Journal of Traumatic Stress Disorders & Treatment .ISSN: 2324-8947

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Research Article, J Trauma Stress Disor Treat Vol: 9 Issue: 3

Exploring the Connection between Gender Roles and Posttrauma Growth

Amanda Metcalfe1*, Phillip Morris1 and Richard Delewski2

1Department of Mental Health, University of Colorado Colorado Springs, USA

2Insight Behavioral Dynamics, LLC, USA

*Corresponding Author: Amanda Metcalfe
Department of Mental Health, University of Colorado Colorado Springs
Tel: 7196505675
E-mail: [email protected]

Received: May 01, 2020 Accepted: June 25, 2020 Published: July 02, 2020

Citation: Metcalfe A, Morris P, Delewski R (2020) Exploring the Connection between Gender Roles and Posttrauma Growth. J Trauma Stress Disor Treat 9:2. doi: 10.37532/jtsdt.2020.9(3).203

Abstract

Gender roles may play an important part in an individual’s response to trauma and is an area of trauma treatment that has lacked empirical focus and treatment planning attention. Defined here, as the personal growth that occurs after traumatic experiences, Posttraumatic Growth (PTG) refers to the benefits of experiencing and overcoming adversity. In examining psychological theories of resilience, aspects of gender norms in the context of posttraumatic growth processes is not well understood. Here we use qualitative methods to investigate how perceptions of gender roles relate to sense of self-efficacy and the ability to grow from traumatic experiences. With this realization, we present results that express ways in which clinicians can use gender role experiences to better support growth after trauma. Findings point to the ways that genderrole mixing, role strain and gendered response to trauma, inform the PTG process. By exploring gender roles in trauma recovery, this research provides valuable insight for social service systems and broader helping communities. Moreover, we suggest that such findings can improve psychological treatment, social welfare and help transitional support specialists to be more effective in their direct support of trauma survivors and their families. This research also informs studies on the relationship between gender role and mental health and can help to ultimately increase resilience for those exposed to trauma.

Keywords: Trauma, Post-traumatic Growth, Gender roles, Recovery, Veterans

Introduction

Approximately eight million adults suffer from PTSD symptoms each year [1]. Many studies have focused on PTSD treatment, coping with/managing symptoms, public health approaches to trauma and resilience and even on pre-dispositions and physiology as it relates to PTSD [2]. The relationship between cultural norms and trauma recovery has likewise been discussed in the field of social work and clinical counseling [2]. For example, military members and first responders who experience trauma may have difficulty seeking help due to group stigma that comes with PTSD [1]. Scott t al. [3] found that competing roles (work, family and social milieu of the military) created strain and predicted intrusive PTSD symptoms for U.S. Army National Guard soldiers exposed to combat. Gender roles were not explicitly identified/studied by Scott et al. [3], but expectations around gender may be an important consideration for response to trauma.

Although gender is a primary product of a socializing process that shapes us as individuals and creates a mindset for behavior and response [4], scant published research focuses on the relationship between gender roles and posttraumatic growth (PTG). Defined as the personal growth that occurs after traumatic experiences, PTG refers to the benefits of experiencing and overcoming adversity [5]. Examining the ways in which gender roles factor in this experience of “positive change” can enhance our understanding of the human experience of trauma and enhance the success of social action in supporting individuals through recovery from trauma [6].

Martin [7] discusses gender as a social institution that is as historically powerful as family, economy and polity. Understanding gender roles as maneuverable social constructions is an increasingly important focus for social scientists. People generally act with purpose, but the effects of their actions are often unintended. Martin [7] describes this phenomenon as “un-reflexivity.” The absence of reflexivity in our thinking makes gender a powerful social institution, potentially causing harm. Cultural context is an important contributor to both gender roles and PTG, as culture draws from a community’s legacy of trauma then consequently impacts societies and individuals [8]. The power of social change lies in reflexive awareness, therefore research on gender roles and PTG can serve as a catalyst for social action, particularly in communities with high exposure to trauma. The following review of literature frames our research and provides a foundation for the line of inquiry followed.

Literature Review

Trauma is a human condition, one that all societies experience. A plethora of research marks characteristics that contribute to trauma symptomology. Diverse psychological factors continue to be studied in examinations of the effects of trauma. This review, however, is intended to explore extant research around the relationship between gender roles and PTG. Here we examine the relationship between socialized gender roles on an individual’s ability to grow after adversarial events. It is accomplished through qualitative interviewing and categorical aggregation of themes presented by participants who have struggled with the human condition of trauma. What guides this review is a framework that questions the gender-role elements that contribute to an individuals’ PTG. Actionable steps for improved care will be presented through the conclusive themes of this review.

Gender roles

It is important to understand whether gender, or one’s representation on the spectrum of gender roles, affects individual resiliency at a psychological level. Are men and women born psychologically different, or are their internal responses to trauma a result of socially prescribed gender roles? Eagly’s Social-role Theory describes the path of men and women in work, in relationships and in response to environments as one determined by the gender roles we take on, normalize and behave within [9,10]. Eagly also points out that these roles are quite flexible and dependent upon our social environment. They are not purely psychological differences. Hyde [11], in a meta-analysis of psychological gender differences, concludes that men and women are in fact very similar on most psychological variables. These findings suggest that differences occur as adaptations to social roles, rather than from psychological characteristics inherent in men and women. Social-role Theory claims that gender role expectations contribute to how an individual responds to and perceives experiences. It implies flexibility since gender roles are dependent on the immediate social-role demands of an individual; they are non-inherent and can frequently shift. This theory points toward a person’s capacity to shift perception of gender roles and, in turn promotes a capacity for growth.

