• April 17, 2014

Bouncing Back May Be Tough, but So Are We

Bouncing Back May Be Tough, but So Are We  Bouncing Back May Be Tough, but So Are We 1

Teake Zuidema, HH

In 2005 the National Science Foundation brought together some unlikely collaborators—ecologists and psychologists among them—to talk about resilience. It turns out they had a lot in common.

For decades researchers in each field had been studying the ways in which external events and stresses could transform complex systems. Their conclusions were strikingly similar: Resilience is often the result of a period of stress and change.

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Just as ecosystems can absorb serious shock and transform into different, but stable versions of themselves, so can people. Resilience, it seems, is hard-wired into us.

That idea appears to fly in the face of our overstressed and overmedicated culture. If everyone is so resilient, then why are we all so anxious? But a deeper look at what it means to be resilient shows that much of what psychologists, sociologists, and others have learned makes perfect sense. Resilience itself is a complex, variable, and sometimes messy process, one suited for a world in which threats to human health and safety are ever present and often unpredictable.

But research also shows that a critical piece of the resilience puzzle lies in our connections to each other, through neighborhoods, civic organizations, and government agencies. People cannot cope unless their larger networks function. And that poses a more complicated challenge. As recent disasters have shown, those networks are often quite fragile.

The first studies of individual resiliency began in the 1970s, when developmental psychologists started tracking children who grew up in extremely adverse circumstances. Some had mentally ill parents. Others were born into environments of poverty or neglect. Researchers were surprised to find that many of those children, despite the tremendous emotional, social, and economic deficits they faced, went on to lead normal, healthy lives.

Ann S. Masten, a professor of child psychology at the University of Minnesota-Twin Cities, coined the term "ordinary magic" to explain why.

Masten found the elements that lead to resilience in children and young people to be quite common. They include a positive attachment to caregivers and other adults; solid intellectual skills, impulse control, and sense of self; and supportive schools, communities, and cultures.

While some of those factors may at first glance seem innate, Masten stresses that many characteristics of resiliency are learned. Parents, teachers, coaches, and other adults provide the guidance that develops a child's intellect and regulates impulses, for example. These form what Masten calls "protective factors" that create a resilient person.

Those factors make a difference "across many different kinds of adversity, from war to childhood maltreatment," she says.

In more recent decades, researchers have found that people who experienced a traumatic event—the death of a spouse, severe physical injury, war, natural disasters—also tend to bounce back within a couple of years. Relatively few experienced long-term depression or anxiety. That runs counter to beliefs mental-health professionals held widely, as recently as the early 1990s, that coping with trauma was a lengthy process that benefited from clinical intervention.

George A. Bonanno, a professor of clinical psychology at Columbia University, traces that idea back to Sigmund Freud's theories of "grief work," in which painful experiences must be examined and processed. Elisabeth Kübler-Ross's profoundly influential 1969 book, On Death and Dying, popularized the idea that, faced with a life-altering event, people go through a series of emotional stages as they come to terms with what's happening to them.

In a seminal paper published in 2004—subtitled "Have We Underestimated the Human Capacity to Thrive After Extremely Aversive Events?"—Bonanno notes that therapists and others tend to greet resiliency in the face of loss with skepticism, assuming that the person must be repressing negative emotions. Yet research paints a different picture. Some studies have even shown that interventions like critical-incident-stress debriefings are potentially harmful. Instead, Bonanno argues, most people cope quite well on their own.

As many as 65 percent of people, he says, experience what he calls "minimal-impact resilience." By that he means that they may suffer sleeplessness, anxiety, sadness, and other normal reactions, but that their overall ability to function remains largely unchanged. Other people may take up to two years to regain normal functioning, while still others may seem fine at first only to see their stress grow over time.

That final, "chronic," group is the one that is most troubled. It is also the one, naturally, that has become the focus of mental-health professionals, particularly since the term "post-traumatic stress disorder was introduced in 1980. Yet, Bonanno stresses, this group typically comprises only 10 to 15 percent of people who encounter major trauma. That figure holds true, he says, whether one is looking at soldiers returning from war, survivors of natural disasters, or people with severe spinal-cord injuries.

"When you look at very nasty things," he says, "you still get a lot of resilience."

There are, of course, substantial differences in what resilience means in the face of trauma, depending in part on what a person has to endure and when. A teenager who has survived an abusive childhood is going to go through a different process than a woman who lost her house in a hurricane. And a violent attack is more likely to lead to post-traumatic stress than the death of a spouse.

Moreover, researchers have come to think of resilience as a process rather than a characteristic. And because resilience depends on so many interlocking internal and external supports, individuals can be more or less resilient to different traumas at different times.

Some of these supports are nuanced, such as the ability to adapt to an altered set of circumstances. Others are what Bonanno tags "coping ugly," like repressing bad memories or having a high regard for oneself. These traits don't serve one well in all situations, but in the face of trauma they can help people soldier on.

One of the more attention-grabbing ideas to emerge in recent years is that, as in ecosystems, stress can build resilience. The fear that a life lacking adversity leaves people unable to cope with inevitable setbacks has captured the public—or at least parental—imagination, from Too Much of a Good Thing: Raising Children of Character in an Indulgent Age (2001) to the infamous Battle Hymn of the Tiger Mother (2011).

