Building resilience

Adapting to stress and adversity

Psychological resilience is defined as your ability to properly adapt to stress and adversity.

Wellbeing literature asserts that resilience is a component of our make-up that can be harnessed given the right conditions.

This understanding derives from the notion of human flourishing, which embodies autonomy, self-determination, interest and engagement, aspiration and motivation, and whether people have a sense of meaning, direction or purpose in life. Resilience can be advanced through the acknowledgement and development of people’s capabilities.

Here are some key strategies to build and maintain resilience.

Build strong relationships

From medical school onwards, you need to appreciate the nature of a career in medicine and how stressful it can be. While you are busy building a career, working long shift hours, changing locations through rotations, little time is left over for developing strong relationships.

Good relationships with close family members, friends and others are important. Accepting help and support from those around you who care and will listen to you strengthens resilience. Assisting others in their time of need also can benefit you.

In addition to your friends and family, try to have one or two people at work who you feel you can call on for support. This is particularly important if you are doing acute call. If you are having difficulties it is important to remember that you can inform your Trainer without disclosing the details to him/her.

Challenge your language and your thoughts in difficult situations

Pay close attention to words like “this is awful” and “this is terrible” and “I can’t cope” or “I have had enough”.

You can't change the fact that highly stressful events happen, but you can change how you interpret and respond to these events. Try instead to say “this is difficult, but I am resourceful enough to be able to cope” or “this is not the end of the world, however difficult this is for me right now. I have what I need to get through this”.

Note any subtle changes whereby you feel a bit better as you deal with difficult situations. This will build your confidence in your own coping abilities in the future.

Challenge Perfectionism

Perfectionism is a personality trait characterised by a person's striving for flawlessness and setting excessively high performance standards, accompanied by overly critical self-evaluations and concerns regarding others' evaluations.

There are two types of perfectionism, adaptive and maladaptive. Adaptive perfectionism can also be called “striving for excellence”. This drive can motivate you to reach goals, providing they are realistic in the context of the resources available to you.

Maladaptive perfectionism drives people to attempt to achieve unattainable ideals, and because these are unattainable, the person internalises failure which can lead to inaction, self-criticism and at times, depression.

Set goals and plans to attain them

Develop realistic goals and consider using the BSMART method.

Benefits– clarify the benefits of attaining this goal.
Specific– be specific about what you want to achieve.
Measurable– your goal has to be something that you can ‘see’. This could be a number, a title, a position, a location or any measurable aspect you can think of.
Aligned– make sure that you align your goal to your values. If you value being fit and healthy, then your goal of being fit is aligned your values.
Realistic- once you have set your goal you need to ask yourself what you need to do in order to achieve it. You will need to consider your task list and your existing schedule and assess if it is realistic for you to undertake this goal. If the answer is yes, then do something regularly — even if it seems like a small accomplishment — that enables you to move toward your goals. Instead of focusing on tasks that seem unachievable, consider breaking big tasks into small achievable tasks that will get you closer to your goal.
Time Bound– a goal is not a goal unless you set a realistic timeframe to achieving the goal. This will help you in setting your realistic plan to achieve it. You can either set your timeframe first and then align your tasks accordingly or you can write down all your steps, consider your current workload/life style and adjust the timeframe accordingly.

Accept that change is a part of living

Certain goals may no longer be attainable as life takes a different course. Accepting circumstances that cannot be changed can help you focus on circumstances that you can change, and will allow you to recover quicker and re-set your goals.

Act

Act on adverse situations as much as you can. Take decisive but considered actions, rather than detaching completely from problems and stresses and wishing they would just go away.

Look for opportunities for self-discovery

People often learn something about themselves and may find that they have grown in some respect as a result of their struggle with loss. Many people who have experienced tragedies and hardship have reported better relationships, greater sense of strength even while feeling vulnerable, increased sense of self-worth, a more developed spirituality and heightened appreciation for life.

Develop your self-confidence

The working environment of doctors can potentially expose them to bullying and harassment, legal challenges, complaints from patients, examination failure, and any other personal failures that could potentially make you doubt yourself.

Developing confidence in your ability to solve problems and trusting your instincts helps build resilience. Ask yourself where you might feel lacking in confidence and address this by considering your goals. Achievements and succeeding in attaining your goals can greatly enhance your confidence and self-esteem.

Keep things in perspective

Even when facing very painful events, try to consider the stressful situation in a broader context and keep a long-term perspective. Avoid blowing the event out of proportion. It might help to ask yourself, “Will I remember this in a year’s time? What impact is this current situation going to have in the long term?”

Foster hope

If you notice that your brain is attracted to all the negative consequences that can potentially impact on your life, try to entertain the opposite. Consider all the positive and good things that might come your way.

An optimistic outlook enables you to expect that good things will happen in your life. Foster hope and trust that whatever will come your way – it will be ok.

Look after yourself

Pay attention to your own needs and feelings. Engage in activities that you enjoy and find relaxing. Exercise regularly but try and find an exercise that you enjoy. There is little point in selecting an exercise that does not meet your needs.

Selecting an activity that both challenges you and that you look forward to, will make you more likely to stick with it. It is a great feeling to notice progress in your fitness level, flexibility and strength.

Taking care of yourself helps to keep your mind and body strong and primed to deal with situations that require resilience.

RCPI Physician Wellbeing Programme

Tel: +353 1 863 9700

Through our Physician Wellbeing programme we are providing support, training and information to doctors at all stages of their careers.