Americans often report money as a significant source of stress in their lives, as well as a lack of personal time. The holiday season can increase both financial stress and time pressure. But there are some steps that you can take to help manage these stressors. Happy holidays involve developing a set of realistic goals for the season that includes time for relaxation and for low-key celebration with good friends and family.
The American Psychological Association suggests a number of simple strategies:
Set realistic expectations. Start by creating a realistic budget and remind your children that the holidays aren't about expensive gifts. No celebration will be perfect. Be flexible.
Take time for yourself. If you take care of yourself, you will be better able to care for others in your life. Try to get exercise during the holidays. Take a long walk. Enjoy the holiday music. Enjoy your favorite foods, but in moderation.
Volunteer. With the recession, many charitable organizations face new challenges. Find a local charity, such as a soup kitchen or a shelter, and organize your family to volunteer together. Helping others can be a source of resilience for you and for them.
Prioritize and remember what is really important. Material things can be a part of the holidays, but commercialism can overshadow the true sentiment of the holiday season. Remind yourself that your relationships with your family and friends are what really matters.
Seek support. Talk about the stress and the disappointments you may be feeling. If you're feeling extremely blue and talking with others isn't helping that much, consider talking with a professional such as a psychologist to help you develop coping strategies and better manage your stress.
For additional information on stress and lifestyle and behavior, visit the American Psychological Association website: www.apahelpcenter.org and read the blog www.yourmindyourbody.org
Thursday, December 22, 2011
Being an Effective Communicator
In the last blog, we began to talk about communication skills. Communication is one of the basic elements in resilience. Effective communication is one of the keys to building resilience and maintaining balance in your life. If we do not communicate clearly and directly with others, we will not understand and we will not be understood. If people are to talk with you and share information, especially if they are to say things that may be difficult to say or for you to hear, they need to know that they are connecting with you. They need encouragement. If you meet their attempts to communicate with silence, or if you assume the attitude of interrogator, you will not put other people at ease and you will not encourage them to tell you what you need to know.
To be effective in understanding another's perspective and helping them through a difficult time, you need to do things which show interest and genuine concern. In the last blog, we discussed four of these: Using neutral expressions, such as "I see," "Go on," "I understand," etc., nodding your head or smiling, echoing back or simply rephrasing what the person has said and asking good questions of people, questions that are open-ended and that encourage people to talk.
Here are two more ways of encouraging people to talk and improving your effectiveness as a communicator:
Get down to details. If, for example, on a medical crisis you are trying to find out what is happening, be specific. One of the major blocks to communicating in a crisis is the inability of people to describe exactly what was said or done by another person. Being able to accurately describe what happened is often essential to being able to understand a very tense and complex situation.
Being specific requires that you focus on observable actions of others without making value judgments or interpretations of what they meant. As a society, we love to talk in generalities. We often accuse people of behaving in a certain way because of a motive or a value that we believe is hidden behind their behavior. It can be important to look at people's motives, but at this point in the process, that is not your goal. Your goal is to try to understand what is happening and what people did and said.
Reflect back to others what they are saying. This is a technique frequently used by counselors. It is a very effective way of helping people hear themselves and understand what they are saying. Very often, people need to say things out loud, and they need to hear other people's reactions.
When you reflect back what a person is saying, you are not simply trying to say the same thing with different words. It is not a slick use of language that you are trying to achieve. You say back to the person what his or her statement meant to you. This gives the person you are talking with an opportunity to hear themselves, to hear your impressions of what they are saying and to correct you if the impression that they are giving is not accurate. It is also another way of letting people know that you care about what they are saying and that they matter to you.
Here is an example. Your friend may make a general statement that you respond to with a specific statement. For example, she may say, "I can't eat anything I like since I was diagnosed with diabetes." And you may respond by saying, "You like certain vegetables? You mean you can't even eat those now?" Sometimes your specific statement may be humorous and may encourage your friend to look more realistically at the situation that she is confronting and to not exaggerate or generalize.
The reverse may also be true. Your friend may list the things that she hates about her new diet, and you may respond by making a general statement, like, "It sounds like there's not much on your diet that you really like."
What your friend is saying may also bring to mind an example that you believe reflects what she is trying to say. For example, your friend is saying that she has been hesitant to go out to restaurants since she was diagnosed with diabetes. You recall that she turned down an invitation from you and your family to try a new restaurant that had just opened. You may want to mention this as an example.
To be effective in understanding another's perspective and helping them through a difficult time, you need to do things which show interest and genuine concern. In the last blog, we discussed four of these: Using neutral expressions, such as "I see," "Go on," "I understand," etc., nodding your head or smiling, echoing back or simply rephrasing what the person has said and asking good questions of people, questions that are open-ended and that encourage people to talk.
Here are two more ways of encouraging people to talk and improving your effectiveness as a communicator:
Get down to details. If, for example, on a medical crisis you are trying to find out what is happening, be specific. One of the major blocks to communicating in a crisis is the inability of people to describe exactly what was said or done by another person. Being able to accurately describe what happened is often essential to being able to understand a very tense and complex situation.
Being specific requires that you focus on observable actions of others without making value judgments or interpretations of what they meant. As a society, we love to talk in generalities. We often accuse people of behaving in a certain way because of a motive or a value that we believe is hidden behind their behavior. It can be important to look at people's motives, but at this point in the process, that is not your goal. Your goal is to try to understand what is happening and what people did and said.
Reflect back to others what they are saying. This is a technique frequently used by counselors. It is a very effective way of helping people hear themselves and understand what they are saying. Very often, people need to say things out loud, and they need to hear other people's reactions.
When you reflect back what a person is saying, you are not simply trying to say the same thing with different words. It is not a slick use of language that you are trying to achieve. You say back to the person what his or her statement meant to you. This gives the person you are talking with an opportunity to hear themselves, to hear your impressions of what they are saying and to correct you if the impression that they are giving is not accurate. It is also another way of letting people know that you care about what they are saying and that they matter to you.
Here is an example. Your friend may make a general statement that you respond to with a specific statement. For example, she may say, "I can't eat anything I like since I was diagnosed with diabetes." And you may respond by saying, "You like certain vegetables? You mean you can't even eat those now?" Sometimes your specific statement may be humorous and may encourage your friend to look more realistically at the situation that she is confronting and to not exaggerate or generalize.
The reverse may also be true. Your friend may list the things that she hates about her new diet, and you may respond by making a general statement, like, "It sounds like there's not much on your diet that you really like."
What your friend is saying may also bring to mind an example that you believe reflects what she is trying to say. For example, your friend is saying that she has been hesitant to go out to restaurants since she was diagnosed with diabetes. You recall that she turned down an invitation from you and your family to try a new restaurant that had just opened. You may want to mention this as an example.
Can We Change Our Thinking?
In my work as a clinical psychologist, I frequently see people who are convinced that they cannot change their thinking. Indeed, such change involves hard work. We have all developed patterns of thinking that have reached the level of habit. It is almost automatic. Unfortunately, many of these ways of thinking are traps.
They are traps in the sense that they often do not lead us to a solution to the problem that we are confronting. Instead, they encourage us to avoid situations, to give up before we need to and to apply simplistic solutions to complicated problems. From a pragmatic point of view, they do not work.
The first step in changing thinking patterns is to recognize the ones that we have, and especially to focus on the ones that we have that don't work. We have discussed in some detail in a previous blog "Catastrophic Thinking," the tendency to assume the worst and spend much of our time thinking and planning about how we are going to deal with the terrible events that we are quite sure are going to befall us before any of them even occur. Catastrophic thinking is defined simply as ruminating about irrational worst-case outcomes. Needless to say, it can increase anxiety and prevent people from taking action in a situation where action is required. This can be especially true in a crisis situation.