Roxane Cohen Silver, a professor of psychology and social behavior at the University of California at Irvine, became intrigued by this concept decades ago when she met a woman whose son, an award-winning athlete, was having enormous difficulty coping after he didn't get a job for which had interviewed.

"This woman said to me, 'You know, every week he would come in first. Week after week. I always wished that sometimes he would come in second.'"

"That really struck me as a profound comment," says Silver, a longtime resiliency researcher. "Because what she was saying is that he didn't develop the ability to lose."

Beginning in 2001, Silver began testing that theory. She and her colleagues tracked more than 2,000 people, measuring both the amount of adversity in their lives and their overall mental health and well-being.

Their findings showed that people who had experienced some adversity during their lifetimes reported being better off than those who had not experienced any major setbacks or had tumultuous histories.

The authors concluded that while chronic adversity is damaging, a manageable amount is a valuable teacher.

Whether that means that it's possible to inoculate people against trauma is a more contentious question. "The genetic contribution to resilience is probably moderate," notes Steven M. Southwick, a psychiatry professor at the Yale School of Medicine and one of the authors of Resilience: The Science of Mastering Life's Greatest Challenges. "Virtually anyone can become more resilient if they follow a set of principles." That idea has spawned a new industry known as resiliency building, but it has received mixed reviews from some researchers. Bonanno, for example, has publicly criticized one of the most high-profile resiliency-building programs out there: Comprehensive Soldier Fitness, a $125-million Army-supported project that uses the principles of positive psychology to train soldiers to be more resilient. It was designed by Martin E.P. Seligman, a professor of psychology at the University of Pennsylvania.

Bonanno's objection: It is untested.

It's possible that resiliency building can be done, he says, "but people are leaping right to it. They're taking off the hat of trauma counselor and putting on the hat of resilience builder."

A common criticism of resiliency research done by psychologists is that it focuses too much on the individual. Much of what makes people resilient, sociologists and others argue, depends on larger forces, such as where they live and whether they have access to decent health care.

"When people write about resiliency, they rarely talk about service accessibility," says Michael Ungar, a professor in the School of Social Work at Dalhousie University, in Nova Scotia. "It's a strange thing if you think about it. We spend billions of dollars on services, and yet a lot of my colleagues in the resilience field don't ever mention this."

In 2002, Ungar helped establish the Resilience Research Centre, an international network of researchers who study what he calls the "social and physical ecologies" that feed resilience, like schools, culture, and politics.

Back in the 1990s, when he began his work, Ungar says, the buzzword was "empowerment." The name has changed, but the ideas are similar. In addition to basic services like health care and education, strong webs of relationships are crucial to healthy communities. Social justice is key: believing that you'll be treated fairly regardless of gender, race, or religion. And personal and social efficacy are necessary as well. For people to be resilient, they must believe they have the power to control their lives.

"The reason in Canada we haven't had so much home-grown terrorism is that we do a really good job of providing all those things," Ungar says. The American system, by contrast, is focused "on a narrow understanding of what makes people survive and thrive. It's so much up to the individual. There's so little sense of collective reasoning."

Robert J. Sampson, a Harvard sociologist who has been studying Chicago neighborhoods for decades, has reached similar conclusions.

In his recent book, Great American City, he writes about the social personality of neighborhoods. One of his more intriguing findings is that some of the poorest neighborhoods in Chicago function relatively well. Strong, well-operated, and interconnected organizations, from churches to schools to community groups, help provide a collective efficacy that is independent of income or race. These social networks provide protection against what Sampson calls the "steady drip" of daily challenges, like crime and joblessness.

That has proved true across countries and cultures. A study Roxane Cohen Silver helped conduct of two Israeli communities—one rural, one urban—exposed to seven years of daily mortar fire found that residents of the rural community reported stress levels similar to those of residents in a relatively peaceful area, while the urban community had high levels of stress.

"Increased community solidarity, sense of belonging, and confidence in authorities may have served a protective function for residents of rural communities despite the chronic attacks to which they were exposed," she and her co-authors wrote in a 2011 paper.

Findings like those may be relevant to a growing number of national resiliency-building efforts.

"Resilience is a buzzword in Washington and has been for three or four years," says Silver, who was part of a community-resilience task force organized by the Homeland Security Advisory Council. "We cannot protect every community from natural disaster or terrorist attack," she says of the ideas driving the task force's work. "So are there things communities can do to be better prepared for, and respond to, natural disasters?"

The recommendations of her task force reflect the research on resilience. It emphasizes such things as enhanced communication to build trust between citizens and government authorities, flexible response systems that can adapt to changing situations, and promoting personal responsibility.

Similarly, that 2005 National Science Foundation gathering of resilience researchers led participants to think in new ways about disaster preparation and recovery.

"Each time we are thinking in a more integrated way, a more systemic way," says Masten, who was part of the team. "Disaster preparation, or preparation for a flu pandemic: A lot of these efforts are trying to prepare systems that are interrelated so we can increase the odds for resilience."

Beth McMurtrie is a senior writer at The Chronicle.

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