Resilience in the Individual and in the Family System
by Dr. Barbara Cunningham
Webster’s Dictionary (1974) defines resilience as “an ability to recover from or adjust easily to change or misfortune” (p. 596). Although this definition is widely accepted, resilience may be conceptualized as being more than merely bouncing back from setbacks. Resilience may also be the ability to bounce forward in the face of an uncertain future (Walsh, 2004). Resilience has been conceptualized as the forging of strengths through adversity (Wolin & Wolin, 1993). Like the willow tree, people thrive if they have a strong, healthy root system. With branches flexible enough to bend with the storm and firm enough to weather strong winds without breaking, the willow tree can continue to grow despite being twisted into differing shapes. The willow tree may be a metaphor for the resilient individual and resilient family system. Resiliency is critical to mental health and healthy aging.
Bonanno (2004) defined adult resilience as a person’s capacity to resist maladaptation in the face of risky experiences. Bonanno’s individually-based definition of adult resilience assumes that resilience resides in the person, an observation supported by the list of individual attributes that covary with resilient outcomes in Bonanno’s work (hardiness, self-enhancement, repressive coping, and positive emotion.). Importantly, this definition of resilience does not identify the positive outcomes that can result from adversity in the hardy individual. Despite Bonanno’s (2004) narrow definition, his analysis includes an interesting finding that loss and brief traumatic experiences, despite being aversive and difficult to accept, are normatively not sufficient to overwhelm the adaptive resources of ordinary adults. Bonanno’s research calls into question the research of Sameroff, Bartko, Baldwin, Baldwin, and Seifer (1998), which demonstrated in longitudinal analyses that as levels of adversity rise, and as resources fall, resilience becomes less tenable.
Rutter (1985) observed that strong self-esteem and self-efficacy make successful coping more likely, whereas a sense of helplessness increases the likelihood that one crisis will lead to another. In a similar vein, Kobasa’s (1985) research findings supported his hypothesis that people with resilience possess three general traits: (1.) the belief that they can influence or control events in their lives; (2.) an ability to feel deeply committed and involved in activities in their lives; and (3.) a tendency to embrace change as an opportunity to grow and develop more fully. Thus, resilient children are more likely to have an inner locus of control (Seligman, 1990), or an optimistic belief that they can positively impact their fate.
Dugan and Coles (1989) suggest that individuals prevail over adversity more effectively if they have moral and spiritual resources. In a phenomenological study of nine subjects who had experienced such traumas as life in a concentration camp, disability, breast cancer, massive head injury, a life of violence and abuse, and loss of a child, Rose (1997) identified similar themes of resilience which emerged from individual interviews: the role of supportive others, empathy, self-care, faith, action orientation, moving on, positive outlook, and persistence. Rose identifies the foundational structure of resilience as faith, self-respect, striving, supportive others, coping, empathy, self-reliance, and moving on.
Closer scrutiny of children and families that are at risk reveals many exceptions to the “damage model” of development, which considers stress or disadvantage as predictive of dysfunction. For example, Werner and Smith (1992) conducted an extensive longitudinal study of almost a half a century of children from Kuai. The researchers found that in spite of early medical distress, poverty, school difficulties, teen pregnancy, or arrest, children were able to learn and persevere through difficulty, given adequate supports. In their analysis of how these impoverished children matured successfully, Vaillant (2002) notes that Werner and Smith emphasized, “. . . the importance of being a ‘cuddly’ child and of being a child who elicits predominantly positive responses from the environment and who manifests great skill at recruiting substitute parents” (p. 285). Werner and Smith point out that key turning points for most of these troubled individuals were meeting a caring friend and marrying an accepting spouse. It is also salient that Werner and Smith found that more girls than boys overcame adversity at all age levels. Walsh (2004) speculates that this finding reflects the notion that “. . . girls are raised to be both more easygoing and more relationally-oriented, whereas boys are taught to be tough and self-reliant through life. . . [and] often because of troubled family lives, competencies were built when early responsibilities were assumed for household tasks and care of younger siblings” (pp. 13-14). Werner and Smith’s study is especially important in reminding clinicians that early life experiences do not necessarily guarantee significant problems in later life. Walsh (2004) suggests that their most significant finding is that resilience can be developed at any point over the course of the life cycle. Walsh extrapolates from Werner and Smith’s research that “. . . unexpected events and new relationships can disrupt a negative chain and catalyze new growth” (p. 14). Favorable interactions with individuals, families and their environments have a systemic effect of moving resilience in upward spirals, and a downward spiral can be reversed at any time in life (Walsh, 2004).
