Book Nook - Resilience: The Science of Mastering Life's Greatest Challenges

In today's world, families are facing the rapid evolution of social media and AI, sociopolitical upheaval, record-breaking temperatures, fires and flooding, school shootings, new diseases.

To combat the pressures of this era, Dr. Dennis S. Charney and Dr. Jonathan M. DePierro—along with their late co-author Dr. Steven M. Southwick—have recently released a new edition of their landmark book RESILIENCE: THE SCIENCE OF MASTERING LIFE’S GREATEST CHALLENGES .

In this timely guide to mental fortitude and positivity (updated for a post-COVID world), they share the 10 factors that they've found contribute to individual resilience—as well as personal stories, the latest science, and practical suggestions for putting their findings into practice.

You can learn more in this interview.

You’ve both been at the forefront of research into resilience for years—and then the pandemic hit, and everyone in the world experienced trauma at once. Did the collective response to the pandemic unfold the way you expected? Did anything surprise you?

New York City–and the Mount Sinai Health System–was at the epicenter of the pandemic in those first few months of 2020. We knew from our experience working with responders to 9/11, that this work would take a toll on our healthcare workers. In fact, early on we saw that nearly 2 in 5 healthcare workers were experiencing stress-related symptoms. This was an even bigger impact than we saw after 9/11. At the same time, what we also saw was tremendous creativity, comradery, bravery, and a sense of mission and purpose. Many of our healthcare workers saw this pandemic as the moment they trained for, when they could be of help to people in their time of greatest need. 

How do you measure a person’s resiliency?

We think about resilience as what people do to help them adapt, grow, and recover from stressful situations. It’s important when we are measuring resilience that we look at someone who has been through or is currently facing a tough situation – we don’t know if someone is resilient unless they’ve faced something, unless they’ve been tested. In our work, we have used a lot of different questionnaires to look at resilience – asking about how much social support a person has, how optimistic they are, how they connect to faith and gratitude, and whether they are flexible in their thinking. Other researchers measure resilience simply as the absence of a mental health condition after a trauma, but we think that is far too limiting and doesn’t really account for what people do when they are struggling and how they recover. 

In RESILIENCE, you articulate 10 core principles that resilient people often share. Can these traits be learned or are they innate?

Our work, both in research studies and treating patients, has shown us that the 10 resilience factors can be learned. In our book, we discuss many different ways people can build their resilience, all of which are backed up by the latest science. Of course, we all know people who seem to be born optimists or have a natural capacity for facing fears, but our genes and early experiences are only part of the story. We know that the human brain is always making new connections and changes in response to new experiences, which we want to put out there as a hopeful message.

Dr. Charney: In 2016, you were shot by a former co-worker and seriously wounded. How did this incredibly traumatic experience square with your research? Did your research in the field help you recover? Did you glean new insights?

After I was shot, I had to ask myself – can I practice what I preach? Here I am, an expert in the science of resilience, wondering if I could be resilient and use what I had studied as I recovered. A few different things helped me, all of which were factors that we had written about before. First, physical fitness was a big part of my identity before I was shot; I took part in long kayaking competitions and tough hikes. That level of fitness helped in my recovery, and I started grueling physical therapy immediately. I also had a purpose – a mission in mind. Just two weeks after the shooting, I was set to give the “White Coat” speech as Dean of the Icahn School of Medicine at Mount Sinai. This is where our medical students don their coats for the first time, welcoming them into the practice of medicine– it’s an extraordinarily special occasion for us and for the students and their families. I decided to do whatever it took to be there, to stand up in person and give that speech, and I did.  Social support also helped tremendously – I am lucky to have a big network of colleagues, friends, and family who were there for me. The altruism and love of complete strangers really stood out to me, though. One local police officer, Officer Davenport, came to my hospital off duty to stand guard, and I remember him telling us that he wished he had been there to take the bullet for me.

The first edition of RESILIENCE came out around 10 years ago. This edition is full of new material about the pandemic and current events, your personal stories, and the latest science. What's the most important thing you’ve learned in the past decade? Do we know more about how the brain processes trauma now?

