Who
rallies and who succumbs to hardship is not easy to predict as shown in a
comparison of my years of experience with two patients whom I’ll refer to as Mr.
C and Ms. Z.
After
decades of working for a big corporation, Mr. C. witnessed flaws in the system
which he believed led to the death of a child. He tried to inform his superiors who ignored his concerns. He
became increasingly angry and feared he’d resort to revenge, buy a gun and shoot
his boss and co-workers.
Mr.
C. ‘s thoughts were disorganized at times and vaguely paranoid, focused on the
lack of caring of large businesses. According to the Diagnostic Statistical
Manual (of the American Psychiatric Association which links symptoms to
diagnostic categories) Mr. C. would be diagnosed as schizophrenic. I took his threats seriously and
testified in court, advising that he be excused from work.
Mr.
C. was willing to take medication and attend weekly psychotherapy sessions. He acknowledged
a problem with alcohol and began
to follow the AA program. He found wisdom in the Serenity prayer, ”God grant me
the serenity to accept the things I cannot change, courage to change the things
I can; and wisdom to know the difference.” He began to ask and distinguish what
he was able to change in his life, and what he had to accept as immutable.
For
several years, he ranted and raved about past and present events in regard to
recent struggles with the ‘indifferent’ corporation. I listened and realized he
did not want me to intervene as he ventilated.(The sessions were tough for me
because I had to be alert and silent).
Then
for no reason beyond the passage of time, his rage lessened and he allowed me
to comment. I supported his present goals, including taking better care of
himself, eating well, going to the gym and fixing up his home.
The
gym served the purpose of providing social life. He gravitated to people who
needed his advice, serving as a lay therapist as he shared what he’d learned
from his years of therapy.
By
contrast, Ms. Z, a highly intelligent woman with a Ph.D., was injured at work. In weekly sessions, she expressed
herself well and her thinking showed no disorder beyond a rigid defensiveness which
locked her into less than satisfying patterns of behavior. She held on to
super-high expectations of other people and wasn’t able to extricate herself
from a life long pattern of hoarding. She confessed to imbibing several
martinis a day but refused to consider that alcohol might contribute to her
problems. She preferred to remain isolated and alone, although she included me
in her short list of trustworthy doctors/people.
Mr.
C. recognized exercise helped him feel strong and positive and to let go of his
rage. The gym also provided social contact. He acknowledged that his life had
never been better. Ms. Z denied the needs of her body. She drank and remained
relatively sedentary.
I
can’t explain the outcomes of these two people on the basis of intelligence,
education, or diagnosis (or ability to form a working alliance with me). Perhaps
a major variable related to resilience is exercise.
Conclusion: To a degree, resilience remains a
riddle. We best keep an open
mind in predicting who will bounce back and adjust or even excel in the face of
adversity.
Our minds can lock us into a prison of
our own making. The mind/body/feeling (or spiritual) connection most likely
contributes to resilience and resiliency.
Dear
Reader, I invite you to share your thoughts, feelings and experiences. (jsimon145@gmail.com)
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