Felsman and Vaillant (1987) followed the lives of 75 males living in impoverished, socially disadvantaged families. People who suffered from substance abuse, mental illness, crime and violence parented these men. Several of these men, although scarred by their childhoods, lived brave lives and became high functioning adults. Felsman and Vaillant concluded, “The events that go wrong in our lives do not forever damn us” (1987, p. 298).
Another study refuting the accuracy of the “damage model” is Kaufman and Zigler’s (1987) finding that most survivors of childhood abuse do not go on to abuse their own children. Similarly, other research found that children of mentally ill parents or dysfunctional families have been able to prevail over early experiences of abuse or neglect to lead productive lives (Anthony, 1987; Cohler, 1987; Garmezy, 1987).
Werner (1995) identified clusters of protective factors that have emerged as recurrent themes in the lives of children who overcame great odds. The protective factors that were characteristic of the individual were myriad. Resilient youngsters are engaging to other people. Additionally, they excel in problem-solving skills and display effective communication skills. Problem solving skills included the ability to recruit substitute caregivers. Moreover, they have a talent or hobby valued by their elders or peers. Finally, they have faith that their own actions can make a positive difference in their lives.
From a developmental perspective, Werner (1995) emphasizes that having affectional ties that encourage trust, autonomy, and initiative enhances resilience. Members of the extended family or support systems in the community frequently provide these ties. These support systems reinforce and reward the competencies of resilient children and provide them with positive role models. Such supports may include caring neighbors, clergy, teachers, and peers.
In Vaillant’s (2002) Study of Adult Development at Harvard University, arguably the longest longitudinal study on aging in the world, it is suggested that resiliency researchers who focus on risk factors and pathology are mistaken in believing that misfortune condemns disadvantaged children to bleak futures. Instead, Vaillant calls upon clinicians to count up the positive and the protective factors when conducting assessments. Vaillant cites Sir Michael Rutter (1985), who reminds clinicians, “The notion that adverse experiences lead to lasting damage to personality ‘structure’ has very little empirical support” (p. 598).
Vaillant (2002) identifies four protective factors in the individual’s potential to age well. A future orientation, a capacity for gratitude and forgiveness, a capacity to love and to hold the other empathically, and the desire do things with people instead of to people are personal qualities identified as resiliency factors. He posits that “. . . marriage is not only important to healthy aging, it is often the cornerstone of adult resilience” (p. 291).
Furthermore, Vaillant (2002) describes resilience as being a combination of nature and nurture. Both genes and environment play crucial roles. He explains, “On one hand, our ability to feel safe enough to deploy adaptive defenses like humor and altruism is facilitated by our being among loving friends. On the other hand, our ability to appear so attractive to others that they will love us is very much dependent upon the genetic capacity that made some of us ‘easy’ attractive babies” (p. 285).
An essential part of resilience is “. . . the ability to find the loving and health-giving individuals within one’s social matrix wherever they may be” (Vaillant, 2002, p. 286). Thus, like Werner and Smith (1992), Vaillant’s research identified extended families and friendship networks as key foundations to resilience in the individual and the family system.
