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RUNNING HEADER: DEVELOPING RESILIENCE SKILLS 1
Development of Resilience Skills in
Women with PTSD
By: Tamara Baker & Dr. Karen Yescavage
Colorado State University – Pueblo
Developing Resilience Skills 2
Development of Resilience Skills in Women with PTSD
I
There are many therapeutic paradigms bringing individuals from pathology back into
homeostasis or what is considered normal functioning. Yet there are factors that reside in each
person, which if tapped into can maintain homeostasis. Resilience and hardiness are factors that
assist each person in maintaining positive mental health even through adversity (Herman, et al.,
2011). This is what has been recognized in the resilience research as successfully engaging
adversity (Anderson, 2010). Program designs have been proposed, that should be instituted in a
collaborative framework, through policies and varied health clinics to help teach and improve the
skills of resilience throughout the lifespan of individuals (Herrman et al., 2011).
The individuals in need of these programs are those that have gone through varied forms
of severe trauma. The forms of trauma can be anything from, child sexual assault (CSA),
domestic violence, rape and any trauma that would take an individual out of their positive mental
health, resulting in long-term effects. These individuals have lost homeostasis and are suffering
from Post-Traumatic Stress Disorder (PTSD), severe anxiety, and depression (Valentine &
Feinauer, 1993; Mendelson, Zachary & Harney, 2007; Beck et al, 2011; Ullman & Filipas, 2001;
Schumm, Briggs-Phillips & Hobfoll, 2006; Feinauer, Mitchell, Harper & Dane, 1996; Wyatt,
Notgrass & Newcomb, 1990; & McClure, Chavez, Agars, Peacock & Matosian, 2008; &
Anderson, 2010). Personality disorders such as borderline personality, and histrionic personality
have also been linked to some of these traumas e.g. CSA (Anderson, 2010; & Orzeck, Rokach &
Chin, 2010). All of these diagnoses lead to decreases in interpersonal trust, communication
skills, self-efficacy, autonomy, and optimism.
Developing Resilience Skills 3
II.
Traumatic cycle of abuse
There are myriad varying levels and categories of trauma any one individual can
experience in their lifespan; however, this paper will focus on women of domestic violence, child
sexual assault, child abuse, and sexual assault. Women that were involved in a traumatic
situation, through power and control, have been oppressed. These women have experienced
feelings of internalized shame and guilt as well as powerlessness and hopelessness (Anderson,
2010; Feinauer, Hilton & Callahan, 2003; McEwan, de Man & Simpson-Housely, 2005; Regehr,
Cadell & Jansen, 1999; Thornton, Rychman & Robbins, 1982; & Beck et al., 2011). The
victimization has for so many years been looked at from a pathological paradigm allowing the
dynamics of abuse to be understood and yet not fully understood on a holistic approach (Orzeck,
Rokach & Chin, 2010; & Anderson, 2010;).
An abusive situation shapes the core beliefs of a person promoting victim identification
and conflicting messages regarding their perpetrator. During one phase of the victim–offender
relationship it is loving and caring; while in another phase the person of trust is untrustworthy,
intimacy is dangerous (Anderson, 2010). Simply put, the emotions of trust and love are a danger
to their personhood, creating a contradiction to the ideal psychosocial paradigm of interpersonal
relationships. The psychosocial construction of interpersonal relationships is of safety and
security as is identified by Maslow’s hierarchy of needs; however, when the paradigm becomes
power and control over an individual’s freedom the probability of safety and security have now
come into question (Brockett, 1975; & McCoy, 2007). This leaves the victim of this power and
control dynamic feeling betrayed by the one they love/trust as well as themselves and their
Developing Resilience Skills 4
environment (Regehr, Cadell & Jansen, 1999; Anderson, 2010; Beck et al., 2011; & Wilkinson
& Hamerschlag, 2005) and unable to trust their ability to solve problems.
Dynamics of the abusive relationship have been identified to have a continuous cycle
between the victim – offender compounding the psychopathology of the victim, the longer that it
occurs. The cycle contains three stages: the offender begins to get angry and the tension builds,
the victim starts to “walk on egg shells” or the battering begins, and then the batterer feels sorry
for what has occurred and apologizes in such a way that the victim feels guilty for what was said
the victim did. The stages will also start to get shorter with no apologies, as the batterer starts to
blame the victim for the abusive behaviors more. Victims caught in this cycle of oppression
begin to transform their identity according to the violence causing the violent relationship to
become a part of their identity (Wilkinson & Hamerschlag, 2005; & Niehaus, Jackson, & Davies,
2010). The variables related to trauma and personality traits have an impact on the severity of
physical and psychological effects that an individual will experience. Some of the variables
include the number of victimizations, the relation to the perpetrator, as well as the age (at time of
victimization), duration, and severity of the victimization. Women that have been victimized as
children are more likely to be revictimized as adults, due in part to their identity (Feinauer,
Mitchell, Harper, & Dane, 1996; Messing, Flair, Cavanaugh, Kanga, & Campbell, 2012; &
Orzeck, Rokach, & Chin, 2010). It has been identified that child sexual assault (CSA) victims
who have been revictimized have an increased risk of PTSD (Schumm, Briggs-Phillips, &
Hobfoll, 2006; Feinauer, Hilton, & Callahan, 2003; Banyard, Williams, Siegel, & West, 2002; &
Valentine & Feinauer, 1993).
Developing Resilience Skills 5
Consequences of Trauma
The oppression of the traumatic situation victims are in has long-term effects on their
psychological being resulting in such pathologies as PTSD, anxiety, and depression, not to
mention the possibility of Axis II diagnoses (Anderson, 2010; & Orzeck, Rokach, & Chin,
2010). The individual that is in a constant state of heightened awareness due to stressors in their
environment will start to suffer from a decreased ability to problem solve or even handle
everyday situations (Hanson & Mendius, 2009). Women in abusive situations begin to believe
they cannot solve or handle daily situations, resulting in a loss of trust in themselves not to
mention interpersonal trust. The interpersonal problems are seen in many facets of the
relationship such as: self-esteem issues, isolation, sexual dysfunction/hypersexuality, and
academic/occupational impairments (Valentine & Feinauer, 1993; Mendelson, Zachary, &
Harney, 2007; Ullman & Filipas, 2001; Schumm, Briggs-Phillips, & Hobfoll, 2006; Feinauer,
Mitchell, Harper, & Dane, 1996; Wyatt, Notgrass & Newcomb, 1990; Niehaus, Jackson, &
Davies, 2010; & McClure, Chavez, Agars, Peacock & Matosian, 2008). When individuals lose
confidence in their abilities to problem solve and handle crisis. This can result in the loss of self-
efficacy and a feeling of helplessness where their actions produce no change to their environment
(Feinauer, Hilton, & Callahan, 2003; Seligman, 2006).
Victim-blaming is often what individuals experience only further victimizing them,
leading to feelings of isolation, anxiety and increased self-blame (Ullman & Filipas, 2001; &
Regehr, Cadell, & Janesen, 1999). With increased self-blame there is an increase in the
individual’s negative self-identity, leading to a greater psychological impact of guilt (Beck et.al.,
2011; & Babock & DePrince, 2012). The statements made by someone that is blaming
themselves for the trauma are similar to “I am unworthy of anything better” or “I deserved the
Developing Resilience Skills 6
(abuse) ____that happened”. Indicating they see themselves as a bad person and the situation
will never get better making their assessment negatively personal/pervasive/permanent.
According to Seligman, this results in a pessimistic explanatory style (2006) which contributes to
depression. It is seen to be a cycle of thoughts that directly relates to the emotions that are
formulated about a situation or the self. Pessimistic individuals are at an increased risk of
depression because of thoughts that are negative about the self/situation/space (Seligman, 2006;
Seligman, 2007; & Reivich, & Shatte, 2003).
Further associated with the psychological effects of victim-blaming there are
physiological effects such as the decreased levels of oxytocin. Oxytocin is the neurohormone
that is involved with the functioning of the autonomic nervous system (Norman et. al., 2011).It
has been identified that in childhood the levels of oxytocin are determined according to the
amounts of crisis and stress that the child experiences. The increased levels of stress the child
experiences the lower the levels of oxytocin, because of the inability to decrease the levels of
stress and access the parasympathetic nervous system (Diamond, 2006; & Norman et. al., 2011).
