Tag: Psychology

What is Flooding?

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Introduction

Flooding, in psychology terms, sometimes referred to as in vivo exposure therapy, is a form of behaviour therapy and desensitisation — or exposure therapy—based on the principles of respondent conditioning. As a psychotherapeutic technique, it is used to treat phobia and anxiety disorders including post-traumatic stress disorder (PTSD). It works by exposing the patient to their painful memories, with the goal of reintegrating their repressed emotions with their current awareness. Flooding was invented by psychologist Thomas Stampfl in 1967. It is still used in behaviour therapy today.

Refer to Immersion Therapy.

Outline

Flooding is a psychotherapeutic method for overcoming phobias. In order to demonstrate the irrationality of the fear, a psychologist would put a person in a situation where they would face their phobia. Under controlled conditions and using psychologically-proven relaxation techniques, the subject attempts to replace their fear with relaxation. The experience can often be traumatic for a person, but may be necessary if the phobia is causing them significant life disturbances. The advantage to flooding is that it is quick and usually effective. There is, however, a possibility that a fear may spontaneously recur. This can be made less likely with systematic desensitisation, another form of a classical condition procedure for the elimination of phobias.

How it Works

“Flooding” works on the principles of classical conditioning or respondent conditioning—a form of Pavlov’s classical conditioning—where patients change their behaviours to avoid negative stimuli. According to Pavlov, people can learn through associations, so if one has a phobia, it is because one associates the feared stimulus with a negative outcome.

Flooding uses a technique based on Pavlov’s classical conditioning that uses exposure. There are different forms of exposure, such as imaginal exposure, virtual reality exposure, and in vivo exposure. While systematic desensitisation may use these other types of exposure, flooding uses in vivo exposure, actual exposure to the feared stimulus. A patient is confronted with a situation in which the stimulus that provoked the original trauma is present. The psychologist there usually offers very little assistance or reassurance other than to help the patient to use relaxation techniques in order to calm themselves. Relaxation techniques such as progressive muscle relaxation are common in these kinds of classical conditioning procedures. The theory is that the adrenaline and fear response has a time limit, so a person should eventually have to calm down and realize that their phobia is unwarranted. Flooding can be done through the use of virtual reality and has been shown to be fairly effective in patients with flight phobia.

Psychiatrist Joseph Wolpe (1973) carried out an experiment which demonstrated flooding. He took a girl who was scared of cars, and drove her around for hours. Initially the girl was panicky but she eventually calmed down when she realized that her situation was safe. From then on she associated a sense of ease with cars. Psychologist Aletha Solter used flooding successfully with a 5-month-old infant who showed symptoms of post-traumatic stress following surgery.

Flooding therapy is not for every individual, and the therapist will discuss with the patient the levels of anxiety they are prepared to endure during the session. It may also be true that exposure is not for every therapist and therapists seem to shy away from use of the technique.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Flooding_(psychology) >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Positive Disintegration?

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Introduction

The theory of positive disintegration (TPD) is an idea of personality development developed by Polish psychologist Kazimierz Dąbrowski.

Unlike mainstream psychology, the theory views psychological tension and anxiety as necessary for personal growth. These “disintegrative” processes are “positive”, whereas people who fail to go through positive disintegration may stop at “primary integration”, possessing individuality but nevertheless lacking an autonomous personality and remaining impressionable. Entering into disintegration and subsequent higher processes of development occurs through developmental potential, including over-excitability and hypersensitivity.

Unlike other theories of development such as Erikson’s stages of psychosocial development, it is not assumed that even a majority of people progress through all levels. TPD is not a theory of stages, and levels do not correlate with age, nor do tension and anxiety correlate to maturity.

Origins

Dąbrowski’s worldview was likely influenced by his life experiences. As a teenager in World War I, he witnessed a major battle near his village. He walked among the bodies of the dead soldiers and later recalled that the looks on their faces were wildly different—some expressed fear, some horror, while some looked calm and peaceful.

During World War II, he was imprisoned by the Nazi police several times and his wife paid ransom for his release; when Stalin seized Poland, Dąbrowski and his wife were imprisoned for 18 months. Dąbrowski said he wrote his theory to encapsulate the lowest human behaviours he had observed during the war, as well as the highest acts of self-sacrifice. He said that no other psychological theory had captured this wide range of human behaviour. After his release, his behaviour was closely monitored by the Polish authorities until at least the early 60s. In 1965 he established a base in Edmonton, Alberta, and spent the rest of his life alternating between Canada and Poland.

Dąbrowski’s Theory

The development of the theory of positive disintegration began in Dąbrowski’s earliest Polish works, as reflected in his 1929 doctoral thesis. His first work in English also contained seeds of the theory. His next major English work was his 1964 book Positive Disintegration. He proposed that the key to mental growth was having strong “developmental potential”: a constellation of psychological factors often leading to the disintegration of existing psychological structures. These disintegrations allow the individual to voluntarily reorganize their priorities and values, leading to psychological growth.

Dąbrowski’s theory of personality development emphasizes several major features, including that having a unique personality is not a universal trait: it must be created and shaped by the individual to reflect their own unique character. Personality develops as a result of developmental potential (DP), including overexcitability and the autonomous (third) factor; not everyone displays sufficient DP to move through the process of mental growth via positive disintegration.

Dąbrowski used a multilevel approach to describe the continuum of developmental levels seen in the population. In his theory, developmental potential creates crises characterised by strong anxieties and depressions (which he called psychoneurosis) that precipitate disintegrations. For personality to develop, initial integrations based on instinct and socialisation must disintegrate through a process Dąbrowski called positive disintegration. He said that the development of a hierarchy of individual values and emotional reactions was a critical component in developing one’s personality and autonomy; thus, in contrast to most psychological theories, emotions play a major role.

Emotional reactions guide the individual in creating their individual “personality ideal”, an autonomous standard that acts as the goal of individual development. Individuals must examine their essence and develop their own unique personality ideal. Only then can they make existential choices that emphasize the aspects of self that are higher and “more myself”, and inhibit those aspects that are lower or “less myself”, based upon their ideal personality; thus shaping their personality and creating an authentic self based upon the fundamental essence of the individual. Critical components of individual development include: self-education, subject-object, personality ideal, self-perfection, and autopsychotherapy.

Factors in Personality Development

Dąbrowski observed that most people live their lives in a state of “primary or primitive integration” largely guided by biological impulses (“first factor”), by uncritical endorsement and adherence to social conventions (“second factor”), or by both at once. He called this initial integration Level I. Dąbrowski observed that at this level, there is no true individual expression of the autonomous human self; the individual has no autonomous personality, and rather, they exhibit Nietzsche’s idea of the herd personality. Individual expression at Level I is influenced and constrained by the first and second factors.

The first factor directs energy and talents toward self-serving goals that reflect the “lower instincts” and biological needs, as its primary focus is on survival and self-advancement. The second factor, the social environment (milieu) and peer pressure, constrains individual expression and creativity by encouraging mob mentality and discouraging individual thought and expression. The second factor externalises values and morals, thereby externalising conscience; social forces shape behaviour. Behaviour, talents and creativity are funnelled into forms that follow and support the existing social milieu. As conscience is derived from an external social context, so long as social standards are ethical, people influenced by the second factor will behave ethically. However, if a society becomes corrupt, people strongly influenced by the second factor will not dissent. Socialisation without individual examination leads to a rote and robotic existence (the “robopath” described by Ludwig von Bertalanffy). Individual reactions are not unique, as reactions are based on the social context. According to Dąbrowski, people primarily motivated by the second factor represent a significant majority of the general population.

Dąbrowski felt that society was largely influenced by these two factors and could be characterised as operating at Level I, where the external value system absolves the individual of actual responsibility. He also described groups of people who display a different developmental course—an individualised developmental pathway. Such people break away from an automatic, rote, socialised view of life (which Dąbrowski called negative adjustment) and move into, and through, a series of personal disintegrations. Dąbrowski saw these disintegrations as a key element in the overall developmental process. Crises challenge the status quo and cause people to review the self, their ideas, values, thoughts, ideals, etc.

If development continues, one goes on to develop an individualized, conscious and critically evaluated hierarchical value structure (called positive adjustment). This hierarchy of values acts as a benchmark by which all things are now seen, and behaviour is directed by these internal values, rather than by external social mores. At these higher levels, individual values characterize an eventual second integration reflecting individual autonomy and the arrival of the individual’s true personality; each person develops their own vision of how life ought to be and lives according to that vision. This is associated with strongly individualised approaches to problem solving and creativity. One’s talents and creativity are applied in the service of these higher individual values and visions of how life could, and should, be. The person expresses their “new” autonomous personality energetically through action, art, social change, and so on.

Development Potential

Advanced development is often seen in people who exhibit strong developmental potential. Developmental potential represents a constellation of features: it may be positive or negative, it may be strong or weak. If it is strong, the input of the environment is minimal. If it is weak, the environment will play a critical role. Many factors are incorporated into developmental potential but three major aspects are overexcitability, one’s specific abilities and talents, and a strong drive toward autonomous growth (a feature Dąbrowski called the “third factor”).

Overexcitability

The most evident aspect of developmental potential is overexcitability (OE), a heightened physiological experience of stimuli resulting from increased neuronal sensitivities. The greater the OE, the more intense the day-to-day experiences of life. Dąbrowski outlined five forms of OE: psychomotor, sensual, imaginational, intellectual, and emotional. These overexcitabilities, especially the last three, often cause a person to experience daily life more intensely and to feel the joys and sorrows of life more profoundly. Dąbrowski studied human exemplars and found that heightened overexcitability was a key part of their developmental and life experience. These people are steered and driven by their values and their experiences of emotional OE. Combined with imaginational and intellectual OE, these people have an intense and multilevel perception of the world.

Although based in the nervous system, overexcitabilities are expressed psychologically through the development of structures that reflect the emerging autonomous self. The most important of these are “dynamisms”—the biological or mental forces that control behaviour and development. As used by Dąbrowski, dynamisms are instincts, drives, and intellectual processes combined with emotions. With advanced development, dynamisms increasingly reflect movement toward personal autonomy.

Abilities and Talents

The second aspect of developmental potential—specific abilities, and talents—tends to conform to the developmental level. At lower levels people use talents to support egocentric goals or to climb the social and corporate ladders. At higher levels, specific talents and abilities become an important force as the person uses their hierarchy of values to express, and achieve, their vision of their ideal personality and their view of how the world should be.

The Third Factor

According to Dąbrowski, the third factor of developmental potential (DP) is a drive toward individual growth and autonomy. He saw this as a critical factor in applying one’s talents and creativity toward autonomous expression, and in providing motivation to strive for more and to try to imagine (and achieve) goals currently beyond one’s grasp. Dąbrowski was clear to differentiate this third factor from free will. He felt that free will did not go far enough in capturing the motivating aspects that he attributed to this third factor, for example, an individual can exercise free will and show little motivation to grow or change as an individual. The third factor specifically describes motivation—a motivation to become one’s own true self. This motivation is often so strong that a person can find that they must develop themself, despite putting themself in danger by doing so. This feeling of “I’ve gotta be me”, especially when it is “at any cost”, and is expressed as a strong motivator for self-growth, is beyond the usual conceptualisation free will.

Dąbrowski’s theory says that a person whose DP is high enough will generally undergo disintegration, despite any external social or family efforts to prevent it; whereas person whose DP is very low will generally not undergo disintegration (or positive personality growth) even in a conducive environment. Dąbrowski’s notion of overexcitability appears to have been developed independently of Elaine Aron’s highly sensitive person, as her approach is substantially different.

Developmental Obstacles

Dąbrowski called overexcitability “a tragic gift” to reflect that the road of the person with strong OE is not a smooth or easy one. Potentials to experience great highs are also potentials to experience great lows. Similarly, potentials to express great creativity come with the potential of experiencing a great deal of personal conflict and stress. This stress drives development and is a result of conflict—both socially and within oneself. Suicide is a significant risk in the acute phases of this stress, and the isolation often experienced at this stage may also heighten the risk of self-harm.

Dąbrowski advocated autopsychotherapy, educating the person about his theory and the disintegrative process to give them a context within which to understand their intense feelings and needs. Dąbrowski suggested giving people support in their efforts to develop and find their own self-expression. According to Dąbrowski, both children and adults with high DP (and OE) have to find and walk their own path, often at the expense of fitting in with their social peers and even with their families. At the core of autopsychotherapy is the awareness that no one can show anyone else the “right” path—everyone has to find their own path for themselves. Alluding to the knights on the Grail Quest, the Jungian analyst, Joseph Campbell allegedly said: “If a path exists in the forest, don’t follow it, for though it took someone else to the Grail, it will not take you there, because it is not your path.”

Levels

The first and fifth levels of Dąbrowski’s theory of Positive Disintegration are characterized by psychological integration, harmony, and little inner conflict. There is little internal conflict at Level I because at this level one can almost always justify their behaviour – it is either for their own good and is therefore “right”, or society endorses it and it is therefore “right”. In either case, the individual confidently acts as they think anyone else would and does what everyone is “supposed to do”. Dąbrowski compared this to Level V, where there is no internal conflict because what a person does is in harmony with their own internal sense of values. Regardless of internal conflict, external conflict can, and does, still occur.

Dąbrowski used Levels II, III, and IV to describe various degrees and types of disintegration. He was very clear that the levels he presents “represent a heuristic device”. Accordingly, in the process of developing the structures, two or even three contiguous levels may exist side by side, although they exist in conflict. The conflict is resolved when one of the structures is eliminated, or comes under complete control of another structure.

Level I: Primary Integration

The first level is called primitive or primary integration. People at this level are often influenced primarily by either the first factor (heredity/impulse), the second factor (social environment), or both. The majority of people at Level I are integrated at the environmental or social level (Dąbrowski called them average people). Dąbrowski distinguished the two subgroups of Level I by degree: “the state of primary integration is a state contrary to mental health. A fairly high degree of primary integration is present in the average person; a very high degree of primary integration is present in the psychopath.” Marked by selfishness and egocentrism (both covert and explicit), those at level one generally seek self-fulfilment above all else, justifying their pursuits through a sort of “it’s all about me” thinking. They adhere strongly to the phrase “the ends justifies the means”, and may disregard the severity of the “means”. Many people who are considered “leaders” fall into this category.

The vast majority of people do not break down their primitive integration at all, and those who do after a relatively short period of disintegration, usually during adolescence and early youth, either reintegrate at level one, or partially integrate of some of the functions of higher levels, but do not experience a transformation of their whole mental structure. Dąbrowski thought that primary integration in the average person could be of value as it is stable and predictable, and, when accompanied by kindness and good-will, could represent those who can provide support and stability to people experiencing disintegration.

Level II: Unilevel Disintegration

The prominent feature of this level is an initial, brief, and often intense crisis, or series of crises. Crises are spontaneous and occur on only one level—though they may appear to be different choices, they are ultimately on the same, horizontal, level.

Unilevel disintegration occurs during developmental crises such as puberty or menopause, in periods of difficulty handling an external stressful event, or under psychological conditions such as nervousness and psychoneurosis. Unilevel disintegration occurs on a single structural and emotional level; there is a prevalence of automatic dynamisms with only slight self-consciousness and self-control.

Horizontal conflicts produce ambitendencies and ambivalences: one is equally attracted by different but equivalent choices (ambitendencies) and is not able to decide what to do as they have no real preference between the choices (ambivalences). Ultimately, if developmental forces are strong enough, the person is thrust into an existential crisis as their social rationales no longer account for their experiences and there is no alternative explanation. During this phase, existential despair is the predominant emotion. The resolution of this phase begins as individually chosen values start to replace rote, ingrained, social mores and are integrated into a new hierarchy of personal values. These new values often conflict with the person’s previous social values. Many of the status quo explanations for the “way things are”, learned through education and society, collapse under this scrutiny. This causes additional conflicts focused on the person’s analysis of their reactions to the world at large and the behaviour of themself and others. Common behaviours, and the ethics of the prevailing social norm, come to be seen as inadequate, wrong or hypocritical; positive maladjustment prevails. For Dąbrowski, these crises represent a strong potential for development toward personal growth and mental health. Using a positive definition, mental health reflects more than social conformity: it involves a careful, personal examination of the world and of one’s values, leading to the development of an individual personality.

Level II is a transitional period. Dąbrowski said a person will either fall back (reintegration on a lower level), move ahead to Level III, or the crises will end negatively, in suicide or psychosis. The transition from Level II to Level III involves a fundamental shift that requires a phenomenal amount of energy. This period is the crossroads of development, from here one must either progress or regress. The struggle between Dąbrowski’s three factors reflects this transitional crisis: “Do I follow my instincts (first factor), my teachings (second factor) or my heart (third factor)?” The developmental answer is to transform one’s lower instincts (automatic reactions like anger) into positive motivation, to resist rote and social answers, and to listen to one’s inner sense of what one ought to do.

Level III: Spontaneous Multilevel Disintegration

Level III describes a new type of conflict—a vertical conflict between two alternatives that are not simply different, but that exist on different levels; one is genuinely higher and the other lower. These vertical conflicts initially arise from involuntary perceptions of higher versus lower choices in life. In the words of G.K. Chesterton: “You just look at something, maybe for the 1000th time, and it strikes you—you see this one thing differently and once you do, it changes things. You can no longer ‘go back and see it the way you did before.'” Dąbrowski called this vertical dimension multilevelness, and saw it as a gradual realization of the “possibility of the higher” (a phrase Dąbrowski used frequently), and of the contrasts between the higher and the lower in life. These vertical comparisons often contrast the lower, actual, behaviour of a person with the higher, imagined ideals, and to alternative idealised choices. Dąbrowski believed that the authentic individual would choose the higher path as the clear and obvious one to follow, erasing the ambivalences and ambitendencies of unilevel conflicts. If the person’s actual behaviour subsequently falls short of the ideal, internal disharmony and a drive to review and reconstruct one’s life will often follow. Multilevelness thus represents a new and powerful type of conflict that drives development.

Vertical conflicts are critical in leading to autonomy and advanced personality growth. If the person is to achieve higher levels, the shift to multilevelness must occur. If a person does not have the developmental potential to move into a multilevel view, then they will fall back from the crises of Level II to reintegrate at Level I. In the shift to multilevelness, the horizontal (unilevel) stimulus-response model of life is replaced by a vertical and hierarchical analysis. This vertical view becomes anchored by the individual’s emerging value structure, and all events are now seen in relation to their ideal values and how they want to live their life. As events in life are seen in relation to this multilevel, vertical view, it becomes impossible to support positions that favour a lower course of action when higher goals can be imagined and identified.

Level IV: Directed Multilevel Disintegration

In Level IV the person takes full control of their development. The involuntary spontaneous development of Level III is replaced by a deliberate, conscious, self-directed review of life from the multilevel perspective. This level marks the emergence of the third factor, described by Dąbrowski as an autonomous factor “of conscious choice (valuation) by which one affirms or rejects certain qualities in oneself and in one’s environment.” The person consciously reviews their existing belief system and tries to replace lower, automatic views and reactions with carefully thought out, examined and chosen ideals. These new values will increasingly be reflected in the person’s behaviour. Behaviour becomes less reactive, less automatic and more deliberate as choices increasingly fall under the influence of the person’s higher, chosen, ideals.

Social mores are reviewed and may be consciously re-accepted and internalised, or rejected and replaced by a self-determined alternative value system. One’s social views come to reflect a deep responsibility based on both intellectual and emotional factors. At the highest levels, “individuals of this kind feel responsible for the realization of justice and for the protection of others against harm and injustice. Their feelings of responsibility extend almost to everything.” This perspective results from seeing life in relation to one’s hierarchy of values (the multilevel view) and the subsequent appreciation of the potential of how life could, and ought to, be lived. Disagreements with a world operating at a lower level are expressed compassionately by doing what one can to help achieve the “ought”.

Given their genuine, authentic, prosocial outlook, people achieving higher developmental levels also raise the level of their society; prosocial, as used here, is not just support of the existing social order. If the social order is lower and you are adjusted to it, then you also reflect the lower (negative adjustment in Dąbrowski’s terms, a Level I feature). Here, prosocial means a genuine cultivation of social interactions based on higher values. These positions often conflict with the status quo of a lower society (positive maladjustment). In other words, to be maladjusted in a low-level society is a positive feature.

Level V: Secondary Integration

The fifth level displays an integrated and harmonious character, but one vastly different from that at the first level. At this highest level, one’s behaviour is guided by conscious, carefully weighed decisions based on an individualised and chosen hierarchy of personal values. Behaviour conforms to the person’s inner standard of how life ought to be lived, and thus little inner conflict arises.

Level V is often marked by creative expression. Especially at Level V, problem solving and art represent the highest and most noble features of human life. Art captures the innermost emotional states and is based on a deep empathy and understanding of the subject, often human suffering and sacrifice are the subjects of these works. Truly visionary works, works that are unique and novel, are created by people expressing a vision unrestrained by convention. Advances in society, through politics, philosophy and religion, are therefore commonly associated with strong individual creativity and personal accomplishments.

Applications in Therapy

The theory of positive disintegration has an extremely broad scope with many implications. One central application applies to psychological and psychiatric diagnosis and treatment. Dąbrowski advocated a comprehensive, multidimensional diagnosis of the person’s situation, symptoms and developmental potential. Accordingly, if the disintegration appears to fit into a developmental context, then the person is educated in the theory and encouraged to take a developmental view of their situation and experiences. Rather than being eliminated, symptoms are reframed to yield insight and understanding into life and the person’s unique situation.

