Australia The coronavirus pandemic is testing — and building — our resilience

00:11  20 september  2020
00:11  20 september  2020 Source:   abc.net.au

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a person taking a selfie: Why are some of us able to bounce back from and even thrive following stressful or challenging experiences while others fail to? (ABC News: Emma Machan) © Provided by ABC Health Why are some of us able to bounce back from and even thrive following stressful or challenging experiences while others fail to? (ABC News: Emma Machan)

When Emmy Werner first began sifting through the findings of her ground-breaking study on resilience, she was shocked to discover just how many children who had difficult upbringings didn't, as predicted, go off the rails or succumb to mental health problems.

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For 32 years Werner, a developmental psychologist and one of the pioneers of modern resilience research, followed 698 children born in 1955, on the Hawaiian island of Kauai. Though most of the kids grew up in stable, supportive homes, a third were considered "at risk" because they'd been born into poverty, experienced turbulent episodes like divorce, or had alcoholic parents.

Two-thirds of the at-risk kids developed serious learning or behavioural problems by the age of 10, or had delinquency records, mental health issues or teenage pregnancies by age 18.

But to Werner's surprise, the remaining third instead matured into "competent, confident, and caring young adults" thanks to the influence, she wrote in 1989, of a range "protective factors" that seemed to boost their resilience — their capacity to adapt to change or withstand severe stress.

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Strikingly, though, Werner found that resilience was not fixed. Even the troubled, non-resilient teens (or at least most of them) had managed to "stage a recovery" by the time they'd reached midlife. They did so by building skills and seeking out opportunities to turn their lives around for the better.

Resilience, it seemed, could be learned.

"Unless the environment is just so adverse that nothing can flourish", Werner said in a 2012 interview, "the vast majority of human beings seem to veer toward a form of basic, normal development. In other words ... there is built into us, through many millions of years of evolution, the ability to bounce back."

What doesn't kill you makes you stronger?

In the decades since, many other researchers have followed Werner in trying to understand what makes some people more resilient than others. Why are some of us able to bounce back from and even thrive following stressful or challenging experiences while others fail to? And, crucially, how can we cultivate resilience in ourselves?

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These questions have taken on new urgency during the coronavirus pandemic, a global crisis that is taking a severe toll on mental health and testing our capacity to cope under sustained pressure — particularly those in places like Victoria, which remain under strict lockdowns.

But some insist the crisis, like other natural disaster and emergency events, is also an opportunity to better understand how individuals and communities can grow in even the harshest conditions, and to appreciate the things in life that matter most.

"I believe everybody has a capacity to deal with disruption and change — it's why sometimes you hear the expression, 'What doesn't kill you makes you stronger'," said Lisa Gibbs, a Melbourne University professor and lead of community resilience at the Centre for Disaster Management and Public Safety. "But actually, if it's a really severe trauma it can undermine your capacity to deal with future events."

While most people who endure trauma will eventually get "back on track", she said, a significant minority will not, and may go on to develop PTSD or mental illness.

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Unlike "rapid onset events" such as bushfires, the pandemic is an ongoing, "slow rollout" event that can chip away at people's resilience over a long period of time. "But the human impacts are often very similar," Professor Gibbs said.

"We also know that uncertainty is really difficult and that, on top of the impacts of the hazard itself, the major life stresses that tend to arise from these events are also potentially very damaging. For example, the loss of income, the loss of accommodation, the relationship breakdowns — all these additional factors really undermine people's capacity to cope."

But first, it's important to recognise that resilience is not just about individual traits and skills, Professor Gibbs said.

"People's capacity to deal with change and adversity is also influenced by the resources and support that are available to them ... what may have happened to them in the past and ... what context they're in — for example, some people might cope really well when they're at school or at home but not the reverse."

Nature or nurture

Over the years researchers have attempted to determine the extent to which we're born with certain characteristics associated with resilience, or whether they can be acquired or learned.

Many of the "protective factors" Emmy Werner identified in her cohort of resilient kids were the product of luck, and the environment they'd grown up in — having strong relationships with parents or mentors, for instance.

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But others were psychological. Even as toddlers, Werner noted, the resilient kids "tended to meet the world on their own terms": they were autonomous and independent, cheerful and sociable, sought out new experiences and had advanced self-help skills.

By the time they graduated from high school, they'd also developed an "internal locus of control": they influenced their circumstances, not the other way around.

More recent studies on resilience have also examined the influence of neurobiology and genetic processes, as well as the potential benefits of experiencing pain or adversity.

"There are some people who appear to have personality traits or are born with certain capacities that allow them to withstand and manage adversity more easily," said Brock Bastian, a psychology professor at Melbourne University. "I suppose what is more interesting, though, is what are the sorts of things you can do to build resilience? How can you influence it?"

Resilience is important for managing difficult times, Professor Bastian said, "but difficult times are also important for building and knowing our capacity for resilience". In general, research suggests undergoing a controlled amount of stress is best, and can have the inoculating effect of a vaccine.