The socially held belief that men and women are born to behave a certain way comes at a social cost [12]. Such beliefs create stereotypes of masculinity and femininity in relationships, in the workplace and in contending with adversarial events—often with dire social consequences. Gloria Steinem [13], widely regarded as a champion for social and political justice for women, notes that violence is always more extreme in societies where gender roles are polarized. For trauma survivors, stereotypes of masculinity and femininity are likewise a source of concern. Growth requires self-efficacy and self-awareness that allows one to comfortably be authentic. In the field of social work and clinical psychology, authenticity is the agency by which emotional change safely occurs. For some, this might mean remaining outside the lines of stereotypical femininity and masculinity and broadening one’s utility of gender roles. This would allow for self-esteem and selfefficacy to develop rather than remain constrained due to gender-role expectations [14]. A model of treatment that addresses gender-role expectations may be an important way forward for trauma workers [4].

Although literature within the fields of gender and trauma point to differences in the ways that men and women relate, cope and grow [14], social-role theory purports that these differences arise not from inherent psychological differences between women and men, but from the societal expectations associated with gender roles. Socialrole theory explores the differences between men and women through observable psychological studies of social behavior and compares these findings to those of role distribution [9,10]. Social-role theorists discuss self-construal as an individual’s cognitive assessment of selfversus- others, accounting for gender differences as spectrums of roles and statuses taken on by men and women [15]. They predict that when men and women fill the same roles, then behavior is not as controlled by gender role expectation, but by the expectations of the role itself; in such a case, the power of gender roles is eased [10].

Posttrauma Growth (PTG)

To understand PTG, we begin with the activating conditions. This is useful because it assists us in understanding how individuals tend to view their own growth after trauma. The Posttraumatic Growth Inventory (PTGI) created by Tedeschi and Calhoun [16] posits five possible dimensions of growth. The five dimensions identified include: relating to others, new possibilities, personal strength, spiritual change and appreciation of life. These dimensions can be used as a lens through which to view the conceptual relationship between gender roles and trauma. For example, individuals may apply gender theory when thinking about personal strength after trauma. As noted in our literature review, men are more likely to view themselves as needing to be strong through trauma. Deploying such strategies can fine tune a helper’s observations when understanding the role of gender in PTG. Additionally, these dimensions serve as reference for triangulation when discussing any study covering PTG.

Wortman [8] assessed PTG through a qualitative interviewing process that involved open-ended questions about participants’ current life experiences. Results showed that most participants experienced one or more elements of growth. It is important to note that analysis of growth has been quantified and measured but does not suggest an absence of negative effects due to trauma. Negative outcomes, such as intrusive memories, avoidance of the memories, interpersonal stress and hyper-vigilance, have been shown to coexist with PTG [17,18]. This non-distinction is a marked limitation of the PTG development work of Tedeschi and Calhoun [16]. The conceptual foundation of PTG has, nevertheless, opened new doors in achieving resiliency and growth. A host of studies, referenced below, illustrate the implications of gender roles as they apply to PTG and therefore the necessity for expanding forms of trauma treatment to consider the social origins of each client.

Gender roles and trauma

Ample analysis of how gender affects the psychology and coping of an individual have been extensively drawn upon by researchers. Self-efficacy and identity are moderators of an individual’s ability to relate, respond and grow—all components necessary for an individual’s capacity for growth [19,20]. The following empirical studies discuss gender role differences as a powerful influence on how men and women experience and recover from trauma. McLean and Anderson [14] discuss the gender differences of experienced fear and the coping differences in dealing with fear. They note that women are more likely to develop anxiety disorders due to gender-related and etiological factors, relating many anxiety traits observed in women to gender socialization. There are numerous factors associated with the gendered response to trauma and evidence has become increasingly supportive of society’s role in those responses. Kira et al. [21] discuss the mediating effects of social-collective identity stressors and trauma upon PTSD. They conclude that studying trauma in the absence of social-identity can be misleading and that an individual’s social and status identities, to include gender, intersect the severe stressors that create trauma. Thus, it is important that we deepen our understanding of PTG by studying the collective social factors that contribute to or inhibit growth after trauma.

Masculinity and expression: Mejia [4], explores the burdens men feel by the high-pressure standards of masculinity, stating that social standards associated with masculinity create an altered view of self in the context of trauma. Mejia [4], in the same vein as social-role theory, examines men and women’s experiences of trauma through the lens of gender theory, as opposed to only innate psychological and behavioral traits. She found gender roles to be so powerful that she recommends beginning treatment for male trauma survivors by redefining masculinity and its legacy.

Affleck et al. [22] qualitatively explored the unique mental health stressors of refugee men with their experiences of war. They drew attention to the following theme:

Gendered helplessness of war: participants commonly reported ongoing negative rumination regarding experiences where they were unable to adequately protect loved ones from physical suffering or death.

They discussed the overwhelming appraisal that self-sacrifice and protection of others was embedded within the psycho-social experiences of these men. Themes showed that war trauma was more overwhelming experienced, not by the event itself, but by the situations in which they could not protect others from suffering. The appraisal of their war trauma landed in helplessness and a belief that “men should protect.”

