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CAN RESILIENCE BE LEARNED?

There is some debate about whether it is effective to train people in resilience. As Launer (2015) says, resilience is a ‘fuzzy’ concept. It can therefore be difficult to set outcome measures. However, many people now agree that although people can develop strategies to become more resilient, it is important to recognise that organisational and workplace cultures also need to change.

In describing the need for medical trainees to develop ‘career resilience’ or ‘self-reliance’ Remington et al (2013) list a number of issues that they may have to deal with e.g. caring for dependents, managing relationships, coping with illness and moving to a new part of the country. These are relevant to all healthcare professionals, especially when combined with the need to work in a rapidly changing work environment.

According to Grote et al (2012) the following factors are associated with career resilience:

  • Internal locus of control (seeing yourself as an agent of your own destiny, rather than a pawn)
  • Flexibility
  • Creativity
  • Sense of purpose
  • Optimism
  • Courage and determination
  • Minimal focus on blame or guilt
  • Capacity for emotional expression (both positive and negative)
  • Problem solving skills

Bonanno (2004) has suggested that resilience is probably more common than is often believed. Because many of the original studies on resilience were carried out on individuals who exhibited excessive distress, it is difficult to know how relevant the findings are to the general population and, in particular, to healthcare professionals. Genetics and epigenetics are likely to play a part in how we respond to adversity and stress. However, advances in neuroscience suggest that it is possible to train people to develop resilience.

There is accumulating evidence of our brain’s plasticity; learning can change the structure of the brain. You may be aware of the research (Woollett and Maguire 2011) involving London taxi drivers who were studying for ‘The Knowledge’. This showed that they developed changes in the posterior hippocampus of their brain. The areas of the brain involved in resilience are thought to be the amygdala and hippocampus. Because changes in our behaviour affect neural pathways this helps us to understand how people can emerge more enhanced and resilient if they experience difficult situations and challenges within a protective environment.

 

EXERCISE - YOUR OWN RESILIENCE

Exercise

  1. Take a large, unlined sheet of paper and note down what you consider most people would suggest are the key personal qualities contributing to resilience.
  2. Underline those which you believe are the most important.
  3. Highlight the qualities that you already possess.
  4. Which qualities do you feel that you need to strengthen? (What difference would it make i.e. what positive impact would you expect if you strengthened those qualities?)
  5. What external factors (e.g. work, environment, other people) can positively promote or foster your personal resilience?
  6. What could you do to implement or strengthen these?
  7. Note down some first simple steps. (The smaller the step, the more likely the change.)
  8. When could you realistically start to work on these?
  9. By when do you hope to achieve them?
  10. What will be the first green shoots that you might see
  11. How will you know that you have been successful?