Pyschological resilience in the face of trauma

Traumatic experiences can shatter one’s world and perspective on life. Even persons with healthy coping skills have areas of vulnerability. When severe adversity intersects with an area of personal vulnerability, the resulting flood of emotion can make it difficult to go on. Normally effective coping mechanisms give way to the symptoms of post-traumatic stress as a once-manageable world disintegrates and a fragmented mind struggles to regain balance. Yet, despite the very real risk of persistent post-trauma challenges, in the majority of cases people do not shatter, lose hope or require psychological interventions. Why is that? One variable is something researchers have called resilience, or the ability to adaptively cope in the face of adversity.

Resilience is a relatively new psychological construct and like with any new concept, understanding develops over time, some ideas gaining traction while others give way to richer, more nuanced conceptualizations. Along the way, resilience has become a popular household term, often used to describe people who come through adversity relatively unscathed. Yet popular understanding has also adopted some ideas that have since been discarded by researchers. This article will explore those misconceptions and then discuss new themes in resilience research, concluding with research-based suggestions for increasing resilience.

Challenging some popular understandings of resilience
Psychological resilience is not a personality trait. There are no resilient people: rather, resilience is a context-specific response to adversity. For example, an individual may show resilience in responding to a natural disaster, but display very little adaptive coping when confronted with the loss of a loved one. Likewise, despite a life-threatening car accident, a child may show positive adaptive coping in school, but experience disabling anxiety following a frightening encounter with an aggressive dog. Context impacts resilience.

Resilience does not imply invulnerability or a lack of suffering. Consider, for example, the loss of a loved one in a house fire. Deep grief, anger, blame and loss of purpose would all be normal responses following such an event. One would expect recovery to be complex and take time, social support and new forms of meaning-making. Resilience is displayed when positive coping leads to healthy adjustment following trauma: it does not mean the absence of suffering.

Properly conceptualized, resilience does not result in self-blame. Some activists claim that self-blame is implicit in the concept of resilience. They argue that highlighting how some people can cope with a traumatic event while others do not implies that the traumatized individual is to blame or is in some way, defective. These activists further contend that focusing on individual coping and recovery depoliticizes the injustice inherent in many traumatic events such as violence against women, accidents resulting from inattention to safety standards or disasters resulting from ecological mismanagement. Instead of focusing on recovery, these activists maintain that energy should be invested in collective action to bring about justice.

While collective action is essential, the concept of resilience, properly understood, does not involve blaming the victim or depoliticizing violence. For example, just as being physically injured in the process of armed robbery might require medical treatment, so too may post-traumatic stress symptoms require psychological intervention. Yet receiving physical or psychological treatment should in no way imply that the victim is to blame or exempt the violent offender from penalty. Responses to shocks and traumas must include recovery for the survivor and action to resolve injustice.

What, then, is psychological resilience?
Psychological resilience is the normal human response to adversity. Resilience is demonstrated when a person’s coping methods, although challenged, help negotiate adversity until stability is regained. Yet, if resilience is normal, why do some people struggle long-term? Everyone has areas of vulnerability, and when a shock or trauma happens to coincide with an area of vulnerability, or stressors occur too rapidly, anyone can find her normal coping mechanisms faltering, while even those who view themselves as strong can find themselves in need of help.

Certainly, there are protective factors that increase the likelihood of resilience, including: the personality traits of optimism, hope and hardiness; the practice of healthy cognitive and self-regulation skills; positive and compassionate views of self; and the belief that one can make a difference. External factors also contribute to resilience, such as: the support of family, friends and community; access to needed material resources; and access to rescue equipment or medical aid. No single factor can predict traumatic stress symptoms or resilience. Rather, the struggle to survive and recover involves a recursive relationship among managing overwhelming emotions, remaining grounded in personal values and beliefs and garnering social support, all the while addressing physical needs.

The more stability and healthy coping practiced in normal life, the more likely the resources to cope with shocks and traumas will be available when needed. Replacing unhealthy coping methods is less problematic during non-traumatic periods of life and may well be lifesaving. Once destabilized by traumatic events, it is difficult to train the brain to start new healthy coping behaviours.

Accessing new forms of healthy coping during shocks and trauma is difficult because of the way the brain functions. During a shock, the amygdala, the part of our brain that leads to fight or flight impulses, takes over, releasing adrenaline and leaving our prefrontal cortex, or our thinking brain, underutilized. That means that during a shock the brain goes into survival mode and the part of the brain needed for complex behaviours and high-level thinking is simply not available. It is only as the brain calms, and starts releasing serotonin, that the pre-frontal cortex returns to normal functioning. As the pre-frontal cortex is reactivated, higher-level thinking and coping mechanisms are once again made available. The more habitual the coping mechanisms are, the more likely they will be activated following shocks and trauma, thus resulting in demonstrations of resilience.

