Wednesday, May 27, 2015


As we did in the last blog, I presented a challenge from the card game called “Bounce Back” that is a tool that we have been using for teaching the skills and the attitudes of resilience.  This is a “serious game” that asks you to apply the skills and the attitudes of resilience to a specific challenge and describe how you would respond to that challenge using these skills.  Just like life, we don’t know what challenge we will be dealt.
Here’s one that relates to co-workers.
You’ve never gotten along well with one of your co-workers.  Your job has changed recently and now you must work with this person each day.
How can you use the skills and the attitudes of resilience to deal with this person and manage this situation?
Take some time and think about this and about what skills and attitudes you might apply in this situation.  We would assume that you may need the job and you might not want or be able to just quit.
Here are some of our suggestions about ways that you might deal with this situation.  Again, these are only suggestions.  Every situation is different, as is every person.
First of all, we would think that you might want to do a lot of communicating and talking, perhaps, with your supervisor about the problem and with friends and family about what suggestions they might have for you in dealing with the situation.  So we would assume that connecting with others and communication would be critical.  We would also assume that perhaps trying to talk with this person would be a good idea too.  This might require you being flexible and being willing to do something that doesn’t come easy, perhaps getting outside of your comfort zone doing this.  We would also assume that you would need to deal with the feelings that you may have developed over time regarding this person.  Otherwise, the feelings may get in the way of you being able to find a solution.  We would assume that doing some problem solving talk with others might help you to develop a plan for managing this situation and being able to make life more comfortable for yourself and for your co-worker.  We’re sure that there are other ideas that you may have or others may have about how to deal with this situation and how the other skills and the attitudes of resilience we haven’t mentioned might apply.  We would encourage you to think this through and to talk with others about how they would deal with a similar challenge.
We have found over the years in using this game that it encourages people to really think about what they would do in a specific situation and requires them to actually demonstrate how they would apply the skills and the attitudes of resilience to the challenge.
So talk about it with others.  Ask them what they would do and, if you value their opinion and their direction, ask them to coach you.  We’ll present another challenge in our next post.

Ronald L. Breazeale, Ph.D.

Wednesday, May 13, 2015

Chronic Illness: Part 2

Chronic Illness: Part 2
Managing an emotional or physical illness requires resilience. Unfortunately, the very nature of these disorders sometimes makes it very hard for the patient to exercise the skills and the attitudes of resilience.
Coping with a brain injury is difficult no matter what level of support one has. The very nature of a head injury usually involves a loss of control, not just over physical functions, but over emotional ones as well. Dyscontrol is one of the hallmarks of a brain injury, meaning that people have difficulty regulating their thought and their feelings and emotions. If recovering from a brain injury, often the patient will engage in perseverative behavior. Perseveration is again one of the factors that make management of a head injury difficult. People get stuck. They have difficulty letting go of a particular thought or idea. They may behave in a repetitive fashion, may continue to attempt to do something in the same way over and over again, even though their behavior is not being effective. This results usually in increased rigidity and more frustration and anger
Learning to control perseveration and to be “flexible” is a difficult process for most people with a head injury.  But with time and patience, new coping skills can be learned and people can learn with a brain injury to be more flexible, to try in new and different ways to solve a problem and to gain control over their emotions and their world.
Other chronic illnesses such as cancer can make it very hard to exercise the skills and the attitudes of resilience. In the face of a devastating illness, optimism can be hard to come by. Inadequate insurance coverage and medical debt, which is the number one cause of bankruptcy in this country, can be overwhelming and people can sink into feelings of helplessness and hopelessness. These are times when finding a sense of purpose and direction is crucial.
I have learned from many of my patients that with time, patience and support can change things for the better. A chronic illness doesn’t have to change every aspect of your life, and the changes that occur may not be permanent. There is much wisdom in the saying, “This, too, will pass,” and blaming yourself or others for your troubles never makes things any better.
Many of the patients that I have seen with chronic illnesses over the years tell me that the one thing that was essential for them to continue moving forward, to continue battling the cancer, or learning new coping strategies was a sense of purpose, a reason for doing it. They may have found that sense of purpose through their religious beliefs or through their family, their work or their friends. But they found it. And through that they found resilience and the ability to bounce back from adversity.