Catastrophic thinking, like other thinking traps, needs to be disputed. In order to do this, you must first identify the thinking for what it is.
Here are three other patterns of faulty thinking:
Confirmation bias. This involves accepting only information and data that support your current beliefs and values. This is the classic "don't bother me with the facts." You don't have to look very far to find this type of thinking rampant in our society. Just look at some of the debates that have occurred over the last few years regarding global warming and evolution.
A second faulty pattern of thinking that can be a thinking trap is "all or none" thinking in which events are seen as either black or white. There is no gray. No flexibility. Indeed, these patterns of thinking encourage rigidity and not resilience.
A third pattern is over-generalization. This is a tendency to see a single temporary event as a general permanent state of affairs. Eric Byrne years ago talked about this as one of the classic dirty-fighting tactics that couples use in an argument. They often accuse each other of "never" or "always" when that simply is not an accurate description of what has occurred. We all know that no one can be that consistent. Like other thinking traps, they do not work very well. In an argument with someone, they simply are a way of putting yourself one-up and the other person one-down. What is the outcome? The other person simply gets angry or hurt and tries to rebalance the contest, which is what it has turned into by now, by saying something equally outrageous.
A faulty thinking pattern, like any old habit, does not die easily. A first step in changing it is to recognize it for what it is and to commit ourselves to try very hard not to make use of it. This may be especially difficult when we are feeling angry or upset. It is at these times that our strong feelings may lead us back to these old patterns.
They are traps in the sense that they often do not lead us to a solution to the problem that we are confronting. Instead, they encourage us to avoid situations, to give up before we need to and to apply simplistic solutions to complicated problems. From a pragmatic point of view, they do not work.
The first step in changing thinking patterns is to recognize the ones that we have, and especially to focus on the ones that we have that don't work. We have discussed in some detail in a previous blog "Catastrophic Thinking," the tendency to assume the worst and spend much of our time thinking and planning about how we are going to deal with the terrible events that we are quite sure are going to befall us before any of them even occur. Catastrophic thinking is defined simply as ruminating about irrational worst-case outcomes. Needless to say, it can increase anxiety and prevent people from taking action in a situation where action is required. This can be especially true in a crisis situation.
Catastrophic thinking, like other thinking traps, needs to be disputed. In order to do this, you must first identify the thinking for what it is.
Here are three other patterns of faulty thinking:
Confirmation bias. This involves accepting only information and data that support your current beliefs and values. This is the classic "don't bother me with the facts." You don't have to look very far to find this type of thinking rampant in our society. Just look at some of the debates that have occurred over the last few years regarding global warming and evolution.
A second faulty pattern of thinking that can be a thinking trap is "all or none" thinking in which events are seen as either black or white. There is no gray. No flexibility. Indeed, these patterns of thinking encourage rigidity and not resilience.
A third pattern is over-generalization. This is a tendency to see a single temporary event as a general permanent state of affairs. Eric Byrne years ago talked about this as one of the classic dirty-fighting tactics that couples use in an argument. They often accuse each other of "never" or "always" when that simply is not an accurate description of what has occurred. We all know that no one can be that consistent. Like other thinking traps, they do not work very well. In an argument with someone, they simply are a way of putting yourself one-up and the other person one-down. What is the outcome? The other person simply gets angry or hurt and tries to rebalance the contest, which is what it has turned into by now, by saying something equally outrageous.
A faulty thinking pattern, like any old habit, does not die easily. A first step in changing it is to recognize it for what it is and to commit ourselves to try very hard not to make use of it. This may be especially difficult when we are feeling angry or upset. It is at these times that our strong feelings may lead us back to these old patterns.
Sunday, October 23, 2011
Navigating a Course Adjustment
All aspects of life change as circumstances, interests, demands and needs weigh in to influence "what was" to "what should be or is" and the accompanying indicators, if observed, lead to a course correction.
I am at that point and following the message, I am embarking on a revision of thought and approach to work and life contribution. Taking my long career and the experiences and lessons I have acquired, my new focus is on organizations and people, their mission, goals and focus that leads to positive change.
Possibilities for improvement and systems that work to reflect needs and positive outcomes are needed in this day and age. We banter about, sometimes in disarray, and the goals and long-term expectations diminish in the chaos. It is all about people, and it is that direction I seek to plot a path forward.
What are our needs as a society? A system of justice? Improved quality of life? Perhaps doing the right thing in the face of adversity and challenge. The answer lies in the purpose of being that includes environment, family, friends, work, and social events.
My focus will be on organizations and systems that touch many lives particularly in public safety and first responders.
Richard Lumb
Thursday, July 14, 2011
Act On What We Believe
Resilience requires that we be able to ask and answer the question each morning, Why am I getting up? The answer is hopefully not because we have to or we should, but because we have some sense of purpose and direction for the day.
Being able to adapt well to adversity, to be able to bounce back from difficult times, requires us to have a sense of direction in our lives and a belief that we are acting in a way that is consistent with our values.
In the novel, Reaching Home, Muqtada is a terrorist who is planning a bio-terror attack on the city of Boston. A man in his mid-sixties with thinning hair and a light gray beard, Muqtada feels he has spent most of his life in motion. He is an average man in many ways, height and build, but his life has not been average. He fled Iran with his family in the early 1970s when the Shah's regime collapsed. Although his father reestablished the family in New England, Muqtada always dreamed of returning home. He dropped out of college and tried to create his own future in business, but failed. He lost his left hand and part of his arm in one of these failed efforts. In the story he now wears a glove prosthesis as a means of keeping from being easily recognized by the authorities.
After his father's death, he took his inheritance and traveled in the Arab world. It was there that he found a way back home. He would prove himself, not as a traitor to his country and his faith as his father had been seen, but as a true believer in the cause of his countrymen. When the nuclear accident occurs at Pine Grove Labs, he believes that the government of the United States will be preoccupied. They will not have the time to worry themselves with him. The time is now, he thinks. He and his allies have planned and waited. They are ready.
The values that Muqtada is acting on may be quite different from ours. But his belief in what he sees as right and just helps give him the resilience to continue on. To continue the plan and to act, as a human being, he is similar to us in that his sense of purpose and direction gives him the strength and the resilience to act on his plans, no matter how misguided and evil we may see believe them to be.
Dr. Ron Breazeale, Ph.D
Author of Duct Tape Isn't Enough
Original blog can be found at www.psychologytoday.com/blog/
On Being Flexible
Flexibility is a primary factor in resilience and is reflective of an individual's emotional adjustment and maturity. From the early studies in the fifties of what factors contribute to emotional health, flexibility has consistently been seen as one of the most important. As indicated previously, it requires that an individual be flexible in both his or her thinking and his or her actions.
One of the main characters in Reaching Home is Special Agent Douglas Jennings. In the story, Special Agent Jennings rolls over and looks at his watch. It's 3:00 a.m. Groaning as he pulls himself out of bed, he flips on the television and then begins throwing clothes in a battered, old leather two-suiter that, like him, has seen too many early morning flights. He is being assigned to the investigation at Pine Grove, an accident at a nuclear reactor. Newscasters are speculating as to whether it is an act of terror. He doubts it. Jennings knows that the real act of terror is yet to come. A terrorist cell in the Boston area is planning on carrying out what the Cold War Soviets had only schemed and dreamed of, unleashing a disease that could spread not just death, but panic across the U.S. in a matter of days. Jennings has been working on the investigation, Project Outbreak, for a year.
Jennings is a man who does what he is told. As the story unfolds, Jennings will be tested a number of times. His inflexibility and rigidity, as well as his inability to deal with his own anger, will cost the lives of a number of his agents and almost destroy him.
Persistence in pursuit of a direction and a purpose must also be tempered with flexibility in thinking and action if one is to manage adversity and not be destroyed by it.
