5.4.1 Trauma and Change in Identity Strength

In some of the earliest research I completed after my PhD, I was interested in how experience of the political violence in Northern Ireland affected people. By that stage, it was clear to me that many people in my life had been affected by their experiences over the course of the conflict. My father was from the border region and he and his family had been devastated by the imprisonment and subsequent death of his brother as a young man. This brother, my uncle, had become involved in the Irish Republican Army’s 1960s ‘border campaign’, a period of warfare that predated the later and better-known ‘Troubles’. Similarly, my husband and his siblings had lived through the violence in the Bogside of Derry as children in the early 1970s. These were dark days and his childhood had little of the hope that characterised and popularised the recent Derry Girls TV show, set as it was more than twenty years later in the 1990s.

My father was, psychologically speaking, a strong man. He was resilient and purposeful. His brother’s death was not something he spoke of often, and indeed I was in my twenties before I heard the full story from a cousin. The past was not something that my father ever wanted to dwell on. He (and my mother) were of the school of thought that you could ‘make too much of things’. My father did have very different views politically to many people I knew, and to those who lived and worked around him in the Dublin area, where he lived most of his adult life. He was one of the few people I knew who voted against the Belfast Good Friday Agreement, the accord that brought a resolution to the conflict in Northern Ireland. Indeed, 99 per cent of the population in the Irish Republic voted in support of it. My father’s position was ideological and unmovable. We shouldn’t give up the claim on Northern Ireland, or the North of Ireland, as he preferred. Reunification wasn’t an aspiration as laid down in the Belfast Good Friday Agreement; in his view, it was an ideological imperative.

Drawing on these observations, in some of the early research I completed, I was interested in how potentially traumatic experiences might affect people’s commitment to their political positions. My working hypothesis was that if traumatic experience strengthens a person’s sense of identification with a group, this will tend to reduce its psychological toll. However, if the trauma compromises belonging or identification with a meaningful group, then this will tend to amplify mental health costs. In the social identity literature, a wealth of research has demonstrated that adverse experiences, such as discrimination, increase identification with the group. Schmitt et al. (Reference Schmitt, Branscombe, Postmes and Garcia2014) have demonstrated convincingly that adversity and discrimination as a consequence of social identities (such as race or gender) can lead to increased social identification with a person’s group. My sense then, and now, was that these findings also had important implications in terms of the impact of trauma. Social identities can be powerful resources in the face of adversity and trauma. Traumatic experience can consolidate an identity, thus generating the resource people need to adapt to the event.

There was a cost for my father in losing his older brother. They had had a good relationship growing up. His death and the loss of his life was perhaps easier to bear if it was linked to the pursuit of a higher-order political goal. And though my father himself never supported any campaign of violence in Ireland, he had a strong view that Ireland had a legitimate claim to the north-eastern six counties of Ireland and that it ought to be honoured. Psychologically speaking, absorbing the cost of his brother’s death may have been easier for him to rationalise if he could see it as part of a wider collective effort, a loss endured in the hope of better days ahead – if he could ‘winter it out’.

This type of identity process is evident in a large-scale representative study of the population in Northern Ireland and the Border Regions that we have completed (Muldoon et al., Reference Muldoon, Schmid and Downes2009; Schmid and Muldoon, Reference Schmid and Muldoon2015). Personal experience of the conflict mattered to the strength of people’s identification with their preferred national group. This effect was apparent for people who had the highest direct experience of conflict and trauma as well as those, like my father, who could be thought of as having an indirect experience of conflict-related events. The effect was there for those who saw themselves as Catholic/Irish as well as British/Protestant. There was no difference between the two ethnoreligious groups. Importantly, at least for our present purposes, the extent to which the conflict was associated with psychological well-being was driven by people’s strength of national identity. Whilst the perceived threat associated with the conflict had a direct negative effect on well-being, there was also an indirect positive effect of social identification on well-being. So, we find that those with the most experience of political violence were those with the strongest identification with their national group and that this strong pattern of identification protected psychological health.