Chronic Illness

Managing a chronic illness, either physical or emotional, requires resilience. Unfortunately, the nature of the illness can severely impair a person’s ability to apply the skills and the attitudes of resilience. For example, a severe emotional disorder, such as schizophrenia, makes communicating and connecting with others a difficult task. Distrust and paranoia often accompany the disorder. Instead of relationships being a source of support, they can be a source of fear and aversion.
Emotional control may be an extremely difficult chore for the patient, and feelings may fluctuate from one extreme to the other. Dr. Paul Meehl identified chronic ambivalence as one of the hallmarks of the disorder. These strong feelings may be extremely hard to manage. Even with antipsychotic medications, patients may still have difficulty thinking clearly and reasoning in a logical and rational fashion. Feeling confident in yourself and secure in a world that is distorted by a thought disorder is very challenging, to say the least.
But as I write this, I recall two of the patients that I worked with for many years who have been struggling with the disorder most of their lives. It has been an extremely rocky road for them, but both have learned to manage their illness in different ways. One has learned to do this by accepting the reality that the psychotropic medication can help in controlling his thought and should be taken as prescribed. He has also learned that he needs to have some basic trust and check reality out with a therapist on a regular basis. It has been a difficult process, but over the years he has gotten better at taking care of himself and feeling confident in his ability to manage his life.
My second patient, who is a very bright and creative woman, has learned to use her brightness and her thinking, although at times distorted, to better control her emotions. This has allowed her in the last few years to have less difficulty with the police and other authority figures in the community, to reconcile with her daughter and to live in a supportive relationship with her family. It is also worth noting that both patients have learned to use their sense of humor, admittedly somewhat bizarre at times by my perception, in dealing with the world.
In the next blog I will talk more about chronic illness; specifically, chronic physical illnesses and physical disabilities such as brain injury.

How resilient are we really?

I’ve been doing workshops in resilience since 2007. I have often found that when we present the skills and the attitudes of resilience, most people can immediately identify with them and many people indicate that, yes, they can and do apply the skills. No problem, they say. But applying the skills and the attitudes of resilience involves more than just being able to list them and define what they are. It means being able to apply them to specific situations.
As I have indicated a number of times in these blogs over the years, we have used storytelling as a way of teaching the skills and the attitudes of resilience. A novel, in particular, can be an excellent tool for teaching these skills, and we have used Reaching Home and now First Night as tools for teaching these skills and attitudes.  This tends to work well and we encourage people to tell their own stories about how they’ve dealt with situations in their life and what skills and attitudes of resilience they’ve used.
A few years ago we developed a card game called “Bounce Back” and have used it in the training over the last few years. The game asks participants to respond to a challenge card that they have drawn from the deck of challenges. Like life, we never know what card we will be dealt. Participants must then respond with the skills and the attitudes that they would use in dealing with the challenge that they have received. In some cases we have imposed a time limit on response, creating another pressure that they have to deal with in responding. We have also asked participants to describe exactly how they would use the skill and the attitude that they have chosen from the list of skills and attitudes that we have reviewed in this blog. We have found this as a very useful tool, because it requires people to demonstrate how they would utilize the skills and the attitudes of resilience.
As I have mentioned over the last year and a half, we have been developing this hardcopy card game into an electronic card game. In the game participants are dealt a challenge that they must respond to. They must use the skills and the attitudes of resilience and they must describe in detail how they would apply them to the specific challenge. This is a game that will be played over the Internet from a website that we are developing. After the participant responds to the challenge, a dropdown box appears and describes the skills and the attitudes that we think might have been useful for them to apply in dealing with the challenge that they responded to. Players can hold their responses and be coached on their responses either in real time or, if they save their responses, later. We believe this is an excellent tool for helping people to develop and use the skills and the attitudes of resilience.
In the next blog I’m going to give you a demonstration of how this works by presenting a challenge and then describing how we would suggest that it might be dealt with. Again, these are only suggestions of skills and attitudes of resilience that might apply. Every situation is different, as is every person. So tune in in a couple of weeks and we’ll present a challenge and discuss the skills and the attitudes that might be applied to dealing with the challenge.

