Resilience – bouncing back from adversity – is a complex, dynamic skill set developed over years of dealing with the hard things in life: losing one’s health, losing a relationship, losing a job, losing one’s purpose. Clients become resilient, and come to know that they are, by learning to meet the inevitable disappointments, difficulties and even disasters of life skilfully, gracefully and effectively, and finding the lessons in the losses and the growth in their sense of self.

As the American Psychological Association puts it: ‘Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress.’1

Cultivating or recovering resilience is at the heart of every therapeutic process. Whatever the presenting issues – illness or injury, infertility or infidelity; whatever the presenting symptoms – anxiety, depression, shame, despair; whatever theoretical orientation or modality therapists bring to bear – cognitive-behavioural, psychodynamic or somatic experiencing, clients come to therapy for guidance and support in recovering (or discovering) their strengths, their competencies and their wellbeing.

Resilience becomes a mindset – an ongoing approach to the hiccups and the hurricanes inevitable in the human condition. With this mindset, we learn how to perceive what’s happening accurately, bring self-awareness, self-acceptance and self-compassion to our reactions to what’s happening, and consciously discern options and make wise choices. We also learn that we can make those choices, and to deeply trust that we can, no matter what happens. Any adverse change in circumstances, any potentially traumatising event, becomes an opportunity, a cue to practise strengthening resilience.

I find this view from Kelly McGonigal, health psychologist at Stanford University, helpful: ‘Resilience is not about being untouched by adversity or unruffled by difficulties. It’s about allowing stress to awaken in you these core human strengths of courage, connection, and growth. Whether you are looking at resilience in over-worked executives or war-torn communities, people in military deployment, immigrants or refugees, people living in poverty, battling cancer, or raising a child with autism, the same themes emerge.

‘People who are resilient allow themselves to be changed by the experience of adversity. They maintain a basic sense of trust in themselves and a connection to something bigger than themselves. They also find ways to make meaning out of suffering. To be resilient is not to avoid difficulty but to play an active role in how difficulty transforms you.’ 2

Resilience is learnable, trainable, because capacities for resilience are innate in the human brain. They are functions of the prefrontal cortex, the centre of executive functioning in the higher brain, that develop as the brain matures from experience.

Dan Siegel, psychiatrist at the University of California, Los Angeles, identifies these major functions of the prefrontal cortex as follows:3

  • to regulate the body and nervous system
  • to quell the fear response of the amygdala (the fear centre)
  • to manage a broad range of emotions
  • attunement – the felt sense of feelings, one’s own or another’s
  • empathy – making sense of experience
  • insight and self-knowing
  • response flexibility
  • planning, judgment, decision-making.

Because of these functions, especially the function of response flexibility, Canadian psychiatrist Gabor Maté calls the prefrontal cortex ‘the CEO of resilience’.4

We can strengthen the functioning of the prefrontal cortex because of the lifelong neuroplasticity of the brain. Any experience at all, positive or negative, causes neurons in the brain to fire. If you repeat the experiences, the neural firing repeats. With enough experience, the brain creates new neural circuitry, new neural pathways, new ways of responding to life events. When we teach clients to choose and repeat the experiences that especially cultivate the capacity of response flexibility, we are teaching them how to strengthen their resilience. In fact, we are transforming any adversity into learning and growth.

Richard J Davidson, founder-director of the Center for Investigating Healthy Minds at the University of Wisconsin-Madison, notes:5 ‘The brain is shaped by experience. And, based upon everything we know about the brain in neuroscience, change is not only possible but is actually the rule rather than the exception. It’s really just a question of which influences we’re going to choose for the brain. And because we have a choice about what experiences we want to use to shape our brain, we have a responsibility to choose the experiences that will shape the brain toward the wise and the wholesome.’

One of those wholesome choices would be to cultivate the mindset that we do have choices. Carol Dweck, psychology professor at Columbia University, notes in her research on shifting from a fixed mindset (giving up in the face of failure or setback) to a growth mindset (persevering in the face of a failure or setback):2 ‘The fixed mindset robs people of capacities to cope. The growth mindset fosters curiosity and a passion for learning through effort and experience. People with growth mindsets respond especially well when things are not going well; they tend to stretch themselves, confront obstacles, embrace risk, and stick through the hard times. Rather than being embarrassed or blocked by a sense of deficiency, they can acknowledge what skill or capacity is missing and set to work to cultivate it. They take direct, wise and compassionate action.’

Edith Chen, psychology professor at Northwestern University, noted something similar in her ‘shift-and-persist’ mindset.2 Shifting is accepting that the stressor is real and changing the way you think about it; persisting is maintaining the optimism needed to pursue meaning, even in the face of adversity. My colleague Frankie Perez sums it up as: ‘How you respond to the issue… is the issue.’6

I teach my clients very specific tools for choosing to learn how to transform adversity into learning and growth.

