How to Survive (Practically) Anything

Early November past, Steven Wolin, a soft-spoken psychiatrist, walked onto a stage in Dallas and delivered a critical karate chop to the 4,000 members of the American Association for Marriage and Family Therapy sitting in stunned silence before him. He told them that America is being turned into "a nation of emotional cripples" under their eyes.

Over the past 10 years, he said, traditional psychiatric thinking "has slipped out of professional hands, where it had shortcomings enough, into the popular culture, where it has gone wild. I am referring to the Recovery Movement, which I believe has become dangerous. It completely bypasses our capacity for resilience. It glorifies frailty, lumps trivial disappointments with serious forms of mental illness, and portrays the human condition as a disease."

Instead, he said, together they needed to foster awareness of the human capacity for strengths and resilience. He told them he was taking his case to the AAMFT because family therapists have generally made the best case for strengths. He hoped they would join him in objecting to "the modern-day voices of doom on both the professional and popular front." His speech, "The Challenge Model: How Children Rise Above Adversity,'' described how people develop resilience and laid out a way to help people who grow up in troubled families. In the end, Dr. Wolin received a standing ovation.

Wolin, a researcher at George Washington University, in the nation's capital, also practices psychiatry there. He is currently writing a book, Resilience: How Survivors of Troubled Families Keep the Past in its Place, due out later this year and coauthored with his wife, Sybil Wolin, Ph.D., a child-development specialist. On the eve of the AAMFT speech, PSYCHOLOGY TODAY talked with the doctors Wolin about their provocative work.

PT: You are indeed bringing good news to people. You maintain that, contrary to popular thinking, adults aren't prisoners of troubled childhoods; they have powers of resiliency. What is resiliency and how do people get it?

Steven: Resiliency is the capacity to rise above adversity and forge lasting strengths in the struggle. It is the means by which children of troubled families can rebound from hardship and emerge as strong and healthy adults, able to lead gratifying lives, albeit with some scars to show for their experience. Children can overcome trauma, protect themselves, grow and learn in the process, and emerge in surprisingly good health.

Sybil: It is not the ability to escape unharmed. It is not about magic.

PT: Where does your concept of resilience come from?

Steven: My thinking on the subject reflects my own 20 years of research on adult children of alcoholics who do not repeat their parents' drinking patterns; an existing body of research on resilient children; child-development theory; and a recent series of interviews Sybil and I have conducted with resilient adults.

The seriously troubled families we/re referring to are pretty clearly definable. They are those in which the parents are suffering from substance-abuse problems--alcohol, other drugs; serious mental illness, such as manic-depressive disorder; serious depression; or schizophrenia. Also included are those families marked by chronic marital disputes often leading to divorce, but it is really the bitterness of the battle that is the serious trouble. And there is a large number of families in which the parents suffer serious personality disorders: parents who are very paranoid, who have very fragmented lives, or who have serious obsessive-compulsive disorders.

Sybil: We also include families troubled by racial discrimination and poverty because they create conditions that make it very difficult for children. They test resilience. We don't want to suggest that the psychopathology in those circumstances is inherent.

Steven: We don't think the human condition is a disease, nor do we think that difficulties or human failures are diseases.

PT: This idea is particularly intriguing now, because there are large cultural forces that actively work against people knowing about resilience.

Sybil: We would still be closet academics if it were not for the recovery and codependency movements. Steven's been doing this research for a long time. We've come out of the closet to combat what we see as a "Damage Model" mania.

PT: There seems to have been extensive contamination of the language and a metastasis of the concept of disorder and disease.

Steven: The Damage Model is a belief about the intergenerational transmission of disease. It basically says that if your family is having trouble, the chances that you are going to get it are very high. It derives from traditional psychiatric thinking, conventional wisdom, and popular psychology, which stress how children growing up in adverse circumstances suffer lasting emotional disturbances. I call this prediction, with its bias toward pathology, the Damage Model. It is prophecy of doom.

PT: And the "Challenge Model"?

Steven: I offer it: to give survivors of troubled families a more balanced perspective about their past. I also, hope to have an effect on my professional colleagues.

Sybil: We want to restore balance to the mental-health professions, which really are the mental-illness professions.