Dr. Ron Breazeale, Ph.D
Author of Duct Tape Isn't Enough
Original blog can be found at www.psychologytoday.com/blog/in-the-face-adversity
One of the main characters in Reaching Home is Special Agent Douglas Jennings. In the story, Special Agent Jennings rolls over and looks at his watch. It's 3:00 a.m. Groaning as he pulls himself out of bed, he flips on the television and then begins throwing clothes in a battered, old leather two-suiter that, like him, has seen too many early morning flights. He is being assigned to the investigation at Pine Grove, an accident at a nuclear reactor. Newscasters are speculating as to whether it is an act of terror. He doubts it. Jennings knows that the real act of terror is yet to come. A terrorist cell in the Boston area is planning on carrying out what the Cold War Soviets had only schemed and dreamed of, unleashing a disease that could spread not just death, but panic across the U.S. in a matter of days. Jennings has been working on the investigation, Project Outbreak, for a year.
Jennings is a man who does what he is told. As the story unfolds, Jennings will be tested a number of times. His inflexibility and rigidity, as well as his inability to deal with his own anger, will cost the lives of a number of his agents and almost destroy him.
Persistence in pursuit of a direction and a purpose must also be tempered with flexibility in thinking and action if one is to manage adversity and not be destroyed by it.
Dr. Ron Breazeale, Ph.D
Author of Duct Tape Isn't Enough
Original blog can be found at www.psychologytoday.com/blog/in-the-face-adversity
Friday, June 17, 2011
Making Realistic Plans and Taking Action
Dealing with adversity requires that people be able to think clearly. For most of us, this is difficult in a crisis. Emotion may cloud our thinking. It may act as a filter through which we view our world. For those in this society with a severe emotional illness, the filter seldom comes off. Being able to see what is, rather than what we would like or what we fear, is part of the skill. Being able to take action proactively rather than reactively or impulsively, being able to behave assertively rather than aggressively or passively are critical to our ability to survive adversity and to bounce back from tragedy.
One of the characters in Reaching Home, Howard, illustrates the impact that a chronic mental illness can have on an individual's life. In the story, Howard is homeless. Thirty years ago he would have been a patient in the State hospital. But Howard receives no treatment. He has consistently rejected efforts to involve him in community-based treatment.
Howard wears large glasses with black plastic frames. He is slightly balding. He is dressed in gray coveralls and a pair of old workboots. A long chain runs from his belt to his wallet in the rear pocket of his coveralls. A toothbrush, a tube of toothpaste and an assortment of pens and pencils are tucked tightly into the coveralls outer breast pocket. Howard has been on the street for years.
Most of Howard's family is either dead or will have nothing to do with him. Howard has been diagnosed a number of times as being mentally ill. He has been treated in institutions and placed on medication, which upon leaving the institution, he has refused to take. He once had a wife and children, but they are gone now. The children are in foster care or adopted - he's not sure which. He just knows he doesn't see them anymore. He doesn't know where his wife is.
In the story, Howard has spent the night on the floor of the Good Will store. When the bus came to the shelter yesterday to evacuate its residents, he refused to leave. He ran away. Most of the residents of the city in which Howard has lived most of his life are gone. They have left because of a nuclear accident at a facility near the city. At least, that's what the police are saying, but Howard doesn't believe them. He thinks they're just trying to scare people to get them to leave and not come back.
Howard's paranoia and his mental illness have compromised his ability to make plans and take actions based on reality, yet his intelligence and street smarts have helped him to survive, even when acting on a perception of reality not shared by those around him. As the story unfolds, we learn that Howard, despite his mental impairment, is much more resilient than he first appears. Howard, in his way, plans for the future and takes action. He also communicated and attempts to solve problems. He tries to find meaning in what is happening and to make sense out of his world.
Dr. Ron Breazeale
Author, Duct Tape Isn't Enough
One of the characters in Reaching Home, Howard, illustrates the impact that a chronic mental illness can have on an individual's life. In the story, Howard is homeless. Thirty years ago he would have been a patient in the State hospital. But Howard receives no treatment. He has consistently rejected efforts to involve him in community-based treatment.
Howard wears large glasses with black plastic frames. He is slightly balding. He is dressed in gray coveralls and a pair of old workboots. A long chain runs from his belt to his wallet in the rear pocket of his coveralls. A toothbrush, a tube of toothpaste and an assortment of pens and pencils are tucked tightly into the coveralls outer breast pocket. Howard has been on the street for years.
Most of Howard's family is either dead or will have nothing to do with him. Howard has been diagnosed a number of times as being mentally ill. He has been treated in institutions and placed on medication, which upon leaving the institution, he has refused to take. He once had a wife and children, but they are gone now. The children are in foster care or adopted - he's not sure which. He just knows he doesn't see them anymore. He doesn't know where his wife is.
In the story, Howard has spent the night on the floor of the Good Will store. When the bus came to the shelter yesterday to evacuate its residents, he refused to leave. He ran away. Most of the residents of the city in which Howard has lived most of his life are gone. They have left because of a nuclear accident at a facility near the city. At least, that's what the police are saying, but Howard doesn't believe them. He thinks they're just trying to scare people to get them to leave and not come back.
Howard's paranoia and his mental illness have compromised his ability to make plans and take actions based on reality, yet his intelligence and street smarts have helped him to survive, even when acting on a perception of reality not shared by those around him. As the story unfolds, we learn that Howard, despite his mental impairment, is much more resilient than he first appears. Howard, in his way, plans for the future and takes action. He also communicated and attempts to solve problems. He tries to find meaning in what is happening and to make sense out of his world.
Dr. Ron Breazeale
Author, Duct Tape Isn't Enough
Testing for PTSD & Other Disorders
Testing for and treating Posttraumatic Stress Disorder’s, as well as other related disorders, has become a norm in the military. Military personnel in Iraq and Afghanistan often experience traumatic events such as being shot at, taking a life, witnessing a colleague be injured or killed etc. The traditional response has been to treat PTSD and similar disorders after testing for it. As such, screening for these disorders has developed rapidly.
However an article in the January 2011 edition of American Psychologist entitled ‘Comprehensive Soldier Fitness’ suggests an alternative approach in dealing with the mental heath of military personnel and their families: The Comprehensive Soldier Fitness Program (CSF). The program is designed to assess and teach mental toughness. There are four components: Assessment, Universal Resilience Training, Individual Training, and Master Resilience Trainers.
The assessment consists of a physical and a psychological component. The Army Physical Fitness Test is taken twice a year and involves a two-mile run, sit-ups, and push-ups. Meanwhile, the Global Assessment Tool measures emotional, social, family and spiritual fitness. Current plans call for a reassessment at least once every two years to allow time for maturity and learning. As such and to promote honesty, the GAT score is only available to the individual who takes it. The second component, universal resilience training, involves instruction on specific mental and physical skills to enhance well-being in the personal and professional lives of military personnel. The third component involves working with the individual to improve each component by offering a menu of self development opportunities based on his/her score. The last component focuses on training military personnel to be resilience trainers within their own units.
The rise in PTSD, suicide and divorce rates along with many other reasons have created an opportunity to, for the first time, insert positive psychology into a large organization in order to improve the well being of the individuals, as well as the well being of the organization as a whole.
For more information about the Comprehensive Soldier Fitness Program please visit APA website.
Rosalba Breazeale
However an article in the January 2011 edition of American Psychologist entitled ‘Comprehensive Soldier Fitness’ suggests an alternative approach in dealing with the mental heath of military personnel and their families: The Comprehensive Soldier Fitness Program (CSF). The program is designed to assess and teach mental toughness. There are four components: Assessment, Universal Resilience Training, Individual Training, and Master Resilience Trainers.
