Monday, July 30, 2007

Resilience, wellness, balance and flexibility

I'm embarking on a study of people who experience persistent pain, but live 'well'. This is somewhat ironic given that I'm still working through a rehabilitation process relating to my post-concussion syndrome dating from the end of February this year!

As I ponder what defines a person who is 'well', a number of concepts keep coming up - relevant to me as well as to the people I work with each day.

What is 'resilience'? Is it the ability to withstand problems as they occur each day? Weathering the normal daily troubles without being bothered by them? Is resilience about being 'rock-like', stable, enduring despite the odds, 'keeping the faith'?
The people around me who seem 'well' don't seem all that rock-like! Instead they seem to flow along with troubles - choosing when to bend and sway, and when to hold steady, developing and growing flexibly as events happen and then pass. Is resilience then about being flexible?
Is being 'well' about the ability to choose when to balance resistance with acceptance? Is resilience about knowing that 'I' still am despite changing my goals, my choices, my actions, but holding on to my values?

I work daily with people seeking help to live despite having persistent pain. Their pain invades everything in their lives - they tell me 'I just want to have 'me' back!'

Traditional medical management has focused on reducing pain - so that 'normal' is available again. For many this works but equally many can't achieve pain relief despite the best efforts of the health care team.
Traditional pain management has focused on helping people develop coping skills - withstanding the onslaught of pain by 'resisting', 'coping', 'doing despite'. Cognitive therapy teaches people to 'challenge' their 'maladaptive' thinking.
What if their thinking reflects reality? What if their pain is unexpected? If their pain means they can't think straight? If they can no longer work in the manual work they love?

Recently 'acceptance' has become a popularised concept - meaning instead of fighting against pain, people choose to live to their important values.
This requires looking at how we go about activities differently. How can we live according to important values despite having limitations as to how much we can do at any one time?

Now this doesn't seem any different from what all of us do - none of us can do 'everything', we all have 'limitations', and we all make choices about what values and goals are important.

In a round-about way I guess I’m thinking that learning to be flexible about what we do, provided that we live in line with the ‘compass’ of our values may lead us to become resilient. Hopefully less judgmental of ourselves and others, more tolerant of ambiguity, more able to be appreciated for who we are rather than what we do.

Resilience requires flexibility and balance, a delicate dance of wellness.

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