Individuals in abusive situations react to their trauma, for example: when in a crisis
situation the individual has what is referred to as ticker tapes. These ticker tapes are the
immediate thoughts an individual has about the situation that are closely related to the
consequences (emotions) and are triggered by the adversity (Seligman, 2006; & Reivich, &
Shatte, 2003 ). When emotions are felt individuals in crisis have immediate thoughts about
adversity affecting their values, feelings, and identity resulting in emotional reactions that reflect
their identity, or values (Reivich, & Shatte, 2003). A victim will react with their victimhood
identity ensuring what safety and security they have identified with to this point through their
coping/adapting skills (McCoy, 2007). Victims often will enable that power and control
Developing Resilience Skills 7
paradigm because that is what feels safe and secure considering it is what they are accustomed
to.
Victims of abuse, as mentioned earlier, often suffer from PTSD. The etiology of PTSD
has been associated with, flashbacks, anxiety, and low self-esteem, making it easy for the victim
to be triggered by actions, smells, and sights. The victim’s identity will surface through the
ticker tapes reflecting that identity through their emotions and how they ultimately handle the
adversity. Victims, because of the trauma, tend to over-react to situations that remind them of
their abusive relationship. Their over-reaction reflects what has become their core belief about
their identity and values, referred to as ice bergs (Seligman, 2006; Reivich, & Shatte, 2003).
Resilience
Resilience is the ability of an individual to recover, or maintain positive mental health
and adaptability despite adversity. This ability is identified by the presence of certain factors in
the individual such as: positive personality traits of optimism, some biological factors such as
oxytocin levels and hormonal levels, a good social support system, education, spiritual
connections, autonomy, and self-efficacy (Herrman et al., 2011; Diamond, 2006; & Anderson,
2010). These are all factors encouraged during childhood (Speilgman, 2007; Herrman et al.,
2011) and can determine how an individual will eventually handle crisis when they reach
adulthood. However because of the pathological paradigm used to treat individuals of abuse,
there is increased difficulty for the victim and the treatment communities to acknowledge their
abilities to prevail in the face of adversity (Anderson, 2010).
In the last decade researchers have questioned whether individuals could gain resilience
skills improving interpersonal and self-trust, optimism, self-efficacy, and autonomy. The theory
or an individual’s identity being fixed during childhood has been re-evaluated. It is now
Developing Resilience Skills 8
theorized that the identity is fluid and changes throughout an individual’s lifespan according to
the environment and the experiences of the individual (Anderson, 2010). Individuals that
experience an abusive situation will do things enabling them to adapt/cope with their situation.
The ability to cope with the situation is a sign of resilience although it is not fully realized until
one experiences “posttraumatic growth”. Posttraumatic growth occurs when the individual is
able to distance themselves from the abusive situation and deconstruct the dichotomy of the
power play and vulnerability that the victim feels. This deconstruction allows them to see that
they in fact, had some power and control in the chaotic world they lived in. Positive social
support can offer the guidance and encouragement needed to promote this growth (Anderson,
2010; Seligman, 2007; Herrman et. al., 2011; Feinauer, Hilton, Howard, & Callahan, 2003; &
Reivich, & Shatte, 2003 ). The social support system allows them to challenge the identity and
core beliefs that they formed as a victim giving them a chance to create a new identity and core
beliefs in a safe place without judgment if it doesn’t work and unconditional acceptance through
the process.
The ability to look at things optimistically is to gain accuracy of the situation rather than
to necessarily view everything as positive. An individual views events in their lives according to
three factors, whether it is personal, permanent, or pervasive; understanding that good things
happen because of the hard work you do, will happen again because of working harder the next
time and the good things have a specific reason for happening (Seligman, 2007; & Reivich, &
Shatte, 2003). An individual’s self-efficacy and autonomy go hand in hand, the more an
individual feels they can accomplish tasks on their own (self-efficacy) the more they will begin
to integrate the needs of others with their own needs, creating autonomy. Through doing this
their relationships need to be maintained and even improved if possible. In this process there
Developing Resilience Skills 9
needs to be increased self-awareness however with a desire for connection and attachment with
the other individual (Allen, 2010; & Phillips, 2008).
Interpersonal trust and self-trust are important aspects for an individual to regain after
being in an abusive situation. Trust relates to safety and security and according to Maslow’s
hierarchy of needs an individual cannot progress towards any of the other needs until the need
for safety is met. One of the intricate factors of safety and security is there is trust in individuals
and environment for our safety (McCoy, 2007). Once an individual meets the need for safety
they can start to gratify their other needs, so they need to know they can trust individuals and
themselves. This does not mean they can always trust the environment or there will never be bad
things that will happen but rather they will be able to handle the situations as they arise. This will
also allow them to feel as though their feelings have been validated and they are valued by
having others they can talk with and trust. (McCoy, 2007; & Mendelsohn, Zachary, & Harney,
2007)
As they learn they can be trusted to handle situations as they arise they will also learn a
new way of thinking about crisis. They begin to see things in a more positive optimistic
explanatory style (Seligman, 2006). This means they recognize the good things come their way
are because of them (personalization); even though they may not be permanent (permanence)
and they are only in that area of their life (pervasive). This individual might start saying things
like, “My talent and charm got me this job today”, “Today was a great day for me and the kids”.
The individual also starts to challenge the negative thoughts and situations that happen to them in
their lives recognizing their value system is changing and what they believe about themselves.
Optimism is not replacing the negative thoughts with positive thoughts but rather looking at the
situation accurately and then acting accurately in accordance with the situation (Seligman, 2006).
Developing Resilience Skills 10
While an individual is increasing in their optimistic explanatory style they should also be
working on their self-efficacy. Self-efficacy is defined as the “belief that you can master your
environment and effectively solve problems as they arise” (Reivich, & Shatte, 2003 pg. 19).
Every time that an individual is able to overcome one small crisis they feel accomplished and
successful, increasing self-efficacy. The individual also increases in trust of themselves and
others, and they begin to move through the levels of the hierarchy of needs as Maslow predicts.
The individual also begins to access the other protective factors of resilience to include their
social support system, autonomy through setting boundaries and goals, and self-actualization
(McCoy, 2007; Mendelsohn, Zachary, & Harney, 2007). Due to accessing the other levels of the
hierarchy they are and striving towards the probability of happiness, then the individual obtains a
psychological well-being (self-actualization: Abraham Maslow; Brockett, 1975).
When an individual feels they have control over situations they also begin to feel they
have choices in their life. The realization they can determine their own actions and plans for
their lives allows them autonomy in their lives. By leaving the abusive situation it creates an
opportunity to have autonomy, self-regulating their beliefs with those that surround them (Allen,
2010). This autonomy allows the individual to take action in their lives instead of reacting to the
chaos they find surrounding them (Feinauer, Mitchell, Harper, & Dane, 1996). Having the
ability to act gives an individual the chance to accurately identify the pros and cons of the
situation and plan for the consequences of their choices (Seligman, 2006; & Reivich, & Shatte,
2003). However when we react there is not the opportunity to identify what the consequences
might be to even plan for them, therefore the consequences will only increase emotional
problems and maladjustment (Eschelman, Bowling & Alarcon, 2010; & Feinauer, Mitchell,
Harper & Dane, 1996).
Developing Resilience Skills 11
Methods
Researchers designed a workbook to combine activities that would encourage the
following skills: self-control and trust, interpersonal trust, communication, optimism, self-
efficacy, and autonomy. These components of resilience will be promoted by implementing
empirically supported methodologies. Resilience programs for women and men would need to be
approached in different manners due to gender differences in the way trauma is processed
(Orzeck, Rokach, & Chin, 2010). This program has been designed specifically for women who
have suffered varied forms of interpersonal trauma such as: domestic violence, CSA, rape, and
varied forms of child abuse.
Self-regulation and trust in the self:
The work book asks the individual participating in the program to learn and participate in
a Tai Chi exercise program. Through meditation and exercise an individual can learn to relax,
refocus and slow down their physiological responses (Leung & Singhal, 2004). In this exercise
participants are asked to think about their body and the responses they had, as they focused on
their thoughts. The participant is asked to identify what those thoughts are and told through the
following weeks they are to continue working through this exercise. They are reminded that they
are to try to use this exercise to slowly focus on their breathing, releasing the stress from their
body and refocusing their energy (Tollefson, Webb, Shumway, Block, & Nakamura, 2009;
Seligman, 2006; & Reivich, & Shatte, 2003).
