RESILIENCE: Status of the Research and Research-Based Programs

Draft March 30,1999

The power of the human spirit to sustain grief and loss
and to renew itself with hope and courage defies all description.

-- Dr. Daniel Gottlieb, 1991

Perhaps resilient children are, in the words of Dr. Norman Garmezy, "the keepers of the dream," our best hope for learning how to use the lessons of the past to help ourselves in the present.

-– Drs. Steven and Sybil Wolin, 1994

One of the unexpected benefits of working with individuals with mental illness is that, at some point, the clinician begins to respect greatly their strength in the face of adversity. "How," she asks, "did this woman even survive her early years? How did he ever make it through college? What enabled them to become professionally successful, make good marriages, and raise healthy children?" One appreciates how all people move along the mental health-mental illness continuum, and how even those with the most serious illnesses have substantial strengths care givers can build on.

Paralleling the experience of individual clinicians, the mental health world as a whole has begun to broaden its focus to include, not just illness and disease, but also the complexity of factors involved in the development of health, competence, and resilience. The search for these factors has assumed a special importance within the last 25 years as we have seen increased rates of divorce, homelessness, and poverty among young families with children, more concern about births to single parents, teenage pregnancy, child abuse, and domestic violence, and surges in problems such as suicide, substance abuse, and violence among children and adolescents. All these problems come at a time when funding for mental health services has been drastically curtailed. Ironically, it is in part because of the current need and wish to control health care costs that policy makers are beginning to realize that one way to do so is to help people live healthier lives. That is what prevention, health promotion, and programs that foster the development of competence and resilience are all about.

The "peerless pioneer in the study of competence and resilience" is Dr. Norman Garmezy (Masten & Coatsworth, 1998). After doing ground breaking research on adaptive and maladaptive performance of adults with schizophrenia, Garmezy and his colleagues studied children of parents with schizophrenia to determine their risk for also developing the illness. They found that having a parent with schizophrenia does indeed increase one’s risk for the illness, but what impressed them most was that about 90% of their subjects did not develop the illness. Garmezy states that these children:

upset our prediction tables and in childhood bear the visible indices that are hallmarks of competence – good peer relations, academic achievement, commitment to education and to purposive life goals, early and successful work histories.... Were we to study the forces that move such children to survival and to adaptation, the long range benefits to our society might be far more significant than our many efforts to construct models of primary prevention designed to curtail the incidence of vulnerability (Garmezy, 1971).

Garmezy and his colleagues went on to investigate what protected these children, and the field of resilience research was born.

Since Garmezy’s pioneering work, a multitude of researchers throughout the world have studied children and adolescents living in "high risk" conditions such as poverty-stricken or war-torn communities or families where parents are mentally ill, alcohol or drug abusers, physically and/or emotionally abusive or neglectful, or criminal. The recurrent finding from longitudinal studies of these children is that from 50% to 70% of them somehow manage to develop significant competencies and to grow up to lead successful lives as adults with strong abilities to love and to work. Similarly, researchers have found that most children with chronic illnesses are not psychologically maladjusted, but rather they and their parents function well and "demonstrate remarkable resiliency" (Midence, 1994, p. 309). This is even true for about 50% of long-term survivors of childhood brain tumors (Carpentieri, et al., 1993). It is an understandable evolution that researchers would begin to ask, "How do they do it?" and would set out to understand the factors and/or processes that enable people to function well despite adversity. Interestingly, as early as 1962, Dr. Lois Murphy, whom Garmezy calls a "distinguished advocate of children’s coping behavior," observed:

It is something of a paradox that a nation which has exulted in its rapid expansion and its scientific technological achievements should have developed so vast a "problem" literature: a literature often expressing difficulties, social failures, blocked potentialities, and defeat.... In applying clinical ways of thinking formulated out of experience with broken adults, we were slow to see how the language of adequacy to meet life’s challenges could become the subject matter of psychological science.

Resiliency research greatly expands the focus of social and behavioral science research to include, not just risk, deficit, and pathology, but also what Drs. Emmy Werner and Ruth Smith call self-righting capacities – that is, the strengths people, families, schools, and communities call upon to promote health and healing. They go on to state that those factors or processes which facilitate self-righting capacities "make a more profound impact on the life course of children who grow up under adverse conditions than do specific risk factors or stressful life events" (Werner & Smith, 1992). The idea that all people are born with at least some self-righting capacities hearkens back to what Dr. Robert White called effectance motivationthe innate urge to actively engage with our environment to make our influence felt, and to master tasks in a competent fashion (White, 1959).

According to noted preventionist Bonnie Benard (1996), who has reviewed and synthesized resilience research for the past fifteen years, this research "offers the prevention, education, and youth development fields solid research evidence for placing human development at the center of everything we do." Or, in the words of Gordon (1995), "this information can aid in the process of keeping resilient people resilient throughout all stages of their lives. It can also aid in the process of enhancing resilience in nonresilient people."

Fundamental to the concept of resilience is the concept of plasticity, that is, substantial psychological change is possible when a person’s environment changes. Kagan (1996) stresses that "the continuous possibility for change has been supported by work of neuroscientists who study environmentally produced alterations in brain structure." To embrace the concept of plasticity, one must reject what Rockwell (1998) calls the Four Myths that Prevent Fostering Resilience. The first of these is the Myth of Predetermination which says that children "will not be able to escape the cycles of violence, poverty, or failure that have characterized the lives of parents, family members, or community members." Next is the Myth of Irreparable Damage; seeing "at risk"children grow into healthy, successful adults leads one to know not to jump to conclusions early on about how a child will "turn out." As Rockwell says,"the self-righting potential of youth is not a static phenomenon.... We can do ourselves and our youth great harm by deciding the parameters of their lives too early."

The Myth of Identity cautions one not to label and dismiss "at risk" children, but to constantly engage "in a talent search, defining the identities of those youth in terms of their strengths" (Rockwell, 1998). Far more productive it is to reframe people’s overcoming difficulties as proof of their strength, intelligence, insight, creativity, and tenacity. Such reframing "not only helps practitioners to be more compassionate and effective, but it helps the youth to see themselves as heroes in their own struggles to self-right" (Rockwell, 1998). As one survivor said, "Abuse is what happened to me, not who I am" (Rubin, 1996, p. 228). Finally, anyone who has worked well with people in pain know to reject the Myth That, Ultimately, "It Doesn’t Matter." In the words of Rockwell, people "carry the lessons of kindness, compassion, and simple acts of grace with them their whole lives" (Rockwell, 1998). It is critical to remember that, given an adequately facilitating environment, people have the capacity for positive change and for the development of at least some characteristics of resilience throughout their lives.

Well over a thousand journal articles and books exist which, in one way or another, address the issue of resilience. In the following pages, I review many of these. Due to constraints of time and space, I focus almost exclusively on the literature relating to children and adolescents; a comparable, though perhaps not as lengthy, a paper could be written on resilience in adulthood and among the elderly. You will find several words and phrases italicized; these emphases are mine unless I indicate otherwise.