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).

Art as resilient practice

The arts provide time-tested techniques for recovering from the stresses and wounds of trauma. Through the arts we access and process our emotions, both individually and collectively. For longer than recorded history, art has been part of human negotiation of life experiences—more of a sacred rite than a spectacle or commodity. In this article I discuss how art functions to support trauma healing while describing my experiences with particular arts-based trauma healing projects.

Healing properties of art
In order to begin healing from traumatic events, we need to reach a sense of safety and stability. We need to stop the harm, examine and clean the wound and provide conditions under which we can heal from the deep pain of trauma. We possess an amazing ability to cope when the pain is too great, but coping is an emergency instinct, not a long-term solution. The arts can offer a sense of security by temporarily transporting us to a ritual world that transcends pain and fear. Sharing art with others also reconnects us to sources of support and security in our communities.

Dissociation and other coping mechanisms inhibit emotions, sensory processing and memory functions so that we can continue basic daily functions needed to survive. Traumatic events remain emblazoned in memory, yet our brains can block these memories and leave us feeling distant and disconnected. Simply acknowledging a traumatic experience can be a powerful step toward healing.

The process of finding the roots of our stress often requires deep self reflection and soul-searching. The arts support this process by stimulating and integrating numerous regions of the brain simultaneously. Memory is linked to senses and emotions. Creating art is like coming home to oneself: it incorporates body, mind and spirit so we can access and address hidden emotional wounds.

The arts help us to engage our emotions and to relish what these emotions teach us. Art calls us back to our bodies and invites the most difficult emotions into the open where they can be examined. Art invites us to play with what we most fear. Poetry, in particular, allows the imagination to weave words together with feelings. Likewise, visual arts employ symbols, colors and textures to integrate aesthetics with rational thinking. Music, too, uses non-verbal expressions through rhythm, melody and sound to engage not only the mind, but also the body. This kind of holistic coordination is inherent in the expressive arts.

The arts can thus be extremely therapeutic. They can help us mourn—and celebrate—by expressing things viscerally. Thus art, music, movement and drama therapies have all become effective tools for practitioners working with traumatized individuals and communities to engage brains and bodies in regenerative processes.

Healing through song
For me, songwriting is therapeutic. When I release inhibitions, I allow emotions to find voice. The best songs come with minimal conscious interference. While the logical, rational and literal brain functions are aware and active, they allow the body, spirit and environment to lead. Various programs enable those suffering with post-traumatic stress to use songwriting as part of their healing. In some programs, military veterans or inmates use their musical abilities to write songs or partner with professional songwriters to collaborate on compositions. Other programs, such as playback theater, involve artists listening to stories of traumatized persons, and then offering those stories back to them in art forms, allowing them to view their stories from different perspectives. I have experimented with playback songwriting. One song, “Hole in Her Heart,” represents my mother’s story of grieving following my father’s death.

Healing through storytelling
Traditional cultures recognize the need for community support and provide rituals to bring individuals back into the community after traumatic events. Such rituals offer safety, belonging, permission to mourn, mentoring, accompaniment and meaning-making structures. Storytelling is one such ritual.

Storytelling is an ancient way to communicate both positive and negative experiences. Recounting our narratives is an important part of navigating the trauma landscape. Sharing painful stories is difficult, but it can bring validation when we feel heard and honored. Story sharing fosters a sense of connection between the protagonist and empathetic listeners. The telling and retelling of our stories can also be self-revelatory.

Music-making can be a form of corporate storytelling. Singing or drumming together creates and strengthens bonds among participants in music therapy groups. Creating music in collaboration calls for participants to engage personally and communally in the music: stating an idea, listening to the ideas of others and responding to each other, be it in unison, harmony or countermelody, expressing either dissonance or consonance. Through such collaboration, we model and practice desirable relationships.

Gradually, the stories we hold for ourselves make more and more sense to us as we regenerate our narratives. Storytelling through the arts helps us finds new meaning for the past, within the present and the imaginable future. Through art we reimagine and reintegrate worlds fractured by trauma and in the process we grow more resilient. As pain subsides, we can turn our attention beyond ourselves and perhaps support others on their journeys.

Art and resilience
My own commitments to the arts and to trauma healing converged in my involvement with the Strategies for Trauma Awareness and Resilience (STAR) program in Haiti, known in Creole as Wozo. Wozo is a reed that grows wild throughout the island. It offers a wonderful metaphor for resilience. Haitians say that wozo can be knocked over by wind or flood, yet still right itself; wozo can be broken off, yet a new shoot will grow; wozo can be cut down to the ground and burned, yet come back stronger than ever. A Haitian proverb captures this resilience: “We are wozo. We bend, but we do not break.”

