Monday, July 12, 2010

Guest Post: Mark Walsh - Resilience and Stress Management Training

Resilience is a hot topic in psychology - if we can understand why and how some people come through stress and trauma easier than others, then maybe we can develop effective training to help those more impacted by challenges to come through them with fewer issues.

Mark Walsh specializes in stress management training, integral business leadership training, and resilience training providers, based in Brighton (Sussex), Birmingham, and London UK. He has kindly written this article for Integral Options Cafe. He is a leader in resilience training and stress reduction methods.

This is new material never before presented, so it is an honor to host this excellent article.

Resilience and Stress Management Training

(An integral approach to keeping sane under pressure)

Resilience training is a hot topic but what does it mean? Simply put, resilience is the ability to bounce back, not crack under pressure, and this skill-set can be built. Or as I explained my work to a old friend recently, “I help people stay sane when the shit hits the fan.” Resilience training is preventative, building people’s capacity to manage stress gracefully. This article takes an integral look at resilience training and offers a few practical tips for anyone who’s life isn’t always easy.

Introduction

I have spent the last three years running a leadership and stress management training company, working in the corporate world and the not-for-profit sector (where I had worked previously in areas of conflict). We specialize in integral business training, taking into account quadrants, lines, levels, types, and states in our courses. We are one of the few training providers in Europe using integral theory as a core meta-model (our Brighton neighbours Integral College, NLP practitioner Peter McNab, and our Dutch friends Realize are also noteworthy Wilberites).

Stress management training has been a core part of my business training courses from the start, and last year I founded a social enterprise dedicated to supporting the mental health and well-being of people working in areas of conflict. This group is called the Achilles Initiative after the first recorded case of PTSD in Western literature. This project is very close to my heart because I have seen trauma and associated mental health problems up close and personal in such places as the favela slums of Brazil, East Africa, and various parts of the Middle East. I believe passionately that it is essential to prepare people as well as humanly possible for challenging environments. The cost of not doing this is reduced functioning in the field (trauma has caused whole military units to become useless in war, for example), expensively high staff sickness and burn-out rates, and the human suffering caused by such problems as PTSD, depression, anxiety disorders, suicide, and addiction in combat and on returning home. When relatively large numbers of young people are involved in conflict, as is currently the case in the USA and UK, for example, this has a huge knock-on effect to the levels of violence and “inter-well-being” of society (one UK report estimated 20,000 ex-military personnel in UK prisons and on probation for example), so this is a problem for all of us.

So what, if anything, can be done to build personal resilience? Let’s start with the fact that we all have challenging life events such as personal loss and job difficulties, but some people manage stress better than others. Part of this may be genetic but a large proportion of this healthy adaptation has been shown to be about how people think, manage their physical health and use social support. There have now been numerous studies showing that people can build resilience (in children from at-risk backgrounds, for example). In other words, there is hope as these things can all be learned. Resilience is a set of life-skills that are absolutely essential for people working in high stress jobs and locations, and that anyone can benefit from improving.

Mental Stress Management Training

It is not external events but our minds that create stress. This may seem like an odd idea but consider two people stuck in a traffic jam. One may get annoyed thinking about how unfair it is and dwelling on the appointment they will miss, while another may take it in their stride, saying to themselves “Heh, that’s life, at least I can listen to the radio for a change.” It’s the thought process that creates stress, not just the stimulus that initiates it. The following are some good resilient thinking strategies:

  • Acceptance of what can’t be changed

Acceptance is a key component of resilient thinking - don’t fight reality, you won’t win.

  • An internal “locus of control”- i.e. not being a victim

The balance to acceptance is agency - feeling empowered to change the things you can.

In integral typologies, agency and acceptance can be equated to masculine and feminine sides of resilience, though I appreciate these terms can be problematic for many, and I’m certainly not being prescriptive. Whatever the labeling, these two sides of resilience need to be in balance for mental health. What complicates this is that people’s self-perception of what can and can’t be done is determined by the physical mood they live in, so it tends to be highly biased. Agenticly inclined people are also prone to resentment trying to change the impossible, while accepting people are prone to resignation, saying that nothing can be done and they’re “just being realistic.” If you’d like to know your basic mood, it is wise to ask others and triangulate on what your lens might be - because you can’t see it.

  • Creative problem solving

Seeing life as a series of challenges requiring creative problem-solving is a resilient attitude. Other creative practices such as art and journalling can also be very useful. These can be particularly helpful for those reluctant to talk abut their feelings or who lack the vocabulary (children for example). The processing involved is also of benefit.

  • Flexibility

Things change, learn to go with the flow and adapt, flexible people are resilient people. The flexibility and ability to “make do” of certain successful non-profit workers and army units for example is legendary.

  • Realistic optimism

Resilient people are both realistic - able to face reality, not just “positive thinkers” - and yet also optimistic when they have done all they can. Both are important. Again, ask others what your “lens” is like in this regard.

