Terri A Lewis, PHD

Terri A Lewis, PHD

According to Merriam-Webster’s online dictionary, the definition of ‘resilience’ is (1) the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress or alternatively (2) an ability to recover from or adjust easily to misfortune or change.  Applied literally to persons who live with conditions of chronic pain, they will tell you that there is no snapping back and no recovery in sight.  A ‘happy face’ is not an indicator of well-being nor is the ‘absence of a happy face’ an indicator of failure to cope.

In the field of behavioral health (often overlooked as a treatment resource), ‘resilience’ tends to be defined as a set of attributes that help people to navigate through the choppy waters of poor health and to re-orient their personal resources to focus on the coping with pain and illness as a specific problem rather than dwelling on their personal limitations or equating the problem of chronic illness as a personal failure.  These attributes tend to allow people feel like they have more control over their daily lives and to -

  • form realistic and attainable goals, even if they are small.
  • Properly identify the nature or root cause of the problems they are experiencing.
  • attack the identified problem with persistence and education rather than faulting their own limitations.
  • be responsive and thoughtful rather than impulsive.
  • effectively communicate with others about the nature of the problem.
  • learn from past experience and adapt different strategies.
  • see your health problems from the perspectives of others.
  • care about the feelings and welfare of others who are important to your coping.
  • separate the health problem from the person.
  • maintain positive self regard and self image.
  • understand that personal actions are directly related to feelings of self control over one’s decisions and choices.
  • Recover an optimistic stance after periods of pessimism or loss of control.

Clearly, not everyone has mastered these attributes, and even the most well adjusted among us have extended periods of time when one’s stance has shifted to depression, anxiety, and loss of hope in the face of prolonged coping with chronic pain.

If you didn’t have a well developed resilient outlook before the onset of chronic illness, it may be a challenge to acquire this orientation after chronic pain develops, especially in the early stages of understanding, acceptance, and adaptation.  But it is possible. Resilience is a set of learned behaviors that promote the personal actions that help one to gain mastery over the demands of coping with chronic pain and illness.  This is an excellent focus for health counseling or support from friends and family.

The acquisition of these personal behaviors are important for you and for your care partners.  Like the development of a daily habit, acting to  develop changed cognitions about your role in managing illness allows one a strategy for coping that persists long after those without these skills have become so demoralized that they have given up.

One cannot change what happened, but you can change how you respond to what happened.  Reframing your personal cognitions allows you to lead your decisions and redirect personal outcomes. It allows your care partners to support and advocate for your explicit wishes.  Acquiring some or all of these skills, and practicing them with your support team,  puts you on the path that allows you to control the direction of treatment, and the meaning of your illness, instead of the illness controlling you.

Authored by: Terri A Lewis, PhD.

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Anna Raymann

Great article!
Thank you.

Sheri Kay

Short and to the point comment by Dr Ibsen. Just extremely curious as to some stats on these successful results! Surely not mod to severe chronic pain sufferers with RSD/CRPS, multiple severe spinal issues, neurological issues, etc. just seems like 50% is high. Yes, very successful for sure. But wonder what exactly that data is based on. So many factors to be looked at for sure! Hmmmm…

Mark Ibsen MD

Thank you Dr Lewis, for that practical summary of resilience, or
The ingredients of well being.
These conversations were entwined in every interaction in our highly successful “demonstration project”
In Helena.
We were able to focus on resiliency
And functionality as well as Integrity, as in workability. And we got over 50 % of our patients off opiates.
And 100% were heard, acknowledged and validated.
This is such a rich field of inquiry: transformation, recovery and empowerment is a place to come from, a declaration/intention.
Having a great coach can make all the difference.
Thank you for your contribution.