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Can Tragedy Teach Resilience, and Can It Last?

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Aug. 22, 2018 -- On the morning of Dec. 14, 2012, Michele Gay decided not to put her daughter Josephine on the school bus. The first-grader was recovering from a concussion, and Michele thought a little more rest at home might be good for her. But Joey, as she was affectionately called, really wanted to go to school that day. So Gay relented and drove her in a little late.

The mother of three dropped her youngest daughter off at Sandy Hook Elementary School just minutes before a gunman burst in. His massacre left 20 first-graders and six adults dead.

For hours, Michele Gay waited with about 25 other families in the banquet room of the local firehouse for their children to appear. Since Joey had autism, was non-verbal and had an aide with her at all times, Gay believed her youngest had likely been taken to another location and would be found soon.

Instead, she felt blindsided when police finally told her Joey was dead.

“When they told us all at once, it was a disaster. At that point there was no hearing any more information. It was obviously too much for any of us to handle,” Gay recalls.

Gay and her husband went to their car, distraught, and prayed. Then they drove home, without their little girl who loved the color purple, “Fancy Nancy” books and watching football with her family. Joey had turned 7 just 3 days earlier and the whole family had been excited for her birthday party scheduled for the next day. The purple cupcakes already sat in their refrigerator.

While much of that day is a blur, Gay says after hours of trying to hold it together for her family, she had a moment of clarity while sitting in her car in the school parking lot before heading home.

“I remember having the realization that I would fall apart soon,” Gay says. But she also vividly recalls vowing to herself that one day when she picked herself up again, she would use the pain she was feeling to help others.

“I remember making this choice almost like a promise to myself and my daughter,” she says.

Six months later her family teamed up with another Sandy Hook family to form Safe and Sound Schools. The nonprofit serves as a national network of school tragedy survivors and experts on all aspects of school safety, including mental health, physical safety, culture, and climate. 

“Safe and Sound is part of our healing and resilience journey.  It is about looking at the shattered remains in front of you and trying to find a way to re-assemble them into something useable for yourself and others,” Gay explains. “Resilience for us has meant taking control of these really difficult circumstances by choosing to help others.”

The Rise of Resilience Research

The idea that you have the power to build your resilience is fairly new, but it’s being widely studied and embraced for its benefits to health and overall well-being.

“Originally we thought people were born with characteristics of resilience or a more positive outlook. But now we understand those are things you can definitely learn to do,” says  Anita Thomas, PhD, dean of the College of Applied Behavioral Sciences at the University of Indianapolis.

Resilience is the ability to bounce back from adversity and deal with life’s downturns and challenges -- even when those events are so catastrophic, surprising, overwhelming, or devastating that they seem impossible to recover from.

It isn’t the absence of stress or suffering, but how you adapt and deal with it.

“Resilience is not a trait. It’s not like brown eyes that you have or don’t. It truly is a mental muscle that can be learned and practiced and incorporated into everyday life,” says  Joanne Pedro-Carroll, PhD, a clinical psychologist in Rochester, NY, who’s written several articles on resilience and a book that talks about it.

A growing body of research now looks at resilience as a way to retrain your brain to help you handle everything from major crises to daily life stress. Studies show it has benefited health, well-being, and stress management for cancer survivors, medical providers, college students, immigrants, office workers, and others.

“Resilience is the core strength you use to lift the cognitive and emotional load of life. If you are carrying an excessive load, you can either decrease the load or increase your capacity to lift the load,” says Amit Sood, MD, a professor of medicine at the Mayo Clinic in Rochester, MN, and author of The Mayo Clinic Handbook for Happiness. “Decreasing the load isn’t easy or always possible, but the second option -- increasing your resilience -- is.”

Sood and his team have done more than 20 clinical trials on resilience and report that while about 50% is genetic, the other half is acquired, to a great extent, through your choices. “The cutting-edge discovery is that resilience can be moved,” Sood says. “By training, we can enhance people’s resilience. That to me is where there is the greatest impact and interest of hospitals and doctors and patients.”