As well as well-being, we measured post-traumatic stress (PTS) in those who reported a particularly traumatic event. Exposure to conflict-related violence was a significant predictor of PTS. However, strong national identification was associated with fewer symptoms of PTS (Muldoon & Downes, Reference Muldoon and Downes2007). Respondents with a strong sense of national identity, who saw their preferred nationality as an important part of who they were, were those who were least likely to be PTS ‘cases’. Central to understanding expression and maintenance of PTS symptoms are people’s subjective appraisals of events. Perhaps not surprisingly, then, subjective perceptions of threat are more powerful predictors of symptoms and responses to treatment than ‘objective’ indicators (Alvarez-Conrad, Zoellner, & Foa, Reference Alvarez‐Conrad, Zoellner and Foa2001). Identification can thus be seen as an important factor that alters perceptions of threats, including those emanating from other groups as a result of intergroup tensions and violence (Schmid & Muldoon, Reference Schmid and Muldoon2015).

In other parts of the world, we find similar patterns of resilience and risk linked to identity strength. In Lebanon, mothers with the strongest commitment to their group position during the conflict show the lowest level of PTS symptoms. This benefit was also evidenced in higher levels of well-being of their children (Qouta et al., Reference Qouta, Punamki and El Sarraj2008). And in Palestine, those who see the political violence as essential to improving the rights of Palestinians experience less psychological distress despite greater exposure to conflict-related violence (Hammack, Reference Hammack2010). Effectively, a person’s subjective social identification with their political group affects interpretation of both threat and violence. This allows the traumatic experiences associated with the conflict to be interpreted as meaningful, and even expected, towards achieving valued group outcomes. This minimises the health costs of the trauma and in particular is associated with less PTS.

Interview research also indicates that political and religious activists understand trauma as something that can be endured. It is taken as reflecting and embodying a higher commitment to a cause and one’s part in it (Silove, Reference Silove1999). Indeed, because of this, activists demonstrate reduced risk of PTS (Basoglu et al., Reference Başoğlu, Paker, Özmen, Taşdemir, Şahin, Ceyhanli and Sarimurat1996). In their studies, Basoglu and colleagues observe that among those who experience torture within their own countries, political activists tend to be less traumatised than non-activists – even though activists often endure more severe torture (Basoglu et al., Reference Basoğlu, Paker, Paker, Özmen, Marks, Incesu and Sarimurat1994; Basoglu et al., Reference Başoğlu, Mineka, Paker, Aker, Livanou and Gök1997). Moreover, non-activists – who have little or no commitment to the cause, and also had no pre-trauma expectations of arrest or torture – are more likely to experience psychological distress. They also experience higher levels of PTS than members of activist groups. Thus, despite their prolonged exposure to severe traumatic experiences, Basoglu and colleagues observed that levels of PTS among activists were moderate rather than severe, and that those with strong commitment to their cause were least likely to be symptomatic.

This brings us to the fit between an identity and the trauma experienced. We conducted another analysis of the same large dataset (N = 3000; Muldoon et al., Reference Muldoon, Schmid and Downes2009) where we considered which group memberships were useful for negotiating trauma. In Northern Ireland, there were by this time three widely used national categorisations: British, Irish and Northern Irish. Self-categorising as British or Irish is generally associated with the long-standing oppositional political attitudes associated with the conflict. These are the two sides from which the violence is seen to arise. Seeing oneself as Northern Irish is a relatively more recent national identity associated with more inclusive and socially progressive attitudes (Lowe & Muldoon, Reference Schmid and Muldoon2015) that emerged after the Belfast Good Friday Agreement. In this second analysis, we looked at not only the strength of identification but also people’s preferred national self-categorisation. National identification protected well-being for respondents who described their identity as British or Irish. However, this mechanism did not mitigate the impact of conflict experiences for those who saw themselves as Northern Irish. This is consistent with the historical context, where British and Irish identities (rather than the Northern Irish identity) are used to frame, and help to make sense of, the animosities of the conflict.

In essence, then, we see that it is only when a group offers an interpretative frame to assist understanding of the traumatic events endured that strong social identities are helpful. Taken together, this evidence suggests that identities associated with the trauma of political conflict can provide an interpretative lens through which any traumatic experiences are given meaning. In this way, conflict-related events can appear less traumatising and are endured because they are seen as part of a wider collective cause. On the other hand, events that undermine identity positions can lead to increased post-traumatic symptoms. Put differently, these findings suggest that people are less likely to be traumatised by violence that flows from conflict if they define themselves in terms of a social identity that allows them to make sense of that conflict in a meaningful way. So, a strong sense of the importance of ‘us’ and ‘our cause’ can make conflict worth enduring. Without this, the conflict and its traumatic consequences are much harder to negotiate.

