CHAPTER 5 - The science of resilience - The antithesis to stress

Friedrich Nietzsche, the German philosopher, famously said: "That which does not kill us makes us stronger."

That phrase has become part of our idiom because we intuitively know Nietzsche was right.  We see it every day, from small babies who fall over time and again but who finally learn to walk, all the way through to cultural heroes who either seem to thrive on adversity or who, despite failures, set backs and despair, push through and eventually triumph.

But for every hero who conquers the hardship and heartbreak, there are many other nameless casualties, who suffered the same hardships, the same setbacks, and who sank rather than swam.  What is it that separates the nameless casualties from the heroes?  Is it a good thought pattern, or is it something deeper?  The answer lies in resilience.

What is resilience?

Resilience is the term given to the individual’s capacity to cope.

Researchers in the field of psychiatry often use the term resilience, which “is the capacity and dynamic process of adaptively overcoming stress and adversity while maintaining normal psychological and physical functioning” [120] although psychologists and social science researchers would use the term “coping”, which is defined by Compas et al as, “conscious and volitional efforts to regulate emotion, cognition, behavior, physiology, and the environment in response to stressful events or circumstances.” [121] Skinner and Zimmer-Gembeck define coping as, “action regulation under stress.” [122]

Considering the definitions used, the terms are essentially interchangeable.  The other observation to be made here is that coping/resilience is an active process.  It’s not something that happens despite of us - we actively cope with stress.  In the face of a situation involving emotional arousal (danger or stress), we take steps to deal with our inner and outer environments (the physiological processes of our body, as well as the environment around us).  Sometimes these steps are conscious and/or under our control.  But theorists also consider automatic, unconscious, and involuntary responses to also be part of the coping spectrum [123].

What contributes to resilience?

Coping Strategies

What makes up those actions?  What influences the action steps?

Psychologists have described hundreds of individual methods of coping through recent research, although there have been efforts to consolidate the plethora of individual coping strategies into “family” clusters, based on function.  For example, a primary tier is to “Coordinate actions and contingencies in the environment” which involves “finding additional contingencies” which on the third level involves “reading, observation, and asking others.” [122] Table 1 in the paper by Skinner and Zimmer-Gembeck [122] summarize the many ways of coping and how they can be grouped together into families, and their corresponding adaptive process.

Personality factors

Coping strategies follow along the lines of personality type [124], as well as the stage of development in children [122].  Personality types such as Neuroticism and Openness have been well studied, with Neuroticism associated with maladaptive coping strategies, and Openness correlated with adaptive coping (in marital relationships [125] and in public speaking tasks [124]).

Further research has shown how personality significantly influences coping, with the severity of the stress, and the age and culture of a person influencing the strategy and strength of the coping response [123].  Of course, personality traits like neuroticism sound bad, but they confer their own strengths.  For example, negative affect has protective benefits by enhancing the detection of deception [126].

Biological factors

The shared connection that personality types and coping responses have is in their shared genetics, with personality and coping styles influenced by common genes [127].  This makes perfect sense as it has been shown that changes in individual genes effect the ability of the brain to associate the correct value to rewards [128], which then influences both mood [11], and learning [129].  Even though environmental variables are important in determining personality and learning aspects of coping with stress, the brains underlying capacity to process the incoming signals correctly will significantly influence the direction and outcome of the learning process, which includes learning which coping strategies work best for each individual.

On a deeper level, there are several biological processes that make up the features of resilience.  Animal studies on resilience, as a whole, have shown that resilience “is mediated not only by the absence of key molecular abnormalities that occur in susceptible animals to impair their coping ability, but also by the presence of distinct molecular adaptations that occur specifically in resilient individuals to help promote normal behavioral function.” [130] That is, resilient individuals have the full complement of critical components in the resilience pathway, and have some extra tools too.

Human studies thus far have shown strong links to genetic changes that affect the proteins in the stress system.  Epigenetic mechanisms are involved, and the role of the environment is also significant, especially uncontrollable early childhood trauma.  Wu et al list the current studies of genetic changes that effect resilience in humans [120: Table 1].  The proteins involved are responsible for the growth of new nerve pathways (BDNF), and for their function, especially within the stress system (CRHR1, FKBP5) and in control of mood and reward systems (COMT, DAT1, DRD2/4, 5-HTTLPR, the HTR group).

Wu et al [120] also summarised the currently known facts about epigenetic factors in resilience.  Interestingly, they noted an animal study in which chronic stressors increased an epigenetic marker called histone acetylation in the hippocampus in mice, which enhanced the protective effects of the stress (we’ll further discuss the significance of this in chapter 12).

Resilience on a personal level

So coping and resilience are known protective factors for stress, and are more commonly deployed than most people realize.  Despite all of the publicity that stress has generated, human beings remain remarkably unscathed.  It’s estimated that, “in the general population, between 50 and 60% experience a severe trauma, yet the prevalence of illness is estimated to be only 7.8%.” [130] (Note: By ‘illness’, the authors were referring to Post Traumatic Stress Disorder, not all of human sickness). 

But when it comes to recommending different coping strategies on an individual level, it is a much harder thing to do.  What is adaptive in some situations and for some people is maladaptive in other situations and for other people.

For example, in animal studies, “stressed females tend to perform better than males on non-aversive cognitive or memory tasks … Conversely, in tests of acute stress or aversive conditioning, stress enhances learning in males and impairs it in females … the literature suggests that in cognitive domains females cope better with chronic forms of stress, whereas males tend to cope better with acute stress.” [130] So animal studies confirm a difference in the biological stress response between men and women.  If these studies in animals can be extended to humans, it may explain the tendency for men to engage in “fight-or-fight” responses to stress where women usually move to “tend-and-befriend” mode [131].

Human studies on coping also demonstrate that what is good for one is not necessarily good for another.  Connor-Smith and Flachsbart confirm that, “In particular, daily report and laboratory studies suggest that individuals high in sensitivity to threat may either benefit from disengagement or be harmed by engagement in the short term, with the opposite pattern appearing for individuals low in threat sensitivity.” [123]

So in other words, just because engaging may be a positive method of coping does not mean that it should be recommended to everyone.  Some people will have more harm from trying to engage.  Care should be taken when giving people advice about how to manage their stress.  Ill-informed instructions can actually make things worse.

Summary

It’s well established that stress can have negative impacts on your physical and mental health.  But contrary to the popular view, stress is not always bad.  As a number of authors point out, most people go through significant stress at some point in their lives, but only a fraction succumb to that stress.

The difference is the factors that make up resilience.  Where we are along the stress spectrum (that is, whether you are wired to be more stressed, or more resistant to stress) depends on our genetic predisposition, which determines the physiology of our stress system and our personality, and the ways we learn to cope.

How we cope best depends on our individual traits and the situation.  There is no one-size-fits-all.  Pushing a person into a form of coping that’s not suitable can actually cause a lot of harm.

Remember, we normally find what coping strategies work for us automatically as our resilience is mostly innate, and we all go through severe stress at some point or another in our lives, but only a small fraction of us will succumb to that stress.