Resilience-Continuing

A common association with the word 'resilience' is the idea of "bouncing back" after a setback, an illness, a trauma or even a sudden uncomfortable change in life. 
The Mayo Clinic says, “Resilience is the ability to adapt well to stress, adversity, trauma or tragedy. People who have a resilient disposition are better able to maintain poise and a healthy level of physical and psychological wellness in the face of life’s challenges.”      
Resilience is a holistic term since recovery and adjustment physically are only part of the process of healing.   Emotional resilience has become an overused buzz word for the ability to restore and maintain one's emotional health and spiritual well being.  The implication is that once one is "restored" and "positive" then that step is complete.  For most of us who have suffered extreme trauma in physical or psychological terms, traumatic brain injury or dramatic life changes such as having to flee from one's ancestral home and lands; 'bouncing back' will be a life long adaptation, coping with the waves of pain, illness, loss, vulnerabilities, plagues of uncertainty and memory.   

However research and history have shown us that like other "muscles" and "skills" you can certainly increase your ability to be resilient even if your family history (epigenetics) physical/psychological make up is weak, and your resources are limited. No matter how horrible one's condition is, often because of circumstances and events beyond one's personal control,  the ultimate giving up, being overcome and overwhelmed by events, conditions and despair need not result in taking one's own life.  

This week I outline strategies/programs to help increase resilience and recovery.   I speak from personal experience as well as from the standpoint as a health practitioner who has treated many patients who are survivors of trauma over the past twenty years in a variety of locations and from diverse cultures, backgrounds, professions, faiths and from all ages groups, races and genders.  We used a combination of Traditional Chinese Medicine, "Medicine" learned from living/working in Indigenous communities in the USA, Australia and New Zealand, as well as therapeutic strategies from western psychological methods, and witnessed resilience from other survivors over time.  There are no "short fixes"  FYI

Heart breaking statistics were just released by Pentagon in regard to the number of active duty and veterans who commit suicide. The statistics by branch from 2018, shout out once again that the United States needs to do better in terms of building resilience in our population and especially in members of our military. "The rate of active duty service members who take their own lives has been rising an average of 6 percent year-over year the past five years, the Pentagon announced Thursday.  The number of suicides jumped from 285 to 325 between 2017 and 2018, according to the 2018 Annual Suicide Report, from a rate of about 22 suicides per 100,000 service members to about 25."
www.militarytimes.com/news/your-military/2019/09/26/active-duty-suicides-are-on-the-rise-as-the-pentagon-works-on-new-messaging-and-strategy/

​We need to examine why countries who have decades of war, hardship, trauma and struggle do not have the high statistics of suicide we do, especially in their active and retired military members.  I would offer that after more than a generation of comfort, easing of life circumstances, lowering of standards in most levels of education/training, a generally sedentary, physically and emotionally undemanding lifestyle with easy access to licit and illicit drugs-the US population has become weakened in all respects.  It is easier to see if you have been away for a significant period of time and then return to the USA with fresh eyes.

One reason for the fragility of personality is trauma, violence within a family of origin and/or the break up or absence of a loving family environment for a child growing up anywhere.   If a child has just one consistent loving family member that one factor may be able to mitigate all hardships.   If a family is strong, multi-generational and has a foundation in "faith", a belief in purpose in life and other than human assistance and guidance, children and adults can endure much more than those who are bereft of these foundations in life.  More western countries now have societies where these foundations have been eroded and attacked over decades.

Moreover, material affluence and comfort have wasted the muscles of determination, persistence, creativity and hard work.   The inability to obey those in authority to develop discipline has resulted in an erosion of self discipline, too.  The greed for acquiring and not being satisfied that "enough is enough"  can suck out the joy of appreciating what is there instead of hankering after what is not.  Notice    children can find a way to play almost anywhere and still smile.   