American culture glorifies the “rugged individual.” John Wayne, the personification of masculinity and strength, has been adored by generations of Americans as a hero. However, there is an inherent danger in the myth of rugged individualism, which implies that vulnerability and emotional interdependence are weak and dysfunctional (Walsh, 2004). As Felsman and Vaillant (1987) note, “The term ‘invulnerability’ is antithetical to the human condition. . . In bearing witness to the resilient behavior of high-risk children everywhere, a truer effort would be to understand, in form and by degree, the shared human qualities at work” (p. 304). Avoidance of personal suffering and the glorification of stoicism are hallmarks of American culture. Such cultural attitudes are typified by the call to “move on,” to “cheer up,” to get over catastrophic events, to put national and global tragedies behind us, or to rebound (Walsh, 2004). Higgins (1994) notes that struggling well involves experiencing both suffering and courage, effectively processing and working through challenges from intrapersonal and interpersonal perspectives. In Higgin’s study of resilient adults, it became clear that they became stronger because they were severely tested, endured suffering, and developed new strengths as a result of their trials. These adults experienced their lives more deeply and passionately. Walsh (2004) observes that over fifty per cent of the resilient individuals studied by Higgins were therapists. Egeland, B. R., Carlson, E. and Sroufe (1993) offer an alternative approach to thinking about resilience as “. . . a family of processes that scaffold successful adaptation in the context of adversity” (p. 517).
Important research conducted by Wolin and Wolin (1993) points toward the notion that although some children are born with innate resiliencies, resiliency can be modeled, taught, and increased. They emphasize that persons tend to seek healing from pain instead of holding on to bitterness. The researchers note that the resilient person draws lessons from experience instead of repeating mistakes, and that they maintain openness and spontaneity in their relationships rather than becoming rigid or bitter in interaction. Wolin and Wolin also found that resiliency in individuals is strongly correlated with humor and creativity, as well as mental and physical health. The Wolins identify seven traits of adults who survived a troubled childhood: insight (awareness of dysfunction), independence (distancing self from troubles), relationships (supportive connections with others), initiative (self/other-help actions), creativity (self-expression, transformation), humor (reframing in a less threatening way), and morality (justice and compassion rather than revenge). Traits are viewed as dynamic processes by which resilient individuals adapt to and grow through challenge, rather than static properties that automatically protect the invulnerable. These observations are correlated with empirical studies of resilient children (Baldwin, Baldwin, & Cole, 1990; Bernard, 1991; Garbarino, 1992; Masten, Best, & Garmezy, 1990; Werner & Smith, 1992) and adults (Klohnen, Vandewater, and Young, 1996, Vaillant, 2002).
Walsh (2004) asserts, “In the field of mental health, most clinical theory, training, practice, and research have been overwhelmingly deficit-focused, implicating the family in the cause or maintenance of nearly all problems in individual functioning. Under early psychoanalytic assumptions of destructive maternal bonds, the family came to be seen as a noxious influence. Even the early family systems formulations focused on dysfunctional family processes well in the mid-1980’s” (p. 15).
The popularity of the Adult Children of Alcoholics Movement surged in the late twentieth century and encouraged people to blame their families for their problems. This movement tempted the individual to make excuses for his behavior in terms of his dysfunctional family history instead of looking for family strengths that might help him/her overcome challenge and become stronger. Adult Children of Alcoholics “. . . spend much of their time other-focused, and it is easy for them to become preoccupied with another group member’s problem, take responsibility for it, and avoid the painful job of self-examination and taking responsibility for their own behavior” (Lawson & Lawson, 1998, p. 263).
