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Pernille Buelow

The lived experience and neurobiology of resilience

Pernille Bülow, PhD
Pernille Bülow, PhDPublished on February 14, 2023

Mental health newsletter, December 2022

By Pernille Bülow, PhD

In the face of traumatic experiences, some people recover easily while others do not. I have interviewed numerous people who lived through childhood sexual abuse, rape, extreme violence, severe disease, and chronic illness, and while they all were deeply affected yet reflective on their experiences, some had recovered faster than others. Their mental health was less impacted, their life maintained some sort of normalcy, and they sought out help faster and more successfully. I was struck by what makes these people different from the rest.

I published a shorter version of this article in Psychology Today but here I am going to dive more into the science of resilience while incorporating what I learned through my interviews.

Photo by Ivan Samkov/Pexels.

What makes them different?

These people are resilient, meaning that they are particularly good at engaging adaptive strategies to recover from acute stress and trauma or chronic forms of adversity. The way we respond to adversity is usually referred to as ‘coping’, and is, in its essence, about how you deal with things happening to you (Folkman and Moskowitz, 2004). There are various types of coping strategies. One of the most studied is called ‘cognitive reappraisal’, which specifically focuses on reframing how you think about an event. This is an iterative process, where we reinterpret our situation over multiple time points, thus the process is called cognitive reappraisal due to its ongoing and active nature.

What makes some people better at cognitive reappraisal? Research has found that brain activity differs between resilient and non-resilient people exposed to the same trauma (Feder et al., 2009). These brain differences are associated with distinct gene expression, but it is unknown whether the differences are inherent or acquired. Gene expression can be inherent, meaning that we are born with them, or acquired, meaning that our genes change in expression in response to experiences. This latter process is also referred to as epigenetics. Intriguingly, research has found that certain forms of psychotherapy can cause epigenetic changes, potentially leading to changes in how our brain functions (Feder et al., 2009).

Cognitive reappraisal is one of many coping strategies. Some coping strategies have positive and beneficial effects on your life quality, while others can maintain or lead into a mental illness. For example, food restriction is a coping mechanism in response to intense stress, but it is also a “gate way” to disordered eating behavior. In contrast, cognitive reappraisal, journaling, and controlled distractions are coping strategies that tend to contribute to healthy stress-management.

Resilience and coping are often talked about in the context of responding to and recovering from negative events. An important aspect of resilience is that it can be trained to help you prepare for adversity by practicing healthy coping strategies (Steinhardt and Dolbier, 2008). In this article, I dive into two examples of coping strategies that have helped prevent trauma from leaving a lasting mark in people I interviewed: cognitive reappraisal through religious or non-religious mindsets and education. But before we get to that, let’s explore the neurobiology of resilience.

The Neurobiology of Resilience

Researchers have found many interesting differences between the brains of resilient and non-resilient people (Feder et al., 2009). Resilient people tend to have a different composition of neurotransmitters and hormones that have, in part, been attributed to genetic differences, either through genetic inheritance or epigenetic modifications. However, while these neurobiological differences are interesting, they do not tell us much about why a person is more resilient and more capable of engaging healthy coping mechanisms.

To understand that better, it makes more sense to address the neural circuitry and neural activity of resilient people. Said another way: understanding how different brain regions speak to each other, and how active they are.

If you have read the ‘Intro to the Brain’ article you know that the prefrontal cortex (PFC), a large region at the front of your brain, plays an important role in emotion and behavior regulation. If the PFC is not up to speed, we end up making questionable decisions. This is for example the case with many teenagers since their PFCs have not fully matured yet.

