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Review of "Restoring Resilience"

By Eileen Russell
W. W. Norton, 2015
Review by Roy Sugarman, PhD on Jan 5th 2016
Restoring Resilience

Resilience, if you consider it a medical entity, would be considered (again if you think in terms of past philosophies) as a genetically determined capacity with some modifications in response to the environment. However, in modern terms, resilience is a more complex and accessible phenomenon. The term suggests a capacity to weather storms of various kinds, to face adversity and survive and hopefully thrive. Various concepts related to this have emerged in the work of Seligman and other Positive Psychology proponents, and Mindfulness has emerged more strongly, perhaps the next 'fad' after CBT and ACT and so on, and of course NLP led to EMDR and AEDP, Focusing and so on. Confused? By the abbreviations? Then perhaps  you should not read this book as the terms are those well known to psychologists, and this is who the book is written for.

Firstly, the introductory sections cover what she considers to be the Arc of Resilience, and indication that this isn't a static number or entity at all, but evolving or with the capacity to evolve. Nor is this a linear concept of you have less, or you have more. It is described as more abstract, and hence capable of increasing complexity or a changing set of epigenetic expressions.

As with other evolving approaches, the attention is given to a more positive experience rather than insight induction or similar more outmoded but still clung to propositional virtues of psychotherapy.  Resilience is thus a potential capacity built on multifaceted entities.  This also does not mean that resilient people don't break, but it is more of the Japanese pottery concept of emerging better for the fact of having been broken, of what to do when we feel we can do nothing, and then move on and thrive that defines resilience in these cases.  So the focus is not on pathology, but on deriving strength from what remains behind after some collapse of some kind.  Accelerated Experiential Dynamic Psychotherapy (AEDP) theory is the basis for her approach to start.  The use of the word Self, perhaps relating back to Kohut, is constantly evoked to begin to define the approach and terminology.  Triangulated diagrams and therapy transcripts are used as illustration of the reframing of resilience and the move therefore to resilience as potential.

Resilience depends on supportive others. This is a startling admission here as of course so many of our more damaged clients have no support, or little, sometimes as a result of personality variables, war, trauma, emigration and so on. This makes resilience an interdependent phenomenon, and as such will resonate for most of us in terms of Attachment Theory.  Self-Regulation and self-reflection are also capacities more resilience people are shown to possess, and the neuro's amongst us then think frontal-executive and Insula.  From a clinical psychologists perspective, three elements are thus likely to emerge from what I have commented on so far, namely a focus on secure attachment, an awareness of internal and external resources either present or perhaps as noted above, absent from the individual armory, and finally and understanding of emotion and emotional processes as this author outlines and then discusses in this chapter, including a focus on the individual as an affective communication system in the interpersonal,  attachment theory bidirectional way.

Rumination is thus both draining for the individual and the therapist. Self at best, self at worst, are the dipole concepts that Russell uses in the wise mind kind of way that DBH uses (yes, the laymen have gone, but they should have stayed, it is not only psychojargon here, there is lots of interesting, understandable stuff).  She outlines here AEDP stuff for those of us unfamiliar with the approach.  The next chapter continues this approach, but even draws on object relations theory in describing separation and the formative 'ego differentiation' years and drawing on quotes and evidence from Bollas.  Again the chapters are peppered with transcripts illustrating the transformative approach and the transformational 'other' as in Martin Buber. By now you will realize how widely Russell draws on the eclectic storeroom of the therapist, integrating models so that her book will reflect useful heuristic weapons derived by various authors as I have noted serially above.  This is the kind of  approach experienced therapists admire, as it decries the 'latest fad'  modus operandi of so many psychotherapists today who apply an evidence based approach, often  enforced by guild-like authorities, but without an understanding of for instance attachment theory or a fundamental attribution error in defense of the ego. Metaphors perhaps, but that is seen here too. psychologists are not short in self-serving bias.

Nothing new here about creating a safe environment in which defenses that provide avoidance are softened and anxiety quietened. This can apply to a 6'10" basketball player as much as anyone else. Resistance and avoidance wane as the patient heals. Here the polyvagal theory of emotion is the latest meme to be integrated, as in Stephen Porges and the need for others, as per Cozolino, to enable the resilient client to self-regulate.  

In this way, Russell proposes that resilience remains a potential until released by the processes of dynamic change, or the promise of transformation (in the Watzlawick and Weakling sense now), and highly dependent on empathy (Rogers and the Self-Determination and Motivational Theory sense), in themselves very precise methods, and hence evidence based or at least subject to establishing those parameters).  The next chapter is thus a more sometimes overwhelming integration of these values, but done in a very skilled set of writings. Resilience in the above fashion is dynamic and changing, transformative, and hence frightening as a path towards (back to Seligman) flourishing.

Once again a new work has emerged with nothing truly new, but with a magnificent integration of the established wisdom of psychotherapy (for a 'change'). This means focusing the practice of clinical psychotherapy on the dynamics of change, how change is supported by empathy, how attachment disorders or issues once again dominate the thinking of psychotherapy, how relationships that are warm and empathic support client resilience and not dependency, how transformation is painful but yet done in the presence of supportive other(s), and how to facilitate a safe and warm context in which the client encounters their own resolve to change. And Russell does it well. Resilience is felt to be a given, but not static, and hence is a form of homeostasis which when resorted is dynamic and leads to a sense of flourishing rather than just surviving at a sustained level. This gives breadth and depth to the concept, and this book operationalizes  Resilience by drawing on the established knowledge base of psychotherapy, and no CBT in sight.

Highly recommended for the modern therapist, and for those who delightedly recognise how Russell got there in the first place.

 

© 2016 Roy Sugarman

 

Roy Sugarman PhD, Director: Applied Neuroscience, Performance Innovation Team, EXOS USA.