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Caring for a family member who is suffering from a mental illness can be difficult, complex and complicated. The challenging relationships involved in these situations can affect a caregiver’s own health, quality of life, and often disrupts the family structure (Zauszniewski, Bekhet & Suresky, 2009; Zausniewski, Bekhet & Suresky, 2010).
It is interesting to consider what components can assist people to shield themselves during these times and help them to manage effectively in a family unit but also individually.
One such person, who took part in a study by Marsh et al (1996), made a comment about herself after caring for a loved one for many years;
“I can now say that, like the old aluminum foil advertisement, I am ‘oven-tempered for flexible strength’”
So which aspects potentially led this woman to flourish this in a difficult situation, and which aspects would have made her flounder?
Looking at Resilience
There are many different definitions of resilience.
It can be a process consisting of positive adaptation when facing significant hardship, or adversity (Zausniewski, Bekhet & Suresky, 2010) or the capability that we hold to re-bound from adversity, and conquer circumstances that pose a threat to our lives (Marsh et al., 1996).
Whilst yet another definition is that resilience is a dynamic set of skills utilized when facing a difficult situation, encompassing a range of thoughts (eg. positive outlook), feelings (eg. sense of humor) and behaviors (eg. capacity to utilize social support) (Simpson & Jones, 2012).
Whatever the definition, there is a common theme amongst all:
“Resilience isn’t about just overcoming the day-to-day burdens and hassles; it is also about thriving, becoming a stronger, healthier, a more flexible person and compassionate family unit.”
It has been noted that families have their own unique set of restorative powers (Marsh et al, 1996). That in order to overcome crises, families rise to the occasion and in turn, become more cohesive and strengthen interpersonal bonds (Marsh et al., 1996; Rungreangkulkij & Gilliss, 2000).
The Resilience Theory
The Resilience Theory states that resiliency is determined by both risk and protective factors (Greff, Vansteenwegen & Ide, 2006; Zauszniewski, Bekhet & Suresky, 2009). Let’s have a deeper look at these conditions.
The Risk Factors
These are the factors that pose a threat to caregiver resilience and mental health, examples of these include elements such as stigma, isolation and occupational restrictions (Zauszniewski, Bekhet & Suresky, 2009).
In relation to cognition, an example of a risk factor could be if a caregiver choses to appraise their situation as life threatening, burdensome and stressful (Zausniewski, Bekhet & Suresky, 2010).
The Protective Factors
These are factors that facilitate and foster resiliency. They tend to focus predominantly on positive cognitions.
These factors improve a caregiver’s response to stress and strain, producing a positive outcome (Zausniewski, Bekhet & Suresky, 2010). There are said to be 7 main determinants for conquering adversity in order to become resilient, stronger, more flexible and healthier (Zausniewski, Bekhet & Suresky, 2010, Marsh et al., 1996):
- Acceptance: Refers to tolerating what is perceived to be undesirable behavior from a relative with mental illness, and the ability to understand the deeper role of that behavior, its importance and value. Acceptance that you cannot change another’s behavior, but that you can change the way you perceive it.
- Hardiness: This refers to internal strengths such as cognitive and behavioral flexibility, endurance, control and commitment. Resilience flourishes from the ability to accept the challenge, and use active problem solving techniques when looking after a loved one with a mental illness.
- Mastery: Is when family members believe they have a sense of control over the situation, or that perhaps they hold the belief that they are the masters of their outcome. It is a form of coping that facilitates adaptation and a sense of competence.
- Hope/Optimism: This has been said to be an integral component of coping. It is produced through positive memories and interpersonal relationships, which facilitate fresh insights and a sense of purpose.
- Self-efficacy: A caregiver’s belief that they are both competent and confident in dealing with stressful events is important. It has been said that higher levels of self-efficacy are related to more effective management of problems.
- Sense of coherence: Is when an individual believes that the world is manageable and meaningful. It refers to a global perspective and orientation towards life. It is the way in which all family members come together and combine their strengths and shared values to manage the tension and strain in a given challenging situation.
- Resourcefulness: Being ‘thrifty’ when it comes to utilizing positive cognitions to cope effectively through positive thoughts, feelings and behaviors. It also refers to being willing to seek help from others when needed.
A ‘resilient survivor’ is an individual with a combination of damages and strengths, however they predominantly hold positive insights, independence, positive interpersonal relationships, initiative and humor (Marsh et al., 1996).
The Take Home Message
It is clear that family and caregiver resiliency does not result from the evasion of risk, but rather the utilization of protective factors in order to manage adversities and come out of the situation not only stronger, but flourishing (Benzies & Mychasink, 2009).
Resilience can be seen as a great opportunity to change perspectives and create positive, constructive strategies, that way strengthening family bonds, and become people of substance, strength and compassion.
“If your heart is broken, make art with the pieces.”
– Roy Koyczan
Benzies, K., & Mychasink, R. (2009) Fostering family resiliency: a review of the key protective factors. Child and Family Social Work, 14 (1), 103-114.
Greff, A., Vansteenwegen, A., & Ide, M. (2006) Resiliency in famililes with a member with a psychological disorder. The American Journal of Family Therapy, 34(4), 285-300.
Marsh, D., Lefley, H., Evans-Rhodes, D., Ansell, V., Doerzbacher, B., LaBarbera, L., & Pauluzzi, J. (1996) The family experience of mental illness: Evidence for resilience. Psychiatric Rehabilitation Journal, 20(2), 3-12.
Rungreangkulkij, R.N., & Gilliss., C.L. (2000) Conceptual approaches to studying family caregiving for persons with severe mental illness. Journal of Family and Nursing, 6(4), 341-366.
Simpson, G., & Jones, K. (2012). How important is resilience among family members supporting relatives with traumatic brain injury or spinal cord injury? Clinical Rehabilitation, 27(4), 367-377.
Zausniewski, J.A., Bekhet, A.K., & Suresky, M.J. (2010) Resilience in family members of persons with serious mental illness. The Nursing Clinics of Northern America, 45(4), 612-626.
Zausniewski, J.A., Bekhet, A.K., & Suresky, M.J. (2009) Effects on resilience of women family caregivers of adults with serious mental illness: The role of positive cognitions. Archives of Psychiatric Nursing, 23(6), 412-422