The assessment consists of a physical and a psychological component. The Army Physical Fitness Test is taken twice a year and involves a two-mile run, sit-ups, and push-ups. Meanwhile, the Global Assessment Tool measures emotional, social, family and spiritual fitness. Current plans call for a reassessment at least once every two years to allow time for maturity and learning. As such and to promote honesty, the GAT score is only available to the individual who takes it. The second component, universal resilience training, involves instruction on specific mental and physical skills to enhance well-being in the personal and professional lives of military personnel. The third component involves working with the individual to improve each component by offering a menu of self development opportunities based on his/her score. The last component focuses on training military personnel to be resilience trainers within their own units.
The rise in PTSD, suicide and divorce rates along with many other reasons have created an opportunity to, for the first time, insert positive psychology into a large organization in order to improve the well being of the individuals, as well as the well being of the organization as a whole.
For more information about the Comprehensive Soldier Fitness Program please visit APA website.
Rosalba Breazeale
Wednesday, June 8, 2011
No One's Perfect
We are a product of the genetic patterns we have inherited and the learning experiences that we have encountered throughout our life. We have learned both good and bad things from our role models, things that work in some situations and don't work in others. We've learned from watching ourselves deal with adverse situations and difficult times, thus we are a mix of attitudes and skills that have been shaped through this process. We aren't solely optimists and we aren't solely pessimists. We are a mix of both. Sometimes we can see the bigger pictures, and sometimes we can't. We may try to think of things both good and bad as being temporary and as only having a specific rather than a pervasive impact on our lives. But it's easy to slip back into thinking things will never change or into believing that one event can make everything better or will make everything worse. And, of course, it's easy to play the "blame game." In recent years, the political system in our country and the media have taught us how to be even better at doing this.
Resilience is the ability to adapt well to adversity, to bounce back from difficult times, to deal with tragedy, whether it be a national disaster like 911 or a personal one like the loss of someone close, such as a spouse, parent, or child. Resilience is not inherited. It is a set of skills and attitudes that can be learned.
Storytelling is, I believe, one of the best ways to identify and examine resilience skills in yourself and others and to learn them. My novel Reaching Home tells the story of a number of different characters facing adversity from a number of different quarters - from the death of a child to a nuclear accident. I have used it over the last few years as part of the Duct Tape Isn't Enough program, a multi-session workshop focused on conquering fear and building resilience. The characters through their thinking and their actions often demonstrate, and in many cases fail to demonstrate, the skills and the attitudes of resilience.
Meet Lee: Lee is the main character in Reaching Home, - a quiet man, an ordinary man in most ways. He has, as the Census Bureau counts such things, a disability. He was born with only one hand. His "other hand" isn't really a hand, it is an ugly stump, a wrist, no fingers or thumb. In many ways a useless appendage. As a child, Lee hid it in his pocket or under his arm when he could, before, that is, he had the hook. He is not tall in stature but has always tried to stand up for what he believes. For most of his life, he has had what he calls a "love/hate relationship" with his first home, the South. He is a Southern refugee and a storyteller.
The story he tells in Reaching Home began when he was sixty-six years old. He was alone on a road near Pine Grove Labs - an area where the nuclear bombs that were dropped on Japan in World War II were created, where research and development of nuclear devices continued into the morning of that first day of Passover 2013. He was driving back to his hotel after meeting with a group opposing a nuclear incinerator that was to be built in a nearby town. He had just glanced at the car's clock. It was 9:21. That's when it happened. A blue flash of light. The entire sky lit up. The sound of an explosion followed.
Throughout the story Lee demonstrates many of the skills of resilience that will unfold in this blog series. Like all human beings, sometimes he is able to apply them to situations and sometimes he isn't. At times he acts totally out of emotion, assuming that things will never change, that the situation is hopeless. At other points in the story, his ability to communicate, to think clearly under stress, and to connect with others allows him and others to face adversity and survive.
As I share these characters journey it should help you identify and integrate the skills and the attitudes of resilience in your life.
Dr. Ron Breazeale, Ph.D
Author of Duct Tape Isn't Enough
Original blog can be found at www.psychologytoday.com/blog/in-the-face-adversity
Resilience is the ability to adapt well to adversity, to bounce back from difficult times, to deal with tragedy, whether it be a national disaster like 911 or a personal one like the loss of someone close, such as a spouse, parent, or child. Resilience is not inherited. It is a set of skills and attitudes that can be learned.
Storytelling is, I believe, one of the best ways to identify and examine resilience skills in yourself and others and to learn them. My novel Reaching Home tells the story of a number of different characters facing adversity from a number of different quarters - from the death of a child to a nuclear accident. I have used it over the last few years as part of the Duct Tape Isn't Enough program, a multi-session workshop focused on conquering fear and building resilience. The characters through their thinking and their actions often demonstrate, and in many cases fail to demonstrate, the skills and the attitudes of resilience.
Meet Lee: Lee is the main character in Reaching Home, - a quiet man, an ordinary man in most ways. He has, as the Census Bureau counts such things, a disability. He was born with only one hand. His "other hand" isn't really a hand, it is an ugly stump, a wrist, no fingers or thumb. In many ways a useless appendage. As a child, Lee hid it in his pocket or under his arm when he could, before, that is, he had the hook. He is not tall in stature but has always tried to stand up for what he believes. For most of his life, he has had what he calls a "love/hate relationship" with his first home, the South. He is a Southern refugee and a storyteller.
The story he tells in Reaching Home began when he was sixty-six years old. He was alone on a road near Pine Grove Labs - an area where the nuclear bombs that were dropped on Japan in World War II were created, where research and development of nuclear devices continued into the morning of that first day of Passover 2013. He was driving back to his hotel after meeting with a group opposing a nuclear incinerator that was to be built in a nearby town. He had just glanced at the car's clock. It was 9:21. That's when it happened. A blue flash of light. The entire sky lit up. The sound of an explosion followed.
Throughout the story Lee demonstrates many of the skills of resilience that will unfold in this blog series. Like all human beings, sometimes he is able to apply them to situations and sometimes he isn't. At times he acts totally out of emotion, assuming that things will never change, that the situation is hopeless. At other points in the story, his ability to communicate, to think clearly under stress, and to connect with others allows him and others to face adversity and survive.
As I share these characters journey it should help you identify and integrate the skills and the attitudes of resilience in your life.
Dr. Ron Breazeale, Ph.D
Author of Duct Tape Isn't Enough
Original blog can be found at www.psychologytoday.com/blog/in-the-face-adversity
Getting through the loss of someone dear to you
When I think of those weeks before my mother's death, I think first of the night I called my wife who was out of town. I had nothing really new to report. My mother wasn't better. She wasn't worse. I told my wife that I wanted her to come home as soon as possible because I just wanted her to be physically near me. We didn't have to talk. In fact, I felt a little bit talked out. I just wanted her to be physically near me. I wanted to feel that connection with her.
In the last weeks before her death, things seemed to change every day. What I had planned never seemed to work out the way I had planned it. Being able to change plans and staying flexible was a daily requirement.
On the really difficult days, the days when my mom was losing ground, every sip of water she took was a triumph and every bite of food a victory. Time seemed to move so slow. I had done what I could do. I couldn't change what I knew was coming. "This too will pass," I muttered to myself on more than one occasion.
In the weeks before and after her death, my feelings were a mix of sadness, anger and relief. I felt on edge most of the time. Some days I felt a bit of guilt. Had I done everything I could do to care for her in her final weeks, months? I felt guilty that I had not wanted her to die during the holidays. I found it hard to be on top of what I was feeling from one day to the next, and sometimes from one minute to the next. But I tried to take time for the feelings. It was tempting to throw myself into the details of the things that had to be done, to arrange her funeral or to plan for my clinical practice in my absence. Some days I gave in to this urge just to get through and make it easier for me. But it was important through this process to talk with others about the feelings I was having and, again, to simply take time to feel the feelings.
