Journeys through illness: suffering and resilience

This chapter:
•  explores the notion of living with chronic illness as a journey;
•  explores the concepts of enduring and uncertainity as aspects of the
   suffering associated with living with chronic illness;
•  defines resilience
•  explores the ways in which people develop and use resilient strategies
    in the face of chronic illness;
•  describes survivorship as an outcome of resilience; and
•  discusses the role of nurses and other caring professionals in relation to
    supporting a person through their suffering, and to develop their resilience
    in the face of that suffering.

Cognitive vulnerability and resilience to depressed mood

This study evaluated positive and negative attributional styles, sociotropy, autonomy and optimism as contributors to positive affect and negative affect. The two affect measures respectively separated depression from general psychological distress. Model fit for 168 adult women indicated that each attributional style contributed indirectly to depression via optimism. Further, negative attributional style directly contributed to psychological distress as did sociotropy and autonomy. Results also confirmed an interrelatedness between negative attributional style, sociotropy and autonomy. Discussion addresses interpretation of the model and implications for research.

The phenomenon of resilience in crisis care mental health clinicians

The purpose of this study, undertaken in 2003, was to explore the phenomenon of resilience as experienced by Australian crisis care mental health clinicians working in a highly demanding, complex, specialized and stressful environment. For the purpose of this research, the term 'resilience' was defined as the ability of an individual to bounce back from adversity and persevere through difficult times. The six participants for this study were drawn from Melbourne metropolitan mental health organizations – the disciplines of nursing, allied health and medicine. A number of themes were explicated from the participants' interview transcripts – Participants identified the experience of resilience through five exhaustive descriptions, which included: 'The team is a protective veneer to the stress of the work'; Sense of self; Faith and hope; Having insight; and Looking after yourself. These exhaustive descriptions were integrated into a fundamental structure of resilience for clinicians in this role. The study's findings have the potential to inform organizations in mental health to promote resilience in clinicians, with the potential to reduce the risk of burnout and hence staff attrition, and promote staff retention and occupational mental health.

Young people with an intellectual disability: risk and resilience.

There is a large body of literature about personal risk and resilience among children and adolescents from a variety of subpopulations. However, in intellectual disability research, resilience has almost exclusively been investigated and reported at the level of family stress and coping rather than an individual child's capacity to function adaptively despite severe risk. In this study young people with an intellectual disability, family members and non-family members (carers, teachers and family friends) were interviewed and asked about the young people’s relationships, coping styles, behaviour patterns and resilience. The main features placing these young people at risk included having autism or inflexible patterns of behaviour, displaying some forms of challenging behaviour, difficulty with receptive and expressive communication, living in families with high competing demands for time and living in a relatively unaccommodating community environment. The main factors leading to resilience were an attractive appearance/disposition, ability to get one’s message across, ability to adapt behaviour to changing contexts, low family stress levels and high sense of competence, stable relationships with supportive others and an accommodating/accepting community environment (both school and social).

Associations between student pursuit of novel mathematical ideas and resilience

As part of a broader study of characteristics of situations that promote or inhibit spontaneous student exploration of novel mathematical ideas, student inclination to display these spontaneous behaviours was studied in conjunction with resilience. Resilience was operationalised using the dimensions of optimism (Seligman, 1995). Indicators of optimism were identified in post-lesson video-stimulated reconstructive interviews with year eight students. Students who demonstrated the pursuit of novel mathematical ideas were found to also display indicators of resilience.

Affect-regulated indirect effects of trait anxiety and trait resilience on self-esteem

This study examined the influence of trait resilience and trait anxiety on self-esteem and investigated the mediating role of positive and negative affect in this relationship. Specifically, it was proposed that trait resilience and trait anxiety may exert indirect effects on self-esteem by promoting increased positive and negative affect, respectively. The final sample comprised of 240 participants (age, M = 21.55, SD = 4.16) who completed questionnaire measures of trait resilience (CD-RISC; Connor & Davidson, 2003), trait anxiety (STAI-T; Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983), affect (PANAS; Watson, Clark, & Tellegen, 1988) and self-esteem (RSES; Rosenberg, 1965). Path analyses (AMOS), controlling for measurement error revealed significant indirect effects of trait anxiety and trait resilience on self-esteem via negative and positive affect. The indirect model provided a very close fit to the data; estimation of the full model (direct paths) did not yield a significantly better fit. It was concluded that the impact of trait anxiety and trait resilience on self-esteem may be due to their effects on regulating affective experiences which in turn may be more proximal predictors of individual feelings of self-worth.