It is possible to distinguish resilient and non-resilient women that have a history of sexual trauma based on their brain activity (Feder et al., 2009). In one experiment, resilient women were better at sustaining attention to aversive pictures which correlated with higher PFC activation. Another study found that during cognitive reappraisal, PFC activity is increased while activity in the amygdala is decreased. Based on these and other studies, researchers think that the PFC is important for regulating emotional responses by modulating amygdala activity. To further corroborate that idea, studies report that cognitive behavioral therapy, a therapeutic approach that utilizes cognitive reframing, is associated with reduced amygdala activation while frontal lobe regions, including the PFC, display increased activity. Thus, healthy coping strategies and high levels of resilience appear to correlate with increased PFC activity which in turn reduces amygdala activation (Drabant et al., 2009). In parallel, these individuals also experience increased optimism and ability to cognitively reappraise negative events in a more positive light. In psychological terms, one could say that these people utilize their ‘inhibitory’ self-control to better regulate their emotions and behaviors to find purpose and/or meaning in their trauma.

How do we train our brain (and bodies) to become resilient and rely on effective coping strategies? We do so through practice! As I mentioned above, therapy can literally change the way your brain works, and so can everything you do that requires practice and reflection. Below, I will dive into two examples of coping strategies that can make you more resilient to trauma.

Cognitive reappraisal through religious and non-religious mindsets can change the way you think about a negative life experience

If you talk to a neuroscientist or psychologist, we will often say that cognitive reappraisal involves re-interpreting an event by changing one’s attention and emotions towards it. However, there are different methods to do this, one of which is the ancient practice of religion. Several studies have identified clear parallels between cognitive reappraisal and religious thinking (Dezutter et al., 2010; Doucet and Rovers, 2010; Bosson et al., 2012). The conclusion: both can help people find purpose and/or meaning amid trauma and adversity.

One way that religion helps promote resilience is by helping people find meaning in their adversity (Dezutter et al., 2010). One interviewee said: “God gives you what you can handle. There is always a reason for what’s happening, but I do not necessarily have to understand. I just need to keep going with the task I have been given” (JB, age 45, Colorado USA). To her, religion created a path forward which helped her maintain a positive outlook. An optimistic outlook is associated with better mental wellbeing, and religious practice correlates with reduced long-term mental health consequences in the face of acute or chronic adversity (Townsend et al., 2002; Tix and Frasier, 1998).

A similar, but non-religious, cognitive reappraisal strategy is to think about what one can gain from their circumstances. Instead of attributing the adversity to a part of a god’s greater plan, it is seen as a random event that is a steppingstone for personal growth. “The idea that “Everything happens for a reason” is outdated to me. The reason is bad luck. It has not allowed me, but rather forced me to focus on what is important in my life, to understand what makes me feel fulfilled. The illness has forced me to become more like myself, but I don’t know if I really wanted that” (JE, age 38, Zwolle Netherlands). In contrast to the other interviewee, this person saw the adversity as ‘bad luck’ that could just as well not have happened. However, instead of wallowing in her misery and frustration, she chose to utilize her situation as an opportunity for self-inquiry.

A similarity between both interviewees was the importance they placed on social support. Community, whether that be through friends, colleagues, or religious practice, can help change the way we think of our negative life experiences, and thus aid in the process of cognitive reappraisal. This may be one of the ways that religious practice can mitigate long-lasting effects of trauma. Finding meaning or purpose in trauma and knowing that you have a community to lean on can provide the foundation for turning post-traumatic stress into post-traumatic growth regardless of your religiosity.

Education can prevent traumatic responses to negative life events

A less discussed and researched topic is that of education as a preventative strategy to reduce the impact of future trauma. I found it interesting that two people specifically mentioned their previous education as key factors in understanding their own responses to chronic illness and rape, respectively. Both interviewees’ education revolved around the body, both in theory (how does the body function) and practice (how the body can be treated and how the body performs).

