Human Resiliency

Alan L. Peterson, PhD, University of Texas Health Science Center at San Antonio, South Texas Veterans Health Care System, and University of Texas at San Antonio

AffiliationsUniversity of Texas Health Science Center at San Antonio

Professor and Chief, Division of Behavioral MedicineDepartment of Psychiatry, School of Medicine

Aaron and Bobbie Elliott Krus Endowed Chair in PsychiatryDirector, STRONG STAR Consortium

Director, Consortium to Alleviate PTSDAssociate Director of Research, Military Health Institute

South Texas Veterans Health Care SystemResearch Health Scientist

University of Texas at San AntonioProfessor, Department of Psychology

2

9-11-2001

Armed Forces Mortuary

Operation Enduring Freedom

Operation Iraqi Freedom

The Air Force Theater Hospital

Contingency Aeromedical Staging Facility

What is Resiliency?• We all know what it is• Not so easy to define• We all want it in:• Ourselves, our family members, our co-workers• Our military personnel, first responders• Our community, state, and national leaders

• How do you get it?• Are you born with it?• Do you learn it?• Can you train for it?• Can you bottle it?

What is Resiliency?• Ability to sustain physical and psychological

functioning despite extremely adverse conditions

• Ability to rebound or recover from injury or illness

• The “Blister-Callus Model of Resiliency” suggests increased resiliency results from repeated exposure and recovery from trauma or adversity

• Resiliency allows for the potential for “posttraumatic growth” after trauma exposure

Bonanno (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? Am Psychol. 2004 Jan;59(1):20-8.

Definitions of Resilience • Concept used in several disciplines • Examples of definitions:• “The power or ability to return to the original

form, position, etc., after being bent, compressed, or stretched; elasticity.” • “Resilience is the ability of individuals to survive

and thrive despite exposure to negative circumstances.”• “Preservation and/or recovery of premorbid

functioning after exposure to a physical and psychological trauma”

Dictionary.com; Miranda et al., 2011, RAND Report; for review, see McGeary, 2011

The Blister-Callus Model of Psychological

ResiliencyPeterson, Blount, & McGeary (2014). Stress and psychological resiliency. In C. M. Pariante & M. D. Lapiz Bluhm (Eds.), Current topics in behavioral neurosciences: Vol. 18. Behavioral neurobiology of stress-related disorders (pp. 297-312). Berlin & Heidelberg, Germany: Springer-Verlag. doi:10.1007/7854_2014_293.

The Blister-Callus Model

• Based on analogy of how skin calluses occur with sustained or repeated physical activity

• Skin calluses allow individuals to perform strenuous activities for long periods of time without physical damage or injury

• Blister-Callus Model posits that psychological resilience develops from repeated and gradually increasing periods of psychological and physical stress, followed by periods of recovery

Psychological Resiliency• Blister-Callus Model• Throughout life, psychological resilience

develops from repeated and gradually increasing periods of psychological and physical stress, followed by periods of recovery• Too little/too much can cause problems• Experiencing, adapting, and recovering from

psychological and physical stress is beneficial and enhances resiliency

Extreme Resiliency Training• What military groups are often thought to be

the most resilient?• Serve in the most extreme environments• Have most physically and psychologically

rigorous training programs• Have highest washout rate during initial

training?

Extreme Resiliency Training• Special Forces• Navy SEALS• Army Rangers/Berets/Delta Force• Marine RECON• Air Force Pararescue

Extreme Resiliency Training

• What can we learn about resiliency from Special Forces training?• Extreme physical and mental fitness

= extreme resiliency?

Personal Resilience Training• Army 10-miler, Joint Base Balad, Iraq, 2004• First ½ marathon (13.1 miles) 48 years old• First marathon 2006• 50K, 50 mile, 100K, 100 mile• Lean Horse 100-mile endurance run• Extreme physical and psychological exhaustion• Similar to fog of war• DNF at mile 76!• Pressing the reset button!

Summary• Blister-Callus Model of Psychological

Resiliency is simple model with direct military operational relevance• Military has always had outstanding

resiliency training programs• What have they called the resiliency

training program?

Summary• Blister-Callus Model of Psychological

Resiliency is simple model with direct military operational relevance• Military has always had outstanding

resiliency training programs• What have they called the resiliency training

program?•MILITARY TRAINING!