Before March 2009, many Americans had never heard of the Red River of the North, the twisting ribbon of blue that separates North Dakota from Minnesota. It took a disaster to make the Red famous: in the final days of that month, the river rose to a level of over 40 feet, causing a flood of historic proportions in the twin cities of Fargo, North Dakota and Moorhead, Minnesota.

Yet, as Dr. Katherine O’Neill of North Dakota State University points out, “The people of the area displayed incredible resilience in the face of this natural disaster. The communities rallied to quickly build numerous sandbag dikes to protect homes and buildings along miles of river banks. People pulled together, offering support and instrumental assistance to one another for many weeks until flood waters finally receded. Disaster relief officials from out of the area marveled at the extent to which the process of ‘neighbors helping neighbors’ allowed residents of these cities to maintain determination, confidence and hope while fighting the flood.”

The citizens’ reaction to the emergency in Fargo and Moorhead is a perfect illustration of how to build resilience—an example for us all. As explained by Dennis P. Hopkins, MBA, Psy.D., executive director of the Iroquois Mental Health Center in Watseka, Illinois, “Resilience is a dynamic process of how one adapts when confronted with an irregular situation. Responses to adversity, such as loss from tragedy, shock and other reactions to trauma, various perceptions of threats, and reactions to stress are all situations that call upon personal resiliency. How one adapts and deals with the significance of risk, and if one adapts positively or negatively, are measures.”

Tools for Recovery

The effects of traumatic events are generally scaled to how closely they impact an individual’s space. “The invasion of personal space, reducing your physical integrity, such as a sexual assault, defending yourself against a death threat, or causing harm to someone else are the most immediate threats, and more likely to evoke post traumatic stress disorder (PTSD),” says Dr. Aaron M. Jacoby, coordinator for Trauma Recovery at Veterans Affairs (VA) Maryland Health Care System. “The more distant you are from knowing the individual or handling the trauma, the quicker your recovery generally is.”.

Recognizing the effects of trauma and the resiliency tools available is critical to promote successful coping and natural recovery. An understanding of how adults and children learn resilience differently is also key. Dan Ranieri, Ph.D., president/chief executive officer of La Frontera Arizona, Inc., in Tucson explains, “Adults have a lifetime of experience to help build their resilience, whereas children do not. Adults react to negative experiences primarily based on their previous life experiences. Children do not have these experiences to draw upon, and therefore they rely on adults for guidance. Children can learn to become more resilient by living vicariously through the experiences of the adults around them.”

“Natural recovery occurs for many people who are exposed to traumatic events. The resilience acronym FACTS established by the Red River Resilience group can be a very useful tool to help individuals increase their resiliency,” says Dr. O’Neill. The key components of resilience are:

Foster hope: focus on the positive, have confidence in yourself and put things in perspective.

Act with purpose: solve problems, move toward your goals, cope actively with distress.

Connect with others: share thoughts and feelings, give and receive help, spend time with others.

Take care of yourself: take care of your body, make time to relax, and nurture your spirituality.

Search for meaning: find positive meaning in your situations, learn about yourself, look for personal growth.

Therapeutic Strategies

When traumatic events are more severe, psychotherapy may be necessary to achieve a full recovery. Dr. Jacoby emphasizes the importance of participating in programs that demonstrate evidence-based practices. He describes two primary methods that Veterans Affairs Health Care supports: “Cognitive Processing Therapy (CPT) looks at a person’s thoughts associated with a trauma and at the associated patterns in thinking that are not helpful and that keep the cycle of negativity going. Through this therapy the patients are helped to migrate to alternate thoughts that are healthier. Prolonged Exposure Therapy (PE) is used to help persons who have developed a fear structure within their current environment, based on a past trauma. Generally they have an over-learned fear and avoidance of things that could cause them harm. By identifying the things that are causing their inability to function, through habituation, getting used to the situation, they can extinguish the fear.” These interventions can be delivered in both outpatient and residential settings.

The American Psychological Association (APA) also offers guidance for building resiliency. Dr. O’Neill provides the following examples for implementing the three suggestions presented by the APA:

1. Take decisive action in adverse situations: Applied to a natural disaster, this could involve taking steps to protect your property, evacuating to a place of safety, completing paperwork for financial assistance in a timely manner, etc.
2. Develop self-confidence for dealing with a stressful situation: This can result from remembering your past successes in overcoming adversity, noticing ways in which the situation is improving as a result of your efforts, and viewing the crisis as an opportunity to develop new skills and abilities.
3. Keeping a long-term perspective and considering the stressful event in a broader context: This could mean that you recognize that dealing with a disaster drains your emotional, physical, and financial resources, but that eventually you will recover and return to a “normal life”. Sometimes people need to find a “new normal”. There is often a tendency for us to focus on our losses, but we also need to remember that many important aspects of life remain unchanged, or even improve, as a result of a disaster.

The Flood Within

Resilience is a dynamic process that changes as an individual learns to use internal resources and a network of people in their community. Dr. Cheryl Gagne, research and training associate at the Center for Psychiatric Rehabilitation at Boston University, reports that the most popular coping strategies used by individuals in her program are based on relationships: “We teach the interpersonal skills needed to recruit other people into an individual’s life and how to reciprocate the support. Other popular coping strategies are mindfulness practices that assist a person to be in the moment. Ultimately, it is a personal responsibility for each individual to find the joy in their life and simple practices like reading a book, engaging in a favorite hobby, positive self-talk, participating in a spiritual practice or proactively managing health all build resilience.”

“Life is uncertain,” reminds Dr. O’Neill. “Despite our best attempts to create a happy and safe world for ourselves and our children, traumatic events do happen. Resilience is the ability to bounce back from crisis or adversity, and to adapt well to changes in your life. Everyone has the capacity for resilience, and you can learn to develop your resilience skills at any age.”.

A flood can strike at any time. Whether the waters are literal, like those sweeping over Minnesota and North Dakota in 2009, or figurative, like waves of stress rising in your mind, you can cope and recover by building your resilience.

About the author

Nikki Migas, managing director of the Behavioral Health and the Child and Youth Services customer service units of CARF International, has more than 35 years of experience developing and administering behavioral health and other human services programs. With additional material by Nathan Beck.

 

 

 

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