Body-based tools

Our most basic responses to all of life’s challenges and adversities begin in our bodies, where trauma memories of when we couldn’t cope so well are also stored implicitly. I teach clients tools of breath, touch and movement to regulate their nervous system’s response to stress or danger (the first function of the prefrontal cortex) and return the functioning of the brain to its innate safety zone, its innate range of resilience. In fact, the rapidity and reliability with which we can return the nervous system to baseline, calm and engaged, is an objective measure of resilience.

In his book Resilient: how to grow an unshakable core of calm, strength and happiness, Rick Hanson calls this equilibrium the ‘Green Zone’.7 Neurophysiologists call it the zone of safety. Psychotherapists call it the range of resilience, as I do here. Trauma therapists call it the window of tolerance. We use empirically based tools to recover the brain’s internal perception that it’s safe to function. That neuroception of safety primes the neuroplasticity of the brain for learning. 

Movement

Any time you move your body and shift your posture, you shift your physiology. Any time you shift your physiology, you shift the activity of your autonomic nervous system and its state of excitement-stress, calm or shut-down collapse. Clients can intentionally use movement to shift their emotions and their mood. Here is an example from my own clinical practice.

My client, Marian, was an educational psychologist, acting as a consultant to parents who needed to place their son or daughter in a residential treatment facility for young people with a dual diagnosis. Although very competent and successful, Marian experienced severe anxiety and a fair amount of self-doubt and shame whenever she first met the parents of such children. Would she be good enough? Would they find her adequate and trustworthy?

We began practising a form of power posing, based on Amy Cuddy’s research at Harvard Business School.8 Marian would practise how she stood in her own office before meeting the parents. She would stand tall, proud and strong, pulling the energy up from her feet, which were planted firmly on the floor, up through her torso, up through her spine and neck, so she stood erect and empowered.

Marian had so much success with that experiment in using movement to shift her emotional state that we changed to beginning the practice with her feeling the anxiety in her body, embodying the self-doubt, and then shifting into the posture of strength and confidence. The shifting all the way through from negative to positive was even more effective in changing Marian’s emotional state. She noticed that, over time, she hardly felt the anxiety and self-doubt any more at all. She could embody the strength and confidence the moment she needed to.

Power posing helps clients access an inner, body-based sense of strength and confidence. Shifting from an embodied negative state (anxiety, shame) to a more positive embodied state helps clients learn they can use the movement of their body to change their internal state, turning a dreaded situation into learning and growth.

Effects of positive emotions

Just as daily living triggers the stress response, so simply living evokes emotions; clients experience some kind of emotion every single moment of their day. Whether they like having these emotions or not, whether they trust them or know what to do with them or not, their feelings constantly filter their perceptions and guide (sometimes misguide) their responses to all of their experiences, and so play an integral role in how well or poorly they bounce back from any adversity. Learning to manage their feelings, their emotions, rather than be hijacked or shut down by them, is essential to flexibility, resilience, to creating wise choices, learning and growth.

Data from 25 years of neuroscience research and 25 years of behavioural science research9 are now dovetailing nicely to demonstrate the benefits of cultivating positive emotions – gratitude, kindness, compassion, joy, awe, delight, serenity – to help antidote the innate negativity bias of the human brain and reliably shift the functioning of the brain from negativity, reactivity and contraction to receptivity, openness to learning, and a more optimistic perspective. A direct, measurable cause-and-effect outcome of cultivating positive emotions is resilience.

Here are two examples from my clinical practice. Both these clients were retired lawyers battling cancer.

We were already working with Noah’s lifelong patterns of negativity, his ‘poor me’, complaining and rumination, when he was diagnosed with lung cancer. His mood plunged into despair. It was hard to sit with Noah in that overwhelming darkness, and it became very hard to get any traction in the therapy sessions.

Almost out of desperation, yet knowing how powerful a positive emotion practice could be in shifting mood, I suggested we begin each session with a five-minute gratitude free-write.10 Each of us would write down, in silence, whatever we had to be grateful for in that moment. For Noah, being alive, being able to drive his car to his medical appointments, a good friend bringing soup and salad for lunch, a neighbour helping to fix a blocked kitchen drain... In just three sessions of focusing on gratitude, Noah shifted his attitude toward more optimism and hope; he became much more compliant with his treatment protocol. And, in fact, surgery and radiation proved completely effective. The cancer went into remission, and so did much of Noah’s pessimism and rumination.

Kate, already a much more people-oriented person, developed a very steady mindful self-compassion practice when diagnosed with breast cancer. ‘This really sucks. My body aches and I’m scared to death. May I be kind to myself in this moment, in any moment, in every moment. May I accept this moment exactly as it is. May I accept myself exactly as I am in this moment.’ That self-acceptance, no matter how discouraged and grumpy she felt, together with the support of loyal and caring friends, proved to be a powerful ally in tolerating the rigours of many rounds of chemotherapy.