In the workbook the “inner critic” is described as the thought processes causeing the
individual to feel as though they cannot problem solving and manage the physiological responses
related to the task at hand. While learning to control their physiological responses an individual
gains control over their environment, this is achieved through the slowing of the autonomic
Developing Resilience Skills 12
nervous system response to crisis, allowing the brain to function better (Leung & Singhal, 2004).
The participant of the program is asked to reframe the thoughts they have so the accuracy of the
situation is what the participant recognizes rather than the cognitive processes they are used to.
The more the individual is able to recognize this physiological control, and start to accomplish
small tasks they will start trusting in their own abilities to effectively problem solve. They will
do this by consciously slowing down their cardiac response to the stressful adversity. This
physiological control also assists with many of the long-term effects of PTSD allowing the
individual to get more sleep, effectively decrease anxiety levels, and decrease the sympathetic
nervous system responses (Leung & Singhal, 2004). As an individual is working on trusting
themselves and others they are also solving problems during stressful situations.
Interpersonal trust:
The second issue the workbook addresses is interpersonal trust. The first activity
associated with trusting others is the Blind Trust Walk. This activity requires the group to break
into pairs, trusting their partner to guid them from point A to point B while they are blind folded.
Their partner is to give them verbal cues and guidance through light touch. They are to
communicate and provide verbal encouragement to/from their partner. At no time is there to be
any foul, dehumanizing, or abusive language so that we can start to trust each other in an
extremely vulnerable state, recognizing we all are only there to support and help with the healing
process. Once the obstacle course is completed the process will be repeated by switching places.
By implementing group work and pairs we are encouraging a social support system,
which is supported by the research as another factor in resiliency assisting individuals of abuse in
counteracting the effects of isolation. If the support group has had similar experiences with
trauma then it will be easier to share with another individual, thus reducing the isolation that an
Developing Resilience Skills 13
individual may feel (Mendlesohn, Zachary & Harney, 2007; & Phillips, 2008). The sharing
process must be done when the individual is ready to share and in a safe environment, where the
individual is believed and not blamed for the best recovery process (Ullman & Filipas, 2001).
The remaining exercises in the workbook address a combination of self-trust and
interpersonal trust incorporating what is referred to as the “encourager”. The principle is that as
the individual is struggling with the “inner critic”. They then start hearing the voice of their
partner as their encouragement pairing that with a person who has always encouraged them. The
participant then makes this an internal voice (i.e. theirs, God, a relative) encouraging them to be
successful. After an individual recognizes the thoughts keeping them from being successful the
next step is to challenge the inaccuracy or accuracy of the thoughts that have occurred. The goal
is not to merely replace the negative thoughts with positive ones, but rather to assess the
accuracy of their thoughts about what is happening (Seligman, 2006). An individual needs to be
able to clarify when the belief is a thought of the moment or a core belief; if it is a core belief
that might be why an individual would react in what would appear to be irrational behavioral
patterns (Seligman, 2006; & Reivich, & Shatte, 2003).
The participants throughout these sessions and workbook activities are challenged to
evaluate the “inner critic” and alter those messages to reflect a more positive or accurate
message. This process is related to the ABC (i.e. adapted from Albert Ellis’ rational emotive
therapy [RET]) technique explained by Reivich and Shatte in their book about increasing
resilience (2003). In this process the individual identifies the adversity (A) which would be the
specific exercise in the workbook, they are asked to identify what they are thinking (B) which
were identified as the “inner critic”, and then relate that to the consequences (C) of their thoughts
which were related to the emotional response. The cognitive restructuring as one goes through
Developing Resilience Skills 14
this process allows the individual to create a new identity related to higher psychological well-
being (Reivich, & Shatte, 2003; & Wilkinson & Hamerschlag, 2004). The researchers encourage
the participants to continue evaluating their thoughts about experiences in their lives and
applying these skills. Empowering them to challenge the thoughts that they have about these
experiences, and learning to identify the accurate messages about each experience.
Communication:
During the sessions and workbook activities the participants are always encouraged to
communicate with each other in a positive, encouraging, and constructive manner. The
participant’s needs are to be expressed in a respectful way remaining mindful of the other group
member’s needs. The group members are to recognize and understand multiple forms of
communication (i.e. verbal, body, written,) and the effects that they have on the cohesiveness of
the group. It is of the utmost importance that the facilitator of the group maintains safety and
security because communication can have an impact on whether individuals feel safe. People are
in constant communication and when communication has negative affect or contradictory it can
be toxic (DeVillers, ?, chapter, 6).
The participant’s communication is important in each session due to the need to convey
skills, encouragement, and even gratitude to each other. When other members of the group
progresses through the program, this allows everybody as a group to build on the factors of
resilience. As the tasks steadily increase in difficulty, the participants are challenged to step
outside of their comfort zone and encouraged to rely on each other, as well as the facilitators, to
understand they have support and a partner they can work the problem out with, ie., they are not
alone.
Developing Resilience Skills 15
The last session is designed around communication skills, verbal and non-verbal, when
the group is asked to place a piece of paper with a written scenario on it in a hat. This
anonymous scenario is to identify a situation that triggers an emotional response they would like
to work on in the group. The group will break up into pairs and draw a scenario from the hat,
allowing anonymity for the participants, and then decide how to playback the response. The rest
of the group will assist in problem solving using the skills that they have learned in the previous
sessions by having the pair playback the solutions offered by the group. The group will be
encouraged to work through the ABC method especially during these scenarios to determine the
accuracy of the solutions offered. During the playback there will be respect for everyone’s
opinions, practicing the controlled physiological responses learned through Tia Chi.
Optimism:
As the workbook’s activities build on one another, optimism is a factor of resilience that
is slowly encouraged. However it can be harmful when not realistic, in other words, it has to be
something that is accurately based in the experience. So the workbook guides the participants
through the activities encouraging them to find accuracy in the activity and their part in it. They
are encouraged to take feedback from the facilitator, and other group members, that will be said
in a respectful manner to maintain physical and emotional well-being. Activity 4 is a gratitude
journal in which they are to assess their personal accomplishments with the third activity (rock
wall climbing). In addition to their physical goals they are asked to include their emotional and
psychological goals as well. They are encouraged to accurately assess their ability compared to
their accomplishment and then to be grateful for the successes they had.
They are reminded to view this as a challenge rather than a threat; ie., a challenge is
something they can safely approach and actively change. When a problem arises the participants
Developing Resilience Skills 16
learn to become cognitively flexible, problem-focused, and informed of resources (Eschleman,
Bowling, & Alarcon, 2010; & Anderson, 2010) through the activities in the program. The
facilitators are to ensure a non-judgmental environment where the participants can at all times
feel safe and able to express their fears or insecurities, so that they can be validated and then
encouraged to challenge themselves as far as they can. Just as a mother encourages her child to
walk, we are encouraging the participants to take baby steps, and trust us to help them back up
when they fall.
Self-efficacy:
An “essential ingredient in steering through chronic stress is self-efficacy – the belief that
you can master your environment and effectively solve problems as they arise…(B)y solving a
problem, their confidence is enhanced, which in turn increases the likelihood that they will
persevere even longer the next time they are faced with a challenge.”(Reivich, & Shatte, 2003
pg. 19). Throughout this workbook the participants are working on self-efficacy as the
researchers are slowly increasing the social and physical difficulty and risk of the tasks. For
example, activity 5 introduces a male instructor so that the participants are now challenged with
accepting someone from outside the group, and someone that could be seen as a potential danger
depending on the trauma suffered. After some practice in some of these activities, the individual
can learn to apply the advantages of the other skills allowing them to refocus their energy on the
task and controlling their response to the experience. As Reivich and Shatte reminds us (2003)
“Keeping the body calm despite the chaos that surrounds you is an important part of being
resilient, so we encourage you to use the calming techniques whenever you feel stress spread
through your body.” (pg. 198). A daily practice of meditational exercises is encouraged by many
researchers as it has been found to offer a physiological control over responses to crisis (Leung
Developing Resilience Skills 17
and Singhal, 2004; chapter 9 humanistic extential). These practices also allow the participant
relief in other areas including may have been hindering sleeping, eating, and exercise.
Autonomy:
Participants are asked to be respectful of the other participants in the group and their
values and feelings, and at the same time given the same respect, allowing them the ability to
take action in their own lives (Allen, 2010; & Feinauer, Mitchell, Harper & Dane, 1996).