  • Maintaining positive and stable self-esteem

Things that give you pleasure, things that you’re good at, and things that help others are all worth engaging in if you want to build self-esteem according to Positive Psychology. This self-esteem acts as a buffer when times are tough. Note that this is not the same as being narcissistic or having a self-esteem which goes wildly up and down, both of which are negatively correlated with resilience.

  • Managing (but not repressing) emotions

Part of resilience is being aware of and managing emotions. I recommend Daniel Goleman’s work and Non-Violent Communication work for those interested in emotional intelligence.

  • Managing stress and conflict skilfully (not confrontational or avoidant)

Conflict is a part of life and leaning to manage it skilfully boosts resilience. Is your tendency to be “pushy” or a “pushover” under pressure? Note that these are embodied characteristics and like all these “mental” stress management skills, it can also be examined and developed through the body as well - it’s always a four quadrant affair and I make divisions here only for convenience.

  • Humour

Laughter has been proven to fight disease and prolong life - it is a key resilience skill. Organisations that place politically correct restrictions on the often bad-taste humour of those working in challenging environments do their employees a great disservice when it comes to resilience. It is also worth differentiating humour as a healthy coping mechanism from humour used as a defence mechanism to deny emotions - as well as the seemingly inappropriate laughter that can happen at times of extreme stress.

  • Mindfulness and Spirituality

There is now a large evidence base to show that being present to the here-and-now is great for stress and resilience. The human animal has the capacity to self-generate a lot of stress through dwelling on the past and constructing terrible potential futures in the mind. Very often the present is not so bad and, even when it is, mindfulness can stop the dissociation that leads to future trauma related problems. This is somewhat counter-intuitive as people disassociate for a good reason under extreme stress, as it is also counter-intuitive that mindfulness can be reduce pain as Kabat-Zinn and colleagues have proven for years.

Other spiritual practices such as prayer, gratitude (shown by Positive Psychology to be an important variable), and more formal meditation also have a positive effect on resilience in my opinion. Where traditional therapies and spirituality meet in relation to resilience is the crucial importance of meaning. I recently talked to several survivors of the 7:7 terrorist attacks for example and the meaning they had made of the event seemed central (some for example had gone on to work in peace-building or campaigning for changes to UK government policy. for example). A number of researchers now discuss Post Traumatic Growth (PTG) beyond mere resilience, as well as the more familiar PTSD - but without integral maps the idea of what “growth” is can be ill-defined.

  • Limiting Beliefs

As well as the resilient thinking strategies highlighted, their opposite, “limiting beliefs” or narratives, can undermine resilience. If I believe that “all people are selfish and weak at the core” how resilient will I be and how easily will I be able to ask for help? We live “in” our beliefs as fish in water, and examining them is crucial for resilience.

Cognitive Behavioural Therapy (CBT) deals in-depth with some of the factors I’ve identified so far and is the basis of the US Military’s Master Resilience programme. CBT also discusses “thought distortions” such as over-generalising, personalising, and (my personal favourite) “catastrophising.” For a more light-hearted look at CBT and resilience, look at this article on dealing with shit.

While just knowing about stress and trauma is not enough to prevent them, I would also recommend some basic “psycho-education” as a good place to start for anyone at risk. Just letting people knowing that if they experience some hyper-arousal or intrusive memories, for example, does not mean they are “going crazy,” which can be a great relief and in itself aid “natural hardiness” (most people who experience acute traumatic stress disorder for example do not develop full-blown PTSD).

Resilience and Adult Development

From an integral developmental standpoint, many of the mental processes discussed might be easier from higher developmental levels, which would therefore be associated with increased resilience. People can take greater levels of perspective on their experience as altitude increases and can, for example, see that they have narratives and are not just “right,” for example. The work of Susan Crook Grueter has been applied to resilience, and higher self-structures have been said to correlate with resilience by at least one US trainer I know. While this has some appeal, I’m not yet convinced - I’ve seen too many examples of “solid blue” and “wishy-washy green” in the field (to switch to the Spiral Dynamics memes). There are other complicating factors (e.g. how people “at” different altitude orient themselves to the body or risk “compassion altitude” through increased empathy), and I’d suggest more research is needed.

Resilience Training and The Body

Maintaining good physical health is a key foundation of resilience. The fundamentals of good diet, plenty of exercise, rest, good quality sleep, and minimal alcohol and drug intake cannot be ignored as they have a huge effect on how much pressure someone can handle. Beyond the basics of health, physical grounding and centring exercises to manage stress arousal can also build resilience (they are, for example, now used by the Australian Defence Force). The following is the ABC “centering” technique to manage stress:

ABC De-Stress “Centring” Practice – “Get Yourself Together” in 3 min:

  • Aware – Be mindful of the present moment using the five senses, especially feeling the body, ground (yourself on your chair and feet), and your breath
  • Balance – In posture and attention; Have an expansive feeling
  • Centre-Line Relaxed – Relax your mouth and stomach - breathe deeply into your belly (Also - Connected to why you are doing this and to other people)

In my view it is absolutely essential to involve the body when working with resilience and trauma prevention, as these matters are limbic and brainstem affairs. The cognitive processing of the neocortex is not really where trauma “is at,” as it gets “locked in the body” and laid down as a very different kind of memory than our everyday memories. There are a number of different approaches to working with the body and trauma, such as Peter Levine’s Somatic Experiencing and Paul Linden’s Being in Movement. The US Military is currently looking into a number of somatic/embodied approaches to resilience and, despite resistance caused by the deeply entrenched body-mind split in therapy, I think working with the body in this way is becoming more common-place.