"People who have experienced a moderate amount of adversity in their life tend to be the ones who have higher levels of wellbeing, respond better to setbacks and are more resilient in general," he said. "Too much stress is not good, but neither is too little."

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Reframe threats as challenges

For that reason, Professor Bastian said, it can be helpful to reframe what you may perceive as a stressful or threatening experience as a challenge, an opportunity for growth.

"If you're going to deal with a challenge life has thrown at you, the worst thing you can do is see it as purely a negative thing that's bringing you down — it makes it much harder to cope with," he said. Instead it's important to take stock of what resources you might have and "lean in" to the difficulty.

"Even just to acknowledge we won't always be able to manage well is important," Professor Bastian said. "During the pandemic you're probably going to feel anxious and depressed sometimes — it would be very surprising if you didn't ... but it's how you respond to that which matters.

"Do you come down hard on yourself for feeling that way, or do you allow yourself to feel low for a day and then recognise you'll probably move through it?" Sometimes, he said, "you have to lean into the less-positive experiences in life in order to get some of the benefits, to build some of that capacity".

Be mindful of how you respond to stress

It's also important to be mindful of how you cope with stress and deal with difficult emotions, said Justine Gatt, a senior research scientist at Neuroscience Research Australia (NeuRA) who is currently studying hundreds of twins to understand how people's genes, environment and neural factors affect their mental wellbeing and resilience.

Dr Gatt began her study in 2009, recruiting 1,669 healthy adult twins to undertake a series of assessments and procedures: cognitive tests, emotional regulation questionnaires, brain imaging and genetic analyses.

Her results led to the development of a wellbeing scale called "COMPAS-W", which gives an accurate measure of overall mental health and wellbeing.

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It also allowed her team to identify various factors associated with higher wellbeing and resilience — things like lower depression and anxiety, better working memory and attention to certain tasks, even differences in brain structure and function.

Now, she's now re-testing the twins to see how their wellbeing has changed over time and ideally determine how different life experiences — including, unexpectedly, the COVID-19 pandemic — may have affected participants' resilience or vulnerability to mental health issues.

"One strategy I suggest is for people to become more aware of when they're physically becoming stressed," Dr Gatt said. "Your hands might start to sweat, you become irritable, your heart might race."

Being conscious of those physical cues can provide an opportunity to change your automatic coping response from a "maladaptive" one to something more constructive, she said. "You can use mindfulness to calm down and get back in the moment, or yoga or other exercise to relieve tension ... there are many other ways of coping with stress."

Maintaining good physical health, she added — eating well, exercising regularly and getting enough sleep — can also have "huge benefits" for mental health. (A new study has found regular exercise improves rodents' resilience to stress.)

Step out of your comfort zone

"Another thing that's really important for building resilience is mastery," Dr Gatt said — pursuing goals and practicing skills that test our abilities and foster a sense of achievement.

"During the pandemic you might have found yourself unemployed or that your working situation has changed. You might need to rethink how you're working or the profession you're in, whether you need to build on your strengths or look at weaknesses you need to overcome," she said.

"It's about being prepared to learn something new, to step out of your comfort zone and gain more experience in different areas."

Build close connections

Studies have also consistently shown that having strong interpersonal relationships and community support — giving and receiving care — is associated with better recovery from traumatic events.

Professor Gibbs's research on how Victorians recovered from the Black Saturday bushfires in 2009, for instance, found the risk of developing mental health disorders was reduced for people who belonged to local community groups.

"In communities where a lot of people belonged to one or two groups, the benefits extended to others living in the community," she said.

Enduring traumatic or painful events alongside others — even strangers — can also strengthen relationships.

"I think the pandemic is highlighting the need for resilience because one of the things that is interesting when there is a natural disaster ... is that people are incredibly compassionate and concerned for those affected; there's a kind of 'reaching out' that takes place," Professor Gibbs said.

"And then life moves on and everyone assumes it's over with. And yet for the people in affected communities, it goes on for years afterwards. So for me, one of the potentially helpful things in this moment is that people are going to understand that these kinds of events can go on and on and affect you in all sorts of ways."

Look for silver linings

Of course, it's not all doom and gloom. For all the distress and pain the pandemic is causing, there may also be silver linings, and experts say it's important to look for them.

For Professor Gibbs, it's helped her identify the little things in life that matter most. "I could have told you how much I'd miss seeing my friends, but I never realised how much I needed to be outside in fresh air every day," she said.

"Realising what elements of your life are essential to you can be useful in understanding what helps you to be resilient."

As can focusing on the positives. "After disaster events you also see many examples of people experiencing post-traumatic growth," Professor Gibbs said — for example, an unplanned career change that turns out for the best, or the mending of a fractured relationship.

"There are different ways people can draw something positive out of what is a really intense, transformative experience, and I think that's what we're seeing with the pandemic," she said.

"There are real challenges, but there are also some 'wins' in there which, for some people, can be really affirming."

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Life returning to normal in Africa, but virus fears linger .

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