Vol 5 n° 3 - Anxiety II
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hat is resilience? Simply put, it is the ability to bounce  back  from  some  real,  experienced  adversity. Perhaps more elegantly, we can say that it refers to an indi- vidual’s utilization of inner strengths and outer resources in order to overcome seriously adverse, even traumatic, circumstances, and still continue to pursue and succeed in one’s endeavors. It is a generic, multidetermined attribute (ie, there is no one gene site for resilience), and varies according to personal hardiness and social supports, as well as the nature and degree of the imposed hardship or impediment. Like so many other false dichotomies prevalent in con- temporary psychiatry (eg, psychodynamic versus biolog- ical, nature versus nurture, etc), there are also conflicting perspectives on this important subject. It has long been conventional  (psychiatric)  wisdom,  in  spite  of  our avowed professional stance on positive outcomes of psy- chotherapy and personal growth, that significant early deprivation and trauma in childhood inevitably and pre- dictably eventuate in adult suffering, scarring, and psy- chopathology. On the other hand, there have been those who have postulated an inherent resistance or immunity to misfortune and calamity in some individuals, going so far as to invoke the unfortunate term “invulnerable” to depict either an inherent, genetic empowerment, or a vital, enviable, strength of character.1 Of course, as with the other false dichotomies, neither polar opinion is cor- rect, the truth, rather, lying somewhere in between. It  is  entirely  understandable  that  clinicians  working directly with adults harboring major psychopathological and social disorders would often attribute their deriva- C l i n i c a l   r e s e a r c h 2 7 3 Psychological and social aspects of resilience: a synthesis of risks and resources Saul Levine, MD Keywords:   resilience;   resources;   risk;   prevention;   intervention;   children; adolescent Author  affiliations:  Children’s  Hospital,  San  Diego;  University  of  California, San Diego, Calif, USA Address  for  correspondence:  Saul  Levine,  MD,  Chairman,  Department  of Psychiatry,   Children’s   Hospital,   San   Diego;   Professor   of   Psychiatry, University of California, San Diego, 3030 Children’s Way, Suite 111, San Diego, CA, 92123-4226 USA (e-mail: slevine@ucsd.edu) W It has been conventional wisdom that early deprivation and trauma can lead unequivocally to later adult debili- tation and disorder. That this is not in fact the case has become abundantly clear via a variety of recent new research. While early adversity can be a severe impedi- ment, there is a myriad of accounts of people who have been born into lives of abject destitution, yet have grown into stable, productive, and generative adults. There are certainly personal and social factors that increase the risks of frailty and failing. By the same token, these same risk factors can contribute to the enhancement of one’s life, and increase the chances of resilience and of leading ful- filling lives. There is now evidence that society has the knowledge to implement prevention and early interven- tion programs that foster and enhance personal devel- opment; the question is, does it have the will and com- mitment to do so? © 2003, LLS SAS Dialogues Clin Neurosci. 2003;5:273-280. Copyright © 2003 LLS SAS.  All rights reserved www.dialogues-cns.org