During the weeks before and after her death, I didn't take care of myself very well in terms of diet and exercise. Those things were not on the top of my list. I often ate too much and often ate the wrong foods. And I seldom exercised. I gained some weight, which I am only now beginning to lose as I get back into the routine of taking care of myself.
During this period, talking with others about what was going on with me was often hard. I am someone who has a need at times simply to be by myself. Many of us do. Sometimes you can have too much support. Too many people wanting me to talk. Too many people offering their condolences.
As I informed others of my mother's death or talked with her friends at the funeral service, I tried to help them deal with their loss. It was easy for me as a therapist. It felt familiar. But it also was a way for me to take care of myself.
I found a sense of purpose in helping my mother out of this world and seeing that the contribution that she had made to my life and to others was recognized. Making phone calls to her friends, talking with other people about her and planning and executing the service gave me strength. I felt comfort in knowing that I was doing what she had wanted and certainly deserved.
Through it all, she and I kept a sense of humor. I remember her joking with staff at the nursing facility about their plans for New Year's Eve and how they should take her with them so they could be assured of having a really good time. I will miss her smile and her laugh.
Dr. Ron Breazeale, Ph.D
Author of Duct Tape Isn't Enough
Original blog can be found at www.psychologytoday.com/blog/in-the-face-adversity
In the last weeks before her death, things seemed to change every day. What I had planned never seemed to work out the way I had planned it. Being able to change plans and staying flexible was a daily requirement.
On the really difficult days, the days when my mom was losing ground, every sip of water she took was a triumph and every bite of food a victory. Time seemed to move so slow. I had done what I could do. I couldn't change what I knew was coming. "This too will pass," I muttered to myself on more than one occasion.
In the weeks before and after her death, my feelings were a mix of sadness, anger and relief. I felt on edge most of the time. Some days I felt a bit of guilt. Had I done everything I could do to care for her in her final weeks, months? I felt guilty that I had not wanted her to die during the holidays. I found it hard to be on top of what I was feeling from one day to the next, and sometimes from one minute to the next. But I tried to take time for the feelings. It was tempting to throw myself into the details of the things that had to be done, to arrange her funeral or to plan for my clinical practice in my absence. Some days I gave in to this urge just to get through and make it easier for me. But it was important through this process to talk with others about the feelings I was having and, again, to simply take time to feel the feelings.
During the weeks before and after her death, I didn't take care of myself very well in terms of diet and exercise. Those things were not on the top of my list. I often ate too much and often ate the wrong foods. And I seldom exercised. I gained some weight, which I am only now beginning to lose as I get back into the routine of taking care of myself.
During this period, talking with others about what was going on with me was often hard. I am someone who has a need at times simply to be by myself. Many of us do. Sometimes you can have too much support. Too many people wanting me to talk. Too many people offering their condolences.
As I informed others of my mother's death or talked with her friends at the funeral service, I tried to help them deal with their loss. It was easy for me as a therapist. It felt familiar. But it also was a way for me to take care of myself.
I found a sense of purpose in helping my mother out of this world and seeing that the contribution that she had made to my life and to others was recognized. Making phone calls to her friends, talking with other people about her and planning and executing the service gave me strength. I felt comfort in knowing that I was doing what she had wanted and certainly deserved.
Through it all, she and I kept a sense of humor. I remember her joking with staff at the nursing facility about their plans for New Year's Eve and how they should take her with them so they could be assured of having a really good time. I will miss her smile and her laugh.
Dr. Ron Breazeale, Ph.D
Author of Duct Tape Isn't Enough
Original blog can be found at www.psychologytoday.com/blog/in-the-face-adversity
Tuesday, May 24, 2011
Confronting Her Own Death
Death is the final challenge that we will all confront. How we approach our own death reflects how we have confronted other challenges in our lives. If we have denied and avoided the challenges that we have confronted, we may well attempt to do this as we approach life's final test. For most of us, unless we are exceedingly lucky, living a long and productive life requires that we face and deal with directly the challenges that we confront in our lives. The resilience skills and the attitudes that we have learned and practiced throughout our lives are the ones that we will apply to our death.
My mother died during the Christmas holidays. She was 95. Mom and I had an opportunity to talk a lot during the last few weeks before her death. We were lucky. Her decline in health had not affected her ability to think clearly or to be as quick and witty as she had been throughout her life. To understand how my mother died, you must understand how she lived. In many ways, she was like so many others. She grew up in a small town, she graduated from high school, she worked, she married, she had a child. What my mother did possess, however, what made her stand out, was her tremendous resilience.
Mom she understood what many people do not - the meaning of unconditional love, which she practiced on a regular basis throughout her life. She was a mother to many of my friends and to her niece, her younger sister's child, when her younger sister died at 59. In the last years of her life, she befriended her fellow residents at the elderly housing unit that she lived in, many of whom were younger than her. For many of them, she was their memory, reminding them of meal times and activities. She had a huge heart. She understood the importance of connectedness to others - a vital resilience factor.
The great love of her life was my father. They were married for 57 years. She indeed stood by him in sickness and in health. This was especially true in the last 25 years that they were together, struggling with my father's rheumatoid arthritis, which finally took his life. My dad loved her dearly. One of his favorite stories was the story of his wedding band. When they had gotten married during the Depression, my mother had no money to buy a wedding band. World War II came along and my father ended up in San Francisco waiting to be deployed to the war in the Pacific. My mother had traveled to San Francisco, worked there and was able to put aside enough money to buy a wedding band for him. One evening when my father was on leave, they walked out to the center of the Golden Gate Bridge, which they had done a number of times before. But that night was different. My mother slipped the wedding band on his hand and, as my father told it, he never took it off. The two of them taught me, and many other people, what being partners meant. My mother's love and devotion exemplifies two more resilience characteristics: the ability to hang tough during difficult times, and having a "Where there's a will, there's a way" attitude.
My mother was also a woman who spoke her mind, and increasingly so in the last years of her life. She would say, "At this age, what do I have to lose?" But whether she had something to lose or not, she always spoke up against injustice when she saw it, and she always acted on her beliefs and her values which she attributed to her parents who instilled them in her through their Christian faith. Having a deep-rooted faith, whether in a religious or philosophical system, is another characteristic of resilient people.
She was a woman who had a great sense of humor throughout her life. When she was being transported by ambulance from her last hospital stay to the rehabilitation center for the fourth time in five months, the ambulance driver remarked to her that he thought he might have met her earlier. My mother smiled and said that if he had driven an ambulance in the City of Portland, Maine, in the last six months, he had probably met her.
The last trip my mother took before her death was to Bermuda. She had always wanted to take a cruise and never had. Her excitement, her energy and her enthusiasm for the journey impressed everyone, including the cruise ship's staff. When her niece and my wife and I were ready to turn in for the night, she was still ready to party. "You can sleep when you get home," she would say.
When she developed an infection a few months after her return that required infusion treatments, she accepted that she would have to be in a nursing facility for a few weeks. But she had a goal to be back home and be independent as soon as she could. The next few months were a struggle. She was back and forth between the rehabilitation facility and her apartment a number of times. She didn't like being in the nursing facility, and she made that clear. The staff understood that she didn't want to give her independence up and they admired her spirit. Through it all, she treated with respect the staff who helped her face each day. She kept her sense of humor and her willingness to help others if she could, a few days before her death giving her personal care assistant a little bit more advice on how to manage her finances - an example of Mom's resilient ability to turn problems into opportunities.
When my mother faced her death, she didn't deny it. She talked about it. She wanted us to be with her if we could. She said that when she took her last breath, she would visualize a small white dress, perhaps a christening gown. She didn't know why; the image just came to her, she said.
And thankfully we were with her on that last day. My daughter and I were there and had the privilege of holding her hand as she took that last breath.