The Importance of Narratives

Dąbrowski illustrated his theory through autobiographies of and biographies about those who have experienced positive disintegration. The gifted child, the suicidal teen, or the troubled artist is often experiencing the features of TPD, and if they accept and understand the meaning of their intense feelings and crises, they can move ahead, not fall apart. The completion of an extensive autobiography to help the individual gain perspective on their past and present is an important component in the autopsychotherapy process. In this process, the therapist plays a very small role and acts more as an initial stimulus than an ongoing therapist. Dąbrowski asked clients to read his books and to see how his ideas might relate to their lives.

Autopsychotherapy

For Dąbrowski, the goal of therapy is to eliminate the therapist by providing a context within which a person can understand and help themself – an approach to therapy that he called autopsychotherapy. The client is encouraged to embark on a journey of self-discovery, with an emphasis on looking for the contrast between what is higher versus what is lower within their personality and value structure. They are encouraged to further explore their value structure, especially as it relates to the rationale and justification of their positions; discrepancies between values and behaviour are highlighted. The approach is called autopsychotherapy to emphasize the important role that the individual must play in their own therapy process and in the larger process of personality development. The individual must come to see themselves as being in charge of determining or creating their own unique personality ideal and value structure. This includes a critical review of the social mores and values they have learned.

Dąbrowski was very concerned about what he called one-sided development, in which people display significant advanced development in only one aspect of life, usually intellectual. He believed that it is crucial to balance one’s development.

Overexcitability

In describing overexcitability (OE), Dąbrowski emphasized two main aspects: higher-than-average sensitivity, and higher-than-average responsiveness, of the nerves to stimuli. Dąbrowski explained, “The prefix ‘over’ attached to ‘excitability’ serves to indicate that the reactions of excitation are over and above average in intensity, duration and frequency.” If someone has strong OE, they will need less stimuli to cause a reaction and the reaction will be stronger than an individual who does not demonstrate overexcitability.

Dąbrowski reminded clients that without internal unease there is little stimulus for change or growth. Rather than trying to rapidly ameliorate symptoms, this approach encourages individuals to fully experience their feelings and to try to maintain a positive and developmental outlook regarding what they may perceive as strong depression or anxiety. An emphasis is placed on the client becoming aware that they can consciously control the direction of their life and apply what Dabrowski called autopsychotherapy.

Key Ideas

Dąbrowski based his theory on certain key ideas:

  • Lower animal instincts (first factor) must be inhibited and transformed into “higher” forces for people to be truly human as this ability to transform instincts is what separates people from other animals.
  • The common initial personality integration, based upon socialization (second factor), does not reflect true personality.
  • At the initial level of integration, there is little internal conflict as when one “goes along with the group”, there is little sense of individual wrongdoing. External conflicts often relate to the blockage of social goals—career frustrations for example. The social mores and values prevail with little question or conscious examination.
  • True personality must be based upon a system of values that are consciously and volitionally chosen by the person to reflect their own individual sense of “how life ought to be” and their “personality ideal” – the ideal person they feel they “ought to be”.
  • The lower animal instincts, the forces of peer groups, and socialisation are inferior to the autonomous self (personality) consciously constructed by the person.
  • To break down the initial integration, crises and disintegrations are needed, usually provided by life experience.
  • These disintegrations are positive if the person can achieve positive and developmental solutions to the situation.
  • “Unilevel crises” are not developmental as the person can only choose between equal alternatives, such as whether to go left or right.
  • A new type of perception involves “multilevelness”, a vertical view of life that compares lower versus higher alternatives and now allows the individual to choose a higher resolution to a crisis over other available, but lower, alternatives—the developmental solution.
  • “Positive disintegration” is a vital developmental process.
  • Developmental potential describes the forces needed to achieve autonomous personality development.
  • Developmental potential includes several factors including innate abilities and talents, “overexcitability” and the “third factor”.
  • Overexcitability is a measure of an individual’s nervous system’s level of response.
  • Overexcitability, or an overly sensitive nervous system, makes one prone to angst, depression and anxiety. Dąbrowski’s calls these psychoneuroses—a very positive and developmental feature.
  • The third factor is a measure of an individual’s drive toward autonomy.
  • When multilevel and autonomous development is achieved, a secondary integration is seen reflecting one’s mature personality. The individual has no inner conflict; they are in internal harmony as their actions reflect their deeply felt hierarchy of values.

Dąbrowski’s approach is of interest philosophically as it is Platonic, reflecting the bias of Plato toward seeing an individual’s essence as a critical determinant of their developmental course in life. However, Dąbrowski also added a major existential aspect as well, one that depends upon the anxieties a person feels and on how they resolve the day-to-day challenges they face. According to Dąbrowski’s theory, essence must be realised through an existential and experiential process of development. The characterisation advanced by Kierkegaard of “Knights of faith” may be compared to Dąbrowski’s autonomous individual.

Dąbrowski also reviewed the role of logic and reasoning in personal development and concluded that intellect alone does not fully help people know what to do in life. His theory incorporates Jean Piaget’s views of development into a broader scheme guided by emotion, as the emotions one feels about something are the more accurate guide to life’s major decisions.

Secondary Integration versus Self-Actualisation

People[example needed] have often equated Maslow’s concept of self-actualisation with Dąbrowski’s idea of secondary integration, despite there being some major differences between the two ideas. Dąbrowski, a personal friend and correspondent of Maslow, rejected Abraham Maslow’s description of self-actualisation. Actualisation of an undifferentiated self is not a developmental outcome in Dąbrowski’s theory, whereas Maslow described self-actualisation as a process where the self is accepted “as is”, with both higher and lower aspects of the self being actualised. For Maslow, self-actualisation involved “being all that one can be and accepting one’s deeper self in all its aspects”.

Dąbrowski instead applied a multilevel (vertical) approach to self. He spoke of the need to become aware of and inhibit and reject the lower instinctual aspects of the intrinsic human self, and to actively choose and assemble higher elements into a new unique self. Dąbrowski would have people differentiate the initial self into higher and lower aspects, and reject the lower and actualise the higher aspects to create their unique personality; Maslow would have people “embrace without guilt” all aspects.

Dąbrowski introduces the notion that although the lower aspects may initially be intrinsic to the self, people can develop a self-awareness of their lower nature and discover how they feel about these low levels. If they feel badly about behaving in these ways, they can cognitively and volitionally decide to inhibit and eliminate these behaviours; Dąbrowski called this personality shaping. In this way, the higher aspects of the self are actualised while the lower aspects are inhibited. For Dąbrowski, this inhibition is the unique aspect of humans sets people apart from other animals – no other animal is able to differentiate their lower instincts and inhibit their animalistic impulses, an idea also expressed in Plessner’s eccentricity.

Dąbrowski and the Gifted Individual

An appendix to Dąbrowski (1967) reports the results of investigations done in 1962 where “a group of [Polish] gifted children and young people aged 8 to 23” were examined.  Of the 80 youth studied, 30 were “intellectually gifted” and 50 were from “drama, ballet, and plastic art schools”. 

Dąbrowski found that every one of the children displayed overexcitability

Which constituted the foundation for the emergence of neurotic and psychoneurotic sets. Moreover it turned out that these children also showed sets of nervousness, neurosis, and psychoneurosis of various kinds and intensities, from light vegetative symptoms, or anxiety symptoms, to distinctly and highly intensive psychasthenic or hysterical sets.

Dąbrowski asked why these children would display such “states of nervousness or psychoneurosis” and suggested that it was due to the presence of OE. 

Probably the cause is more than average sensitivity which not only permits one to achieve outstanding results in learning and work, but at the same time increases the number of points sensitive to all experiences that may accelerate anomalous reactions revealing themselves in psychoneurotic sets.

The association between OE and giftedness has been the topic of extensive research done by Michael Piechowski and colleagues Lysy and Miller. It appears that intellectual OE is a marker of potential for giftedness/creativity, and that other types of OE may be as well. Dąbrowski’s thesis is that the gifted will disproportionately display this process of positive disintegration and personality growth.

Criticism

For the last 40 years, efforts to measure Dabrowskian constructs have been limited to looking at overexcitability. The most widely known instrument is the Overexcitability Questionnaire-Two.

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What is Flourishing?

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Introduction

Flourishing, or human flourishing, is the complete goodness of humans in a developmental life-span, that somehow includes positive psychological functioning and positive social functioning, along with other basic goods.

The term has gained more usage and interest in recent times, but is rooted in ancient philosophical and theological usages. Aristotle’s term eudaimonia is one source for understanding human flourishing. The Hebrew Scriptures, or the Old Testament, also speak of flourishing, as they compare the just person to a growing tree. Christian Scriptures, or the New Testament, build upon Jewish usage and speak of flourishing as it can exist in heaven. The medieval theologian Thomas Aquinas drew from Aristotle as well as the Bible, and utilised the notion of flourishing in his philosophical theology. More recently, the Positive Psychology of Martin Seligman, Corey Keyes, Barbara Fredrickson, and others, have expanded and developed the notion of human flourishing.

Empirical studies, such as those of the Harvard Human Flourishing Program, and practical applications, indicate the importance of the concept and the increasingly widespread use of the term in business, economics, and politics. In positive psychology, flourishing is “when people experience positive emotions, positive psychological functioning and positive social functioning, most of the time,” living “within an optimal range of human functioning.” It is a descriptor and measure of positive mental health and overall life well-being, and includes multiple components and concepts, such as cultivating strengths, subjective well-being, “goodness, generativity, growth, and resilience.” In this view, flourishing is the opposite of both pathology and languishing, which are described as living a life that feels hollow and empty.

Etymology and Definition

Although “flourishing” could refer to the general healthy state of a plant as it grows, properly speaking it is the stage in a vascular plant’s morphogenesis, specifically the stage of growth when it develops flowers.

Etymology

The English term “flourish” comes from the Latin florere, “to bloom, blossom, flower,” from the Latin flos, “a flower.” To contrast the term with a plant’s lack of full development, “flourish” came to indicate growth or development with vigour. Around 1597, the term came to include the notion of prosperity, insofar as a to bear flowers is an indication of the fullness of life and productivity.

Definitions

As an obvious consequence of the widespread use of the term “flourishing” in different fields and by different authors, there is not a general consensus about a definition of flourishing.

For instance, there is also a lot of debate about the mutual relations between flourishing and some related concepts, as the Aristotelian concept of eudaimonia, and the concepts of happiness and well-being. According to a Neo-Aristotelian view, the concept of human flourishing offers an explanation of the human good that is objective, inclusive, individualized, agent-relative, self-directed and social. It views human flourishing objectively because it is desirable and appealing. Flourishing is a state of being rather than a feeling or experience. It comes from engaging in activities that both express and produce the actualization of one’s potential.

According to some voices in Positive Psychology, flourishing is a “descriptor of positive mental health.” According to Fredrickson and Losada, flourishing is living:”

…within an optimal range of human functioning, one that connotes goodness, generativity, growth, and resilience.”

According to the Mental Health Foundation of New Zealand (Fredrickson & Lahoda, 2005), flourishing:”

…is a state where people experience positive emotions, positive psychological functioning and positive social functioning, most of the time. In more philosophical terms this means access to the pleasant life, the engaged or good life and the meaningful life […] It requires the development of attributes and social and personal levels that exhibit character strengths and virtues that are commonly agreed across different cultures (Seligman, Steen, Park and Peterson, 2005). On the other hand languishing includes states of experience where people describe their lives as “hollow” or “empty”.“

According to Keyes, mental health does not imply an absence of mental illness. Rather, mental health is a “separate dimension of positive feelings and functioning.” Individuals described as flourishing have a combination of high levels of emotional well-being, psychological well-being, and social well-being. Flourishing people are happy and satisfied; they tend to see their lives as having a purpose; they feel some degree of mastery and accept all parts of themselves; they have a sense of personal growth in the sense that they are always growing, evolving, and changing; finally, they have a sense of autonomy and an internal locus of control, they chose their fate in life instead of being victims of fate.

Psychologist Martin Seligman, one of the founding fathers of happiness research, wrote in his book, Flourish, a new model for happiness and well-being based on positive psychology. This book expounds on simple exercises that anyone can do to create a happier life and to flourish. Flourish, is a tool to understand happiness by emphasizing how the five pillars of Positive Psychology, also known as PERMA, increase the quality of life for people who apply it to their lives.

According to Fredrickson and Losada (2005), flourishing is characterised by four main components: goodness, generative, growth, and resilience.

According to Keyes, only 18.1% of Americans are actually flourishing. The majority of Americans can be classified as mentally unhealthy (depressed) or not mentally healthy or flourishing (moderately mentally healthy/languishing).

Tyler J. VanderWeele, a prominent epidemiologist and expert in biostatistics who has extensively studied human flourishing, has proposed the following, quite different, definition:

Flourishing itself might be understood as a state in which all aspects of a person’s life are good. We might also refer to such a state as complete human well-being, which is again arguably a broader concept than psychological well-being. Conceptions of what constitutes flourishing will be numerous and views on the concept will differ. However, I would argue that, regardless of the particulars of different understandings, most would concur that flourishing, however conceived, would, at the very least, require doing or being well in the following five broad domains of human life: (i) happiness and life satisfaction; (ii) health, both mental and physical; (iii) meaning and purpose; (iv) character and virtue; and (v) close social relationships. All are arguably at least a part of what we mean by flourishing. […]If, however, we think about flourishing not only as a momentary state but also as something that is sustained over time, then one might also argue that a state of flourishing should be such that resources, financial and otherwise, are sufficiently stable so that what is going well in each of these five domains is likely to continue into the future for some time to come.[…] I would in no way claim that these domains above entirely characterize flourishing. […] I would only argue here that, whatever else flourishing might consist in, these five domains above would also be included, and thus these five domains above may provide some common ground for discussion.

Summary

To summarise the definitions above: Human flourishing is the ongoing fulfilment of human capacities within given contexts by advancing one’s own good and the common good.

In order to better understand this synthesis, one has to keep in mind that, in the view of Aristotle and Thomas Aquinas, a capacity of a being is a potential stemming from its nature to perform certain kinds of activities, or to undergo certain kinds of changes in accordance with its inner dynamism. For instance, the capacity to bear fruit or the capacity to grow are within a tree’s natural potential. On the other hand, the common good is some good—whether material or non-material—that has four characteristics: it is specific, in the sense that it is not general good-in-itself; it is objective, that is, it exists outside of the individual and is independent from the existence of any particular person; it is collective, for it exists only within some community; it is shareable, that is, many people can participate, enjoy, or use it simultaneously.

Aristotle and Flourishing

Aristotle and Biology

The Greek philosopher, Aristotle, contributed greatly to a deeper understanding of flourishing as a model for human life. Better-known for his work in metaphysics and logic, he was nevertheless a biologist first and foremost. His understanding of the development of flora and fauna, seen especially in his work Generation of Animals, provided a scientific background for recognising a similar development in the human being.

Eudaimonia

Aristotle’s term for the optimal state of the human being is eudaimonia (Greek: εὐδαίμονία). He gives various definitions and descriptions of eudaimonia, in the Nicomachean Ethics, the Eudemian Ethics, and in his Politics, among which:

  • “The active exercise of his soul’s faculties in conformity with excellence or virtue, or if there be several human excellences or virtues, in conformity with the best and most perfect among them. Moreover this activity must occupy a complete lifetime; for one swallow does not make spring, nor does one fine day; and similarly one day or a brief period of happiness does not make a man supremely blessed and happy.”
  • “Happiness therefore is co-extensive in its range with contemplation: the more a class of beings possesses the faculty of contemplation, the more it enjoys happiness, not as an accidental concomitant of contemplation but as inherent in it, since contemplation is valuable in itself. It follows that happiness is some form of contemplation.”
  • “So, as the function of the soul and of its excellence must be one and the same, the function of its excellence is a good life. This, then, is the final good, that we agreed to be happiness. It is evident from our assumptions (happiness was assumed to be the best thing, and ends-the best among goods-are in the soul; but things in the soul are states or activities), since the activity is better than the disposition, and the best activity is of the best state, and virtue is the best state, that the activity of the virtue of the soul must be the best thing. But happiness too was said to be the best thing: so happiness is the activity of a good soul. Now as happiness was agreed to be something complete, and life may be complete or incomplete-and this holds with excellence also (in the one case it is total, in the other partial)-and the activity of what is incomplete is itself incomplete, happiness must be activity of a complete life in accordance with complete virtue.”
  • “Happiness is the complete activity and employment of virtue, and this not conditionally but absolutely. When I say ‘conditionally’ I refer to things necessary, by ‘absolutely’ I mean ‘nobly: for instance, to take the case of just actions, just acts of vengeance and of punishment spring it is true from virtue, but are necessary, and have the quality of nobility only in a limited manner (since it would be preferable that neither individual nor state should have any need of such things), whereas actions aiming at honours and resources are the noblest actions absolutely; for the former class of acts consist in the removal of something evil, but actions of the latter kind are the opposite – they are the foundation and the generation of things good.”

Sometimes eudaimonia is translated as “happiness”; other times, as “welfare” or “well-being,” showing that no translation is fully adequate to capture its meaning in Greek.

Philosopher Joe Sachs emphasizes the importance of the activity of eudaimonia, a “being-at-work” of the human soul. This indicates that “flourishing” can adequately translate eudaimonia, insofar as the term signifies the dynamism of the principle of life and growth within a human.

Positive Psychology and Flourishing

Brief History

“Flourishing” as a psychological concept has been developed by Corey Keyes and Barbara Fredrickson.

Keyes collaborated with Carol Ryff in testing her Six-factor Model of Psychological Well-being, and in 2002 published his theoretical considerations in an article on The Mental Health Continuum: From Languishing to Flourishing. qualified by Fredrickson as “path-breaking work that measures mental health in positive terms rather than by the absence of mental illness.”

Barbara Fredrickson developed the broaden-and-build theory of positive emotions. According to Fredrickson there is a wide variety of positive effects that positive emotions and experiences have on human lives. Fredrickson notes two characteristics of positive emotions that differ from negative emotions:

  1. Positive emotions do not seem to elicit specific action tendencies the same way that negative emotions do. Instead, they seem to cause some general, non-direction oriented activation.
  2. Positive emotions do not necessarily facilitate physical action, but do spark significant cognitive action. For this reason, Fredrickson conceptualises two new concepts: thought-action tendencies, or what a person normally does in a particular situation, and thought-action repertoires, rather an inventory of skills of what a person is able to do.

Previous theories of emotion stated that all emotions are associated with urges to act in particular ways, called action-tendencies. According to Fredrickson, most positive emotions do not follow this model of action-tendencies, since they do not usually occur in life-threatening circumstances and thus do not generally elicit specific urges. Fredrickson proposes that instead of one general theory of emotions, psychologists should develop theories for each emotion or for subsets of emotions.

The broaden-and-build theory of positive emotions proposed by Fredrickson states that while negative emotions narrow thought-action tendencies to time tested strategies as handed down by evolution, positive emotions broaden thought-action repertoires. Positive emotions often cause people to discard time-tested or automatic action tendencies and pursue novel, creative, and often unscripted courses of thought and action. These positive emotions and thought-action repertoires can be seen as applicable to the concept of flourishing because flourishing children and adults have a much wider array of cognitive, physical, and social possibilities, which results in the empirical and actual successes of a flourishing life.

The concept has also been used by Martin E.P. Seligman, the founder of positive psychology, in his 2011 publication Flourish. Seligman, usually considered the father of positive psychology, characterizes human flourishing as excellence in 5 fields: positive emotion, engagement, relationships, meaning, and achievement. Consequently, his model of human flourishing is usually called the PERMA model. He claims also that health is an essential element of flourishing, but he presents a quite vast notion of health, including biological assets (e.g. the hormone oxytocin, longer DNA telomeres), subjective assets (e.g. optimism, vitality), and functional assets (good marriage, rich friendships, engaging work). Although Seligman’s PERMA model is certainly useful for psychological studies on flourishing, it doesn’t capture the essence of human flourishing, since it may allow us to consider as flourishing evidently evil people, as brutal dictators, if they test good in these five fields. To avoid this misunderstanding of human flourishing, Seligman himself, and also other thinkers as Christopher Peterson, have also discussed what they call “character strengths” or “virtues.”. Seligman gives the following definition of flourishing:

To flourish is to find fulfilment in our lives, accomplishing meaningful and worthwhile tasks, and connecting with others at a deeper level—in essence, living the “good life”.

Measurement and Diagnostic Criteria

With the concept of flourishing, psychologists can study and measure fulfilment, purpose, meaning, and happiness. Flourishing can be measured through self-report measures. Individuals are asked to respond to structured scales measuring the presence of positive affect, absence of negative affect, and perceived satisfaction with life. Participants are specifically asked about their emotions and feelings because scientists theorize that flourishing is something that manifests itself internally rather than externally.

