Revisiting Resilience – The Practice of “Presilience”
“How we respond to the issue is the issue.” – Linda Graham, LFT, psychotherapist, author, and resilience expert
Oh no! Not another blog about resilience! The topic of resilience in healthcare has been tossed around so much in the last decade that if often immediately triggers a reaction from physicians that spans the spectrum from defensiveness (“Quit blaming me and fix the system!”) to some version of learned helplessness (“I’ll be in survival mode until retirement so why keep talking about it?").
When I started getting involved in leadership around clinician and care team well-being, I, like many others, was dismayed that so much focus was being given to the insistence that physicians needed to become more resilient in the face of a broken healthcare system rather than holding the “system” accountable for creating the conditions that were leading to unprecedented emotional distress. This was often likened to trying to make a stronger canary rather than fixing the coal mine. Indeed, I, like many others, countered that physicians were some of the most resilient people in the world – that we couldn’t get through the rigors of medical training and practice without being incredibly resilient and that by encouraging us to strengthen our resilience in the face of organizational dysfunction gave the appearance of blaming us for our burnout.
While all that is still true for me, it is only part of the truth, and I’m realizing more and more that there was an important part being left out. This stance made the assumption that resilience, the ability to “bounce back” from adversity, was an enduring quality – that once you had it, you always had it. While it would be wonderful for that to be true, it is no more true than trying to apply that same logic to one’s physical fitness or clinical skills.
In her book Resilience: Powerful Practices for Bouncing Back from Disappointment, Difficulty, and Even Disaster, psychotherapist Linda Graham defines resilience as “response flexibility,” and indicates that our ability to respond to any circumstance, to “bounce back” from or “cope with” any distressor, is directly related not only to our personal emotional, cognitive, and physical resources, but also to the severity of the stress (both duration and intensity) and the strength of our external resources (support system).
As you think about your own “response flexibility” in the face of recent challenges, consider how you tapped into all the resources at your disposal, both internal and external, and where they might use some strengthening. Here’s a brief article from the American Psychological Association on building resilience that can help provide a roadmap. As I reviewed the ideas in the article and my own “response-ability,” I plan to work more on embracing healthier thoughts, as I’ve noted a tendency to “go negative” recently.
How about you? Where could your “resilience muscles” use a workout? Even if you’re doing well presently, becoming “presilient” will pay off for you with the inevitable distressors to come. And don’t forget that “your” resilience is also a “team sport.” Yet one more reason to check in with your PeerRx partner this week, as if you needed one. Afterall, no one should care alone. Now’s a good time to make sure you don’t think you’re the exception ….