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Fostering Resilience in Times of Stress and Distress

Resilience is the ability individually or collectively to maintain stability and experience positive emotions, with minimal disruption to normal physical and psychological function, despite experiencing a threat or trauma. Resilience exists in individuals and communities. In individuals, it manifests as a sense of self-determination and an ability to find and stay focused on positive aspects of living. In communities, resilience is present when there is communication, leadership, preparedness, economic investment in the community, and when there are networks and relationships or sub-communities with adequate resources. Finding ways to boost both individual and community resilience and increasing access to resources can help mitigate the risk of chronic stress response.

RESILIENT TRAITS to CULTIVATE and PRACTICE

Hardiness

  • The belief that life has meaning, and one has a purpose
  • Belief in self-efficacy
  • Belief in the ability to find ways to benefit from negative experiences
  • Belief in social support

Self-enhancement

  • The tendency to credit oneself for positive outcomes
  • A positive bias toward oneself – to view oneself as above average in
  • skill, resources, or luck, and therefore less likely to suffer

Positive emotions and laughter

  • Ability to oppose negative emotions with positive emotions – Affection, Humor/Amusement, Gratitude, Hope

TRAITS ASSOCIATED WITH POOR RESILIENCE to ADDRESS WITH THERAPY and SKILL BUILDING

Mood signs or symptoms

  • Anxiety, fear, or panic
  • Sadness, grief, despondence
  • Guilt
  • Anger or irritability
  • Feeling numb or disconnected

Physical Signs or symptoms

  • GI distress
  • Headaches
  • Unintentional weight gain/loss due to appetite change
  • Fidgeting or shaking
  • Fatigue or restlessness

Behavioral signs or symptoms

  • Difficulty sleeping or relaxing
  • Crying more often or more easily
  • Yelling or cursing more frequently or with decreased provocation
  • Increased physical expression of anger (punching, slamming, throwing, or breaking things)
  • Isolating or having difficulty being alone

Cognitive signs or symptoms

  • Forgetting things
  • Difficulty focusing
  • Confusion
  • Difficulty making decisions
  • Increased worrying or more easily worried
  • Thinking catastrophically
  • Feeling uncomfortable talking or hearing others talk about what took place

CULTIVATING RESILIENT TRAITS

While some are intrinsically more resilient than others, there is abundant literature on techniques for promoting resilient thoughts and behaviors, and there are behavior strategies to give individuals a leg up during and after a crisis or traumatic event. These strategies are often referenced as Control, Challenge, and Commitment also called the Three C’s of Hardiness.

Control

  • No one of us can change the world, but we can try to change how we react
  • Try to accept and tolerate ambiguity and uncertainty
  • Remind yourself that change is more normal than stability and that what we do not know is usually more than what we know
  • Remind yourself that change can help you increase your ability to adapt and become more resilient over time
  • Separate and set aside that which is absolutely out of your control and accept it.
  • Look for aspects of a difficult situation that you can change, influence, or just manage, and commit to those challenges.
  • Be realistic about both – do not try to change things that are simply out of your control, while committing fully to what you can do.

Challenge

  • Identify challenges, and start small
  • Turn these challenges into thoughts and behaviors directed toward a goal or goals
  • Use your goal-oriented thoughts and actions to distract from feeling helpless and try to avoid thoughts of futility.
  • In a setting of frustration, setback, disappointment, or failure, try to see these as opportunities for increasing strength, knowledge, or skill from situations that are difficult or even distressing.

Commitment

  • Commit to a cause outside yourself – family, community, a creative or skilled project – get busy and stick to it
  • Remind yourself to focus on the process – what you are doing in the present – rather than the outcome
  • View end results with curiosity or wonder, rather than expectation


Kobasa, S. C. (1979). Stressful life events, personality, and health: An inquiry into hardiness. Journal of Personality and Social Psychology, 37(1), 1-11. http://dx.doi.org/10.1037/0022-3514.37.1.1
Patel SS, Rogers MB, Amlôt R, Rubin GJ. What Do We Mean by ‘Community Resilience’? A Systematic Literature Review of How It Is Defined in the Literature. PLOS Currents Disasters. 2017 Feb 1 . Edition 1. doi: 10.1371/currents.dis.db775aff25efc5ac4f0660ad9c9f7db2.


Alison Badger (she/her/hers) is a physician assistant (PA) specializing in psychiatry and providing mental health and medical care to individuals of all ages. She completed her undergraduate degree at the University of Michigan and holds a masters degree in biomedical science from The University of Toledo. She also holds a certificate of additional qualification in psychiatry, bestowed by the National Committee for the Certification of Physician Assistants. Formerly working exclusively on inpatient psychiatric units, Alison now works with individuals of all ages and stages at Heron Ridge Associates, managing medications targeting the spectrum of mental health needs. Areas of special clinical interest include integrated medical and psychiatric care, adolescents transitioning into adulthood, and all individuals with mental health comorbidities intersecting with sexuality and gender identity or status. As an author and educator, Alison has published case reports on medical illnesses presenting as psychiatric disorders and has presented on anxiety disorders, LGBTQ+ healthcare needs, building resilience, and teaching empathy to healthcare providers. As an advocate for expanding access to mental health care, she serves on the Michigan Academy of Physician Assistants legislative task force and the Michigan Nurse Practitioner/Physician Assistant task force and has testified at state house and senate hearings regarding the expansion of access to quality mental health care in Michigan.

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