Sarah Currie is a management consultant in Ottawa, Ontario.
I learned a new term recently: semantic satiation. It’s the phenomenon whereby, through repetition, a word loses its meaning to the listener and simply becomes a sound. COVID-19 has probably led to several words achieving semantic satiation status. I think ‘resilience’ is one.
The last day I spent in person in the office was Friday the 13th of March 2020. I didn’t know when I left that evening that the following day we would get a call from my husband’s work to tell us that he’d been in close contact with someone who developed symptoms of and tested positive for COVID-19. We were told to isolate ourselves and our son for the next two weeks and, while we did, we watched the world grind to a near halt.
We survived those two weeks in isolation, and we’ve survived each week since. My makeshift workspace in the corner of our bedroom has become less makeshift by the day. Our kitchen table converted back and forth from family gathering point to classroom as schools opened and shut like a screen door banging in the wind. We celebrated birthdays and holidays outdoors in masks or over Zoom. We survived. We were resilient.
We have been hearing a lot about resilience these past 18 months. We need our kids to be resilient as they switch back and forth from in-person to online learning. We want our employees to be resilient as they juggle working and living from home. We hope our health care professionals can be resilient in the face of wave after wave of ICU-crushing pandemic.
The word resilience has started to lose its meaning for me. I am beginning to question whether any of us really understood it to begin with.
Among researchers who study resilience theory, the term has been defined as both an outcome (the result of experiencing of adversity) and a process (the process of adjusting well to adversity). However, when we consider resilience solely in either of those terms, we can fall victim to faulty thinking that places all accountability and responsibility for resilience in the hands of the individual, with little or no consideration for the mediating factors or supportive systems outside of the individual’s control. A perceived lack of resilience then becomes a character flaw, a performance goal that is not being met. Alternately, an apparent abundance of resilience — the employee who never says “no” or who asks “how high?” when called upon to jump — can be ripe for exploitation by poor or callous leaders. Resilience is not without its limits. No amount of positive thinking, mindfulness, or gratitude journaling will adequately replenish a person’s supply of resilience in a toxic environment. A seed may germinate in the absence of light, but it will only grow for as long as there is energy stored in the root. Resilience peters out when the challenge is unrelenting.
Our response to hardship cannot simply be repeating “resilience!” like a mantra; if we truly want people to be resilient, we must also find ways to remove barriers, lower obstacles, and respect limits and boundaries. Resilience cannot be maintained without respite.
Nurturing resilience is a wicked problem. To date, most of our attempts at solutions have focused on the individual. In being “coached for resilience” myself, solutions offered to me have included journaling, meditation, yoga, and various other forms of “self-care,” the implication being that finding the time and energy to do any of these things falls squarely within my internal locus of control. Like any other wicked problem we face as a population, however, there is no single key to building the resilience of individuals. We need to consider systemic changes that aspire toward building a more resilient society. What might those changes look like? Allowing people more paid time off and creating conditions that support them to take it, such as providing affordable child and elder care, and reframing how employers view their workforce — as capital worth investment, rather than resources to be consumed. No longer considering self-care (a concept steeped in privilege) a viable substitute for mental health care. Acknowledging that mental health services are medically necessary and should be included among the offerings of a publicly funded health service as primary care.
It is no coincidence that the components of the infrastructure needed to support resilience are also the characteristics shared by top-ranking nations in the World Happiness Report year after year. A comfortable standard of living, meaningful access to supportive social systems, good health, and faith in a government that places equal or higher emphasis on its denizens’ well-being as on its GDP go a long way in removing the stressors that sap our resilience daily.
We have defeated wicked public health problems before by investing in better systems: the London sewer network to eliminate cholera; pesticide and land management to eradicate malaria and yellow fever from North America. We can do it again. Individuals just can’t do it alone.
What a refreshing read, Sarah! I’d always thought resilience was in my wheelhouse only, that I alone was solely responsible for its maintenance and replenishment, but you’re right in that societal collective change is required to pave an individual’s journey to SUSTAINABLE resilience. Thanks for your thoughts.
I very much agree that systemic changes are required to support physician resilience. As our capability grows, so does patient complexity and expectations. There are more health care providers, increased use of technology and increasing use of management techniques that impact practice. There is frequent talk of health care transformation but, too often, it seems largely focused on physicians changing their practice. So much more is necessary. Ideally, our profession will increase our ability to use our substantial influence to help make the ‘system’ better for patients and more supportive for physicians, with other team members, to provide excellent care.
Well said. Problems with resilience have become a character flaw, like obesity.
You make some good points to ponder. Thanks.
Resilience reengineer ing diversity interesting words with lot of meaning for us to use or manipulate but in practice they are meant to use with certain sense of practicality snd wisdom.interesting to note that your office was open last in march 2020 that mean you must practicing virtual medicine. Not a good idea for elderly and children pregnant mothers.however no one can blame anyone based on this virus capability to infect us and the suffering etc. phone call discussions about your health is fine but it is subject to lot of misinformation if the individual on other side of the phone has sensory defect with his hearing or catching the words sentences interpreting in a wrong way.we are informed physicians offices will open direct contact with respective patients still we need to follow strict rule of wearing masks and safe distances till all of our populations reasonably vaccinated to higher percentage at present which most likely delivered to public appropriate specialities in the field not by politicians