“I believe I was less affected by the rape, both acutely and in the long-term, compared to many survivors, because of my background in body work. My own body work practice enabled me to understand my body's reactions, and I knew what it needed to heal after the rape”” (LH, age 76, Georgia USA)

“I have been so frustrated with my illness. But my work as a dance performer researcher has helped me connect the dots between my body and my mind. My work gave me something to hold on to, it provided me with an understanding and embodiment of myself with the disease" (JE, age 38, Zwolle Netherlands)

Psychoeducation refers to the philosophy of providing people with information about the mind, feelings, and body to help them better understand their own sensations and reactions (Ekhtiari et al, 2017). Psychoeducation can be done after a trauma or before a trauma has occurred. The power of psychoeducation prior to a trauma is its ability to prevent severe symptomatology and reduce the associated treatment load. Psychoeducation as a preventative strategy is particularly useful for groups of people that are at high likelihood of experiencing trauma, for example military personnel. Indeed, studies have found that receiving preparatory information before stressful events (such as combat) reduces subsequent trauma responses and protects miliary personel’s mental wellbeing (Hourani et al., 2011). First time pregnant females also benefit from psychoeducation and are less likely to experience symptoms of post-traumatic stress disorder after giving birth (Gökçe et al., 2016).

Psychoeducation is not just about reading a book, watching a documentary, or listening to a lecture. A key aspect of its success is to practice strategies to regulate your body and attention. This practical training is important for several reasons:

1. After enough training, you will be able to regulate your own physiology and cognition, even during negative life events, panic attacks, or trauma flashbacks. This ability to self-regulate will reduce the long-term effects a negative event will have on your body and mindset, and help you restructure how you think about the events.

2. Understanding your body will help you identify what kind of support you need at a given time. Do you need to see a psychotherapist? Do you need to meditate? To pray? Do you need to go kickboxing? These insights instill you with self-efficacy - the belief that you have the capacity to do what it takes to achieve your goals - which correlates with higher mental wellbeing.

Psychoeducation has the potential to change more than one life. A new phenomenon is that of ‘community-initiated care’ (CIC), which trains the public to support people with mental health challenges and help them access resources when they need professional help (Siddiqui et al., 2022). There is no doubt that effective implementation of CIC can revolutionize mental wellbeing and healthcare, in large part because we can prevent a “light” depression turn into a “severe” one, and we can catch a person with early signs of disordered eating before they fall into a full-fledged eating disorder. But there is another benefit that is often not mentioned in this research: by educating the public on how to help and support others with mental health challenges, we are helping them deal better with their own (future) circumstances. Imagine a world where we train children, youth, and adults to understand how your body and mind react to trauma and adversity and what it needs to recover. Not only will we become better at non-judgmentally supporting others, but we can also support ourselves and self-regulate our own emotions more effectively.

Resilience in the face of acute vs chronic adversity

A negative life event can happen over minutes, hours, days, months, or years. Dealing with a trauma that happened during a couple of hours (for example a rape) is very different from dealing with the struggles of a life-long illness. In both scenarios, one’s reactions can, and often do, change with time. Your acute reactions may be that of disbelief and denial, evolving later into anger and then fear. Your resilience will be tested at every time point, and just because you are effectively handling the acute phase does not mean you will be for the later stages. The way your body reacts to what has or is happening will evolve and will influence how your mind thinks. People that are high in resilience effectively reevaluate which coping strategy they need to engage at different time points. They understand that their body and mind are not static and that their needs will change over time. This flexible mindset is a core feature of resilient people, and correlates with better physical health, mental wellbeing and even body image.

Preventing trauma from taking root

In sum, there are various ways we can prepare ourselves to mitigate the effects of adverse life events, whether they be acute or chronic. One of the most important actions is to restructure the way you think about those events, with the help of psychotherapeutic strategies, religion, or something completely different that works for you. If you live or work in a high-stress environment, psychoeducation will likely help you prevent these experiences from causing trauma. When that’s said, everyone, regardless of high-stress exposure, benefits from psychoeducation, in particular children and youth. Childhood and youth are especially formative years, and experiences during this period can have long-term influences on how you develop and tackle future stressful experiences. Understanding why one’s body feels and reacts the way it does can determine how a person decides to tackle a situation. Will they reach out to a trusted friend or family member? Will they run away? Will they turn to violence? Empowering people with the skill sets to understand and regulate their own bodies is one of the most promising ways to prevent adversity from leaving a lasting mark, and in the long run, one of the most effective ways of combating mental illness. Ultimately, these strategies will help a person find purpose and meaning in their life in the face of trauma.


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