Dennis Charney: Resilience Lessons from Our Veterans
Dr. Southwick and I, Steve Southwick, my co-author, we're psychiatrists, and we over many years, over about three decades working together, have been trying to understand what causes serious forms of depression, both biologically and psychologically, serious forms of post-traumatic stress disorder and other anxiety disorders, developing new treatments.
At one point, about 15 years ago, we decided to study resilience. This is the ability of individuals who, despite having been seriously traumatized in their life—whether it was combat, rape, physical abuse, or facing a serious illness—were able to rise above it. They could bounce back; in other words, be resilient. We thought if we could understand resilience, we could help our patients discover new treatments and help people in general because everybody, at some point in their life, faces tough challenges.
So, we started, 15 years ago, to identify people that we thought were resilient. We interviewed 30 or more prisoners of war from Vietnam. The reason for that is that we had found out that the POWs from Vietnam, who had been held for six to eight years in prison, heavily tortured in solitary confinement for years, many of them had done well when they got out. The most famous example is John McCain.
Through that process, over many years, we started hearing the same thing over and over again about what enabled people to get through tough times. That ultimately led to this book that discusses ten ways, ten factors that relate to resilience. We also became convinced that you can essentially train yourself to be a more resilient person, and we hope the book enables you to come up with some ideas to do that.
One of the ten factors is optimism—having a positive attitude. We found, and research in general has found, that optimism, in part, is genetic. I'm sure many of you know people that just seem to see the glass half full. They have the confidence that they think they can get through tough times. They're optimistic. So, genetics is part of it, but genes are not destiny, and in some cases, you can help people become more optimistic.
In fact, there is a form of therapy for depression and anxiety problems called Cognitive Behavioral Therapy, and that can enable you to become a more positive person. Now, the kind of optimism that is important is not Pollyanna optimism, optimism that doesn't fully take into account the challenge that you face. There is a term called the Stockdale Paradox. Jim Stockdale was a heroic POW, and the Stockdale Paradox really defines the optimism that is most important in becoming a resilient person.
That is, when you're faced with a challenge or a trauma, you look at that challenge objectively. You might make the assessment, “I'm in really big trouble.” You have a realistic assessment of what you're facing. On the other hand, you have the attitude and the confidence to say, "But I will prevail. I'm in a tough spot, but I will prevail." That is the optimism that relates to resilience.
Having strong social support is a very important ingredient toward becoming resilient, and one of the analogies that we use relates to the POWs that we studied. The POWs from Vietnam had developed a tap code that enabled them to communicate through the wall to an individual, another POW, in the cell next to them. They weren't allowed to talk, but they developed a tap code.
The tap code involved tapping on the wall and it involved five letters in five rows. If you tapped once, that meant row one, and then three times would be the third letter in that row. So the first row was A, B, C, D, E. They tapped once, row one, three times, and it's letter C; they developed that kind of tap code. They told me that if they didn't have a tap code to communicate with somebody they couldn't even see for years, they wouldn't have been able to get through that experience and stay sane.
They developed friendships for life through the tap code from one cell to another. So our analogy is: everybody needs a tap code. Everybody needs a set of individuals in their life that they can count on, that they can share their feelings with, that they can ask for advice in terms of facing a trauma. Social support is very important. Very few people can go through it alone. So, search with your friends and your family members to develop a network of friends that you can really communicate with.