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Why Resilience is Harmful and How to Improve it

Resilience is awesome, but also poses some risks and challenges. In 2012 a special edition of the Social Justice Studies academic research journal explored some of the risks. An intro and 5 academic research articles go very deeply into the topic of the "Dangers of Resilience Promotion." All the articles can be downloaded free at this link. 

https://journals.library.brock...hp/SSJ/issue/view/70

I will attempt to summarize those 6 articles here in common language, cuz the articles are really academic. Each summary is followed by an action item for what Resilience Workers can do to reduce potential harms and increase positive impacts. Remember, I don't think we should throw away the work being done on ACES/Resilience, but there are things to know that would make it more effective and less risky. 

Intro: People in the social justice sector don't really look at mental health because they believe in the disease model view.  It's time we do so. Resilience and recovery are really political concepts that try to explain social level problems as individual level problems.  "Why resilience and recovery? The
answer: precisely because these concepts appear so benign at first glance.
Unpacking these notions can reveal the ways in which they are powerful
tools in the governance of those deemed mentally ill, and also by extension,
all citizens." 

For more info, look at this article on Scientific American on the risks of the disease model view, and remember that all Resilience Workers should be actively challenging this model as much as possible. Remember, stacking good stuff (ACES/Resilience info) on top of a pile of poo (the disease model of mental illness) is not that effective. It's better to first sweep away the poo and then implement good stuff.

Article 1: The Resistible Rise of Recovery and Resilience: Well, resilience is nice but it doesn't challenge the basic disease model view of mental health. It still makes it seem like an individual problem instead of a social level problem. The focus on overcoming adversity still makes it pretty deficit based. "This approach to recovery does not offer an alternative means of
understanding the nature of emotional distress; it simply reframes existing
understandings of mental illness. This is problematic when the point of origin
of much recovery work was about challenging existing notions of mental
health and proposing alternative notions of emotional distress."

See more info on this at the Frameworks Institue Website, on how to frame support for social services (ie ACES programs). Basically, use people's values (future prosperity will increase), use a simplifying metaphor (ie, trauma is a fulcrum that that tip one way or another), have a specific action item (support policy or funding) and conclude with more values (local ingenuity). 

Article 2: Towards a social justice framework. Recovery is nice, but recovery "from what?" The concept of recovery inherently reinforces power imbalances. If you want to fix the system, people need a way to get off of disability.  Talking too much about the neurobiology [of trauma] is just going to make people feel more hopeless. 
   "Biomedicalism also operates discursively within society to ensure that the dominant way of understanding distress is through the lens of neurobiology, eclipsing all other possible frameworks and approaches. We counter this trend with a call towards applying the analytic lens of intersectionality to the study of and amelioration of social and structural inequities in mental health."

For more information, look at the Mind UK's guide on Resilience Impact. They basically coach people to get nonprofits to do a Wellbeing Impact Assessment. My nonprofit has a sample form online for nonprofits to learn how to improve their ability to increase resilience. This is a better way to increase resilience that the US ACES Cookbook way, which is basically, "Let's form a coalition and preach the importance of ACES/ Trauma and beg lawmakers for money."

Article 3: Power and participation: Lots of people say they want "service-user" engagement but they don't address actual power imbalances. So usually it just ends up being tokenism that's pretty harmful and traumatizing to the advocates trying to give input. Don't just give us a seat at the table, let's build a new table together. "Without addressing the underlying power dynamics
one must ask to what extent the energy and radical potential of the service user movement is being hijacked by illusionary inclusion."

For more information, do a google search for "Community Engagement Best Practices." Here is one tip sheet. Also, my nonprofit was banned or blocked from multiple local resilience projects, so we wrote our own grant and just got funded by PCORI to do some better community engagement work. So message us if you want to be part of that project.

Article 4: Resilience on Campus: The standard view is to look at distressed individuals as "flawed," and needing to be "restored back to productivity," by instilling "common sense resilience skills." Instead, what if we allowed emotional distress to be a legitimate expression of grief about a flawed world, and looked at disability and distress as diversity issues or legitimate forms of protest?   "Vocabularies of resilience promote a notion of adversity as an opportunity for individuals to demonstrate that they know how to make the most of their experiences. Adversity thus understood, occasions the appearance of new, perhaps more efficient and economical relations to increasingly scarce resources. In this way, university students who experience distress, or are identified as distressed, are constructed as inflexible and maladjusted.....Instead, we should see embodied and emotional difference as
expressions of agency, protest and affirmation, rather than simply signs of
passivity, sites of exploitation, or barriers to success that can be overcome
through resilience."

For more info, check out the Neurodiversity Movement. ASAN, the Autism Self-Advocates Network, is pretty cool.

Article 5: Recovering our Stories: Telling Recovery Stories used to be an act of protest against the mental health system that didn't believe in recovery. But now, the mental health system likes to share recovery stories in order to beg for money and look they are effective. A lot of these turn into "disability tourism," or "patient porn." "By pornographic we mean
that, [in these recovery stories] while some people reveal their most intimate personal details, others achieve relief through passive watching, while still others profit from the collaboration of those on the front lines in compromised positions."

See more info on the risks of neurobiology in messaging campaigns here. This article by Pescolido et al now has 790 citations and is the most cited article on stigma reduction. In other words, promoting ACES/ trauma in a disease framework is not going to increase support for services or programs. Come to the national health care messaging conference Sept 11-13 in Atlanta if you want to learn the right way to do healthcare messaging.

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