Dr. Ron Breazeale, Ph.D
Author of Duct Tape Isn't Enough
Original blog can be found at www.psychologytoday.com/blog/in-the-face-adversity
My mother died during the Christmas holidays. She was 95. Mom and I had an opportunity to talk a lot during the last few weeks before her death. We were lucky. Her decline in health had not affected her ability to think clearly or to be as quick and witty as she had been throughout her life. To understand how my mother died, you must understand how she lived. In many ways, she was like so many others. She grew up in a small town, she graduated from high school, she worked, she married, she had a child. What my mother did possess, however, what made her stand out, was her tremendous resilience.
Mom she understood what many people do not - the meaning of unconditional love, which she practiced on a regular basis throughout her life. She was a mother to many of my friends and to her niece, her younger sister's child, when her younger sister died at 59. In the last years of her life, she befriended her fellow residents at the elderly housing unit that she lived in, many of whom were younger than her. For many of them, she was their memory, reminding them of meal times and activities. She had a huge heart. She understood the importance of connectedness to others - a vital resilience factor.
The great love of her life was my father. They were married for 57 years. She indeed stood by him in sickness and in health. This was especially true in the last 25 years that they were together, struggling with my father's rheumatoid arthritis, which finally took his life. My dad loved her dearly. One of his favorite stories was the story of his wedding band. When they had gotten married during the Depression, my mother had no money to buy a wedding band. World War II came along and my father ended up in San Francisco waiting to be deployed to the war in the Pacific. My mother had traveled to San Francisco, worked there and was able to put aside enough money to buy a wedding band for him. One evening when my father was on leave, they walked out to the center of the Golden Gate Bridge, which they had done a number of times before. But that night was different. My mother slipped the wedding band on his hand and, as my father told it, he never took it off. The two of them taught me, and many other people, what being partners meant. My mother's love and devotion exemplifies two more resilience characteristics: the ability to hang tough during difficult times, and having a "Where there's a will, there's a way" attitude.
My mother was also a woman who spoke her mind, and increasingly so in the last years of her life. She would say, "At this age, what do I have to lose?" But whether she had something to lose or not, she always spoke up against injustice when she saw it, and she always acted on her beliefs and her values which she attributed to her parents who instilled them in her through their Christian faith. Having a deep-rooted faith, whether in a religious or philosophical system, is another characteristic of resilient people.
She was a woman who had a great sense of humor throughout her life. When she was being transported by ambulance from her last hospital stay to the rehabilitation center for the fourth time in five months, the ambulance driver remarked to her that he thought he might have met her earlier. My mother smiled and said that if he had driven an ambulance in the City of Portland, Maine, in the last six months, he had probably met her.
The last trip my mother took before her death was to Bermuda. She had always wanted to take a cruise and never had. Her excitement, her energy and her enthusiasm for the journey impressed everyone, including the cruise ship's staff. When her niece and my wife and I were ready to turn in for the night, she was still ready to party. "You can sleep when you get home," she would say.
When she developed an infection a few months after her return that required infusion treatments, she accepted that she would have to be in a nursing facility for a few weeks. But she had a goal to be back home and be independent as soon as she could. The next few months were a struggle. She was back and forth between the rehabilitation facility and her apartment a number of times. She didn't like being in the nursing facility, and she made that clear. The staff understood that she didn't want to give her independence up and they admired her spirit. Through it all, she treated with respect the staff who helped her face each day. She kept her sense of humor and her willingness to help others if she could, a few days before her death giving her personal care assistant a little bit more advice on how to manage her finances - an example of Mom's resilient ability to turn problems into opportunities.
When my mother faced her death, she didn't deny it. She talked about it. She wanted us to be with her if we could. She said that when she took her last breath, she would visualize a small white dress, perhaps a christening gown. She didn't know why; the image just came to her, she said.
And thankfully we were with her on that last day. My daughter and I were there and had the privilege of holding her hand as she took that last breath.
Dr. Ron Breazeale, Ph.D
Author of Duct Tape Isn't Enough
Original blog can be found at www.psychologytoday.com/blog/in-the-face-adversity
Teaching Resilience Through Storytelling
Storytelling has been around since the first human beings sat down around a fire and talked about their lives. These first training sessions on resilience occurred thousands of years ago. From campfires to fireplaces, potbelly stoves to water coolers, we continue to tell stories about resilience.
In more recent times we've written these down in the form of novels and biographies, and more recently, recorded them on tape and film, and, most recently, posted on the Internet. Hearing the stories of others often enables one to identify with one or more of the characters in the story. Based on my experience with the Duct Tape Isn't Enough program, I believe that storytelling is an ideal vehicle for teaching resilience skills and attitudes, far better than lectures, textbooks, or brochures.
Research by psychologist James Pennybaker and others has found that writing about difficult things may actually improve our health. In a series of studies, one group of individuals was asked to write down their deepest thoughts and feelings about a traumatic event they had experienced. Another group wrote about ordinary matters, such as their plans for the day. Both groups wrote for 15-20 minutes a day for three consecutive days. The results were surprising. When compared with the people who wrote about ordinary events, the ones who wrote about their traumatic experiences reported fewer symptoms, fewer visits to the doctor, fewer days off from work, improved mood, and a more positive outlook. Their immune function was enhanced for at least six weeks after writing.
These studies suggest that words can help us understand and absorb the traumatic event and eventually put it behind us. It can give us a sense of relief and control. Confiding our feelings in others can have a similar benefit.
One of the most difficult life events for most of us to talk about is death. It is a natural event, an experience all of us will share. And before our own death, we will encounter the death of others, especially those closest to us, such as a parent, spouse or, God forbid, a child.
Both living and dying require resilience. For the dying it may be staying alive long enough to say goodbye to the last child who's driving through a snowstorm to be at your bedside. For those caring for the person who is dying, being resilient requires, among other things, being able to wait and watch the person you love transition, and requiring you to change your routine every day as the situation demands. Staying flexible is the daily requirement.
Having just lost my mother during the Christmas holidays I am acutely aware of the resilience my mother demonstrated, not only throughout her life, but particularly in the weeks before her death. And I am acutely aware of the impact that her death will have on all of those who have been touched by her life.
In the next few weeks using storytelling, I will examine resilience from both sides, from the person who is dying and from those who are impacted by the person's death.
Original blog can be found at www.psychologytoday.com/blog/in-the-face-adversity
In more recent times we've written these down in the form of novels and biographies, and more recently, recorded them on tape and film, and, most recently, posted on the Internet. Hearing the stories of others often enables one to identify with one or more of the characters in the story. Based on my experience with the Duct Tape Isn't Enough program, I believe that storytelling is an ideal vehicle for teaching resilience skills and attitudes, far better than lectures, textbooks, or brochures.
Research by psychologist James Pennybaker and others has found that writing about difficult things may actually improve our health. In a series of studies, one group of individuals was asked to write down their deepest thoughts and feelings about a traumatic event they had experienced. Another group wrote about ordinary matters, such as their plans for the day. Both groups wrote for 15-20 minutes a day for three consecutive days. The results were surprising. When compared with the people who wrote about ordinary events, the ones who wrote about their traumatic experiences reported fewer symptoms, fewer visits to the doctor, fewer days off from work, improved mood, and a more positive outlook. Their immune function was enhanced for at least six weeks after writing.
These studies suggest that words can help us understand and absorb the traumatic event and eventually put it behind us. It can give us a sense of relief and control. Confiding our feelings in others can have a similar benefit.
One of the most difficult life events for most of us to talk about is death. It is a natural event, an experience all of us will share. And before our own death, we will encounter the death of others, especially those closest to us, such as a parent, spouse or, God forbid, a child.
