MUST READ: The importance of resilience!!

The importance of 'resilience'

in helping people cope

with adversity

I first became interested in the subject of resilience when I was a commissioner on The Royal Commission on Human Relationships in the 1970s, and encountered people who faced a wide range of adversities with courage and grace. Later I made films in Africa where families struggled with famine, war, and disease – yet even in the face of such epic disasters, most still managed to find some kind of joy and meaning in life.

Where did these people find their resilience, I wondered? Why did adversity sometimes lead to transformation and other times only to more suffering? Was resilience a skill that could be learned, handed down from one generation to the next?

Later, my own resilience was tested when my elder son Jonathan developed schizophrenia at a time when there were few resources and when he did not respond to any available medication. He died 7 years later at the age of 24. Notions of resilience are deeply embedded within the cultures in which we live – from the stiff-upper-lip concepts of Victorian England to today's Harvard Business Review exhorting business executives to develop resilient business practices.

Origins of resilience research go back some fifty years when a young American psychologist called Norman Garmezy (now Emeritus Professor of Psychology at the University of Minnesota) began investiating aspects of schizophrenia in the days before neuroleptic medication brought at least some relief from a bewildering and frightening disease.

Schizophrenia was then loosely categorised into two distinct groups, 'process' and 'reactive'. People with process schizophrenia tended to be chronically and severely ill. Those who had reactive schizophrenia fared better and were more competent than people in the first category. Garmezy wondered if this had anything to do with the way they handled stress. He decided to explore the development of childhood competence by looking for children who were succeeding in spite of overwhelming odds.

The child whose story Garmezy found the most moving became known as 'the boy with the bread sandwich.' He was nine years old. His father had left home, his mother was an alcoholic, he grew up in poverty and pretty much on his own.

He would bring a sandwich to school each day which he had carefully made himself from two pieces of dry bread. He did this so that no one would feel pity for him and no one would know about his mother. You know, if you get hit with a case like that, you begin to think, let's take a look at children who are resilient in other kinds of stresses and circumstances. Let's find out what's making it work?

One of the most ambitious and well known studies of resilient children ever undertaken was begun in 1955 by Dr. Emmy Werner and her colleagues, who followed the progress of over 200 high-risk children in the island of Kauai, Hawaii, from birth to 32 years.

These children had experienced four or more risk factors ranging from poverty to parental alcoholism. Even with such heavy handicaps, one in three of these young people grew into competent young adults who, by the age of 18, 'loved well, worked well, played well and expected well.' Most of the others had settled down by the time they were 32, perhaps because of something that Emmy Werner and Ruth Smith call 'an innate self-righting mechanism' – the strengths that people, families, schools and communities call upon to promote health and healing. They felt that these made a stronger impact on the life course of children at risk than any potential damage in their environment.

For a long time, the general public and the media found it hard to accept any kind of positive findings about resilience. Either they didn't believe them or, because resilience wasn't a familiar concept, they decided children who did well must be an exception. The Washington Post carried a story about resilient children on March 7, 1976 with a headline, 'Trouble's a Bubble to Some Kids'.

This was followed by the myth of the golden child: a heroic child, who stood in the midst of despair, yet remained shining and unscathed. The problem with this kind of approach was that it promoted the idea that not only were resilient children somehow special but that resilience was a quality given only to a few.

On top of this, the profound bias of Western culture toward examining the negative rather than the positive was still well entrenched. Even as late as 1986, Garmezy wryly said that the entrenched focus of the mental health disciplines on disease processes could best be explained by philosopher Abraham Kaplan's 'law of the hammer'.

Simply put, the law's basic postulate is: 'Give a child a hammer and everything the kid sees will need pounding.' Armed with our hammer of psychopathology, everywhere we turn in our clinics and waiting rooms we perceive primarily disorders, symptoms, and their dynamics. So we pound away, even though our overarching goal is mental health, not mental disorder.

But massive shifts in western thinking were slowly gathering support. The Cartesian split between body and mind which had been so central to medical practice and thinking since the 17th century began to be replaced by a belief that mind and body were inseparable, and that human systems – like other systems – possessed a natural drive towards good health.

By the nineties, most resilience research confirmed that resilience arises from a myriad of interactions within and between organisms and their environment. This recognition of the dynamic qualities of resilience marked a true turning point in the field of resilience research.