The military and policy makers have not fully taken into account what a drugging of elementary, middle and high school children has done to the potential pool of military recruits.  When I returned to Texas in late 1998, after a decade away in other countries, I was stunned to see how many children would line up at the nurse's office in the public middle school where I was teaching, during breaks and lunchtime.  When I inquired I learned these were the children who had medication they had to take during the day.   The norm became "medicate" especially if a child was "restless, couldn't concentrate, demonstrated aggressive behavior".  Teacher conferences urged parents to see designated, "approved" doctors who would also prescribe medication.   I was pressed to "observe and label" children so the school could be eligible for more state and federal funds.   I refused to categorize otherwise healthy, curious, intelligent, active and original thinking children as needing "special education and medication."  I left public and charter school teaching in 2005, in the USA.

​There are side effects to these medications including stunted growth, headaches, insomnia, loss of motivation (will power) rashes, loss of appetite, anxiety, higher blood pressure, etc (for Ritalin or Methylphenidate) and serious side effects for psychiatric drugs such as suicidal ideations, weight gain, agitation, dry mouth, constant fatigue, loss of libido, muscle spasms, and so on.    In a report of 2015, almost five years ago-the number of children under 18 was estimated to be about 75 million in the USA.   The number of children diagnosed with mental illness was 17.1 million children on record.  the current estimate is that 22.2% of American children have a mental illness.    However, consider that many more "disorders" have been added to the Diagnostic and Statistical Manual V which is in current use.  childmind.org/2015-childrens-mental-health-report/
There are "defiant" disorders  (children who answer back or are questioning), the pressure of "gender identity confusion" disorders, the castigation of boys as having male "toxicity" etc.  These weaken the next generation so their capacities are diminished and  resiliency is not strengthened.  In fact in many cases it is enfeebled.  When hard times, quick changes, trauma, loss and isolation happen-these young adults are not as prepared or armored-physically, emotionally and spiritually-as previous generations, or as children in other countries where medicating and coddling children is not part of the culture, education or medical systems.

​The triggers of trauma are individual.  Each person experiencing the same event may respond in their body, mind and spirit differently. The timeline will vary for each person.   Some triggers may ease over time, others develop over time.  The process to heal is variable and cannot be predicted or packaged. This is where western medicine approaches, the military and government organizations and NGOs who have members with post trauma reactions-get it terribly wrong in my opinion.  Here are a few practical ideas which would not be difficult to implement in the USA:

• There needs to be choice for the patient or person who self diagnoses or is diagnosed with post trauma.   
• TRICARE and Medicare, as well as private health insurances need to add the option of licensed acupuncture, herbal medicines, therapeutic sports/exercise as part of "rehabilitation" options.  In the long run it is much less expensive to support gym memberships than 24 hour residential care in a clinic or hospital. 
• Survivors of trauma groups need to be either free or on a sliding scale and available in all cities and with both day and evening/weekend meetings.  I suggest something similar to AA be initiated where if you wish, you do not have to reveal your real name and you have a sponsor and ongoing support without being put into a med data base.   The stigma of asking for help for "mental problems/illness/reactions" is still prevalent in all societies.  Confidentiality is crucial in these programs.
• For those who have severe injuries and find life better for them in rural settings, working farms with animals could be an alternative to residence in a group "home" in the city.   Some survivors of trauma find living with nature a balm in itself but do not have the financial means to run a farm on their own.
• Helping others is one way to find purpose and remember you are not alone in your suffering.   Opportunities in communities to volunteer on a consistent basis in shelters for the homeless, clean ups in parks, city neighborhoods, neglected areas, national and local communal gardens, sports programs, music programs and with those in senior housing, in animal shelters-could be a way to help vets appreciate the health, youth and status they retain in contrast to others.
• Re-training programs which involve paid residential or non-residential positions should be ongoing so assistance with basic routines such as meal preparation, hygiene, alcohol and drug free environments to adjust to a healthier lifestyle over time, can be established and a network of human support.   On staff should be those who have come through themselves and have for years lived a "resilient" life.
• Programs which encourage creative visual and performing arts to express trauma, pain, suffering have proved effective in other countries but are not an integral part of US military programs.  Role playing (drama) keeping journals, writing, painting, drawing, sculpture, murals, music and dance have helped significantly in refugee camps and church/community programs in Iraq, Jordan, Ukraine, Israel, Canada, France and Italy.   These means of extracting the thorns of trauma are often part of programs for children and could be implemented for adults.  Many survivors do not want to speak or be verbally counselled but can relate their stories with other vehicles. ​   Below is a mural painted on the outside wall of a middle school by children in Kurdistan area of Iraq in 2017, after the siege by Daesh/ISIS. ​

