Category Archives: resilience

Resilience: More Than Preventing Negative Outcomes

Resilience is typically studied as either a recovery/ bouncing back factor where you return to baseline levels of functioning before an acute stressor had occurred, or as a sustainability factor where you continue performing/ adapting well despite the presence of a chronic stressor.

How resilience is typically operationalised, in terms of outcome, is whether the individual survives the acute trauma/stressor and/or chronic stress and still remains psychopathology free. If he doesn’t then he is non resilient, but if he indeed remains free of negative outcomes then he is resilient. Sometimes, very rarely, in case of trauma, the concept of post traumatic growth is studied, whereby an individual actually grows following the traumatic experience. While that is important, today I wish to discuss something different.

First if resilience is about preventing negative outcomes or psychopathology, we need to understand why psychopathology happens in the first place. One popular model to understand psychopathology is the stress-diathesis model.

Basically, what the model says is that there is some vulnerability in the individual (diathesis) and some adverse life experiences (stress) the individual is subjected to, and that combination may lead to psychopathology or negative outcomes.

Now daithesis is your pre-psychopathology brain biochemistry that is affected by your genetic makeup and your early childhood experiences. The genes and early environment cumulatively make you vulnerable to future threats.

Stress can be of two types : acute stress or traumatic experiences like death of a spouse and chronic life conditions like living in poverty/ working in a high pressure job with an nonsupporting boss.

By themselves, neither vulnerability factors nor stress factors may be enough to trigger psychopathology, but cumulatively they raise risks and make it more likely that one could get unhinged.

To sum up, the risk factors for psychopathology are:

  1. Genetic (as evidenced in personality factors like high Neuroticism)
  2. Early environmental (as measured by Adverse Childhood Experiences (ACEs) like abuse, neglect etc
  3. Chronic environmental (chronic life conditions like unemployment )
  4. Acute situational (acute life events like bereavement etc)

The above are all very well studied and sometimes resilience is just studied as moderators of the association between these risk factors and negative outcomes/psychopathology. For eg, given that high Neuroticism leads to high chances of developing depression / anxiety , are there any other protective factors say high Exraversion or presence of secure attachment that can prevent or moderate the effect of High Neuroticism on depression/anxiety. The same logic applies to other risk factors: given a child had suffered 4 or more ACEs, what is the risk of psychopathology and whether and how it is moderated by presence of protective factors like a caring caregiver.

Now, the above is only applicable if you are descriptive and trying to find what elevates and what depresses the risk of psychopathology; however resilience studies have moved ahead and now also focuses on how resilience is achieved or looks at the underlying processes.

But I want to take the discussion in a whole new direction: by conceptualizing resilience also as the presence of advantages be it genetic, early childhood, chronic environmental or acute situational and how that may lead to positive outcomes like flourishing and growth.

Now admittedly, the discussion of resilience would necessarily be descriptive in this sense for now; later a full science could be established looking at how one is able to harness things like Positive Childhood Experiences (PCEs) for later flourishing outcomes. You may think I just made the term but PCEs actually exist in the literature.

To cut a long story short, I want to propose an opportunities- strengths model of flourishing on the lines of the stress-diathesis model of psychopathology. Now we all know that not all people flourish in life and most, if not suffering from psychopathology, are at best languishing in life. And we don’t really know why some people flourish, go on to self actualize and self transcend while others don’t.

What I propose is that analogues to the risk factors we have some promotive factors in our life; they are not just protective from stress/psychopathology but helpful in us reaching our potential and being happy/ thriving.

These promotive factors are:

  1. Genetic (as evidenced in personality factors like high Extraversion/ positive emotionality )
  2. Early environmental (as measured by Positive Childhood Experiences (PCEs) like enriched environment, secure attachment etc
  3. Chronic environmental (chronic life conditions like high education/ income )
  4. Acute situational (acute life events like peak experiences etc)

However , not much work has happened on these promotive factors and how they lead to positive outcomes. At best, they have been studied in the context of providing protection/buffering against risk factors and studied in context of psychopathology only. And some promotive factors like personality traits have been studied more. I could only find a handful of studies looking at PCEs; one looked at PCEs and increased remission from Personality disorders; another looked at PCEs leading to presence of social and emotional support in adulthood and absence of depression/ poor mental health.

The whole field of opportunities or chronic/ acute advantages like lucky breaks, being born and living in privilege and their impact on life trajectory and positive outcomes is very much unexplored. Whats more we even lack any vocabulary or listing of these acute/chronic advantages/ opportunities.

What we desperately need is a new framework for resilience (or may use another term) where we look at the role of promotive factors in enuring positive outcomes; once we have such a framework in place we can look at underlying processes too.

Why am I stressing the need for this? Once upon a time therapy could hope to achieve more than lifting people out of deep misery to common unhappiness; since the advent of positive psychology we have started to aim a little higher looking at ways people can lead flourishing lives.

Preventive interventions based on understanding the risk and protective factors have done a good job in reducing psychopathology (or not!), I think its time to up the ante and star t thinking about what promotive factors and life experiences can be harnessed in a the most optimal way to ensure flourishing.

I hope people will explore this new paradigm and start conceptualizing and doing research around this framework…