Your Job

In the next few months I’m going to be presenting some challenges and then discussing some possible ways of dealing with them using the skills and the attitudes of resilience. These challenges are part of a game called “Bounce Back” that we developed a few years ago to teach the skills and the attitudes of resilience. We are in the process of creating an electronic “Bounce Back” that can be played over a website that will present these challenges to players and provide them with some immediate feedback regarding the skills and the attitudes of resilience that we think might be useful in responding to the challenge.
So let’s assume that you are playing “Bounce Back” and you have just been dealt this challenge:
Because of your job, you are repeatedly missing activities that your children are involved in, such as Little League games and dance recitals. Your boss e-mails you at home. You’re working long hours and you spend a great deal of time apologizing and trying to explain why you’re not able to leave the office earlier.
How would you use the skills and the attitudes of resilience in dealing with the challenge?
As I have said previously, everyone is different and what we are going to give you now are just suggestions as to the skills and the attitudes that you might apply to the situation that’s just been described. First of all, we assume that it might be good to try to talk with your boss and especially with the other people in your life about the conflict that you are facing. Communication would be one of the critical skills to use in dealing with this challenge. We also would assume that you might have some feelings about what’s going on and would need to manage those too. Again, communicating about those and venting them might be a good idea. Flexibility would also be useful in trying to develop a plan and a solution to dealing with the situation that you are confronting. Stepping back a bit and reviewing the priorities in your life and looking at what’s really important might also help you make some decisions and develop a plan of action. And, obviously, after you’ve developed a plan of action and talked with others and looked at what’s important in your life, doing something is going to be critical. Hopefully, after communicating with others and developing a plan, you may feel more confident that you can now deal with the situation.
As I said earlier, these are only suggestions, and we would suggest that you think through if and how you might apply them. There might be other skills that you think you could apply or other ways you might want to approach this situation. Again, every situation is different, as is every individual confronting a challenge.
In our next blog we’ll take another challenge and discuss the skills and the attitudes of resilience that might be useful in managing it.

The Storm

As Mother's Day approached this year I began to think more about my mom. She died three years ago just a few months before I began doing this blog for Psychology Today. A number of my first blogs about resilience were about her and her struggle with macular degeneration and eventual blindness. In the last few years of her life I learned much about resilience from her struggles. But I learned a lot about resilience from her before I could spell the word.
One of my earliest memories of her was when I was four or maybe five. I was playing out in our backyard. It was a hot summer afternoon.I had hardly noticed that the sun had gone behind the clouds and that the wind was getting stronger. Suddenly she was standing next to me. She took my arm and said we needed to go inside the house. I started to make my usual protest but stopped. The expression on her face told me that I should do exactly what she said.
We hurried into our home. My mom closed all the windows and the shutters. We laid down on top of the big wooden bed in my father and mother's room. She pulled me close to her as she peered out through a slit in the shutters at the dark cloud that was approaching our small community. I didn't know about tornadoes but she did. It was hot. Very hot. I felt I could hardly breathe. The wind blew louder. The shutters and  windows rattled. The rain came, beating hard against the roof and the windows. My mom pulled me closer. But in the middle of the storm I felt safe. I fell asleep.
When I woke the air was cool. The windows were open. The storm had passed. My mom sat on the edge of the bed. She smiled at me. We were safe.