EDITOR I A L
The Art and Science of Resilience
M y editorial in the Fall 2013 issue (Matuska,
2013) was about the importance of
engagement in meaningful occupation to
health. I used gardening as an example of experienc-
ing flow or a just-right challenge that is considered
healthy. When people engage in activities that allow
them to refresh, or renew, that could be viewed as
a strategy used for managing stress and promot-
ing resilience. Although this issue does not include
articles addressing research about resiliency directly,
it is probably true to say that resiliency is a construct
that relates to or underlies many aspects of occupa-
tional therapy practice and research.
Resiliency refers to positive adaptation, or the abil-
ity to maintain or regain mental health, despite expe-
riencing adversity (Herrman et al., 2011). The science
of psychological resilience came from developmental
psychologists, psychiatrists, and other mental health
professionals working in the 1970s. These pioneering
investigators had begun to document the large num-
bers of children who, despite growing up in highly
aversive circumstances, nonetheless emerged as
functional and capable individuals (Bonanno, 2012).
Much has been written and studied about resilience
since then, but as it is with most complex psycho-
logical constructs, there is little agreement or consis-
tency in use of the term. One way resiliency has been
conceptualized is a psychological stress-resistance
resource where individuals who feel that events are
comprehensible, manageable, and meaningful have
higher self-esteem, health, and life satisfaction (An-
tonovsky, 1993). Resiliency has also been described
as a set of behaviors, traits, or abilities, or a process
in terms of life outcomes (Chang & Taormina, 2011).
Resiliency has been associated with fewer physi-
cal symptoms (Armata & Baldwin, 2008), dental
health (Sanders, Lim, & Sohn, 2008), and lower rates
of depression in sexual abuse victims (Goldstein,
Faulkner, & Wekerle, 2013), among others.
The science of resilience has recently advanced
to examining DNA biomarkers that show the effects
of accumulated stress on aging (Puterman & Epel,
2012). Recent research found that telomere length
(i.e., the DNA-based biomarker that protects it from
damage and indicates cellular aging) was shortened
2 Copyright © American Occupational Therapy Foundation
with severity and duration of life stressor exposure
(Puterman & Epel, 2012). For example, children ex-
posed to severe adversity have shorter telomeres
going into adulthood (Puterman & Epel, 2012). Con-
versely, stress resilience and healthy lifestyles and so-
cial connections are associated with telomere length
and protect from stress-induced shortening. If pro-
longed or severe stress negatively affects the body
and hastens aging of cells, but this can be avoided
with healthy lifestyles and strong social support,
then it makes sense to find ways to promote resil-
ience in people or populations in crisis.
This is where the art of resilience is also impor-
tant—where the science informs creative and effec-
tive interventions that make a positive difference in
the lives of people. Occupational therapists are inter-
ested in the art of resilience because of regular inter-
actions with individuals and families who have been
exposed to difficult and stressful life events. If these
clients can be coached to recognize their strengths
and resourcefulness, find some ability to control
even small events, and strengthen their social sup-
port, then maybe they will also be building their re-
silience.
On an individual level, several studies have
shown that certain lifestyle factors have been asso-
ciated with resilience. Successful foster youth who
were considered resilient had a sense of compe-
tence, goals for the future, social support, and were
involved in community service activities (Hass &
Graydon, 2009). To build resilience in youth, Bell
(2001) suggested that professionals help them en-
gage in activities that increase physical health, in-
crease social skills with peers and adults, and turn
traumatic helplessness into opportunities to help
others. Adults with chronic pain had better mental
health-related quality of life after resilience-building
interventions in a pain management program (Vig-
gers & Caltabiano, 2012).
Health care and public service professionals are
exposed to stressful events every day and witness
countless events of human suffering. Personal resil-
ience is necessary in these workers so they can con-
tinue to stay healthy while providing critical service
to others. Nurses who participated in a resilience-
building program that focused on building positive
and nurturing professional relationships, maintain-
ing positivity, developing emotional insight, achiev-
ing life balance and spirituality, and becoming more
reflective reduced their vulnerability to workplace
adversity and improved the overall health care set-
ting (Jackson, Firtko, & Edenborough, 2007). Simi-
larly, police officers built their resilience through
organizational interventions that emphasized peer
and supervisor support, trust, and empowerment
(Paton et al., 2008).
On a population scale, building resilience re-
quires deliberate societal protections against pover-
ty or impoverished environments that lead to stress
and poor mental and physical health. When poverty
itself cannot be eliminated, improving the quality of
the built and social environments will foster resil-
ience to its harmful health effects (Sanders, Lim, &
Sohn, 2008). As people age, they are more vulner-
able to isolation and poverty and need community
resources and social-political structures that support
resilience.
Resiliency building has always been a part of oc-
cupational therapy practice but might not always
be recognized or named as such. Multidisciplinary
literature on the science of resiliency is robust, and
occupational therapy has a lot to add regarding the
art of resiliency and how individuals, families, and
communities can improve their abilities to adapt
and respond positively to life stressors.
References
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2018.2012.00726.x
Kathleen Matuska, PhD, OTR/L, FAOTA
Editor
The author has no financial or proprietary interest
in the materials presented herein.
doi:10.3928/15394492-20131211-01
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