Keyes has operationalized symptoms of positive feelings and positive functioning in life by reviewing dimensions and scales of subjective well-being and, therefore, creating a definition of flourishing. To complete, or “operationalize”, the definition of what it means to be functioning optimally, or flourishing, diagnostic criteria have been developed for a flourishing life:

  1. Individual must have had no episodes of major depression in the past year
  2. Individual must possess a high level of well-being as indicated by the individuals meeting all three of the following criteria
    • High emotional well-being, defined by 2 of 3 scale scores on appropriate measures falling in the upper tertile.
      • Positive affect
      • Negative affect (low)
      • Life satisfaction
    • High psychological well-being, defined by 4 of 6 scale scores on appropriate measures falling in the upper tertile.
      • Self-acceptance
      • Personal growth
      • Purpose in life
      • Environmental mastery
      • Autonomy
      • Positive relations with others
    • High social well-being, defined by 3 of 5 scale scores on appropriate measures falling in the upper tertile.
      • Social acceptance
      • Social actualisation
      • Social contribution
      • Social coherence
      • Social integration

Major Empirical Findings

Positive emotional feelings such as moods, and sentiments such as happiness, carry more personal and psychological benefits than just a pleasant, personal subjective experience. Flourishing widens attention, broaden behavioural repertoires, which means to broaden one’s skills or regularly performed actions, increase intuition, and increase creativity. Secondly, good feelings can have physiological manifestations, such as significant and positive cardiovascular effects, such as a reduction in blood pressure. Third, good feelings predict healthy mental and physical outcomes. Also, positive affect and flourishing is related to longevity. In a 2022 study of intrusive thoughts and flourishing, Jesse Omoregie and Jerome Carson found that people who experience flourishing would usually experience minimal intrusive thoughts. Omoregie and Carson further concluded that flourishing is a variable that helps in the reduction of psychological problems such as anxiety, depression, and intrusive thoughts.

The many components of flourishing elicit more tangible outcomes than simply mental or physiological results. For example, components such as self-efficacy, likability, and prosocial behaviour encourage active involvement with goal pursuits and with the environment. This promotes people to pursue and approach new and different situations. Therefore, flourishing adults have higher levels of motivation to work actively to pursue new goals and are in possession of more past skills and resources. This helps people to satisfy life and societal goals, such as creating opportunities, performing well in the workplace, and producing goods, work and careers that are highly valued in American society. Authors, Robert Kegan and Lisa Laskow Lahey, in their book, An Everyone Culture, “argues that organizations do best when they build an environment that encourages constant personal development among their employees.” This success results in higher satisfaction and reinforces Frederickson’s Broaden and Build model, for more positive adults reap more benefits and, are more positive, which creates an upward spiral.

Studies have shown that people who are flourishing are more likely to graduate from college, secure “better” jobs, and are more likely to succeed in that job. One reason for this success can be seen in the evidence offered above when discussing languishing: those that flourish have less work absenteeism, cited by Lyubomirsky as “job withdrawal.” Finally, those that are flourishing have more support and assistance from co-workers and supervisors in their workplace.

Flourishing has been found to impact more areas than simply the workplace. In particular community involvement and social relationships have been cited as something that flourishing influences directly. For example, those that flourish have been found to volunteer at higher levels across cultures. Moreover, in terms of social support and relationships, studies have shown that there is an association between flourishing and actual number of friends, overall social support, and perceived companionship.

Applications

The definition or conceptualisation of mental health under the framework of flourishing and languishing describes symptoms that can cooperate with intervention techniques aimed at increasing levels of emotional, social, and psychological well-being. Furthermore, as Keyes implies, in a world full of flourishing people, all would be able to reap the benefits that this positive mental state and life condition offers.

Education

Keyes mentions children as well as adults. He says that children are directly affected by maternal depression, and points out that the flourishing or languishing of teachers and the effect on students have not been studied. Keyes also speculates that teacher retention may be associated with the students’ frames of mind. Furthermore, if students can be made to flourish, the benefits to the education process are greater, as flourishing can increase attention and thought-action repertoires.

Engagement

Flourishing also has many applications to civic duty and social engagement. Keyes believes that most people do not focus enough on those aspects of life and focus instead on personal achievement. Keyes suggests that people should provide encouragement to children, and adults, to participate socially. People that exhibit flourishing are engaged in social participation and people that are engaged in social participation exhibit flourishing. Therefore, he suggests that people should give their kids a purpose, which creates a sense of contribution and environmental mastery that enhances feelings of well-being and fulfilment.

Criticisms

This psychological concept of flourishing is built on Fredrickson’s broaden-and-build theory of positive emotions, but some researchers have suggested that there are other functions of positive emotions. Mackie and Worth propose that positive emotions diminish cognitive capabilities. They showed that when exposed to a persuasive message for a limited amount of time, subjects experiencing a positive mood showed reduced processing as compared with subjects in a neutral mood. Others have suggested that positive emotions diminish the motivation but not the capacity for cognitive processing. Flourishing is still a newly developing subject of study and, more tests need to be done to fully define, operationalise, and apply the concept of flourishing; this lack of research is also one criticism of the concept of flourishing.

Contemporary Flourishing Research

Global Flourishing Study

It is a longitudinal study about human flourishing, involving data collection of individuals of 22 countries all around the world. It is carried out by scholars at the Human Flourishing Program at Harvard and Baylor’s Institute for Studies of Religion, in partnership with Gallup and the Centre for Open Science. Its preparation began in 2018 and its first data are expected by the summer of 2023.

Johns Hopkins: Paul McHugh Programme for Human Flourishing

This programme based at Johns Hopkins University, founded in 2015, and directed by Margaret S. Chisolm, aims at bringing the results of interdisciplinary research on health and human flourishing to an audience of both clinicians and clinicians-in-training.

Harvard Human Flourishing Programme

This programme was founded in 2016 at Harvard’s Institute for Quantitative Social Science and directed by Tyler J. VanderWeele. Its aim is to study and promote human flourishing.

University of Pennsylvania: Positive Psychology Centre and Flourishing and Humanities Project

This interdisciplinary research project, based at the University of Pennsylvania’s Positive Psychology Centre, directed by James Pawelski and founded in 2014, studies the relations of the arts and humanities with human flourishing.

Humanity 2.0

The Humanity 2.0 Foundation mission is to identify impediments to human flourishing and then work collaboratively across sectors to remove them by sourcing and scaling bold and innovative solutions. To support this mission, the Humanity 2.0 Institute integrates global research on key questions: What is human flourishing? What are the pathways to achieve human flourishing? What obstacles block these pathways? What are practical solutions to remove these obstacles? Research partners include the Human Flourishing Programme at Harvard University, the Pontifical Gregorian University and the University of Pennsylvania Positive Psychology Centre and Flourishing Humanities Project.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Flourishing >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Distress Tolerance?

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Introduction

Distress tolerance is an emerging construct in psychology that has been conceptualised in several different ways.

Broadly, it refers to an individual’s “perceived capacity to withstand negative emotional and/or other aversive states (e.g. physical discomfort), and the behavioral act of withstanding distressing internal states elicited by some type of stressor.” Some definitions of distress tolerance have also specified that the endurance of these negative events occur in contexts in which methods to escape the distressor exist.

Measurement

In the literature, differences in conceptualisations of distress tolerance have corresponded with two methods of assessing this construct.

As self-report inventories fundamentally assess an individual’s perception and reflection of constructs related to the self, self-report measures of distress tolerance (i.e. questionnaires) specifically focus on the perceived ability to endure distressful states, broadly defined. Some questionnaires focus specifically on emotional distress tolerance (e.g. the distress tolerance scale), others on distress tolerance of negative physical states (e.g. discomfort intolerance scale), and yet others focus specifically on tolerance of frustration as an overarching process of distress tolerance (e.g. frustration-discomfort scale).

In contrast, studies that incorporate behavioural or biobehavioural assessments of distress tolerance provide information about real behaviour rather than individuals’ perceptions. Examples of stress-inducing tasks include those that require the individual to persist in tracing a computerised mirror under timed conditions (i.e. computerised mirror tracing persistence task) or complete a series of time-sensitive math problems for which incorrect answers produce an aversive noise (i.e. computerised paced auditory serial addition task). Some behavioural tasks are conceptualised to assess physical distress tolerance, and require individuals to hold their breath for as long as possible (breath holding task).

As this is a nascent field of research, the relationships between perceptual and behavioural assessments of distress tolerance have not been clearly elucidated. Disentangling distinct components of emotional/psychological distress tolerance and physical distress tolerance within behavioural tasks also remains a challenge in the literature.

Theoretical Structures

Several models about the structural hierarchy of distress tolerance have been proposed. Some work suggests that physical and psychological tolerance are distinct constructs. Specifically, sensitivity to feelings of anxiety and tolerance of negative emotional states may be related to each other as aspects of a larger construct representing sensitivity and tolerance of affect broadly; discomfort surrounding physical stressors, however, was found to be an entirely separate construct not associated with sensitivity to emotional states. Notably, this preliminary work was conducted with self-report measures and findings are cross-sectional in nature. The authors advise that additional longitudinal work is necessary to corroborate these relationships and elucidate directions of causality.

Recent work expands on the distinctness of emotional and physical distress tolerance to a higher-order construct of global experiential distress tolerance. This framework draws upon tolerance constructs that have been historically studied as distinct from distress tolerance. The five following constructs are framed as lower-order factors for the global distress tolerance construct, and include:

  • Tolerance of uncertainty, or “the tendency to react emotionally, cognitively, or behaviourally to uncertain situations”
  • Tolerance of ambiguity, or “the perceived tolerance of complicated, foreign, and/or vague situations of stimuli”
  • Tolerance of frustration, or “the perceived capacity to withstand aggravation (e.g. thwarted life goals)”
  • Tolerance of negative emotional states, or “the perceived capacity to withstand internal distress”
  • Tolerance of physical sensations, or “the perceived capacity to withstand uncomfortable physical sensations”

Within models that solely conceptualise distress tolerance as the ability to endure negative emotional states, distress tolerance is hypothesized to be multidimensional. This includes individual processes related to the anticipation of and experience with negative emotions, such as perceived and actual ability to tolerate the negative emotion, the appraisal of a given situation as acceptable or not, the degree to which an individual can regulate his/her emotion in the midst of a negative emotional experience, and amount of attention dedicated to processing the negative emotion.

Biological Bases

There are several candidate biological neural network mechanisms for distress tolerance. These proposed brain areas are based on the conceptualization of distress tolerance as a function of reward learning. Within this framework, individuals learn to attune to and pursue reward; reduction of tension in escaping from a stressor is similarly framed as a reward and thus can be learned. Individuals differ in how quickly and for how long they display preferences for pursuing reward or in the case of distress tolerance, escaping from a distressful stimulus. Therefore, brain regions that are activated during reward processing and learning are hypothesized to also serve as neurobiological substrates for distress tolerance. For instance, activation intensity of dopamine neurons projecting to the nucleus accumbens, ventral striatum, and prefrontal cortex is associated with an individual’s predicted value of an immediate reward during a learning task. As the firing rate for these neurons increases, individuals predict high values of an immediate reward. During instances in which the predicted value is correct, the basal rate of neuronal firing remains the same. When the predicted reward value is below the actual value, neuronal firing rates increase when the reward is received, resulting in a learned response. When the expected reward value is below the actual value, the firing rate of these neurons decreases below baseline levels, resulting in a learned shift that reduces expectancies about reward value. It is posited that these same dopaminergic firing rates are associated with distress tolerance, in that learning the value of escaping a distressing stimulus is analogous to an estimation of an immediate reward There are several potential clinical implications if these posited distress tolerance substrates are corroborated. It may suggest that distress tolerance is malleable among individuals; interventions that change neuronal firing rates may shift predicted values of behaviours intended to escape a distressor and provide relief, thereby increasing distress tolerance.

Other neural areas may be implicated in moderating this reward learning process. Excitability of inhibitory medium spiny neurons in the nucleus accumbens and ventral striatum have been found to moderate the association between the value of an immediate reward and probability of pursuing reward or relief. Within rats, it has been demonstrated that increasing the excitability of these neurons via increased CREB expression resulted in an increased amount of time that the rats would keep their tail still when a noxious thermal paste was applied, as well as an increased amount of time spent in the open arms of a complex maze; these behaviours have been conceptualised as analogous distress tolerance in response to pain and anxiety.

Associations with Psychopathology

Distress tolerance is an emerging research topic in clinical psychology because it has been posited to contribute to the development and maintenance of several types of mental disorders, including mood and anxiety disorders such as major depressive disorder and generalised anxiety disorder, substance use and addiction, and personality disorders. In general, research on distress tolerance have found associations with these disorders that are tied closely to specific conceptualisations of distress tolerance. For instance, Borderline Personality Disorder is posited to be maintained through a chronic unwillingness to engage in or tolerate emotionally distressful states. Similarly, susceptibility to developing anxiety disorders is often characterised by low emotional distress tolerance. Low distress tolerance of both physical and emotional states is perceived to be a risk factor in maintaining and escalating addiction. Distress tolerance is particularly important in neurobiological theories that posit that advanced stages of addiction are driven by use of a substance to avoid physical and psychological withdrawal symptoms.

As a result of this interest in distress tolerance and its relationship with clinical psychopathology, several psychosocial treatments have been developed to improve distress tolerance among populations that are traditionally resistant to treatment. Many of these interventions (e.g. acceptance-based emotion regulation therapy) aims to boost distress tolerance by increasing the willingness to engage with emotion and meta-skills of acceptance of emotional conflict. Other behavioural interventions include components of building distress tolerance for various treatment targets, including acceptance and commitment therapy (ACT), dialectical behaviour therapy (DBT), functional analytic psychotherapy, integrative behavioural couples therapy, and mindfulness-based cognitive therapy. Multiple studies suggest that such distress tolerance interventions may be effective in treating generalised anxiety disorder, depression, and borderline personality disorder.

Therapy Approaches to Improving Distress Tolerance

DBT and ACT are therapy approaches which include specific focus on distress tolerance.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Distress_tolerance >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

An Overview of Environmental Psychology

Published on by Andrew Marshall3 Comments

Introduction

Environmental psychology is a branch of psychology that explores the relationship between humans and the external world.

It examines the way in which the natural environment and our built environments shape us as individuals. Environmental Psychology emphasizes how humans change the environment and how the environment changes humans’ experiences and behaviours. The field defines the term environment broadly, encompassing natural environments, social settings, built environments, learning environments, and informational environments. According to an article on APA Psychnet, environmental psychology is when a person thinks of a plan, travels to a certain place, and follows through with the plan throughout their behaviour.

Environmental psychology was not fully recognised as its own field until the late 1960s when scientists began to question the tie between human behaviour and our natural and built environments. Since its conception, the field has been committed to the development of a discipline that is both value oriented and problem oriented, prioritising research aimed at solving complex environmental problems in the pursuit of individual well-being within a larger society. When solving problems involving human-environment interactions, whether global or local, one must have a model of human nature that predicts the environmental conditions under which humans will respond well. This model can help design, manage, protect and/or restore environments that enhance reasonable behaviour, predict the likely outcomes when these conditions are not met, and diagnose problem situations. The field develops such a model of human nature while retaining a broad and inherently multidisciplinary focus. It explores such dissimilar issues as common property resource management, wayfinding in complex settings, the effect of environmental stress on human performance, the characteristics of restorative environments, human information processing, and the promotion of durable conservation behaviour. Lately, alongside the increased focus on climate change in society and the social sciences and the re-emergence of limits-to-growth concerns, there has been an increased focus on environmental sustainability issues within the field.

This multidisciplinary paradigm has not only characterised the dynamic for which environmental psychology is expected to develop, but it has also been the catalyst in attracting other schools of knowledge in its pursuit, aside from research psychologists. Geographers, economists, landscape architects, policy-makers, sociologists, anthropologists, educators, and product developers all have discovered and participated in this field.

Although “environmental psychology” is arguably the best-known and most comprehensive description of the field, it is also known as human factors science, cognitive ergonomics, ecological psychology, ecopsychology, environment–behaviour studies, and person–environment studies. Closely related fields include architectural psychology, socio-architecture, behavioural geography, environmental sociology, social ecology, and environmental design research.

Refer to Mental Environment.

Brief History

The origins of the field can be traced to the Romantic poets, such as Wordsworth and Coleridge who drew attention to the power of nature and the significance of human interaction with it. Darwin pointed to the role of the environment in shaping evolution. This idea was quickly applied to human interactions with the surroundings. An extreme Victorian acceptance of this were ‘environmental determinists’ who insisted the physical environment and climate influenced the evolution of racial characteristics. Willy Hellpach is said to be the first to mention “environmental psychology”. One of his books, Geopsyche, discusses topics such as how the sun and the moon affect human activity, the impact of extreme environments, and the effects of color and form (Pol, E., 2006, Blueprints for a history of environmental psychology (I): From first birth to American transition. “Medio Ambiente y Comportamiento Humano”, 7(2), 95-113). Among the other major scholars at the roots of environmental psychology were Jakob von Uexküll, Kurt Lewin, Egon Brunswik, and later Gerhard Kaminski and Carl Friedrich Graumann.

The end of World War II brought about a demand for guidance on the urgent building programme after the destruction of war. To provide government planning requirements many countries set up research centres that studied how people used space. In the UK the Building Research Centre studied space use in houses and later noise levels, heating and lighting requirements. The glass maker Pilkingtons set up a daylight research unit, led by Thomas Markus to provide information on the influence of natural lighting in buildings and guidelines on daylight requirements. Peter Manning developed this further at the Pilkington Research Unit at the University of Liverpool in the 1960s. He studied offices, employing one of the first people to obtain a Ph.D. in environmental psychology, Brian Wells. Markus went on to set up the Building Performance Research Unit at the University of Strathclyde in 1968 employing the psychologist David Canter who had been supervised by Wells and Manning for his Ph.D. with the Pilkington Research Unit. Canter then went on to the University of Surrey to set up Environmental Psychology programme there in 1971 with the Department of Psychology. The head of that Department was Terence Lee who had conducted his Ph.D. on the concept of neighbourhood under the supervision of Sir Frederick Bartlett at the University of Cambridge.

In parallel with these developments people in the US had begun to consider the issues in environmental design. One of the first areas was the consideration of psychiatric hospitals. Psychiatrists worked with architects to take account of the experience of patients who were mentally ill. Robert Sommer wrote his book on ‘Personal Space’ and Edward T Hall commented as an anthropologist on how people related to each other spatially. Amos Rapoport caused considerable interest amongst architects with his book ‘House Form and Culture’, showing that the form of buildings was not solely functional but had all sorts of cultural influences. This contributed to the emergence in architecture of ‘post-modernism’ which took the symbolic qualities of architecture very seriously. These early developments in the 1960s and 1970s were often seen as part of ‘architectural psychology’. It was when Harold Proshansky and William Ittelson set up the Environmental Psychology program at the City University of New York Graduate Center that the term Environmental Psychology replaces Architectural Psychology as the widely used term for the study of the ways in which people made sense of and interacted with their surroundings. This was institutionalised when Canter established The Journal of Environmental Psychology in 1980 with Kenneth Craik a personality psychologist at the University of California at Berkeley. President Nixon’s campaign to deal with depredations of the environment gave impetus to a change of direction in the field from aspects of buildings and making sense of cities to the broader issues of climate change and the impact of people in the global environment.

Environmental Psychologist

Environmental psychologists are the ones who study the relationship between human behaviour and the environment that surrounds them. These psychologist study any type of environment, even the ones who are “built” such as peoples homes. They study how we as humans behave and interact in the world. As of May of 2020, the annual salary of an environmental psychologist is $82,180. The two sub-disciplines:

  • Conservation Psychology which is the study of the development of attitudes in the environment; and
  • Ecopsychology which is similar to conservation psychology, but it focuses on the ties of environmental and societal degradation.

Orientations

Problem Oriented

Environmental psychology is a direct study of the relationship between an environment and how that environment affects its inhabitants. Specific aspects of this field work by identifying a problem and through the identification of the said problem, discovering a solution. Therefore, it is necessary for environmental psychology to be problem-oriented.

One important aspect of a problem-oriented field is that by identifying problems, solutions arise from the research acquired. The solutions can aid in making society function better as a whole and create a wealth of knowledge about the inner workings of societies. Environmental psychologist Harold Proshansky discusses how the field is also “value-oriented” because of the field’s commitment to bettering society through problem identification. Panyang discusses the importance of not only understanding the problem but also the necessity of a solution. Proshansky also points out some of the problems of a problem-oriented approach for environmental psychology. First, the problems being identified must be studied under certain specifications: they must be ongoing and occurring in real life, not in a laboratory. Second, the notions about the problems must derive directly from the source – meaning they must come directly from the specific environment where the problem is occurring. The solutions and understanding of the problems cannot come from an environment that has been constructed and modelled to look like real life. Environmental psychology needs to reflect the actual society, not a society built in a laboratory setting. The difficult task of the environmental psychologist is to study problems as they are occurring in everyday life. It is hard to reject all laboratory research because laboratory experiments are where theories may be tested without damaging the actual environment or can serve as models when testing solutions. Proshansky makes this point as well, discussing the difficulty in the overall problem oriented approach. He states that it is important, however, for the environmental psychologist to utilise all aspects of research and analysis of the findings and to take into account both the general and individualized aspects of the problems.

