Cultivating Resilience

Debrah Lee, LCSW (she/her)

Veterinary Well-Being Program Director

“Psychologists define resilience as the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress — such as family and relationship problems, serious health problems, or workplace and financial stressors. As much as resilience involves "bouncing back" from these difficult experiences, it can also involve profound personal growth.”i

Resilience is not a fixed trait; it’s not something that you either have or you don’t have. It’s a skill that involves behaviors, thoughts, and actions that can be learned and developed. Resilience is also not an exceptional skill; it’s very ordinary. Anyone who has worked through and grown from the challenges that life presents has already demonstrated resilience.

“What is to give light must endure burning.”

Viktor Frankl

Engaging with intention to cultivate resilience is significant because of the unique stressors—or adversity—present in the field of veterinary medicine. The second iteration of the Veterinary Well-Being Study sponsored by Merck identified higher levels of burnout among veterinarians when compared to physicians. Suicidal thoughts and attempts continue to remain higher in veterinarians than in the general public.ii The field is impacted by the issues of moral distress, trauma, and chronic stress.

“With vicarious trauma, there really is a permanent shift in one’s worldview…Once you’ve experienced and borne witness to trauma, you don’t go back to a time of not knowing.”

Laura van Dernoot Lipsky

“Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individuals’ functioning and mental, physical, social, emotional, or spiritual well-being.”iii Trauma may directly impact an individual or the impact may be indirect, resulting in vicarious or secondary trauma. The Adverse Childhood Experiences study has provided insight into both the pervasiveness of specific adverse experiences in childhood and the health risks associated with these factors.iv There is growing knowledge of the health impacts resulting from trauma and the cumulative toll that can result from chronic stress. Both trauma and chronic stress are mind-body processes and learning what is happening in the brain and body—understanding its responses—opens the space for compassion. This awareness can empower us—shifting us away from isolation, fear, and shame—to understand the body’s protective responses and to encourage us to engage in the healing and care of ourselves.

“Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”

Viktor Frankl

While much of this piece focuses on the individual, internal environment to cultivate resilience—by finding and growing the “space” described by Viktor Frankl—it’s important to acknowledge the coexistence and influence of our external environment. As stated by Dr. Lucy Hone, the author of Resilient Grieving: “While there is much that individuals can do to strengthen their own resilience, we are also products of the systems that surround us.”v The way that we perceive adversity impacts our resilience. One characteristic of resilient people is that they accept adversity as a part of life and recognize challenge as a potential for growth. The Yerkes-Dodson law recognizes that rather than all stress being bad, humans tend to perform optimally with levels of moderate pressure.vi

The triune brain provides an evolutionary perspective to our brain’s valuable functions—all intended to help us survive.vii The primate brain is capable of imagination and creativity; when it is being informed by the reptilian brain, it reverts to survival supports, such as ruminating or catastrophizing. The brain and spine are the structures of the central nervous system and work in conjunction with the peripheral nervous system. When discussing the impact of trauma and chronic stress on the body, it’s important to consider the functions of the sympathetic nervous system, the parasympathetic nervous system, and the physiology of stress. The body’s physiological response to non-immediate stresses are largely the same as when you are fighting for survival, and the brain’s response to threat is based on perceived rather than actual threat. These systems are all designed to support our survival. Rather than thinking of one process in opposition to the other, it’s important to remember that we thrive when they are balanced.

Dr. Dan Siegel utilizes the “Window of Tolerance” to describe the optimal level of arousal where people are best able to cope with stress. Stress and trauma can shrink the “Window of Tolerance,” and there are intentional practices that can be used to expand the window. Expanding the window supports our ability to cope with challenges, thus supporting our resilience.

Mindfulness is a practice that supports awareness and is woven throughout the following strategies. Mindfulness includes more than meditation and is simply about paying attention to what you are experiencing in the present moment without judgement. With self-awareness it is possible to discern which strategies may be supportive to you based on your needs. Bottom-up strategies are those that use sensory input as it is coming in. Accordingly, many of these strategies involve using the body’s senses—promoting calm or encouraging stimulation—to signal to the nervous system that there is no survival-level threat.

Top-down strategies are based in our perception and harness the functions of attention and reasoning. Recognizing limiting beliefs, such as our negativity bias, the role of core beliefs, and our tendency towards automatic negative thoughts is a skill that helps us move towards balance. As Dr. Lucy Hone identifies, it can be valuable for us to find the space to ask: “Is what I’m doing helping me or harming me?”viii Humans are meaning-making creatures, and it is valuable to recognize the influence of the stories we tell ourselves about ourselves. Practicing self-compassion means acknowledging our shared humanity, including the presence of limiting beliefs, which encourages us to direct kindness and care towards ourselves. “The acronym RAIN is an easy-to-remember tool for bringing mindfulness and compassion to emotional difficulty.”ix RAIN asks us to follow these four steps:

1. Recognize what is happening; 2. Allow the experience to be there – just as it is; 3. Investigate with interest and care; 4. Nurture with self-compassion

Using these steps with offers a way to practice responding to emotional difficulty with intention and compassion towards yourself.

Self-care is, most simply, the things that you do to take care of yourself. Self-care is unique to everyone.

There are perceptions that we may have of self-care that limit our engagement with it—including thoughts that it may be selfish or indulgent. This can result in feelings of guilt. Additionally, it’s not difficult to set yourself up to fail when it comes to self-care, as we make plans based on what we think we “should” do. Self-care can sometimes look like parenting yourself. Recognizing the neurobiology of trauma and chronic stress further informs the value of the items identified on The Healthy Mind Platter.x The Healthy Mind Platter also comes from the work of Dr. Dan Siegel, and it offers a framework to understand the full spectrum of essential mental activities to optimize brain matter and create well-being. This includes balancing time dedicated to focus, play, connection, physical activity, internal reflection, downtime, and sleep.

There is sometimes a disconnect between knowing the things that are beneficial to us and doing the things that are beneficial to us. It can be helpful to examine some of the underlying beliefs that may be contributing to the separation between knowing and doing. WOOP (Wish, Outcome, Obstacle, Plan) is one strategy that also encompasses envisioning obstacles in order to reach your goals.xi It is inevitable that there will be obstacles that you may encounter as you move towards a goal, and planning ahead for that eventuality can help prepare you to manage obstacles rather than being derailed by them. WOOP is one way to help act on motivation with intention.

“Sometimes resilience is just putting one foot in front of the other without knowing where you’ll end up.”

Dr. Lucy Hone

Additional Resources

Mental Health Resources

Are you an atDove member? Watch Debrah's full presentation on atdove.org.

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Resources

i. https://www.apa.org/topics/resilience ii. https://www.merck-animal-health-usa.com/about/us/veterinary-wellbeing-study iii. https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_Trauma.pdf iv. https://www.cdc.gov/violenceprevention/aces/index.html v. http://www.nytimes.com/2020/06/15/health/resilience-trauma-emdr-treatment.html vi. https://delphis.org.uk/peak-performance/stress-and-the-pressure-performance-curve/ vii. http://www.nicabm.com/brain-a-quick-and-simple-way-to-think-about-the-brain/?qwk=homepageinfographics viii. https://ideas.ted.com/sorrow-and-tragedy-will-happen-to-us-all-here-are-3-strategies-to-help-you-cope/ ix. http://www.tarabrach.com/rain-practice-radical-compassion/ x. http://www.drdansiegel.com/resources/healthy_mind_platter/ xi. https://woopmylife.org/en/home


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