Turning Points and Transitions on the Hero's Journey: Posttraumatic Growth and Transformation in U.S. Veterans

Background and Purpose Turning points (i.e., events, experiences, and awarenesses marking a change in one's life path) can serve as opportunities for change for veterans recovering from war trauma (Kerr et al., 2019; Bray & James, 2019). Elder and colleagues (1991) explored the concept of turning points within the context of a life course perspective, focusing on how military service could dramatically alter one's life trajectory. Following military service, many veterans with posttraumatic stress injuries embark on a journey of recovery in which they transform their trauma to find meaning and purpose. Most war trauma research has focused on the deleterious effects of posttraumatic stress and factors related to posttraumatic growth (Xue et al., 2015). However, less is known about what turning points are most likely to result in posttraumatic transformation (i.e., channeling trauma into positive societal contributions beneficial to themselves and others, e.g., volunteerism, public service, social advocacy, and creative works). Building on the framework of Campbell's hero's journey narrative and incorporating insights from life course perspective (Elder et al., 1998), we explored how turning points contribute to the broader posttraumatic transformation of trauma-exposed veterans, fostering their growth.

Methods: We recruited U.S. veterans with military-related trauma via flyers, Facebook, and snowball sampling to complete a QuestionPro survey. After eliminating duplicate, missing, and disingenuous responses, we conducted a qualitative thematic analysis of 310 responses to an open-ended question about turning points spurring posttraumatic transformation. Using QDA Miner qualitative software, two researchers independently coded participants' responses, and a third researcher resolved disagreements. Participants ranged in age from 20 – 75 (M=34.34, SD=9.63) and were males (68.9%), females (28.3%), and nonbinary (0.9%). Race classification was White (82.5%), American Indian/Alaska Native (0.9 %), Black/African American (7.4 %), Asian (1.8 %), Bi/Multiracial (3.1%), and 35.6% identified as Hispanic. Most were married (60.7%) and served in the Army (59.08%).

Findings: We uncovered 94 unique turning points leading to a transformation. More than one turning point type was reported by 25% (M = 1.24 , SD = .05), and 24 (7.7%) could not determine a turning point. Eleven categories were distilled into six supraordinate event categories by case frequency and percentage: (1) supportive relationships (e.g., family support: 197, 60.6%); (2) personal growth and development (e.g., perceptual shift: 129, 41.6%); (3) getting help (e.g., entering treatment: 88, 28.3%); (4) adverse events and crises (e.g., suicide attempt: 38, 11.9%); (5) normative life events (e.g., birth of child: 32, 10.2%); and, (6) spiritual/religious change (e.g., discovering faith:10, 3.1%).

Conclusion and Implications: This research adds to the social work discourse by identifying turning points that may facilitate trauma-exposed veterans' journeys toward higher levels of posttraumatic growth. Findings highlight the importance of social support, a malleable asset that can be bolstered through targeted services designed to improve the ability to form, utilize, and sustain social relationships. Further, strengthening social and societal support systems can provide crucial opportunities for personal growth, identified as the second most common turning point and essential for veterans' post-service reintegration and healing.