In contrast to this damage model, the Wolins offered an alternative way to view challenging family backgrounds: a Challenge Model to build resilience, stating that “. . . the capacity for self-repair in adult children of alcoholics taught [them] that strength can emerge from adversity” (p. 15). The Wolins reflect a paradigm shift in recent years, as family systems therapists have started to focus upon a competence-based, strength-oriented approach (Barnard, 1994; Walsh, 1993, 1995a). A family resilience approach builds on recent research, empowering therapists to move away from deficit and focus upon ways that families can be challenged to grow stronger from adversity (Walsh, 2004). From the perspective of the Challenge Model, stressors can become potential springboards for increased competence, as long as the level of stress is not too high (Wolin & Wolin, 1993). Walsh notes, “The Chinese symbol for the word ‘crisis’ is a composite of two pictographs: the symbols for ‘danger’ and ‘opportunity’” (p. 7). Wolin and Wolin (1993) observe that we may not wish for adversity, but the paradox of resilience is that our worst times can also become our best.
It is clear that the extensive research on resilient individuals largely points toward the social nature of resilience. However, most resiliency theory has approached the systemic context of resilience tangentially, in terms of the influence of a single, important person, such as a parent or caregiver (Bowlby, 1988). Looking at resilient family functioning through a systemic lens calls upon the clinician to view individual resilience as being embedded in family process and mutual influence (Walsh, 2004). Walsh suggests that if “. . . researchers and clinicians adopt a broader perspective beyond a dyadic bond and early relationships, [they] become aware that resilience is woven in a web of relationships and experiences over the course of the life cycle and across the generations” (p. 12).
It has only been in the last twenty five years or so that families that cope well under stress have been the subject of research (Stinnet & DeFrain, 1985; Stinnett, Knorr, DeFrain, & Rowe, 1981). A growing body of knowledge has pointed toward the multidimensional nature of family processes that distinguish adaptive family systems from maladaptive family systems (Walsh, 2004). Walsh (2004) defines “family resilience” as “. . . the coping and adaptational processes in the family as a functional unit,” [and adds that]. . . a systems perspective enables us to understand how family processes mediate stress and enable families to surmount crisis and weather prolonged hardship” (p. 14). Strong families create a climate of optimism, resourcefulness, and nurturance which mirrors the traits of resilient individuals (Walsh, 2004).
In fact, research on family adaptation and on family strengths suggests the following traits of resilient families: commitment, cohesion, adaptability, communication, spirituality, effective resource management, and coherence (Abbott, et al., 1990; Antonovsky, 1987; Beavers & Hampson, 1990; Moos & Moos, 1976; Olson, Russell, & Sprenkle, 1989; Reiss, 1981; Stinnett, et al., 1982). Walsh observes, “. . . a family resilience lens fundamentally alters our perspective by enabling us to recognize, affirm, and build upon family resources” (Walsh, 2004, p. viii). Rutter’s (1987) research added further confirmation that resilience is fostered in family interactions through a chain of indirect influences that inoculate family members against long-term damage from stressful events. It is essential to consider family resilience as a major variable in a family’s ability to cope and adapt in the face of stress (McCubbin, McCubbin, McCubbin, & Futrell, 1995).
Bennett, Wolin, and Reiss (1988) concluded from their research that children who grew up in alcoholic families that deliberately planned and executed family rituals, valued relationships, and preferred roles were less likely to exhibit behavior or emotional problems. They argue that families with serious problems, such as parental alcoholism, which can still impose control over those parts of family life that are central to the family’s identity, communicate important messages to their children regarding their ability to take control of present and future life events. These messages can determine the extent to which the children are protected from developing future problems, including alcoholism in adolescence and adulthood.
Patterson (1983) asserts that it is only to the extent that stressors interrupt important family processes that children are impacted. However, from a systemic perspective, it is not only the child who is vulnerable or resilient; most salient is how the family system influences eventual adjustment (Walsh, 2004). Even those family members who are not directly touched by a crisis are profoundly affected by the family response, with reverberations for all other relationships (Bowen, 1978).
Following from these ideas, it is clear that “Slings and arrows of misfortune strike us all, in varying ways and times over each family’s life course. What distinguishes healthy families is not the absence of problems, but rather their coping and problem-solving abilities” (Walsh, 2004, p. 15).
