Resilience: Building Immunity in Psychiatry

By Shastri, Priyvadan | Indian Journal of Psychiatry, July-September 2013 | Go to article overview

Resilience: Building Immunity in Psychiatry


Shastri, Priyvadan, Indian Journal of Psychiatry


Byline: Priyvadan. Shastri

The challenges in our personal, professional, financial, and emotional world are on rise, more so in developing countries and people will be longing for mental wellness for achieving complete health in their life. Resilience stands for one's capacity to recover from extremes of trauma and stress. Resilience in a person reflects a dynamic union of factors that encourages positive adaptation despite exposure to adverse life experiences. One needs to have a three-dimensional construct for understanding resilience as a state (what is it and how does one identify it?), a condition (what can be done about it?), and a practice (how does one get there?). Evaluating the level of resilience requires the measurement of internal (personal) and external (environmental) factors, taking into account that family and social environment variables of resilience play very important roles in an individual's resilience. Protection factors seem to be more important in the development of resilience than risk factors. Resilience is a process that lasts a lifetime, with periods of acquisition and maintenance, and reduction and loss for assessment. Overall, currently available data on resilience suggest the presence of a neurobiological substrate, based largely on genetics, which correlates with personality traits, some of which are configured via social learning. The major questions about resilience revolve around properly defining the concept, identifying the factors involved in its development and recognizing whether it is actually possible to immunize mental health against adversities. In the clinical field, it may be possible to identify predisposing factors or risk factors for psychopathologies and to develop new intervention strategies, both preventive and therapeutic, based on the concept of resilience. The preferred environments for application of resilience are health, education, and social policy and the right approach in integrating; it can be developed only with more research and analysis with focus on resilience. Be it patient or family member or caregiver, advocating resilience will empower psychiatrists in India.

Introduction

Respected seniors, President of Indian Psychiatric Society (IPS) and Chairman of this session, all my friends and fellow psychiatrist of IPS, ladies and gentlemen; it is indeed a great honor, my privilege and pleasure to be chosen for the DLN Murthy Rao Oration Award for 2012. I am highly grateful to the IPS for giving me this honor, which is also its highest award in the field of psychiatry in India.

The journey of my belief and understanding of 'Resilience' started as early as 1969, when Department of Pediatrics-B. Y. L. Nair Hospital appointed a Psychiatrist for Child Guidance Clinic for the first time. The team of therapists involved along with me comprised of a psychologist, a social worker, and a play therapist.

Cerebral palsy was the most active disability group followed by the group for mentally challenged. Treatment, training, and research were essential components while planning for the growth and development of children with multiple disabilities. It was while working with this group of special children and their families that I realized that resilience is a dynamic process involving a strong interaction between both causative as well as negative life events.

My 45-years-long journey in the field of child psychiatry built my belief in the need for building resilience with an interventional outlook. This need was recognized not only in special children mentioned above but also in normal children. That is the key reason why school mental health has international back-up by World Health Organization (WHO) world over across all countries. Resilience continues to be important element in child development.

Understanding Resilience

Defining resilience

"Resilience" is interestingly a term taken from the physics of materials, i. …

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