5.4.2 Trauma and the Subjective Devaluation of Identities

Where traumatic events arise from experiences that undermine people’s faith in themselves, or others they value, social identities may not be able to offer an appropriate interpretative frame. This may be particularly likely when the trauma emanates from trusted others with whom we share a strong social identity. For example, being a victim of torture is consonant with the expectations of highly identified political activists who oppose a political regime. It is not, however, consonant with the expectations we have of our parents, siblings and spouses or even state services such as the police or health and social care services. In these latter examples, the traumatic experiences can be a violation of our beliefs about people and things we previously held dear. If traumatic experiences undermine highly valued identities and identity-based connections, they can also undermine our sense of ourselves as a cherished member of that group. It is to this issue we now turn.

Returning to my own story of depression, and in particular the weeks and months after my friend’s death by suicide, there were many dark days. I really valued my friendship with Clare and thought of her as a close and dear friend. I have always valued friendship and have tried to be a good friend to others. I was saddened by her death but also felt that I failed her. I didn’t see her death coming, and that left me with a sense that I was not a good or useful friend. I ruminated on whether I could have done more. I felt guilty. These types of feelings, of guilt, shame, sadness, humiliation, frequently accompany and exacerbate poor psychological health in the aftermath of traumatic experience (Freyd, Reference Freyd1996; Resick & Schnicke, Reference Resick and Schnicke1992; Reynolds & Brewin, Reference Reynolds and Brewin1999). In a series of studies with passengers who survived the sinking of the cruise ship Jupiter, those who attributed negative experiences during the unfolding disaster to their own actions had much poorer mental health outcomes and more severe symptoms of PTS (Joseph et al., Reference Joseph, Brewin, Yule and Williams1991; Joseph et al., Reference Joseph, Brewing, Yule and Williams1993).

The two years that immediately followed Clare’s death I probably found the most difficult. I was trapped in a cycle of going over old messages, replaying events endlessly, wondering if I could have done more, or less, or better. I recall a colleague commenting that there were many who would claim friendship in the wake of her death. This I could not understand, as all I had was a profound sense of having failed as a friend. It is true that there can be a kind of beatification of those who die young. Indeed, ‘Only the good die young’ is immortalised in Billy Joel’s lyrics. There can be an additional unhealthy aggrandizement of those who die by suicide (Carmichael & Whitely, Reference Carmichael and Whitley2018). As I ruminated endlessly over my failings as her friend, I was very clear she was the best friend I had so wanted as a child. Finding that connection in young adulthood was wonderful. Feeling that you hadn’t lived up to her friendship was devastating.

Shifting contexts can impact on the value, or devaluation, of identities. So even though people may be able to harness social identities in support of their health at one point in time, a change in the context or, for that matter, political culture can mean an important aspect of our sense of social self is devalued. An illustration of this is seen in a study of the Royal Ulster Constabulary (RUC) in Northern Ireland. At the front line of the conflict for many years, this police force was comprised almost entirely of one section of the divided community in Northern Ireland (the Protestant British Unionist population). At best seen as partisan, and at worst likened to a military wing of the British state, in the period after the Belfast Agreement, the force was reformed and renamed, effectively winding down the RUC. This reform process opened up a discourse in which the RUC was no longer presented as protectors of the people or peace in Northern Ireland. Members of the police who had previously negotiated difficult security contexts with limited mental health consequences (Wilson et al., Reference Wilson, Poole and Trew1997) began to evidence much higher incidences of PTS (Mulcahy, Reference Mulcahy2013). The post-Agreement context, where the RUC was seen as part of the problem in Northern Ireland, effectively undermined the occupational identity previously so central and valued by officers (Mulcahy, Reference Mulcahy2013). Similar findings are evident amongst former members of the South African security forces, forced to relinquish military roles and identities in the post-apartheid era (Langa & Eagle, Reference Langa and Eagle2008).