Environmental psychology addresses environmental problems such as density and crowding, noise pollution, sub-standard living, and urban decay. Noise increases environmental stress. Although it has been found that control and predictability are the greatest factors in stressful effects of noise; context, pitch, source and habituation are also important variables. Environmental psychologists have theorised that density and crowding can also have an adverse effect on mood and may cause stress-related illness or behaviour. To understand and solve environmental problems, environmental psychologists believe concepts and principles should come directly from the physical settings and problems being looked at. For example, factors that reduce feelings of crowding within buildings include:

  • Windows – particularly ones that can be opened and ones that provide a view as well as light
  • High ceilings
  • Doors to divide spaces (Baum and Davies) and provide access control
  • Room shape – square rooms feel less crowded than rectangular ones (Dresor)
  • Using partitions to create smaller, personalized spaces within an open plan office or larger work space.
  • Providing increases in cognitive control over aspects of the internal environment, such as ventilation, light, privacy, etc.
  • Conducting a cognitive appraisal of an environment and feelings of crowding in different settings. For example, one might be comfortable with crowding at a concert but not in school corridors.
  • Creating a defensible space (Calhoun)

Personal Space and Territory

Proxemics is known as the study of human space. It also studies the effects that population has on human behaviour, communication, and social interaction. Having an area of personal territory in a public space, e.g. at the office, is a key feature of many architectural designs. Having such a ‘defensible space’ can reduce the negative effects of crowding in urban environments. The term, coined by John B. Calhoun in 1947, is the result of multiple environmental experiments conducted on rats. Originally beginning as an experiment to measure how many rats could be accommodated in a given space, it expanded into determining how rats, given the proper food, shelter and bedding would behave under a confined environment.

Under these circumstances, the males became aggressive, some exclusively homosexual. Others became pansexual and hypersexual, seeking every chance to mount any rat they encountered. As a result, mating behaviours were upset with an increase in infant mortalities. With parents failing to provide proper nests, thoughtlessly ditching their young and even attacking them, infant mortality rose as high as 96% in certain sections. Calhoun published the results as “Population Density and Social Pathology” in a 1962 edition of Scientific American.

Creating barriers and customising the space are ways of creating personal space, e.g., using pictures of one’s family in an office setting. This increases cognitive control as one sees oneself as having control over the competitors to the personal space and therefore able to control the level of density and crowding in the space. Personal space can be both good and bad. It is good when it is used as stated above. Creating “personal space” in an office or work setting can make one feel more comfortable about being at work. Personal space can be bad when someone is in your personal space. In the image to the right, one person is mad at the other person because she is invading her personal space by laying on her.

Systems Oriented

The systems-oriented approach to experimenting is applied to individuals or people that are a part of communities, groups, and organisations. These communities, groups, and organisations are systems in homeostasis. Homeostasis is known as the “state of steady conditions within a system.” This approach particularly examines group interaction, as opposed to an individual’s interaction and it emphasizes on factors of social integration. In the laboratory, experiments focus on cause and effect processes within human nature.

Interdisciplinary Oriented

Environmental psychology relies on interaction with other disciplines in order to approach problems with multiple perspectives. The first discipline is the category of behavioural sciences, which include: sociology, political science, anthropology, and economics. Environmental psychology also interacts with the inter-specialisations of the field of psychology, which include:

  • Developmental psychology;
  • Cognitive science;
  • Industrial and organisational psychology; psychobiology;
  • Psychoanalysis; and
  • Social neuroscience.

In addition to the more scientific fields of study, environmental psychology also works with the design field which includes: the studies of architecture, interior design, urban planning, industrial and object design, landscape architecture, and preservation.

Space-Over-Time Orientation

Space over time orientation highlights the importance of the past. Examining problems with the past in mind creates a better understanding of how past forces, such as social, political, and economic forces, may be of relevance to present and future problems. Time and place are also important to consider. It’s important to look at time over extended periods. Physical settings change over time; they change with respect to physical properties and they change because individuals using the space change over time. Looking at these spaces over time will help monitor the changes and possibly predict future problems.

Concepts

Nature Restoration

Environmental health shows the effects people have on the environment as well as the effects the environment has on people. From early studies showing that patients with a view of nature from their hospital recovered faster than patients with a window view of a brick wall, how, why, and to which extent nature has mental and physical restorative properties has been a central branch of the field. Although the positive effects of nature have been established, the theoretical underpinning of why it is restorative is still discussed. The most cited theory is the Attention Restoration Theory, which claims nature is a “soft fascination” which restores the ability to direct attention. It is said that being in nature can reduce stress. Studies show that it can reduce anger, improve mood, and even lower one’s blood pressure. Secondly, Stress reduction theory claims that because humans have evolved in nature, this type of environment is relaxing, and more adjusted to the senses. Newer theoretical work includes the Conditioned Restoration Theory, which suggests a two-step process. The first step involves associating nature with relaxation, and the second step involves retrieving the same relaxation when presented with an associated stimulus.

Place Identity

For many years Harold Proshansky and his colleagues at the Graduate School and University Centre of the City University of New York, explored the concept of place identity. Place identity has been traditionally defined as a ‘sub-structure of the self-identity of the person consisting of broadly conceived cognitions about the physical world in which the individual lives’. These cognitions define the daily experiences of every human being. Through one’s attitudes, feelings, ideas, memories, personal values and preferences toward the range and type of physical settings, they can then understand the environment they live in and their overall experience.

As a person interacts with various places and spaces, they are able to evaluate which properties in different environments fulfil his/her various needs. When a place contains components that satisfy a person biologically, socially, psychologically and/or culturally, it creates the environmental past of a person. Through ‘good’ or ‘bad’ experiences with a place, a person is then able to reflect and define their personal values, attitudes, feelings and beliefs about the physical world.

Place identity has been described as the individual’s incorporation of place into the larger concept of self; a “potpourri of memories, conceptions, interpretations, ideas, and related feelings about specific physical settings, as well as types of settings”. Other theorists have been instrumental in the creation of the idea of place identity. Three humanistic geographers, Tuan (1980), Relph (1976) and Buttimer (1980), share a couple of basic assumptions. As a person lives and creates memories within a place, attachment is built and it is through one’s personal connection to a place, that they gain a sense of belonging and purpose, which then gives significance and meaning to their life.

Five central functions of place-identity have been depicted: recognition, meaning, expressive-requirement, mediating change, and anxiety and defence function. Place identity becomes a cognitive “database” against which every physical setting is experienced. The activities of a person often overlap with physical settings, which then create a background for the rest of life’s interactions and events. The individual is frequently unaware of the array of feelings, values or memories of a singular place and simply becomes more comfortable or uncomfortable with certain broad kinds of physical settings, or prefers specific spaces to others. In the time since the term “place identity” was introduced, the theory has been the model for identity that has dominated environmental psychology.

Place Attachment

According to the book, “Place Attachment”, place attachment is a “complex phenomenon that incorporates people-place bonding”. Many different perceptions of the bond between people and places have been hypothesized and studied. The most widespread terms include place attachment and sense of place. One consistent thread woven throughout most recent research on place attachment deals with the importance of the amount of time spent at a certain place (the length of association with a place). While both researchers and writers have made the case that time and experience in a place are important for deepening the meanings and emotional ties central to the person-place relationship, little in-depth research has studied these factors and their role in forging this connection.

Place attachment is defined as one’s emotional or affective ties to a place, and is generally thought to be the result of a long-term connection with a certain environment. This is different from a simple aesthetic response such as saying a certain place is special because it is beautiful. For example, one can have an emotional response to a beautiful (or ugly) landscape or place, but this response may sometimes be shallow and fleeting. This distinction is one that Schroeder labelled “meaning versus preference”. According to Schroeder the definition of “meaning” is “the thoughts, feelings, memories and interpretations evoked by a landscape”; whereas “preference” is “the degree of liking for one landscape compared to another”. For a deeper and lasting emotional attachment to develop (Or in Schroeder’s terms, for it to have meaning) an enduring relationship with a place is usually a critical factor. Chigbu carried out a rural study of place-attachment using a qualitative approach to check its impact on a community, Uturu (in Nigeria), and found that it has a direct relationship to the level of community development.

Environmental Consciousness

Leanne Rivlin theorised that one way to examine an individual’s environmental consciousness is to recognise how the physical place is significant, and look at the people/place relationship.

Environmental cognition (involved in human cognition) plays a crucial role in environmental perception. All different areas of the brain engage with environmentally relevant information. Some believe that the orbitofrontal cortex integrates environmentally relevant information from many distributed areas of the brain. Due to its anterior location within the frontal cortex, the orbitofrontal cortex may make judgments about the environment, and refine the organism’s “understanding” through error analysis, and other processes specific to the prefrontal cortex. But to be certain, there is no single brain area dedicated to the organism’s interactions with its environment. Rather, all brain areas are dedicated to this task. One area (probably the orbitofrontal cortex) may collate the various pieces of the informational puzzle in order to develop a long term strategy of engagement with the ever-changing “environment”. Moreover, the orbitofrontal cortex may show the greatest change in blood oxygenation (BOLD level) when an organism thinks of the broad, and amorphous category referred to as “the environment”. Research in this area is showing an increase in climate change related emotional experiences that are seen to be inherently adaptive. Engagement with these emotional experiences leads to a greater sense of connection with others and increased capacity to tolerate and reflect on emotions.

Because of the recent concern with the environment, environmental consciousness or awareness has come to be related to the growth and development of understanding and consciousness toward the biophysical environment and its problems.

Behaviour Settings

The earliest noteworthy discoveries in the field of environmental psychology can be dated back to Roger Barker who created the field of ecological psychology. Founding his research station in Oskaloosa, Kansas in 1947, his field observations expanded into the theory that social settings influence behaviour. Empirical data gathered in Oskaloosa from 1947 to 1972 helped him develop the concept of the “behaviour setting” to help explain the relationship between the individual and the immediate environment. This was further explored in his work with Paul Gump in the book Big School, Small School: High School Size and Student Behaviour. One of the first insightful explanations on why groups tend to be less satisfying for their members as they increase in size, their studies illustrated that large schools had a similar number of behaviour settings to that of small schools. This resulted in the students’ ability to presume many different roles in small schools (e.g. be in the school band and the school football team) but in larger schools, there was a propensity to deliberate over their social choices.

In his book Ecological Psychology (1968), Barker stresses the importance of the town’s behaviour and environment as the residents’ most ordinary instrument of describing their environment.

“The hybrid, eco-behavioral character of behavior settings appear to present Midwest’s inhabitants with no difficulty; nouns that combine milieu and standing behavior are common, e.g. oyster supper, basketball game, turkey dinner, golden gavel ceremony, cake walk, back surgery, gift exchange, livestock auction, auto repair.”

Barker argued that his students should implement T-methods (psychologist as ‘transducer’: i.e. methods in which they studied the man in his ‘natural environment’) rather than O-methods (psychologist as “operators” i.e. experimental methods). Basically, Barker preferred fieldwork and direct observation rather than controlled experiments. Some of the minute-by-minute observations of Kansan children from morning to night, jotted down by young and maternal graduate students, may be the most intimate and poignant documents in social science. Barker spent his career expanding on what he called ecological psychology, identifying these behaviour settings, and publishing accounts such as One Boy’s Day (1952) and Midwest and Its Children (1955).

Natural Environment Research Findings

Environmental psychology research has observed various concepts relating to humans’ innate connection to natural environments which begins in early childhood. One study shows that fostering children’s connectedness to nature will, in turn, create habitual pro-ecological behaviours in time. Exposure to natural environment may lead to a positive psychological well-being and form positive attitudes and behaviour towards nature. Connectedness to nature has shown to be a huge contributor to predicting people’s general pro-ecological and pro-social behaviours. Connectedness to nature has also been shown to benefit well-being, happiness, and general satisfaction. “Nature-deficit disorder” has recently been coined to explain the lack of connectedness to nature due to a lack of consciousness identification and nature disconnect. Further research is required to make definitive claims about the effects of connectedness to nature.

Applications

Impact on the Built Environment

Environmental psychologists rejected the laboratory-experimental paradigm because of its simplification and skewed view of the cause-and-effect relationships of human behaviours and experiences. Environmental psychologists examine how one or more parameters produce an effect while other measures are controlled. It is impossible to manipulate real-world settings in a laboratory.

Environmental psychology is oriented towards influencing the work of design professionals (architects, engineers, interior designers, urban planners, etc.) and thereby improving the human environment.

On a civic scale, efforts toward improving pedestrian landscapes have paid off, to some extent, from the involvement of figures like Jane Jacobs and Copenhagen’s Jan Gehl. One prime figure here is the late writer and researcher William H. Whyte. His still-refreshing and perceptive “City”, based on his accumulated observations of skilled Manhattan pedestrians, provides steps and patterns of use in urban plazas.

The role and impact of architecture on human behaviour is debated within the architectural profession. Views range from: supposing that people will adapt to new architectures and city forms; believing that architects cannot predict the impact of buildings on humans and therefore should base decisions on other factors; to those who undertake detailed precedent studies of local building types and how they are used by that society.

Environmental psychology has conquered the whole architectural genre which is concerned with retail stores and any other commercial venues that have the power to manipulate the mood and behaviour of customers (e.g. stadiums, casinos, malls, and now airports). From Philip Kotler’s landmark paper on Atmospherics and Alan Hirsch’s “Effects of Ambient Odors on Slot-Machine Usage in a Las Vegas Casino”, through the creation and management of the Gruen transfer, retail relies heavily on psychology, original research, focus groups, and direct observation. One of William Whyte’s students, Paco Underhill, makes a living as a “shopping anthropologist”. Most of this advanced research remains a trade secret and proprietary.

Environmental psychology is consulted thoroughly when discussing future city design. Eco-cities and eco-towns have been studied to determine the societal benefits of creating more sustainable and ecological designs. Eco-cities allow for humans to live in synch with nature and develop sustainable living techniques. The development of eco-cities requires knowledge in the interactions between “environmental, economic, political, and socio-cultural factors based on ecological principles”.

Organisations

  • Project for Public Spaces (PPS) is a non-profit organisation that works to improve public spaces, particularly parks, civic centres, public markets, downtowns, and campuses. The staff of PPS is made up of individuals trained in environmental design, architecture, urban planning, urban geography, urban design, environmental psychology, landscape architecture, arts administration and information management. The organisation has collaborated with many major institutions to improve the appearance and functionality of public spaces throughout the US. In 2005, PPS co-founded The New York City Streets Renaissance, a campaign that worked to develop a new campaign model for transportation reform. This initiative implemented the transformation of excess sidewalk space in the Meatpacking District of Manhattan into public space. Also, by 2008, New York City reclaimed 49 acres (200,000 m2) of traffic lanes and parking spots away from cars and gave it back to the public as bike lanes and public plazas.
  • The Centre for Human Environments at the CUNY Graduate Centre is a research organisation that examines the relationship between people and their physical settings. CHE has five subgroups that specialise in aiding specific populations: The Children’s Environments Research Group, the Health and Society Research Group, the Housing Environments Research Group, the Public Space Research Group, and the Youth Studies Research Group.
  • The most relevant scientific groups are the International Association of People-Environment Studies (IAPS) and the Environmental Design Research Association (EDRA).
  • Urban Ecology: The Urban Ecologist, and the International Eco-City Conference were some of the first collectives to establish the idea of eco-cities and townships.

Challenges

The field saw significant research findings and a fair surge of interest in the late 1970s and early 1980s, but has seen challenges of nomenclature, obtaining objective and repeatable results, scope, and the fact that some research rests on underlying assumptions about human perception, which is not fully understood. Being an interdisciplinary field is difficult because it lacks a solid definition and purpose. It is hard for the field to fit into organisational structures. In the words of Guido Francescato, speaking in 2000, environmental psychology encompasses a “somewhat bewildering array of disparate methodologies, conceptual orientations, and interpretations… making it difficult to delineate, with any degree of precision, just what the field is all about and what might it contribute to the construction of society and the unfolding of history.”

A grand challenge in the field of environmental psychology today is to understand the impact of human behaviour on the climate and climate change. Understanding why some people engage in pro-environment behaviours can help predict the necessary requirements to engage others in making sustainable change.

Environmental psychology has not received nearly enough supporters to be considered an interdisciplinary field within psychology. Harold M. Proshanksy was one of the founders of environmental psychology and was quoted as saying:

“As I look at the field of environmental psychology today, I am concerned about its future. It has not, since its emergence in the early 1960s grown to the point where it can match the fields of social, personality, learning or cognitive psychology. To be sure, it has increased in membership, in the number of journals devoted to it, and even in the amount of professional organizational support it enjoys, but not enough so that one could look at any major university and find it to be a field of specialization in a department of psychology, or, more importantly, in an interdisciplinary center or institute”.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Environmental_psychology >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Invisible Support?

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Introduction

In psychology, invisible support is a type of social support in which supportive exchanges are not visible to recipients.

There are two possible situations that can qualify as acts of invisible support. The first possibility entails a situation where “recipients are completely unaware of the supportive transaction between themselves and support-givers”. For example, a spouse may choose to spontaneously take care of housework without mentioning it to the other couple-member. Invisible support also occurs when “recipients are aware of an act that takes place but do not interpret the act as a supportive exchange”. In this case, a friend or family member may subtly provide advice in an indirect manner as a means to preserve the recipient’s self-esteem or to defer his or her attention from a stressful situation. Invisible support can be viewed on both ends of an exchange, in which the recipient is unaware of the support received and the provider enacts support in a skilful, subtle way.

Background

It is known that perceptions of social support availability predict better adjustment to stressful life events; it has been found that the perception of support availability is inherently comforting, and can serve as a psychological safety-net that motivates self-reliant coping efforts in the face of stress. Although the perception of support availability is associated with better adjustment, the knowledge that one has been the recipient of specific supportive acts has often been unhelpful to effectively reduce stress. The knowledge of receiving help may come at a cost with decreased feelings of self-esteem and self-efficacy, because it increases recipients’ awareness towards their personal difficulties to manage stressors. People’s well-intentioned support attempts may also be miscarried, and their efforts could either fail or even worsen the situation for a person under stress. Since supportive acts benefit recipients but their actual knowledge of receiving support is sometimes harmful, it has been theorised that the most effective support exchange would involve one in which the provider reports giving support but the recipient does not notice that support has occurred. From a cost-benefit point of view, invisible support would be optimal for the recipient because the benefits of provision are accrued while the costs of receipt are avoided. Using the same idea, it also implies that the least effective type of support would be one in which the provider does not report providing support but the recipient reports receiving it.

The first investigation of invisible support involved a couples study in which one member was preparing for the New York State Bar Exam. Support receipt and provision were measured by having both couple members complete daily diary entries. Over the course of one month, stressed individuals who reported low frequency of received support (but whose partner ranked their own actions as highly supportive) rated themselves low on anxiety and depression compared to other individuals who reported high frequency of received support.

Compared to Visible Support

A substantial body of work has evidence to suggest that support is most effective when it is invisible or goes unnoticed by recipients. While invisible support has been shown to benefit recipients over visibly supportive acts in some cases, there have also been instances where recipients have benefitted from visible support as well. For example, greater observed support enacted by intimate partners during couples’ support-relevant exchanges have been shown to build feelings of closeness and support, boost positive mood and self-esteem, and foster greater goal achievement and relationship quality across time.

It has been recently suggested that acts of invisible support and visible support may be beneficial or costly depending on different circumstances. To investigate this idea, a recent study in 2013 compared the short-term and long-term effects of visible and invisible support reception during romantic couples’ discussions of each partner’s personal goal. It was found that either type of support was more beneficial depending on the emotional distress that recipients felt at the time. Visible emotional support (support through reassurance, encouragement, and understanding) was associated with perceptions of greater support and discussion success for recipients who felt greater distress during the discussion. In contrast, invisible emotional support was not associated with recipients’ post-discussion perceptions of support or discussion success. For long-term support effects, it was found that only invisible emotional support predicted greater goal achievement across the following year.

When put together, these findings suggest that visible support and invisible support have unique functions for well-being. When people are under distress, visible support appears to be a short-term remedy to reassure recipients that they are cared for and supported. These benefits are only present when recipients are actually distressed during the time that the supportive act takes place. On the other hand, while invisible support tends to go unnoticed by recipients, it seems to play an integral role in the long-term success of goal-maintenance. This increasingly complex view of the implications of support visibility is reinforced by a growing body of research suggesting the effects of invisible social support – as with visible support – are moderated by provider, recipient, and contextual factors such as recipients’ perceptions of providers’ responsiveness to their needs, or the quality of the relationship between the support provider and recipient.

Effects on Support Providers

Refer to Social Support, Psychology, Stress (Psychological; Eustress and Distress), Coping (Psychology), Self-Esteem, and Self-Efficacy.

The effects of invisible support on recipients have been extensively investigated, but the consequences of invisible support on providers are less known. One study in 2016 investigated the benefits and costs of invisible support on couple-members who enacted supportive behaviours by differentiating the processes of invisible emotional support (support through reassurance, encouragement, and understanding) from processes of invisible instrumental support (providing tangible aid such as sending money or childcare). No costs of support-giving were found for providers when they demonstrated acts of invisible emotional support. The effects for invisible instrumental support told a different story, where providers who reported high relationship satisfaction were unaffected, but providers who reported low relationship satisfaction were negatively affected by their acts of invisible instrumental support with an increase in negative mood. These findings suggest that emotional comfort may be a more central function to maintain close relationships than instrumental support. Therefore, providing invisible emotional support may lead to less perceptions of a costly inequity than providing invisible instrumental support on average. However, since invisible instrumental support did not incur costs for providers who reported high relationship satisfaction, it implies that high relationship satisfaction may buffer potential costs that would otherwise be felt by support-providers. The differential results between invisible instrumental and emotional support indicate that a solid distinction between instrumental and emotional social support may be useful to take into account when investigating effects of invisible support as a whole.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Invisible_support >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Health Realisation?

