The Emotional Strengths and Posttraumatic Growth Among Families of Addicts

To Investigate The Relationship Between The Emotional Strengths (love, spirituality, kindness, hope, forgiveness) and Posttraumatic Growth Among Families of Addicts

Abstract

The present study was conducted to investigate the relationship between the emotional strengths (love, spirituality, kindness, hope, forgiveness) and posttraumatic growth among families of addicts. There is evidence about influence of posttraumatic growth and emotional strengths among the families in past studies. So it was hypothesized that the emotional strengths positively correlated with the posttraumatic growth. In addition we also explored that traumatic problems lead to increase in posttraumatic growth. A sample of 100 participants (male=50, female=50) were taken from different addiction centers, families and Government hospital addiction departments. They were assessed on the Posttraumatic Growth Inventory (PGI) and Values in Action Inventory (VIA). Correlation research design was used for this research purpose. The Posttraumatic Growth Inventory (PGI) developed by Richard Tedeschi and Lawrence Calhoun (1996) was used to assess posttraumatic growth. The Values in Action Inventory (VIA) developed by Christopher Peterson and Martin Seligman (2005) was used to assess the emotional strengths. There is significant negative relationship between the emotional strengths and posttraumatic growth. In addition forgiveness significantly negatively while hope significantly positively predicted post traumatic growth. Increase in forgiveness predicted low post traumatic growth while increase hope leads to high post traumatic growth and vice versa. In a nutshell learning from this exploration is when people undergo the miseries and sorrows and conceded from the traumatic life events they become emotionally stronger and an increase in their approach to take the things positive.

Chapter 1

Introduction

Addiction is one of the gravest psychological and social problems facing our contemporary periods. Drug addiction is not affected only an addict but also the entire family. The present study focuses on relationship between emotional strengths and posttraumatic growth among families of addicts. The thrust of this study is also find out the which emotional strengths is promote the growth in the families of addicts. Addiction can be defined as the frequent use of mood-altering addicting substances or behaviors (e.g., gambling, obsessive sexual behaviors) despite adverse consequences. Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is described by frequent or periodic impaired control over drinking, preoccupation with the alcohol, use of alcohol despite adverse consequences, and distortions in thinking, remarkably denial ( Jama, 1992).

Since that time, frequent probe of the nature of addiction includes other mood-altering substances aside from alcohol, as well as a number of highly reinforcing behaviors. Some common pathways that affect memory and learning, motivation, control, and decision making are also a part of addictive process. Global understanding of addiction has introduced more treatment strategies, such as meditation and mindfulness training, psychosocial interventions, and pharmacologic approaches. Interestingly, our growing understanding of addiction as a disease has not diminished the value of the spiritually driven approaches, such as 12-step-oriented treatments (R. Janoff, 2006).

• Addiction

Drug addiction is defined as a condition characterized by an overwhelming desire to continue taking a drug to one gas become habituate through repeated consumption because it produce a particular effect usually an alteration of mental status. Drug addiction is a state of periodic and chronic intoxication produced by repeated consumption of drugs. Addiction is accompanied by a compulsion to obtain the drugs, a tendency to increase the dose, a psychological or physical dependence;

1.1.1. Some Common Drugs

Common addictive drugs are the tobacco. One of the most widely used drugs; tobacco is a bunch of dry leaves that contain the drug nicotine, which acts as a stimulant or relaxant when ingested. It can be smoked, chewed, dipped, or snuffed. Its short term effects are increased blood pressure, increased heart rate, at low levels, can act as a stimulant, at higher levels, can act as a relaxant or sedative, Oxygen imbalance. Its long term effects are chronic lung disease, Heart disease, Stroke, Many different types of cancer addiction (Cohen, 2010).

In hookah a water pipe used to smoke flavored tobacco, hookahs are increasing trend in the U.S, especially amongst the youth set. After being heated with charcoal, the tobacco smoke passes through water before being inhaled from the mouthpiece. Smoking hookah is usually a social activity, in which people smoke from the same mouthpiece and pass it around the group. Like cigarettes, hookahs contain the addictive drug nicotine, which acts as a stimulant or relaxant (Taylor, 1983).

Anabolic steroids are synthetic substances resembling testosterone. Steroids work by binding to the hormone receptors on a cell and stimulating muscle growth. They can be prescribed for hormone deficiencies or weight gain by people with body-wasting diseases like cancer or AIDS. People who abuse steroids usually take them to build muscle mass or enhance their athletic performance (Armor & Bower, 2001).

Any of a number of common industrial or household substances whose chemical vapors give you a rapid “high” when inhaled. Inhalants work by displacing oxygen in the lungs with mind-altering chemicals, inducing effects similar to alcohol intoxication, such as lightheadedness, euphoria, and lack of coordination. They’re most often abused by young people because they’re easily accessible and inexpensive. It’s like laughing gas, poppers, snappers, whippets (Grunewald, 2000).

The most abused opiate is heroin is a white, brown, or black and sticky substance that can be injected, snorted, or smoked. When ingested, heroin converts to morphine and binds to opioid receptors in the brain and spinal cord, which control such important functions as pain perception, pleasure perception, breathing, and blood pressure. When this happens, heroin induces sensations of euphoria, drowsiness, and heaviness of the extremities (Marcher & Moeller, 2004).

A strong central nervous system stimulant that gives a powerful, short-lived “high” when used. Cocaine blocks the brain from recycling its supply of dopamine, neurotransmitters linked to the brain’s reward circuit. This suppression leads to a dopamine over stimulation, resulting in feelings of euphoria, as well as increased energy and alertness, for the user. Different type of hallucinogens has different impact some of common are following and have severe effect on daily life routine works (Galena & Johnson, 2006).

1.1.2. Drug addiction and its Personal effects

Drug addiction effects a person in various ways such as biologically, morally, socially and also in domain of career, education, occupation and destroyed family life of that person. The brief review of all this taken respectively.

1.1.2.1. Biological and Psychological Effect. Drug addiction affects a person biologically in a way person psychological or physical functioning disturbs. Drug addiction leads to psychotic symptoms and disorders. As early as the 19th century, there are references in medical texts to the interaction between addictions. It was called “intemperance,” which states that the use of alcohol and tobacco will lead to excessive eating, sexual behavior, and other misadventures. Addiction Interactive Disorder (AID) implies that addiction has many forms, such as gambling, food, sex, work, certain financial behaviors, and even religiosity (Updegraff & Taylor, 2000).

Bill and wooden (1992) discussed addictions do not just coexist; they reinforce, intensify, or become part of the rituals of the chemical addiction. A major factor in relapse in chemical dependency is the failure to recognize and treat companion addictions that are a part of the addictive process. He himself, the founder of Alcoholics Anonymous, suffered from compulsive sexual behavior and financial disorders after he became sober from alcohol. He said reward deficiency syndrome that includes not only alcoholism and drug addiction but also other compulsive behaviors, including gambling, sexual compulsivity, and compulsive overeating.

William (2006) nearby exists strong evidence that abuse of substances is associated with greater risk for psychosis and preliminary evidence for their causative role in the development of psychosis. More systematic examination of this issue is likely to throw light on the neurobiology of psychosis and possibly help the vulnerable population in primary prevention. Psychosis and substance abuse co-occur more frequently than can be explained by chance alone. This may be because substance abusers are at a higher risk of developing psychosis and also because psychotic patients are at a high risk of developing the tendency for substance abuse. This review focuses on the former issue: psychosis among users of alcohol and illicit substances, namely, cannabis, amphetamines, cocaine, opioids, phencyclidine (PCP), hallucinogens and inhalants. Such differentiation of co-occurring problems is, no doubt, artificial as common vulnerabilities are likely to underlie the development of both disorders.

Wilkins (2006) states when a drug user has a mental illness prior to drug use, it may be hard to identify symptoms that are exclusively due to the drug use itself. Most symptoms, if the condition is unrelated to drugs, will continue after abstinence from the drug. The opposite is true for drug-induced psychosis; the schizophrenic-like effects will more or less subside after the drug wears off. However, this is not true for all drug users as frequent and prolonged use can cause side effects that last up to years after use discontinues. Some of them are following:

• Changes in emotion: no emotional response, difficulty expressing feelings, flat affect (appearance or no emotional expression)
• Lethargy; lack of motivation
• Socially withdrawn
• Incoherence in thought and actions; disorganized speech
• Violent behavior; erratic, sometimes dangerous, actions

1.1.2.2. Effect on Morality and Social Life. Addiction correspondingly affects morally an addict. They become harsh and aggressive towards the family, friends and relatives due to their craving. It’s also impact on the social life of addicts. Many people wonder about the social effects of drug abuse. Drug abuse corrodes the social life of the addict, tearing apart his family, friendships and professional relationships. Without intervention, the drug addict can wind up alone, with the drug being his only “friend. As heroin addicts remain social and continue to associate with others, only with their secret habit hidden from view. But this changes over time as they become more and more withdrawn from their usual social circles, and they start to shift their time to spending more of it isolated or with other heroin users. Becoming dependent on the drug quickly changes how the addict spends their time, and this has enormous social implications. The other factors are following that socially influenced by the drug addiction:

• Isolation is the most common social effect of drug abuse. The drug abuser eventually maintains a connection only with his drug of choice.
• Depending upon the drug of choice, the financial strain can be devastating. Buying drugs becomes more important to the drug addict than daily
• Close connections to the drug abuser are affected. Relationships become dysfunctional, as the co-dependent recognizes the effects of the drugs.
• Social effects on the family can be felt long after the addiction. The family can be dissolved, children can develop emotional issues and trust can be shattered.
• Drug abuse can lead to unexplained absences, depleted sick days and eventually job loss. The severity of the drug abuse will determine the time line (Jerry, 2013).

1.1.2.2. Effect on the Family Life. As the addiction destroys the person social, educational, occupational life it’s also demolished its family life. Family start isolated with an addict. Spouse goes to tremendous distress and don’t like to talk with an addict. Usually, one of the children becomes a “hero child”; he excels in academic or athletic achievements outside the home. Another child, usually the youngest, becomes the” lucky charm.” The mascot provides comic relief in order to decompress the tensions within the family. Several different roles have been described over time and different individuals within the family can temporarily assume different roles according to the present needs of the family structure. The end result of this compensatory role playing is the loss of the inherent uniqueness of each individual within the family. Instead of becoming who they were meant to be, the children become caricatures of the roles which they played within the dysfunctional family. The relationship between the husband and wife changes from a mutually supportive marital dyad into a confrontational relationship. The drugs addict child start to be considered as “Disobedient child” (LaMond & Tullis, 2010).

As deduction addiction constitutes a major health problem, yet so many addicts are left untreated. With the mounting evidence that verifies addiction as a disease, it is the hope of the authors that these individuals will be less harshly judged and has more access to treatment. The Primary care physician is in a pivotal role to begin that process. Professionals with addictions are particularly sensitive to the stigma of the label of alcoholic or addict and desperately need their peers to understand and support their recovery. Today, it is understood that addiction is a disease that impacts reward, memory and learning, motivation, and decision making, as well as the social, occupational, marital, physical and family life of addicts (Meichenbaum, 1985).

1.1.3. Drug Addiction and Families of Addicts

Alcoholism and drug addiction affects the whole family – young, teenage, or grown-up children; wives or husbands; brothers or sisters; parents or other relatives and friends.  One family member addicted to alcohol and drugs means the whole family suffers.  Addiction is a family disease that stresses the family to the breaking point, impacts the stability of the home, the family’s unity, mental health, physical health, finances, and overall family dynamics. Without help, active addiction can totally disrupt family life and cause harmful effects that can last a lifetime. Regrettably, no family is born with the knowledge of how to deal effectively with addiction.  It is a skill that must be learned and practiced daily (Froude & Elias, 2012).

Sharon (2010) from Orchard Recovery Centre a counselor states that addiction and alcoholism are not just a matter of curing the addict or alcoholic, the family also needs to acknowledge their pain and get help. As Al-Anon (2013) states, families and friends are relieved and surprised when they learn they didn’t cause the alcoholism, they can’t cure it and they can’t control it. The family with an alcoholic or substance abuser becomes dysfunctional and falls into chaos and crisis. It is no longer a healthy vibrant system. As the substance abuse progresses the family also becomes unwell: socially, financially, mentally, emotionally and even physically – with poor health resulting from various stress-related issues.

1.1.3.1. Effect on Family Well-Being. Spiritually there is a loss of hope and an end to contentment. Family members are unable to separate the illness from the person they love, so there is conflict between loving the substance abuser and holding them in contempt. An environment of trust, courtesy, respect, love and kindness is replaced with one of suspicion, fear, betrayal, depression and resentment. Co-dependency develops as a response to the chaotic conditions in the family of the alcoholic/drug addict and produces unhealthy patterns of relating and behavior. Often co-dependents develop compulsions of their own and a loss of control very similar to that of the substance abuser. Dysfunctional emotions, thinking and reactions between family members and the alcoholic or drug addict begin as coping mechanisms to help the family survive as they start live through deep emotional pain, but these soon become self-defeating. Co-dependency patterns may include controlling, perfectionism, repression of emotions, oppressive rules, a lack of true intimacy, and behavioral addictions, such as overworking, overspending, overeating, religiosity (Jackson, 2013).

Families with members suffering drug addiction or alcoholism also have patterns of denial. They fail to acknowledge the extent or progression of the problem. Types of denial include anger, blame, minimizing the problem, excuses, evasion and deflection. Denial blinds the alcoholic or substance abuser and their family from recognizing the truth. Enabling is a common response to addiction that takes many forms. It allows the alcoholic or drug addict to avoid the consequences of his or her substance abuse and behavior. The enabler is a friend or family member who tries to help the alcoholic or drug addict and who will lie for and rescue the substance abuser or alcoholic from various calamities. While the enabler may think he or she is helping the person with an addiction the opposite is true. Enablers allow the disease of addiction to progress to more acute levels (Mojito &Gautama, 2011).

