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Resilience is described as the ability to recover and grow in the face of stressors and changing demands (Deuster & Silverman, 2013). A lot of research about resilience has come from the US military, triggered a decade back by troops returning from Iraq and Afghanistan with severe emotional trauma.

There is a saying that there is a silver lining in every black cloud. Increasing numbers of servicemen returning from duty with post-traumatic stress disorder (PTSD) motivated the Department of Defense (DoD) to initiate new research on resilience (Jonas, O’Connor et al., 2010). What researchers learned has relevance to civilian populations as well, particularly individuals living with chronic pain.

The DoD called their new resilience paradigm “Total Force Fitness.” The multi-modal program includes eight domains: psychological, behavioral, social, physical, environmental, medical, spiritual and nutritional. There is an obvious association between Total Force Fitness and the bio-psychosocial model long used to describe chronic pain.

Resilience, like pain, is a complex construct, and building resilience requires a whole person approach that considers the individual, social and environmental supports.

Building resilience requires a whole person approach with individual, social and environmental supports. The key is emotional flexibility.

What became clear is that resilience cannot be addressed through the traditional approach of disease prevention via physical exams, vaccinations and exercise. A person’s emotions influenced by both personality (trait) and day-to-day challenges (state) are equally important (Sturgeon & Zautra, 2010). 

Researchers also learned that these factors don’t operate in isolation. Mental toughness and hardiness, often developed through participation in physical activities, build resilience (Duester & Silverman, 2013). Participation in sports can also enhance a person’s self-efficacy (belief in their ability to complete a challenge), and boost motivation.

On the flip side, psychological contributors, particularly a person’s view of the world and extraversion (a person’s tendency to socialize) can be impactful. A key factor is what psychologists describe as “benefit finding,” the ability to recast a negative event in positive light. This contributes to skills some people have for finding strength in adversity and emerging from stressful situations with new personal insights and enhanced self-image.

The key to resilience is emotional flexibility: finding the most appropriate strategy for addressing a particular challenge. A professor of mine equates overwhelming demands to “eating an elephant,” (Harrell, ASU webinar, 2023).

The best strategy is to “chunk it out,” conquering each barrier one small step at a time. What might work for one situation, for example, developing the physical function to return to work post-injury, may not be as effective for enhancing enjoyment of life, where relationships with family and friends are more of a factor.

Resilience depends on a person’s ability to survive and thrive. Rather than coping with pain through avoidance, resilient individuals seek novel solutions that enable them to live a fuller and more satisfying lives. Going to an exercise class may seem intimidating, but it also holds the possibility of new friendships and social support.

Spiritual guidance, whether one finds it from attending a church, temple or mosque or in personal meditation, can offer comfort in dark moments. Getting out in the world is important as well, be it walking around the neighborhood or along a favorite trail. Facing each challenge with a positive mindset is the key to bouncing back from adversity.