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Introduction

Health realisation (HR) is a resiliency approach to personal and community psychology first developed in the 1980s by Roger C. Mills and George Pransky, and based on ideas and insights these psychologists elaborated from attending the lectures of philosopher and author Sydney Banks. HR first became known for its application in economically and socially marginalised communities living in highly stressful circumstances (refer to Community Applications below).

HR focuses on the nature of thought and how it affects one’s experience of the world. Students of HR are taught that they can change how they react to their circumstances by becoming aware that they are creating their own experience as they respond to their thoughts, and by connecting to their “innate health” and “inner wisdom.”

HR also goes under the earlier name of “Psychology of Mind” and most recently “Three Principles” understanding.

The Health Realisation Model

In the Health Realisation (“HR”) model, all psychological phenomena, from severe disorder to glowing health, are presented as manifestations of three operative “principles” first formulated as principles of human experience by Sydney Banks:

  • Mind – the universal energy that animates all of life, the source of innate health and well-being.
  • Consciousness – the ability to be aware of one’s life.
  • Thought – the power to think and thereby to create one’s experience of reality.

“Mind” has been likened to the electricity running a movie projector, and “Thought” to the images on the film. “Consciousness” is likened to the light from the projector that throws the images onto the screen, making them appear real.

According to HR, people experience their reality and their circumstances through the constant filter of their thoughts. Consciousness makes that filtered reality seem “the way it really is.” People react to it as if this were true. But, when their thinking changes, reality seems different and their reactions change. Thus, according to HR, people are constantly creating their own experience of reality via their thinking.

People tend to experience their reality as stressful, according to HR, when they are having insecure or negative thoughts. But HR suggests that such thoughts do not have to be taken seriously. When one chooses to take them more lightly, according to HR, the mind quiets down and positive feelings emerge spontaneously. Thus, HR also teaches that people have health and well-being already within them (in HR this is known as “innate health”), ready to emerge as soon as their troubled thinking calms down. When this happens, according to HR, people also gain access to common sense, and they can tap into the universal capacity for creative problem solving or “inner wisdom.” Anecdotal reports suggest that, when a person grasps the understanding behind HR in an experiential way, an expansive sense of emotional freedom and well-being can result.

Health Realisation as Therapy

In contrast to psychotherapies that focus on the content of the clients’ dysfunctional thinking, HR focuses on “innate health” and the role of “Mind, Thought, and Consciousness” in creating the clients’ experience of life.

The HR counsellor does not attempt to get clients to change their thoughts, “think positive”, or “reframe” negative thoughts to positive ones. According to HR, one’s ability to control one’s thoughts is limited and the effort to do so can itself be a source of stress. Instead, clients are encouraged to consider that their “minds are using thought to continuously determine personal reality at each moment.”

HR characterizes feelings and emotions as indicators of the quality of one’s thinking. Within the HR model, unpleasant feelings or emotions, or stressful feelings, indicate that one’s thinking is based on insecurity, negative beliefs, conditioning or learned patterns that are not necessarily appropriate to the live moment here and now. They simultaneously indicate that the individual has temporarily lost sight of what HR asserts is his or her own role in creating experience. Pleasant or desired feelings (such as a sense of well-being, gratitude, compassion, peace, etc.) indicate, within the HR model, that the quality of one’s thinking is exactly as it needs to be.

HR holds that the therapeutic “working through” of personal issues from the past to achieve wholeness is unnecessary. According to the HR model, people are already whole and healthy. The traumas of the past are only important to the extent that the individual lets them influence his or her thoughts in the present. According to HR, one’s “issues” and memories are just thoughts, and the individual can react to them or not. The more the clients’ experience is that they themselves are creating their own painful feelings via their own “power of Thought,” HR suggests, the less these feelings bother them. Sedgeman has compared this to what happens when we make scary faces at ourselves in the mirror: because we know it is just us, it is impossible to scare ourselves that way.

Thus HR deals with personal insecurities and dysfunctional patterns almost en masse, aiming for an understanding of the “key role of thought”, an understanding that ideally allows the individual to step free at once from a large number of different patterns all connected by insecure thinking. With this approach, it is rare for the practitioner to delve into specific content beyond the identification of limiting thoughts. When specific thoughts are considered to be limiting or based on insecurity or conditioning, the counsellor encourages the individual to disengage from them.

Relationships

From the perspective of HR, relationship problems result from the partners’ low awareness of their role in creating their own experience via thought and consciousness. Partners who respond to HR reportedly stop blaming and recriminating and react to each other differently. HR counsellors aim to get couples to consider that each one’s own feelings are not determined by one’s partner and that the great majority of issues that previously snarled their interactions were based on insecure, negative, and conditioned thinking. HR counsellors further suggest that every person goes through emotional ups and downs and that one’s thinking in a “down” mood is likely to be distorted. HR teaches that it is generally counterproductive to try to “talk through” relationship problems when the partners are in a bad mood. Instead HR suggests that partners wait until each has calmed down and is able to discuss things from a place of inner comfort and security.

Chemical Dependency and Addiction

HR sees chemical dependency and related behaviours as a response to a lack of a sense of self-efficacy, rather than the result of disease. That is, some people who are, in HR terms, “unaware” of their own “innate health” and their own role in creating stress via their thoughts turn to alcohol, drugs, or other compulsive behaviours in the attempt to quell their stressful feelings and regain some momentary sense of control. HR aims to offer deeper relief by showing that negative and stressful feelings are self-generated and thus can be self-quieted and it seeks to provide a pathway to well-being that does not depend on external circumstances.

Community Applications

The Health Realisation (“HR”) model has been applied in a variety of challenging settings. An early project, which garnered national publicity under the leadership of Roger Mills, introduced HR to residents of a pair of low-income housing developments in Miami known as Modello and Homestead Gardens. After three years, there were major documented reductions in crime, drug dealing, teenage pregnancy, child abuse, child neglect, school absenteeism, unemployment, and families on public assistance. Jack Pransky has chronicled the transformation that unfolded there, in his book Modello, A Story of Hope for the Inner City and Beyond.

Later projects in some of the most severely violence-ridden housing developments in New York, Minnesota, and California and in other communities in California, Hawaii, and Colorado built upon the early experience in the Modello/Homestead work. The Coliseum Gardens housing complex in Oakland, California, for example, had previously had the fourth highest homicide rate of such a complex in the US, but after HR classes were launched, the homicide rate began to decline. Gang warfare and ethnic clashes between Cambodian and African-American youth ceased. In 1997, Sargeant Jerry Williams was awarded the California Wellness Foundation Peace Prize on behalf of the Health Realisation Community Empowerment Project at Coliseum Gardens. By the year 2006, there had been no homicides in the Complex for nine straight years.

The HR model has also found application in police departments, prisons, mental health clinics, community health clinics and nursing, drug and alcohol rehabilitation programmes, services for the homeless, schools, and a variety of state and local government programmes. The County of Santa Clara, California, for example, has established a Health Realisation Services Division which provides HR training to County employees and the public. The Services Division “seeks to enhance the life of the individual by teaching the understanding of the psychological principles of Mind, Thought and Consciousness, and how these principles function to create our life experience,” and to “enable them to live healthier and more productive lives so that the community becomes a model of health and wellness.” The Department of Alcohol and Drug Services introduced HR in Santa Clara County in 1994. The Health Realisation Services Division has an approved budget of over $800,000 (gross expenditure) for FY 2008, a 41% increase over 2007, at a time when a number of programmes within the Alcohol and Drug Services Department have sustained budget cuts.

HR community projects have received grant funding from a variety of sources. For example, grant partners for the Visitacion Valley Community Resiliency Project, a five-year, multimillion-dollar community revitalisation project, have included Wells Fargo Bank, Charles Schwab Corporation Foundation, Charles and Helen Schwab Foundation, Isabel Allende Foundation, Pottruck Family Foundation, McKesson Foundation, Richard and Rhoda Goldman Fund, S.H. Cowell Foundation, San Francisco Foundation, Evelyn & Walter Haas, Jr. Fund, Milagro Foundation, and Dresdner RCM Global Investors. Other projects based upon the HR approach have been funded by the National Institute of Mental Health, the US Department of Justice, the National Institute on Drug Abuse, the California Wellness Foundation, and the Shinnyo-en Foundation.

Ongoing community projects organised by the Centre for Sustainable Change, a non-profit organisation founded by Dr. Roger Mills and Ami Chen Mills-Naim, are funded by the W.K. Kellogg Foundation. The Centre for Sustainable Change works in partnership with grassroots organisations in Des Moines, Iowa; Charlotte, North Carolina; and the Mississippi Delta to bring Three Principles training to at-risk communities under the umbrella of the National Community Resiliency Project. The Centre also works with schools, agencies and corporations.

Organisational Applications

From the original applications, as people in the business world have been introduced to HR or the “Three Principles” (as the core understanding is known), they have started to bring these ideas into the business world they have come from. The approach has been introduced to people in medicine, law, investment and financial services, technology, marketing, manufacturing, publishing, and a variety of other commercial and financial roles. It has been reported anecdotally to have had significant impact in the areas of individual performance and development, teamwork, leadership, change and diversity. According to HR/Three Principles adherents, these results flow naturally as the individuals exposed to the ideas learn how their thoughts have been creating barriers to others and barriers to their own innate creativity, common sense, and well being. As people learn how to access their full potential more consistently, HR adherents say, they get better results with less effort and less stress in less time.

Two peer-reviewed articles on effectiveness with leadership development were published in professional journals in 2008 (ADHR) and 2009 (ODJ):

  • C.L. Polsfuss & A.Ardichvili, “Three Principles Psychology: Applications in Leadership Development & Coaching”, Advances in Developing Human Resources Journal, 2008; 10; 671 doi:10.1177/1523422308322205. Online article at: http://adh.sagepub.com/cgi/content/abstract/10/5/671.
  • C.L. Polsfuss & A.Ardichvili, “State of Mind as the Master Competency for High-Performance Leadership”, Organizational Development Journal, Volume 27, Number 3, Fall 2009.

Philosophical Context

Health Realisation (“HR”) rests on the non-academic philosophy of Sydney Banks, which Mr. Banks has expounded upon in several books. Mr. Banks was a day labourer with no education beyond ninth grade (age 14) in Scotland who, in 1973, reportedly had a profound insight into the nature of human experience. Mr. Banks does not particularly attempt to position his ideas within the larger traditions of philosophy or religion; he is neither academically trained nor well read. His philosophy focuses on the illusory, thought-created nature of reality, the three principles of “Mind”, “Thought”, and “Consciousness”, the potential relief of human suffering that can come from a fundamental shift in personal awareness and understanding and the importance of a direct, experiential grasp of these matters, as opposed to a mere intellectual comprehension or analysis. Mr. Banks suggests that his philosophy is best understood not intellectually but by “listening for a positive feeling;” and a grasp of HR is said to come through a series of “insights,” that is, shifts in experiential understanding.

Teaching of Health Realisation

Health Realisation (“HR”), like Sydney Banks’s philosophy, is deliberately not taught as a set of “techniques” but as an experiential “understanding” that goes beyond a simple transfer of information. There are no steps, no uniformly appropriate internal attitudes, and no techniques within it. The “health of the helper” is considered crucial; that is, trainers or counsellors ideally will “live in the understanding that allows them to enjoy life,” and thereby continuously model their understanding of HR by staying calm and relaxed, not taking things personally, assuming the potential in others, displaying common sense, and listening respectfully to all. Facilitators ideally teach in the moment, from “what they know” (e.g. their own experience), trusting that they will find the right words to say and the right approach to use in the immediate situation to stimulate the students’ understanding of the “Three Principles”. Rapport with students and a positive mood in the session or class are more important than the specific content of the facilitator’s presentation.

Evaluations of Health Realisation

A 2007 peer-reviewed article evaluating the effectiveness of HR suggests that the results of residential substance abuse treatment structured around the teaching of HR are equivalent to those of treatment structured around 12-step programmes. The authors note that “these results are consistent with the general findings in the substance abuse literature, which suggests that treatment generally yields benefits, irrespective of approach.”

A small peer-reviewed study in preparation for a planned larger study evaluated the teaching of HR/Innate Health via a one-and-a-half-day seminar, as a stress- and anxiety-reduction intervention for HIV-positive patients. All but one of the eight volunteer participants in the study showed improved scores on the Brief Symptom Inventory after the seminar, and those participants who scored in the “psychiatric outpatient” range at the beginning of the seminar all showed improvement that was sustained upon follow-up one month later. The study’s authors concluded that “The HR/IH psychoeducational approach deserves further study as a brief intervention for stress-reduction in HIV-positive patients.”

A 2007 pilot study funded by the National Institutes of Health evaluated HR in lowering stress among Somali and Oromo refugee women who had experienced violence and torture in their homelands, but for whom Western-style psychotherapeutic treatment of trauma was not culturally appropriate. The pilot study showed that “the use of HR with refugee trauma survivors was feasible, culturally acceptable, and relevant to the participants.” In a post-intervention focus group, “many women reported using new strategies to calm down, quiet their minds and make healthier decisions.” Co-investigator Cheryl Robertson, Assistant Professor in the School of Nursing at the University of Minnesota, was quoted as saying, “This is a promising intervention that doesn’t involve the use of highly trained personnel. And it can be done in the community.”

The Visitacion Valley Community Resiliency Project (VVCRP) was reviewed by an independent evaluator hired by the Pottruck Foundation. Her final report notes that “Early program evaluation…found that the VVCRP was successful in reducing individuals’ feelings of depression and isolation, and increasing their sense of happiness and self-control. The cumulative evaluation research conducted on the VVCRP and the HR model in general concludes that HR is a powerful tool for changing individuals’ beliefs and behaviours.” In the Summary of Case Studies, the report goes on to state, “The VVCRP was effective over a period of five years of sustained involvement in two major neighbourhood institutions…at influencing not just individuals, but also organisational policies, practices, and culture. This level of organisational influence is impressive when the relatively modest level of VVCRP staff time and resources invested into making these changes is taken into account. The pivotal levers of change at each organisation were individual leaders who were moved by the HR principles to make major changes in their own beliefs, attitudes, and behaviours, and then took the initiative to inspire, enable, and mandate similar changes within their organisations. This method of reaching “critical mass” of HR awareness within these organisations appears to be both efficient and effective when the leadership conditions are right. However, this pathway to change is vulnerable to the loss of the key individual leader.”

Research Efforts on Effectiveness

Pransky has reviewed the research on HR (through 2001) in relation to its results for prevention and education, citing about 20 manuscripts, most of which were conference papers, and none peer-reviewed journal articles, although two were unpublished doctoral dissertations. (Kelley (2003) cites two more unpublished doctoral dissertations.) Pransky concludes:

“Every study of Health Realization and its various incarnations, however weak or strong the design, has shown decreases in problem behaviors and internally experienced problems. This approach appears to reduce problem behaviors and to improve mental health and well-being. At the very least, this suggests the field of prevention should further examine the efficacy of this … approach by conducting independent, rigorous, controlled, longitudinal studies….”

Criticism

In a criticism of the philosophy of Sydney Banks and, by implication, the HR approach, Bonelle Strickling, a psychotherapist and Professor of Philosophy, is quoted in an article in the Vancouver Sun as objecting that “it makes it appear as if people can, through straightforward positive thinking, ‘choose’ to transcend their troubled upbringings and begin leading a contented life.” She goes on to say that “it can be depressing for people to hear it’s supposed to be that easy. It hasn’t been my experience that people can simply choose not to be negatively influenced by their past.” Referring to Banks’s own experience, she says, “Most people are not blessed with such a life-changing experience…. When most people change, it usually happens in a much more gradual way.” Strickling, however, displays by her very criticism, a lack in understanding of the Health Realization approach which has nothing at all to do with “choosing” or “positive thinking”.

The West Virginia Initiative for Innate Health (at West Virginia University Health Sciences Centre), which promotes HR/Innate Health and the philosophy of Sydney Banks through teaching, writing, and research, was the centre of controversy soon after its inception in 2000 as the Sydney Banks Institute for Innate Health. Initiated by Robert M. D’Alessandri, the Dean of the medical school there, the institute reportedly was criticized as pushing “junk science,” and Banks’s philosophy was characterized as “a kind of bastardized Buddhism” and “New Age.” William Post, an orthopaedic surgeon who quit the medical school because of the institute, was reported along with other unnamed professors to have accused the Sydney Banks Institute of promoting religion in a state-funded institution, and Harvey Silvergate, a civil-liberties lawyer, was quoted as agreeing that “essentially [the institute] seems like a cover for a religious-type belief system which has been prettified in order to be secular and even scientific.”

There is, however, no organised religion associated with the principles uncovered by Mr. Banks.

A Dr. Blaha, who resigned as chairman of Orthopaedics at WVU, was quoted as criticising the institute as being part of a culture at the Health Sciences Centre that, in his view, places too much emphasis on agreement, consensus, and getting along. Other professors reportedly supported the institute.

Anthony DiBartolomeo, chief of the rheumatology section, was quoted as calling it “a valuable addition” to the health-sciences centre, saying its greatest value was in helping students, residents, and patients deal with stress.

Reportedly in response to the controversy, the WVIIH changed its name from The Sydney Banks Institute to the West Virginia Initiative for Innate Health, although its mission remains unchanged.

Support for Specific Tenets of HR from other Philosophies and Approaches

Some of the tenets of HR are consistent with the theories of philosophers, authors and researchers independently developing other approaches to change and psychotherapy.

A large body of peer-reviewed case literature in psychotherapy by Milton Erickson, M.D., founding president of the American Society for Clinical Hypnosis, and others working in the field of Ericksonian psychotherapy, supports the notion that lasting change in psychotherapy can occur rapidly without directly addressing clients’ past problematic experiences.

Many case examples and a modest body of controlled outcome research in solution focused brief therapy (SFBT), have likewise supported the notion that change in psychotherapy can occur rapidly, without delving into the clients’ past negative experiences. Proponents of SFBT suggest that such change often occurs when the therapist assists clients to step out of their usual problem-oriented thinking.

The philosophy of social constructionism, which is echoed in SFBT, asserts that reality is reproduced by people acting on their interpretations and their knowledge of it. (HR asserts that thought creates one’s experience of the world.)

A major body of peer-reviewed research on “focusing”, a change process developed by philosopher Eugene Gendlin, supports the theory that progress in psychotherapy is dependent on something clients do inside themselves during pauses in the therapy process, and that a particular internal activity – “focusing” – can be taught to help clients improve their progress. The first step of the six-step process used to teach focusing involves setting aside one’s current worries and concerns to create a “cleared space” for effective inner reflection. Gendlin has called this first step by itself “a superior stress-reduction method”. (HR emphasizes the importance of quieting one’s insecure and negative thinking to reduce stress and gain access to “inner wisdom,” “common sense,” and well-being.)

Positive psychology emphasizes the human capacity for health and well-being, asserts the poor correlation between social circumstances and individual happiness, and insists on the importance of one’s thinking in determining one’s feelings.

Work by Herbert Benson argues that humans have an innate ‘breakout principle’ which provides creative solutions and peak experiences which allow the restoration of a ‘new-normal’ state of higher functioning. This breakout principle is activated by severing connections with current circular or repetitive thinking. This is heavily reminiscent of Health Realisation discussion of the Principle of Mind and of how it is activated.

Finally, resilience research, such as that by Emmy Werner, has demonstrated that many high-risk children display resilience and develop into normal, happy adults despite problematic developmental histories.

See also National Resilience Resource Centre LLC additional discussion of resilience research and complimentary science found on the Research page at http://www.nationalresilienceresource.com .

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Health_realization >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Distress Tolerance?

Published on by Andrew Marshall1 Comment

Introduction

Distress tolerance is an emerging construct in psychology that has been conceptualised in several different ways. Broadly, it refers to an individual’s:

“perceived capacity to withstand negative emotional and/or other aversive states (e.g. physical discomfort), and the behavioral act of withstanding distressing internal states elicited by some type of stressor.”

Some definitions of distress tolerance have also specified that the endurance of these negative events occur in contexts in which methods to escape the distressor exist.

Measurement

In the literature, differences in conceptualisations of distress tolerance have corresponded with two methods of assessing this construct.

As self-report inventories fundamentally assess an individual’s perception and reflection of constructs related to the self; self-report measures of distress tolerance (i.e. questionnaires) specifically focus on the perceived ability to endure distressful states, broadly defined. Some questionnaires focus specifically on emotional distress tolerance (e.g. the distress tolerance scale), some on distress tolerance of negative physical states (e.g. discomfort intolerance scale), and others focus specifically on tolerance of frustration as an overarching process of distress tolerance (e.g. frustration-discomfort scale).

In contrast, studies that incorporate behavioural or biobehavioural assessments of distress tolerance provide information about real behaviour rather than an individual’s perceptions. Examples of stress-inducing tasks include those that require the individual to persist in tracing a computerised mirror under timed conditions (i.e. computerised mirror tracing persistence task) or complete a series of time-sensitive math problems for which incorrect answers produce an aversive noise (i.e. computerised paced auditory serial addition task). Some behavioural tasks are conceptualised to assess physical distress tolerance, and require individuals to hold their breath for as long as possible (breath holding task).

As this is a nascent field of research, the relationships between perceptual and behavioural assessments of distress tolerance have not been clearly elucidated. Disentangling distinct components of emotional/psychological distress tolerance and physical distress tolerance within behavioural tasks also remains a challenge in the literature.

