Healthcare

How to Facilitate Resiliency in Yourself and Your Patients Following Disasters

Mental health professionals have spent a long time studying post-traumatic stress disorder as a response to disaster. But more recently they have focused on resiliency, defined as “the ability to spring back from and successfully adapt to adversity,” and defined by a 15 year-old high school student as, "Bouncing back from problems and stuff with more power and more smarts." Resiliency is also sometimes referred to as psychological hardiness, wellness, and positive psychology. Regardless of the name we give it, resiliency and the ability to “bounce back from [disasters] with more power and more smarts” is an important goal of mental health, and health care providers can do a lot to facilitate resiliency in their patients.

Each of us has a built-in capacity for resiliency, "a self-righting tendency" that operates best when we have resiliency-building conditions in their lives. These resiliency conditions take place along three dimensions of our experience: I AM, I CAN, and I HAVE. This fact sheet will discuss each of these as it relates to disaster recovery for both patients and providers.

I AM refers to personal characteristics, including

• Self-esteem or the sense that we have of ourselves as capable, loveable, and worthy. Psychological research suggests that our beliefs about how we can cope may be as important as coping behavior itself.
• Mastery, confidence, perceived control, hope, and optimism have been shown to relate positively, strongly, and consistently to mental health in both the short-term and long-term recovery from disaster as illustrated in powerful personal stories.
• Recognition of personal strengths as well as suffering. Although our suffering in response to disaster must be acknowledged with compassion and empathy and patience for ourselves, we must also remind ourselves of our capacity to master this experience.

I CAN as an element of resiliency refers to recognition of not just self-esteem but self-efficacy, which is different from recognizing our personal strengths: it is the difference between “I am good at reading” (self-esteem) and “I can read” (self-efficacy). In self-efficacy we have a sense of our specific abilities and assets and talents as they relate to recovery. Recognizing our problem-solving skills and those of our patients they relate to disaster recovery can enhance resiliency, and promote our ability to “bounce back with more power and more smarts.” In building this element of resiliency, you might ask yourself, and encourage your patients to ask themselves:

• What can I bring to this experience, in terms of talents and skills, that maybe only I can bring? It may be as simple as organizing a reading time for children in a shelter or as complicated as serving as a historian of the disaster.
• What tools do I possess in terms of kindness or gratitude or perspective-taking that I can bring to this experience? How can I bring them courageously and clearly? What gifts do I have, to give?

I HAVE refers to the supports around each of us that promote resilience. These are like the airbags in our cars that even when we crash can keep us from being wounded too seriously: the “I have” of resiliency in disaster recovery might include:

• Our access to service agencies, which can provide us with basic food, clothing, shelter, and protection during times of disaster.
• Our financial resources that, even when depleted, can provide us with basic needs during recovery.
• Careful management of these resources can promote resiliency and recovery.
• Our relationships with significant others and with our professional community always influence our mental health, but are particularly important during times of disaster recovery, when relocation and other influences may disrupt our interactions with support systems. An important feature of the “I have” component of resiliency involves maintaining our relationships with family and friends, and when necessary, rebuilding relationships in the same way that we might rebuild homes or schools.
• Our participation with communities such as spiritual or religious groups, schools, and service organizations can remind us that we are not unique, that we are not alone, and that we can survive and even thrive following disasters.

In summary, relatively few of us who experience disasters become depressed or develop PTSD; most of us exhibit resiliency -- the ability to deal with adversity without becoming overwhelmed by it. We can learn to respond to adversity with resiliency rather than depression and hopelessness.