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.

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”

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”

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.D

Live 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

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.

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.