Theoretical Structures

Several models about the structural hierarchy of distress tolerance have been proposed. Some work suggests that physical and psychological tolerance are distinct constructs. Specifically, sensitivity to feelings of anxiety and tolerance of negative emotional states may be related to each other as aspects of a larger construct representing sensitivity and tolerance of affect broadly; discomfort surrounding physical stressors, however, was found to be an entirely separate construct not associated with sensitivity to emotional states. Notably, this preliminary work was conducted with self-report measures and findings are cross-sectional in nature. The authors advise that additional longitudinal work is necessary to corroborate these relationships and elucidate directions of causality.

Recent work expands on the distinctness of emotional and physical distress tolerance to a higher-order construct of global experiential distress tolerance. This framework draws upon tolerance constructs that have been historically studied as distinct from distress tolerance. The five following constructs are framed as lower-order factors for the global distress tolerance construct, and include:

  • Tolerance of uncertainty, or “the tendency to react emotionally, cognitively, or behaviourally to uncertain situations”.
  • Tolerance of ambiguity, or “the perceived tolerance of complicated, foreign, and/or vague situations of stimuli”.
  • Tolerance of frustration, or “the perceived capacity to withstand aggravation (e.g. thwarted life goals)”.
  • Tolerance of negative emotional states, or “the perceived capacity to withstand internal distress”.
  • Tolerance of physical sensations, or “the perceived capacity to withstand uncomfortable physical sensations”.

Within models that solely conceptualise distress tolerance as the ability to endure negative emotional states, distress tolerance is hypothesized to be multidimensional. This includes individual processes related to the anticipation of and experience with negative emotions, such as perceived and actual ability to tolerate the negative emotion, the appraisal of a given situation as acceptable or not, the degree to which an individual can regulate his/her emotion in the midst of a negative emotional experience, and amount of attention dedicated to processing the negative emotion.

Biological Bases

There are several candidate biological neural network mechanisms for distress tolerance. These proposed brain areas are based on the conceptualisation of distress tolerance as a function of reward learning. Within this framework, individuals learn to attune to and pursue reward; reduction of tension in escaping from a stressor is similarly framed as a reward and thus can be learned. Individuals differ in how quickly and for how long they display preferences for pursuing reward or in the case of distress tolerance, escaping from a distressful stimulus. Therefore, brain regions that are activated during reward processing and learning are hypothesized to also serve as neurobiological substrates for distress tolerance. For instance, activation intensity of dopamine neurons projecting to the nucleus accumbens, ventral striatum, and prefrontal cortex is associated with an individual’s predicted value of an immediate reward during a learning task. As the firing rate for these neurons increases, individuals predict high values of an immediate reward. During instances in which the predicted value is correct, the basal rate of neuronal firing remains the same. When the predicted reward value is below the actual value, neuronal firing rates increase when the reward is received, resulting in a learned response. When the expected reward value is below the actual value, the firing rate of these neurons decreases below baseline levels, resulting in a learned shift that reduces expectancies about reward value. It is posited that these same dopaminergic firing rates are associated with distress tolerance, in that learning the value of escaping a distressing stimulus is analogous to an estimation of an immediate reward There are several potential clinical implications if these posited distress tolerance substrates are corroborated. It may suggest that distress tolerance is malleable among individuals; interventions that change neuronal firing rates may shift predicted values of behaviours intended to escape a distressor and provide relief, thereby increasing distress tolerance.

Other neural areas may be implicated in moderating this reward learning process. Excitability of inhibitory medium spiny neurons in the nucleus accumbens and ventral striatum have been found to moderate the association between the value of an immediate reward and probability of pursuing reward or relief. Within rats, it has been demonstrated that increasing the excitability of these neurons via increased CREB expression resulted in an increased amount of time that the rats would keep their tail still when a noxious thermal paste was applied, as well as an increased amount of time spent in the open arms of a complex maze; these behaviours have been conceptualised as analogous distress tolerance in response to pain and anxiety.

Associations with Psychopathology

Distress tolerance is an emerging research topic in clinical psychology because it has been posited to contribute to the development and maintenance of several types of mental disorders, including mood and anxiety disorders such as major depressive disorder and generalised anxiety disorder, substance use and addiction, and personality disorders. In general, research on distress tolerance have found associations with these disorders that are tied closely to specific conceptualisations of distress tolerance. For instance, Borderline Personality Disorder is posited to be maintained through a chronic unwillingness to engage in or tolerate emotionally distressful states. Similarly, susceptibility to developing anxiety disorders is often characterised by low emotional distress tolerance. Low distress tolerance of both physical and emotional states is perceived to be a risk factor in maintaining and escalating addiction. Distress tolerance is particularly important in neurobiological theories that posit that advanced stages of addiction are driven by use of a substance to avoid physical and psychological withdrawal symptoms.

As a result of this interest in distress tolerance and its relationship with clinical psychopathology, several psychosocial treatments have been developed to improve distress tolerance among populations that are traditionally resistant to treatment. Many of these interventions (e.g. acceptance-based emotion regulation therapy) aims to boost distress tolerance by increasing the willingness to engage with emotion and meta-skills of acceptance of emotional conflict. Other behavioural interventions include components of building distress tolerance for various treatment targets, including acceptance and commitment therapy (ACT), dialectical behaviour therapy (DBT), functional analytic psychotherapy, integrative behavioural couples therapy, and mindfulness-based cognitive therapy. Multiple studies suggest that such distress tolerance interventions may be effective in treating generalised anxiety disorder, depression, and borderline personality disorder.

Therapy Approaches to Improving Distress Tolerance

ACT and DBT are therapy approaches which include specific focus on distress tolerance.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Distress_tolerance >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

An Overview of Psychological Resilience

Published on by Andrew Marshall2 Comments

Introduction

Psychological resilience is the ability to cope mentally or emotionally with a crisis or to return to pre-crisis status quickly.

The term was coined in the 1970s by Emmy E. Werner, a psychologist, as she conducted a forty year long study of a cohort of Hawaiian children who came from low, socioeconomical back grounds. Resilience exists when the person uses “mental processes and behaviours in promoting personal assets and protecting self from the potential negative effects of stressors”. In simpler terms, psychological resilience exists in people who develop psychological and behavioural capabilities that allow them to remain calm during crises/chaos and to move on from the incident without long-term negative consequences. A lot of criticism of this topic comes from the fact that it is difficult to measure and test this psychological construct because resiliency can be interpreted in a variety of ways. Most psychological paradigms (biomedical, cognitive-behavioural, sociocultural, etc.) have their own perspective of what resilience looks like, where it comes from, and how it can be developed. Despite numerous definitions of psychological resilience, most of these definitions centre around two concepts:

  • Adversity; and
  • Positive adaptation.

Many psychologists agree that positive emotions, social support, and hardiness can influence an individual to become more resilient.

Refer to Scale of Protective Factors.

Brief History

The first research on resilience was published in 1973. The study used epidemiology, which is the study of disease prevalence, to uncover the risks and the protective factors that now help define resilience. A year later, the same group of researchers created tools to look at systems that support development of resilience.

Emmy Werner was one of the early scientists to use the term resilience in the 1970s. She studied a cohort of children from Kauai, Hawaii. Kauai was quite poor and many of the children in the study grew up with alcoholic or mentally ill parents. Many of the parents were also out of work. Werner noted that of the children who grew up in these detrimental situations, two-thirds exhibited destructive behaviours in their later teen years, such as chronic unemployment, substance abuse, and out-of-wedlock births (in case of teenage girls). However, one-third of these youngsters did not exhibit destructive behaviours. Werner called the latter group resilient. Thus, resilient children and their families were those who, by definition, demonstrated traits that allowed them to be more successful than non-resilient children and families.

Resilience also emerged as a major theoretical and research topic from the studies of children with mothers diagnosed with schizophrenia in the 1980s. In a 1989 study, the results showed that children with a schizophrenic parent may not obtain an appropriate level of comforting caregiving – compared to children with healthy parents – and that such situations often had a detrimental impact on children’s development. On the other hand, some children of ill parents thrived well and were competent in academic achievement, and therefore led researchers to make efforts to understand such responses to adversity.

Since the onset of the research on resilience, researchers have been devoted to discovering the protective factors that explain people’s adaptation to adverse conditions, such as maltreatment, catastrophic life events, or urban poverty. The focus of empirical work then has been shifted to understand the underlying protective processes. Researchers endeavour to uncover how some factors (e.g. connection to family) may contribute to positive outcomes.

Definition

Resilience is generally thought of as a “positive adaptation” after a stressful or adverse situation. When a person is “bombarded by daily stress, it disrupts their internal and external sense of balance, presenting challenges as well as opportunities.” However, the routine stressors of daily life can have positive impacts which promote resilience. It is still unknown what the correct level of stress is for each individual. Some people can handle greater amounts of stress than others. A portion of psychologists believe that it is not the stress itself that promotes resilience but rather the individual’s perception of their stress and their perceived personal level of control. The presence of stress allows people to practice this process. According to Germain and Gitterman (1996), stress is experienced in an individual’s life course at times of difficult life transitions, involving developmental and social change; traumatic life events, including grief and loss; and environmental pressures, encompassing poverty and community violence. Resilience is the integrated adaptation of physical, mental and spiritual aspects in a set of “good or bad” circumstances, a coherent sense of self that is able to maintain normative developmental tasks that occur at various stages of life. The Children’s Institute of the University of Rochester explains that “resilience research is focused on studying those who engage in life with hope and humour despite devastating losses”. It is important to note that resilience is not only about overcoming a deeply stressful situation, but also coming out of the said situation with “competent functioning”. Resiliency allows a person to rebound from adversity as a strengthened and more resourceful person. Some characteristics of psychological resilience include: an easy temperament, good self-esteem, planning skills, and a supportive environment inside and outside of the family. Aaron Antonovsky in 1979 stated that when an event is appraised as comprehensible (predictable), manageable (controllable), and somehow meaningful (explainable) a resilient response is more likely.

Process

Psychological resilience is most commonly understood as a process. It is a tool a person can use and it is something that an individual develops overtime. Others assume it to be a trait of the individual, an idea more typically referred to as “resiliency”. Most research now shows that resilience is the result of individuals being able to interact with their environments and participate in processes that either promote well-being or protect them against the overwhelming influence of risk factors. This research could be used in support of psychological resilience being a process rather than a trait. Resilience is seen as something to develop. Making it something to pursue and not an endpoint.

Ray Williams (Canadian businessman and author) saw that resilience comes from people able to effectively cope with their environment. He believed that there are three basic ways individuals could react when faced with a difficult situation.

  • Respond with anger or aggression.
  • Become overwhelmed and shut down.
  • Feel the emotion about the situation and appropriately handle the emotion.

The third option is the one he believed that truly helps an individual promote wellness. Individuals that follow this pattern are people who show resilience. Their resilience comes from coping with the situation. People who follow the first and second option tend to label themselves as victims of their circumstance or they may blame others for their misfortune. They do not effectively cope with their environment, they become reactive, and they tend to cling to negative emotions. This often makes it difficult to focus on problem solving or bounce back. Those that are more resilient will respond to their conditions by coping, bouncing back, and looking for a solution. Along with continual coping methods, William believed that the resilience process can be aided by good environments. These environments include supportive social environments (such as families, communities, schools) and social policies.

Criticism

Like other psychological phenomena, by defining specific psychological and affective states in certain ways, controversy over meaning will always ensue. How the term resilience is defined affects research focuses; different or insufficient definitions of resilience will lead to inconsistent research about the same concepts. Research on resilience has become more heterogeneous in its outcomes and measures, convincing some researchers to abandon the term altogether due to it being attributed to all outcomes of research where results were more positive than expected.

There is also some disagreement among researchers in the field as to whether psychological resilience is a character trait or state of being. Psychological resilience has also been referred to as ecological concept, ranging from micro to macro levels of interpretation. However, it is generally agreed upon that resilience is a buildable resource.

Recently there has also been evidence that resilience can indicate a capacity to resist a sharp decline in other harm even though a person temporarily appears to get worse. Similarly, studies have shown that adolescents who have a high level of adaptation (i.e. resilience) tend to struggle with dealing with other psychological problems later on in life. This is due to an overload of their stress response systems. There is evidence that the higher one’s resilience is, the lower their vulnerability.

Related Factors

Studies show that there are several factors which develop and sustain a person’s resilience:

  • The ability to make realistic plans and being capable of taking the steps necessary to follow through with them.
  • Confidence in one’s strengths and abilities.
  • Communication and problem-solving skills.
  • The ability to manage strong impulses and feelings.
  • Having good self-esteem.

However, these factors vary among different age groups. For example, these factors among older adults are external connections, grit, independence, self-care, self-acceptance, altruism, hardship experience, health status, and positive perspective on life.

Resilience is negatively correlated with personality traits of neuroticism and negative emotionality, which represents tendencies to see and react to the world as threatening, problematic, and distressing, and to view oneself as vulnerable. Positive correlations stands with personality traits of openness and positive emotionality, that represents tendencies to engage and confront the world with confidence in success and a fair value to self-directedness.

Positive Emotions

There is significant research found in scientific literature on the relationship between positive emotions and resilience. Studies show that maintaining positive emotions whilst facing adversity promote flexibility in thinking and problem solving. Positive emotions serve an important function in their ability to help an individual recover from stressful experiences and encounters. That being said, maintaining a positive emotionality aids in counteracting the physiological effects of negative emotions. It also facilitates adaptive coping, builds enduring social resources, and increases personal well-being.

The formation of conscious perception and the monitoring of one’s own socioemotional factors is considered a stabile aspect of positive emotions. This is not to say that positive emotions are merely a by-product of resilience, but rather that feeling positive emotions during stressful experiences may have adaptive benefits in the coping process of the individual. Empirical evidence for this prediction arises from research on resilient individuals who have a propensity for coping strategies that concretely elicit positive emotions, such as benefit-finding and cognitive reappraisal, humour, optimism, and goal-directed problem-focused coping. Individuals who tend to approach problems with these methods of coping may strengthen their resistance to stress by allocating more access to these positive emotional resources. Social support from caring adults encouraged resilience among participants by providing them with access to conventional activities.

Positive emotions not only have physical outcomes but also physiological ones. Some physiological outcomes caused by humour include improvements in immune system functioning and increases in levels of salivary immunoglobulin A, a vital system antibody, which serves as the body’s first line of defence in respiratory illnesses. Moreover, other health outcomes include faster injury recovery rate and lower readmission rates to hospitals for the elderly, and reductions in a patient’s stay in the hospital, among many other benefits. A study was done on positive emotions in trait-resilient individuals and the cardiovascular recovery rate following negative emotions felt by those individuals. The results of the study showed that trait-resilient individuals experiencing positive emotions had an acceleration in the speed in rebounding from cardiovascular activation initially generated by negative emotional arousal, i.e. heart rate and the like.

Forgiveness is also said to play a role in predicting resilience, among patients with chronic pain (but not the severity of the pain).

Social Support

Many studies show that the primary factor for the development of resilience is social support. While many competing definitions of social support exist, most can be thought of as the degree of access to, and use of, strong ties to other individuals who are similar to one’s self. Social support requires not only that you have relationships with others, but that these relationships involve the presence of solidarity and trust, intimate communication, and mutual obligation both within and outside the family.

In military studies it has been found that resilience is also dependent on group support: unit cohesion and morale is the best predictor of combat resiliency within a unit or organisation. Resilience is highly correlated to peer support and group cohesion. Units with high cohesion tend to experience a lower rate of psychological breakdowns than units with low cohesion and morale. High cohesion and morale enhance adaptive stress reactions. Post-war veterans who had more social support were less likely to develop post-traumatic stress disorder.

Other Factors

A study was conducted among high-achieving professionals who seek challenging situations that require resilience. Research has examined 13 high achievers from various professions, all of whom had experienced challenges in the workplace and negative life events over the course of their careers but who had also been recognised for their great achievements in their respective fields. Participants were interviewed about everyday life in the workplace as well as their experiences with resilience and thriving. The study found six main predictors of resilience: positive and proactive personality, experience and learning, sense of control, flexibility and adaptability, balance and perspective, and perceived social support. High achievers were also found to engage in many activities unrelated to their work such as engaging in hobbies, exercising, and organizing meetups with friends and loved ones.

Additional factors are also associated with resilience, like the capacity to make realistic plans, having self-confidence and a positive self image, developing communications skills, and the capacity to manage strong feelings and impulses.

Temperamental and constitutional disposition is considered as a major factor in resilience. It is one of the necessary precursors of resilience along with warmth in family cohesion and accessibility of prosocial support systems. There are three kinds of temperamental systems that play part in resilience, they are the appetitive system, defensive system and attentional system.

Another protective factor is related to moderating the negative effects of environmental hazards or a stressful situation in order to direct vulnerable individuals to optimistic paths, such as external social support. More specifically a 1995 study distinguished three contexts for protective factors:

  • Personal attributes, including outgoing, bright, and positive self-concepts;
  • The family, such as having close bonds with at least one family member or an emotionally stable parent; and
  • The community, such as receiving support or counsel from peers.

Furthermore, a study of the elderly in Zurich, Switzerland, illuminated the role humour plays as a coping mechanism to maintain a state of happiness in the face of age-related adversity.

Besides the above distinction on resilience, research has also been devoted to discovering the individual differences in resilience. Self-esteem, ego-control, and ego-resiliency are related to behavioural adaptation. For example, maltreated children who feel good about themselves may process risk situations differently by attributing different reasons to the environments they experience and, thereby, avoid producing negative internalised self-perceptions. Ego-control is “the threshold or operating characteristics of an individual with regard to the expression or containment” of their impulses, feelings, and desires. Ego-resilience refers to “dynamic capacity, to modify his or her model level of ego-control, in either direction, as a function of the demand characteristics of the environmental context”.

Maltreated children who experienced some risk factors (e.g. single parenting, limited maternal education, or family unemployment), showed lower ego-resilience and intelligence than non-maltreated children. Furthermore, maltreated children are more likely than non-maltreated children to demonstrate disruptive-aggressive, withdraw, and internalised behaviour problems. Finally, ego-resiliency, and positive self-esteem were predictors of competent adaptation in the maltreated children.

Demographic information (e.g. gender) and resources (e.g. social support) are also used to predict resilience. Examining people’s adaptation after disaster showed women were associated with less likelihood of resilience than men. Also, individuals who were less involved in affinity groups and organisations showed less resilience.

Certain aspects of religions, spirituality, or mindfulness may, hypothetically, promote or hinder certain psychological virtues that increase resilience. Research has not established connection between spirituality and resilience. According to the 4th edition of Psychology of Religion by Hood, et al., the “study of positive psychology is a relatively new development…there has not yet been much direct empirical research looking specifically at the association of religion and ordinary strengths and virtues”. In a review of the literature on the relationship between religiosity/spirituality and PTSD, amongst the significant findings, about half of the studies showed a positive relationship and half showed a negative relationship between measures of religiosity/spirituality and resilience. The United States Army has received criticism for promoting spirituality in its (then) new Comprehensive Soldier Fitness programme as a way to prevent PTSD, due to the lack of conclusive supporting data.

Biological Models

Three notable bases for resilience – self-confidence, self-esteem and self-concept – all have roots in three different nervous systems – respectively, the somatic nervous system, the autonomic nervous system and the central nervous system.

Research indicates that like trauma, resilience is influenced by epigenetic modifications. Increased DNA methylation of the growth factor Gdfn in certain brain regions promotes stress resilience, as does molecular adaptations of the blood brain barrier.

The two primary neurotransmitters responsible for stress buffering within the brain are dopamine and endogenous opioids as evidenced by current research showing that dopamine and opioid antagonists increased stress response in both humans and animals. Primary and secondary rewards reduce negative reactivity of stress in the brain in both humans and animals. The relationship between social support and stress resilience is thought to be mediated by the oxytocin system’s impact on the hypothalamic-pituitary-adrenal axis.

“Resilience, conceptualized as a positive bio-psychological adaptation, has proven to be a useful theoretical context for understanding variables for predicting long-term health and well-being”.

Building Resilience

In cognitive behavioural therapy (CBT), building resilience is a matter of mindfully changing basic behaviours and thought patterns. The first step is to change the nature of self-talk. Self-talk is the internal monologue people have that reinforce beliefs about the person’s self-efficacy and self-value. To build resilience, the person needs to eliminate negative self-talk, such as “I can’t do this” and “I can’t handle this”, and to replace it with positive self-talk, such as “I can do this” and “I can handle this”. This small change in thought patterns helps to reduce psychological stress when a person is faced with a difficult challenge. The second step a person can take to build resilience is to be prepared for challenges, crises, and emergencies. In business, preparedness is created by creating emergency response plans, business continuity plans, and contingency plans. For personal preparedness, the individual can create a financial cushion to help with economic crises, he/she can develop social networks to help him/her through trying personal crises, and he/she can develop emergency response plans for his/her household.

Resilience is also enhanced by developing effective coping skills for stress. Coping skills help the individual to reduce stress levels, so they remain functional. Coping skills include using meditation, exercise, socialisation, and self-care practices to maintain a healthy level of stress, but there are many other lists associated with psychological resilience.