Because these individuals are transitioning between being controlled and taking control of their
lives, the autonomy that they gain through the validation of their feelings and the ability to self-
regulate and act for their benefit is significant to posttraumatic growth. The participants begin to
understand that they have control over their own lives and this will further give credit to the
previous factors of resilience and their ability to prevail and persevere (Anderson, 2010).
Conclusion
The increase of individuals suffering from Post-Traumatic Stress Disorder (PTSD) due to
traumatic events has encouraged researchers to ask why some people suffer PTSD while others
do not after the same trauma. With this question they have also asked if there is a way they can
encourage these same traits in individuals suffering PTSD. Resilience factors have been
identified in some individuals offering them faster recovery without as many of the lasting long-
term effects of the crisis (McClure, Chavez, Agars, Peacock & Matosian, 2008; Shumm, Phillips,
& Hobfoll, 2006; eschleman Bowling & Alarcon, 2010; Banyard, Williams, Siegel, & West,
2002; Valentine & Feinauer, 1993). The current treatments work using the pathological
paradigm, and what is currently understood about victims of abuse; however, there are
untapped/unacknowledged strengths of these victims that if recognized could be more successful
in their rehabilitation process.
Developing Resilience Skills 18
As stated before the more times that you are unable to resolve a crisis or feel that it is
your fault results in feelings of a pessimistic explanatory style. There is a loss of self-control,
self-trust, interpersonal trust, self-efficacy, and autonomy as the individual feels helpless and
hopeless (Seligman, 2006; Reivich, & Shatte, 2003; Anderson, 2010; & McCoy, 2007). Further
work in resilience provides a framework of Cognitive Behavioral Theory suggesting that if a
person is not yet resilient they can develop these skills. Cognitive Behavior Theory provided the
framework for the program designed by these researchers. By using the ABC’s (identifying the
adversity, what your thoughts are and the resulting emotions), challenging beliefs, and putting it
into perspective, the individual can learn the skills to accurately think about the adversity and
problem solve actively. The individual is then asked to challenge the beliefs about the adversity.
The individual can come to an accurate thought pattern about the adversity through assessing
their immediate and core beliefs and what is at stake because of these beliefs (Reivich, & Shatte,
2003; Anderson, 2010; & McCoy, 2007).
Another Cognitive Behavioral Theory utilized is relaxation and refocusing. An individual
learns to develop self-regulation, by learning to have control over their own responses to their
environment. This process is a control over physiological responses to the environmental
stressors rather than a direct control over the environment (Eschleman, Bowling, & Alarcon,
2010; Frazier, Steward, & Mortensen, 2004). Meditation and physical activities, such as those
used by the Chinese for self-healing, assist individuals in controlling their physiological
responses to stressful events and have also been shown to help with some pathological
paradigms.
This program offers women, who have suffered from traumatic experiences, the
opportunity to take action where once they thought they were helpless. These women have begun
Developing Resilience Skills 19
to learn crisis can be seen as a challenge rather than a threat. Crises can be approached and
changed by acting on the circumstances with commitment and a positive social support system.
Learning these skills allows these women opportunities that otherwise they might not have had,
and affords them life skills to move them forward to a more positive future. These women move
forward by utilizing the ABC’s and gaining accuracy along with optimism over their life events.
To run the program facilities would first identify where the clients rate in optimism and
emotional regulation by obtaining a pre-test prior to the support group. The questions for the
pre/post-test were obtained from Reivich and Shatte (2003) and modified to fit the needs of this
project. The clients/participants would then take part in the six sessions of the resilience training
advancing in their skills. The participants would finally be asked to participate in a post-test to
assess how the group assisted them. This pre/post-test and workbook can be obtained from the
program developers through email.
Future implications for this program would be for it to be run as a support group for
victims of domestic violence or sexual assault in already existing agencies such as: YWCA, rape
crisis centers, college counseling centers, and other crisis shelters/centers. This program is not
designed to help an individual through the initial phase of crisis. Therefore this program should
be used as an advanced program after the individual has managed to get assistance or is no
longer in the initial phases of crisis. For example at the YWCA when the women move to the
second phase of the program that encourages them to find a job and apartment, this would be a
perfect time to run this support group offering them these valuable life skills.
Developing Resilience Skills 20
References
Anderson, K. M., (2010). Enhancing resilience in survivors of family violence. New York, NY.
Springer Publishing Co.
Allen, J. P. (2010). Experience, development, and resilience: The Legacy of Stuart Hauser’s
explorations of the transition from adolescence into early adulthood. Research in Human
Development, 7, 241-256. DOI: 10.1080/15427609.2010.526516
Banyard, V. L., Williams, L. M., Siegel, J. A. & West, C. M. (2002). Childhood sexual abuse in
the lives of black women: Risk and resilience in a longitudinal study. Women & Therapy,
25, 45-58.
Beck, J. G., McNiff, J., Clapp, J. D., Olsen, S. A., Avery, M. L., & Hagewood, J. H. (2011).
Exploring negative emotion in women experiencing intimate partner violence: Shame,
Guilt and PTSD. Behavior Therapy, 42, 740-750.
Brockett, C. (1975). Toward a clarification of the need hierarchy theory; Some extensions of
Maslow’s conceptulization. Interpersonal Development, 6, 77-90.
DeVillers, L. (). Facilitating positive sexual communication. In A. Mitchell Tepper, & B.
Annette Fuglasang Owens (Eds). Sexual Health (pp119-53). Westport, Connecticut:
Praeger Perspectives
Diamond, L. M. (2006). The evolution of plasticity in female-female desire. Journal of
Psychology & Human Sexuality, 18, 245-274. DOI: 10.1300/J056v18n04_01
Herrman, H., Stewart, D. E., Diaz-Granados, N., Berger DPhil, E. L., Jackson, B. & Yuen T.
(2011). What is resilience? La Revue Canadienne De Psychiatrie, 56, 258-265.
Developing Resilience Skills 21
Eschleman, K. J., Bowling, N. A., & Alarcon, G. M. (2010). A meta-analytic examination of
hardiness. International Journal of Stress Management, 17, 277-307. DOI:
10.1037/a0020476
Feinauer, L., Hilton, H. G. & Callahan, E. H. (2003). Hardiness as a moderator of shame
associated with childhood sexual abuse. The American Journal of Family Therapy, 31,
65-78. DOI:10.1080/01926180390167115
Feinauer, L. L., Mitchell, J., Harper, J. M. & Dane, S. (1996). The impact of hardiness and
severity of childhood sexual abuse on adult adjustment. The American Journal of Family
Therapy, 24, 206-214.
Frazier, P., Steward, J. & Mortensen, H. (2010). Perceived control and adjustment to trauma: A
comparison across events. Journal of Social and Clinical Psychology, 23, 303-324.
Leung, Y. & Singhal, A. (2004). An examination of the relationship between qigong meditation
and personality. Social Behavior and Personality, 32, 313-320.
McClure, F. H., Chavez, D. V., Agars, M. D., Peacock, M. J., & Matosian, A. (2008). Resiliency
in sexually abused women: Risk and protective factors. Journal of Family Violence, 23,
81-88. DOI:10.1007/s10896-007-9129-4
McCoy, J. A. (2007). Developing a supportive living envoronment for survivors of intimate
partner violence and domesitc violence. (Doctoral Dissertation). Retrieved from
University of Cincinnati Library: Full Text.
McEwan, S. L., DE Man, A. F. & Simpson-Housley, P. (2005). Acquaintance rape, ego-identity
achievement, and locus of control. Social Behavior and Personality, 33, 587-592.
Messing, J. T., Flair, L. L., Cavanaugh, C. E., Kanga, M. R., & Campbell, J. C. (2012). Testing
Posttraumatic stress as a mediator of childhood trauma and adult intimate partner
Developing Resilience Skills 22
violence victimization. Journal of Aggression, Maltreatment, & Trauma, 21, 792-811.
