Factors promoting resilence after a traumatic event

Humans vary to a great extent in their ability to adapt to adverse experiences. Some individuals, despite being faced with the most pernicious of adversities, manage to avoid psychological collapse and to maintain healthy adjustment. For decades, researchers have searched for the correlates and causes of resilience. Resilience (derives from the Latin word "salire", meaning to "leap or jump", hence "resilire" or to "spring back") is the ability to experience severe trauma or neglect without a collapse of psychological functioning. It involves the creation of a protective inner space, and is enhanced by qualities such as verbal ability, reflectiveness, and impulse control. Resilient individuals are attuned to others' motives, feelings and thoughts, believe that close relationships are very important and have the ability to reflect on the relations between their own and others' emotions and actions. They have an ability to bond with a group with a common mission, place a high value on altruism, have a capacity to tolerate high levels of fear and still perform effectively. These individuals are not fearless, but are willing and able to approach a fear-inducing situation, despite the presence of subjective fear and psychological disturbance. They are usually able to assess what needs to be dealt with. Reality testing, which is helped by good cognitive abilities, reveals the part of reality that matters for survival. This enables resilient individuals to act effectively in difficult situations where others might be blocked. A sense of humor provides helpful levity (it is well-known that humour can also produce beneficial biological changes, including increasing the body's endorphin levels and stimulating the immune system). These individuals also show tolerance for their negative feelings, a manageable sense of guilt and a strong capacity for self-reflection. Added to this, they can generally take responsibility for what has to be done and take charge in difficult situations, without being victimized. They have a need to prove that adversity can be overcome and not be identified as victims. Resilient individuals are capable of building a safe intrapsychic space where they live, and feel invulnerable.

The subject of dealing successfully with major adversities raises the question of child-rearing practices. In fact, overcoming even minor adversities can reveal a child's potential for resilience and in some way can increase the ability to deal with stress. In fact, instead of parental protection against any disruption, it might be more appropriate to allow children more freedom to deal with difficult situations on their own, under parental supervision.

Resilience may represent an important target of treatment in anxiety, depression and stress reactions. In patients with posttraumatic stress disorder in particular, resilience can be used as a measure of treatment outcome, with improved resilience increasing the likelihood of a favorable outcome. It can be monitored using the Connor-Davidson Resilience Scale, and perceived vulnerability to the effects of stress can be monitored with the Sheehan Stress Vulnerability Scale. Both scales are self-rated, easy to use, easy translatable, and, after validation, can be used even by non-specialists.

Positive mental health is considered to be a stage of good, adaptive functioning in an "average environment". Resilience is observed in individuals who overcome years of severe trauma and/or neglect while growing up in a not-so-average environment, or in those who surmount tremendous traumatic experiences after experiencing "normal" childhood years. Positive mental health for a particular individual does not render that individual capable of showing "resilience" in extraordinary threatening situations. In fact, predicting resilience in the face of a serious traumatic event may be very difficult. Future research may find answers to this question and provide ideas for dealing more effectively with adversity.

Key words: Resilience, developmental psychopathology, posttraumatic stress disorder.