These changes in the content and meaning of a valued identity can therefore be seen as part of the driver of risk and resilience. Militarised identities in Northern Ireland and South Africa protected personnel during the many years of prior political violence in both jurisdiction. Betrayed and bewildered by new political dispensations similarly, security forces in both places found their old identities no longer protected their mental health. They, as I did in the wake of Clare’s death, presumed others would see us differently. Misattributed shame I felt altered my belief in myself, as it is likely to do (Joseph et al., Reference Joseph, Brewing, Yule and Williams1993), and so I no longer saw myself as a useful or valued friend or colleague. The extent to which an event is seen as central to our own self-definition is closely related to the damage that a traumatic event inflicts (Robinaugh & McNally, Reference Robinaugh and McNally2011). In essence, then, the inability to no longer see myself as a ‘good friend and colleague’, or the officers’ inability to see themselves as ‘protectors and peace keepers’, can drive post-traumatic responses.

5.4.3 Stigmatising Trauma, Social Identity Change

At the time of Clare’s death her family made the brave decision to be open about the cause of her death. Suicide then, and even now, was stigmatised (Pitman et al., Reference Pitman, Stevenson, Osborn and King2018). The decision by Clare’s family to be open about the cause of her death allowed those of us who knew her well to speak openly to each other. We could talk freely about the guilt and distress and find company for our misery. It allowed us to resist the stigma of suicide and depression. On the other hand, traumas that are stigmatising reduce our ability to engage with others in our existing social networks. People are removed from sources of social support. In extreme cases people who have endured trauma are identified as ‘deviant’ and are excluded and silenced (Kleinman & Hall-Clifford, Reference Kleinman and Hall-Clifford2009).

In adjusting to stigmatised traumatic experiences, then, there are additional identity dynamics at work. Stigma affects the social identity resources or the social and psychological resources that flow from being a member of a group. The relationship between rape and unusually high incidence of PTS speaks to this issue. Rothbaum et al. (Reference Rothbaum, Foa, Riggs, Murdock and Walsh1992) found that 94 per cent of victims had PTSD shortly after their rape, and 47 per cent continued to have PTSD three months after. The continued stigmatisation of the victim and the crime (Anderson, Reference Anderson2007; Walker et al., Reference Walker, Archer and Davies2005) is an important element of these high rates of PTSD. In research studies, attribution of blame and responses to disclosure are seen to exacerbate victims’ distress (Gueta et al., Reference Gueta, Eytan and Yakimov2020).

Stigma is really relevant to accessing social support in those who have been traumatised. And stigma can also change people’s subjective sense of themselves as group members. Sometimes people who are stigmatised no longer feel able to participate or engage with groups and communities they belong to in the ways they had previously (Bradshaw & Muldoon, Reference Bradshaw and Muldoon2020). Male survivors of rape, a highly stigmatised trauma, describe difficulties fitting into traditional male roles and groups and a need to manage and often conceal their trauma from others (Javaid Reference Javaid2016). Other research suggests that the counter-normative nature of male-on-male rape is identity-threatening: it undermines men’s entitlement to and feelings of masculinity (Creamer et al., Reference Creamer, Burgess and McFarlane2001). These processes amplify victims’ exclusion and stigma and are reflected in the very high rates of PTS symptomatology in survivors of this trauma (Walker et al., Reference Walker, Archer and Davies2005).

The damage of stigma for victims of rape is also exemplified in the work of Kellezi et al. (Reference Kellezi, Reicher and Cassidy2009). This team demonstrated that social norms acted as a barrier to accessing support among women who were traumatised by the campaigns of mass rape during the Balkan Wars. PTS was experienced more severely where women remained silent. This silence was built on a fear of being shunned for transgressing culturally acceptable norms of gender-appropriate behaviour (Kellezi et al., Reference Kellezi, Reicher and Cassidy2009; Skjelsbaek, Reference Skjelsbaek2006). Powerful social prohibitions also drive the health impacts of non-violent traumatic events. Adewuya and colleagues (Reference Adewuya, Afolabi, Ola, Ogundele, Ajibare, Oladipo and Fakande2009) investigated the psychological impact of a diagnosis of HIV in Nigeria. This study evidenced the damaging impact of stigma and reduced access to social support networks on health and well-being.

Social stigma, then, has two components. Survivors can often experience self-stigmatising feelings as well as endure the discomfort other people feel when hearing about their traumatic experiences. The severity of PTS has been shown to be strongly amplified by reactions of others, reactions that can be thought of as stigmatising responses. Schneider and colleagues (Reference Schneider, Conrad, Pfeiffer, Elbert, Kolassa and Wilker2018) found that elevated prevalence of current and lifetime PTSD was strongly predicted by stigmatisation, concluding that heightened traumatic responses are because of the stigmatising responses of others. Equally, the perceived severity of stigmatised trauma can be reduced where social support and feelings of inclusion and belonging can be maintained to some degree (Muldoon, Haslam et al., Reference Muldoon, Haslam, Haslam, Cruwys, Kearns and Jetten2019).

