Hey, How Would You Like To Be More Resilient?

Earlier this month, a study was published that showed a training programme based on Stoic philosophy increased resilience in medical students suffering from empathic erosion and burnout.

In ‘Can Stoic Training Develop Medical Student Empathy and Resilience? A Mixed-Methods Study,’ 24 third year med students took part in an online 12-day course developed by psychotherapists who had based this training (in part) on this specific school of philosophic thought. ¹

The authors said their data demonstrated a statistically significant connection between Stoic practice and empathy, which manifested through the development of empathic imagination and a sense of empathic bravery.

The study itself interested me on two fronts. Firstly, I am a practitioner of rational emotive behaviour therapy (REBT), and this form of CBT is itself based on Stoic philosophy. Especially, on the teachings of the Ancient Greek philosopher Epictetus. Secondly, part of my work involves producing and delivering webinars and live presentations on a variety of topics related to mental health and wellbeing. And one subject, more than any other, keeps cropping up as a request. And that topic is resilience.

Before the pandemic, it was a question of “how do we become more resilient in the face of mounting work pressures?” whilst, today, the question has become, “how do we become more resilient in the face of, well, everything.”

Because, if it’s not one thing, then it’s another. And, if it’s not that, then it’s a case of everything all at once. Pandemics, lockdowns, hybrid working, economic uncertainty, wars and more. Here in the UK, our latest “oh dear god, what now?” moment involves an outbreak of Monkeypox Virus. Cases have also been reported elsewhere around the world and the World Health Organisation (WHO) expect more cases globally.

From bats to monkeys and beyond, it’s a never-ending series of challenges both in and out of the workplace.

“May you live in interesting times,” as the Chinese never said (it’s claimed as a Chinese blessing and/or proverb, but the saying is an English expression and one that is meant more as curse than a blessing). Resilience, then, it has always been needed, it is needed now, and it will be needed in whatever the future holds. Which rather begs the question, “what is it?”

Psychological resilience means the ability to cope mentally or emotionally with crisis (or a series of crises) and then quickly return to a pre-crisis status. Think of it as the ability to withstand adversity and bounce back from difficult life events with a degree of hope and optimism. The problem with life over the past couple of years is that the crisis has not abated and so returning to pre-crisis status has been nigh on impossible.

REBT has a lot to say about life and all its adversities. It’s fundamental ethos (based upon the teachings of Epictetus) is that it’s not the events in life that disturb you, but what you tell yourself about those events that does the disturbing. So, if you’re stuck, if you are thinking, feeling, and acting in ways that you don’t like but don’t seem able to change, it’s not the ‘thing’ it’s what you tell yourself about the ‘thing.’ Change your interpretation and you change how you think, how you feel, and how you act in the face of the same adversity.

It's not saying that when stuff happens, that it doesn’t have an influence, because it does. Life has been challenging, difficult and perilous for all of us, and it continues to be so on a daily basis. But, even in the face of the challenging, the difficult and the perilous, you can remain in control (or regain that control if you think you’ve lost it) by looking at what it is that you are telling yourself.

REBT helps you to identify unhelpful and unconstructive beliefs and swap them for beliefs that are more helpful and constructive. Central to this swap is the notion of disputing (or challenging) those beliefs over and again to affect a shift in thinking. Disputing, as a first step, takes the form of three questions, or challenges. And those questions are:

1. Is this belief true?
2. Does this belief make sense?
3. Does this belief help me?

Let’s say, I am giving a presentation, a big one, and it is important to me. So important that I’ve unwittingly developed the belief that “I absolutely must not make a mistake in my presentation.”

Firstly, that statement can’t be true. I have made mistakes in presentations before, and I can’t guarantee that I won’t in the future. Secondly, whilst I clearly wouldn’t want to make a mistake (who would), it doesn’t make sense to say I mustn’t make one because, that’s not how life works. And, thirdly, that statement is hardly likely to help me. Instead, it will pile the pressure on, which means I am more likely to make the mistakes I don’t want to make.

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However, if I hold the belief “I would prefer not to make a mistake in my presentation, but there is nothing to say that I mustn’t,” we would get a different set of answers. This belief is true. Of course, I don’t want to make a mistake, but given that I have and given that I could again, there is nothing to say that mustn’t happen. It’s much more sensible to accept that as much as I like to get what I want, I live in a world where I don’t always get it. And, finally, this belief would help me. It would take the pressure off for a start. And a less pressured me is less likely to make a mistake.

When you challenge your beliefs in this fashion, you not only become more resilient, but also more positive and optimistic about your situation.

REBT isn’t the only form of therapy that advocates challenging your thoughts this way. Positive psychology developed a similar technique known as a Real Time Resilience exercise. It’s an elegant four-step process that allows you to take a negative thought, challenge it and turn it into a more helpful, solution-focussed thought. It’s so effective that it’s used in US Army training. It’s also used in resilience workshops around the world.

Because, let’s face it, it’s not just medical students that are dealing with possible empathic erosion and burnout. It’s pretty much all of us.