Primrose in the Desert
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Why, when exposed to treachery and trauma, do some people flourish and excel, while others are devastated? Many of the men in “Room Seven” of the Hanoi Hilton POW prison in Vietnam survived to extraordinary excellence. Eleanor Roosevelt suffered childhood tragedy, loss and experienced chronic abandonment even as an adult; she was possibly the most outstanding woman of the twentieth century. Madelyn Albright had a secreted family legacy of trauma, was abandoned by her husband, but became Secretary of State. And then there are the quietly heroic people who survive tragedy but manage to lead purposeful, meaningful lives using their suffering to refine their existence, often bearing witness to their losses in their every day efforts of decency and sensitivity.

The question of resiliency is complex. At this time it seems that the major known associated factors are genetic endowment, biochemistry, age at the time of trauma, social support and therapeutic assistance. Who we are and how we are is an interactive process that has dynamic possibilities all of our lives. Much of our internal chemistry that governs our feelings and reactions is finely tuned in a homeostatic balance. Brain chemicals interface so that if one is out of kilter others are affected also. The reactivity levels of these systems depend on genetic traits and early developmental experience which affects our ability to attach to others, manage emotional regulation and establish set points for characteristic stress reaction. The ability to control and thoughtfully manage emotions is a chief characteristic of a resilient person.

The early stages of genetic mapping have revealed that there are genes related to stress resiliency and vulnerability. For example, we all have a certain variation of a serotonin gene, 5HTI. Our level of resiliency is strongly impacted by the version of this particular serotonin gene in our body. The short version predisposes one to alcoholism and depression. The medium long one is mixed potential. Those who have the LL, longer version seem to be resistant to stress reactions. In addition, some people are missing a gene related to certain (alpha 2c) receptors that sooth reactive activation levels. These people, missing the modulating effect of this gene, have a greatly increased risk of heart attack. All genes, of course, constantly interact with our experienced environment. The study of so called epigenetic patterns examines the issue of how genes are turned on and off by environmental experience. It would make sense that if one is aware of certain genetic liabilities routine life strategies could be set in place to address these vulnerabilities. A compensatory effect could be set into motion. Resilient people may be genetically gifted, but it is also possible that their life experience and abilities to transform hardship may be related factors.

Resiliency involves brain structures and chemicals that are set up to activate us to take action against threat. During trauma our bodies enter an exaggerated stress response. The arousal systems and related activating brain chemicals are tempered by other systems and neurotransmitters. The moderating neurotransmitter system interacts with the arousal system so as to move us back to homeostasis. This helps to maintain thoughtful deliberation even under duress and to detoxify the stress chemistry reactions. Apparently we can tolerate stress-related chemicals and physical reactions in moderation on a short term, sporadic basis. But like alcohol or sweets these chemicals and reactions may wreak havoc if there is too much at once or if they stay in our system- as happens when people are chronically stressed. Stress hormones help to stamp in trauma memory so it is easily elicited and coded with the original intense emotional reaction. Historically this served to provide protection from further harm. Although this may have served us well when we lived in the forest, in today’s society easily triggered traumatic memory and associated emotion is most often not helpful. In addition sustained stress may lead to chronic low levels of testosterone in men which can cause various negative health effects. Sometimes traumatic experience can induce a sustained disequilibrium in these very finely tuned systems.

Trauma experienced before the age of four tends to be associated with less resiliency and worse emotional outcomes in adult life. There are probably many reasons for this. Trauma at any stage in life tends to be coded in our bodies in physical sensations and images rather than in language and higher complex thought form. Before age four this is profoundly so. The pre-four year old does not have the cortical development to store memory in language or complex thought. A very young child cannot cognitively integrate trauma so as to understand and make adaptive sense of it. The increased emotional arousal levels are typically acted on in behavior. Most often the child, and frequently the adults in relationship with that child, does not make the connection between problem hyperactive behaviors and experienced trauma.

Throughout life we depend a great deal on relationships for healthy emotional regulation. Before the age of four we are almost totally dependent on adults around us for soothing and safety. One very recent research study noted that seventy-five percent of adult mental hospital patients reported abuse or trauma before age four. Seventy-nine percent of personality disorder patients acknowledged abuse and trauma before this same age. It is primarily in relationship that we experience empathy and caring that facilitates peacefulness and restoration from upset. As the child grows caring adults can begin to speak in a careful soothing manner about the child’s traumatic experience so as to initiate the process of thoughtful reconsolidation.

The concept called reconsolidation is relevant to resiliency. On a neurological level reconsolidation involves decreasing the strength of a traumatic memory by using some antagonistic medication after memory activation that acts on certain (NMDA) receptors. (At this time it has only been tried with animals.) In recovery from traumatic experience reconsolidation may entail bringing early or repressed painful memories into language and into “cortical” awareness. (Remember when we speak we access higher brain functions.) In the safety and intimacy of therapeutic relationship new perspective and sense can be made of past suffering, tragedy or abuse. In the context of a safer and supported present day life it may be more possible to reorganize our thinking and understanding of past hurt. New memory associations can be formed at a higher, thoughtful level. This can facilitate thinking about suffering in a more complex way while easing emotional activation associated with it.

Resiliency involves an ability to bear witness to hurts and losses with increased existential awareness. In reconsolidation there can be a move from overwhelming emotion to acceptance and sensitivity. The ability to establish compensatory life habits after trauma calls for intentional motivation. Our stress reaction systems and our reward systems interface and overlap; motivation which is central to successful adaptation and resiliency in life is part of the reward system. Typically reconsolidation can be developed only with conscious and consistent effort. Strategies can be set in place as life habits that address the activation of traumatic memories on a regular basis. (Remember that traumatic memory is indelible.) Traumatic memory could be thought of as a kind of emotional diabetic state. As long as the disequilibrium- in this case origination from past experienced trauma- is addressed in a multiplicity of ways adequate ongoing adaptation can become a practiced life habit.

Resiliency is complex. It exists on many levels. In essence resiliency means making sense of hard times so that we may be enhanced, not diminished by them. It means bringing difficulty to language and awareness so as to be keenly cognizant of possible related mishaps of thinking and behaving. It means thoughtfully sorting out our actions so as to be fully our best selves in as many moments as is humanly possible. It means being able to non-defensively see woundedness, hypersensitivity and choosing not to act or speak when it may not be reflective of our better selves in the present. It means understanding that being in “thoughtful control” of feelings may depend on a myriad of factors including relationship support, rest, cognition, exercise, nutrition, genetic predisposition, and memory. Reconsolidation of toxic memories can be done but not without partnership and dynamic effort to reframe painful memory and integrate it into a more manageable, useful present day life. A resilient life is not necessarily an easy life. For some it means making good use of life’s hardships.

- Dr. Linda Klaitz, Medical Psychologist


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