DOI:10.1080/10926771.2012.686963
Mendelsohn, M., Zachary, R. S. & Harney, P. A. (2007). Group therapy as an ecological bridge
to new community for trauma survivors. Journal of Aggression Maltreatment & Trauma,
14, 227-243. DOI: 10.1300/J14v14n01_12
Niehaus, A. F., Jackson, J., & Davies, S. (2010). Sexual self-schemas of female child sexual
abuse survivors: Relationships with risky sexual behavior and sexual assault in
adolescence. Archive Sexual Behavior, 39, 1359-1374. DOI:10.1007/s10508-010-9600-9
Norman, G. J., Hawkley, L., Luhmann, M., Ball, A. B., Cole, S. W., Berntson, G. G., &
Cacioppo, J. T. (2011). Variation in the oxytocin receptor gene influences neurocardiac
reactivity to social stress and HPA function: A population based study. Hormones and
Behavior, 61, 134-139. DOI:10.1016/j.yhbeh.2011.11.006
Orzeck, T. L. Rokach, A. & Chin J. (2010). The effects of traumatic and abusive relationships.
Journal of Loss and Trauma, 15, 167-192. DOI: 10.1080/153250209033592
Phillips, G. (2008). Resilience in practice interventions. Child Care in Practice, 14, 45-54. DOI:
10.1080/13575270701733716
Regehr, C., Cadell, S. & Jansen K. (1999). Perceptions of control and long-term recovery from
rape. American Journal of Orthopsychiatry, 69, 110-115.
Reivich, K., & Shatte, A. (2003). 7 keys to finding your inner strength and overcoming life’s
hurdles:The resilience factor. New York: Broadway Books
Schumm J. A., Briggs-Phillips, M., & Hobfoll, S. E. (2006). Cumulative interpersonal traumas
and social support as risk and resiliency factors in predicting PTSD and depression
Developing Resilience Skills 23
among inner-city women. Journal of Traumatic Stress, 19, 825-836.
Doi:10.1002/jts.20159.
Seligman, M. (2006). Learned optimism: How to change your mind and your life with a new
preface. New York: Vintage Books
Thornton, B., Ryckman, R. M, & Robbins, M. A. (1982). The relationship of observer
characteristics to beliefs in the causal responsibility of victims of sexual assault. Human
Relations, 35, 321-330.
Tollefson, D. R., Webb, K., Shumway, D., Block, S. H. & Nakamura, Y. (2009). A mind-body
approach to domestic violence perpetrator treatment: Program overview and preliminary
outcomes. Journal of Aggression, Maltreatment & Trauma, 18, 17-45. DOI:
10.1080/10926770802610657.
Ullman, S. E. & Filipas, H. H. (2001). Correlates of formal and informal support seeking in
sexual assault victims. Journal of Interpersonal Violence, 16,1028-1047. DOI:
10.1177/0886260006010004
Valentine, L. & Feinauer, L. L. (1993). Resilience factors associated with female survivors of
childhood sexual abuse. The American Journal of Family Therapy, 21, 216-224.
Wilkinson, D. L., & Hamerschlag, S. J. (2005). Situational determinants in intimate partner
violence. Aggression and Violent Behavior, 10, 333-361. DOI:
10.1016/j.avb.2004.05.001
Wyatt, G. E., Notgrass, C. M. & Newcomb, M. (1990). Internal and external mediators of
women’s rape experiences. Psychology of Women Quarterly, 14, 153-176.

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Resilience Program Development

  • 1. RUNNING HEADER: DEVELOPING RESILIENCE SKILLS 1 Development of Resilience Skills in Women with PTSD By: Tamara Baker & Dr. Karen Yescavage Colorado State University – Pueblo
  • 2. Developing Resilience Skills 2 Development of Resilience Skills in Women with PTSD I There are many therapeutic paradigms bringing individuals from pathology back into homeostasis or what is considered normal functioning. Yet there are factors that reside in each person, which if tapped into can maintain homeostasis. Resilience and hardiness are factors that assist each person in maintaining positive mental health even through adversity (Herman, et al., 2011). This is what has been recognized in the resilience research as successfully engaging adversity (Anderson, 2010). Program designs have been proposed, that should be instituted in a collaborative framework, through policies and varied health clinics to help teach and improve the skills of resilience throughout the lifespan of individuals (Herrman et al., 2011). The individuals in need of these programs are those that have gone through varied forms of severe trauma. The forms of trauma can be anything from, child sexual assault (CSA), domestic violence, rape and any trauma that would take an individual out of their positive mental health, resulting in long-term effects. These individuals have lost homeostasis and are suffering from Post-Traumatic Stress Disorder (PTSD), severe anxiety, and depression (Valentine & Feinauer, 1993; Mendelson, Zachary & Harney, 2007; Beck et al, 2011; Ullman & Filipas, 2001; Schumm, Briggs-Phillips & Hobfoll, 2006; Feinauer, Mitchell, Harper & Dane, 1996; Wyatt, Notgrass & Newcomb, 1990; & McClure, Chavez, Agars, Peacock & Matosian, 2008; & Anderson, 2010). Personality disorders such as borderline personality, and histrionic personality have also been linked to some of these traumas e.g. CSA (Anderson, 2010; & Orzeck, Rokach & Chin, 2010). All of these diagnoses lead to decreases in interpersonal trust, communication skills, self-efficacy, autonomy, and optimism.
  • 3. Developing Resilience Skills 3 II. Traumatic cycle of abuse There are myriad varying levels and categories of trauma any one individual can experience in their lifespan; however, this paper will focus on women of domestic violence, child sexual assault, child abuse, and sexual assault. Women that were involved in a traumatic situation, through power and control, have been oppressed. These women have experienced feelings of internalized shame and guilt as well as powerlessness and hopelessness (Anderson, 2010; Feinauer, Hilton & Callahan, 2003; McEwan, de Man & Simpson-Housely, 2005; Regehr, Cadell & Jansen, 1999; Thornton, Rychman & Robbins, 1982; & Beck et al., 2011). The victimization has for so many years been looked at from a pathological paradigm allowing the dynamics of abuse to be understood and yet not fully understood on a holistic approach (Orzeck, Rokach & Chin, 2010; & Anderson, 2010;). An abusive situation shapes the core beliefs of a person promoting victim identification and conflicting messages regarding their perpetrator. During one phase of the victim–offender relationship it is loving and caring; while in another phase the person of trust is untrustworthy, intimacy is dangerous (Anderson, 2010). Simply put, the emotions of trust and love are a danger to their personhood, creating a contradiction to the ideal psychosocial paradigm of interpersonal relationships. The psychosocial construction of interpersonal relationships is of safety and security as is identified by Maslow’s hierarchy of needs; however, when the paradigm becomes power and control over an individual’s freedom the probability of safety and security have now come into question (Brockett, 1975; & McCoy, 2007). This leaves the victim of this power and control dynamic feeling betrayed by the one they love/trust as well as themselves and their
  • 4. Developing Resilience Skills 4 environment (Regehr, Cadell & Jansen, 1999; Anderson, 2010; Beck et al., 2011; & Wilkinson & Hamerschlag, 2005) and unable to trust their ability to solve problems. Dynamics of the abusive relationship have been identified to have a continuous cycle between the victim – offender compounding the psychopathology of the victim, the longer that it occurs. The cycle contains three stages: the offender begins to get angry and the tension builds, the victim starts to “walk on egg shells” or the battering begins, and then the batterer feels sorry for what has occurred and apologizes in such a way that the victim feels guilty for what was said the victim did. The stages will also start to get shorter with no apologies, as the batterer starts to blame the victim for the abusive behaviors more. Victims caught in this cycle of oppression begin to transform their identity according to the violence causing the violent relationship to become a part of their identity (Wilkinson & Hamerschlag, 2005; & Niehaus, Jackson, & Davies, 2010). The variables related to trauma and personality traits have an impact on the severity of physical and psychological effects that an individual will experience. Some of the variables include the number of victimizations, the relation to the perpetrator, as well as the age (at time of victimization), duration, and severity of the victimization. Women that have been victimized as children are more likely to be revictimized as adults, due in part to their identity (Feinauer, Mitchell, Harper, & Dane, 1996; Messing, Flair, Cavanaugh, Kanga, & Campbell, 2012; & Orzeck, Rokach, & Chin, 2010). It has been identified that child sexual assault (CSA) victims who have been revictimized have an increased risk of PTSD (Schumm, Briggs-Phillips, & Hobfoll, 2006; Feinauer, Hilton, & Callahan, 2003; Banyard, Williams, Siegel, & West, 2002; & Valentine & Feinauer, 1993).