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Ankawa neighborhood, Iraq Photo by Jo Patti - 2018

Let's be real, it is often still a career "killer" to admit you have post traumatic stress even though you might get a few extra points on a government application for checking the box.    With the  inter connectivity of phones to net linked databases, "hotlines" are not as viable for anonymity as they might have been decades ago.  The creation/development of a truly "anonymous" hotline for post trauma sufferers not labelled as a "suicide hotline" and run by paid counselors, staff and survivors available 24/7 with a connection to local ambulance/hospitals (only if there is an emergency situation the lifeline cannot handle)-would be a vital component to this national framework to combat veteran and post trauma survivor suicides. ​

The enrichment of human to human contact instead of virtual contact cannot be duplicated.  Having an actual shoulder to cry on, someone to hold you, someone to listen with a caring heart as you repeat the story of trauma and pain, is more important to resilience than pills and screens.   Each person is unique though the symptoms of post trauma may be similar.   

We also have to be courageous enough to ask those suffering to rise to expectations rather than dismissing their previous capabilities as "lost" and impossible to regain.  They may not ever be "the same as before" but can emerge different and even stronger than before the trauma(s) they experienced.  Sometimes harsh words, strong reminders and coaching are needed and human hands, human presence extended again and again and again.  Those helping cannot give up either.   The narratives and mindset about people who have post trauma reactions need to be re-directed.   See my more detailed article on this subject here:  https://www.scitechnol.com/peer-review/managing-post-trauma-reactionschanging-the-dialogue-and-protocols-4dbv.php?article_id=6525

The path back to functioning, the steps on the ladder to re-framing your life outlook, your relationships, your goals and your challenges - is part of the adaptation required after trauma.  If you don't have a supportive family or spouse/partner or close brotherhood/sisterhood, colleagues to support you and love you in your climb, then truly you have an exponentially more difficult road to navigate, but it can be done.   

​What must be understood by those designing and running projects and programs for veterans and survivors, is that this is a continual process.   People may need to "refresh" and "start over" from time to time.   Two steps up the ladder to health may also need one step down.  There are no guarantees.

​The United States is the wealthiest country in the world.  We give aid to over 100 other countries including to those suffering from trauma of all kinds yet our own programs are lacking within our own country and especially for our own military and first responders.   This should be of national concern, urgent redress, action and passion, but it is just a side note and more power points, video courses and bowed heads are the usual reaction.   Those who have a family member, friends, colleagues who are veterans or first responders need to push for change since we are the majority. 

In research for this article I searched programs in Colorado, a state with many veterans, active military, military bases for programs.  While a number are listed online, when I actually called-few responded with a human being-just more screens or voice messages.   This is a deterrent to many who might seek help but be put off by robotic voices or more demands for information and more delay.   Our national aim should be to lower that 25 a day to 0 step by step.   Do you agree?  Alright then-visualize and actualize a first step this week.  I have an average of 2,000 viewers per week depending on the subject I write about-it has been as high as 4,600.  If even 50% of you starts moving on this problem that is motion in the right direction.  

This week I am closing with a song entitled:  "You Raise Me Up"  by the Irish/Norwegian duo 'Secret Garden'.  Music composed by Rolf Lovland and lyrics by Brendan Graham, performed live by Celtic Woman in concert.
May you find it inspiring.  www.youtube.com/watch?v=Yfwlj0gba_k


Keep steady on your path wherever you may be, whichever rung you may be climbing.  Until next week,
​
Jo