At the Orchard Recovery Centre it’s believe that the client’s recovery is contingent on their family’s recovery. That’s why we hold educational and family group therapy sessions necessary. In this safe environment both the addict/alcoholic and the family are given an opportunity to begin the healing of the sometimes catastrophic consequences of their substance abuse. “Self-care and the care of other family members must become the priority. It does not allow the family life to be overshadowed by the negativity of addiction. Alcoholism and drug addiction can cause isolation, guilt and shame. By breaking the cycle of silence and denial both the addict or alcoholic and their loved ones can begin to understand, release shame and process bottled-up feelings. They learn that everyone is responsible – no one is to blame (Moreno, 2004).

1.1.3.2. Confusion in Family Roles. The disease of alcoholism and addiction affects the family on several different levels. The addict or alcoholic is affected with a life limiting and potentially life-threatening illness which is guaranteed to rob him of his dignity, material possessions, and personal relationships before it eventually ends in insanity, incarceration, or death. The family of the alcoholic or addict is also affected at a very deep level. Their survival as individuals and as a family is on the line. If one of the parents is afflicted with alcoholism or drug addiction, that parent becomes progressively unable to fulfill their normal roles and responsibilities. Typically, the spouse then steps in to attempt to manage a constantly changing and potentially threatening environment. The stress and fatigue associated with this endeavor is often overwhelming, and it leaves little time to focus on the welfare of the children within the family. The focus of the family becomes the parent’s addiction and the compensatory responses to the addiction which are necessary to preserve the family as a unit (Shedding, 2002).

1.1.3.3. Impact on Family Social Life. Due to the shame inherent in the disease, the family becomes progressively more isolated and invested in keeping secrets. Unspoken rules evolve which include the following: “don’t talk”, “don’t trust”, and “don’t tell”. The various members of the family become highly invested in manufacturing an appearance for the outside world which does not correlate with their internal reality within the family unit. Because of the imbalance which exists within the family, various members of the family begin to take on roles which are not traditionally their roles. For example, if the husband is the alcoholic, then his wife usually tries to take over responsibility for being the breadwinner along with being in charge of the household. The alcoholic is eventually relegated to the role of “misbehaving child.” In the meantime, the children within the family begin to take on different roles in order to support their mother and her ongoing endeavors to preserve the integrity of the family unit. These roles have been previously described in family systems theory and are briefly discussed here for the purpose of illustration only (Welling, 2004).

As tension mounts within the family, the pressure to seek a solution to the problem increases. Hopefully, the family breaks through the denial which surrounds the disease and acknowledges the primary problem as being that of alcoholism or drug addiction. It is usually at this point that members within the family begin to look outside the family for possible solutions. Fortunately, there is abundant help available to the members of the alcoholic family. There is help, hope, and the prospect of a life filled with joy, happiness, and freedom. The sources of help are numerous and include: Al-Anon, a 12 step program for friends and families of alcoholics and addicts; individual counseling; and marital and family counseling. Since Al-Anon is free and readily available to everyone, it will be the focus of the following remarks. Al-Anon is a 12 step program based on the 12 steps of Alcoholics Anonymous, which little by little, one day at a time, can help people to lead happy and fulfilling lives whether the alcoholic is still drinking or not (Smith, 1998).

The purpose of the aforementioned discussion has been to enlighten the reader with respect to the common manifestations of the family disease of drug addiction. It has also been the intent of this author to instill a degree of hope and insight which did not previously exist. The practice of the principles of Al-Anon is akin to a game of skill– one gets better through repetition of the fundamentals. Al-Anon is free, and the practice of its principles can lead you to a freedom and a peace of mind which was previously thought impossible (Amatol, 2004).

1.1.3.4. Impact of Family System. The effects of substance abuse frequently extend beyond the nuclear family. Extended family members may experience feelings of abandonment, anxiety, fear, anger, concern, embarrassment, or guilt; they may wish to ignore or cut ties with the person abusing substances. Some family members even may feel the need for legal protection from the person abusing substances. Moreover, the effects on families may continue for generations. Intergenerational effects of substance abuse can have a negative impact on role modeling, trust, and concepts of normative behavior, which can damage the relationships between generations (Velleman, 1992).

1.1.3.5. Families Emotional Breakdown. A tense family atmosphere and emotional disconnection occurred. Families have a remarkable ability to maintain what family therapists call homeostasis. But when alcohol or drugs are introduced into a family system, the family’s ability to regulate its emotional and behavioral functioning is severely challenged. The families generally reach as a unit to balance itself. In alcoholic homes, this becomes a dysfunctional sort of balance. Family members become subsumed by the disease to such an extent they lose their sense of normal. Their life becomes about hiding the truth from themselves, their children and their relational world. Trust and faith in an orderly and predictable world is challenged as their family life becomes chaotic, promises are broken and those they depend upon for support and stability behave in untrustworthy ways. Alcoholic families become characterized by a kind of emotional and psychological constriction, where family members do not feel free to express their authentic selves for fear of triggering disaster; their genuine feelings are often hidden under strategies for keeping safe, like pleasing or withdrawing. The family becomes organized around trying to manage the unmanageable disease of addiction. They yell, withdraw, cajole, harangue, criticize, understand get fed up; you name it. They become remarkably inventive in trying everything they can come up with to contain the problem and keep the family from blowing up (Schaefer, 1998).

The alarm bells in this system are constantly on a low hum, causing everyone to feel hyper vigilant, ready to run for emotional (or physical) shelter or to erect their defenses at the first sign of trouble. Because family members avoid sharing subjects that might lead to more pain they often wind up avoiding genuine connection with each other. Then when painful feelings build up they may rise to the surface in emotional eruptions or get acted out through impulsive behaviors. Thus, these families become systems for manufacturing and perpetuating trauma (Janoff, 2006).

1.1.3.6. Feeling of Guilt and Shame in Families. Trauma affects the internal world of each person, their relationships and their ability to communicate and be together in a balanced, relaxed and trusting manner. As the “elephant in the living room” increases in size and force, the family has to become ever more vigilant in keeping its strength and power from overwhelming their ever weakening internal structure. But they are engaged in a losing battle. The guilt and shame that family members feel at the erratic behavior within their walls, along with the psychological defenses against seeing the truth, all too often keep this family from getting help. The development of the individuals within the family, as well as the development of the family as a resilient unit that can adjust to the many natural shifts and changes that any family moves through, becomes impaired. It is no wonder that families such as these produce a range of symptoms in their members that can lead to problems both in the present and later in life (Lachman, 1996).

Children from these families find themselves moving into adult roles carrying huge burdens that they don’t know exactly what to do with and that get them into trouble in their relationships and/or work lives. The Importance of Talking about What’s Going On is started. When what is going on within the family is never talked about, children are left to make sense of it on their own. Talking need not be constant, but avoiding talking altogether leads to confusion and disconnection. Talking about and processing pain is also an important deterrent to developing post traumatic symptoms that show up later in life. Intense emotions such as sadness, that are an inevitable part of processing pain, make family members feel like they’re “falling apart” and consequently they may resist experiencing the pain they are in. And the problems in an alcoholic family system are perpetual (Aldwin, 1996).

For the child in an alcoholic system there is nowhere to track, as those they normally turn to are soaked in the problem themselves. Seeing the problem for what it is may alienate them from other family members. Trauma affects both the mind and the body. Intense stress leads to deregulation in the body’s limbic system – that system that helps us to regulate our emotions and our bodily functions. Because the limbic system governs such fundamental functions as mood, emotional tone, appetite and sleep cycles, when it becomes deregulated it affects us in far ranging ways. Problems in regulating our emotional inner world manifests as an impaired ability to regulate levels of fear, anger and sadness. This lack of ability to regulate mood may lead to chronic anxiety or depression. Or, it can emerge as substance or behavioral disorders, for example, problems in regulating alcohol, eating, sexual or spending habits (Stingless, 1987).

1.1.3.7. Seeking Supports Groups. The Nar-Anon Family Groups are a worldwide fellowship for those affected by someone else’s addiction. As a Twelve-Step Program, we offer our help by sharing our experience, strength, and hope. The only requirement for membership is that there is a problem of addiction in a relative or friend. Nar-Anon members are relatives and friends who are concerned about the addiction or drug problem of another. Nar-Anon’s program of recovery is adapted from Narcotics Anonymous and uses Nar-Anon’s Twelve Steps, Twelve Traditions, and Twelve Concepts of Service.

One of the key principles of Al-Anon is the four C’s: “I didn’t cause it, I can’t cure it, I can’t control it, and I don’t need to contribute to it”. This simple recognition of reality results in a great deal of relief for those who are burdened with the idea that they are somehow responsible for the alcoholic’s drinking. Another benefit of Al-Anon is that it teaches healthy detachment from the behavior and the dysfunction promulgated by the alcoholic or addict. Detachment is defined as the ability to love someone enough to allow them to learn from the consequences of their actions. In other words, the practice of detachment involves giving up the role of enabler or facilitator and allowing the alcoholic or addict to suffer the natural consequences that arise from their behavior. Of course, these ideas are radical departures from the status quo, and it takes some time and practice in order to implement them. Nevertheless, consistent application of the principles of Al-Anon combined with regular Al-Anon meeting attendance can result in increased serenity and peace of mind. This author would highly recommend that anyone involved in a relationship with an active alcoholic or addict seek out Al-Anon and begin attending meetings. It is suggested that people who are new to Al-Anon, attend at least six meetings in different locations before they decide whether or not it is for them (Fishbein, 1990).

The Nar-Anon Family Group is for those who know or have known a feeling of desperation due to the addiction problem of someone close to them. Nar-Anon members share the experiences, strength, and hope at meetings. The meetings are usually held at locations such as treatment centers, hospitals, churches, community centers, or local twelve-step clubs. Nar-Anon is a twelve-step program designed to help relatives and friends of addicts recover from the effects of coping with an addicted relative or friend. Nar-Anon’s program of recovery uses Nar-Anon’s Twelve Steps and Twelve Traditions. The only requirement to be a member and attend Nar-Anon meetings is that there is a problem of drugs or addiction in a relative or friend. Nar-Anon is not affiliated with any other organization or outside entity.

In a recent research by Bowen and Brawly (2010) on how NA works: Cross descriptive perspective, they focused on the evidence from multiple lines of research supports effectiveness and practical importance of Narcotic Anonymous. This report summarizes the attending 12-steps by the families of addicts make the stronger, self-managed and gave abilities to cope with the problem and the addict patient in their families.

Family members need to realize that they need help regardless of the addict’s or alcoholic’s commitment to recovery. They can begin by focusing on their own pain, learning about the disease and detaching from the alcoholic or drug addict with love. But, with the proper help and support, family recovery has become a reality for millions (Bernad & Ryan, 2009).

1.2. Posttraumatic Growth

In the 20th century, several clinicians and scientists have addressed the ways in which critical life crises offered possibilities for positive personal change. The widespread assumption that trauma will often result in disorder should not be replaced with expectations that growth is an inevitable result. Instead, continuing personal distress and growth often coexist that is post traumatic growth (Coyer, 2001).

Tedeschi and Lawrence (1993) supposed that Posttraumatic growth is the experience of positive change that occurs as a result of the struggle with highly challenging life crises. It is manifested in a variety of ways, including an increased appreciation for life in general, more meaningful interpersonal relationships, an increased sense of personal strength, changed priorities, and a richer existential and spiritual life. Posttraumatic growth mutually interacts with life wisdom and the development of the life narrative, and that it is an ongoing process, not a static outcome.

Calhoun and Richard (2002) state that Personal growth resulting from a struggle with loss, for at least a stable minority of those who suffer it. Processes addressed include factors such as individual differences, the magnitude of the trauma and the growth processes facilitating a changed sense of self, changed relationships, existential and spiritual growth.

The  process  of posttraumatic  growth  is  set  in  motion  by  the  occurrence  of  a  major  life  crisis  that  severely  challenges  and perhaps  shatters  the  individual’s  understanding  of  the world  and  his  or  her  place  in  it.  Certain kinds of personal qualities-extraversion, openness to experience, and perhaps optimism-may make growth a bit more likely.  Initially, the individual typically must engage  in coping  responses  needed  to  manage  overwhelming emotions,  but  intense  cognitive  processing  of  the difficult  circumstances  also  occurs. The degree  to  which the person  is engaged  cognitively  by  the crisis  appears to be  a central  element  in  the process  of  posttraumatic growth.

The individual’s  social  system  may  also  play an  important  role  in  the general  process  of  growth,  particularly  through  the provision  of  new  schemas  related to  growth,  and  the  empathetic  acceptance  of  disclosures  about  the  traumatic  event  and  about  growth-related  themes. Posttraumatic  growth  seems  closely connected  to  the  development  of  general  wisdom about  life,  and  the  development  and  modification  of  the  individual’s  life  narrative (Antonovisk, 2007).

1.2.1. Factors facilitating the posttraumatic growth

Factors facilitating the posttraumatic growth are including spirituality. It is a process of re-formation which “aims to recover the original shape of man, the image of God. In modern times spirituality has come to mean the internal experience of the individual. It still denotes a process of transformation, but in a context separate from organized religious institutions: “spiritual but not religious. So by the traumatic internal experiences like losing some one and facing problems, people move toward spirituality (Edwin, 2000).