In conclusion, psychological resilience is demonstrated when adaptive coping helps a person negotiate adversity toward a return to stability and recovery. Psychological resilience is context-specific and does not preclude pain and suffering. Individuals can increase the likelihood that they will be able to access resilience following shocks and trauma by incorporating healthy coping practices in daily living.

Dawn Penner is an international trauma consultant specializing in work
with survivors of violence, including war, gender-based violence and
natural disasters. She has worked in the Democratic Republic of Congo,
Lebanon and Bangladesh.

Trauma awareness and resilience in Kenya

Over the past two years Kenya has been shaken by a series of violent attacks on civilians carried out by factions in Somalia’s ongoing civil war. These attacks have had a traumatic impact on the communities where they were carried out. Daima Initiatives for Peace and Development (DiPaD), headed by Doreen Ruto, is a Kenyan organization that has responded to these attacks by promoting trauma healing and psychosocial resiliency techniques. This article, based on an interview with Ruto, discusses the opportunities and challenges DiPaD has experienced as it has responded to recent traumatic emergencies in Kenya.

In September 2013 an attack on Kenya’s Westgate shopping mall took the lives of 67 individuals and left many more wounded. DiPaD organized workshops for caregivers and emergency first responders (Red Cross staff, journalists, military, police and pastors) in the wake of the attack. More recently, DiPaD responded to an attack at Moi University in Garrissa in April 2015 by conducting workshops for caregivers and first responders in trauma healing. DiPaD has also provided pre-deployment training in trauma awareness and psychosocial resilience for military members and their families, particularly those being deployed to high-risk areas. In all of these interventions, Ruto explains, DiPaD’s efforts go beyond addressing immediate psychosocial needs, also seeking to equip individuals with tools for long-term resilience.

In the five years that Ruto has been leading DiPaD, she has utilized and adapted knowledge, skills and resources from her education at Eastern Mennonite University. As a certified trainer for the Strategies for Trauma Awareness and Resilience (STAR) program, Ruto aims to accompany trauma survivors by equipping them with “self-help” tools for coping and healing. Ruto’s goal is for these tools to be part of a long-term response to trauma, as participants practice trauma healing skills with their friends and family following STAR workshops. Ruto stresses that DiPaD’s approach is a long-term one, which can present challenges. Some participants in DiPaD-organized trauma awareness and healing workshops come to the program with the idea that they will be receiving therapy. The organization’s training goals, however, include a more comprehensive approach to trauma that increases awareness of trauma and resilience while promoting trauma-informed dialogue.

Ruto has also grappled with adapting STAR resources, developed in the United States, for use in her Kenyan context. While Ruto appreciates efforts that STAR has made to enhance the effectiveness of its materials in multicultural settings, she finds that she must still make adaptations to account for different levels of literacy and cultural mores. As part of a recent trauma healing project in South Sudan, Ruto trained translators and local artists to work on translating STAR materials into nine of South Sudan’s major languages and contextualizing visual materials in STAR manuals for the local context.

Ruto explained that over the years some of her methods have changed due to her experience with trauma work. In addition to the typical STAR training format of four-and-a-half days, Ruto has also started a learning community to provide long-term follow-up for the trainees. She expects that after STAR trainees complete the workshop they will return to their communities, disseminate information they have learned and put their new skills into practice. She then has trainees come back together for what she calls harvest meetings to learn from one another’s activities and to discuss ongoing trauma response needs, successes and struggles within their communities.

After the April 2015 attack on Garissa University that killed 147 people and injured 79 others, DiPaD received an invitation from Radio Waumini, a broadcaster affiliated with the Catholic Church, to collaborate in producing 12 hour-long radio slots to air over a three month period focusing on trauma awareness and recovery in the wake of terrorist violence. These live broadcast programs not only educate listeners about trauma and its effects but also disseminate community-based strategies for addressing traumatic events. Ruto plans to invite survivors of the Westgate Mall attack to share personal experiences on the radio broadcast as a way to educate others.

Working as a trainer for trauma awareness and resilience is exhausting, Ruto shares, noting that few people work at trauma healing and psychosocial resilience in Kenya. Ruto observed that she has learned that she must recognize when to “step back” and be deliberate in finding time to rest and reflect. When asked about what imagery she would use to describe trauma work, Ruto said she compared it to a butterfly. “In the beginning, you only see ugliness, hurt, pain and darkness. Then you begin to see transformation and can recover and look toward a better future,” she shared. “Trauma can even help us to become better people.” Asked what advice Ruto has for other trauma practitioners, she reiterated the need to respond to immediate psychosocial needs while also working to build long-term resilience at individual and communal levels.

Beth Good, MCC Health Coordinator, interviewed Doreen Ruto, director
of Daima Initiatives for Peace and Development (DiPaD).