  • 5. Developing Resilience Skills 5 Consequences of Trauma The oppression of the traumatic situation victims are in has long-term effects on their psychological being resulting in such pathologies as PTSD, anxiety, and depression, not to mention the possibility of Axis II diagnoses (Anderson, 2010; & Orzeck, Rokach, & Chin, 2010). The individual that is in a constant state of heightened awareness due to stressors in their environment will start to suffer from a decreased ability to problem solve or even handle everyday situations (Hanson & Mendius, 2009). Women in abusive situations begin to believe they cannot solve or handle daily situations, resulting in a loss of trust in themselves not to mention interpersonal trust. The interpersonal problems are seen in many facets of the relationship such as: self-esteem issues, isolation, sexual dysfunction/hypersexuality, and academic/occupational impairments (Valentine & Feinauer, 1993; Mendelson, Zachary, & Harney, 2007; Ullman & Filipas, 2001; Schumm, Briggs-Phillips, & Hobfoll, 2006; Feinauer, Mitchell, Harper, & Dane, 1996; Wyatt, Notgrass & Newcomb, 1990; Niehaus, Jackson, & Davies, 2010; & McClure, Chavez, Agars, Peacock & Matosian, 2008). When individuals lose confidence in their abilities to problem solve and handle crisis. This can result in the loss of self- efficacy and a feeling of helplessness where their actions produce no change to their environment (Feinauer, Hilton, & Callahan, 2003; Seligman, 2006). Victim-blaming is often what individuals experience only further victimizing them, leading to feelings of isolation, anxiety and increased self-blame (Ullman & Filipas, 2001; & Regehr, Cadell, & Janesen, 1999). With increased self-blame there is an increase in the individual’s negative self-identity, leading to a greater psychological impact of guilt (Beck et.al., 2011; & Babock & DePrince, 2012). The statements made by someone that is blaming themselves for the trauma are similar to “I am unworthy of anything better” or “I deserved the
  • 6. Developing Resilience Skills 6 (abuse) ____that happened”. Indicating they see themselves as a bad person and the situation will never get better making their assessment negatively personal/pervasive/permanent. According to Seligman, this results in a pessimistic explanatory style (2006) which contributes to depression. It is seen to be a cycle of thoughts that directly relates to the emotions that are formulated about a situation or the self. Pessimistic individuals are at an increased risk of depression because of thoughts that are negative about the self/situation/space (Seligman, 2006; Seligman, 2007; & Reivich, & Shatte, 2003). Further associated with the psychological effects of victim-blaming there are physiological effects such as the decreased levels of oxytocin. Oxytocin is the neurohormone that is involved with the functioning of the autonomic nervous system (Norman et. al., 2011).It has been identified that in childhood the levels of oxytocin are determined according to the amounts of crisis and stress that the child experiences. The increased levels of stress the child experiences the lower the levels of oxytocin, because of the inability to decrease the levels of stress and access the parasympathetic nervous system (Diamond, 2006; & Norman et. al., 2011). Individuals in abusive situations react to their trauma, for example: when in a crisis situation the individual has what is referred to as ticker tapes. These ticker tapes are the immediate thoughts an individual has about the situation that are closely related to the consequences (emotions) and are triggered by the adversity (Seligman, 2006; & Reivich, & Shatte, 2003 ). When emotions are felt individuals in crisis have immediate thoughts about adversity affecting their values, feelings, and identity resulting in emotional reactions that reflect their identity, or values (Reivich, & Shatte, 2003). A victim will react with their victimhood identity ensuring what safety and security they have identified with to this point through their coping/adapting skills (McCoy, 2007). Victims often will enable that power and control
  • 7. Developing Resilience Skills 7 paradigm because that is what feels safe and secure considering it is what they are accustomed to. Victims of abuse, as mentioned earlier, often suffer from PTSD. The etiology of PTSD has been associated with, flashbacks, anxiety, and low self-esteem, making it easy for the victim to be triggered by actions, smells, and sights. The victim’s identity will surface through the ticker tapes reflecting that identity through their emotions and how they ultimately handle the adversity. Victims, because of the trauma, tend to over-react to situations that remind them of their abusive relationship. Their over-reaction reflects what has become their core belief about their identity and values, referred to as ice bergs (Seligman, 2006; Reivich, & Shatte, 2003). Resilience Resilience is the ability of an individual to recover, or maintain positive mental health and adaptability despite adversity. This ability is identified by the presence of certain factors in the individual such as: positive personality traits of optimism, some biological factors such as oxytocin levels and hormonal levels, a good social support system, education, spiritual connections, autonomy, and self-efficacy (Herrman et al., 2011; Diamond, 2006; & Anderson, 2010). These are all factors encouraged during childhood (Speilgman, 2007; Herrman et al., 2011) and can determine how an individual will eventually handle crisis when they reach adulthood. However because of the pathological paradigm used to treat individuals of abuse, there is increased difficulty for the victim and the treatment communities to acknowledge their abilities to prevail in the face of adversity (Anderson, 2010). In the last decade researchers have questioned whether individuals could gain resilience skills improving interpersonal and self-trust, optimism, self-efficacy, and autonomy. The theory or an individual’s identity being fixed during childhood has been re-evaluated. It is now
  • 8. Developing Resilience Skills 8 theorized that the identity is fluid and changes throughout an individual’s lifespan according to the environment and the experiences of the individual (Anderson, 2010). Individuals that experience an abusive situation will do things enabling them to adapt/cope with their situation. The ability to cope with the situation is a sign of resilience although it is not fully realized until one experiences “posttraumatic growth”. Posttraumatic growth occurs when the individual is able to distance themselves from the abusive situation and deconstruct the dichotomy of the power play and vulnerability that the victim feels. This deconstruction allows them to see that they in fact, had some power and control in the chaotic world they lived in. Positive social support can offer the guidance and encouragement needed to promote this growth (Anderson, 2010; Seligman, 2007; Herrman et. al., 2011; Feinauer, Hilton, Howard, & Callahan, 2003; & Reivich, & Shatte, 2003 ). The social support system allows them to challenge the identity and core beliefs that they formed as a victim giving them a chance to create a new identity and core beliefs in a safe place without judgment if it doesn’t work and unconditional acceptance through the process. The ability to look at things optimistically is to gain accuracy of the situation rather than to necessarily view everything as positive. An individual views events in their lives according to three factors, whether it is personal, permanent, or pervasive; understanding that good things happen because of the hard work you do, will happen again because of working harder the next time and the good things have a specific reason for happening (Seligman, 2007; & Reivich, & Shatte, 2003). An individual’s self-efficacy and autonomy go hand in hand, the more an individual feels they can accomplish tasks on their own (self-efficacy) the more they will begin to integrate the needs of others with their own needs, creating autonomy. Through doing this their relationships need to be maintained and even improved if possible. In this process there
  • 9. Developing Resilience Skills 9 needs to be increased self-awareness however with a desire for connection and attachment with the other individual (Allen, 2010; & Phillips, 2008). Interpersonal trust and self-trust are important aspects for an individual to regain after being in an abusive situation. Trust relates to safety and security and according to Maslow’s hierarchy of needs an individual cannot progress towards any of the other needs until the need for safety is met. One of the intricate factors of safety and security is there is trust in individuals and environment for our safety (McCoy, 2007). Once an individual meets the need for safety they can start to gratify their other needs, so they need to know they can trust individuals and themselves. This does not mean they can always trust the environment or there will never be bad things that will happen but rather they will be able to handle the situations as they arise. This will also allow them to feel as though their feelings have been validated and they are valued by having others they can talk with and trust. (McCoy, 2007; & Mendelsohn, Zachary, & Harney, 2007) As they learn they can be trusted to handle situations as they arise they will also learn a new way of thinking about crisis. They begin to see things in a more positive optimistic explanatory style (Seligman, 2006). This means they recognize the good things come their way are because of them (personalization); even though they may not be permanent (permanence) and they are only in that area of their life (pervasive). This individual might start saying things like, “My talent and charm got me this job today”, “Today was a great day for me and the kids”. The individual also starts to challenge the negative thoughts and situations that happen to them in their lives recognizing their value system is changing and what they believe about themselves. Optimism is not replacing the negative thoughts with positive thoughts but rather looking at the situation accurately and then acting accurately in accordance with the situation (Seligman, 2006).