Steven: Both models start with the observation that the troubled family can inflict considerable harm on its children. In the Damage Model, children are seen as passive and without choices to help themselves. In the Challenge Model, the family is not only a destructive force but an opportunity. Survivors are challenged by the family's troubles to experiment and to respond actively and creatively. Their preemptive responses to adversity, repeated over time, become incorporated into the self as lasting resiliencies.

PT: Why has it taken scientific research such a long time to get at the value or even the existence of resiliency?

Sybil: People want the stamp of science but they don't know very much about research; they are uneducated scientifically. The word "researched" carries a lot of power and a lot of legitimacy.

PT: Are you saying people have committed a major misinterpretation of research?

Steven: Risk research has by and large focused on the increased risk that a child has because of one factor or another, whether it is the kind of family they grow up in, or the kind of environment that they're growing up in, or some physical disability. There is an increased risk that you will become an alcoholic yourself if you have an alcoholic parent. However, the increase in risk is something like four times or five times normal. Let's say it's four times normal. The risk in the population normally is around four or five percent. So if you have an alcoholic parent, the risk that you're going to be an alcoholic is around 15 percent. In other words, 85 percent are not alcoholic. I felt that this 85-percent majority, who had resisted the noxious influence of the past, had just as much to teach us as the 15-percent minority who had succumbed.

Sybil: The really amazing thing about risk research is that 90 percent of the children of schizophrenics don't become schizophrenic; that's nowhere to be found in the interpretation.

Steven: Nor do they develop any other serious problems. Let's take another problem. The extent to which child abuse is transmitted over generations is six times normal--30 percent become abusers; 70 percent do not.

PT: How does resiliency develop under such circumstances ?

Steven: Children have a coping mentality; they actually do something to handle what's going on inside their parents and manage it in some important way. That's at the core of this resiliency notion. It protects us in some way to not think about kids being able to do that. Resiliency develops out of the challenge to maintain self-esteem.

Sybil: One of the greatest threats to a child in a troubled family, after the actual physical abuse, is the threat to the self, the destruction of children's self-esteem by making them feel powerless and bad about themselves. Resiliency is the capacity for a child to maintain self-esteem despite the powerful influence of the parents.

Steven: While a child may at some point succumb to those self-esteem-diminishing events that are current, there can be a rebounding process occurring simultaneously. If the child does a good job at it, then self-esteem restoration will come at the same time that hurts occur.

Sybil: The idea that children are only damaged by their parents gives no credit to our wonderful complexity as a species. Multiple things are happening psychologically to a child in a troubled family. You can be hurt and rebound at the same time. We're complex enough psychologically to accommodate the two.

PT: How did you get into this field?

Steven: I came to Washington in 1970 to escape going to Vietnam. I was assigned to a unit at St. Elizabeth's Hospital where alcoholics were being studied. The head of the lab decided to include spouses where possible. These studies introduced me to the notion that we should look at the family as a whole system.

Around that time, I became interested in the question of the transmission of alcoholism over generations. It was becoming clear that there was a higher risk than normal for children growing up in alcoholic homes. Because of my interest in families, I began looking for some factor that might predict why certain families were transmitter families and other families nontransmitters.

The first hypothesis we developed was that higher-transmitter families would have inculcated alcohol abuse into their cherished rituals. Rituals are very measurable. They permitted me to latch on to family functioning in a way that was objectively verifiable. As a way of tracking transmission, I could measure holidays, traditions, dinnertime, and see whether alcoholism had become part of those.

PT: What did you find?

Steven: In fact, there were a large number of families that did not transmit alcoholism, and they had something special about their rituals. They had the ability to exclude alcoholism behaviors from their cherished occasions. For example, they wouldn't let the drunken parent come to the dinner table. They would make arrangements so that their holiday would be protected, like going to certain places where they could keep the holiday alive. They would invite their alcoholic father into the back of a station wagon-they didn't want to abandon him but he was sequestered away from the rest of the family--and they would drop him off at the bar and pick him up when they wanted to go home. They kept the alcoholism behavior distinct from the rituals. Ritual protection was helpful to children if they were not going to repeat their parents' alcoholism as adults. This process of focusing on the ones who had protected rituals was the transforming event in my life. It kindled interest in the protective factors.