Another factor is Social support. It is the perception and actuality that one is cared for, has assistance available from other people, and that one is part of a supportive social network. These supportive resources can be emotional (e.g., nurturance), tangible (e.g., financial assistance), informational (e.g., advice), or companionship (e.g., sense of belonging) and intangible (e.g. personal advice). Social support can be measured as the perception that one has assistance available, the actual received assistance, or the degree to which a person is integrated in a social network. Support can come from many sources, such as family, friends, pets, organizations, coworkers (Croons, 2006).

Life Stressor that may be a chemical or biological agent, environmental condition, external stimulus or an event that causes stress to an organism. An event that triggers the stress response may include:

• Environmental stressors (elevated sound levels, over-illumination, overcrowding)
• Daily stress events (e.g. traffic, lost keys, quality and quantity of physical activity)
• Life changes (e.g. divorce, bereavement)
• Workplace stressors (e.g. high job demand v. low job control, repeated or sustained exertions, forceful exertions, extreme postures)
• Chemical stressors (e.g. tobacco, alcohol, drugs)
• Social stressor (e.g., societal and family demands)

Stressors have physical, chemical and mental responses inside of the body. Physical stressor produce mechanical stresses on skin, bones, ligaments, tendons, muscles and nerves that cause tissue deformation and in extreme cases tissue failure. Chemical stresses also produce biomechanical responses associated with metabolism and tissue repair. Physical stressors may produce pain and impair work performance. Chronic pain and impairment requiring medical attention may result from extreme physical stressor or if there is not sufficient recovery time between successive exposures (David & Harmsworth, 2003).

1.2.2. Process of posttraumatic Growth

Three models of posttraumatic growth explain this process of change in the families. The first model is talk about the “Strength through Suffering”. This model of posttraumatic growth, strength through suffering is most apparent in our cultural role, specifically in our beliefs suggesting that whatever does not kill us makes us stronger. This is the message implicit  in  the  redemptive  value of suffering taught  in many religions and is  also a form of the more flip  “no  pain, no gain “conception  of  personal  profit. Just  as  our  bodies  get  stronger  when  we  push  ourselves physically,  our  personal  strengths  also  develop  when we  challenge  ourselves  psychologically. In the  aftermath  of extreme,  negative  life  events,  survivors  recognize  that they  have  gone  through  agony  and  are  stronger  for  it (Taylor, S. E. ,1983).

Through  experiencing  and  coping  with  the  debilitating  pain  and  distress  of  trauma,  survivors  not  only become  aware  of  their  previously  undiscovered strengths,  but  they  develop  new  coping  skills  and  resources  that  provide  them  with  new  possibilities  in  life. For  some  this  is  based  on  a newfound  sense  of  courage and  self-confidence  in  their  abilities;  for  others  it  is based  on  new,  powerful  constraints  on  old  lifestyles. The  latter  describes  the  response  of  the  high  school athlete  paralyzed  in  an  accident,  who  grew  excited when  talking  to  me  about  the great  satisfaction  he  now derived  from  reading  and  “the  life  of  the  mind,”  rather than  from  sports (Grunewald, T. L. ,2000).

Second model of change discourse about Psychological Preparedness. A  second  model  of  posttraumatic  growth-psychological  preparedness-can  best  be  understood  via some  understanding  of  changes  in  the  survivor’s  assumptive  world.  This  model  posits  that  by  virtue  of coping  successfully  with  their  experience, survivors are not  only  better  prepared  for  subsequent  tragedies, but,  as  a consequence,  are  apt  to  be  less  traumatized  by them  as well.  Coping  involves  rebuilding  a  viable  assumptive  world,  and  it  is change  at  this  level  that provides  the  survivor  with  a heavy  dose  of  psychological protection.

Third model of change states about Existential Reevaluation. The  third model  of posttraumatic  growth-existential  reevaluation-concerns  responses  that,  at  least  on  their  face,  appear  far more  unexpected  and  difficult  to  comprehend  in  the context  of  the  anguish  and  agony  of  traumatic  experiences. These are  the  survivors’  self-reports  of  greater appreciation  of  life,  the benefits  that have  received  the most  attention  in  the  burgeoning  literature  on posttraumatic  growth. Humans are meaning-making animals, and traumatic life events have a major impact on survivors’ assumption. In  the  face  of  their  traumatic  experience,  survivors are  not  simply  interested  in  understanding  why  it happened,  but  why  it  happened  to  them  in particular-questions  of  selective  incidence  and  the distribution  of  negative  outcomes (Tedeschi and Calhoun’s, 2007).

1.2.3. Posttraumatic Growth and Families

Often, the victim of alcohol abuse is primarily seen as the individual problem drinker despite alcoholism being characterized as a family illness. Less is written or acted upon on the ‘forgotten victims’ both spouses and children of the problem drinker’s family who often hide the alcohol problem as a shameful secret and participate in the dysfunctional behavior. Social deprivation, poverty and stress compound  the  trauma and childhood in such  a  family  is  distressing hidden  to  those  outside  the family  and  at  times  neglected  by  mental  health  professionals  working  in  the  field  of addiction (Bennett, 2007).

Studies have now established that alcoholism runs in families and children of alcoholics are four times more likely than other children to become alcoholics, though genetic factors play a part, a balance between environmental and genetic factors is important. The effect of strong family relationships on the potential negative effects of parental alcoholism contributes to positive thinking among children of alcoholics, shielding them from developing problems in childhood as well as the early development of alcohol problems in adolescence and adulthood. The protective influences are healthy interaction within the family including cohesiveness, rituals celebrated in the form of festivals and traditions culturally relevant, routine activities  like  mealtimes,  strong  social  support  networks  both  within  and  outside  the  family  and  specific strategies  to  deal  with  stressful situations (Goodwin, 1988).

The presence or absence of these factors help some alcohol impaired families ‘transmit’ problems to the next generation while in others the cycle is broken. Intervention in addiction treatment by mental health professionals has a tendency to focus mainly on the needs of the addicted parent with less attention to the affected family members. It includes specific areas and methods that strengthen key processes to make alcoholic families more resilient and positive growth children more resourceful to handle crises, equipping them to meet future challenges (Velamen, 1995).

Alcohol as a cause of family problems, a number  of  studies  conducted  on  the  dysfunction  in interaction  patterns  among  the  family  members  in alcoholic homes and the psychological problems faced by children of alcoholics have established that an alcoholic  member  in  the  family  causes  problems  not  only  to  themselves  but  also  to  their  own  families. The parent’s drinking disrupts normal routine family tasks and functions, affects roles played by the family members’  increases  conflicts  by  demanding  adaptive  responses  and  creates  an  economic  drain  on  the family’s resources. The family members deny reality at the initial stage and as the alcohol problem escalates and intensifies over time, they try numerous ways to deal with each crisis. They become ‘co-dependent ‘in that their lives become just as dysfunctional as the addicted family member’s, impacting their physical and psychological health resulting in low self-esteem,  and unhealthy coping patterns (Channabasavanna & Bhatti, 1982).

Drug addiction and alcoholism are addictions that most people are familiar with, but there are many addictions families suffer from. The fact is that any addiction from drugs and cigarettes to shopping and gambling can have disastrous social and financial consequences. When the addict has a family, the cost of the addiction can wreck the home and have long-lasting effects on every person he or she touches. Family members might fight a lot because of the problems the drug abuse is causing. The drug user might do and say things that upset neighbors and friends, and make the family ashamed (Jessica & Bonsai, 2012).

Families (both spouses and  children)  also  experience  a  range  of  emotions:  hurt  and  grief  caused  by  the  addicted  parent’s indifference to the family’s feelings, a sense of helplessness – of not knowing what to do, loss of hope and fear- on the impossibility of any positive change, anger – misplaced towards the addicted person, themselves and to the community at large and finally, shame- caused by the painful experiences within and outside their home due to the family member’s drinking behavior. The family chooses to remain isolated to uphold this family ‘secret’ (Jacobs, 1987).

Stingless in (1993) reported that the alcoholic family member’s impact on children including spouses were unhealthy family interaction patterns, change roles played by family members especially the spouse and eldest child, unpredictable routines at home, disruption of rituals and celebrations, restricted social life, recreational activities and financial problems. The children’s physical and emotional demands are neglected. They do not share or talk about their suppressed feelings having no opportunity and develop mistrust because of the unpredictable behavior of their parents.  They take roles and responsibilities often inappropriate to their age, witness violence in different forms at home, feel guilty and responsible for their parent’s behavior.

Faulty role modeling of both parents furthers the damage to children. The children face an increased risk of problems such as conduct disorders in the form of delinquency and aggression, emotional problems that are psychosomatic in nature such as asthma and bedwetting, feelings of self-blame, low self-worth, depression, negative attitudes and school related problems ranging from truancy to learning difficulties. Within this milieu, children continue to grapple and move into their own adulthood. They learn to adopt roles, survive and to try hard to bring stability to their own lives – whilst being burdened with poor self-esteem. Their emotional inadequacies continue to persist into later adult life as evidenced by large social movements of adults like the Adult Children of Alcoholics (ACOA). Thus, it is not a surprise that some of these children who experience parental alcoholism, start drinking at an early age themselves (Velamen, 1993).

Despite  the  negative  effects  of  parental  alcoholism on  the  family  especially  on  children  (as  discussed above), there appeared to be certain factors whose  presence protected the children and kept them away from alcohol related problems or delayed its onset. This balance between environmental and genetic factors is  important  for  children and  not  family  history  of  alcohol  alone  that  makes  someone  an  alcoholic or problem drinker.

There is lot of protective factors contributing to positive thinking that is the role of family interaction in families with an alcohol problem is a protective factor providing a supportive environment to the children. Families that valued relationships, have control over family life and maintain its special identity with a positive outlook provides a stable environment. Quality time allotted for family activities  such  as  hobbies,  sports  and  spending  time  together  helps  in  bonding  and  promotes  cohesion among  family  members (Prabhughat, 2002).

Positive  role  models  for  the  children  to  look  up  to  within  and  outside  the  family played  a  part  and  a  non-drinking  parent  was  found  to  be  an  important  protective  factor. Positive interaction patterns through healthy communication, cohesive relationships, clear leadership and roles, support systems within and outside the family were found to contribute to positive well-being of the individual family members .The family’s ability to distance itself from adverse circumstances  is  another  trait  contributing  to  the  family’s  resilience. This trait was called ‘planning or deliberateness.

The maintenance of family rituals the time of the parent’s heavy drinking contributes to the child’s well-being as adults lowering the risk of transmission of alcohol problems. The preservation of distinctive family rituals (e.g. like mealtimes, regular bedtime) helps the family members disengage by separating from the alcohol  behavior  of  the  parent  and  preserves  the  family’s  collective  sense  of  self,  stabilizes  family life, clarifies  expected  roles  and  defined  family  rules (Vellaman, 1995).

According to Woolen and Jacobs in (1987) rituals fell into three groups. The first one family celebrations- Relatively  standardized  rituals,  specific  to  the  subculture  with  widely  shared symbols  that  assist  families  to  assert  their  group  identity  and  connectedness.  They are holidays, rites of passage, and annual religious or secular celebrations. The second is Family traditions less culture specific and more idiosyncratic to particular families who choose their occasions. They are vacations, visits with extended families, anniversary customs and re – unions.

The third the Patterned routines are most frequently enacted but least consciously planned family rituals, part of daily family life, defining member’s’ roles and responsibilities and such patterned routines provide reinforcement to the family’s  identity. Dinnertimes,  bed  time  routines  with  children  and  regular  leisure  time  activities belong to this category.

The role of problem solving at the time of the parent’s heavy drinking is effective as it continues to help children in coping through adulthood. The support received from caring persons  (within  and  outside  the family),  distancing  from  the  dysfunctional  situations,  the  ability  to  think  through  situations  and  formulate coping  strategies  have  a  protective  role  to  play. Being resourceful, decisive and being flexibly separated from the dysfunction are other family strengths. Moving from the phase of adolescence into adulthood, the learnt problem solving skills helps the children to be assertive, and resist peer pressure to use alcohol and drugs. This deliberateness was evident in the choices and decisions made by  the  now  adult  child,  consciously  planning  on  how to  be  different  from  the  family  of  origin.

Vellaman (1995) views this characteristic with optimism in that having to cope with adversity strengthened people as well as damaged them. It would be beneficial for mental health professionals, to consciously translate the above understanding into practice while addressing the needs of the family and children at risk in particular. A tendency among rehabilitation centers was to work with the addicted person in isolation, holding the family apart almost viewing it as the root cause of addiction while others viewed the family as being ignorant about their manipulative behavior and counseled them to help in the addict’s recovery.

Addiction treatment centers address the physical and psychological problems faced by the addicted person at an individual level. Some treatment centers may have regular programs for families, usually spouses or  a  significant  family  member-  and  address  their  difficulties related  to  living  with  the  addicted  family member.  The  specific  needs  of  the  children  at  risk  often  tend  to  be  neglected,  thereby  missing  an opportunity to enhance the protective factors that the family can afford. Proposed framework for strengthening families in addiction treatment .A  strength  based  framework  that  goes  beyond  routine intervention  is  presented  with  specific  areas  that would  be  useful  for  clinicians  in  addiction  treatment (Vellaman, 1995).

The  aim  is  to  make  families  of  alcoholics, and particularly  children,  more  resourceful  in  dealing  with  crises  and  develop  variable  competencies  to  meet future needs. The  proposed  framework  will address family  in  totality  in order  to  strengthen  resources  at  inter  and  intra levels of the individual. Intervention is proposed at residential and non-residential settings for parents and children and significant support persons in the absence of family supports. The pre and post adolescence stages of the children and developing needs would receive a major thrust in the interventions. Information presented may deploy a variety of media such as play and art therapy, puppetry, craft, role play quizzes, screening or special films and narrative storytelling, to specifically impart skills (Mane, 1989).