"Your job no longer exists!" from experiences of alienation to expectations of resilience - a phenomenological study

We have entered the age of the contingent or temporary worker, the consultant and the subcontractor. Workers are expected to be pliable and tractable; to “fit in.” Being made redundant is also an area where modern workers are expected to be flexible and resilient. However, when these so-called “flexible” workers are told their job no longer exists, the accompanying sense of rejection and alienation can be excruciating. Stories of being made redundant were collected during an exploratory, qualitative study, using Heideggerian phenomenology as the methodological vehicle to capture the lived experiences of those affected. Focused, in-depth interviews were conducted with the ten respondents; nine men and one woman. The stories shared suggest that being made redundant is an alienating experience with respondents sharing feelings of powerlessness, shock, betrayal, shame and social isolation. Unfortunately, those having experienced redundancy were also not as resilient as is routinely assumed. They did not “bounce back” unchanged, but reported significant negative outcomes including fear for the future, underemployment, family disruptions and an erosion of trust. Recommendations are made orienting organisations towards a more human process of redundancy.

Risk and resilience, knowledge and imagination: the enlightenment of David Almond's Skellig

In what Ulrich Beck calls "risk society," and Anthony Giddens a "runaway world," a climate of fear and insecurity has been created by scientific progress, leading to a loss of confidence in the ability of experts to manage risk. Resilience is at the forefront of psychology research informing child-rearing strategies (Luthar, et al.); it entails an approach to child welfare that focuses on fostering internal (psychological) and external (cultural) assets that develop a child's ability to triumph over adversity in the form of individual, familial, and cultural stresses.

Mental health and wellbeing of Australian adolescents: pathways to vulnerability and resilience

The Australian Temperament Project (ATP) provides a unique lens through which to view he pathways to vulnerability and resilience that Australian children take from infancy to adolescence, and beyond. Commencing in 1983, the ATP is now completing its 24th year and 14th wave of data collection. The present paper provides an overview of the data on adolescent antisocial behaviour, substance use, internalising problems and aspects of positive development and wellbeing. Several pathways to vulnerability or resilience are described that vary in their age of onset. Constellations of common risk factors suggest that there may be overlapping priming factors for later mental health problems. A different mix of factors relates to pathways to wellbeing. This unique Australian study provides invaluable insights into stability and change in the pathways to mental health that children take across life.

The three R`s of resilience: redundancy, requisite variety and resources

This paper offers a way of operationalizing resilience according to the sub-systems that comprise a business (technical, social and economic), the kinds of perturbations that might impact a business (local, national and global) and the criteria that determine resilient capacity (redundancy, requisite variety and resources). When a business system has incorporated redundancy, developed requisite variety and adequately monitors its resources, we might then conclude that such a business is a resilient business. The model offered here is theoretical, and is yet to undergo empirical scrutiny. Empirical modeling will enable us to ascertain the strength of a business's internal characteristics against different levels/kinds of external perturbation. Sensitivity analysis of this kind will lead to more in-depth understanding of the dynamics that generate resilient businesses in a complex world.

Resilience: a protector from depression

Personality type and resilient behaviors provide protection from the experience of depression, and resilience can increase the risk of not being depressed. Psychiatric–mental health nurses are well positioned to facilitate the development of resilience qualities in people who are depressed. Clinical strategies, which could be undertaken by the psychiatric–mental health nurse, include early intervention, promoting a positive social and familial climate, promoting self-esteem and support building, social and life skills/vocational education, and linking and brokering clients into extracurricular activities.

Resilience : when coping is emotionally intelligent

The potential for resilient behaviors and emotional intelligence involves an interplay between the individual and his or her broader environment. Studies that have examined resilience explore factors or characteristics that assist individuals to thrive from and in adversity. These protective factors are part of an individual’s general makeup. Some of these factors are considered genetic, such as a personality that is outgoing and social; however, many protective behaviors can be learned. Coping in the face of adversity involves emotional intelligence and resilience, both of which can be developed through support and education. In this context, fostering resilience and emotional intelligence has the potential to improve clinical outcomes for mental health consumers.