From an ecological perspective, Rutter (1987) suggests that it is not enough to take into account the sphere of the family as influencing risk and resilience in the individual and family life cycles. He emphasizes that it is also incumbent upon therapists to assess the interplay between families and the political, social, economic, and social climates in which people either thrive or perish. Rutter’s findings suggest that it is insufficient to focus exclusively on bolstering at-risk individuals and families, but there must also be public policy efforts to change the odds against them.
In the twenty first century, it is apparent that the configuration of the family is shifting. Diverse forms of family systems do not inherently damage children (Walsh, 2004). Walsh emphasizes, “It is not family form, but rather family processes, that matter most for healthy functioning and resilience” (p. 16).
One family process that governs how a family responds to a new situation is the way in which shared beliefs shape and reinforce communication patterns (Reiss, 1981). Hadley and his colleagues (1974) found that a disruptive transition or crisis could potentiate a major shift in the family belief system, with both immediate and long-term effects on reorganization and adaptation. Additionally, Carter and McGoldrick (1999) suggest that how a family perceives a stressful situation intersects with legacies of previous crises in the multigenerational system to influence the meaning the family makes of the adversity and its response to it.
Walsh (2004) asserts, “A cluster of two or more concurrent stresses complicates adaptation as family members struggle with competing demands, and emotions can easily spill over into conflict. . . . Over time, a pileup of stressors, losses, and dislocations can overwhelm a family’s coping efforts, contributing to family strife, substance abuse, and emotional or behavioral symptoms of distress (often expressed by children in the family)” (p. 21). Figley (1989) noted that catastrophic events that occur suddenly and without warning can be particularly traumatic. Bowen (1978) suggested that shock wave effects of a trauma might reverberate through the system and extend forward into multiple generations. Thus, Walsh (2004) calls upon therapists to take a systemic approach to intervention in the face of crisis, with interventions that “. . . strengthen key interactional processes that foster healing, recovery, and resilience, enabling the family and its members to integrate the experience and move on with life” (p. 22).
To understand resilience, one must also look through a developmental lens (Carter & McGoldrick, 1999). Neugarten (1976) found that stressful life events are more apt to cause maladaptive functioning when they are unexpected. Also, multiple stressors create cumulative effects, and chronic severe conditions are more likely to affect functioning adversely. However, Cohler (1987) and Vaillant’s (1995) research found that the role of early life experience in determining adult capacity to overcome adversity is less important than was previously believed. Thus, discontinuity and long-term perspectives on the individual and family life cycle point toward the idea that people are constantly “becoming” and have life courses that are flexible and multidetermined (Falicov, 1988). Furthermore, Walsh (2004) suggests that “. . . an adaptation that serves well at one point in development may later not be useful in meeting other challenges” (p. 13). Research has pointed toward a greater risk in vulnerability for boys in childhood and for girls in adolescence (Elder, Caspi, & Nguyen, 1985; Werner & Smith, 1982). All these variables highlight the dynamic nature of resilience over time.
In the field of family therapy, it is incumbent upon researchers and practitioners to recognize that successful treatment depends as much on the resources of the family as on the resources of the individual or the skills of the clinician (Karpel, 1986; Minuchin, 1992). Family processes can influence the aftermath of many traumatic events, reverberating into the course of the lives of people in future generations. Individual resilience must be understood and nurtured in the context of the family and vice-versa. Both immediate crisis and chronic stressors affect the entire family and all its members, posing threats not only to the individual, but also for relational conflict and family breakdown in current and future generations. Family processes may mediate the impact of crisis on all members and their relationships. Protective processes build resilience by promoting recovery and buffering stress. Indeed, healthy family processes influence the effects of present and future crises far into the future (Bowen, 1978; Kerr & Bowen, 1988). Since all families and their members have the potential to become more resilient, family therapists should work to maximize that potential by strengthening key processes within the individual and within the system.
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Friday, April 24, 2009