Assist  family  members  to  develop  an  appropriate  attitude  to  help  the  addicted  family member. The purpose here is to address both parents and children. The mental health professional would give attention to problems experienced by the family members as a result of addiction  by  helping  them  to  focus  attention  on  themselves  and  see  the  need  to  change  their attitude, behavior and develop larger values- towards optimism and a positive outlook.

For this, psycho-educational  sessions  would  be  conducted  for  the  family  by  providing  information  on alcoholism, the processes of relapse and the family’s role in treatment. As most of these families have not accessed social supports and do not have emotional resources, the proposed intervention creates  deliberate  opportunities  for  the  family  members  to  articulate  their  suppressed  feelings about the alcoholic member including others in the family. As a family, they will have opportunities to appreciate inherent values and perspectives of each other as a source of strength, than conflict. Children  in  particular  would  be  given  an  opportunity  to  express  their  feelings  in  a  safe  and acceptable environment building trust amongst them (Vive, 2002).

1.2.4. Theories of Posttraumatic Growth

1.2.4.1. Theory of Trauma-based accounts of growth from “shattered assumptions”. Posttraumatic growth (the term used in this body of literature) is triggered by highly stressful life events that pose a significant challenge to an individual’s assumptive beliefs about the world. Most people have a general set of beliefs about the predictability, controllability, and benevolence of the world that they use to guide their behavior and make sense of why things happen in their lives. Adverse events however have the power to challenge the validity of these beliefs and cause individuals to question their understanding of the world as well as their place in it, a process which is usually accompanied by high levels of psychological distress. These stressful life events can shatter an individual’s prior assumptive beliefs about the world. The metaphor of an earthquake is sometimes used by researchers to convey the suddenness and force with which assumptive beliefs are shattered (Coyne & Tannin, 2010).

According to this theory, posttraumatic growth occurs when individuals attempt to come to terms with the event and rebuild their assumptive world. Similar to rebuilding after an earthquake, individuals who have experienced highly stressful events have the opportunity to think carefully about how they want to rebuild their lives. By taking into account the changed reality of their life circumstances, the inherent complexity and fragility of the human condition, as well as the knowledge that they have survived the event and associated distress, individuals can develop adaptive beliefs that will lead them to be more resilient in the face of future challenges.

During this process, individuals often identify new characteristics and strengths. While none of the individuals who have lived through highly stressful events would ever choose to relieve these circumstances, many of them recognize that these events have changed them in positive ways. By integrating these positive changes into their life stories, individuals become aware that they have grown in important and meaningful ways (Coyne & Tannin, 2010).

1.2.4.2. Organismic Valuing Theory. According to Organismic Valuing Theory, adversarial growth (the term used in this body of literature) occurs after a highly stressful life event, because individuals have an inherent tendency to comprehend and integrate their experiences in a meaningful way while striving towards optimal well-being. In this theory, adversarial growth is seen as equivalent to the experience of psychological well-being (Joseph & Linley, 2005).

The theory proposes that there are at least three possible outcomes to adverse life events depending on how the individual processes the new trauma-related information. Following an experience of personal adversity an individual can either “assimilate” the trauma-related information by integrating the experience into beliefs or worldviews that they held prior to the event, or they can “accommodate” the trauma-related information by modifying their prior worldviews in light of their experience.

If an individual assimilates the experience into their prior beliefs about the world (e.g., bad things just happen), they can recover from the trauma, but recovery simply marks a return to pre-trauma levels of well-being. The individual does not grow psychologically from their experience, and he/she remains vulnerable to future stressors. If the individual accommodates the trauma-related information in a negative way (e.g., bad things happen and there is nothing anyone can do to prevent them), they experience greater feelings of hopelessness and have a higher likelihood of experiencing post-traumatic stress and/or depression.

However, if the individual accommodates the trauma-related information in a positive way and modifies their prior worldview appropriately (e.g., life is unpredictable, so it should be lived to the fullest), they can experience psychological growth in the aftermath of adversity. In this model, positive benefit-finding and psychological growth is facilitated by many factors including the satisfaction of basic psychological needs (i.e., the need for affiliation, autonomy, and competency) and supportive social environments (Joseph & Linley, 2005).

1.2.4.3. Deviation Amplification Model. According to the deviation amplification model the psychological resources, skills, and personality traits of an individual play an important role in determining whether the individual is more or less likely to be able to find long-term and positive benefits from highly stressful and challenging life events. The model proposes that the stress response is regulated by two processes: deviation countering and deviation amplification. The deviation countering process functions using negative feedback loops and is similar to homeostatic processes (Aldine & Karen, 2012).

For example, an increase in blood pressure is countered by biological processes that lower blood pressure back to optimal levels. In contrast, deviation amplification processes function via positive feedback loops that magnify small changes. Severe stressors such as diagnosis with terminal illness or death of a loved one, for example, are believed to be regulated by amplification processes resulting in either positive or negative spirals depending on whether small changes in adaptive or maladaptive coping responses are magnified.

The deviation amplification model predicts that major life stressors can have long-lasting effects on an individual’s personality, especially processes such as self-esteem and personal mastery. Specifically, people who have higher levels of self-esteem or personal mastery before encountering the stressor are likely to engage in more adaptive styles of coping, resulting in a greater frequency of positive long-term effects and increases in personal mastery. In contrast, people who have lower levels of self-esteem or personal mastery initially are likely to engage in more maladaptive styles of coping, resulting in poorer outcomes (Aldine & Karen, 2012).

1.2.4.4. Stress Inoculation and Resilience Approaches. According to this approach, one positive outcome that can result from an experience of adversity is the ability to be able to better cope with subsequent stressors. Essentially, a history of past success at effectively coping with moderate-level stressors is predicted to enhance resilience and inoculate the individual against some of the potentially distressing consequences of subsequent stressors (Hill’s, 1958).

This approach argues that the “silver lining” to stressful experiences is the ability to more effectively handle future adversity. From this perspective, individuals with a history of some lifetime adversity are predicted to show a greater propensity for resilience, lower global distress, lower functional impairment, fewer symptoms of posttraumatic stress disorder, and higher life satisfaction over time, compared to individuals with no experience of adversity and those with high cumulative lifetime adversity. Thus, with regards to moderate-level stressors, this approach claims that whatever doesn’t kill us can make us stronger (Hill’s, 1958).

1.2.4.5. Cognitive Adaptation Theory. According to this theory, stressful and threatening life events challenge an individual’s self-esteem, sense of personal control, and optimism about the future. In an effort to cope with and adjust to these threatening experiences, individuals tend to rely on cognitive strategies that enable them to restore and enhance their self-esteem, perception of control, and optimism. For example, a cancer patient might try to enhance their self-esteem by comparing their recovery to other individuals who are less fortunate, or boost their optimism by inflating their chances of entering remission.

In this theory, successful adaptation to threatening experiences is based on the individual’s ability to develop and maintain a set of “positive illusions”. It is the ability to form these positively distorted beliefs or “illusions” in the aftermath of adversity that provides an individual with protection in the initial stages of threat and allows them to eventually come to terms with and accept their situation. Research has shown that positive illusions – the ability and resources used to restore a person’s self-esteem, control, and optimism – offer protective benefits both for psychological adaptation to threatening experiences and physical health (e.g., slower temporal course of illness) (Taylor, 1983).

It is important to note that positive illusions only represent modest departures from reality, as feedback from the environment keeps the individual from distorting their beliefs too dramatically. In summary, cognitive adaptation theory proposes that individuals respond to threatening life events by developing a protective set of positive illusions pertaining to their self-esteem, personal control, and optimism that help them to return to (or exceed) pre-trauma levels of psychological functioning (Shelly &Taylor, 1983).

1.2.4.6. The Janus-Face-Model of Self-Perceived Growth. According to this model, posttraumatic growth has both a functional, constructive side and an illusory, self-deceptive side. The functional or constructive side of posttraumatic growth is depicted in trauma-based theories of growth (e.g., assumptive world theory and organismic valuing theory) that have shown that individuals often report positive changes after a stressful life event (Zoellner, T. ,2004).

For example, many people report feeling stronger, more resilient, or wiser. In contrast, the illusory or self-deceptive side of posttraumatic growth is depicted in the literature on positive illusions that has shown that people cope with threatening situations by positively distorting their perception of the event or themselves. For example, people tend to exaggerate their sense of control and hold unrealistic optimistic expectations about the future. The Janus-face-model is essentially an attempt to offer a comprehensive account of posttraumatic growth by integrating these conflicting areas of research. In this model, illusory and constructive posttraumatic growth are believed to co-exist, each unfolding over a different time course with independent relationships to psychological adjustment (Maercker, A., 2004).

The illusory perception of growth is not necessarily maladaptive; when illusory perceptions of growth coexist with active and deliberate reflection of the trauma then illusory growth represents an adaptive coping response to reduce distress in the short-term. However, when the illusory component coexists with attempts to avoid thinking about the trauma, then self-reported growth is likely to reflect cognitive avoidance rather than actual positive change. The functional and constructive side of growth is associated with actual change and is therefore related to greater adjustment and well-being in the long term. The model posits that in successful adaptation to trauma the constructive side of posttraumatic growth increases over time while the illusory perceptions of growth decrease (Janus, 2006).

1.2.4.7. Action Growth Theory. According to the Action Growth Approach, a stressful or traumatic life event often results in high levels of psychological distress, because such an event poses a significant challenge to the individual’s psycho-social resources (e.g., self-esteem, health, and social support networks). While this model acknowledges that self-reported experiences of growth often occur after adversity, it argues that posttraumatic growth does not simply result from cognitive attempts to find meaning and re-structure assumptive beliefs about the world (Butler, 2010).

For posttraumatic growth to occur individuals must translate these cognitive benefit-finding processes into action. Similar to other perspectives described earlier, posttraumatic growth has two possible manifestations – an illusory coping side and a functional and constructive side. The model claims that the illusory side of posttraumatic growth (i.e., cognitive attempts to find positive benefits in adversity) might simply function as a coping mechanism in the aftermath of extreme stress, and not necessarily translate into real positive change. Alternatively, real and constructive side of posttraumatic growth can offer a protective function against negative outcomes such as posttraumatic stress disorder, but only when individuals attempt to integrate these perceived positive benefits into their subsequent behaviors (Joseph & Butler, 2010).

1.3. Emotional Strengths

Kaufman and Pattison (1981) suggest that alcoholism can adversely affect the family system and that dysfunctional family systems can promote, and maintain, alcoholism. According to Bennett and Wolin (1990) alcoholism is very much a family illness, when alcoholism is diagnosed for one family member, the chances are very good that it has previously appeared in prior generations and that it will surface again in the next generation. Family studies show that first-degree relatives of alcoholics are three to five times more likely to develop alcoholism than the general population. Family celebrations, family traditions, Patterned routines and everything are disturbed. Families face severe emotional problems when addict become the part of it. Some become very weak emotionally but it may give strengths to the emotionality (Schukit 1999).

Basically Emotional strength is the quality of having stable emotions, characterized by assertiveness, stress management, caring and coping skills. It is also about being positive about life, having inner peace and having hope for the future (Alexander, 2001).Emotional strengths means different things to different people for there are many levels of discourse over it, or many ways to talk about it, different levels of understanding it. Some psychologists tell us that negative emotions are normal and should be embraced. According to Rosanne (2006) Emotional strength is the ability to not have negative emotions, and to only have positive ones positive ones are those that feel good and are constructive. Fear is not one of those, nor is anger.

1.3.1. Emotional Strengths and Families

The trick is to learn to transmute negative emotions into positive ones until we no longer have the negative ones in the first place. This takes a lot of practice with techniques that really work. It does not have space or time here to explain the details. So for now, just know that negative emotions are not required, and that it is possible to not have them, and that does not mean repressing them. Arriving at that ability is arriving at emotional strength.

Emotional strength does not mean ignoring or repressing. When we hear of strength training we immediately think of lifting weights or something to do with physical strength. It seems as if more focus is given to physical fitness and to a lesser degree on one’s emotional fitness. Emotional fitness must receive more attention because without it we can become emotionally, mentally and physically paralyzed, unable to achieve the kind of success we deserve. Some of us are emotionally stronger than others. Some of us even have an inherent resilience (Tennen & Affleck, 1998).

The emotionally strong person can handle enormous challenges. Even though the pressures of life may be overwhelming and they may become fragmented, the emotionally strong person is resilient, gaining knowledge from their struggles and developing emotional ammunition to recover and move forward. The emotionally fit person will stop at nothing to find solutions for whatever difficulties arise while maintaining a forward struggle. The not so emotionally strong person will also become fragmented when faced with the pressures and challenges of life but they are not as resilient. Some may become depressed, others may give in to drugs and alcohol to cope, while others may become overwhelmed and give up (Linley, A. P., 2005).

Many people invest in self-help books, searching for answers while others meet frequently with therapists to find solutions. Some attend seminars or purchase offers of feeling better, longing to feel something inside they know they lack. There is no one magic formula for achieving emotional strength; however, we will examine why it is important and the different ways in which we can improve our emotional strength. By knowing your emotional boundaries, the subconscious take over and helps to alert you when the boundaries have been crossed.

Setting emotional boundaries helps you to stay motivated in achieving what you want to feel. As someone realizes new boundaries each day he establishes a new set of rules for itself. As live by these rules the feelings want to feel will emerge. The emotional muscles will just keep growing and before long you will have the stamina to handle more challenges that arise in your life. It’s amazing how emotional baggage can take up permanent residence in our lives because letting them go at first feels too uncomfortable.

