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Resilience As a Vital Sign

Columnist: Kirk Pappas, M.D.
May, 2015 Issue

Kirk Pappas, M.D.
All articles by columnist

How people deal with challenges in their daily lives has a great effect on their well-being.

Recently, I was caring for a patient I’ve known for almost 20 years. Over that time, he’s been challenged with problems not within my specialty, including cancer, a heart condition that required surgery and other chronic medical conditions that interfere with his daily life. Throughout the challenges, however, he’s remained upbeat and able to bounce back.
At our last visit, he asked me how I was doing. He was wondering about my new job, my new responsibilities and how they’ve affected my life. It was a great conversation. In addition to what I could teach him about coping with his challenges, he was interested in me. Afterward, I spent a long time contemplating our conversation and came to the conclusion that what we were really talking about was the concept of resilience.
Resilience has been studied quite extensively. It’s not a trait people are born with, but it can be learned. And like other vital signs, your resilience is something to monitor on a regular basis. In many ways, the analogy for me is that resilience is like a muscle that needs to be exercised. This concept involves behaviors, thoughts and actions you can learn and develop.
How people deal with challenges in their daily lives has a great effect on their well-being. Whether it’s something significant, like the loss of a loved one, a job change, a change in living situation or even something simple, how we respond can make a difference in our life and the lives of others. There are many factors that contribute to resilience, including thoughts, experiences, beliefs, social environment and behavior.
We must first start with our own past experiences so we can learn from ourselves about how we’ve developed resilience. Simple questions to ask yourself include: How have I responded to obstacles in the past? Do I have people I can reach out to during these times? What have I learned from these obstacles? Is there a particular type of experience that was most stressful? Did I learn anything from helping someone else? How do I remain hopeful in the face of what might seem like an uncertain future? These questions aren’t a test, but a journey—the journey of life.
After that patient went home, I thought a lot about our interaction and how I could share my knowledge with other patients. By reading, watching and listening to several resources, I came up with what one might call the “David Letterman Top 10 List of Ways to Build Resilience.” Some are deeply rooted in science. Others are based on the wisdom of the life experience my patient shared with me that day.
10. The optimist question: When challenged, are you able to remain hopeful, visualizing good things instead of worrying about fears?
9. The self-reflection question: Are you in touch with your feelings so you can find pleasure in daily life by exercising your mind, body and spirit?
8. The self-discovery question: Are you curious, always looking to learn something new? Many people who’ve been challenged with hardship find personal strength by learning a new skill, language or getting interested in new things that continue to stimulate their minds and bodies.
7. The realistic question: Do you have goals in life and continue to make progress, even small steps, toward them? Even a small, daily improvement can help build resilience.
6. The making-the-connection question: Do you have relationships with others? Having friends, family members, spiritual groups or even being sports fans together can help make the connections to improve resilience. (Go Giants!)
5. The knowing-you-aren’t-really-in-control-of-everything question: Do you accept change as part of daily life? Once you’re able to do that, you can bounce back from inevitable challenges more easily.
4. The can-you-accept-yourself-and-even-like-yourself question: Can you engage in self-reflection and find the positive in yourself despite shortcomings?
3. The perspective question: Are you able to be objective and keep things in perspective so when you do have a challenge, you see your own frailty? Are you able to view things in a broader context of the long-term outcome?
2. The forest-through-the-trees question: When you have a challenge, do you view it as an insurmountable crisis or in an objective light (perhaps as spilled milk)? Can you look beyond the crisis to the broader perspective?
1. The make-an-active-decision question: Are you able to assess what’s going on and make clear and definitive choices as to the next steps after evaluating the options?
As I look at this list, it makes me think of the Olympic decathlon. The athlete who wins isn’t usually the one who’s perfect at all 10 parts, but instead has trained and developed a regimen, an exercise program and a collection of experiences to always get better at each one. For us, that event is called life.
My conversation with my patient was so helpful to me that I wondered, “Who was the doctor that day?” It’s clearer to me now that we’re always learning from each other—especially about how to support one another. That seems to be one of the most important lessons I’ve learned about resilience. When I help build it in a fellow human being, I’ve actually helped build my own—and that makes a difference in the lives of others.

Resilience Resources

Kirk Pappas, M.D., is a board certified physical medicine and rehabilitation doctor. He’s the physician-in-chief of the Kaiser Permanente Medical Center in Santa Rosa.




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