'What began as a quest to understand the extraordinary had revealed the 'power of the ordinary,' said Professor Anne Masten from the University of Minnesota. 'Resilience does not come from rare and special qualities, but from the everyday magic of ordinary, normative human resources in the minds, brains, and bodies of children, in their families and relationships, and in their communities.'

Masten also pointed out that even the most basic of human adaptational systems are not invulnerable and require nurturance. All too often, children who contend with the greatest adversities do not have the protections afforded by basic resources nor the opportunities and experiences that nurture the development of adaptive systems.'

In the 1970s, Garmezy became part of a 12-year international consortium exploring the resilience of children at risk for mental illness because their mothers had schizophrenia. The researchers believed that if they could understand how some of these children developed healthily in spite of their genetic backgrounds and profound family difficulties, it might lead to an increased understanding of mental illness and also how to make a difference in the lives of children at risk.

Children whose parents have schizophrenia mostly live in one of the most stressful situations imaginable. They have no control over what is happening; no time for childhood; loneliness, because it is impossible to ask friends home; sadness; anger at how their lives are being spoiled; dread of inheriting the madness.

Yet the researchers found these children did far better than was predicted and showed an extraordinary range of survival mechanisms. Children who did well understood that they were not responsible for their parents and were able to avoid engulfment in their illness. Having a stable, loving relationship with another adult was important, as was support from school and community.

Garmezy concluded that the quality of resilience played a greater role in mental health than anyone had previously suspected. In 1971, he cut across prevailing ideas and practices by suggesting that instead of trying to devise models to stop children becoming ill, it might be more useful to study the forces helping children survive and adapt. He called resilient children, the 'keepers of the dream – our best hope for learning how to use lessons of the past to help ourselves in the future.'

Throughout the seventies, as human rights movements became involved with the poor and oppressed, and as the world opened up to a greater awareness of environmental influences, the study of resilience itself opened up and became mainstream. In western societies, the euphoria of the sixties gave way to an increasing urgency to protect young people from the damaging effects of stressful life events and conditions.

Researchers realised that if children who lived with the chaos of mental illness could reveal such resilience, how about those in other high-risk situations?

One factor relating to resilience in children stands out above everything else – they need a secure base from which to explore the world and to grow up with one or more adults who are there for the long haul. People who love and believe in them and will provide consistent emotional support – ideally parents, but good relationships with other adults can also make a big difference in a child's life.

Emmy Werner's famous research in Hawaii which reached back over 40 years, found it was the informal stuff that worked the best, not the formal. The grandparents, uncles, aunts, friends and teachers were the ones who shone the magic, and brought resilience into young people's lives. But all of this needs community infrastructure and community workers who understand that one of the most important competencies we can give our children is therefore the ability to link into their neighbourhoods and communities.

Poor families are more vulnerable than middle-class families, not because they have less capacity to be resilient, but because they are likely to have more adversities in their life.

For quite a while, researchers tended to look at the big things that went wrong in people's lives – major traumas like war and death – but it is a cumulation of adversities that does the most harm – poverty, overcrowded homes, overcrowded schools, alcoholism or drug abuse, unemployment, sickness, separated families – a piling up of disasters which can damage the natural resilience of a child.

Many of the early theories about resilience focused on the role of genetics. Today, we know that although genes and personality are important, they are influenced by environment from the moment of conception. Who we are, and what happens to us, helps determine how we deal with life – whether we are vulnerable to anxiety and stress; whether we are inhibited or uninhibited; how we tackle adversities; how we interact with others.

This notion of a dynamic interweaving of personality and environment is exciting because it means suddenly there are many points of possible intervention – from early childhood through to old age, all drawing upon the healing powers and adaptive resilience of the individual, strengthened by those environmental factors which might make a difference.

Hope is important; learning how to ask for help; humour; viewing ourselves and others in terms of strengths not weaknesses; and having some kind of meaning in life – which does not necessarily mean having a formal religion.

Celebrated French writer, Colette, who was crippled by arthritis in old age found meaning in the beauty that she saw in the very room in which she was confined. For those whose spirits are darkened through trauma or illness, this isn't always easy. But I have seen it happen, through friendship, through helping people feel needed, through listening, through acceptance, and through finding those things that bring joy in life.

Ultimately,

a sense of connectedness

lies at the heart of resilience.

This article was first published in Auseinetter Issue 19 – November – No 3/2003, journal of the Australian Network for Promotion, Prevention and Early Intervention for Mental Health (Auseinet).