Both living and dying require resilience. For the dying it may be staying alive long enough to say goodbye to the last child who's driving through a snowstorm to be at your bedside. For those caring for the person who is dying, being resilient requires, among other things, being able to wait and watch the person you love transition, and requiring you to change your routine every day as the situation demands. Staying flexible is the daily requirement.
Having just lost my mother during the Christmas holidays I am acutely aware of the resilience my mother demonstrated, not only throughout her life, but particularly in the weeks before her death. And I am acutely aware of the impact that her death will have on all of those who have been touched by her life.
In the next few weeks using storytelling, I will examine resilience from both sides, from the person who is dying and from those who are impacted by the person's death.
Original blog can be found at www.psychologytoday.com/blog/in-the-face-adversity
Sunday, April 24, 2011
Confronting Calamity
Adversity is defined as a condition marked by misfortune, calamity, or distress; an unfortunate event or circumstance. Potentially adverse events and circumstances come in all shapes and sizes, and how distressful they are is usually determined by our perception of them. If we believe that we have the ability to meet the challenge, or if the demand of the situation is not an important one, we aren't stressed. However, if we don't believe we have the skill or knowledge to manage the situation, but believe we must handle it well, we will feel stressed. In meeting daily challenges, our perceptions of which ones are important, and our assessment of our abilities and skills, determines whether we are facing adversity or just a situation that may be slighting annoying.
So what do we do when stressed, when we are faced with a situation that makes an important demand on us, one we are not sure we can meet? The general answer is we do what we have learned, what we have seen others do in a similar situation, or what we have done in the past. And being creatures of habit, if what we did in the past appeared to work, we will often try it in a new situation. Unfortunately, trying harder in the same way may not work. A new situation, even if it resembles one we've dealt with before, may require a new and different solution.
What can help us to be resilient, to bounce back during hard times? Certainly training and education about resilience skills and attitudes is key. Bay Path College in Massachusetts is a fine example. The college recently began offering a stress management course to students in its One-Day-A-Week Saturday Program, an accelerated, full-time degree program for women looking to earn an undergraduate degree. The women who enter the One-Day-A-Week Saturday Program are seeking to transform their professional and personal lives. Many of them have young children at home, work full-time jobs; a number of the women are working, single mothers, and so their stress level is high to begin with.
The course examines the concepts of stress and its effect on physical and mental performance, how to recognize and tackle stress indicators, examines effective communication and stress reduction, the importance of understanding our past and its affects on stress, breaking through old patterns of thinking, the importance and value of developing a resilience plan, and an in-depth analyses of the factors and characteristics that make up resilience. By the end of the course, the students create for themselves a personal stress management and resilience-building plan.
Rita Schiano, the course instructor, shared the following: "At the start of the course, many students believed the stress in their lives was insurmountable. I had to get my students to understand how thinking styles and habits that don't serve us affect our emotions and behavior." Each week she took them through a series of quizzes and thought-provoking questionnaires that helped them to identify and recognize their stress triggers. Next, she taught them a Kaizen approach to stress management -- making incremental change or improvement by breaking stress-reduction tasks into small, manageable steps.
The latter half of the course was dedicated to resilience building. "By reconstructing their personal stories, each student was able to identify situations and/or moments in their lives that tested their limits," she said. "Some had faced horrific tragedy, others had dealt with the loss of a spouse or child. Some were dealing with catastrophic illness. Yet, step-by-step -- again, utilizing a Kaizen approach -- they discovered the resilient skills and attitudes that they already possessed and began to formulate a workable plan to build upon that foundation to heighten their resilience."
In the weeks ahead, through story-telling, I will be looking at these skills and attitudes and I'll discuss how the ones that work, that make for resilience, can be learned and how the ones that don't work can be unlearned. This process is key to facing adversity.
Psychologist Ronald L. Breazeale, Ph.D., is the author of Duct Tape Isn't Enough and Reaching Home.
Making our Health Care systems more resilient
Adversity often comes in the form of a medical crisis for ourselves or for someone we care about. Managing an illness or injury, and the medical system that we must depend on, is not an easy task. It is obvious that we, or our loved one, must be resilient to survive, but perhaps less obvious that the medical system that we depend upon must be resilient so that the attempted cure does not kill the patient.
As reported in The New York Times (November 25th, 2010), a study of patient safety was conducted from 2002 until 2007 in ten North Carolina hospitals. The study found that 18% of patients were harmed by medical care, some more than once, and that 63% of the injuries were judged to be preventable. The good news was that most of the problems were temporary and treatable, but some were serious, and a few fatal. The author of the study, Dr. Christopher P. Landrigan, pointed out that process changes may help somewhat. However, the key for improving these statistics is through educating providers on how to identify and fix safety hazards, and by encouraging a culture of strong communication and teamwork. What Landrigan is describing here is a resilient medical system.
Other studies like those from the Institute of Medicine suggest that a correct diagnosis is either missed or delayed in 5% to 14% of urgent hospital admissions and diagnostic error rates overall are between 10% and 20%. These statistics come from research by Ian Scott, the Director of Internal Medicine and Clinical Epidemiology at Princess Alexandra Hospital in Brisbane, Australia. Scott and other researchers have found that errors in physician reasoning may account for many of these mistakes. The problem Scott points out is not just incompetence or inadequate knowledge, but it is when physicians get stuck in a particular mode of thinking. An accurate diagnosis may require flexible thinking, e.g., being able to think outside of the box.
Resilient medical systems have ways of catching physician mistakes and errors. This often involves the use of rules and crosschecks. For example, many hospitals have what is called an "ad hoc rule" that chemotherapy should not be started on weekends because the most knowledgeable physicians and pharmacists usually do not work on weekends. Unfortunately, that rule may be overlooked when someone has a rapidly growing cancer or wants to start treatment immediately. So...what to do? More about this in the next post.
Psychologist Ron L. Breazeale, Ph.D., is the author of Duct Tape Isn't Enough.
Wednesday, March 23, 2011
The 33: A Postscript
The drama of the 33 Chilean miners who were trapped for weeks hundreds of feet underground has been the source of countless news stories, blog posts, articles and interviews. The world was fascinated by the resilience of the 33. They demonstrated on a daily basis the skills of resilience with their ability to work together, to communicate effectively with each other and their would-be rescuers, to care for themselves and each other, to problem-solve, and to stay focused on their goal to get to the surface alive. It is becoming clear as we follow the individual stories of the 33 that each miner has been affected differently by the trauma. A number appear to have grown from the experience. To be stronger and more able to deal with the world than they were before the mine collapsed. Others appear to have been traumatized with many reporting difficulty in sleeping, problems with anxiety and depression and what might be labeled by many as “paranoia,” e.g., one miner is building a concrete wall around his home. I would assume as we look more closely, each miner’s reaction to the trauma, positive or negative, will be determined by the skills and the attitudes of resilience that they possessed prior to the trauma. In other words, the stronger these skills and attitudes prior to the trauma, the more likely the miner will exhibit post-traumatic growth rather than post-traumatic stress.
Ronald L. Breazeale, Ph.D.
Psychologist and Author of “Duct Tape Isn’t Enough”
Ronald L. Breazeale, Ph.D.
Psychologist and Author of “Duct Tape Isn’t Enough”
Conquering Fear: Egypt
In the last few weeks the world has witnessed something truly remarkable: The people of a nation confronting a regime that has maintained control over the years through the use of fear and intimidation. We have seen this before in other countries in the world. What is unique this time was the ability of the people involved in this confrontation to use social media to connect with each other, to communicate and to problem solve. Social media, such as Facebook and Twitter, were the tools that allowed the people of Egypt to apply the skills and attitudes of resilience to bounce back and prevail against those who would use fear to manipulate and control. A number of the leaders of the movement have said in recent interviews that once the people confronted their fears and pushed through them, they could not be stopped. Social media helped them to be unstoppable.Ronald L. Breazeale, Ph.D.