Emotional strength training can only take place when you can free yourself of unnecessary weight and allow yourself the freedom to emotionally breathe. There is no magical formula for building emotional strength. It requires a combination of self-control, discipline, ferocity, determination, courage, and faith to stick with the workout schedule. Actually from the different traumas of life people going to be stronger emotionally (Sandoz & Kalivas, 2000).

The strengths perspective explains that every individual has strengths. Professionals who use the strengths perspective identify, mobilize, and respect the resources, assets, wisdom, and knowledge that every person has. They view people as able to marshal these strengths to accomplish their goals. Trauma, abuse, illness, and struggle, while sources of difficulty and challenge, can also be sources of opportunity for growth and change. Negative experiences can yield knowledge, wisdom, insight, and compassion for others. This does not mean that scars and pain are not legitimate; of course they merit attention and validation. It does mean that humans who weather adversity are resilient, resourceful survivors who can cull meaning and skills from their travails.

People who slog through suffering use their coping skills and can learn from their experience. Individual goals matter. By aligning with the hopes, values, aspirations, and visions of teens and their families, professionals can help people enhance their promise and possibilities. Separating the person from the diagnosis acknowledges that illnesses and disabilities do not define the person—they are merely conditions the person has (Smith 2003).

Professionals serve people best by collaborating with them as colleagues on the intervention team. The therapist who uses a strengths perspective may have specialized education, tools, and experience to offer but is also open to the wisdom, knowledge, and experience of the teen and her family. The therapist works with the teen and family members rather than on their cases. The goals of the consumer, not the professional, are primary, and consumers’ voices are heard and valued at all levels of intervention and in policy advocacy.  Every environment is full of resources. Regardless of how poverty ridden or chaotic, every environment has individuals, families, informal groups, associations, and organizations that may be willing to provide help. Given the opportunity, they may contribute needed assets and resources. Once recognized and recruited, partnerships and strengths available in the community can be highly constructive (Taylor, 2004).

1.3.2. Factors facilitate Emotional Strengths

Emotional strengths facilitates according to approach of being positive. It’s necessary to see things in a positive light; you will see them as such. We control how we perceive the world. When you choose to focus on the positive, you will begin to see positive changes in both your emotional health and the rest of your life. Being positive will help you to face the things that might upset you, thus allowing becoming stronger emotionally.

Second thing about which we talk is change. One of the things that cause us the most emotional stress is change. Even when you are excited about the change (ie. moving away from home to college) you might still be feeling other negative emotions (i.e. fear, sadness, uncertainty, etc.) When you accept change by deciding to make the most of it, you can choose to control those negative feelings. Be aware of your emotions and accept them. Say to yourself, “I am feeling scared and sad about leaving my family and moving to college, but I must accept this change and focus on the exciting aspects of moving away–new friends, new experiences, etc.” Keep in mind that this is a hard thing to do, but with practice you will become better at it (Schaefer& Moos, 1998).

Need of Confidence when person start becoming stronger. It’s a key when becoming emotionally stronger. Being confident in the fact that you are an awesome, beautiful, smart individual will allow you to be more in control of your emotions. When something bad happens, rather than bursting into tears and getting nothing done, remind yourself that you have the ability to overcome this obstacle, whatever it may be. Once you believe you are confident and strong emotionally, you will unconsciously act stronger than before and begin to take control over your emotional whims. As it happens, it really is important to ‘stop and smell the roses.’ A person who takes time to enjoy life will be a happier, more peaceful person. We live incredibly rushed lives with lots of data coming at us from all angles. It is really important to occasionally stop and admire the world around you. Go on a hike, visit a museum, simply sit in your garden–what you do is up to you, but just remembers to take a minute and simply be where you are (Riffs, 2002).

Another thing that how face the negative emotions and disasters, so part of becoming stronger emotionally is recognizing our emotions, accepting them, and then moving on. Fear is a big part of losing emotional control. Everyone has them–whether you are afraid of being alone, or are simply terrified of spiders–but not everyone can control them. Part of accepting your fears are confronting them. Do something that scares you. Start small (i.e. catching a spider in a glass and taking it outside rather than screaming and throwing a shoe at it) and work your way towards larger fears (ie. spending several days by yourself, learning how to handle being alone.)When you get stressed out, you may find that don’t have as much control over your emotions. While it is nearly impossible to cut all stressful things from your life, you can learn how to deal with the stress that those things create (Lumb, 2007).

There is lot of factors contributing to emotional strengths including resilience. Resilience is the capacity to withstand stress and catastrophe. Psychologists have long recognized the capabilities of humans to adapt and overcome risk and adversity. Individuals and communities are able to rebuild their lives even after devastating tragedies. Being resilient doesn’t mean going through life without experiencing stress and pain. People feel grief, sadness, and a range of other emotions after adversity and loss. The road to resilience lies in working through the emotions and effects of stress and painful events (Fitzgerald, 2007).

Resilience is the absence of psychopathology in the aftermath of exposure to potentially traumatic events (Gabi & Wilson, 2005). Resilience is also not something that you’re either born with or not. Resilience develops as people grow up and gain better thinking and self-management skills and more knowledge. Resilience also comes from supportive relationships with parents, peers and others, as well as cultural beliefs and traditions that help people cope with the inevitable bumps in life.  Resilience is found in a variety of behaviors, thoughts, and actions that can be learned and developed across the life span and factors that contribute to resilience are Close relationships with family and friends, a positive view of yourself and confidence in your strengths and abilities.

The ability to manage strong feelings and impulses, Good problem-solving and communication skills, Feeling in control, Seeking help and resources, Seeing yourself as resilient (rather than as a victim), Coping with stress in healthy ways and avoiding harmful coping strategies, such as substance abuse, Helping others, Finding positive meaning in your life despite difficult or traumatic events (Kokoris, 2006).

1.3.3. Common emotional strengths

There is the list of emotional strengths including Creativity (Thinking of novel and productive ways to conceptualize and do things), Curiosity (Interest, novelty-seeking, openness to experience) Taking an interest in ongoing experience for its own sake; exploring and discovering, Open-mindedness (Judgment, critical thinking) Thinking things through and examining them from all sides; weighing all evidence fairly, Love of learning (Mastering new skills, topics, and bodies of knowledge, whether on one’s own or formally), Perspective (Wisdom) Being able to provide wise counsel to others; having ways of looking at the world that make sense to oneself and to other people, Strengths of Courage (Emotional strengths that involve the exercise of will to accomplish goals in the face of opposition, external and internal), Bravery (Valor) not shrinking from threat, challenge, difficulty, or pain; acting on convictions even if unpopular,  Persistence (Perseverance, industriousness) Finishing what one starts; persisting in a course of action in spite of obstacles, Integrity (Authenticity, honesty) Presenting oneself in a genuine way; taking responsibility for one’s feeling and actions, Vitality (Zest, enthusiasm, vigor, energy) Approaching life with excitement and energy; feeling alive and activated, Strengths of Humanity (Interpersonal strengths that involve tending and befriending others), Love (valuing close relations with others, in particular those in which sharing and caring are reciprocated), Kindness  (Generosity, nurturance, care, compassion, altruistic love, “niceness”) Doing favors and good deeds for others, Social intelligence  (Emotional intelligence, personal intelligence) Being aware of the motives and feelings of other people and oneself, Strengths of Justice (Civic strengths that underlie healthy community life), Citizenship (Social responsibility, loyalty, teamwork) Working well as a member of a group or team; being loyal to the group), Fairness (Treating all people the same according to notions of fairness and justice; not letting personal feelings bias decisions about others), Gratitude (Being aware of and thankful of the good things that happen; taking time to express thanks), Hope (Optimism, future-mindedness, future orientation) Expecting the best in the future and working to achieve it, Humor (Playfulness) Liking to laugh and tease; bringing smiles to other people; seeing the light side), Spirituality (Religiousness, faith, purpose) having coherent beliefs about the higher purpose, the meaning of life, and the meaning of the universe.

1.3.4. Theories of Emotional Strength

1.3.4.1. Strength and Vulnerability Integration (SAVI).

A Model of Emotional Well-Being Strength and Vulnerability Integration (SAVI) describe how processes of emotion regulation change in later adulthood. This model, illustrated that age-related differences in emotion regulation outcomes vary according to the timing of the emotion regulation process. Aging is related to increased strengths in the frequency and successful use of intentional strategies, appraisals, and behaviors to regulate everyday emotional experiences. These emotion regulation skills explain why researchers generally find higher levels of overall affective well-being with age when surveying younger, middle-aged and older adults. In addition, these strategies often allow people to circumvent or minimize the experience of negative emotions and stabilize or even enhance positive emotional experiences after initial exposure to minor irritations or setbacks. These strategies are also used long after an emotional event is over, when people are recalling the past (Seedy & Holman, 2010).

The greater reliance and successful use of these strategies with age stem from age-related changes in perspective garnered from time lived and time left to live. If these strategies are not employed appropriately or successfully, people will experience emotional distress. Because strategies to employ thoughts and behaviors to change the nature of the situation are no longer possible, subjective reports of emotional states of older adults will be more similar to those of younger adults. At the same time, age-related vulnerabilities are hypothesized to result in greater difficulty modulating the high and sustained levels of physiological arousal occurring at this time.

Reduced physiological flexibility leads to prolonged physiological arousal, hence delaying recovery from the event. Prolonged arousal may also create greater stress on the physical system with age. Thus, SAVI proposes that when older adults are able to employ the strengths of aging skills including intentional strategies, appraisals and behavior to avoid or de-escalate a negative event, age-related improvements in affective well-being will emerge. Slower physiological arousal to these events may even help to quickly de-escalate a short-lived experience (Cohen, S. R ,2010).

In situations where people cannot avoid negative experiences, however, age-related improvements in affective well-being will be attenuated and may even disappear completely. Situations where people cannot easily employ these skills include times when they encounter the threat or loss of social belonging, the continued exposure to chronic unrelenting stressors, or neurobiological dysregulation that makes employing skills to avoid distress difficult if not impossible (Susan &Charles, 2001)

1.3.4.2. Socio-emotional Selectivity Theory.

Socio-emotional selectivity theory posits that the priority placed on emotion-related goals increases with age. The theory maintains that two overarching sets of goals motivate much of human behavior. One set encompasses goals related to information and knowledge acquisition, and the other set of goals centers around emotional states and emotionally meaningful activities. Although both sets of goals are important for all adults throughout the life span, the relative importance of each one depends on a person’s temporal perspective. According to socio-emotional selectivity theory, all people have a conscious or unconscious perception of time left to live, and this temporal perspective correlates strongly with age. When people perceive time as expansive, as is normative for a younger adult living in a society with a long life expectancy, information goals are most important. When time left to live grows shorter, as in late life, emotional goals assume primacy (Carstensen, 2006).

Studies have directly examined both age and the role of time perspective on thoughts and behaviors aligned with emotion regulation strategies. Time is intrinsically related to age. Although people have successfully manipulated time perspective by asking people to imagine an impending ending or an expansive future, chronological age serves as a constant marker for the passage of time .As such, emotions increase in salience with age. In a test of age-related changes in the saliency of emotional versus non-emotional information, younger, middle-aged, and older adults were presented with emotional and non-emotional material and then later asked to recall what they could remember.

Socio-emotional selectivity theory posits that greater emotional saliency and desire to maintain emotional well-being will motivate people to regulate their emotions to maintain high levels of well-being. In this study of younger adults, people who were primed with emotion control-related words exhibited reduced emotional reactivity to negative stimuli. The authors attribute reductions in reactivity to greater increases in automatic emotion regulation strategies once emotional control was primed (Carstensen, 2006).

1.3.4.3. The Theory of the Dipper and the Bucket.

Each of us has an invisible bucket. It is constantly emptied or filled, depending on what others say or do to us. When our bucket is full, we feel great. When it’s empty, we feel awful. Each of us also has an invisible dipper. When we use that dipper to fill other people’s buckets — by saying or doing things to increase their positive emotions — we also fill our own bucket. But when we use that dipper to dip from others’ buckets — by saying or doing things that decrease their positive emotions — we diminish ourselves (Dipper & Bucket, 2004).

Like the cup that runneth over, a full bucket gives us a positive outlook and renewed energy. Every drop in that bucket makes us stronger and more optimistic. But an empty bucket poisons our outlook, saps our energy, and undermines our will. That’s why every time someone dips from our bucket, it hurts us. So we face a choice every moment of every day: We can fill one another’s buckets, or we can dip from them. It’s an important choice — one that profoundly influences our relationships, productivity, health, and happiness (Dipper & Bucket, 2004).

1.3.4.4. The Four Theories of Emotional strengths.

There are four main theories of emotion.

Firstly, that of James Lange. It states that emotions are not caused by the perception of an event but rather the physical changes within the body (Lange, 2002).

Cannon-Bard theory. It argues that emotion comes from the perceptual experience that results in the emotion acting independently from physical body changes, yet both occurring at the same time (Bard, 2004).

The Schechter-Singer Theory. It’s different in the way that it states, emotion derives from bodily influences, as well as the perceptual experience, but most importantly one needs to take consideration of the type of perceptual experience (Singer, 1998).

Opponent-Process Theory. It declares that emotions come from bodily changes, and each emotion we have has a balance with another opposite emotion. So that when we experience one emotion, it suppresses the other. Such as pleasure can suppress pain and vice versa (Ghodse, 1995).