Clare’s life and death is without question something that is now part of my own autobiographical memory, the story of my life. Traumatic experience can profoundly change a person’s sense of ‘who I am’. Clare’s death did alter me in many ways. It changed how I viewed my occupational identity irrevocably. Clare’s death made me much more aware of the stress inherent in the academy. It also altered my connections to others, helped me think about those I should value and prioritise. Charuvastra and Cloitre (Reference Charuvastra and Cloitre2008) articulate a key role for social bonds in determining risk and recovery from traumatic experiences, which highlights their importance in shaping our internal working model of relationships and social expectations during times of subsequent distress or difficulty. And available research would say that a trauma that brings negative and permanent changes in these working models is linked to poorer outcomes (Dunmore et al., Reference Dunmore, Clark and Ehlers1999; Ehlers & Clark, Reference Ehlers and Clark2000). Clare’s death made it clear to me that I needed to learn to lean more on those in my network. Before her death I was slow to ask for help. I was always willing to help but was slow to take help. Her death made me see how problematic this pattern was. It changed my tendency and ability to ask for and avail myself of social support from friends and family. I was lucky to have that network. This care and love allowed me to see the value of these existing connections.

5.5.1 More Is More: Social Identity Gain and Resilience

There is considerable research evidence that potentially stressful life transitions, such as retirement (Haslam et al., Reference Haslam, Jetten, Cruwys, Dingle and Haslam2018; Haslam, Haslam et al., Reference Haslam, Haslam, Jetten, Cruwys and Steffens2021), childbirth (Seymour-Smith et al., Reference Seymour-Smith, Cruwys, Haslam and Brodribb2017) and migration (Jetten et al., Reference Jetten, Dane, Williams, Liu, Haslam, Gallois and McDonald2018), are negotiated more successfully where people have many group memberships. A key strand of research that has been done in this area particularly relates to people affected by acquired brain injury (ABI). ABI is one of the most common neurological conditions worldwide, and an estimated 69 million people are affected globally each year. An acquired brain injury can lead to long-term physical, behavioural and cognitive impairments, and many people report a profound change, and even a loss of their pre-injury sense of self, in the wake of their injury (Bryson-Campbell et al., Reference Bryson-Campbell, Shaw, O’Brien, Holmes and Magalhaes2013; Gracey et al., Reference Gracey, Palmer, Rous, Psaila, Shaw, O’Dell and Mohamed2008; Walsh et al., Reference Walsh, Muldoon, Gallagher and Fortune2015). Our qualitative research highlights how many of those affected by ABI lose occupational identities and, with that, also lose access to employment-based social connections (Muldoon, Walsh et al., Reference Muldoon, Walsh, Curtain, Crawley and Kinsella2019). Often occupational identities are central to who we are and are very highly valued. For instance, one police officer we spoke to talked poignantly about the sense of identity loss that arose when it became clear her future career and ambitions for her occupational life had imploded.

In those affected by acquired brain injury, Jones and colleagues (Reference Jones, Williams, Jetten, Haslam, Harris and Gleibs2012) demonstrated that the acquisition of new group memberships was important to reducing PTS symptoms. Measuring group membership and PTS symptoms across time, this study demonstrated that forming new group memberships was linked to lower levels of PTS symptoms following brain injury. Development of new group memberships after a brain injury has been explored in other studies too (Walsh et al., Reference Walsh, Muldoon, Gallagher and Fortune2015). This research found that social identities have an important effect on adjustment after brain injury. These studies asked people living with acquired brain injuries to complete measures of identity and health over time (Walsh et al., Reference Walsh, Muldoon, Gallagher and Fortune2015, Reference Walsh, Muldoon, Fortune and Gallagher2017). We found a positive and reinforcing relationship between social identities and social support. Those with higher numbers of identities prior to their injury enjoyed greater social support, which facilitated the acquisition of new active identities after their injury. Importantly, these newly acquired identities were linked to post-injury emotional status and psychological health in this very vulnerable population (Walsh et al., Reference Walsh, Muldoon, Fortune and Gallagher2017). This idea is encapsulated in the social identity ‘gain’ hypothesis, which states that the addition of new group memberships promotes resilience in the face of trauma (Muldoon et al., Reference Muldoon, Trew and Devine2020)