  • 10. Developing Resilience Skills 10 While an individual is increasing in their optimistic explanatory style they should also be working on their self-efficacy. Self-efficacy is defined as the “belief that you can master your environment and effectively solve problems as they arise” (Reivich, & Shatte, 2003 pg. 19). Every time that an individual is able to overcome one small crisis they feel accomplished and successful, increasing self-efficacy. The individual also increases in trust of themselves and others, and they begin to move through the levels of the hierarchy of needs as Maslow predicts. The individual also begins to access the other protective factors of resilience to include their social support system, autonomy through setting boundaries and goals, and self-actualization (McCoy, 2007; Mendelsohn, Zachary, & Harney, 2007). Due to accessing the other levels of the hierarchy they are and striving towards the probability of happiness, then the individual obtains a psychological well-being (self-actualization: Abraham Maslow; Brockett, 1975). When an individual feels they have control over situations they also begin to feel they have choices in their life. The realization they can determine their own actions and plans for their lives allows them autonomy in their lives. By leaving the abusive situation it creates an opportunity to have autonomy, self-regulating their beliefs with those that surround them (Allen, 2010). This autonomy allows the individual to take action in their lives instead of reacting to the chaos they find surrounding them (Feinauer, Mitchell, Harper, & Dane, 1996). Having the ability to act gives an individual the chance to accurately identify the pros and cons of the situation and plan for the consequences of their choices (Seligman, 2006; & Reivich, & Shatte, 2003). However when we react there is not the opportunity to identify what the consequences might be to even plan for them, therefore the consequences will only increase emotional problems and maladjustment (Eschelman, Bowling & Alarcon, 2010; & Feinauer, Mitchell, Harper & Dane, 1996).
  • 11. Developing Resilience Skills 11 Methods Researchers designed a workbook to combine activities that would encourage the following skills: self-control and trust, interpersonal trust, communication, optimism, self- efficacy, and autonomy. These components of resilience will be promoted by implementing empirically supported methodologies. Resilience programs for women and men would need to be approached in different manners due to gender differences in the way trauma is processed (Orzeck, Rokach, & Chin, 2010). This program has been designed specifically for women who have suffered varied forms of interpersonal trauma such as: domestic violence, CSA, rape, and varied forms of child abuse. Self-regulation and trust in the self: The work book asks the individual participating in the program to learn and participate in a Tai Chi exercise program. Through meditation and exercise an individual can learn to relax, refocus and slow down their physiological responses (Leung & Singhal, 2004). In this exercise participants are asked to think about their body and the responses they had, as they focused on their thoughts. The participant is asked to identify what those thoughts are and told through the following weeks they are to continue working through this exercise. They are reminded that they are to try to use this exercise to slowly focus on their breathing, releasing the stress from their body and refocusing their energy (Tollefson, Webb, Shumway, Block, & Nakamura, 2009; Seligman, 2006; & Reivich, & Shatte, 2003). In the workbook the “inner critic” is described as the thought processes causeing the individual to feel as though they cannot problem solving and manage the physiological responses related to the task at hand. While learning to control their physiological responses an individual gains control over their environment, this is achieved through the slowing of the autonomic
  • 12. Developing Resilience Skills 12 nervous system response to crisis, allowing the brain to function better (Leung & Singhal, 2004). The participant of the program is asked to reframe the thoughts they have so the accuracy of the situation is what the participant recognizes rather than the cognitive processes they are used to. The more the individual is able to recognize this physiological control, and start to accomplish small tasks they will start trusting in their own abilities to effectively problem solve. They will do this by consciously slowing down their cardiac response to the stressful adversity. This physiological control also assists with many of the long-term effects of PTSD allowing the individual to get more sleep, effectively decrease anxiety levels, and decrease the sympathetic nervous system responses (Leung & Singhal, 2004). As an individual is working on trusting themselves and others they are also solving problems during stressful situations. Interpersonal trust: The second issue the workbook addresses is interpersonal trust. The first activity associated with trusting others is the Blind Trust Walk. This activity requires the group to break into pairs, trusting their partner to guid them from point A to point B while they are blind folded. Their partner is to give them verbal cues and guidance through light touch. They are to communicate and provide verbal encouragement to/from their partner. At no time is there to be any foul, dehumanizing, or abusive language so that we can start to trust each other in an extremely vulnerable state, recognizing we all are only there to support and help with the healing process. Once the obstacle course is completed the process will be repeated by switching places. By implementing group work and pairs we are encouraging a social support system, which is supported by the research as another factor in resiliency assisting individuals of abuse in counteracting the effects of isolation. If the support group has had similar experiences with trauma then it will be easier to share with another individual, thus reducing the isolation that an
  • 13. Developing Resilience Skills 13 individual may feel (Mendlesohn, Zachary & Harney, 2007; & Phillips, 2008). The sharing process must be done when the individual is ready to share and in a safe environment, where the individual is believed and not blamed for the best recovery process (Ullman & Filipas, 2001). The remaining exercises in the workbook address a combination of self-trust and interpersonal trust incorporating what is referred to as the “encourager”. The principle is that as the individual is struggling with the “inner critic”. They then start hearing the voice of their partner as their encouragement pairing that with a person who has always encouraged them. The participant then makes this an internal voice (i.e. theirs, God, a relative) encouraging them to be successful. After an individual recognizes the thoughts keeping them from being successful the next step is to challenge the inaccuracy or accuracy of the thoughts that have occurred. The goal is not to merely replace the negative thoughts with positive ones, but rather to assess the accuracy of their thoughts about what is happening (Seligman, 2006). An individual needs to be able to clarify when the belief is a thought of the moment or a core belief; if it is a core belief that might be why an individual would react in what would appear to be irrational behavioral patterns (Seligman, 2006; & Reivich, & Shatte, 2003). The participants throughout these sessions and workbook activities are challenged to evaluate the “inner critic” and alter those messages to reflect a more positive or accurate message. This process is related to the ABC (i.e. adapted from Albert Ellis’ rational emotive therapy [RET]) technique explained by Reivich and Shatte in their book about increasing resilience (2003). In this process the individual identifies the adversity (A) which would be the specific exercise in the workbook, they are asked to identify what they are thinking (B) which were identified as the “inner critic”, and then relate that to the consequences (C) of their thoughts which were related to the emotional response. The cognitive restructuring as one goes through
  • 14. Developing Resilience Skills 14 this process allows the individual to create a new identity related to higher psychological well- being (Reivich, & Shatte, 2003; & Wilkinson & Hamerschlag, 2004). The researchers encourage the participants to continue evaluating their thoughts about experiences in their lives and applying these skills. Empowering them to challenge the thoughts that they have about these experiences, and learning to identify the accurate messages about each experience. Communication: During the sessions and workbook activities the participants are always encouraged to communicate with each other in a positive, encouraging, and constructive manner. The participant’s needs are to be expressed in a respectful way remaining mindful of the other group member’s needs. The group members are to recognize and understand multiple forms of communication (i.e. verbal, body, written,) and the effects that they have on the cohesiveness of the group. It is of the utmost importance that the facilitator of the group maintains safety and security because communication can have an impact on whether individuals feel safe. People are in constant communication and when communication has negative affect or contradictory it can be toxic (DeVillers, ?, chapter, 6). The participant’s communication is important in each session due to the need to convey skills, encouragement, and even gratitude to each other. When other members of the group progresses through the program, this allows everybody as a group to build on the factors of resilience. As the tasks steadily increase in difficulty, the participants are challenged to step outside of their comfort zone and encouraged to rely on each other, as well as the facilitators, to understand they have support and a partner they can work the problem out with, ie., they are not alone.