Chapter 2

Literature Review

            Researches and different scientific studies in all fields have taken and direction and help from work done in past in the relevant field. Reviewing of the relevant literature gives the background information about the matter which is to be explored in the study. Literature review also provides further learning about the problem under consideration and at the same time removes the chances of the duplication of efforts (Good & Hatt, 1981).

In this study literature view was taken from the previous work such as thesis, relevant books, journals, articles related to relevant topic. This chapter explores the previous researches showed the relationship between the emotional strengths and posttraumatic growth. The present chapter will focus on relevant researches between these variables and other relevant factors.

2.1. Effect of Addiction

            Simon and Jones (2012) conducted research to see the addiction consequences on the brain system. Research states that drugs is a major contemporary public health issue, characterized by maladaptive behavior to obtain and consume an increasing amount of drugs at the expense of the individual’s health and social and personal life. He discovered abnormalities in frontal-striatal brain systems implicated in self-control in both stimulant-dependent individuals and their biological siblings who have no history of chronic drug abuse; these findings support the idea of an underlying neurocognitive endophenotype for stimulant drug addiction.

Nick and Gooder (2012) suggested a study on a growing clinical literature indicates that there is a link between substance abuse and stress. The study aimed to find out the relation between stress, motivation and addiction.  One explanation for the high co-occurrence of stress-related disorders and drug addiction is the self-medication hypothesis, which suggests that a dually diagnosed person often uses the abused substance to cope with tension associated with life stressors or to relieve symptoms of anxiety and depression resulting from a traumatic event. Stress reduction, either alone or in combination with pharmacotherapies targeting the HPA axis, may prove beneficial in reducing cravings and promoting abstinence in individuals seeking treatment for addiction.

Robert and Rider (1992) examine the effects of cocaine and marijuana use on the wages of young adults. The endogeneity of drug use in a wage equation is considered, and a two-stage least squares procedure is implemented. The results suggest that increased use of marijuana or cocaine is associated with higher wages. The positive relationship between drug use and the wage does not diminish with age. I also investigate whether systematic differences in the return to measures of human capital investments can explain the positive relationship between drug use and wages.

Foster (2010) carries a study examines glutamate plays a pivotal role in regulating drug self-administration and drug-seeking behavior. As be reviewed here, that glutamate receptors are involved in normal and drug-induced synaptic plasticity, drug reward, reinforcement and relapse-like behaviors, and addiction-related cognitive processes such as maladaptive learning and memory, behavioral inflexibility and extinction learning.

Christian (2013) make a study on drug use and its associated behaviors. The use of psychoactive drugs is a wide spread behavior in human societies. The systematic use of a drug requires the establishment of different drug use-associated behaviors which need to be learned and controlled. However, controlled drug use may develop into compulsive drug use and addiction, a major psychiatric disorder with severe consequences for the individual and society. Results show a crucial, but distinct involvement of the 5-HT system in both processes with considerable overlap between psychostimulant and opioidergic drugs and alcohol. Altogether suggest a new trajectory by which serotonergic neuroadaptations induced by first drug exposure pave the way for the establishment of addiction.

Chein (1964) hold view from some studies. He studies male heroin addicts and found symptoms of relief to be one of the most striking effects of drug use. They provide the explanation that drug gives feeling of comfort, disengagement from world even from the ones fantasies with essence of having all of its need satisfied.

A review of the effect of the addiction on the social life of addicts was conducted. The sample consisted of 50 males from the rehabilitation centers. Some psychological test conducted on the sample of addicts. Results showed that they were isolated and have no interest in the peers relationships and gatherings. They detach themselves from the world fantasies (Ahmad & Shafi, 2004).

Lennox and Johnston (1999) conducted a research on the effects of tobacco smoking on the health. The sample consisted of 100 people from different rusty areas. The analysis applied and results showed that such people had affected lungs and stomach because tobacco weakened badly the immune system of addicts.

2.2. Effect of Addiction on the Families

            Velamen and Coppell (2013) conducted a research and offers a conceptual overview of a neglected field. Evidence is presented to suggest that, globally, addiction is sufficiently stressful to cause pain and suffering to a large but uncounted number of adult affected family members (AFMs), possibly in the region of 100 million worldwide. A non-pathological stress–strain–coping–support model of the experience of AFMs is presented. The model is based on research in a number of different sociocultural groups in Mexico, England, Australia and Italy and aims to be sensitive to the circumstances of AFMs in low and middle income countries and in minority ethnic and indigenous groups as well to those of majorities in wealthier nations. It highlights the social and economic stressors of many kinds which AFMs face, their lack of information and social support, dilemmas about how to cope, and resulting high risk for ill-health. Family members affected by addiction have for too long been a group without a collective voice; research and action using the model and method described can make a contribution to changing that state of affairs.

The research deals with the impact of addiction on family, culture, women, older adults, mental illness, and sexual minorities. The American Society of Addiction Medicine Patient Placement Criteria, a treatment-matching scheme, was developed by professionals who incorporate client evaluation for placement at an appropriate level of care and financing. The results revealed that the family life disturbs more as compared to the addict. Whole family system destroys and suffers the difficulties (Samuel & Obembe, 2002).

Stanton and Shadish (1997) sort a review of synthesizes drug abuse outcome studies that included a family–couples therapy treatment condition. The meta-analytic evidence, across 1,571 cases involving an estimated 3,500 patients and family members. The family members who suffer because of addicted family member. Family therapy is as effective for adults as for adolescents and appears to be a cost-effective adjunct to methadone maintenance. Because family therapy frequently had higher treatment retention rates than did nonfamily therapy modalities, it was modestly penalized in studies that excluded treatment dropouts from their analyses, as family therapy apparently had retained a higher proportion of poorer prognosis cases.

David and Thomas (2012) conducted this retrospective study investigated relationships among early family circumstances, peer associations, and narcotic addiction. The sample was 601 urban males. Results of logistic regression analyses indicated that the extent of deviant behavior among close friends at ages 12–14 and disruption in family structure (parental divorce/separation) prior to age 11 were significantly associated with narcotic addiction. Additional regression analyses indicated that deviant behavior among family members, as well as family disruption, experienced prior to age 11, also increased the probability of association with deviant peers and a negative home atmosphere at ages 12–14.

2.3. Posttraumatic Growth and Families

Different researches proved the existence of posttraumatic growth that is of following. The study examined posttraumatic growth among refuges. Analysis used that shows good percentage of the Posttraumatic growth among refugees. They become more cooperative and accepted toward the problems and life difficulties (Vicki & David, 2012).

Calhoun and Richard (2002) state from a study that Personal growth resulting from a struggle with loss, for at least a stable minority of those who suffer it. Processes addressed include factors such as individual differences, the magnitude of the trauma and the growth processes facilitating a changed sense of self, changed relationships, existential and spiritual growth.

Young and Long (2014) examined that whether resilience and social support could predict PTG in women with infertility. The role of positive coping as a potential mediator was also assessed. Using a cross-sectional design, all members of a convenience sample of 182 women with infertility completed self-report measures of PTG, resilience, perceived social support, positive coping and background information. It was found that resilience, social support and positive coping positively correlated with PTG, which explained 34.0% of the total variance. The results suggested that positive coping partially mediated the impact of resilience on PTG while it totally mediated the relationship between social support and PTG.

Enrich and Christiania (2008) conducted research on the posttraumatic growth in Cancer patients and their families. It was found that they become more forgiving and helping towards others and life. They actually realize the reality of life and difficulties management.

Joseph, Patrice and Rojer (2010) Posttraumatic growth (PTG) in cancer patients has been studied and reported its progress in five main domains that’s were appreciation of life, relating to others, increased personal sense, sense of new possibilities and positive spiritual change

Yuli and Danfeng (2011) conducting a research on posttraumatic growth among parents of children undergoing inpatient corrective surgery for congenital disease. Posttraumatic growth was reported 74.3% in parents. Posttraumatic growth was positively associated with self-efficacy, resilience. Social support was positively associated with the domain of relating to others in the Posttraumatic Growth Inventory. The research studies the posttraumatic growth level of the patients with hemodialysis and examines the perceived social support, positive thinking and ways of coping. It was seen that there would be a good increase in optimism, social support to others, fatalistic coping family support and problem solving in such patients (Hactice & Seda, 2010).

The research studies the posttraumatic growth among the people who suffer the disaster and earth quakes. They show the positivity in their actions in later life and becoming more loving and passionate in helping others. It’s positively correlated with their sufferings (Zwahalen & Rama, 2010).

A meta-analysis is conducted to explore the relationship between posttraumatic growth and psychological and physical wellbeing in adults diagnosed with cancer or HIV/AIDS and examined potential moderators of these relationships. It includes the analysis of 38 studies (N = 7927) of posttraumatic growth after cancer or HIV/AIDS revealed that growth was related to increased positive mental health, reduced negative mental health and better subjective physical health (Alexander & Susanne, 2010).

Richard and Tedeschi (1990) conduct a research on posttraumatic growth in survivor and their societies.  Posttraumatic Growth Inventory (PGI) used to analyze the growth of survivors. Analysis shows that the survivor had good ratio of optimism and helping the others in their difficulties. Survivors often report positive changes in identity, philosophy, and goals.

Natalie and Chan (2011) investigate the association of the positive coping strategies, hope and optimism, on posttraumatic growth (PTG) in oral cavity (OC) cancer patients. Hope and optimism correlated significantly positive with PTG. Hope and optimism represent important indicators for PTG in OC cancer patients. An intact dyad relationship seems to be important for hope and consecutive higher levels of PTG.

The meta-analysis explored the relationship between posttraumatic growth and psychological and physical wellbeing in adults diagnosed with cancer or HIV/AIDS and examined potential moderators of these relationships. Analysis of posttraumatic growth after cancer or HIV/AIDS revealed that growth was related to increased positive mental health, reduced negative mental health and better subjective physical health (Alexandra & Susanne, 2010).

A study examined the relationship between coping, rumination and posttraumatic growth in mothers of children with autism spectrum disorders (ASD). Analysis indicated that positive coping positively predicted PTG and growth on relating to others, deliberate rumination  was positively correlated with growth on appreciation of life and intrusive rumination negatively predicted growth on personal strength, new possibilities and spiritual change (Hastings, 2005).

Research examined the relationship between copings, positive thinking and helping behavior in the families who have addicts. The studies shows positive correlation between this traumatic situation of having addict in home and coping, positive thinking and helping behavior (Jiang, 1999).

The research compared breast cancer (BC) survivors self-reports of depression, well-being, and posttraumatic growth with those of age- and education-matched healthy comparison women and identified correlates of posttraumatic growth among BC survivors. Groups did not differ in depression or well-being, but the BC group showed a pattern of greater posttraumatic growth, particularly in relating to others, appreciation of life, and spiritual change (Cordova & Cunningham, 2001).

Lehman, Wortman and Williams (1987) conducted Interviews with people who lost a spouse or child in a motor vehicle accident that occurred 4 to 7 years previously, and with a control group of non-bereaved individuals. The results provide support for the idea that most people perceived positive change as a result of the tragedy in fact, 74% of the bereaved respondents reported at least one positive life change. The two most frequent changes mentioned were increased self-confidence and focusing more on enjoying the present.

A meta-analysis study have reported that the death of a spouse, the surviving spouse may manifest such changes as greater feelings of self-confidence, a greater inclination to try new experiences, a greater awareness of one’s strengths (Bernard & Schneider, 1996).

McMillan (1997) conducted a longitudinal study among people who were exposed to one of three different disasters: a plane crash, a tornado, or a mass shooting. Three years after the disaster, respondents reported that they were able to identify some benefit regarding to social support, perception in positive sense and spirituality.

The research studies the posttraumatic growth among people who have lost a loved one, those who reported never searching for meaning reported fewer symptoms, reported higher well-being, and rated themselves as more recovered from the loss than those who reported searching for meaning (Davis 2000).

This study investigated the psychological impact of personal traumatic events in Judeo-Christian clergy. Analysis shows that personal traumatic events facilitate the posttraumatic growth, helping behavior and spirituality (Cann & Richard, 2007).

According to Young’un and Ling (2013) clinical experience with individuals facing infertility has demonstrated that positive psychological changes can arise from the struggle involved that names posttraumatic growth (PTG). The research studies the posttraumatic growth (PTG) in coronary artery disease outpatient. It is frequently reported after the strike of a serious medical illness. The study assesses the relationship between degree of cardiac“threat”and PTG. Results reported the significant relationship in good ratio (David & Peter, 2012).

The study aimed to explore prevalence and predictors of posttraumatic growth among adult survivors of a severe earthquake. Analysis shows that they produce positive outcomes after disasters, programs on adjustment and management (Jiuping & Liao, 2005).

The above quoted literature highlights the different psychological and societal aspect that studied and analyzed over the years. In nut shell, it can be concluded that life sufferings and traumatic situation that every person bears vary from individual to individual. In most researches the results lead to a same compilation that tragedies in the life make stronger the people, while the posttraumatic growth induces in the families or the persons after bearing the traumatic events and situations.

2.4. Emotional Strengths and families

Basically Emotional strength is the quality of having stable emotions, characterized by assertiveness, stress management, caring and coping skills. It is also about being positive about life, having inner peace and having hope for the future (Alexander, 2001). When some disease indicated in a member of some family, family members become stresses and lead to increase in their emotional strengths. To explore this assumption the study was conducted to investigates the emotional strengths among the families whose children diagnosed with cancer. The analysis reports they become emotionally stronger after such type of suffering and fears. Findings show more kindness, love and affection in such families (Maurice, 2012).

This research investigates the emotional strengths among the families who had the some family member addicted of drugs. The research conducted on the 200 families by taking some interviews. After conducting the interviews relevant problems inventories used and analysis conducted. So it was concluded that they possess greater degree of helping behavior, compromising nature and attitude (Paul & Niger, 2010).