The number of identities people have also acts to promote health in those affected by brain injury by supporting self-regulation. One of the key issues for people living with an ABI is associated with their (in)ability to self-regulate their emotions and their behaviour (Barkley, Reference Barkley and Lyon1994). The ability to effectively self-regulate enables individuals to organise their actions towards goals, manage emotional distress, obey laws and internalise societal standards of moral and competent behaviour (Vohs & Baumesiter, Reference Vohs and Baumeister2016). Self-regulation enhancement is a central component of ABI rehabilitation as it facilitates improved personal care, participation in meaningful occupation, and managing one’s emotions and psychological well-being (Brinkmann & Franzen, Reference Brinkmann and Franzen2015). In our research we have shown that ABI survivors tended to lose group membership after their injury. In our quantitative work, loss of group memberships after being injured predicted depression symptoms. However, where survivors acquired new group memberships, often through occupational rehabilitation and employment initiatives, self-regulation was enhanced and symptoms of depression were reduced. In this way our research has shown that the number of group memberships predicts social support and self-regulation, both of which are important bases for resilience in the face of life-changing injury.

Along the same lines, a group of researchers in Australia have looked specifically at the value of therapeutic groups. In a series of papers, they explore the value of these support groups for people with addiction and substance misuse issues, a population that often has a history of traumatic experience. These longitudinal studies have shown that participants who lose their ‘user’ identity and instead gain a ‘recovery’ identity are those who have the most successful rehabilitation outcomes (Dingle et al., Reference Dingle, Stark, Cruwys and Best2015). Identity change was measured as the difference between user identity and recovery identity over the period of time participants were engaged in their group rehab. This identity change explained more than a third of subsequent substance misuse. As well as reducing misuse over time, comorbid PTS symptoms were often reduced in this cohort (Perryman et al., Reference Perryman, Dingle and Clark2016). These studies also demonstrate that this group approach offered additional identity resources in terms of social connections and support for those recovering from substance misuse. This was particularly potent for those who could harness these group resources in support of their recovery (Best et al., Reference Best, Beckwith, Haslam, Alexander Haslam, Jetten, Mawson and Lubman2016).

It is not surprising, then, that recent contributors in social and political psychology have moved the focus from the isolating consequences of trauma to highlight the way in which traumatic events can be instrumental in developing new community and political identities (Drury et al., Reference Drury, Cocking and Reicher2009; Hutchinson, Reference Hutchinson2010). Drury and colleagues’ study (Reference Drury, Cocking and Reicher2009) of survivors of the London bombings presented evidence that survivors reported that their collective experience of this event led to the emergence of a new shared identity. This, in turn, led to more effective coordination of responses in the immediate aftermath of the event. In effect, the development of social identification had a positive role in ameliorating both the threat to life during the traumatic event and the longer-term psychological consequences. In a similar vein, Hutchinson’s (Reference Hutchinson2010) analysis of media reactions to the Bali bombing suggests that consolidated community solidarity lessened the impact of the event. These situations, then, where a new identity is shared with others affected by the same trauma, can be seen as fundamental to resilience.

5.5.2 Social Identity Loss, Identity Ambivalence and Risk

To now, our discussion has focused on the value of social identity gain to resilience. On the other hand, social identity loss has the potential to damage health. Indeed, in the literature on trauma, social identity loss is also a common theme. In longitudinal studies, the impact of losing a child on the health of their mothers is evident across the lifespan and even into later adulthood (Cohen-Mansfield et al., Reference Cohen-Mansfield, Shmotkin, Malkinson, Bartur and Hazan2013). An important protective factor for mothers recovering from such a loss appears to be having additional children (Rogers et al., Reference Rogers, Floyd, Seltzer, Greenberg and Hong2008). Using the Wisconsin longitudinal study, Rogers and colleagues (Reference Rogers, Floyd, Seltzer, Greenberg and Hong2008) demonstrated that parents’ adjustment to losing a child an average of eighteen years following the death was positively associated with having additional children. The authors linked this finding to the associated sense of purpose parenting gives in such cases. Additional children also allow parents to retain, unambiguously, their identity as a parent. On the other hand, parents who lose an only child are likely to also feel the loss of their identity as mother or father alongside the loss of their child. This can aggravate their situation.

