Characteristics of Resilience
The current pandemic has shown us that we never know when disaster can strike, whether it be in the form of prolonged worldwide illness such as the novel Coronavirus or a large-scale attack on a city like New York as happened at the World Trade Center. Yet even day to day stress can result in job-related burnout for rescue workers, healthcare professionals, and behavioral health providers – the very people we all rely on to take care of the rest of us when we have reached our limit for coping both for life’s challenges and when we are confronted with a major crisis. What happens when our behavioral and healthcare workforce has reached their limit for coping mentally, emotionally, and physically? Is it really just as simple as Aunt Eller says “you gotta be hardy” and “tough?” (Zinnemann, 1955).
A study of disaster workers following the Great East Japan Earthquake of 2011 found some important characteristics that are associated with higher levels of resilience (Xiaorong et al., 2019). Searchers interviewed disaster healthcare rescue workers in an effort to understand more about the resilience that allowed them to continue working and suffer no evident adverse psychological effects. The qualitative study recorded and analyzed the results of interviews with 21 workers. The analysis identified characteristics that fell into four themes as follows:
- Strength of Personality
- Availability of Social Support
- Support from Family and Friends
- Support from Colleagues
- Appropriate Coping Strategies
- Emotion-oriented Coping Strategies
- Problem-oriented Coping Strategies
- Adequate Preparation
- Preparatory Training
- Provision of Basic Physical Needs
- Psychological Support after Deployment
Healthcare workers also described the positive changes that occurred in their personal lives as a result of their participation in the emergency response, such as improved relationships, changes in personal values, increased meaningfulness of life, and a sense of efficacy. While “hardiness” certainly was among the characteristics found among healthcare workers who were identified as “resilient” there is much more to the story of what traits are truly indicative of resilience. The authors cited some limitations: participants were identified as “resilient,” as having suffered no obvious negative consequences due to their deployment to the earthquake rescue mission, and as able to continue with normal work by team leaders, which could indicate selection bias. The workers were selected from a single rescue mission and the results may not apply to other rescue missions or those from other cultures. The results do provide a beginning for primary health and behavioral healthcare providers who would like to build resilience as individuals and with those they treat and to help build more resilient communities and systems of care.
Resilience for Organizations
Dr. Michael Ungar defines resilience as a process of awakening what is already inside of us: “our capacity in adversity, individually or in groups, to navigate the psychological, social, cultural, and physical resources needed for well-being.” He goes on to say that “It is also our ability individually or in groups to negotiate for those resources to be offered to us in contextually and in culturally meaningful ways” (Dr. Michael Ungar: What is Resilience 2017). Because resilience is a process that involves person-environment interaction over time, it can be thought of as “plastic,” with the ability to evolve through intervention (Giordano, Ragnoli & Brajda, 2019; Giordano, Ragnoli, Brajda et al., 2019; Giordano & Ungar, 2021; as cited in Giordano et al., 2021). A recent study of strained healthcare workers in a region of Italy that was highly impacted by the COVI-19 pandemic found satisfaction was high for a resilience-building intervention designed to help organizations, businesses, and educational institutions enhance the wellbeing of those workers who experience stress and adversity. After a needs assessment was conducted, the intervention focused on building organizational capacity for resilience and helping leaders to implement policies, procedures and resources that promote resilience for employees in contextually specific ways (Giordano et al., 2021). This research supports the theory that resilience is not only an individual trait that people can foster in themselves and others, but that organizations can promote the characteristics of resiliency with the right kind of support and resources.
Resiliency and Podcasts: Season 2 of CASAT Conversations
CASAT Conversations is a resource for exploring how our environment, behaviors and actions can affect our health and wellbeing. While there are a variety of ways for primary health and behavioral healthcare providers to learn more about resilience, podcasts are becoming a popular and important way of learning while on the go or while multitasking. In the Catalyst Blog post Listen to a Podcast: It’s good for your brain! Data about who listens to podcasts is provided and some interesting research is presented that explains how listening to podcasts can actually be good for growing your brain, while introducing Season 1 Behind the Front-Line: Supporting the Families of Front-Line Staff and First Responders, listeners can hear experts, first responders, and their families discuss topics for front-line staff and their families.
Season 2: Exploring the Importance of Resilience in Healthcare is currently available to help providers explore both ways to build resilience as individuals, communities, and within organizations. Listening to the new season is a great way to dive deeper into the complexities of resilience, more of the latest research, and to discover tools healthcare providers can use for developing resilience. Five episodes are currently available as described on the CASAT Conversations Season 2 website, with brief speaker biographies available on the website:
Episode 1: Little Moments Of Light – Within this episode Dr. Michael Ungar shares his wealth of knowledge on the key elements of resilience. His research focuses on the impact of the environment on our resilience. You’ll hear about the complexities of resilience and what healthcare providers can do to support their own resilience.
Key Topics: Resilience, rugged individualism vs a resourced individual, resilient systems, vicarious resilience, social prescriptions
Episode 2: Stress First Aid – Episode Description: Dr. Patricia Watson has been supporting people in stressful jobs (i.e. military, first responders, healthcare providers) with her work at the National Center for PTSD for many years. She discusses the stress continuum, along with the five key elements for supporting a person who is experiencing stress, burnout and fatigue. In addition, she discusses the importance of psychological safety, and ways to help build a sense of psychological safety within organizations.
Key Topics: psychological safety, resilience, meaning and purpose, stress continuum, burnout, fatigue, social connectedness, self-efficacy.
Episode 3: The Cost of Doing Business in High Stress Environments – Dr. Kathy Kain discusses the science behind a somatic approach to help heal the impacts of stress and trauma. She also describes how the body responds to the experiences of our lives and gives important recommendations for how to support ourselves when working in high stress environments.
Key Topics: allostatic load, enteroception, exteroception, neuroception, somatic approach, polyvagal theory, stress, trauma, aging, health, chronic disease.
Episode 4: Addressing Burnout Through Integrative Medicine – Within this episode, Alaine Duncan discusses the role of Integrative Medicine in treating burnout and compassion fatigue. She discusses how she has combined Eastern and Western philosophies to treat physical symptoms of stress and trauma within the body. Her approach to treating the body and helping to support the parasympathetic nervous system is critical for helping us understand how the nervous system impacts the people around us (i.e., family, patients, and clients).
Key terms: acupuncture, integrative medicine, five elements theory, somatic experience, polyvagal theory, trauma, stress
Episode 5: CPR For Healthcare Providers – Within this episode Joshua Michael Wenner shares best practices for dealing with stress and trauma. He discusses the importance of creating a warrior culture, and how to practice self-regulation so that you can have better relationships with those that you love.
Key terms: Trauma, self-regulation, emotional-regulation, resilience, warrior culture
Your Turn: Have you tuned in to CASAT Conversations to listen to Season 1 or Season 2? What is you favorite Podcast? Please share your experience in the comments below.
Check out more Catalyst Blog posts, such as:
For more resources on a variety of podcast and blog topics, visit the CASAT OnDemand Resources & Downloads page.