Sybil: Holidays are the last bastion. If a family was able to keep their holidays intact, you could make certain assumptions about how well they were doing in general. Steven: Dinnertime went first. In virtually all the alcoholic families, dinnertime was pretty destroyed by the alcoholism. Even in some of the nontransmitter families, dinnertime was destroyed, but holidays like Thanksgiving and Christmas were protected. When Thanksgiving went, when the family couldn't carry out Christmas--because, for example, the Christmas tree went up in flames--some deep functioning within the family sense of itself, its identity, went too. Those were the highest transmitter group.

Sybil: From a scientific perspective, holidays are a measurable variable. From a family perspective, holidays are very highly charged occasions. They mean "we're valuable enough as a group to get together; we love each other enough that we could spend Christmas together." The holidays did have a unique protective factor.

PT: How does resiliency manifest itself? What forms does it take?

Steven: We think that there are seven styles, aspects of the self that typify survivors. One is insight, the mental habit of asking oneself penetrating questions and giving honest answers. Another is independence, the drawing of boundaries between oneself and troubled parents, keeping one's emotional distance while satisfying the demands of conscience. There's relationships, doing the give-and-take work necessary to derive emotional gratification from other people. There's initiative, taking charge of problems, stretching and testing oneself. Also humor-finding the comic in the tragic; creativity-expressing and resolving inner conflict in symbolic form; and morality-adhering to standards of decency.

Some kids are more practical, other kids are more creative, and some are more intellectual. Personality type will direct the shape of resilience.

One facet of resilience is definitely cognitive. Children--perhaps as young as five or six---develop a hunch that something is wrong with their troubled parents. Their first awareness may be sensory: the father's key rattling and missing the lock, the sound of feet dragging on the front walk. Over the course of development, these initial sensory impressions refine and diversify into empathy, introspection, clear thinking, and an ability to tolerate life with its complexities and ambiguities. As adults, resilient children expand their sensitivities and understanding, which become permanent, protective, and growth-producing parts of the self.

Sybil: I'll give you a prime example. Lois Murphy is a researcher looking at naturally occurring resilience, not resilience in survivors of troubled families. One day she received a phone call from her four-year-old daughter's nursery school teacher, who reported that the kid got hit over the head with a shovel in the playground. She bled, and she was real scared. Then, inexplicably, the girl rallied. She just stopped and said, "Oh God, aren't I lucky I wore a red hat today so this blood is not gonna show."

PT: The kid has a brilliant future as a stand-up comic.

Sybil: No--a stand-up therapist. It really is a matter of shifted focus--from the misfortune of getting hit on the head to the good fortune of wearing a red cap.

PT: And that's at the heart of resilience--reframing, a way of shifting focus from the cup half empty to the cup half full? Reframing is a very resonant topic for family therapists, isn't it?

Steven: My family-therapy colleagues understand reframing, but only in one context. To them reframing typically means that some activity the family identifies as negative, destructive, or sick in fact has a positive purpose. They understand reframing only as something happening currently in a family being observed. They do not pay attention to the strengths that were located inside the survivors of troubled families. So family therapists have to reframe those life stories to bring/out the resiliency.

A Challenge Model therapist would be in the business of finding strengths and complimenting them, and getting people to see how heroic their acts had been as children. That's the reframe--going back to an incident, finding the strengths, and building self-esteem on the achievement.

PT: So how do people breed resilience? Aren't you saying that even troubled families can breed resilience, and one of the ways is by protecting their rituals ?

Steven: That certainly is a message, that even in the face of serious troubles, there are things families can do. The one I have investigated has to do with protecting, cherishing, altering, and strengthening family rituals. In the face of trouble, families can evaluate, alter, and improve family rituals, adopt new ones, revive lost ones. They can remove a bad thing--like the alcoholic drinking--from an otherwise good ritual, like a holiday gathering. They can reinvigorate a ritual by changing it based on the current needs of the family. Individuals can do the same thing both in terms of their own rituals from the past as well as various other aspects of their resilient self.

PT: You single out rituals because they're so emotionally salient in family life.

Steven: And every culture loves them.

PT: You say that at some point successful survivors put distance between themselves and their past. What do they do?

Steven: Many kids find ways to move out of their family and into other families. They cultivate a talent and win recognition for it; they join youth organizations. Children of alcoholics marry into nonalcoholic families or into families with very strong rituals. They create strong rituals of their own.