With support from MCC, STAR-Wozo began in Haiti after the earthquake that devastated the country in 2010. Jhimy St. Louis, a participant in a Wozo seminar I attended, composed a poem about Haitian resilience that he recited on the final day. He and others encouraged me to set the poem to music. The resulting song, “We are Wozo,” has become important in my collaborations with colleague Frances Crowhill Miller. (Listen: sopasol.com/music)

Frances and I, as Sopa Sol, are currently offering a project called Wozo—Songs of Resilience, in which we explore the journey from trauma to recovery through our stories and songs. Each presentation includes space for participants to enter in through their own stories of trauma and resilience. The project is customized for each group of participants and is continually transformed by the feedback we receive. This confluence of songwriting and trauma healing work seems to be an ongoing part of my story, and I am eager to find out where it will lead.

Daryl Snider is a songwriter and a graduate of Eastern Mennonite
University’s Center for Justice and Peacebuilding.

Understanding stories of trauma

In many cultures, including Congolese culture, storytelling functions as a means of preserving and transmitting historical memory while building community solidarity. Narrative also plays a therapeutic role in reducing the psychosocial impact of trauma by allowing individuals or groups to tell their stories and listen to the stories of others within safe spaces (Kiser, 51). However, in some cases traumatic events are so horrific that survivors choose to suffer in silence. Fear of retribution and rejection prevent those who have experienced the trauma of rape from acknowledging the event and seeking assistance. My research with Congolese women who have been raped has underscored the key role that narrative can play in assisting rape survivors and others in understanding the trauma of rape and in helping rape survivors heal from that trauma.

Sexual- and gender-based violence (SGBV) is rampant in the Democratic Republic of Congo (DRC). A 2009 study found that 462,293 Congolese women, aged 15 to 49 years, reported having been raped within the past year (Peterman, Palermo and Bredenkamp, 2011). This stunning figure excluded girls under the age of 15 and women over the age of 49 who had also experienced this horror. Furthermore, for a number of reasons, many women choose not to report their attacks. Reporting rape too rarely ends in any form of justice for the victim and can often have negative effects, with raped women facing stigma, discrimination and retribution.

In February 2014, I collected stories from 14 women who had survived rape in the eastern DRC as part of dissertation research into trauma healing for SGBV survivors. I assessed interview data using narrative analysis techniques to identify themes that surfaced across all of the interviews, using that data to then compile one biographic narrative using the data and themes from all of the narratives. While I had planned for only ten interviews, many more women requested the opportunity to share their stories of rape and its aftermath. Nearly all of the women I interviewed expressed gratitude for the opportunity to share their stories and asked that I share their stories so that other women might find healing.

One of the primary goals of the narrative approach to trauma healing is to increase awareness of the dominant stories that shape the lives of storytellers (Bennet, 12-13). Becoming aware of these dominant narratives can assist rape survivors in identifying and developing responses that can bring healing and build resilience for individuals and communities. The narrative approach I employed in my research consisted of very loosely structured interviews. In responding to a limited set of interview questions, my informants focused on the key aspects of their own stories of rape as they experienced and remembered it. Rather than adopting a structured interview style focused on eliciting information about particular topics, I sought through more free-flowing interviews to allow my informants to identify the crucial dimensions of their experiences and memories.

The findings of my study resonated with a theory of social justice developed by Madison Powers and Ruth Faden, whose work in philosophy and bioethics has articulated how indicators of human well-being can serve as a measure of social justice. Powers and Faden have described six essential dimensions of human well-being: health (physical and mental); respect (self-respect and respect from one’s family and community); reasoning (ability to engage in coherent, rational thought); attachment (presence of intimate relationships); self-determination (ability to exercise agency); and personal security. While Faden and Powers grant that one can have a decent life without having a high threshold in all six of these dimensions, they do contend that human well-being can be negatively affected by a serious deficiency in one or more of these dimensions.

My research with Congolese rape survivors found that the traumatic experiences these women had undergone significantly affected their wellbeing in all six dimensions of human well-being identified by Powers and Faden. That said, the dimensions of well-being most adversely affected, I discovered, were attachment and respect. Though many of the women had suffered significant physical trauma, most only mentioned their physical injuries after I questioned them specifically about physical complications resulting from the attack. The majority of my interviewees, however, did highlight in their narratives the pain of rejection by their husbands and/or stigma they faced from other community members because they had been raped.

Stigma toward rape victims, particularly stigma from other women, often results from a need on the part of stigmatizers to distinguish themselves from persons who have been raped. This distinction acts as a pseudoprotective measure, cultivating the illusion that one is definitively safe from suffering the same fate as the victim (Grubb and Turner, 2012).

Trauma healing, awareness and resilience efforts aimed at addressing the particular needs of rape survivors must therefore pay particular attention to deficits in attachment and respect. My research found that narrative opportunities for rape survivors to share their stories can contribute to a reduction in the stigmatization and discrimination of rape survivors in at least two ways. First, by affirming and supporting rape survivors in exercising self-determination as they share their stories, thus building their resilience as individuals and in turn strengthening their confidence in fostering intimate attachments and building relationships. And second, by expanding and deepening family and community understandings of rape and the experiences of women who have faced it, in turn reducing the stigmatization of rape survivors. Storytelling by rape survivors thus becomes a key way of expressing and building individual and communal resilience.

Beth Good is MCC’s Health Coordinator and holds a Ph.D. in Nursing.