ALSO IN THIS SPECIAL REPORT
Phebe Tucker, MD
Resilience and Healthy Aging
Igor Linkov, PhD, MSc; Stephanie Galaitsi, MSEE; Katarzyna Klasa, MPH, BSN; Andrew Wister, PhD
Acknowledging a patient's ability to grow and recover may help them feel more understood despite ongoing suffering.
SPECIAL REPORT: EXPLORING RESILIENCY
Resiliency is a common term that describes individuals’ amazing capacity for resistance. Its sibling term, posttraumatic growth (PTG), is less well known, however. PTG describes the positive psychological changes individuals will be able to notice in themselves in spite of a traumatic experience. Examples of PTG include statements such as, “Despite all the bad things that happened, I realize that I feel much more connected to other people now,” or “After what happened, I find myself focusing more on what is important to me and not what others want me to do.”
Phebe Tucker, MD
Resilience and Healthy Aging
Igor Linkov, PhD, MSc; Stephanie Galaitsi, MSEE; Katarzyna Klasa, MPH, BSN; Andrew Wister, PhD
The resiliency concept has had many academic mothers and fathers, including Emmy Werner, PhD, (1929-2017; developmental psychologist at the University of California), and George Vaillant, MD, (born 1934; psychiatrist at Harvard University). The concept of PTG derives substantially from the work of psychologists Lawrence G. Calhoun, PhD, and Richard G. Tedeschi, PhD, from the University of North Carolina. Their cutting-edge research drew inspiration from ancient sources, including Greece and the Judeo-Christian Bible, as well as some of the teachings of Hinduism, Buddhism, and Islam that contain statements on the possibility of positive change through one’s own suffering.1
Over the past 20 years, the main area of application for PTG and resiliency research has remained posttraumatic stress disorder (PTSD). As this disorder is globally prevalent and one that affects many US immigrants, it is important to assess the relevance of these concepts in a global context, especially for individuals from socially disadvantaged countries. Also important is that comorbidities are common in many patients with psychiatric disorders. Therefore, the area of application of PTG and resiliency research has expanded to include more mental disorders.
A significant question that has arisen from global research on the topic remains: How much resiliency and PTG can humans draw from themselves?
PTG, Positive Psychiatry, and Resiliency
Resiliency is the trait-like capability of maintaining normal psychological functioning in the face of adversities or challenging life conditions. It is associated with the ability to interact flexibly with the environment and use personal resources effectively. Resiliency is relatively stable but not static because this capability may grow through cognitively reconstructing one’s understanding of adversities, or it may grow during the recovery process. Therefore, the growth or development of resiliency may be accompanied by PTG.
The assessed effectiveness of psychosocial intervention comes from results of clinical studies that have focused on the meaning-making process. The results of a
Cultural Understanding of Psychiatric Resiliency
Culture is a a social constellation of components that include practices, competencies, ideas, symbols, values, norms, institutions, goals, constitutive rules, artifacts, and modifications of the physical environment. In clinical settings, culture involves contextual features, such as the economics, availability, and accessibility of services; patient variables, including differences in prevalence or manifestation of disorders, preference of alternative or informal services, health literacy, and adherence; and provider variables, such as referral bias and patient-clinician alliance. Cultural differences in clinical representations of mental disorders have been evident in studies involving cultural samples.
For example, various
Psychiatric resiliency refers to maintaining normal psychological functioning while responding to adversities that are related to psychiatric disorders. The inverse correlations are found between resiliency and the severity of psychiatric disorders, such as
Cultural factors may affect resiliency through genetics and environment. In terms of genetics, culture may contribute to, or interact with, individuals’ self-identifying process through biological characteristics (eg, skin color, eye color, or facial features associated with race), behavioral phenotype (eg, eye movement deficits in schizophrenia), and the way they perceive adversities related to psychiatric disorders.
Environmentally, culture may shape resiliency by influencing human developmental processes and behavioral patterns through religion, education, and other physical circumstances. Research indicates that
As one of the most important components of culture, religion may affect one’s comprehension of the world and the self (Table). Religious contexts and spiritual appraisals of traumatic events have a robust relationship with posttraumatic outcomes, including PTG. The trauma recovery process involves rebuilding an assumptive world. Religion provides a meaning-making framework to process traumatic experiences and its related distress, as has been evidenced by different cultural studies. For example, results of
The Meaning and Implications of Resiliency
Preventive psychiatry aims to promote health and to protect individuals from developing mental disorders through early diagnosis, effective treatment, disability limitation, and rehabilitation.
When we as professionals acknowledge patients’ ability to recover and grow, they feel more understood despite their often ongoing state of suffering. Interventions involving resiliency-enhancing and PTG-recognizing processes may benefit not only patients, but also health care workers and caregivers.
Dr Zheng is an assistant professor of psychology in the Division of Social & Behavioral Science at Elmira College. Dr Maercker is a professor and head of division for the Department of Psychology, Psychopathology, and Clinical Intervention at the University of Zurich.
References
1. Weiss T, Berger R, eds. Posttraumatic growth around the globe: research findings and practice implications. In: Weiss T, Berger R, eds. Posttraumatic Growth and Culturally Competent Practice: Lessons Learned From Around the Globe. Wiley; 2010:189-196.
2. Tedeschi RG, Calhoun L. Posttraumatic growth: a new perspective on psychotraumatology. Psychiatric Times. 2004;21(4):58-60.
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