005) also seems to emphasize the need to view aging as a growth process related not to eschewing of losses but to embracing them and the potential for gain they present. He reminds us that aging can be an


opportunity for spiritual growth because, as the Sufis say, When the heart grieves for what it has lost, the spirit rejoices for what it has found (p. 62).

The emphasis on spirituality or change of consciousness could hold the key to conceptual synthesis between PTG and gerotranscendence. It could be argued that PTG and GT are two facets of the universal human striving toward self-transcendence and imply the need to shift from the assumptions of positive psychology to Cloningers (2004, 2008) conceptualization of pos-itive philosophy. Cloninger suggests that individuals seem to be evolving along a path of ever-increasing awareness of cosmic coherence and that the transformation involves drastic shifts in self-awareness. He argues that the full human potential involves a progression from a materialistic worldview, through a dualistic consciousness that views individuals as separate from each other, to a nondualistic consciousness with awareness of the universal unity of being. He offers methods for assessing self-aware consciousness that might be helpful for studying personal transformation in aging as well as in the context of trauma.

The intersection of PTG and gerotranscendence also provides implications for practice. The role of a supportive sociocultural context cannot be underesti-mated in facilitating human growth. We have to insure that people, whether survivors of trauma or those grappling with aging, have opportunities for engaging in reflection and contemplation in a validating social environment rich with narratives of positive transformation. In working with older adults, Moody (1976, 2005) emphasizes the need to facilitate conscious aging. However, he cautions that it is important to recognize older adults needs to avoid a sense of rejection, receive social services, and have a sense of participa-tion in society. These needs must be addressed before self-actualization/transcendence needs can emerge. Wacks (2011) similarly reminds us, As Maslow (1968), Wilber (2000), Beck and Cowan (2006), and others have long advocated, we will need to address the first three of Moodys Stages before a consciousness based spirituality is likely to make itself known (p. 145-146).

Because both gerotranscendence and PTG emphasize growth as associ-ated with wisdom, there is much to be learned from research about these concepts connection with the broad and varied definitions of wisdom. For example, it would be important to explore the connection between PTG and McKee and Barbers (1999) definition of wisdom as the ability to see through illusions. A positive association between PTG and such wisdom will lend further support to the idea that PTG is not an illusion. Furthermore, connect-ing PTG to gerotranscendence, and conceptualizing it as related to develop-mental end states such as wisdom, should trigger further research into its relationship with other developmental peaks such as Fowlers (1981) univer-salizing faith (Bruyneel, Marcoen, & Soenens, 2004).

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The present article offered a conceptual analysis of PTG and gerotrans-cendence. This analysis should be empirically explored to gain better understanding of the connection between PTG and gerotranscendence. PTG as one of the precursors of gerotranscendence should be further explored in longitudinal studies. If spirituality is defined in Kierkegaards (1989) terms, as courage to embrace the unknown, then it could be argued that being pushed into the unknown by trauma and coming out with PTG would make it easier to face the end of life. This connection will have clear practice implications, namely, that allocating resources to trauma resolu-tion and facilitating PTG could be a way to improve adjustment to aging. Empirical exploration of the connection between the various dimensions of PTG and gerotranscendence is also indicated. For example, exploring the association between the PTG factor of spiritual change with the cosmic dimension of gerotranscendence could help deepen the understanding of the PTG worldview change. Thus, this article is a call for continued explo-ration of the diverse and overlapping pathways to personal transformation as exemplified by PTG and gerotranscendence.

Acknowledgment

The author thanks Drs. Rich Tedeschi and Lars Tornstam for their reviews and gener-ous comments.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publi-cation of this article.

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Author Biography

Tzipi Weiss is an associate professor at Long Island University Post Department of Social Work and director of the undergrad baccalaureate program. She teaches under-graduate and graduate courses. She is also a clinician spe-cializing in the care of older adults and their families. She studied the biological, psychological and social aspects of human behavior and received the following degrees: BA from Tel Aviv University; masters degrees from Israels Institute of Technology Medical School (MSc), Columbia (MA), and Adelphi (MSW); and a DSW from Adelphi University. Her research in the area of stress and coping has focused on the experiences of people encountering life cri-ses or trauma. She has studied the responses of women with

breast cancer and their husbands and their tendency to report not only pain and suffer-ing but also some benefitsa phenomenon called posttraumatic growth. She has also studies the positive changes in the aftermath of a struggle with traumatic events in the context of immigration. She has published her work in key professional journals, including Psycho-Oncology, the Journal of Psychosocial Oncology, and the Journal of Social and Clinical Psychology. She has contributed book chapters and coedited a book on posttraumatic growth in cross-cultural perspective.

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Personal Transformation Posttraumatic Growth And Gerotranscendence