A qualitative study by Chesler [23] examines gendered stressors specific to men when coping with a child diagnosed with cancer. The stress of contending with the crisis was found to be compounded by the need to fulfill a gender role, which challenged the men’s ability to cope and access supports. The cultural norms and expectations of masculinity played a significant role in shaping these fathers’ experiences and defining the ways in which they dealt with the emotional and social stress related to their crises. Chesler found that it was difficult for men to express strong feelings, which created a “strong and silent” coping approach [23]. This manner of coping consequently created a denial of feelings and delayed the men’s access to emotional support, even leading to friction within the family because their response differed significantly from that of their wives. From the standpoint of growth, some men reported positive changes due to newfound understandings of their family members, as well as transformations resulting from dealing with a child’s cancer. Several men reported that the positive effects were in part related to psychological counseling, further suggesting that when men do reach out for support during recovery, positive effects follow.

Cognitive appraisal: Kurt Lewin [24] in his classic efforts to explain gendered behavior [B=f(P, E)], stresses the importance of both person (P) and environment (E) in predicting behavior. An individual’s appraisal of a situation or event then depends as much upon social-regulation as it does upon self-regulation [21]. Longitudinal studies by Linley and Joseph [17], review the cognitive appraisal variables that predict PTG and find that positive reinterpretation, acceptance coping, internal religiousness, optimism and positive affect likely lead to PTG. Their findings minimized the impact of gender and highlight the importance of cognition appraisal for responding to trauma in a pro-growth manner. While several studies have suggested that women tend to experience higher levels of PTG [4,17,25,26] identify gender to be a mixed predictor of PTG. They use a much smaller sample size than others and show a nonsignificant trend in the direction of women reporting more growth. Nevertheless, the cognitive appraisal skills suggested by Linley and Joseph [17] relate to social-role theory and can be applied to this study through examining the cognitive or self-examining patterns emerging from interviews.

Support seeking: Looney [27] examines the relationship between support seeking barriers and PTG using a sample of 1140 Army Reserve National Guard soldiers. He finds stigma related barriers to be rated as more salient than institutional factors in care of PTSD. “Within the military there exist real and perceived barriers preventing service members from receiving mental health treatment, which may also inhibit PTG” [27]. His study demonstrates that both formal and informal social support plays a vital role in PTG. Swickert and Hittner [28] discuss the levels of PTG that occur between men and women by looking specifically at social support coping. Within a study sampling 220 college students and community adults, they find gender to be significantly associated with social support coping processes. Data from post trauma measures show that women, who are more likely to seek social support in times of stress, reported higher levels of PTG. Furthermore, they found that support-seeking behavior in men is largely discouraged as a response to stress. This discouragement can be damaging for males, as support seeking in response to stress leads to positive healthy and emotional outcomes. They conclude that support seeking is significantly correlated to PTG and that women who exhibited more frequent support seeking behavior reported higher PTG [28].

Summary of Literature

The above review illustrates the importance of recognizing the role of gender in PTG. Research in this area has pointed to a proclivity of men to:

1. Inhibit expression of emotional pain

2. Exhibit a “strong and silent” coping approach

3. Experience demands of masculinity that affect the construction of self in gender-roles which lead to role strain in coping processes

4. Be less likely to seek support

5. Experience support seeking barriers

Both men and women experience PTG when:

1. Using pro-growth cognitive appraisal of adverse situations

2. Experience positive emotional outcomes when using social support coping

3. Experience higher PTG when exhibiting more frequent support seeking behavior.

The extant literature posits that coping responses such as progrowth appraisal and support seeking behavior promote PTG for both men and women. However, men experience more barriers both internally in their appraisal of what is expected of them as men and externally in their comfort readiness to reach out for social support. This problem raises a series of questions, e.g. what resources are available for trauma workers to address these barriers and what social plans-of-action might we develop with the knowledge of the function that gender roles play in these barriers?

Purpose of the Study

Support-seeking behaviour is a social proposition that men struggle with. The literature reviewed above notes how gender role norms contribute to differences in behaviour and psychological response to trauma, which can be socially driven preferences that are flexible and non-innate. Therefore, a client’s response to gender norms may be a crucial lever within therapeutic systems. The following research is intended to examine individual experiences to better understand how gender norms relate to trauma and how this knowledge can contribute to healthy coping, recovery and growth. Using a social-role lens and the PTG framework developed by Tedeschi & Calhoun [16], this study aims to explore the felt experiences of trauma survivors as well as the multiple effects gender roles may have on recovery and growth.

Methods

The relationship between gender roles and PTG is explored here through a qualitative method analysis using social-role theory framework. Qualitative, semi-structured interviews were used to explore the effects of gender roles on trauma growth. Fifteen participants with varying types of trauma were recruited. The path of interview questioning developed through use of literature summary trends on PTG and gender roles. Finally, an inductive analysis was accomplished through thematic coding of interview data. The following sections provide greater detail of each step comprising the research methods.

Research questions

Three research questions guided this study.

1. According to individuals who have experienced some type of trauma, how do gender roles affect PTG?

2. What are the social-action implications of the effects of genderrole traits on PTG?

3. How can helping professionals use knowledge of gender roles to create healthy coping, behaviour and growth?

These questions encompass more specific inquiries about coping and the meaning an individual prescribes to gender roles. From their answers to our questions, we learn their personal perceptions of gender roles and how those roles relate to their ability to grow after trauma. The ways in which individuals cope with difficult events and use their support system to initiate growth is specifically examined to address differences highlighted in existing research. A primary goal of this research is to discover findings that can be applied practically to trauma treatment in local communities and influence social action.

Research design

The current study is best described as a transformative social inquiry. Creswell [29,30] described qualitative transformative design as one that captures the complexity of a problem within a community by focusing on a specific population. Transformative design involves a convergence of information that exposes social inequality, then creates solutions based on that information [31]. It is useful for attempting to confirm, cross-validate and corroborate findings using an advocacy lens. Such design promotes voice and call for diverse perspectives that advocate specifically for the research participants. By nature, it creates better understanding of a phenomenon that may be changing as a result of being studied [32,33]. In the case of trauma, transformation occurs when we use knowledge of relationships (gender and PTG) to create clinical applications and social action plans. Semi-structured interviews were conducted to explore participants’ workings of gender-role construction and the ways PTG occurs within this framework.