Other forms of stress-busting body awareness practices such as yoga and tai chi are also recommended for resilience. Because stress happens in the body, building at least some body awareness and learning a few physical defusing and arousal reduction techniques will massively aid resilience. If you can’t practice any of the forms mentioned or have access to an experienced somatic practitioner, and you have a potentially traumatic experience, simply going for a walk or allowing the body to move in other ways can be very beneficial. I would recommend Basel van Der Kolk’s article “The Body Keeps the Score” or any of Paul Linden’s e-books a as a place to start if you are interested in this area.

Social Support, Culture and Resilience Training

No matter how well you manage your stress in body and mind you will also need other people to be truly resilient. Social support and empathy are critical factors in psychological resilience so if you want to bounce, not break, build a support network around you and invest in relationships. Equally, if you want to help those around you, really listen to them - empathy is a great gift that builds resilience. I now talk about “inter-well-being” to adapt a phrase from Thich Nhat Hanh (himself no stranger to trauma).

Cultural factors can also have a huge impact on resilience. For example, how does an organisation or society orient itself around attachment and intimacy? Is healthy grieving or emotional repression the norm? What archetypes and metaphors are used when discussing resilience? Any effective resilience training programme needs to consider culture very carefully.

For example, in the armed services talking of “mental wounds and armour” is likely to go down better than fluffy therapist psychobabble. Around the world, beliefs have an effect on resilience - for example, is it a fair world? Does fate, karma, or the will of the gods decide how life turns out? One study conducted by University of Sussex professor Sally Munt found that religious beliefs were an important part of resilience for many refugees in Brighton, for example, while others have pointed to the “just world hypothesis” held by some religious people as a major factor in decreasing resilience (how do you make sense of your family dying in an earthquake if there is a just and fair God?).

Gender is another critical issue to consider and there may be different coping styles and patterns of resilience for men and women.

Collective shadows related to resilience can also occur in the cultures of organisations and need to be considered. Some charities I have worked alongside, for example, saw themselves as superhuman - entirely good saviours, helping poor vulnerable other people made to suffer by “bad guys.” These collective, disowned projections do not lead to resilience.

Resilience, Environmental Factors and Organisational Structures

Environmental factors have been shown to significantly effect stress. Background noise is a good example for office workers, and contact with the natural world is a stress-buffer. Even ensuring you receive a little natural light and getting a few house plants can make a big difference. Many people also find organising and cleaning their environment to have an impact on stress and well-being. One therapist friend I know had a depressed patient, who for years was totally untouched by several types of treatment, who recovered nearly overnight when they moved house.

I would highly recommend that occupations that regularly involve risk (e. fireman, armed services, police), or who work in contact with those who are suffering (e.g. nurses, social workers), or work with stressful confrontations (e.g. customer services), invest in professional resilience training and develop appropriate support structures. Good organisational systems are necessary such as formalised “watchful waiting” (e.g. The UK Armed Service’s Trauma Risk Incident Management - TRIM), critical incident stress debriefings (though there is evidence to suggest these may not be at all helpful), good HR procedures and Employee Assistance Programmes (EAPs), which may employ counsellors on a “listening-line.”

I believe that good resilience training and preventative stress management measures are the future - making sense ethically, operationally and financially. Whatever job you’re in and whatever stresses you face, I hope a few of these resilience tips are of use.

~ Mark Walsh leads Integration Training - specializing in stress management training, integral business leadership training and resilience training providers, based in Brighton (Sussex), Birmingham and London UK. His clients include multi-national blue chip companies, UNICEF, and The Institute of Development Studies. Prior to this he worked for a charity in conflict-zones worldwide. In his spare time Mark meditates, dances, practices aikido and enjoys being exploited by two cats.



2 comments:

S. Training said...

Hope this finds you well – I would love to attend the day and also bring along a couple of collagues, if they are free. Thought I would check with you first whether that would be ok – I guess I could get them to also sign up and then you have their details, which would be useful. So, if possible pencil in 3 places and I will contact them asap to get them to take action.

Tom Von Deck said...

Resilience has quite a science behind it. One thing that meditation type approaches do is to train the brain not only to be more flexible, but to grow more synapses. Synapses are what connect brain cells. The more synapses, the more connections.

This process leads to "whole brain funcioning". This means that the various parts of the brain work together more efficiently, harmoniously and as a whole unit. The mind and body also learn that they are one unit. A tremendous amount of resilience results from this process.

As you build those synapses, everything in this blogger's course becomes easier to learn, too.