The American Psychological Association suggests “10 Ways to Build Resilience”, which are to:

  • Maintain good relationships with close family members, friends and others;
  • Avoid seeing crises or stressful events as unbearable problems;
  • Accept circumstances that cannot be changed;
  • Develop realistic goals and move towards them;
  • Take decisive actions in adverse situations;
  • Look for opportunities for self-discovery after a struggle with loss;
  • Develop self-confidence;
  • Keep a long-term perspective and consider the stressful event in a broader context;
  • Maintain a hopeful outlook, expecting good things and visualizing what is wished; and
  • Take care of one’s mind and body, exercising regularly, paying attention to one’s own needs and feelings.

The Besht model of natural resilience building in an ideal family with positive access and support from family and friends, through parenting illustrates four key markers. They are:

  • Realistic upbringing.
  • Effective risk communications.
  • Positivity and restructuring of demanding situations.
  • Building self efficacy and hardiness.

In this model, self-efficacy is the belief in one’s ability to organise and execute the courses of action required to achieve necessary and desired goals and hardiness is a composite of interrelated attitudes of commitment, control, and challenge.

A number of self-help approaches to resilience-building have been developed, drawing mainly on the theory and practice of CBT and rational emotive behaviour therapy (REBT). For example, a group cognitive-behavioural intervention, called the Penn Resiliency Programme (PRP), has been shown to foster various aspects of resilience. A meta-analysis of 17 PRP studies showed that the intervention significantly reduces depressive symptoms over time.

The idea of ‘resilience building’ is debatably at odds with the concept of resilience as a process, since it is used to imply that it is a developable characteristic of oneself. Those who view resilience as a description of doing well despite adversity, view efforts of ‘resilience building’ as method to encourage resilience. Bibliotherapy, positive tracking of events, and enhancing psychosocial protective factors with positive psychological resources are other methods for resilience building. In this way, increasing an individual’s resources to cope with or otherwise address the negative aspects of risk or adversity is promoted, or builds, resilience.

Contrasting research finds that strategies to regulate and control emotions, in order to enhance resilience, allows for better outcomes in the event of mental illness. While initial studies of resilience originated with developmental scientists studying children in high-risk environments, a study on 230 adults diagnosed with depression and anxiety that emphasized emotional regulation, showed that it contributed to resilience in patients. These strategies focused on planning, positively reappraising events, and reducing rumination helped in maintaining a healthy continuity. Patients with improved resilience were found to yield better treatment outcomes than patients with non-resilience focused treatment plans, providing potential information for supporting evidence based psychotherapeutic interventions that may better handle mental disorders by focusing on the aspect of psychological resilience.

Building Resilience Through Language

As the world globalises, language learning and communication have proven to be helpful factors in developing resilience in people who travel, study abroad, work internationally, or in those who find themselves as refugees in countries where their home language is not spoken.

Research conducted by the British Council ties a strong relationship between language and resilience in refugees. Their language for resilience research conducted in partnership with institutions and communities from the Middle East, Africa, Europe and the Americas claims that providing adequate English-learning programmes and support for Syrian refugees builds resilience not only in the individual, but also in the host community. Their findings reported five main ways through which language builds resilience: home language and literacy development; access to education, training, and employment; learning together and social cohesion; addressing the effects of trauma on learning; and building inclusivity.

The language for resilience research suggests that further development of home language and literacy helps create the foundation for a shared identity. By maintaining the home language, even when displaced, a person not only learns better in school, but enhances the ability to learn other languages. This enhances resilience by providing a shared culture and sense of identity that allows refugees to maintain close relationships to others who share their identity and sets them up to possibly return one day. Thus, identity is not stripped and a sense of belonging persists.

Access to education, training, and employment opportunities allow refugees to establish themselves in their host country and provides more ease when attempting to access information, apply to work or school, or obtain professional documentation. Securing access to education or employment is largely dependent on language competency, and both education and employment provide security and success that enhance resilience and confidence.

Learning together encourages resilience through social cohesion and networks. When refugees engage in language-learning activities with host communities, engagement and communication increases. Both refugee and host community are more likely to celebrate diversity, share their stories, build relationships, engage in the community, and provide each other with support. This creates a sense of belonging with the host communities alongside the sense of belonging established with other members of the refugee community through home language.

Additionally, language programmes and language learning can help address the effects of trauma by providing a means to discuss and understand. Refugees are more capable of expressing their trauma, including the effects of loss, when they can effectively communicate with their host community. Especially in schools, language learning establishes safe spaces through storytelling, which further reinforces comfort with a new language, and can in turn lead to increased resilience.

The fifth way, building inclusivity, is more focused on providing resources. By providing institutions or schools with more language-based learning and cultural material, the host community can better learn how to best address the needs of the refugee community. This overall addressing of needs feeds back into the increased resilience of refugees by creating a sense of belonging and community.

Additionally, a study completed by Kate Nguyen, Nile Stanley, Laurel Stanley, and Yonghui Wang shows the impacts of storytelling in building resilience. This aligns with many of the five factors identified by the study completed by the British Council, as it emphasizes the importance of sharing traumatic experiences through language. This study in particular showed that those who were exposed to more stories, from family or friends, had a more holistic view of life’s struggles, and were thus more resilient, especially when surrounded by foreign languages or attempting to learn a new language.

Other Development Programmes

The Head Start programme was shown to promote resilience. So was the Big Brothers Big Sisters Programme, Centred Coaching & Consulting, the Abecedarian Early Intervention Project, and social programmes for youth with emotional or behavioural difficulties.

The Positive Behaviour Supports and Intervention programme is a successful trauma-informed, resilience-based for elementary age students with four components. These four elements include positive reinforcements such as encouraging feedback, understanding that behaviour is a response to unmet needs or a survival response, promoting belonging, mastery and independence, and finally, creating an environment to support the student through sensory tools, mental health breaks and play.

Tuesday’s Children, a family service organisation that made a long-term commitment to the individuals that have lost loved ones to 9/11 and terrorism around the world, works to build psychological resilience through programmes such as Mentoring and Project COMMON BOND, an 8-day peace-building and leadership initiative for teens, ages 15-20, from around the world who have been directly impacted by terrorism.

Military organisations test personnel for the ability to function under stressful circumstances by deliberately subjecting them to stress during training. Those students who do not exhibit the necessary resilience can be screened out of the training. Those who remain can be given stress inoculation training. The process is repeated as personnel apply for increasingly demanding positions, such as special forces.

Children

Resilience in children refers to individuals who are doing better than expected, given a history that includes risk or adverse experience. Once again, it is not a trait or something that some children simply possess. There is no such thing as an ‘invulnerable child’ that can overcome any obstacle or adversity that he or she encounters in life – and in fact, the trait is quite common. All children share the uniqueness of an upbringing, experiences which could be positive or negative. Adverse Childhood Experiences (ACE’s) are events which occur in a child’s life that could lead to maladaptive symptoms such as feeling tension, low mood, repetitive and recurring thoughts, and avoidance. The psychological resilience to overcome adverse events is not the sole explanation of why some children experience post-traumatic growth and some do not. Resilience is the product of a number of developmental processes over time, that has allowed children experience small exposures to adversity or some sort of age appropriate challenges to develop mastery and continue to develop competently. This gives children a sense of personal pride and self-worth.

Research on ‘protective factors’, which are characteristics of children or situations that particularly help children in the context of risk has helped developmental scientists to understand what matters most for resilient children. Two of these that have emerged repeatedly in studies of resilient children are good cognitive functioning (like cognitive self-regulation and IQ) and positive relationships (especially with competent adults, like parents). Children who have protective factors in their lives tend to do better in some risky contexts when compared to children without protective factors in the same contexts. However, this is not a justification to expose any child to risk. Children do better when not exposed to high levels of risk or adversity.

Building in the Classroom

Resilient children within classroom environments have been described as working and playing well and holding high expectations, have often been characterised using constructs such as locus of control, self-esteem, self-efficacy, and autonomy. All of these things work together to prevent the debilitating behaviours that are associated with learned helplessness.

Role of the Community

Communities play a huge role in fostering resilience. The clearest sign of a cohesive and supportive community is the presence of social organisations that provide healthy human development. Services are unlikely to be used unless there is good communication concerning them. Children who are repeatedly relocated do not benefit from these resources, as their opportunities for resilience-building, meaningful community participation are removed with every relocation

Role of the Family

Fostering resilience in children is favoured in family environments that are caring and stable, hold high expectations for children’s behaviour and encourage participation in the life of the family. Most resilient children have a strong relationship with at least one adult, not always a parent, and this relationship helps to diminish risk associated with family discord. The definition of parental resilience, as the capacity of parents to deliver a competent and quality level of parenting to children, despite the presence of risk factors, has proven to be a very important role in children’s resilience. Understanding the characteristics of quality parenting is critical to the idea of parental resilience. Even if divorce produces stress, the availability of social support from family and community can reduce this stress and yield positive outcomes. Any family that emphasizes the value of assigned chores, caring for brothers or sisters, and the contribution of part-time work in supporting the family helps to foster resilience. Resilience research has traditionally focused on the well-being of children, with limited academic attention paid to factors that may contribute to the resilience of parents.

Families in Poverty

Numerous studies have shown that some practices that poor parents utilise help promote resilience within families. These include frequent displays of warmth, affection, emotional support; reasonable expectations for children combined with straightforward, not overly harsh discipline; family routines and celebrations; and the maintenance of common values regarding money and leisure. According to sociologist Christopher B. Doob, “Poor children growing up in resilient families have received significant support for doing well as they enter the social world—starting in daycare programs and then in schooling.”

Bullying

Beyond preventing bullying, it is also important to consider how interventions based on emotional intelligence are important in the case that bullying does occur. Increasing emotional intelligence may be an important step in trying to foster resilience among victims. When a person faces stress and adversity, especially of a repetitive nature, their ability to adapt is an important factor in whether they have a more positive or negative outcome.

A 2013 study examined adolescents who illustrated resilience to bullying and found some interesting gendered differences, with higher behavioural resilience found among girls and higher emotional resilience found among boys. Despite these differences, they still implicated internal resources and negative emotionality in either encouraging or being negatively associated with resilience to bullying respectively and urged for the targeting of psychosocial skills as a form of intervention. Emotional intelligence has been illustrated to promote resilience to stress and as mentioned previously, the ability to manage stress and other negative emotions can be preventative of a victim going on to perpetuate aggression. One factor that is important in resilience is the regulation of one’s own emotions. Schneider et al. (2013) found that emotional perception was significant in facilitating lower negative emotionality during stress and Emotional Understanding facilitated resilience and has a positive correlation with positive affect.

Education

Many years and sources of research indicate that there are a few consistent protective factors of young children despite differences in culture and stressors (poverty, war, divorce of parents, natural disasters, etc.):

  • Capable parenting.
  • Other close relationships.
  • Intelligence.
  • Self-control.
  • Motivation to succeed.
  • Self-confidence & self-efficacy.
  • Faith, hope, belief life has meaning.
  • Effective schools.
  • Effective communities.
  • Effective cultural practices.

Ann Masten coins these protective factors as “ordinary magic,” the ordinary human adaptive systems that are shaped by biological and cultural evolution. In her book, Ordinary Magic: Resilience in Development, she discusses the “immigrant paradox”, the phenomenon that first-generation immigrant youth are more resilient than their children. Researchers hypothesize that “there may be culturally based resiliency that is lost with succeeding generations as they become distanced from their culture of origin.” Another hypothesis is that those who choose to immigrate are more likely to be more resilient.

Research by Rosemary Gonzalez and Amado M. Padilla on the academic resilience of Mexican-American high school students reveal that while a sense of belonging to school is the only significant predictor of academic resilience, a sense of belonging to family, a peer group, and a culture can also indicate higher academic resilience. “Although cultural loyalty overall was not a significant predictor of resilience, certain cultural influences nonetheless contribute to resilient outcomes, like familism and cultural pride and awareness.” The results of Gonzalez and Padilla’s study “indicate a negative relationship between cultural pride and the ethnic homogeneity of a school.” They hypothesize that “ethnicity becomes a salient and important characteristic in more ethnically diverse settings”.

Considering the implications of the research by Masten, Gonzalez, and Padilla, a strong connection with one’s cultural identity is an important protective factor against stress and is indicative of increased resilience. While many additional classroom resources have been created to promote resilience in developing students, the most effective ways to ensure resilience in children is by protecting their natural adaptive systems from breaking down or being hijacked. At home, resilience can be promoted through a positive home environment and emphasized cultural practices and values. In school, this can be done by ensuring that each student develops and maintains a sense of belonging to the school through positive relationships with classroom peers and a caring teacher. Research on resilience consistently shows that a sense of belonging – whether it be in a culture, family, or another group – greatly predicts resiliency against any given stressor.

Specific Situations

Divorce

Often divorce is viewed as detrimental to one’s emotional health, but studies have shown that cultivating resilience may be beneficial to all parties involved. The level of resilience a child will experience after their parents have split is dependent on both internal and external variables. Some of these variables include their psychological and physical state and the level of support they receive from their schools, friends, and family friends. The ability to deal with these situations also stems from the child’s age, gender, and temperament. Children will experience divorce differently and thus their ability to cope with divorce will differ too. About 20-25% of children will “demonstrate severe emotional and behavioural problems” when going through a divorce. This percentage is notably higher than the 10% of children exhibiting similar problems in married families. Despite this, approximately 75-80% of these children will “develop into well-adjusted adults with no lasting psychological or behavioural problems”. This comes to show that most children have the tools necessary to allow them to exhibit the resilience needed to overcome their parents’ divorce.

The effects of the divorce extend past the separation of both parents. The remaining conflict between parents, financial problems, and the re-partnering or remarriage of parents can cause lasting stress. Studies conducted by Booth and Amato (2001) have shown that there is no correlation between post-divorce conflict and the child’s ability to adjust to their life circumstance. On the other hand, Hetherington (1999) completed research on this same topic and did find adverse effects in children. In regards to the financial standing of a family, divorce does have the potential to reduce the children’s style of living. Child support is often given to help cover basic needs such as schooling. If the parents’ finances are already scarce then their children may not be able to participate in extracurricular activities such as sports and music lessons, which can be detrimental to their social lives.

Re-partnering or remarrying can bring in additional levels of conflict and anger into their home environment. One of the reasons that re-partnering causes additional stress is because of the lack of clarity in roles and relationships; the child may not know how to react and behave with this new “parent” figure in their life. In most cases, bringing in a new partner/spouse will be the most stressful when done shortly after the divorce. In the past, divorce had been viewed as a “single event”, but now research shows that divorce encompasses multiple changes and challenges. It is not only internal factors that allow for resiliency, but the external factors in the environment are critical for responding to the situation and adapting. Certain programmes such as the 14-week Children’s Support Group and the Children of Divorce Intervention Programme may help a child cope with the changes that occur from a divorce.

Natural Disasters

Resilience after a natural disaster can be gauged in a number of different ways. It can be gauged on an individual level, a community level, and on a physical level. The first level, the individual level, can be defined as each independent person in the community. The second level, the community level, can be defined as all those inhabiting the locality affected. Lastly, the physical level can be defined as the infrastructure of the locality affected.

UNESCAP funded research on how communities show resiliency in the wake of natural disasters. They found that, physically, communities were more resilient if they banded together and made resiliency an effort of the whole community. Social support is key in resilient behaviour, and especially the ability to pool resources. In pooling social, natural, and economic resources, they found that communities were more resilient and able to over come disasters much faster than communities with an individualistic mindset.

The World Economic Forum met in 2014 to discuss resiliency after natural disasters. They conclude that countries that are more economically sound, and have more individuals with the ability to diversify their livelihoods, will show higher levels of resiliency. This has not been studied in depth yet, but the ideas brought about through this forum appear to be fairly consistent with already existing research.

Research indicates that resilience following natural disasters can be predicted by the level of emotion an individual experienced and were able to process within and following the disaster. Those who employ emotional styles of coping were able to grow from their experiences and then help others. In these instances, experiencing emotions was adaptive. Those who did not engage with their emotions and employed avoidant and suppressive coping styles had poorer mental health outcomes following disaster.

Death of a Family Member

Little research has been done on the topic of family resilience in the wake of the death of a family member. Traditionally, clinical attention to bereavement has focused on the individual mourning process rather than on those of the family unit as a whole. Resiliency is distinguished from recovery as the “ability to maintain a stable equilibrium” which is conducive to balance, harmony, and recovery. Families must learn to manage familial distortions caused by the death of the family member, which can be done by reorganizing relationships and changing patterns of functioning to adapt to their new situation. Exhibiting resilience in the wake of trauma can successfully traverse the bereavement process without long-term negative consequences.

One of the healthiest behaviours displayed by resilient families in the wake of a death is honest and open communication. This facilitates an understanding of the crisis. Sharing the experience of the death can promote immediate and long-term adaptation to the recent loss of a loved one. Empathy is a crucial component in resilience because it allows mourners to understand other positions, tolerate conflict, and be ready to grapple with differences that may arise. Another crucial component to resilience is the maintenance of a routine that helps to bind the family together through regular contact and order. The continuation of education and a connection with peers and teachers at school is an important support for children struggling with the death of a family member.

Professional Settings

Resilience has also been examined in the context of failure and setbacks in workplace settings. Representing one of the core constructs of positive organizational behaviour (Luthans, 2002), and given increasingly disruptive and demanding work environments, scholars’ and practitioners’ attention to psychological resilience in organisations has greatly increased. This research has highlighted certain personality traits, personal resources (e.g. self-efficacy, work-life balance, social competencies), personal attitudes (e.g., sense of purpose, job commitment), positive emotions, and work resources (e.g. social support, positive organisational context) as potential facilitators of workplace resilience.

Beyond studies on general workplace resilience, attention has been directed to the role of resilience in innovative contexts. Due to high degrees of uncertainty and complexity in the innovation process, failure and setbacks are naturally happening frequently in this context. As such failure and setbacks can have strong and harmful effects on affected individuals’ motivation and willingness to take risks, their resilience is essential to productively engage in future innovative activities. To account for the peculiarities of the innovation context, a resilience construct specifically aligned to this unique context was needed to address the need to diagnose and develop innovators’ resilience to minimise the human cost of failure and setbacks in innovation. As a context-specific conceptualisation of resilience, Innovator Resilience Potential (IRP) serves this purpose and captures the potential for innovative functioning after the experience of failure or setbacks in the innovation process and for handling future setbacks. Based on Bandura’s social cognitive theory, IRP is proposed to consist of six components: self-efficacy, outcome expectancy, optimism, hope, self-esteem, and risk propensity. The concept of IRP thus reflects a process perspective on resilience. On the one hand, in this process, IRP can be seen as an antecedent of how a setback affects an innovator. On the other hand, IRP can be seen as an outcome of the process that, in turn, is influenced by the setback situation. Recently, a measurement scale of IRP was developed and validated.

Cross-Cultural Resilience

Areas of Difference

There is controversy about the indicators of good psychological and social development when resilience is studied across different cultures and contexts. The American Psychological Association’s Task Force on Resilience and Strength in Black Children and Adolescents, for example, notes that there may be special skills that these young people and families have that help them cope, including the ability to resist racial prejudice. Researchers of indigenous health have shown the impact of culture, history, community values, and geographical settings on resilience in indigenous communities. People who cope may also show “hidden resilience” when they do not conform with society’s expectations for how someone is supposed to behave (in some contexts, aggression may be required to cope, or less emotional engagement may be protective in situations of abuse).

Resilience in Individualist and Collectivist Communities

Individualist cultures, such as those of the US, Austria, Spain, and Canada, emphasize personal goals, initiatives, and achievements. Independence, self-reliance, and individual rights are highly valued by members of individualistic cultures. Economic, political, and social policies reflect the culture’s interest in individualism. The ideal person in individualist societies is assertive, strong, and innovative. People in this culture tend to describe themselves in terms of their unique traits- “I am analytical and curious” (Ma et al. 2004). Comparatively, in places like Japan, Sweden, Turkey, and Guatemala, Collectivist cultures emphasize family and group work goals. The rules of these societies promote unity, brotherhood, and selflessness. Families and communities practice cohesion and cooperation. The ideal person in collectivist societies is trustworthy, honest, sensitive, and generous- emphasizing intrapersonal skills. Collectivists tend to describe themselves in terms of their roles – “I am a good husband and a loyal friend” (Ma et al. 2004). In a study on the consequences of disaster on a culture’s individualism, researchers operationalised these cultures by identifying indicative phrases in a society’s literature. Words that showed the theme of individualism include, “able, achieve, differ, own, personal, prefer, and special.” Words that indicated collectivism include, “belong, duty, give, harmony, obey, share, together.”

Differences in Response to Natural Disasters

Natural disasters threaten to destroy communities, displace families, degrade cultural integrity, and diminish an individual’s level of functioning. Comparing individualist community reactions to collectivist community responses after natural disasters illustrates their differences and respective strengths as tools of resilience. Some suggest that disasters reduce individual agency and sense of autonomy as it strengthens the need to rely on other people and social structures. Therefore, countries/regions with heightened exposure to disaster should cultivate collectivism. However, Withey (1962) and Wachtel (1968) conducted interviews and experiments on disaster survivors which indicated that disaster-induced anxiety and stress decrease one’s focus on social-contextual information – a key component of collectivism. In this way, disasters may lead to increased individualism.