He says several studies have shown that working to boost a person’s resilience makes a measurable difference in their stress, anxiety, emotional health, mindful attention, and overall quality of life.

“Even a small improvement in resilience is associated with much larger improvement in stress measures,” Sood explains. “You can improve your resilience by 10 or 20%, and for each unit of improvement, you decrease your stress by 20 to 30%. That means if your resilience goes up 10%, your stress can go down 30% or more.”

The Basics of Resilience Training

There’s no one type of resilience training. It varies greatly in terms of content and length. But in general, it involves helping people cultivate several principles in their daily life, including gratitude, self-compassion and forgiveness, as well as the ability to let go of the uncontrollable, to focus on the positive rather than the negative, and to find meaning in life. Getting there involves strategies like deep breathing, meditation, relaxation, goal-setting, and mindfulness.

“We spend a lot of our days on automatic pilot, so it’s only when we get caught with something that is unexpected or surprising or traumatic that our coping styles or lack thereof come into play,” Thomas says. “Resilience is about catching your thoughts, changing the way you think, and learning to develop an action plan to figure out the best way to move forward during stressful times.”

Margie Ruttenberg, 54, of Pittsburgh says her resilience has grown gradually since she was diagnosed with Hodgkin’s lymphoma that has come back about once a year for 9 years. Resilience hasn’t changed her diagnosis, but she says it has been an important way to help her cope. “Cancer has taught me that I am more resilient and stronger than I thought,” she says. “In the beginning, I spent some time questioning why this was happening to me. But then I realized this isn’t my fault. You can either fight your challenges or run from them, and I decided I’m going to be resilient. I’m not going to run.”

Researchers say that is a key part of resilience -- learning to take control of your thoughts by being mindful rather than letting your mind wander.

“We help people become intentional and engage their brain to make it stronger,” Sood explains. “Studies show the average person’s mind wanders 50 to 90% of the time, so we help people become aware of how, from a neuroscience perspective, they are depleting themselves when they let this happen.”

Researchers stress that resilience training should not take the place of mental health services or needed medical treatment. There are also critics who say the field needs more consistency and an agreed-upon definition of resilience. Others believe progress is hard to verify and that some studies cast doubt on just how much improvement training produces.

The Mayo Clinic has created resilience training programs online and in person that have engaged with half a million people over the last 8 years. The hospital now requires resilience training for all new doctors and nurses, and it isn’t alone in embracing the concept.

The U.S. Army teaches resilience training to soldiers, their families, and Army civilians. The concept is being taught more in the corporate world, and Ronald Breazeale, PhD, a clinical psychologist in Portland, ME, says he’s led workshops on the subject to law enforcement, federal disaster crews, university students, teachers, and others.

“It’s really a set of skills and attitudes, and like anything else, the more you practice and apply it, the better you get at it. It involves problem-solving, flexibility, finding a sense of purpose and meaning, being able to help other people, and taking good care of yourself in the process,” Breazeale says. “It can make a major difference when people take it seriously.”

How to Increase Your Resilience

Wondering if you need to increase your resilience? Sood suggests asking yourself a simple question.

“Over the last month, how stressed have I felt on a scale of 1 -- being not at all -- to 10,” he says. “If you are above a 5, you can be helped by resilience.”

Experts say you become more resilient through lifestyle changes that focus on five domains:

  • Physical: Eating a healthy diet can make you happier and physically healthier, and regular exercise and sleep can improve your emotions, focus, and health.
  • Cognitive: Enhancing your focus and improving your mindset through practices like mindfulness, meditation, and yoga
  • Emotional: Working to boost your ability to sustain positive emotions and recover quickly from negative ones
  • Spiritual: Living a life full of meaning -- volunteering or doing substantial work that helps others and gives you purpose, hope, and meaning
  • Social: Having good, nurturing relationships to help you better withstand life’s challenges

Thomas, who specializes in resilience in African-American young people and women, says minorities often need an extra action step in their resilience training that involves learning to deconstruct or depersonalize an experience. “There is an awareness piece around identity and thinking carefully about whether or not something is about you or the other person,” she says.