Kate even created a T-shirt with the logo of a crab for the zodiac sign of cancer: ‘I’m crabby because I have cancer.’ Giving herself permission to be crabby allowed Kate to keep the larger picture in mind; she was undergoing the rigours of treatment to regain her health. She learned to practise mindful self-compassion in order not just to feel better but to do better in battling the disease.11

 Conscious awareness and choices

We all have unconscious patterns in our language that filter how we perceive our experiences and thus shape how we respond to them. ‘Should’ is one of them. ‘I have to’ is another.

Clients can react to these unconscious messages quite unconsciously and automatically. ‘Should’ and ‘have to’ imply obligation, duty, even right or wrong, and the mind contracts. ‘Should’ creates an unconscious expectation or command for performance and sets clients up for criticism if they ‘fail’ to perform. ‘Could’ creates an unconscious perception of possibility and sets clients up for pride in their learning and growth.

Here’s another example from my clinical practice. Maude was the sometimes overwhelmed, often exasperated mother of three boys aged five, four and two. The four-year-old was already diagnosed as having special needs.

Maude worked hard to be consciously patient and loving with her boys, but she was unconsciously, unfailingly critical of herself – for making the wrong decision, for losing her temper, for not being a ‘good enough’, let alone perfect, mum. She spent much of her day feeling like a failure, not meeting the ‘shoulds’ of being the model parent.

Maude had to practise becoming more mindfully aware of her thought patterns when they derailed her in the moment. Then she had to learn the simple practice of ‘Change every should to a could’. When she caught herself saying ‘should’, she repeated the phrase ‘Change every should to a could’ and noticed the shifts in her thinking. Changing every ‘should’ to ‘could’ opened up possibilities and choice, and thus strengthened her response flexibility. She also found that shifting from ‘I have to’ to ‘I get to’ similarly shifted her thinking from burden to privilege. There is a critical difference between ‘I have to...’ and ‘I get to take the kids to school every morning this week’.

This one practice of consciously shifting her self-talk changed how Maude perceived herself as a mother and strengthened her resilience.

As Diana Fosha, developer of Accelerated Experiential Dynamic Psychotherapy, writes:12 ‘The roots of resilience are to be found in the felt sense of being held in the mind and heart of an empathic, attuned and self-possessed other.’

Therapists bring their own resilience mindset to the work of helping clients develop theirs. They need to be able to hold faith in the client’s potential and in the process; to share the knowledge that any adversity provides an opportunity for learning more resilient behaviours; to lead the client in learning the skills that help them cope with the inevitable ups and downs of life more skilfully, in ways that are safe, efficient and effective. Clients become more resilient; they learn that they can become more resilient. Clients experience themselves as more resilient; they experience themselves as someone who can learn and grow.

Linda Graham MFT is an experienced psychotherapist and mindful self-compassion teacher in the San Francisco Bay area, USA. She is the author of the award-winning book Bouncing Back: rewiring your brain for maximum resilience and well-being, and a new book, Resilience: powerful practices for bouncing back from disappointment, difficulty, and even disaster. She integrates modern neuroscience, mindfulness and relational psychology in her national and international trainings. Her weekly Resources for Recovering Resilience are archived on her website at www.lindagraham-mft.net

References

1. American Psychological Association. The road to resilience. [Online.] www.apa.org/helpcenter/road-resilience
2. McGonigal K. The upside of stress: why stress is good for you and how to get good at it. New York, NY: Avery; 2015.
3. Siegel DJ. The developing mind: how relationships and the brain interact to shape who we are. New York, NY: Guilford Press; 1999.
4. Maté G. In the realm of hungry ghosts: close encounters with addiction. Berkeley, CA: North Atlantic Books; 2010.
5. Cited in Beck C. Project happiness. Common Ground 2012; August: 26. http://commongroundmag.com/main-page.html (accessed 15 October 2019).
6. Personal communication.
7. Hanson R. Resilient: how to grow an unshakable core of calm, strength, and happiness. New York, NY: Harmony Books; 2018.
8. Cuddy A. Your body language may shape who you are. TEDGlobal2012; June, 2012.
9. Frederickson B. Positivity: groundbreaking research reveals how to embrace the hidden strength of positive emotions, overcome negativity, and thrive. New York, NY: Crown Publishers; 2009.
10. Emmons R. Gratitude works!: a 21-Day program for creating emotional prosperity. San Francisco, CA: Jossey Bass; 2013.
11. Neff K, Germer C. The mindful self-compassion workbook: a proven way to accept yourself, build inner strength, and thrive. New York, NY: Guilford Press; 2018.
12. Fosha D. The transformative power of affect: a model for accelerated change. New York, NY: Basic Books; 2000.