We certainly have seen an explosion of interest in resilience, particularly since the start of the pandemic. One thing this work has reinforced is the importance of social connection – time and time again, it’s proven to be one of the biggest resilience factors. We are social beings, and the more we give and get support in times of stress, the better off we are.  Conversely, if we are isolated and lonely, we don’t recover as easily from illnesses or stress, and it actually is an additional strain on our bodies. We are also beginning to learn more about the importance of faith, spirituality, and love in keeping us resilient. 

Over the past 10 years, we have also learned a lot about how the brain processes stressful experiences. One important lesson from this work is that memories of traumatic events are not set in stone. When people make a memory of a traumatic event, they store it in their brains together with the sights, sounds, emotions, and thoughts they were having at the time. We now know that when people talk about trauma with the support of a therapist or begin to think about the event from different perspectives, the memory changes. When we bring up a memory and talk about it, we can put it back in our brains a little differently – it does not have to be a tape that we play on a loop.  So, that’s a hopeful message too. People are not stuck with horrific memories of trauma – there is something they can do; they do not have to just rely on avoidance – not talking or thinking about it – because we know that that is almost never a good strategy in the long run.

One of the traits many resilient people share is the belief in a higher power or a sense of faith. Why is that, and what does that mean for non-believers?

We know from our work with religious communities that their faith plays a big part in their resilience. They use their faith to understand that things can get a little better, and often put that faith into practice by using it as motivation to take steps to change their situation or think more flexibly about it. For religious people, we call this “praying with your feet.” Faith becomes, for them, a fuel that pushes them through tough times. But what does this mean for non-religious folks? First, it’s important to know that religion and spirituality can mean different things. There are many people these days who say they are spiritual and feel connected to a sense of a higher power or something greater than themselves who do not practice a formal religion. You don’t have to be “religious” as in going to church or mosque or synagogue or engaging in daily prayer to have faith. Broadly speaking, people who are optimistic people have faith – a belief that tomorrow can be a little better and that it's within their power to make that happen.

ABOUT THE AUTHORS

Steven M. Southwick, Yale University Medical School, Connecticut

Steven Southwick, MD, was Glenn H. Greenberg Professor Emeritus of Psychiatry, PTSD, and Resilience at Yale University Medical School and Medical Director Emeritus of the Clinical Neuroscience Division of the National Center for PTSD of the US Department of Veterans Affairs. Dr. Southwick was one of the world's leading experts in psychological trauma and human resilience. His collaborations with Dr. Dennis Charney led to foundational discoveries about the biology and treatment of post-traumatic stress disorder, and factors that support resilience. His own resilience while fighting advanced prostate cancer for five years was an inspiration to his friends, colleagues, and family. He passed away on April 20, 2022, and this book, which he worked on through his final weeks, is dedicated to his life and legacy.

Dennis S. Charney, MD, is Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai and President for Academic Affairs for the Mount Sinai Health System. 

Dr. Charney is a world expert in the neurobiology of mood and anxiety disorders. He has made fundamental contributions to our understanding of the causes of anxiety, fear, and depression, and among his discoveries is use of ketamine for the treatment of depression – a major advance in the past fifty years of clinical care. He also focuses on understanding the psychology and biology of human resilience, which has included work with natural disaster survivors, combat veterans, and COVID-19 frontline healthcare workers. He has over 600 publications to his name, including books, chapters, and academic articles. In 2016 he was the victim of a violent crime that tested his personal resilience.

Jonathan M. DePierro, Icahn School of Medicine at Mount Sinai, New York

Jonathan M. DePierro, PhD, is Associate Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai and Associate Director of Mount Sinai's Center for Stress, Resilience, and Personal Growth. Dr. DePierro, a clinical psychologist, is an expert in psychological resilience and the treatment of trauma-related mental health conditions. After many years working with individuals impacted by the 9/11 terrorist attacks, he now focuses on supporting the mental health needs of healthcare workers. Having experienced extensive bullying throughout his childhood, he learned important lessons about resilience that continue to inform his clinical and research work.