According to Ryan and Smith (2004) conducted a research on the accidental survivors to check their emotional strengths after losing some part of body in accidents. Sample contains 75 people taken from different shelter homes who survive after severe accidents. The results suggest that survivors adjust the environment and make themselves strengthen emotionally, spiritually.

Alberta (2013) proposed this study to examined emotional strengths among refuges that lost their houses in earthquakes. The scale used in the study contains 21 items and PTG inventory was used. The study analysis shows that after lot of sufferings the refuges become emotionally stronger and helping attitude toward others. Their approach to take the things becomes so positive after the traumatic life experiences.

Najmuddin and Hassan (2011) conducted a survey that was done by selecting 338 high school educators from various boarding schools in Malaysia. All were the students who lose their parents in some tragedies and accidents. They responded to values in action inventory questionnaire in a good way. Data was analyzed using SPSS. Result from the study shows that there are four domains that significantly influence them were love, kindness, helping and empathy after such sufferings.

The study examine the  family  strengths  which  contribute  to the  overall  health  status  and health improvement  of  children who have mild, moderate, and severe  cerebral  palsy. The sample was taken from the different hospitals psychiatry wards and rehabilitation centers. From the results it was revealed that the people who bear all this problems and difficulties, it gives strengths to both family and children’s. They become more justice, spiritual and kind toward others (Marilyn & McCubbin, 2013).

Zabel and Saceomann (2007) conducted a study to examine the strengths of people who lost loved one in some accidents. The sample for the study was taken from the people who face the earthquake and sonami’s. The study results showed that such people have degree of strongness in life matters, understanding the problem of others, passionate in helping others, passionate in doing something in society

Maria and Gillani (2004) conducted the indigenous study on the patient of heart failure to assess their emotional strengths after that trauma. The patient sample was taken from cardiac hospitals and general targeted population with consent. The study aimed to find the emotional strengths of the heart failure people. The study consisted of both male and females. The findings of the study were all that showed the significant output of strengths. They describe degree of positivity and cooperation. Also study revealed the more satisfaction of that people toward the life.

Mustafa, Ashraf and Rabia (2011) studied the research on families of addicts to see their life difficulties and the ways how they cope with all that. The sample was taken from addiction centers of Lahore. In-depth interviews were taken using an interview guide. Through in-depth interviews data were interpreted to see how problems become the strength. From results it was revealed that significant correlation present between addictions related problems and strengths.

The research studies the emotional strengths level of the patients with hemodialysis and examines the perceived social support, positive thinking and ways of coping. It was seen that there would be a good increase in optimism, supporting others and problem solving in such patients (Robert & Susanne, 2007).

The study examines the impact of adjustment, love and coping of partners of cancer patients. Sample was taken from cancer hospital patients and cancer survivors. Interviews conducted by the patients. Data were analyzed and interpreted. The results showed the significant correlation between all these variables. The partner become compromising in themselves and also toward others in love and affection (Linda & Berry, 2000).

2.5. Summary

            The above quoted literature studied the different aspects of the drugs in relevance to addicts and families over the years. It’s also focus on the families approach to take the things positives and become stronger after bearing the sufferings. So according the researches addiction impacts on the drug addict life not limited to their occupation, education, and social life but also have impact on the drug addict biologically, physically and psychologically. Different types of drugs have different impact and lead to physical and psychological impairments.

Impairment occurs in the family system of addicts. Researches revealed that drug addiction effects on the whole family of addicts. A family suffers emotionally and also endures social labialization. They become isolated from the society and feels shame and guilt. Families of addicts needs the support and proper catharsis by which they able to work functionally.

Families of addicts when bears the lot of distresses and life difficulties by facing the society, they start accepting the change and sufferings and become adaptive toward these by coping the problems. As researches support’s that after passing the traumatic events such as loss of some loved one in accidents, having severed diseases such as cancer, heart attacks, renal failure, and people approach toward life become positive and they become emotionally stronger.

Literature focuses on the feelings of shame, guilt, fears and pains of the families of addicts and their growths from these tragedies of life like having an addict in the family and some o chronic disease patient.

2.6. Rationale

Family, friends and neighbors, experience the effects of substance abuse because a person who abuses substances often is unreliable. Families where addiction is present are oftentimes painful to live in. Living with addiction can put family members under unusual stress. Normal routines are constantly being interrupted by unexpected or even frightening kinds of experiences that are part of living with drug use. What is being said often doesn’t match up with what family members sense, feel beneath the surface or see right in front of their eyes. The entire system becomes absorbed by a problem that is slowly spinning out of control. Little things become big and big things get minimized as pain is denied and slips out sideways. Emotionally they become weak after such traumatizing situation that creates a sense of great disturbance in family functioning and abilities to enjoy the life. But after facing the different such situations a positivity created that’s basically psychological change in which person become positive toward life and strengthening in emotionality level (Coyer, 2001). The present study will be beneficial for the assessment of social and psychological functioning in the families of addicts and figure out their emotional strengths and posttraumatic growth.

2.7. Objectives

• The present research focus is to find out the relationship between emotional strengths and post traumatic growth in the families of addicts.
• The research is also focus to find out the contribution of each emotional strength to posttraumatic growth
• The research focus to find out which emotional strengths (Love, kindness, forgiveness, spirituality, hope) is the predictors of posttraumatic growth.

2.8. Hypothesis

1. There is the relationship between the emotional strengths and the posttraumatic growth.
2. Emotional strengths (love, forgiveness, kindness, spirituality, hope) are the predictors of posttraumatic growth.

Chapter 3

Method

The Purpose of the study was to investigate the correlation between emotional strengths and posttraumatic growth among the families of addicts

3.1 Research Design

       Correlational research design was used to assess the relationship among the posttraumatic growth and emotional strengths in the families of addicts.

• Sample

In the present research purposive sampling technique was used. Sample consisted of 100 family members of addicts from different addiction centers and hospitals (N=100). They participated voluntarily and anonymously in the study.

3.2.1. Inclusion Criteria

• Only first biological relatives of addicted patient were included (mother, father, and siblings).
• An education minimum level of families was matric.

3.3. Assessment Measures

• 3.3.1. The Posttraumatic Growth Inventory

The Posttraumatic Growth Inventory developed by Tedeschi and Calhoun (1996) used to assess the positive outcomes reported by the persons who had experienced traumatic events. This inventory has 21 items scale and includes factors of New Possibilities, Relating to Others, Personal Strength, Spiritual Change, and Appreciation of Life. Reliability of this scale reported by authors is .81.

• 3.3.2. The Values in Action Inventory

The Values in Action Inventory of Strengths (VIA-IS) is a psychological assessment measure designed to identify an individual’s profile of character strengths developed by Christopher Peterson and Martin Seligman in 2005. It contains 6 virtues and 24 strengths. The VIA-IS is composed of a 240 item measure of 24 character strengths (10 items per strength). On average, an individual will complete the VIA-IS in 30 to 40 minutes. High rates of agreement, desirability, and development of VIA character strengths were found in remote cultures. There are 24 strengths of character that meet 8, 9, or all 10 of the following criteria: fulfilling, morally valued, do not diminish others; no felicitous opposites; trait like; distinctiveness; paragons; prodigies; selective absence; institutions/rituals. It’s also used to measure military, homelessness, abuser survivor domains. Reliability of this scale is .86. The scoring is based on the Likert Scale. The item example is:

• I am always willing to take risks to establish a relationship.
• There are people who accept my shortcomings.

3.4. Procedure

An authority letter explaining the nature of the study was sought from the Institute of Applied psychology, University of the Punjab, Lahore. The post Traumatic Growth Inventory and The Values in Action Inventory were administered after getting permission from the respective authors via e-mail. Permission was taken from the addiction centers and hospitals. Selection of the participants is from the addiction centers were based on the criteria of first biological relatives. One day was selected for each addiction center and hospital for the collection of data and families were called on that day. Before the administration of questionnaire, participants were briefed about the nature and the purpose of study. They were assured of the confidentiality of their information. It took about 15 to 20 minutes to complete all the questionnaires from each participant. The response rate was 100% because all the questionnaires were completed and given back to the researcher.

The selection of the post Traumatic Growth Inventory (PGI) and The Values in Action Inventory (VIA) based on the conduction of interviews from the families of addicts. The sampling strategy used for interviews conduction was snowball sampling. As I met the first family I had observed that they were in great pain because of the family member who addicted. When I questioned and start interviewing they reported that sufferings gave the pains but also make them strengthen to cope with this world. Same would reported by others family. One family reported that because of having addicted member, an increase in positive attitude like love, spirituality and kindness.

As I go on interviewing families I felt empathetic for the families about how they are suffering due to their addict member. Then I realized that we should support them and work again addiction. After collecting data, statistical analysis was applied to analyze data.

3.5. Ethical Considerations

In order to conduct this research, following ethical considerations were kept in mind.

• Permission was taken from concerned authorities of the data collection by using the permission letter provided by the Institute of Applied Psychology, University of the Punjab.
• Tools were used after getting permission from their representative authors.
• The consent was taken from the participants and they were allowed to withdraw from participation and terminate at any point of study they wish.
• The participants were assured that the information required from them would be held confidential and would not be used for any other purpose other than this research.
• Results were reported accurately.
• Utmost care was taken to not cause any distress as the families are already unhappy and under pressure as well as overwhelmed and feeling helpless due to addiction problem of their family member.

3.6. Statistical Analysis

• The SPSS software version 16.0 was used to analyze the data.
• Descriptive statistics such as mean, standard deviation and demographic data were tabulated.
• Regression analysis was used to assess the predictors of posttraumatic growth.
• Correlation was used to find relationship between posttraumatic growth and emotional strength among families of addicts.

Chapter 4

Results

This study aimed to investigate the relationship between emotional strengths and post traumatic growth among the families of addicts. First the descriptive statistics such as frequency and percentage were computed to provide a preliminary profile of the studied variables. After this Pearson product moment correlation was used to assess relationship emotional strengths and posttraumatic growth. In Third step regression was used to assess the predictors of posttraumatic growth.

Table 4.1

Descriptive Statistics of Studied Variable (N=100)

Variables	M	SD	Min-Max	Α
Love	3.74	0.48	3-5	.70
Kindness	4.27	0.64	2-5	.61
Forgiveness	3.74	0.48	2-5	.59
Hope	4.10	0.63	2-5	.71
Spiritual	3.92	0.51	3-5	.66
Emotional Strength	188.23	18.85	151-223	.87
Posttraumatic Growth	44.56	10.93	26-92	.83

Table showed mean, standard deviation, minimum maximum scores of variables and reliability of variables post traumatic growth, emotional strength and its subscales i.e. love kindness, forgiveness, hope, and spirituality. Emotional strength showed highest reliability among all variables.

Table 4.2

Relationship between Emotional Strengths and Post Traumatic Growth (N=100)

Variables	1	2	3	4	5	6	7	M	SD
1. Love	–	0.49***	0.57***	0.25**	0.45***	0.76**	-0.30**	3.74	0.48
2. Kindness	–	–	0.58***	0.39***	0.43***	0.77**	-0.16	4.27	0.64
3. Forgiveness	–	–	–	0.24*	0.47***	0.76***	-0.36***	3.74	0.48
4. Hope	–	–	–	–	0.40***	0.64***	0.15	4.10	0.63
5. Spiritual	–	–	–	–	–	0.75***	-0.09	3.92	0.51
6. Emotional Strength	–	–	–	–	–	–	-0.20*	188.2	18.8
7. Post Traumatic Growth	–	–	–	–	–	–	–	44.56	10.93

Note: ***p<.001, **p<.01, *p<.05

Pearson product moment correlation was used to find out relationship between emotional strength and post traumatic growth. From the above analysis it was observed that there was significant negative relationship between emotional strength and post traumatic growth. This shows that increase of emotional strength leads to low post traumatic growth and vice versa. Subscales of emotional strength i.e. love and forgiveness showed significant negative relationship with post traumatic growth while hope, kindness and spirituality shows the insignificant negative relationship with posttraumatic growth.

Table 4.3

Multiple Regression Analysis for Predicting Post Traumatic Growth with Emotional Strength (N=100)

Predictors	Posttraumatic Growth
	B	SE	95 % CI
Constant	67.4	10.1	[47.2, 87.6]
Love	-4.72	2.68	[-10.0, 0.60]
Kindness	.27	2.068	[-3.83, 4.380]
Forgiveness	-7.63	2.84	[-13.28, -1.985]
Hope	4.53	1.78	[0.966, 8.10]
Spirituality	.92	2.4	[-3.930, 5.77]
R2	.21
F	5.17

Note: *p<.05, **p<.01, ***p<.00,, CI=Confidence Interval

The results in Table 4.3 revealed that score on emotional strength hope is the only that is positively and significantly predicting posttraumatic growth, which means that as the scores on hope increase, the scores which signify posttraumatic growth also increase. Forgiveness is negatively predicting the posttraumatic growth. The results revealed that the influence of scores on emotional strength hope and forgiveness on posttraumatic growth is β = .261. And β = -3.36 respectively.

4.4. Summary of Results

1. There was a significant negative relationship between emotional strength and post traumatic growth.
2. Love and Forgiveness showed significant negative relationship with post traumatic growth.
3. Emotional strength hope positively predicting the posttraumatic growth among the families of addicts while forgiveness significantly negatively predicting the growth.