Theoretical frame

Social-role theory evolved from a desire to better understand sex differences, where those differences were explored from a psychological and social perspective [10]. It is the charge of socialrole theorists to explore commonly occurring sex differences by examining the characteristics of roles typically held by men and women. This research uses the theoretical framework of social-role theory to guide the process of understanding each participant’s gendered experience of trauma. Using a process of inquiry that aligns with social-role theory, a new lens of gender can be applied to the conditions by which PTG may occur. An integrated interpretation was used to address the subjective nature and varied meaning of growth for study participants. Figure 1 demonstrates the integration of social-role theory into the interview questioning.

This process of logic begins with what we know about our society (Societal role structure base). This was provided within the literature review and through use of Eagly’s social-role theory of gender in our society. For example, many trends emerged from the literature review, a salient one being men’s use of social support. Through the interview and questioning process, differences transpire around the targeted factors of gender role behaviour, support systems and cognition (the questioning process and variation in these factors is explained further in the methods and results sections). Finally, conditions are formulated based on the themes developed from the interview data. They can be viewed as conditions by which participants experience greater PTG.

Participants

Participants were recruited through community trauma partnership venues to include a local non-profit for women’s social enterprise, Women’s Bean Project (WBP). Most WBP clients are recovering from domestic violence, abuse, imprisonment, or drug addiction. Other participants were approached through community social-service organizations or individual community counsellor practitioners, all of whom counsel trauma survivors. The ages of participants range from 20 years to 58 years old. Participants all reside on the Colorado Front Range: Denver, Colorado Springs and Canon City. Of the 15 participants who participated in the interviews, ten were female and five were male. Table 1 presents demographic information and the types of trauma each participant experienced. The participants for each interview were chosen purposely and specifically because of the distinct nature of their trauma experience. (Table 1)

ID Sex Age Range Types of Trauma
1 F 3 Emotional/physical childhood abuse and Lymphoma terminal cancer current
2 F 4 Significant-other attempted suicide
3 F 4 Emotional/physical childhood abuse, one suicide attempt
4 F 5 Emotional/physical childhood abuse
5 F 2 Emotional abuse childhood, domestic violence, homelessness
6 F 4 Emotional/physical childhood abuse, chronic illness current, domestic violence
7 F 2 Drug addiction, psychosis, mother committed suicide, imprisonment
8 F 2 Death of two children
9 F 2 Childhood abuse, chronic illness current
10 M 4 Imprisonment
11 M 3 Emotional/physical childhood abuse, witnessed sibling abuse, combat trauma
12 M 4 Gunshot wound, permanent paralysis
13 M 3 Sexual childhood abuse
14 M 5 Three cancer diagnoses, currently cancer free
15 F 2 Witness to fatal accidents, 1st responder
Note: Age ranges represent number times ten, e.g. 4=40s.

Table 1: Interview Participant Description.

The interview

With this sample, a safe method of inquiry was developed to examine the experience of individuals who have experienced a wide range of trauma. Each participant was recruited only after discussion and explanation of the research process by the investigator or their clinical practitioner. A semi-structured interview with the principal investigator was conducted with each participant. Interview protocol was guided by a social-role theoretical framework presented in Figure 1.

Figure 1: Social-Role Theory diagram adapted by authors.

Qualitative research interviews are often used for asking pointed questions about specific social concerns [29,30]. Mauthner and Doucet [34] discuss the contribution of qualitative interviewing using the epistemological assumption that intellectual and emotional reactions show up in an interview and should be used as reflexive sources of knowledge. An interview allows for a social and emotional situating, in relation to the participant, that recognizes important forces of socialization. Social-role theory approaches social knowledge as both prescriptive and contextual, as the social norms of a group depend upon context as much as they do upon the way in which a norm has become accepted. This approach was instrumental in creating questions for the interview.

Each interview was guided by the following six questions:

1. What are some ways that you cope with difficult events you have experienced in your life?

2. What does your gender role mean to you?

3. When you think about the difficult events in your life, how does your gender role promote growth and coping?

4. For you personally, how does your self-concept of gender roles inhibit growth and coping?

5. What are some traits in the opposite gender that you admire when you think about dealing with difficult events?

6. How does your support system help you in your personal growth path?

The use of support systems, trends in coping, perception of events with the use of gender role concept, self-concept of gender and thoughts about opposite sex coping are built into the design of the interview questions. Prior cited research has shown these processes to relate significantly to PTG. The interview approach was developed by a researcher and counsellor who have participated in thousands of counselling hours focused on the nature of trauma recovery and growth. The interviewer was knowledgeable of community needs related to trauma and skilled in person-centred therapy, holding a Colorado State Professional Counselling License (LPC). The participants in each interview seemed forthright and transparent in their response to questions. Each participant had been involved previously in some type of therapeutic intervention and therefore appeared comfortable with the interviewer when discussing therapeutic details.

Qualitative data analysis

The findings of this analysis were derived inductively, applying specific observations to broader generalizations and inferences regarding PTG. Constant comparison while aggregating data was used to acquire themes from coded data. Themes surrounding the felt experience of trauma and the effects gender roles have upon those experiences emerged through the analysis processes. A valued spectrum of gender roles and the processes by which participants dealt with difficult events in relation to those gender roles was a focal point of analysis.

