Can Do Healthcare - Thinking Differently Together About Trauma Informed Care

Our opportunities to cope, to thrive and reach our potential are to some extent determined by the community capitals, the assets, the people, the places, the access to opportunity and resources, those things are important in terms of whether someone can thrive and reach their potential. It is not all about trying harder – resilience isn’t simply about trying hard and being tough and being gritty, it’s about finding a way of adapting and moving forward no matter what your circumstances are. If you look on the internet the things that will come up are: • ‘The capacity to recover quickly from difficulties; toughness…’ • ‘The ability of a substance or object to spring back into shape; elasticity’ (Oxford English Dictionary) • Resilience is “the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of stress.” (American Psychological Association, 2014) Whilst the first point is off the mark, the second is a little better, it is the third point that describes it fairly well. Human beings are not at the top of the food chain because they are the fastest or the strongest or because we have the biggest teeth – but we are adaptable, and we are social creatures – that’s why we are so successful as a species. Resilience really is about adaptation, about resources, and a combination of biological, psychological, social and cultural and spiritual factors that interact with one another to determine how a person reacts to stressful life events. They can change over time and according to context. There are some important things that happen in our lives in infancy – developmental things in childhood that are really useful in helping us have a happy and successful life, but many other things can be acquired. Resilience also changes over time, so you might be someone with a PhD, a high status job, good pay and a stable social life, and then suddenly war breaks out in your country and you have to flee, finding yourself leaving everything with just the clothes on your back. Your ability to be resilient and your ability to cope is going to change, even though you were doing so brilliantly in this other circumstance. Resilience has to be curated – it’s not stable, it’s not static and the recipe for resilience changes according to time and place, and each individual. Resilience and adversity are a bit like the two sides of a scale: On one side are positive assets and on the other are stresses, or what the Harvard Centre for Child Development refer to as toxic levels of stress. The foundations of health in life are in Maslow’s hierarchy of needs – a safe place to live; food and water; a loving environment; a stable attachment with a caregiver is really helpful. If you have a caregiver who is attuned, who is able to help you emotionally develop, is able to co-regulate and respond to you when you are distressed and help your nervous system calm down and relax and develop that control over your stress response – this is called selfregulation, and you can only develop it through co-regulation (having an attuned care giver). These things give you a really strong foundation of resilience. If you haven’t had those things, that’s alright, you can still develop coping strategies, resources, assets and relationships and cope really well, but those things do have an impact on how difficult you find the social Thinking Differently Together | 12