Psychologist and Author of “Duct Tape Isn’t Enough”
Wednesday, March 2, 2011
Live A Flourishing Life by Rita Schiano
“A practical resource for understanding and managing stress and building the skills and attitudes that make for resilience. Short, concise, and to the point. The workbook makes good use of the Socratic method to encourage self-evaluation and examination. A good complement to other resources on building resilience and managing stress." — Dr. Ron Breazeale, Ph.DLive A Flourishing Life is a self-exploration, process book on how to decrease stress, build resilience, bounce back from adversity, and live the good life. The book includes numerous exercises, quizzes, and personal exploration questionnaires to help you dig deep into your life story to uncover and discover long-standing attitudes and habits that influence your life.
“Live A Flourishing Life™ demonstrates how thinking styles and Aristotelian 'habits that don’t serve us' affect our emotions and behavior. Through a series of quizzes and thought-provoking questionnaires, Rita Schiano guides you in discovering the thoughts and attitudes that foster stress and how to use that knowledge to develop a personal stress management plan. Most importantly, the book offers practical guidance for developing the resilient thinking and skills necessary to manage life’s difficulties.” — Jodi Santangelo, transformational coach and author
About the Author: Rita Schiano melded her three professions — philosophy instructor, stress management trainer, and writer — to create Live A Flourishing Life™. She is an adjunct instructor at Bay Path College in Massachusetts, teaching Stress Management and Philosophy courses.
Available exclusively at http://www.ritaschiano.com/.
-Rita Schiano
Thursday, February 24, 2011
The Year Maine Burned: Resilience
The summer of 1947 was one of the driest in Maine history. Water supplies dwindled, but the people of Maine did not worry. Rain always came in the fall. But by October, there had been little rain. The fires that devastated Maine in October of 1947 began on the 17th. Although in the first three days relatively small areas were burned, the blaze intensified. A number of fires were burning in different areas of the state. In the Bar Harbor-Acadia National Park area, 2,300 acres were burned on October 22nd. Bar Harbor residents not actively engaged in firefighting tried to find safety. At one point, all roads from the town were blocked by flames. People took refuge on the beach and then waded into the ocean to avoid being burned alive. Fishermen from nearby coastal communities began to evacuate the residents of Bar Harbor. Nearly 400 people left by sea.To the south, things were no better. Parts of the towns of Biddeford, Saco and Scarborough were destroyed by the flames. Area fire departments finally decided to make a final stand against the flames at the top of a hill overlooking Kennebunkport. Through their efforts and a list-minute shift in the wind, the town was spared. Property damage was extensive throughout the state, exceeding $23 million. But thanks to the efforts of the fire crew and area residents, the loss of human life was minimal.
I am currently involved with a project, Maine Resilience, that is working with local fire departments, Scarborough being one of these, in developing public education seminars in resilience. The skills and the attitudes that we will be teaching are the same ones that were used by the firefighters and people of Maine who survived the worst series of wildfires the state had ever seen: teamwork, flexibility, effective communication and optimism, to name just a few. These are some of the skills and attitudes that build and maintain resilience, the ability to bounce back, to manage adversity.
To learn more about “The Year Maine Burned” go to Acadia.net. To learn more about Maine Resilience and our training program, “Duct Tape Isn’t Enough,” go to Reachinghome.com.
Monday, February 7, 2011
Resilience and Self-Regulation
To be in control of our lives, we must be in control of our bodies. To do this, we must be aware of what our body is doing. When we are stressed to the point where our nervous system is overwhelmed, our body becomes disregulated. Our blood pressure, instead of coming down as it should after the stressor has passed, stays up, as does our heart rate and respiration. We may continue to sweat, our pupils may remain dilated, and we still feel like eating nothing, since digestion remains stopped. The sympathetic nervous system, which is part of the autonomic nervous system, continues to be in control. Our muscles remain tight and we remain hypervigilant. To calm down, we must put the parasympathetic system back in control.
To do this, we must first of all be aware of our body enough to realize what is happening to us and what we need to do to calm ourselves. To ground ourselves again.
Our connection with others can help us to do this by helping us to normalize our experience. To realize that other people – indeed, all human beings – react this way when stress comes on too fast and there is too much of it. To realize that our nervous system has been overwhelmed and become deregulated and that we must regain control quickly if we are not to be traumatized.
As Genie Everett, Ph.D., RN, points out in her trauma first-aid program, stress does not equal trauma. We can learn to ground ourselves and to put the rational mind back in control, but we need to have learned how to do this long before the potentially traumatic stressors occur. We need to be aware enough of our bodies and our reaction to stress to realize what we can do to calm ourselves and ground ourselves, and we need to practice these calming responses before we need them so that they are put into muscle memory and are there for us when the car accident occurs, when the boss tells us we’re fired, when the terrorist attack occurs. One size does not fit all. For some of us, this may mean taking control of our breathing so that we slow it consciously and make it deeper. For some of us it may be rocking or shaking, or crying, or yawning, or focusing our mind’s eye on a color or a scene. Or putting our hands together or touching our heart. Whatever it is, we need to know it before we need it, and we need to have practiced using it. Resilience means that we need to be in control and that unless we are attempting to escape from the jaws of a saber-toothed tiger, it is usually better if our rational mind rather than our reptilian brain is in control.
To do this, we must first of all be aware of our body enough to realize what is happening to us and what we need to do to calm ourselves. To ground ourselves again.
Our connection with others can help us to do this by helping us to normalize our experience. To realize that other people – indeed, all human beings – react this way when stress comes on too fast and there is too much of it. To realize that our nervous system has been overwhelmed and become deregulated and that we must regain control quickly if we are not to be traumatized.
As Genie Everett, Ph.D., RN, points out in her trauma first-aid program, stress does not equal trauma. We can learn to ground ourselves and to put the rational mind back in control, but we need to have learned how to do this long before the potentially traumatic stressors occur. We need to be aware enough of our bodies and our reaction to stress to realize what we can do to calm ourselves and ground ourselves, and we need to practice these calming responses before we need them so that they are put into muscle memory and are there for us when the car accident occurs, when the boss tells us we’re fired, when the terrorist attack occurs. One size does not fit all. For some of us, this may mean taking control of our breathing so that we slow it consciously and make it deeper. For some of us it may be rocking or shaking, or crying, or yawning, or focusing our mind’s eye on a color or a scene. Or putting our hands together or touching our heart. Whatever it is, we need to know it before we need it, and we need to have practiced using it. Resilience means that we need to be in control and that unless we are attempting to escape from the jaws of a saber-toothed tiger, it is usually better if our rational mind rather than our reptilian brain is in control.
40% Sale
This winter we will be devoting much of our attention to the development and expansion of the Maine Resilience Program. We will be offering few trainings this winter. Since the materials lend themselves well to self-study, we will be offering a 40% discount on the materials, a discount that we have offered in the past only to workshop participators.
WINTER SALE
40% Off All Training Materials
Be a Survivor, not a Victim.
When tragedy strikes your life, be a survivor, not a victim.
Don’t be a victim, build your resilience.
Reaching Home Reading and Discussion Group
Maine Department of Corrections
Probation and Parole
Winter 2010/2011
Ron Breazeale, Ph.D.
Author, Duct Tape Isn’t Enough
www.reachinghome.com
WINTER SALE
40% Off All Training Materials
Be a Survivor, not a Victim.
When tragedy strikes your life, be a survivor, not a victim.
Don’t be a victim, build your resilience.
Reaching Home Reading and Discussion Group
Maine Department of Corrections
Probation and Parole
Winter 2010/2011
Ron Breazeale, Ph.D.
Author, Duct Tape Isn’t Enough
www.reachinghome.com
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