All interviews were recorded through detailed memos by the principal investigator. Each interview averaged about one hour. The coding process for the interviews provided aggregated categories, which were then used to build pronounced themes. This approach follows the general guidelines of qualitative data analysis strategy discussed by [29,30,35] wherein significant phrases are: (1) coded; (2) aggregated into categories; (3) developed into meaningful themes; and (4) presented in a comprehensive description of the social and psychological essence of PTG. Analysing the interview data involved defining themes that had significant growth impact upon the participants. In this case, detailed and verbatim excerpts from the interviews were placed into Dedoose, a qualitative analysis software program and then coded according to multiple occurring patterns that emerged from the fifteen interviews. Coding terminology was derived from frequently occurring statements within the interviews. After three tiers of coding, prominent themes and patterns were identified using a frequency table. To build a trustworthy study, subsequent persistent observation was used to validate coding [36]. Credibility was further established through member-checking so that thematic codes, themes and interpretations of the researcher could be confirmed by participants.

Findings

Three categories of discussion emerged from the interviews: gender-role mixing, gender-role strain and response to trauma.

Gender-role mixing

Both the men and women interviewed discussed admiration for traits present in the opposite sex revealing, in turn, their broader appreciation for gender roles. They noted desire to freely operate and express within both male and female roles. Gender-role mixing can be defined as both masculine and feminine traits holding value in context of societal roles. Women in this study appreciated being able to be conventionally feminine while exhibiting many masculine traits. Men were the same; they noted an appreciation for being able to demonstrate conventionally feminine traits such as emotional expression and compassion. Men noted an admiration for female traits, with compassion being the most admired.

With the men, however, their own expression of feminine traits was not described as socially accepted. When asked about what gender roles meant to him, one male participant stated:

I don’t subscribe to gender roles having faults, admitting/ expressing emotions, being comfortable sharing things that get you emotional. I do not view that as weak. However, there are only a few men that I can share with. I am able talk about stress with anyone, but am unlikely to because of how they perceive their gender roles.

This participant’s answer reflects his appreciation for the ability to express in a way that is more notable in the feminine role. He commented several times on the dangers of clinging too tightly to gender roles, mostly for emotional expressive reasons. Another participant offered his perceptions of gender roles in today’s society.

Its what society teaches you is important and appropriate for a man and a woman—that’s assuming that society will teach traditional roles without fluidity. Society is still focused on traditional roles. There isn’t much thought put into how they are teaching those roles. Most people won’t give it much thought; they just give it lip service.

Here he indicates a concern for the way that society obliviously confers narrowed gender roles onto people. His concern is both for what gender messages are instilled and how it is done in almost an implicit manner.

Both men and women felt that gender-role mixing allowed them to share roles within the home. Most women commented positively about being able to demonstrate masculine traits in their environments such as stoic, strong, physical and confident. They likewise reported an appreciation for the ability to be independent in their expression and felt gender roles were societally prescribed. Men too valued independence in gender and agree that gender roles are societally prescribed rather than intrinsic to the sexes.

Men expressed, that for them, leadership and the ability to give support were important qualities when dealing with stress. The traits reported by women to be most admirable in men included balance, the ability to hold back emotion, strength, being action-oriented and the ability to “let go.” One woman described with some frustration the caution that existed for her in expressing anger and frustration— the opposite being true for men expressing these emotions:

I think men can act out more without repercussion. There is more of a willingness to accept their physicality. They can hit, punch, crash, drive fast and they are not questioned. A man can be aggressive and know what he wants. A woman is called names if she acts this way. It’s ok for men to be angry and blow up, ok for men to have strong sense of self and confidence.

Another woman described her admiration for what she sees men allowing themselves to express: “traits in a male today I admire are more natural, emotional and assertive, rounded, not just aggressive, but with courage in spite of fear to take action.”

Many of the men admired female traits such as the ability to express, the ability to ask for help and compassion. Overall, the ability to express and feel compassion was the highest-rated admirable traits between the sexes. A consistent pattern within the interviews was admiration for traits of the other sex and a desire to be able to behave in fluid ways. The data show that men are more tentative in behaving in society in gender-role mixed ways, even though they exhibited great admiration for female gender-role traits.

Gender-role strain

Gender-role strain is a major focus of this research. This theme emerged from the data when participants described their perspectives on gender based on social messages, cognitions and biases. They spoke from the position of broader social norms, consistent with social-role theory where exacting perspectives on gender roles were associated with inhibition of growth. Gender perspective mostly captures the individuals’ intrinsic views of gender based on their own personal experiences. Participants often described their experiences of gender as children and the ways that their parents placed socially constructed micro demands upon them. For instance, one participant, who experienced the loss of two children, describes the following role strain as a mother:

Being at home as a mom there are certain expectations that you need to accomplish. It’s hard to meet them. I put it on myself that this is what others expect; they should of having kids etc... It’s me pressuring myself, not my friends and family. My mom was at home. She set a bar. She did everything, fresh, homemade, a big bar for stay at home mom. I try to reach it. Some short comings exist. She showed us the outside and worked in the home. I try hard to go play with my kids like my mother did.

This participant went on to express a struggle with guilt in not “snapping out” of the grief she experienced with the loss of her two babies. Though she is attentive to her role as mother, there is extra strain mentioned here, a “bar” that is constantly in her awareness as she accomplishes motherhood now.

