Are You Resilient?

We like to think we are ... but how well do you really "bounce back" from life's stressful events?

I recently heard a wonderful interview with a woman who is 109 years old, and who continues to live independently, "with all her marbles and profoundly engaged with the world around her", as the interviewer noted.

A gerontologist, the interviewer noted that while the woman most likely has a gene that contributes to her unusual longevity, she also exhibits a powerful trait that professionals in his field call "adaptive competence".  In other words, from his experience with thousands of patients, his opinion is that the key to living to a long and healthy old age is the ability to keep moving forward after life's inevitable setbacks.  It's about being resilient.

It made me start thinking about the physicians I work with in a coaching capacity.  Many of them, I've noticed, are somewhat low on the resilience scale.  Why?  Maybe you can help me understand it.

Is it a function of highly intelligent people,  linear thinkers, who spend too much time thinking about the "what could happens", and the "likely probabilities"...?.  Is resilience, or "hardiness" as talked about in the psychological literature, something that's beaten out of you in medical school and residency, with a myriad of difficult experiences feeding off of each other in some kind of a closed loop?  Are physicians highly trained, with deep but narrow skills that tend to create a feeling of insecurity around their "other" abilities, and a sensitivity to rejection, hardship, or perceived failure?  What keeps docs from having an easy time "bouncing back"?  And what, if any, are the bigger ramifications of this, either for them personally, for their practice of medicine, or for their professional fulfillment?

What we do know is that resilience is one of those psychological traits that really matters both personally and professionally ... it affects how much stress you feel, how well you keep perspective on difficulties, how able you are to maintain healthy coping skills.  People low on the resilience scale tend to dwell on things, feel victimized, get overwhelmed and turn to unhealthy coping mechanisms such as avoidance of issues and escapism (such as substance abuse).  Conversely, people high on the resilience scale have higher levels of trust, tolerance for ambiguity, optimism and adaptability - all things associated with strong leadership and higher degrees of personal and professional success.

The APA (American Psychological Association) specifies a combination of factors that contribute to a person's resilience.  They include:

• The capacity to make realistic plans and take steps to carry them out
• A positive view of yourself and confidence in your strengths and abilities
• Skills in communication and problem-solving
• The capacity to manage strong feelings and impulses

How do you rate yourself?  How well do you:

• View problems as opportunities?
• Learn from your mistakes (and accept that you make them)?
• Seek out new and challenging experiences?
• Have a sense of humor and realistic optimism under stress?
• Succeed despite hardships?

In today's practice environment, the need for resilience is stronger than ever.  In order to thrive in an atmosphere of uncertainty, increased performance demands, rapid change, and a growing feeling of loss of control, many physicians are forced to either "bounce" or flounder.

The good news is that even if you are one of those docs that tends towards the low end of the resilience scale, you can develop these skills ... even if they aren't second nature to you.  Here are 10 tips for building your resilience (thanks to the APA):

• Make connections. Good relationships with close family members, friends, or others are important. Accepting help and support from those who care about you and will listen to you strengthens resilience. 
• Avoid seeing crises as insurmountable problems. You can't change the fact that highly stressful events happen, but you can change how you interpret and respond to these events. Try looking beyond the present to how future circumstances may be a little better. Note any subtle ways in which you might already feel somewhat better as you deal with difficult situations.
• Accept that change is a part of living. Certain goals may no longer be attainable as a result of adverse situations. Accepting circumstances that cannot be changed can help you focus on circumstances that you can alter.
• Move toward your goals. Develop some realistic goals. Do something regularly -- even if it seems like a small accomplishment -- that enables you to move toward your goals. Instead of focusing on tasks that seem unachievable, ask yourself, "What's one thing I know I can accomplish today that helps me move in the direction I want to go?"
• Take decisive actions. Act on adverse situations as much as you can. Take decisive actions, rather than detaching completely from problems and stresses and wishing they would just go away.
• Look for opportunities for self-discovery. People often learn something about themselves and may find that they have grown in some respect as a result of their struggle with loss. Many people who have experienced tragedies and hardship have reported better relationships, greater sense of strength even while feeling vulnerable, increased sense of self-worth, a more developed spirituality, and heightened appreciation for life.
• Nurture a positive view of yourself. Developing confidence in your ability to solve problems and trusting your instincts helps build resilience.
• Keep things in perspective. Even when facing very painful events, try to consider the stressful situation in a broader context and keep a long-term perspective. Avoid blowing the event out of proportion.
• Maintain a hopeful outlook. An optimistic outlook enables you to expect that good things will happen in your life. Try visualizing what you want, rather than worrying about what you fear.
• Take care of yourself. Pay attention to your own needs and feelings. Engage in activities that you enjoy and find relaxing. Exercise regularly. Taking care of yourself helps to keep your mind and body primed to deal with situations that require resilience.

I encourage all of you to think about how your degree of resilience may be affecting your ability to attain personal or professional fulfillment or make positive changes in your life.  When there isn't much you can control, this is the one thing you do have a say in.  If that horse knocks you off, are you likely get right back in the saddle?  Or do you wait a while, nursing your wounds ... or not get back on at all?  It's worth exploring, for your sake and for those who you come into contact with every day.

Especially if you want to live to be 109.