Chapter 5

Discussion

In Pakistan Addiction rate is increasing day by day and efforts to reduce this is also increasing as well. Addiction not only affects individual’s personal life but also whole family and community. The individuals or family members try their level best to combat addiction. Addiction treatment is not very easy task. A number of psychosocial aspects are involved in it. Individuals own personal skills play a vital role in it as well as family is it’s a great supportive pillar. They suffer the lot of difficulties and face the community and relatives who labeled such families that having an addict. When families passed through this pained time, they lead toward the positivity and strong emotions (Rutter, 2005).

This research aimed to investigate the relationship between emotional strengths and posttraumatic growth among the families of addicts. First it was hypothesizes that there is a relationship between emotional strengths and posttraumatic growth among the families of addicts. Secondly it was hypothesized that emotional strengths (love, kindness, spirituality, forgiveness, hope) was the predictor of posttraumatic growth. The present results were not so consistent with earlier findings.

The first hypothesis result suggests that there is negative relationship between emotional strengths and post traumatic growth.  In addition in this relation forgiveness significantly negatively correlated with posttraumatic growth.  It was contradictory from the previous literature of this study. Previous literature supported our hypothesis and sates that posttraumatic growth and emotional strengths positively correlated with each other. Some studies are mention here that chains the new findings of study.

Fingarette (1991) found that PTG involves alterations in self (such as new directions or enhanced spirituality and religiosity) and changes in relationships with others, forgiveness as the release of negative feelings toward another and the adoption of positive attitudes might form a causal link between the offense and later growth. In fact, a prominent model of forgiveness suggests that individuals find an altered sense of purpose, one component of posttraumatic growth, through engaging in forgiveness.

Similarly another research by Helmuth (2003) suggested that increased in forgiveness decrease growth and reduce distress. EA was negatively related to PTG and forgiveness, suggesting that contact with private events following trauma may promote growth and forgiveness. The difference is result is may be due to sample and culture biased. It is may due to sample collected don’t perceive post traumatic growth in them.

Another finding gave the evidence that Posttraumatic growth may follow the experience of being significantly hurt by another person. This study examines the roles of forgiveness and the importance of religion and spirituality in posttraumatic growth after a significant interpersonal transgression among a diverse. The sample of 146 adults was included. Results demonstrated that transgression severity was negatively related to forgiveness: the more distressing the event, the more revenge and avoidance were endorsed in response to the offender. Regression analyses used and revealed that benevolence toward the offender predicted growth in the area of relating to others. The negative relationship between forgiveness and posttraumatic growth was predicted. Results suggest that religious and spiritual variables influence how individuals respond to significant interpersonal transgressions through positive processes (Schultz & Benjamin, 2013).

A theory that’s Opponent-Process Theory, It declares that emotions come from bodily changes, and each emotion we have has a balance with another opposite emotion. So that when we experience one emotion, it suppresses the other. Such as pleasure can suppress pain and vice versa but it’s not always happened as (Ghodse, 1995). As from findings it’s reported that there is significant negative relationship between growth and emotions. One thing increase that is a person growth but at the same time relief for others are not developed.

Further the assessment measures were not in native language and experiences of post traumatic growth was not assessed qualitatively that may explain more the level of clarity of subjects with the construct. This relationship can also be affected with the presence of other mediating and confounding variables such as role of spirituality, religiosity, and familial support, marital and socioeconomic status.

The second hypothesis of this study is emotional strengths (love, kindness, forgiveness, hope, spirituality) are the predictors of the posttraumatic growth among the families of addicts. The regression analysis suggested that hope positively predicts the post traumatic growth. These findings were consistent with the previous findings. Miller and Kurtz (1994) found that hope and optimism predict post traumatic growth among the survivors of mount eruption.

Another research by Haring and Natty (2011) focuses on the post trauma adjustment of traumatized war refugees, with a special focus on the possibility of positive transformation. Specific predictors and correlates of posttraumatic growth were examined. The sample was consisted of Somali refugees. Posttraumatic growth was assessed with the Posttraumatic Growth Inventory. The results of the study demonstrated significant accounts of posttraumatic growth among Somali refugees, as well as additional areas of positive changes. Hope, religiosity, negative religious coping, and satisfaction with perceived social support were positively related to reported growth.

Wiesel and Amir (2003) studied the possibility of posttraumatic growth and strengths after the severely traumatizing experience of the Holocaust among child survivors currently living in Israel. He investigated the possibility of personal growth following torture of Palestinian ex-prisoners from the Gaza strip and demonstrated the role of socioeconomic factors in enhancing PTG. However, high levels of torture among the prisoners hindered the capability of generating positive experiences, hope and optimism.

Another research by Ward (1985) concluded that distinct variations of age at diagnosis, marital status, employment, education, prognosis, emotional intensity of disease, and adaptive coping account for variance in posttraumatic growth in relationships with others, new possibilities, and appreciation for life, respectively. At the same time, hope, optimism, time since illness, surgical procedure, prior health status, the presence of children, and ethnicity were significantly related to any of the sub-domains of the Posttraumatic Growth Inventory (PTGI) in breast cancer survivors.

Similarly Ziegler, Osmond, and Newell (1968) found that there is a relationship between hope and post traumatic growth. They attempted to define the factors that make survival of such families. The result of this study identify the hope is a thing that cause the survival.

Kumar (2001) states that the restoration, maintenance, and development of hope were revealed to be greatly beneficial for Somali refuge. Hope is a means of mastering challenges that refugees face in resettlement and is the basis for future possibilities of thriving. He said the concept of hope, in comparison with optimism, seems to hold more emotional and motivational components, which are essential in managing distress and experiencing positive changes following severe trauma

Bannano (2004) also conducted a research to see the survival of the people after the earthquake who losses their homes and loved ones in this tragedy. The sample consisted of 150 survivors. Analysis conducted and results showed that after survival increase in the hope of that people and personal growth in respect to the optimism in self and toward others.

The conversation is at this juncture that why just the hope is the predictor of posttraumatic growth. Other variables like love, kindness, spirituality and love is not create such variances in families of addicts. According to Roger and Whalen (2011) positive coping strategies, hope and optimism, have an impact with posttraumatic growth (PTG) in oral cavity (OC) cancer patients. This study concludes that hope covers all the factors like love, forgiveness. Hope and optimism represent important indicators for PTG in OC cancer patients. An intact dyad relationship seems to be important for hope and consecutive higher levels of PTG.

Powell and Solomon (2006) supposed that the experience of extreme trauma—in the form of forced labor impeded the development of personal growth, in accordance with previous research These results indicate that mental health professionals should pay special attention to the treatment of severely traumatized refugees and allow more time for the development of positive self-changes. In the initial phase, the restoration of safety, trust, and hope should be the central focus of rehabilitation, followed by gradually addressing issues of personal growth.

Further to reveal these facts interviews was conducted from the family member of addicts in Narcotics Anonymous (NA) meetings. Basically Narcotics Anonymous sprang from the Alcoholic Anonymous Program of late 1940, with NA meetings. Today Narcotics Anonymous is well established throughout much of north and South America. NA’s earliest self-titled pamphlet known among members as “ the white booklet”, describe narcotics anonymous as the non-profit fellowship helps the man and women in the society who passed through the difficulties and specially for the families of drug addicts. In these meetings members of addicts families share their success and problems in overcoming the addiction and living the drug free productive lives, homes and societies.

Basically these meetings enable a person to face past destructive actions squarely and then repair the damage done to families. We visit the NA meetings to make our findings validate. Open ended questions asked by families about their emotional strengths like hope, love, forgiveness and spirituality to find that why just hope predicts the positive thinking’s and approach toward the life in families of addicts.

From families interviews and stories that shared anonymously, in Nar-Anon meetings I had observed and it’s reveled that hope is the basic emotional strength need for the personal growth from the traumas. When i had talk to a family member of an addict. She shared her story that her brother a recovering addict. When it’s exposes to the family members, everyone got shocked and became restless. She states It was during that phase of extreme dejection and helplessness that I came to know of a group for the families and friends of drug addicts. My brother had just returned from his latest sojourn in rehab after suffering another relapse. My family and I were all broke and clueless about what to do next. We were obsessed with monitoring him, even while he was in the washroom. It was becoming insane. I knew that a Narcotics Anonymous group for drug addicts was active in Lahore and had sent my brother to some of its meetings, but recovery from addiction is not just about being ‘dry’ (i.e. not taking alcohol, drugs, etc.) but working on one’s self.  I started working on the self and coping this trauma with the help of meetings. First the personal growth followed by the hope that hope of life and survival from this tragedy. She shapes that hope is everything, when hope developed other factors like love and forgiveness followed by this.

Another story shared by an addict family member anonymously that a recovery gentleman above the 50 years age. He attributed his recovery to his daughter condition. He was very upset when he realized that his daughter leading the same life as he did before 25 years ago. He became hopeless and feeling guilt and shame. Whole family disturbs from his daughter addiction. He started visiting NA family meetings. After attending the meetings he states “we searching for an answer when I reached out and found Narcotics Anonymous. I had come to first family meeting and didn’t know what to expect. After sitting in the meetings, I began to feel that life not ends with these issues. A hope started arousing in my heart, mind and even excite my whole body”. So it’s observed that for the recovery of addict, first the recovery of family members necessary. Recovery is what happens in family meetings. Our life’s are at stake.

There are many theoretical models that may help describing the drug addiction in families. First talk about the moral model it states that families’ weaknesses are the result of human weaknesses and defect to don’t know about that how to face the things. They often have scant sympathy for the people with serious addiction problems in the family. So the family member of an addict with the greater strengths could have the force to break this nutshell in which they closed because of shame of having an addict in the home. The moral model applied to some extent, perhaps purely for social and political reasons, but it’s no longer widely considered having any therapeutic value.

Biological model talks about that “changes of emotion in the person are not caused by the perception of an event but rather the physical and hormonal changes within the body (Lange, 2002).  So when people go through these sufferings, emotions changes and support a person as happened in families of addicts. At the same time Bard (2004) argues that emotion comes from the perceptual experience that results in the emotion acting independently from physical body changes, yet both occurring at the same time. But after conducting interviews from family members of addicts and by observation it’s reveled that perception of event not more supported it’s because of hormonal changes.

As Action Growth Theory from cognitive perspective explains that a stressful or traumatic life event often results in high levels of psychological distress, because such an event poses a significant challenge to the individual’s psycho-social resources (e.g., self-esteem, health, and social support networks). While this model acknowledges that self-reported experiences of growth often occur after adversity, it argues that posttraumatic growth does not simply result from cognitive attempts to find meaning and re-structure assumptive beliefs about the world (Butler, 2010).

For posttraumatic growth to occur individuals must translate these cognitive benefit-finding processes into action. Similar to other perspectives described earlier, posttraumatic growth has two possible manifestations – an illusory coping side and a functional and constructive side. The model claims that the illusory side of posttraumatic growth (i.e., cognitive attempts to find positive benefits in adversity) might simply function as a coping mechanism in the aftermath of extreme stress, and not necessarily translate into real positive change.

The families of the addicts share many environmental, psychological factors that may contribute to their growth and strengths. Results of these studies agree on the influences of domains of personality, growth and strentgs on an individual member of family of addict that also stops due to some factors like shame, blame, and fear of having an addict in family.

Recovery is the experience of meaningful productive life. Recovery is not only associated with the addicts, it’s equally important for the families whose grief all the pains.  The term recovery promises the ability to get back what one once had and such holds out unspoken hope for a return of lost health, lose esteem, lose relationships and lost social and financial status. So a family goes to recovery when they have positive approach toward life and become strengthen by enduring all problems.

Consequently it can be concluded that findings of the current research was incongruent with the previous researches but not so because some findings also gave validate description. Inconsistency with earlier findings may be due to many cultural, religious and personal factors that account for and contributed to results.

5.1. Conclusion

• The present study was focusing on highlighting the emotional strengths and posttraumatic growth among the families of addicts.
• In a nutshell emotional strengths are negatively correlated with posttraumatic growth.
• Love and forgiveness negatively predicts the posttraumatic growth.
• Hope positively predicts posttraumatic growth in families.
• Most of the literature is consistent with the results of present research but the great number of researches shows the overall positive impact of sufferings that family of addicts bears.

5.2. Limitations

• The research based on the data of 100 families. Sample size was not so small but required more for more accurate and valid findings.
• The information provided by respondent is not so validate because the family members were stressed.
• The sample used for this study is purposive. Purposive sampling has the drawback of subjective bias so the results cannot be reliable as they should be
• Language barrier is occurred in this research because the English version of the inventories used whiles its need to be translated.

5.3. Suggestion

Following some suggestions for the improvement of studies

• Further researches should be done upon explored result and more of its dimensions should be found using qualitative method.
• Socioeconomic status must be studied because it gave a direction that which class of families have more emotional strengths and take things positively.
• Sample size should increase to increase the validity and reliability of results
• Probability sampling should be used.

5.4. Implications

• Our results provide several insight and significant association between emotional strengths and posttraumatic growth.
• Although further studies necessary to find out the confirmation of our findings in other populations and settings.
• The findings emanating from it should be subjected to more rigorous researches on the families of addicts.
• This research highlights the importance of families in relation to those members who are addicted that how they suffer and cope with the life difficulties.

The Relationship Between Empathy, Emotional-Behavioral Problems and Cyber Bullying Among Young Adults

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• Seilhamer, R. A. (1991) “Effects of addiction on the family” in D.C. Daley and M.S. Raskin (eds.) Treating the Chemically Dependent and their Families (pp. 172 194) Sage Publications, Newbury Park, California.
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• Vetere, A. and M. Henley (2001) “Integrating couples and family therapy into a community alcohol service: A pantheoretical approach” Journal of Family Therapy, 23:85-101.
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