The loss of a child is widely viewed as an extremely traumatic event. It is interesting to note that although in the English language we have words like widow/widower and orphan, we have no such identity signifier for those who lose a child. Those affected report that losing a child is an unspeakable loss (Rycroft & Perlesz, Reference Rycroft and Perlesz2001). And certainly, the absence of an appropriate language to talk of the loss means that people may find it difficult both to disclose and to discuss this loss. It also has implications for finding and accessing others who have been similarly bereaved for social identity–based support. Parents also report loss of identity-based social connections and difficulty interacting with parents in their social networks prior to their bereavement. These identity factors appear to be predictive of PTS in later life and are more important to parents’ health than the child’s cause of death or the amount of time since the child’s death (Cohen-Mansfield et al., Reference Cohen-Mansfield, Shmotkin, Malkinson, Bartur and Hazan2013; Rogers et al., Reference Rogers, Floyd, Seltzer, Greenberg and Hong2008).

Even in such tragic circumstances, however, gaining new identity-based connections can help people negotiate traumatic experiences. Gaining social identities can buffer the expression of PTS symptoms even when the trauma itself facilitates the development of the new, and unwanted, social identity. Starting in the United States, the Mothers against Drunk Driving organisation is an example of one such identity (Brewer, Reference Brewer2001). This group, founded by a mother whose daughter was killed by someone driving under the influence of alcohol, uses their valued parental identity and shared traumatic experience to band together. Women who engage in advocacy using their mother identity and shared traumatic experience in this way (Brewer, Reference Brewer2001) often report feelings of empowerment and connection to others. Though rooted in grief and trauma, this can offer some catharsis and assist with healing from grief. Importantly, though, mothers also feel that there is a cost to advocacy and going public (Morris et al., Reference Morris, Hyshka, Schulz, Jenkins and Haines-Saah2021). There is a double-edged sword, with both benefits and costs associated with identities arising from trauma.

There is a similar double-edged sword for those who adopt a ‘refugee’ identity. On the plus side, category labels can offer members of traumatised groups a sense of connection with others who have survived similar difficulties (see Section 4.5.2). Refugees often have similar traumatic and dangerous experiences associated with forced migration, including loss of family members, torture and rape (Jeppsson & Hjern Reference Jeppsson and Hjern2005; Schweitzer et al., Reference Schweitzer, Melville, Steel and Lacherez2006). At a time when people may be at their most traumatised and threatened, it is clear, even from my salutary tale (see Section 5.2), that feeling as though others understand the predicament we find ourselves in can be helpful (Hermann, Reference Hernann2016). Equally, retaining a sense of connection to home and prior group memberships is important. In a survey of 361 Syrian refuges in Turkey, Smeekes et al. (Reference Smeekes, Verkuyten, Çelebi, Acartürk and Onkun2017) found that refugees who maintained group memberships and had a sense of identity continuity to their homeland had higher well-being after their migration than those who reported losing group memberships. Echoing this, stories of forced migration point to the importance young refugees ascribe to remembering and living by their family’s values in an effort to survive and maintain hope (Marlowe, Reference Marlowe2010). Thus, as we would expect based on the social identity model of traumatic identity change (Muldoon et al., Reference Muldoon, Trew and Devine2020), whilst a new group identity, refugee, signals a sense of disconnection from one’s nation or family, those who are able to hold onto some of their pre-existing identity resources are more resilient.

‘Refugee’, like so many traumatic labels, is one bound up in ambivalence. It is an unwanted moniker, in much the same way as ‘victim of clerical abuse’ or ‘survivor of genocide’. Having the traumatic label can often afford a number of important material rights and maybe even greater social understanding of the trauma experienced. But being in this new group and assuming this category label also has costs. It can become an everyday signifier of a traumatic past. These identities, because they signal profound trauma, can become a master identity, more important than any other group membership (Brown, Reference Brown2018). And so, this unwanted identity, something that at its heart is derived from a traumatic experience, becomes self-defining. As such, these social identities are identities that people are highly conflicted about. Their traumatic experience has not only resulted in identity recategorisation but delivered a new identity with very equivocal meaning. For this reason, these types of traumatic labels can be associated with both anger and distress (see Chapter 6) and growth (see Chapter 7).