It takes time for these practices to become a habit, and experts stress it is less about trying to reach some sort of endpoint and more about creating an awareness of how you want to handle life.

“Building up resilience doesn’t mean you won’t have the stress or upset feelings,” Pedro-Carroll says. “It’s how we calm ourselves when we are really distressed and how we learn those skills to self-soothe and come through tough times with a measure of grit and gratitude.”

Resilience in Action

Ruttenberg says therapy, meditation, volunteering, a strong support system and learning as much as she can about her disease and treatment options have helped grow her resilience. She’s needed it. She’s undergone multiple rounds of chemotherapy and radiation, lost her hair three times, had a failed stem cell transplant and underwent immunotherapy. She’s now on monthly immune boosting treatment and has

come to terms with the fact that for her, this will be a lifelong battle. “I can tell you that now I feel resilient and relentless,” Ruttenberg says. “I’ve learned that when I encounter a challenge, I am going to tackle it head on and just keep going because there is no alternative.”

She says her increased resilience has helped her make some difficult decisions. On the advice of her doctors, she had to put career on hold because they believe a less stressful life will lead to longer remission. She also moved from D.C. to Pittsburgh to be closer to her medical team and supportive family. “My life was about my career and so I’ve had to find a new way to believe in myself,” Ruttenberg says. “For me now, that is a big part of being strong and resilient -- making major life decisions that are important to my health.”

Honoring a Young ‘Master of Resilience’

Six years after losing her daughter, Gay says her family has slowly found their way forward. “We’ve come to understand this is a lifelong process,” she says. “People talk about recovery, and I think we often think of that as having a defined period of time. But resilience is often the recognition that there isn’t really an endpoint in terms of loss and grief and trauma.”

Even in horror’s aftermath, Gay says you learn to carry on. And in her family’s case, they do so to honor Joey and her life. “I feel like in many ways, our lives with her really strengthened our own resilience. Her life was full of challenge and adversity, yet Joey was a master of resilience. Every day, no matter how challenging it was, she got up and always had a smile on her face,” Gay says.

“We were prepared to handle this loss in ways that some other families may not have been because of what we learned from Joey. We just keep going because so did she.”

WebMD Article Reviewed by Brunilda Nazario, MD on August 22, 2018

Sources

Ronald Breazeale, PhD, Portland, ME.

Michele Gay.

Joanne Pedro-Carroll, PhD, Rochester, NY.

Amit Sood, MD, Mayo Clinic, Rochester, MN.

Anita Thomas, PhD, University of Indianapolis, Indianapolis, IN.

Margie Ruttenberg, Pittsburgh, PA.

A. Sood, Explore:The Journal of Science and Healing, Nov-Dec 2014.

A. Sood, Journal of General Internal Medicine, January 29, 2011.

A.B. Amstadter, Social Psychiatry and Psychiatric Epidemiology, May 2016.

A. B. Amstadter, The British Journal of Psychiatry, October 2014.

C. E. Loprinzi, Clinical Breast Cancer, December 11, 2011.

C. L. Baldwin, Frontiers in Human Neuroscience, August 8, 2017.

J.D. Boardman, Twin Research and Human Genetics, February 11, 2008.

 K.J. Reivich, The American Psychologist, Jan. 2011.

M.A. Killingsworth, Science, November 12, 2010.

M. J. Kane, Psychological Science, July 2007.

S. Joyce, BMJ Open, June 14, 2018.

Thomas, A. J., & Rodgers, C., APA.org. 2009.

The American Psychological Association, “The Road to Resilience.”

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