Mauch and Pfister (2004) questioned the association between socio-ecological indicators and cultural-level change in individualism. In their research, for each socio-ecological indicator, frequency of disasters was associated with greater (rather than less) individualism. Supplementary analyses indicated that the frequency of disasters was more strongly correlated with individualism-related shifts than was the magnitude of disasters or the frequency of disasters qualified by the number of deaths. Baby-naming practices is one interesting indicator of change. According to Mauch and Pfister (2004), urbanization was linked to preference for uniqueness in baby-naming practices at a 1-year lag, secularism was linked to individualist shifts in interpersonal structure at both lags, and disaster prevalence was linked to more unique naming practices at both lags. Secularism and disaster prevalence contributed mainly to shifts in naming practices.

There is a gap in disaster recovery research that focuses on psychology and social systems but does not adequately address interpersonal networking or relationship formation and maintenance. A disaster response theory holds that individuals who use existing communication networks fare better during and after disasters. Moreover, they can play important roles in disaster recovery by taking initiative to organize and help others recognise and use existing communication networks and coordinate with institutions which correspondingly should strengthen relationships with individuals during normal times so that feelings of trust exist during stressful ones.

In a collectivist sense, building strong, self-reliant communities, whose members know each other, know each other’s needs and are aware of existing communication networks, looks like an optimum defence against disasters.

In comparing these cultures, there is really no way to measure resilience, but one can look at the collateral consequences of a disaster to a country to gauge its resilience.

  • Collectivist resilience:
    • Returning to routine.
    • Rebuilding family structures.
    • Communal sharing of resources.
    • Emotional expression of grief and loss to a supportive listener.
    • Finding benefits from the disaster experience.
  • Individualist resilience:
    • Redistribution of power/resources.
    • Returning to routine.
    • Emotional expression through formal support systems.
    • Confrontation of the problem.
    • Reshaping one’s outlook after the disaster experience.

Whereas individualistic societies promote individual responsibility for self-sufficiency, the collectivistic culture defines self-sufficiency within an interdependent communal context (Kayser et al. 2008). Even where individualism is salient, a group thrives when its members choose social over personal goals and seek to maintain harmony and where they value collectivist over individualist behaviour (McAuliffe et al. 2003).

The Concept of Resilience in Language

While not all languages have a direct translation for the English word “resilience”, nearly every culture and community globally has a word which relates to a similar concept. The differences between the literal meanings of translated words shows that there is a common understanding of what resilience is. Even if a word does not directly translate to “resilience” in English, it relays a meaning similar enough to the concept and is used as such within the language.

If a specific word for resilience does not exist in a language, speakers of that language typically assign a similar word that insinuates resilience based on context. Many languages use words that translate to “elasticity” or “bounce”, which are used in context to capture the meaning of resilience. For example, one of the main words for “resilience” in Chinese literally translates to “rebound”, one of the main words for “resilience” in Greek translates to “bounce”, and one of the main words for “resilience” in Russian translates to “elasticity,” just as it does in German. However, this is not the case for all languages. For example, if a Spanish speaker wanted to say “resilience”, their main two options translate to “resistance” and “defence against adversity”. Many languages have words that translate better to “tenacity” or “grit” better than they do to “resilience”. While these languages may not have a word that exactly translates to “resilience”, note that English speakers often use tenacity or grit when referring to resilience. While one of the Greek words for “resilience” translates to “bounce”, another option translates to “cheerfulness”. Moreover, Arabic has a word solely for resilience, but also two other common expressions to relay the concept, which directly translate to “capacity on deflation” or “reactivity of the body”, but are better translated as “impact strength” and “resilience of the body” respectively. On the other hand, a few languages, such as Finnish, have created words to express resilience in a way that cannot be translated back to English. In Finnish, the word “sisu” could most closely be translated to mean “grit” in English, but blends the concepts of resilience, tenacity, determination, perseverance, and courage into one word that has even become a facet of Finnish culture and earned its place as a name for a few Finnish brands.

Criticism of Application

Brad Evans and Julian Reid criticise resilience discourse and its rising popularity in their book, Resilient Life. The authors assert that policies of resilience can put the onus of disaster response on individuals rather than publicly coordinated efforts. Tied to the emergence of neoliberalism, climate change, third-world development, and other discourses, Evans and Reid argue that promoting resilience draws attention away from governmental responsibility and towards self-responsibility and healthy psychological effects such as post-traumatic growth.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Psychological_resilience >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is the Health Belief Model?

Published on by Andrew MarshallLeave a comment

Introduction

The health belief model (HBM) is a social psychological health behaviour change model developed to explain and predict health-related behaviours, particularly in regard to the uptake of health services.

The HBM was developed in the 1950s by social psychologists at the US Public Health Service and remains one of the best known and most widely used theories in health behaviour research. The HBM suggests that people’s beliefs about health problems, perceived benefits of action and barriers to action, and self-efficacy explain engagement (or lack of engagement) in health-promoting behaviour. A stimulus, or cue to action, must also be present in order to trigger the health-promoting behaviour.

Original Health Belief Model.

Brief History

One of the first theories of health behaviour, the HBM was developed in 1950s by social psychologists Irwin M. Rosenstock, Godfrey M. Hochbaum, S. Stephen Kegeles, and Howard Leventhal at the US Public Health Service. At that time, researchers and health practitioners were worried because few people were getting screened for tuberculosis (TB), even if mobile X-ray cars went to neighbourhoods. The HBM has been applied to predict a wide variety of health-related behaviours such as being screened for the early detection of asymptomatic diseases and receiving immunisations. More recently, the model has been applied to understand intentions to vaccinate (e.g. COVID-19), responses to symptoms of disease, compliance with medical regimens, lifestyle behaviours (e.g. sexual risk behaviours), and behaviours related to chronic illnesses, which may require long-term behaviour maintenance in addition to initial behaviour change. Amendments to the model were made as late as 1988 to incorporate emerging evidence within the field of psychology about the role of self-efficacy in decision-making and behaviour.

Health Belief Model in action.

Theoretical Constructs

The HBM theoretical constructs originate from theories in Cognitive Psychology. In the early twentieth century, cognitive theorists believed that reinforcements operated by affecting expectations rather than by affecting behaviour directly. Mental processes are severe consists of cognitive theories that are seen as expectancy-value models, because they propose that behaviour is a function of the degree to which people value a result and their evaluation of the expectation, that a certain action will lead that result. In terms of the health-related behaviours, the value is avoiding sickness. The expectation is that a certain health action could prevent the condition for which people consider they might be at risk.

The following constructs of the HBM are proposed to vary between individuals and predict engagement in health-related behaviours.

Perceived Susceptibility

Perceived susceptibility refers to subjective assessment of risk of developing a health problem. The HBM predicts that individuals who perceive that they are susceptible to a particular health problem will engage in behaviours to reduce their risk of developing the health problem. Individuals with low perceived susceptibility may deny that they are at risk for contracting a particular illness. Others may acknowledge the possibility that they could develop the illness, but believe it is unlikely. Individuals who believe they are at low risk of developing an illness are more likely to engage in unhealthy, or risky, behaviours. Individuals who perceive a high risk that they will be personally affected by a particular health problem are more likely to engage in behaviours to decrease their risk of developing the condition.

The combination of perceived severity and perceived susceptibility is referred to as perceived threat. Perceived severity and perceived susceptibility to a given health condition depend on knowledge about the condition. The HBM predicts that higher perceived threat leads to a higher likelihood of engagement in health-promoting behaviours.

Perceived Severity

Perceived severity refers to the subjective assessment of the severity of a health problem and its potential consequences. The HBM proposes that individuals who perceive a given health problem as serious are more likely to engage in behaviours to prevent the health problem from occurring (or reduce its severity). Perceived seriousness encompasses beliefs about the disease itself (e.g. whether it is life-threatening or may cause disability or pain) as well as broader impacts of the disease on functioning in work and social roles. For instance, an individual may perceive that influenza is not medically serious, but if he or she perceives that there would be serious financial consequences as a result of being absent from work for several days, then he or she may perceive influenza to be a particularly serious condition.

Through studying Australians and their self-reporting in 2019 of receiving the influenza vaccine, researchers found that by studying perceived severity they could determine the likelihood that Australians would receive the shot. They asked, “On a scale from 0 to 10, how severe do you think the flu would be if you got it?” to measure the perceived severity and they found that 31% perceived the severity of getting the flu as low, 44% as moderate, and 25% as high. Additionally, the researchers found those with a high perceived severity were significantly more likely to have received the vaccine than those with a moderate perceived severity. Furthermore, self-reported vaccination was similar for individuals with low and moderate perceived severity of influenza.

Perceived Benefits

Health-related behaviours are also influenced by the perceived benefits of taking action. Perceived benefits refer to an individual’s assessment of the value or efficacy of engaging in a health-promoting behaviour to decrease risk of disease. If an individual believes that a particular action will reduce susceptibility to a health problem or decrease its seriousness, then he or she is likely to engage in that behaviour regardless of objective facts regarding the effectiveness of the action. For example, individuals who believe that wearing sunscreen prevents skin cancer are more likely to wear sunscreen than individuals who believe that wearing sunscreen will not prevent the occurrence of skin cancer.

Perceived Barriers

Health-related behaviours are also a function of perceived barriers to taking action. Perceived barriers refer to an individual’s assessment of the obstacles to behaviour change. Even if an individual perceives a health condition as threatening and believes that a particular action will effectively reduce the threat, barriers may prevent engagement in the health-promoting behaviour. In other words, the perceived benefits must outweigh the perceived barriers in order for behaviour change to occur. Perceived barriers to taking action include the perceived inconvenience, expense, danger (e.g. side effects of a medical procedure) and discomfort (e.g. pain, emotional upset) involved in engaging in the behaviour. For instance, lack of access to affordable health care and the perception that a flu vaccine shot will cause significant pain may act as barriers to receiving the flu vaccine. In a study about the breast and cervical cancer screening among Hispanic women, perceived barriers, like fear of cancer, embarrassment, fatalistic views of cancer and language, was proved to impede screening.

Modifying Variables

Individual characteristics, including demographic, psychosocial, and structural variables, can affect perceptions (i.e. perceived seriousness, susceptibility, benefits, and barriers) of health-related behaviours. Demographic variables include age, sex, race, ethnicity, and education, among others. Psychosocial variables include personality, social class, and peer and reference group pressure, among others. Structural variables include knowledge about a given disease and prior contact with the disease, among other factors. The HBM suggests that modifying variables affect health-related behaviours indirectly by affecting perceived seriousness, susceptibility, benefits, and barriers.

Cues to Action

The HBM posits that a cue, or trigger, is necessary for prompting engagement in health-promoting behaviours. Cues to action can be internal or external. Physiological cues (e.g. pain, symptoms) are an example of internal cues to action. External cues include events or information from close others, the media, or health care providers promoting engagement in health-related behaviours. Examples of cues to action include a reminder postcard from a dentist, the illness of a friend or family member, mass media campaigns on health issues, and product health warning labels. The intensity of cues needed to prompt action varies between individuals by perceived susceptibility, seriousness, benefits, and barriers. For example, individuals who believe they are at high risk for a serious illness and who have an established relationship with a primary care doctor may be easily persuaded to get screened for the illness after seeing a public service announcement, whereas individuals who believe they are at low risk for the same illness and also do not have reliable access to health care may require more intense external cues in order to get screened.

Self-Efficacy

Self-efficacy was added to the four components of the HBM (i.e. perceived susceptibility, severity, benefits, and barriers) in 1988. Self-efficacy refers to an individual’s perception of his or her competence to successfully perform a behaviour. Self-efficacy was added to the HBM in an attempt to better explain individual differences in health behaviours. The model was originally developed in order to explain engagement in one-time health-related behaviours such as being screened for cancer or receiving an immunisation. Eventually, the HBM was applied to more substantial, long-term behaviour change such as diet modification, exercise, and smoking. Developers of the model recognised that confidence in one’s ability to effect change in outcomes (i.e. self-efficacy) was a key component of health behaviour change. For example, Schmiege et al. found that when dealing with calcium consumption and weight-bearing exercises, self-efficacy was a more powerful predictors than beliefs about future negative health outcomes.

Rosenstock et al. argued that self-efficacy could be added to the other HBM constructs without elaboration of the model’s theoretical structure. However, this was considered short-sighted because related studies indicated that key HBM constructs have indirect effects on behaviour as a result of their effect on perceived control and intention, which might be regarded as more proximal factors of action.

Empirical Support

The HBM has gained substantial empirical support since its development in the 1950s. It remains one of the most widely used and well-tested models for explaining and predicting health-related behaviour. A 1984 review of 18 prospective and 28 retrospective studies suggests that the evidence for each component of the HBMl is strong. The review reports that empirical support for the HBM is particularly notable given the diverse populations, health conditions, and health-related behaviours examined and the various study designs and assessment strategies used to evaluate the model. A more recent meta-analysis found strong support for perceived benefits and perceived barriers predicting health-related behaviours, but weak evidence for the predictive power of perceived seriousness and perceived susceptibility. The authors of the meta-analysis suggest that examination of potential moderated and mediated relationships between components of the model is warranted.

Several studies have provided empirical support from the chronic illness perspective. Becker et al. used the model to predict and explain a mother’s adherence to a diet prescribed for their obese children. Cerkoney et al. interviewed insulin-treated diabetic individuals after diabetic classes at a community hospital. It empirically tested the HBM’s association with the compliance levels of persons chronically ill with diabetes mellitus.

Applications

The HBM has been used to develop effective interventions to change health-related behaviours by targeting various aspects of the model’s key constructs. Interventions based on the HBM may aim to increase perceived susceptibility to and perceived seriousness of a health condition by providing education about prevalence and incidence of disease, individualised estimates of risk, and information about the consequences of disease (e.g. medical, financial, and social consequences). Interventions may also aim to alter the cost-benefit analysis of engaging in a health-promoting behaviour (i.e. increasing perceived benefits and decreasing perceived barriers) by providing information about the efficacy of various behaviours to reduce risk of disease, identifying common perceived barriers, providing incentives to engage in health-promoting behaviours, and engaging social support or other resources to encourage health-promoting behaviours. Furthermore, interventions based on the HBM may provide cues to action to remind and encourage individuals to engage in health-promoting behaviours. Interventions may also aim to boost self-efficacy by providing training in specific health-promoting behaviours, particularly for complex lifestyle changes (e.g. changing diet or physical activity, adhering to a complicated medication regimen). Interventions can be aimed at the individual level (i.e. working one-on-one with individuals to increase engagement in health-related behaviours) or the societal level (e.g. through legislation, changes to the physical environment, mass media campaigns).

Multiple studies have used the Health Belief Model to understand an individual’s intention to change a particular behavior and the factors that influence their ability to do so. Researchers analysed the correlation between young adult women’s intention to stop smoking and their perceived factors in the construction of HBM. The intention to stop smoking among young adult women had a significant correlation with the perceived factors of the Health Belief Model.

Another use of the HBM was in 2016 in a study that was interested in examining the factors associated with physical activity among people with mental illness (PMI) in Hong Kong (Mo et al., 2016). The study used the HBM model because it was one of the most frequently used models to explain health behaviours and the HBM was used as a framework to understand the PMI physical activity levels. The study had 443 PMI complete the survey with the mean age being 45 years old. The survey found that among the HBM variables, perceived barriers were significant in predicting physical activity. Additionally, the research demonstrated that self-efficacy had a positive correlation for physical activity among PMI. These findings support previous literature that self-efficacy and perceived barriers plays a significant role in physical activity and it should be included in interventions. The study also stated that the participants acknowledged that most of their attention is focused on their psychiatric conditions with little focus on their physical health needs.

This study is important to note in regards to the HBM because it illustrates how culture can play a role in this model. The Chinese culture holds different health beliefs than the United States, placing a greater emphasis on fate and the balance of spiritual harmony than on their physical fitness. Since the HBM does not consider these outside variables it highlights a limitation associated with the model and how multiple factors can impact health decisions, not just the ones noted in the model.

Applying the Health Belief Model to Women’s Safety Movements

Movements such as the #MeToo movements and current political tensions surrounding abortion laws have moved women’s rights and violence against women to the forefront of topical conversation. Additionally, many organisations, such as Women On Guard, have begun to place emphasize on trying to educate women on what measures to take in order to increase their safety when walking alone at night. The murder of Sarah Everard on 03 March 2021, has placed further attention on the need for women to protect themselves and stay vigilant when walking alone at night. Everard was kidnapped and murdered while walking home from work in South London, England. The health belief model can provide insight into the steps that need to be taken in order to reach more women and convince them to take the necessary steps to increase safety when walking alone.

Perceived Susceptibility

As stated, perceived susceptibility refers to how susceptible an individual perceives themselves to be to any given risk. In the case of encountering violence while walking along, research shows that many women have high amounts of perceived susceptibility in regards to how susceptible they believe themselves to be to the risk of being attacked while walking along. Studies show that around 50% of women feel unsafe when walking alone at night. Since women may already have increased perceive susceptibility to night-violence, according to the health belief model, they may be more apt to engage in behaviour changes to help them increase their safety/ defend themselves.

Perceived Severity

As the statistics on perceived susceptibility demonstrate, many women feel they are at risk for encountering night-violence. Thus, women also have a higher perception of the severity of the violence as stories such as the tragic death of Sarah Everard demonstrate that night-violence attacks can be not only severe, but fatal.

Perceived Benefits and Barriers

As the health belief model states, individuals must consider the potential benefits of adopting the change in behaviour that is being suggested to them. In the case of night-violence against women organisations that seek to prevent it do so by using advertising to demonstrate to women that tools such as pocket knives, pepper spray, self-defence classes, alarm systems, and traveling with a “buddy” can outweigh barriers such as the cost, time, and other inconveniences that pursuing these changes in behaviour may require. The benefit to implementing these behaviours would be that women could feel more safe when walking alone at night.

Modifying Variable

It is not surprise that the modifying variable of sex plays a large role in applying the health belief model to women’s safety agendas/ movements. While studies show that around 50% of women feel unsafe walking at night, they also show that fewer than one fifth of men feel the same fear and discomfort. Thus, it is evident that the modifying variable of gender plays a large role in how night-time violence is perceived. According to the model, women may be more likely to change their behaviour toward preventing night-time violence than men.

Cues to Action

Cues to action are perhaps the most powerful part of the health belief model and of getting individual to change their behaviour. In regards to preventing night-time violence against women, stories of the horrific violent acts committed against women while they are walking at night serve as external cues to action that can spur individuals to take the necessary precautions and make the necessary change to their behaviour in order to reduce the likelihood of them encountering night-time violence. Cues to action further factor into increased perceived susceptibility and severity of the given risk.

Self Efficacy

Self efficacy is another important factor both in the health belief model and in behaviour change in general. When people believe that they actually have the power to prevent the given risk, then they are more likely to take the appropriate measures to do so. When individuals believe that they cannot change their behaviour or prevent the risk no matter what they do, then they are less likely to engage in behaviour to stop the risk. This concept factors greatly into initiatives to help women defend themselves against night violence because, based on the statistics, many women do feel that if they carry items such as tasers, pepper spray, or alarms they will be able to defend themselves against attackers. Self-defence classes are also things that organisations offer in order to teach individuals that they have the power to learn how to defend themselves and acquire the proper skills to do so. These classes can help to increase self efficacy. Organisations such as community centres may offer classes along these lines.

The issues of night violence against women is an issue of safety and wellness which makes it applicable to a health belief model approach. Defence and preparation for night violence can require behavioural changes on behalf of women if they feel that doing so will help them protect themselves should they ever be attacked.

Limitations

The HBM attempts to predict health-related behaviours by accounting for individual differences in beliefs and attitudes. However, it does not account for other factors that influence health behaviours. For instance, habitual health-related behaviours (e.g. smoking, seatbelt buckling) may become relatively independent of conscious health-related decision-making processes. Additionally, individuals engage in some health-related behaviours for reasons unrelated to health (e.g. exercising for aesthetic reasons). Environmental factors outside an individual’s control may prevent engagement in desired behaviours. For example, an individual living in a dangerous neighbourhood may be unable to go for a jog outdoors due to safety concerns. Furthermore, the HBM does not consider the impact of emotions on health-related behaviour. Evidence suggests that fear may be a key factor in predicting health-related behaviour.

Alternative factors may predict health behaviour, such as outcome expectancy (i.e. whether the person feels they will be healthier as a result of their behaviour) and self-efficacy (i.e. the person’s belief in their ability to carry out preventive behaviour).

The theoretical constructs that constitute the HBM are broadly defined. Furthermore, the HBM does not specify how constructs of the model interact with one another. Therefore, different operationalisations of the theoretical constructs may not be strictly comparable across studies.

Research assessing the contribution of cues to action in predicting health-related behaviours is limited. Cues to action are often difficult to assess, limiting research in this area. For instance, individuals may not accurately report cues that prompted behaviour change. Cues such as a public service announcement on television or on a billboard may be fleeting and individuals may not be aware of their significance in prompting them to engage in a health-related behaviour. Interpersonal influences are also particularly difficult to measure as cues.

Another reason why research does not always support the HBM is that factors other than health beliefs also heavily influence health behaviour practices. These factors may include: special influences, cultural factors, socioeconomic status, and previous experiences. Scholars extend the HBM by adding four more variables (self-identity, perceived importance, consideration of future consequences and concern for appearance) as possible determinants of healthy behaviour. They prove that consideration of future consequences, self-identity, concern for appearance, perceived importance, self-efficacy, perceived susceptibility are significant determinants of healthy eating behaviour that can be manipulated by healthy eating intervention design.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Health_belief_model >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.