In a Crisis, We Can Learn From Trauma Therapy Emotional resilience can be deliberately cultivated. B
Article from NY Times June 15, 2020
June 15, 2020
· · This article is the first in a series on resilience in troubled times — what we can learn about it from history and personal experiences.
Two years ago, my notions of resilience, how it works and what it means, were remade.
I’d been struggling with the mental-health fallout from a series of car accidents — when I drove, I experienced sporadic flashbacks, feelings of panic and persistent visions of my own seemingly certain doom. I felt certain that I would crash again, and that this time I would die. Sometimes on the highway I had to pull over to hyperventilate and sob. The situation was unnerving, and dangerous.
That was my first experience with lingering trauma, and the power of those memories frightened me. Lately, as I contemplate the potential mental-health fallout from living through a pandemic, I’ve been thinking back on that time: how my visions of those accidents, my memory of my own terror as they’d occurred, seemed to reach out from the past to the present and grab me by the throat. I wonder, and I worry, about how our memories of this time will grab us in years to come.
In an attempt to relieve my trauma, I signed up for a therapy called E.M.D.R., eye movement desensitization and reprocessing.
E.M.D.R. was developed in the late 1980s and greeted with much skepticism at first. “It sounded like yet another of the crazes that have always plagued psychiatry,” Bessel van der Kolk, a trauma expert, wrote in “The Body Keeps The Score.” But clinical trials and peer-reviewed studies that spoke to its efficacy piled up over the three decades since its invention, and Dr. van der Kolk and many others eventually adopted it as part of their therapeutic practice.
It works like this: A therapist prompts the patient to move their eyes back and forth, rhythmically, behind their eyelids. (Devices that beep or buzz help to encourage and regulate the eye movements.) At the same time, the therapist talks the patient through the traumatic event or events at issue, leading them through a series of questions about how their body is reacting to the discussion. It is a strange, and strangely physical, experience. The precise mechanisms at play are not fully understood, but the theory is that something about the eye motion, combined with the focused discussion, can lay the intrusive memories to rest.
E.M.D.R. taught me an important lesson: that internal resilience can be deliberately cultivated. I suppose, if I had thought of it at all, I had thought of my emotional resilience as a kind of reservoir, there to be drawn on as needed, at least until it was drained. I had never before thought of resilience as a muscle I could train and strengthen. The idea felt empowering.
I experienced that cultivation in a kind of prequel to the main event, a process known by the dystopian-novel-worthy term “resource installation.” My therapist explained that she would have me focus on some of the sources of strength and support in my life, and in a reversal of the main therapy, we would use the eye movements to cement the good memories in my mind rather than to sweep away the bad ones. “We all have resources within us, such as memories of comfort and safety, experiences of being powerful and courageous,” writes Laurel Parnell, a clinician who is a leading proponent of the method, in her book “Tapping In.” “These memories, qualities, and images are stored in our body-mind network and can be accessed, activated, and strengthened.”
On the day of my “resourcing” session, my therapist had me select four resources from my memories: a place where I had felt my safest and happiest, a nurturing figure, a protector, and a source of wisdom.
As I held a vibrating pod in each hand, and as my eyes rolled back and forth behind my eyelids in time to their pulsing, following the vibrations from left to right and back again, I thought about my grandmother — my nurturing figure, who had died when I was 18. I pictured her at the open kitchen window of her suburban bungalow, leaning toward the window screen to exhale cigarette smoke; the deep wrinkles around her mouth and eyes and the clear plastic of her glasses; the smell of Vicks VapoRub and feel of her bony frame when we hugged. The pods pulsed. My eyes moved from side to side. I felt loved and safe. To my surprise, I felt stronger, too. In the time since, I have sometimes called up those sensory memories of my grandmother when I’m upset, or when I feel in need of support. It always helps.
Resource installation is one way to cultivate resilience, but there are plenty of other methods and approaches too, many of which do not involve paying a therapist. “It’s not a trait that’s hard-wired, and you have it or you don’t,” said Karen Reivich, the author of “The Resilience Factor” and the director of resilience and positive psychology training programs at the University of Pennsylvania. Nor is it that reservoir I had imagined, with a fixed, finite capacity. “I define resilience as the ability to navigate adversity and to grow and thrive from challenges,” Dr. Reivich added. And, she emphasized, it is an ability that can be learned.
So how do we learn? It is about small shifts in action and outlook. One critical step: Take meaningful action. “Ask yourself, what’s something I can do today, even if it’s small,” she said, “that reminds me that I am not helpless?” During a lockdown, that could mean something as mundane as doing the dishes, imposing some order on your environment. Step two: Connect to others. Our social relationships can be a critical factor in building our resilience — which, of course, is part of what makes the restrictions in place to weather the coronavirus pandemic so hard. But, Dr. Reivich added, “even if you’re not physically present with them, knowing that there are people somewhere on this globe that are cheering for you, and that you can reach out to, is a driver of resilience.”
Unlike the trauma from my car accidents, which took place entirely inside my head, the pandemic is both an external and an internal crisis. It is a disaster happening outside of us, all around us. Lucy Hone, the author of “Resilient Grieving,” is an expert on both the macro- and micro-level crisis. She has used her research into resilience to help her home city, Christchurch, New Zealand, through the aftermath of the devastating 2011 earthquake, but she has also been forced to apply that training in her own life, after the death of her young daughter in a car crash.
Dr. Hone notes that, while there is much that individuals can do to strengthen their own resilience, we are also products of the systems that surround us. “Our capacity for resilience is nested within the environment and the systems within which we live,” she said. Those systems can encompass access to health care and mental health supports during a crisis, paid time off, child care or the simple acts of support from our friends and loved ones (a meal dropped off, a joke told during a phone call). It can be tempting, she said, to emphasize the actions of the individual — but it is much easier to be resilient when you are not struggling alone with the challenges you face.
At the individual level, she invokes the Stockdale Paradox. Named for Vice Adm. James B. Stockdale, a long-term prisoner of war in Vietnam, it holds that surviving adversity means combining both optimism, or faith, that you will prevail over adversity with a bald, even brutal view of your current reality. So we hope for an improved future, while being honest about where we find ourselves; one without the other only leads to disappointment or despair.
Dr. Hone also suggests that we ask ourselves a question with each decision we make: “Is this helping me or harming me?” That third glass of wine: Does it help or harm? How about continuing to scroll through the news and social media? Going for a walk? The question is a simple framework within which to take better care of ourselves.
Small changes in our mind-sets and our choices can add up to increased resilience. “There’s nothing magical about this work,” Dr. Reivich said. “It’s hard work.”
The good news: Some of that work is instinctual. After the worst of my car accidents, when a U-Haul truck veered across the yellow line and into my lane, I found myself alone in a rural motel room. I had narrowly avoided a catastrophic head-on collision, veering onto the shoulder just in time for my Jeep to receive a full sideswipe instead. Still shaky, and covered with a fine dusting of windshield glass and small cuts, I called first one of my parents, then the other, from the room’s old landline phone. As soon as I did, I felt better.
Years before I had thought about how to cultivate my resilience, I already knew, on some deeper level, how to feel safe again. We all contain the potential to take care of ourselves and the people around us. In all the uncertainty of this frightening time, that is something to hold on to.
Eva Holland is the author of “Nerve: Adventures in the Science of Fear.”