Stephen Clift

Resilience – Links from Social Psychology, Medicine, and Public Health

I

Any discussion of human resilience could usefully start with a consideration of our evolutionary heritage. Every human being alive today is here because countless generations of direct ancestors survived despite every challenge to survival imaginable. Whether natural disasters, disease, famine, conflict, or persecution, each of them survived long enough to find a partner and have at least one surviving child, who in turn survived long enough to reproduce. In consequence, each of us carries within us the resources to meet such challenges in future. Of course, as in all forms of life, there are variations within the human population in such resources, but in general, due to the repeated overcoming of challenges, collectively we carry within us the resources needed to meet such challenges in future. We may be fortunate enough, and especially in affluent societies, not to meet direct challenges to our survival, but the resources are there, nonetheless.

Sources worth pursuing:

Cicchetti & Blender (2006). A multiple-levels-of-analysis perspective on resilience: implications for the developing brain, neural plasticity, and preventive interventions.

Baba (2020). Human Evolution and the Implication of Resilience for the Future.

Jørgensen et al. (2019). Evolution in the Anthropocene: Informing Governance and Policy.

 

II

The WHO itself has defined health as ‘a resource for living’. Over ten years ago, Huber et al. (2010, 2011) initiated a major reassessment of the WHO definition, and suggested a revised view of health, that places central emphasis on our capacity to adapt in the face of challenges and stress – in other words, resilience:

Today there is a “broad support for moving from the present static formulation towards a more dynamic one based on the resilience or capacity to cope and maintain and restore one’s integrity, equilibrium, and sense of wellbeing. The preferred view on health was ‘the ability to adapt and to self manage.’” (Huber et al., 2001, p. 2)

Two sources for this:

Huber et al. (2011). How should we define health?

Huber (2014). Towards a new dynamic concept of health.

 

III

From the perspective of social and psychological science a key concept, reflected in Huber et al.’s formulation is that of Salutogenesis, proposed by Antonovsky – in other words, the multiple processes involved in promoting health and wellbeing, as opposed to Pathogenesis, the multi-faceted processes leading to disease.  For Antonovsky, three processes are key to Salutogenesis: our capacity to find value in experience – ‘Meaningfulness;’ our capacity to make sense of our circumstances – ‘Comprehensibility;’ and the extent to which we can control events in our lives – ‘Manageablity.’ More information about Antonovsky and his ideas here:

Vinje,  Langeland & Bull (2016). Aaron Antonovsky’s Development of Salutogenesis, 1979 to 1994.

Eriksson & Lindström (2011). Life is more than survival: Exploring links between Antonovsky’s salutogenic theory and the concept of resilience.

Harrop et al. (2006). Resilience, coping and salutogenic approaches to maintaining and generating health: A review.

IV

Can we define ‘resilience’ in a scientifically meaningful way, and can we ‘measure’ it in advance of potential challenges, or in the case of people facing circumstances placing them under strain? Here are a few potentially helpful research reports:

UK Government guidance on measuring resilience (2016)

Fletcher and Sarkar (2003). Psychological Resilience A Review and Critique of Definitions, Concepts, and Theory.

Nishimi et al. (2020). Measures of adult psychological resilience following early-life adversity: how congruent are different measures?

 

V

There is much talk currently about ‘resilience’ in the face of the demands of the COVID-19 pandemic. To understand what is at stake we would do well to consider the pressures facing doctors and healthcare staff working with such commitment in the context of intensive care. There is no doubt that the unrelieved, enduring pressures involved in such work has taken and is taking its toll on these professionals on the front line. Their training, their skills, their experience, and their team spirit are all components, no doubt, of their resilience in the face of the enormity of the human suffering, and the experience of death, they are dealing with, day by day. But they continue to do what they have to do, out of duty. Some have had to give up this work, because it has proven too much to bear, but most have endured so far. Will there be an increasing number of professionals affected by burn – out and even post-traumatic stress disorder?

See:

Lancet editorial (2020)

What about the more general impact of the COVID-19 pandemic on people’s lives? What evidence have we seen of resilience, or the lack of it, in the face of the many challenges people have faced? Is there really a mental health crisis due to the COVID-19 lockdown and its impact on the economy and people’s lives? Careful monitoring and research is needed.

See:

Bentall (2021). Has the pandemic really led to a crisis in mental health?

 

Zurück zur Übersicht “Virtuelles W&K-Forum”

Stephen Clift is Professor Emeritus, Canterbury Christ Church University, and former Director of the Sidney De Haan Research Centre for Arts and Health. He is a Professorial Fellow of the Royal Society for Public Health (RSPH) and is also Visiting Professor in the International Centre for Community Music, York St John University.