Further, results indicate that men perceived themselves as more compassionate than other men. When men find themselves to be compassionate (to a greater degree than other men), a societal role demand is created. Men participants expressed the importance of compassion and show of emotion, but not the societal acceptance of its expression. One man describes this pressure:

When you think about gender roles, male/ female, I’m supposed to be a strong man, take care, build, protect. I’ve tried to be that person. I’ve tried to talk to people with my physical abilities (building, providing, caring) because I don’t feel like I can offer emotional support.

An implication of this might be that behaviour and psychological responses to trauma might shift when placed within certain societal contexts. These findings are consistent with Chesler’s finding that men found it difficult to show caring and compassionate feelings and felt, rather, that they were expected to be a “rock” for the family. Additionally, Chesler finds men to be less in touch with their feelings during difficult events. Interestingly, in this study, men appeared to perceive themselves as compassionate but were less likely to display compassion in their social environments [23]. Mejia argues that young men are often made to feel ashamed when they show feelings other than anger and that men tend to adhere to an independent interaction within their social setting.

A female participant recovering from an abusive relationship and recently given a lethal cancer diagnosis describes the relationship of gender-role to her own trauma in this way:

It doesn’t promote growth. I have a reputation as the sick weak unreliable, the woman whining. That’s from other women! Men friends call me strong and unbreakable, younger women are bullies. I lost most close girlfriends with my cancer. A million excuses they had. The men came to see me. I was questioned about friends and sex partners by women.

This participant describing strain set forth by other women to be reliable, exhibit a humble submission to her illness and even to be sexually subdued. In line with this quote, most women described the perception of other women being more deferent than them. Within the framework of social-role theory, this trend is much like the one pertaining to men and compassion. There may be an expectation that women behave with deference, creating a conflict in role adherence. When women perceived a trait or behaviour to be more descriptive of other women than of themselves, a role modification is created from social-role expectations [10]. Mejia relates this phenomenon to oppressive social structures present in society [4].

When asked about dealing with difficult events, three women reported having negative role models and one reported having a good female role model. Most men reported being pressured toward masculine behaviour by one or both of their parents, a prominent example being the “boys must not show weakness” mentality. None of the men reported having a male role model that contributed to support-seeking behaviour.

Each participant was asked about how gender roles might inhibit growth. All women associated features such as being viewed as unempowered to be inhibiting of their personal growth. Most women expressed feelings of pressure, expectation and confinement within their gender role. Many reported difficulties meeting feminine roles and feeling compelled to act a certain way. A woman noted this view: “labels confine and restrict and women are viewed as week and emotional- that’s a negative.” Another woman describes it in this way:

When I think about gender roles and trauma I don’t feel empowered. It [the trauma] helps me to be a better mother, protect kids and work harder in life to get where I need to be. It drives me study criminal justice.

Most men reported feeling underpowered and considered this feeling to be the number-one barrier to PTG. They reported difficulty with fitting masculine ideals, feeling pressured to act a certain way and limited in their ability to express themselves with others. Collectively, being viewed as underpowered was the top-reported reason for inhibited or restricted growth for both men and women.

A woman who experienced childhood abuse described her early experience of gender socialization:

Maybe not allowing myself to be as vocal about what I need and want. I came from a family where you don’t speak up, make waves and stand up— especially the girls. My brother was criticized for not being tougher, stronger. Mom was fragile. Dad took care of her. It’s the learned patterns expected for my gender. My dad didn’t think I needed college, just get married. Being a lesbian gave me freedom to start breeching these.

One male participant described his frustration with his decreasing ability to physically keep up and contribute to his family: “physically, I can’t do what I used to. It creates frustration on my end; that is how I have always contributed and done my part.” Here we see an internal struggle to accomplish what men have been socialized to accomplish for the family.

Positive perceptions of gender roles also surfaced. Men found many gender roles, like being a good father, a good partner, a good role model, being protective and being courageous, to be constructive in the growth process. Women remarked that qualities such as hard working, motherhood and nurturance were present and important within the female gender role spectrum. That being said, most women also reported finding strength in opposing typified gender roles. Promotion of growth for one male participant was described as:

Being a good partner, friend, good father, to be a listener, compassionate, available, a role model, but also willing to follow and seek out other role models.

A gentleman who was paralyzed as a young man described what gender role means to him by discussing how he feels compelled to take care of his wife and family:

Taking care of her with her emotional needs, sexual needs. Making sure she is cared for, it’s reciprocal. I want her to be happy. It means being a spiritual leader. I’m a fixer—what’s your problem so I can solve it, sometimes to a fault. I fix it when they need me to.

Here the power and necessity of gender roles is noted by participants, but it comes with a cost. Men and women do compare themselves to others and rate their own competence when it comes to prescribed gender roles. They describe strain, especially when they are unable to maintain or fulfil what they have in their own sense of efficacy prescribed as normal in the post trauma growth process.

Response to trauma

Two areas of response—use of support systems and coping skills—were discovered through the analysis. Mejia’s [4] describes gender roles as being significantly related to one’s sense of hope, individual resilience and transcendence. Larner and Blow [37] in their review of veteran coping, emphasize intrapersonal interaction as fundamental to the process of meaning-making in PTG. All men and women reported benefits when using support systems, while many also reported negative experiences in learning who to trust and use as supports. Coping skills were naturally discussed throughout and emotional expression, to others, rose as the top listed response for both men and women.

Women reported the highest benefits from their support systems, which include features such as encouragement to get help, support from family and friends, the comfort of being listened to and the feeling of being held accountable. Although most men reported feelings of acceptance as the primary benefit of a support system, only one man reported feeling encouraged to ask for help when discussing his trauma. In fact, reported benefits of support systems were significantly less for men overall. This finding is consistent with Cross and Madson’s research [15], arguing that women’s construction of self is one of interdependence and men’s one of independence. Thus, though men reported benefits in having access to a support system, they were not as likely to view it as helpful in their growth path. Prior literature supports that gender socialization inhibits men from seeking out social support. It further suggests that calling the standards of masculinity into question increases the likelihood that men will seek support.