PT: What is the earliest that resilience manifests itself? What does resilience look like in a five-year-old?

Steven: Children from troubled families who are resilient develop their strengths with a seriousness and a precocity, compared to children from nontroubled families. The comparison group of survivors of troubled families is not survivors of nontroubled families. It's the siblings who do not do as well. I suspect it is a different process to become strong in a troubled family.

Steven: I must tell you that people don't like hearing about their resilience so much, at least at first. They either think that you don't understand them, because you' re not really appreciating exactly how much they have suffered. Or they don't like to think that during those phases of their childhood that they did so much. They'd rather be normal.

PT: Is it because they've been exposed to another philosophy about their past?

Steven: Many of them come in to get affirmation for their victim status. They don't want to hear about being resilient.

Sybil: With victim status comes a promise of sympathy.

Steven: There's a hidden allure that somehow you're going to return to childhood and get what you never got.

Sybil: The recovery movement urges adults to re-create their "inner child."

Steven: In addition, some people don't like to be told that they were resilient because there still burns deep within the dream that maybe something normal could be found within their family. They don't want to think that they were special.

Sybil: To accept resilience is to acknowledge, "Yeah, I really grew up in hard times, and I did special things, and I was resilient." You lose the hope that your family was normal and everything is just going to fall into place. In therapy, it's much easier to express righteous indignation about what's been done to you than to change ingrained patterns of behavior.

Steven: My psychiatrist colleagues also resist the idea of resilience.

PT: Is that because your work implies resiliency isn't the exclusive property of the therapeutic establishment?

Steven: My colleagues fear that talk about the strengths, for example, of children of alcoholics, is going to be seen as endorsement of suffering and abuse as a way of making children stronger. Also, my field has not embraced the notion of strengths as something to be cataloged, categorized, charted, and demonstrated. We are filled with a vocabulary of pathology. There's no Diagnostic and Statistical Manual (DSM-III) for strengths.

PT: You said that your patients do not like to learn they're resilient. Perhaps you have not seen the most resilient of the survivors because they may not be the ones coming in for therapy.

Steven: Many of them have not. The ones who come in as patients have not been so receptive to the notion of their resilience. It's a long process to get them to accept the distance they've come.

Sybil: People want to have their pain acknowledged. That's why they're coming to therapy.

Steven: I don't want to get away from the scars that occur in these families. People can walk around with an awful lot of pain that does deserve to be talked about. But in fact many of the patients I have seen in my practice are very resilient people.

PT: How do you motivate all those people who are not happy about learning they are resilient?

Steven: Slowly. First I achieve a level of trust, that I am not overlooking all they've been through. When I find those elements they can be proud of, you can bet that they will feel better. This is Jesse Jacksonism, in a sense--that people can, in fact, get mobilized by the notion that they have traveled a distance, that they have strengths inside of them, that they can use those strengths for today's problems.

Sybil: Traditional therapies suggest that insight drives change--that you will uncover the hidden or repressed reasons you behave the way you do and the emotions driving your behavior will naturally change as a by-product of these insights. We're saying that changing ingrained habits is hard work, the motivation to do that has to come from some place, and pride can bolster you. Pride drives the engine of change. People would rather be victims, because if you can talk about how other people are making you do it, then you have no obligation to change.

PT: If the Damage Model of life is not true scientifically, why is it being pushed, and what are we getting out of it?

Sybil: Risk research has shown that indeed parents have a tremendous influence on their children. But if 90 percent of these kids are not being so affected by their parents, that's really going after one of the sacred cows of our society--parenting. If we give parents the idea that what they do doesn't matter, God knows where we'll go from there. Steven: The real point is what [Harvard psychologist] Jerome Kagan says: Subjective meaning matters.

Sybil: Addressing the whole body of risk research, Kagan says that as long as we insist upon investigating the effects parents have on children by looking at the objective behaviors of parents, the less we're going to understand the effects parents have on children. It's the interpretation the child makes of the parent's behavior that really determines how the child is going to feel about what the parent has done.

PT: What are the limits of resiliency? Can there be too much resilience?

Steven: You would become so cool, for example, to the distressing battles of your parents, so totally unaffected that you become a rigid automaton.

PT: A tin man?

Steven: Right. That's an example of how somebody starts off by protecting himself with a strength but ends up with something that makes him totally unavailable to other people.

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