Acceptance was described by participants as very important for men when discussing support, but this appeal is also a barrier for men in accessing social support. One male described his experience of acceptance:

I allow myself to feel. At the same time, I notice myself having to hold in emotions in front of people and it is hard. It gets in the way of getting help. I need to cry and can’t in front of friends and family.

In contrast, a woman described her own broadened coping abilities by seeking support: “I used to get high. Now I go to support groups. I talk to my husband, go to therapy. It helps me centre, breathe and get ahold of my thoughts.”

Coping skill is another sphere of responding in the context of trauma. Men list grounding activities, expression and sharing with others as major ways by which they cope with difficult events. Grounding activities was the most prominent among them. For women, sharing with others was listed as most important, followed by emotional expression and perspective taking. Women were much more likely to list sharing with their significant others as a coping mechanism. Collectively sharing with others was coded as the most common coping skill used in response to trauma. One man stated the following as his go-to coping skills: “therapy, talking with friends, physical activity, crying and certainly sharing with others.” Another woman stated:

“I take on its not always about me mindset and breathe through it.”

Prior literature supports the importance of collective sharing and expression of feelings when constructing self-efficacy [15]. Most participants felt that they learned more about themselves through the coping of trauma. One woman describes her new understanding of self:

I’ve been through allot of suffering brain wise. I know what loss is. It’s given me more understanding, greater appreciation for life, understanding people, ability to see things in a different way.

Understanding of self was described by both men and women as an important growth component of trauma. The prospect of new possibilities after trauma was a common theme reported by both men and women.

Two distinct areas of growth that emerged from the interviews were perspective taking and a better understanding of self. These noted areas of growth are consistent with the findings of Linley and Joseph [17], who maintained that cognitive appraisal, or ones assessment of an emotional situation, is most critical in achieving PTG, more so than gender, age, or education. Finally, though men reported more difficulty expressing themselves to others, it is evident in these findings that men find it helpful to share with others when it comes to coping with trauma.

Model of findings

The Figure 2 integrates the theoretical model with the research findings discussed above and illustrates the emergent themes from the interview data (indicated with an asterisk*):

Figure 2: Emergent themes integrated into the PTG model.

This model draws attention to the relationship between social structure and the conditions that impact and contribute to PTG. Use of this model can assist readers in focusing upon conditions that can be addressed socially versus individually.

Discussion

Findings from this study support this claim that men are less likely to demonstrate support seeking behaviour even though they recognize its value in PTG. Even more salient to application is that it is for reasons that are socially invented. Both men and women respond to trauma in socially prescribed ways and they know it isn’t always the healthiest way to cope. Men and women alike valued emotional expression, social support and understanding of self in coping with trauma. However, men were less likely to seek social support even though they reported that they believe sharing with others and emotional expressions are among the most helpful coping skills. These findings hold relevance given that the absence of support seeking has been shown in the literature to inhibit PTG [5].

Transformative social action

Creating opportunity for self-care: Application of this theme lies in the hands of the community and the helper, as support systems are a product of communities as a whole. Coping and support system response to trauma can evolve based on how we, as a society, support all people including those who experience trauma. For example, it is common to see support groups, yoga, journaling, didactic counselling, affect verbalization and mindfulness meditation available to clients who have reached out for trauma care. However, these treatments may not be as acceptable or accessible before-hand or prior to diagnosis. Why not? Opportunities for a variety of self-care and coping strategies could be made more available through employers, community centres, activity centres and schools. For instance, we might open mental-performance centres where collective sharing and education could occur around self-care and coping in any of the above-mentioned settings. Coping and support can occur outside of clinical settings and thus contribute to healthier responses to trauma when it occurs.

Reconstruction of empowerment: This study found that both men and women did feel the strain of their gender roles in coping with trauma, yet all have described ways to empower themselves despite such strains. Men were less likely to have male role models who demonstrated support-seeking behaviour. Though, men reported more difficulty expressing themselves to others they found it empowering when they were able to do so. Women found power in the ability to express themselves. They reported that the greatest sense of empowerment was gained from their support systems included encouragement to get help, support from family and friends, the feeling of being listened to and the feeling of being held accountable. An action item for communities and clinicians is this very construction of what empowerment could look like for those seeking growth.

Application possibilities for this area might include a reconstruction of what empowerment looks like to an individual but also in our communities. Role-strain fits neatly in this assessment as we tend to feel less empowered without options. Clinicians and trauma responders are constantly valuing and rationalizing thought processes of individuals, the strain that one puts on themselves to react in a certain way or perform within a certain set of roles should be no different. To further this application, helpers can assess the origins of gender roles and deconstruct the impact of family or other community influences on gender role. Further application might include questioning the functionality of gender roles, i.e. how is this helping one grow or stay healthy, how might they empower or disempower? Encouraging a better understanding of the origins versus the necessity of gender roles, may represent an additional tool for working with clients and communities.

Reshaping the micro-demands of gender: This research also presents a conflicted and nuanced relationship between men and women and the gender roles they fill. All admire the way the other sex copes. While women reported finding strength in their ability to seek support from others, they also admired the strength of men along with their ability to withhold displays of emotion. Men reported coping in more autonomous ways but admired how women express emotions and reach out for support.

These findings speak to the categories of gender-role strain and gender-role mixing. What stands out is the new possibility for social action and social reflexivity, as both men and women admire the gendered strengths of the opposite sex, feel that those traits contribute to PTG and report appreciation for gender-role mixing. Participants speak to reticence in expressing and experiencing trauma in healthy ways when burdened with the expectations of socially prescribed gender roles. They indicated that micro-demands attached to traditional gender roles was inhibitory in PTG. Those with broader and more fluid conceptualization of their gender roles discussed it as empowering in PTG. Why then do rigid concepts of gender transmit so ordinarily into our social context?

Stereotypes can emerge from culture in subtle ways, which makes them difficult to identify or understand and even more difficult to change. As McLean and Anderson observed, “coping strategies are shaped by social, cultural and developmental contexts that influence men and women differently” [14]. Participants discussed gender expectations within the context of micro-demands experienced in childhood and their current social interactions. This suggests that the observed gaps, particularly ones related to PTG, stem in part from individuals’ desire to fit gender role expectations. Not only do individuals respond based on the perceived benefit of how “most” men and women “should” behave, but they also fail to respond in healthy ways due to the perceived social cost of moving beyond gender-stereotypical responses. Detection and understanding of these narrowed gender concepts must first be detected in order to achieve resilience. This type of social nuance can be transformed through social avenues and can exemplify social action and positive change.

Possible application for clinicians could be the encouragement of expression that psychologically benefits the client no matter the gender role it falls within. For example, a husband struggling with intense emotions could be guided toward goals where expression and compassion are viewed as necessary for healthy functioning and normalized as a positive condition of growth. Likewise, this is an opportunity for communities to promote fluidity in both roles and expression. This can happen through media, education and employment venues. An example of this would be the encouragement of boys to cry in school and girls to assert themselves in conflict. A powerful social-action would be approaching media with gender fluidity in mind, portraying women as action-oriented and independent and men as expressive and compassionate, thereby flexing the set micro-demands of gender.

Growth mindset: Further application of themes could be found in a helper’s ability to promote a growth mindset. A mindset of growth is something that can be skilfully interleaved into the appraised impact of a trauma. This for clinicians might first begin with a detailed and objective understanding of each client’s perspective and how gender roles influence that perspective. Facilitation of the new possibilities could then transpire. For example, a client’s experience of rape is a difficult one to consider possibilities for growth. Self-appraisal that includes self-blames and shame is common. Societies often normalize victim-blaming of female rape. Knowledge of how a rape is appraised by the client in the context of gender can be helpful in supporting them into better understanding themselves. By knowing how gender impacts that understanding, new possibilities for future self can be achieved. Through this discovery, helpers can facilitate growth in a patient no matter how adverse the trauma may be.

Because gender roles are in constant flux, they can be flexed in a way that might support PTG. This can be done through social awareness (reflexivity) and through social service professionals spending community time supporting clients. Therapeutic response and social action can foster growth mindsets that support expression of feelings and help seeking no matter the strain of gender. As mentioned earlier, help-seeking behaviour is empirically linked to PTG [5], as is an appraisal of “new possibilities.” This implication for social-action is important not just for clinicians but for communities. A comprehensive understanding of the client’s full experience of trauma and a clear understanding of perceived gender roles provides an opportunity for fine-tuning resilience through a growth centred mindset.

Limitations

The questions of the study are broad in scope, which is characteristic of qualitative methods; however, more specific inferences could be made if the research questions were narrowed and more focused. Further, this study would benefit from a larger sample and an equivalent amount of men and women included in the study. A larger sample size would allow for more robust qualitative analysis and possibly significant differences emerging between men and women in the growth domains. Additionally, evidence-based literature focusing on effective ways to shift gender-role stereotyping in society is lacking, though this research begins to fill the gap and provide a path forward for additional research.

A research design that requires retrospective recall of traumatic events is vulnerable to recall bias. Looking at gender roles through multiple-scale inventories would more effectively highlight how gender roles affect individuals in society. Though there were a diverse variety of traumas experienced in the sample, further research that controls for specific traumas would benefit the field, adding to the understanding of causal relationships for PTG and gender roles. Park and Lechner [19] also recommend continued observation of PTG changes through improved measurements and carefully designed multi-method, multi-cultural analysis.

Conclusion

The legacy of trauma will always exist and greater insights about gender can ignite those necessary steps toward defining and understanding gender pressure in our society. Growth in the wake of trauma is present in both men and women; however, the paths by which men and women experience growth can be very different. Helping clients and communities recognize the role of gender norms in PTG can generate growth. Helping professionals can encourage clients to explore their socially normed experiences in relation to how they hope to grow. The recovery practices of clients should always pause for consideration of how gender roles play a part. Acknowledging that some of the growth barriers discussed in the study are created through social institutions then concedes that they can be addressed, in-part, socially. Creating opportunities for selfcare, reshaping micro-expressions, reconstructing empowerment and encouraging growth mind set are all ways by which clinicians can begin to act and transform an inequity that exists in our communities. Therapeutic and social action yielding greater awareness of gender roles is a way forward in supporting trauma survivors. These findings open up a door to social transformation and social reflexivity in all contexts where men and women hope to grow. This convergence of information highlights the need for gender-centred approaches to trauma focused trauma support. With a better understanding of gender roles, military, first response leaders and helping professionals can all align to help break down barriers that may limit individual capacity for PTG. It may include gender norming initiatives, conflict resolution programs, peer-to peer programs that assimilate typically condemned behaviour towards positive healthy and normed behaviour, or healthy relationship and domestic violence prevention forums that address role strain. Finally, acceptance of individual expressive tendencies is essential in creating resilience in any community for various sources of trauma.

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