  • 15. Developing Resilience Skills 15 The last session is designed around communication skills, verbal and non-verbal, when the group is asked to place a piece of paper with a written scenario on it in a hat. This anonymous scenario is to identify a situation that triggers an emotional response they would like to work on in the group. The group will break up into pairs and draw a scenario from the hat, allowing anonymity for the participants, and then decide how to playback the response. The rest of the group will assist in problem solving using the skills that they have learned in the previous sessions by having the pair playback the solutions offered by the group. The group will be encouraged to work through the ABC method especially during these scenarios to determine the accuracy of the solutions offered. During the playback there will be respect for everyone’s opinions, practicing the controlled physiological responses learned through Tia Chi. Optimism: As the workbook’s activities build on one another, optimism is a factor of resilience that is slowly encouraged. However it can be harmful when not realistic, in other words, it has to be something that is accurately based in the experience. So the workbook guides the participants through the activities encouraging them to find accuracy in the activity and their part in it. They are encouraged to take feedback from the facilitator, and other group members, that will be said in a respectful manner to maintain physical and emotional well-being. Activity 4 is a gratitude journal in which they are to assess their personal accomplishments with the third activity (rock wall climbing). In addition to their physical goals they are asked to include their emotional and psychological goals as well. They are encouraged to accurately assess their ability compared to their accomplishment and then to be grateful for the successes they had. They are reminded to view this as a challenge rather than a threat; ie., a challenge is something they can safely approach and actively change. When a problem arises the participants
  • 16. Developing Resilience Skills 16 learn to become cognitively flexible, problem-focused, and informed of resources (Eschleman, Bowling, & Alarcon, 2010; & Anderson, 2010) through the activities in the program. The facilitators are to ensure a non-judgmental environment where the participants can at all times feel safe and able to express their fears or insecurities, so that they can be validated and then encouraged to challenge themselves as far as they can. Just as a mother encourages her child to walk, we are encouraging the participants to take baby steps, and trust us to help them back up when they fall. Self-efficacy: An “essential ingredient in steering through chronic stress is self-efficacy – the belief that you can master your environment and effectively solve problems as they arise…(B)y solving a problem, their confidence is enhanced, which in turn increases the likelihood that they will persevere even longer the next time they are faced with a challenge.”(Reivich, & Shatte, 2003 pg. 19). Throughout this workbook the participants are working on self-efficacy as the researchers are slowly increasing the social and physical difficulty and risk of the tasks. For example, activity 5 introduces a male instructor so that the participants are now challenged with accepting someone from outside the group, and someone that could be seen as a potential danger depending on the trauma suffered. After some practice in some of these activities, the individual can learn to apply the advantages of the other skills allowing them to refocus their energy on the task and controlling their response to the experience. As Reivich and Shatte reminds us (2003) “Keeping the body calm despite the chaos that surrounds you is an important part of being resilient, so we encourage you to use the calming techniques whenever you feel stress spread through your body.” (pg. 198). A daily practice of meditational exercises is encouraged by many researchers as it has been found to offer a physiological control over responses to crisis (Leung
  • 17. Developing Resilience Skills 17 and Singhal, 2004; chapter 9 humanistic extential). These practices also allow the participant relief in other areas including may have been hindering sleeping, eating, and exercise. Autonomy: Participants are asked to be respectful of the other participants in the group and their values and feelings, and at the same time given the same respect, allowing them the ability to take action in their own lives (Allen, 2010; & Feinauer, Mitchell, Harper & Dane, 1996). Because these individuals are transitioning between being controlled and taking control of their lives, the autonomy that they gain through the validation of their feelings and the ability to self- regulate and act for their benefit is significant to posttraumatic growth. The participants begin to understand that they have control over their own lives and this will further give credit to the previous factors of resilience and their ability to prevail and persevere (Anderson, 2010). Conclusion The increase of individuals suffering from Post-Traumatic Stress Disorder (PTSD) due to traumatic events has encouraged researchers to ask why some people suffer PTSD while others do not after the same trauma. With this question they have also asked if there is a way they can encourage these same traits in individuals suffering PTSD. Resilience factors have been identified in some individuals offering them faster recovery without as many of the lasting long- term effects of the crisis (McClure, Chavez, Agars, Peacock & Matosian, 2008; Shumm, Phillips, & Hobfoll, 2006; eschleman Bowling & Alarcon, 2010; Banyard, Williams, Siegel, & West, 2002; Valentine & Feinauer, 1993). The current treatments work using the pathological paradigm, and what is currently understood about victims of abuse; however, there are untapped/unacknowledged strengths of these victims that if recognized could be more successful in their rehabilitation process.
  • 18. Developing Resilience Skills 18 As stated before the more times that you are unable to resolve a crisis or feel that it is your fault results in feelings of a pessimistic explanatory style. There is a loss of self-control, self-trust, interpersonal trust, self-efficacy, and autonomy as the individual feels helpless and hopeless (Seligman, 2006; Reivich, & Shatte, 2003; Anderson, 2010; & McCoy, 2007). Further work in resilience provides a framework of Cognitive Behavioral Theory suggesting that if a person is not yet resilient they can develop these skills. Cognitive Behavior Theory provided the framework for the program designed by these researchers. By using the ABC’s (identifying the adversity, what your thoughts are and the resulting emotions), challenging beliefs, and putting it into perspective, the individual can learn the skills to accurately think about the adversity and problem solve actively. The individual is then asked to challenge the beliefs about the adversity. The individual can come to an accurate thought pattern about the adversity through assessing their immediate and core beliefs and what is at stake because of these beliefs (Reivich, & Shatte, 2003; Anderson, 2010; & McCoy, 2007). Another Cognitive Behavioral Theory utilized is relaxation and refocusing. An individual learns to develop self-regulation, by learning to have control over their own responses to their environment. This process is a control over physiological responses to the environmental stressors rather than a direct control over the environment (Eschleman, Bowling, & Alarcon, 2010; Frazier, Steward, & Mortensen, 2004). Meditation and physical activities, such as those used by the Chinese for self-healing, assist individuals in controlling their physiological responses to stressful events and have also been shown to help with some pathological paradigms. This program offers women, who have suffered from traumatic experiences, the opportunity to take action where once they thought they were helpless. These women have begun
  • 19. Developing Resilience Skills 19 to learn crisis can be seen as a challenge rather than a threat. Crises can be approached and changed by acting on the circumstances with commitment and a positive social support system. Learning these skills allows these women opportunities that otherwise they might not have had, and affords them life skills to move them forward to a more positive future. These women move forward by utilizing the ABC’s and gaining accuracy along with optimism over their life events. To run the program facilities would first identify where the clients rate in optimism and emotional regulation by obtaining a pre-test prior to the support group. The questions for the pre/post-test were obtained from Reivich and Shatte (2003) and modified to fit the needs of this project. The clients/participants would then take part in the six sessions of the resilience training advancing in their skills. The participants would finally be asked to participate in a post-test to assess how the group assisted them. This pre/post-test and workbook can be obtained from the program developers through email. Future implications for this program would be for it to be run as a support group for victims of domestic violence or sexual assault in already existing agencies such as: YWCA, rape crisis centers, college counseling centers, and other crisis shelters/centers. This program is not designed to help an individual through the initial phase of crisis. Therefore this program should be used as an advanced program after the individual has managed to get assistance or is no longer in the initial phases of crisis. For example at the YWCA when the women move to the second phase of the program that encourages them to find a job and apartment, this would be a perfect time to run this support group offering them these valuable life skills.
  • 20. Developing Resilience Skills 20 References Anderson, K. M., (2010). Enhancing resilience in survivors of family violence. New York, NY. Springer Publishing Co. Allen, J. P. (2010). Experience, development, and resilience: The Legacy of Stuart Hauser’s explorations of the transition from adolescence into early adulthood. Research in Human Development, 7, 241-256. DOI: 10.1080/15427609.2010.526516 Banyard, V. L., Williams, L. M., Siegel, J. A. & West, C. M. (2002). Childhood sexual abuse in the lives of black women: Risk and resilience in a longitudinal study. Women & Therapy, 25, 45-58. Beck, J. G., McNiff, J., Clapp, J. D., Olsen, S. A., Avery, M. L., & Hagewood, J. H. (2011). Exploring negative emotion in women experiencing intimate partner violence: Shame, Guilt and PTSD. Behavior Therapy, 42, 740-750. Brockett, C. (1975). Toward a clarification of the need hierarchy theory; Some extensions of Maslow’s conceptulization. Interpersonal Development, 6, 77-90. DeVillers, L. (). Facilitating positive sexual communication. In A. Mitchell Tepper, & B. Annette Fuglasang Owens (Eds). Sexual Health (pp119-53). Westport, Connecticut: Praeger Perspectives Diamond, L. M. (2006). The evolution of plasticity in female-female desire. Journal of Psychology & Human Sexuality, 18, 245-274. DOI: 10.1300/J056v18n04_01 Herrman, H., Stewart, D. E., Diaz-Granados, N., Berger DPhil, E. L., Jackson, B. & Yuen T. (2011). What is resilience? La Revue Canadienne De Psychiatrie, 56, 258-265.
  • 21. Developing Resilience Skills 21 Eschleman, K. J., Bowling, N. A., & Alarcon, G. M. (2010). A meta-analytic examination of hardiness. International Journal of Stress Management, 17, 277-307. DOI: 10.1037/a0020476 Feinauer, L., Hilton, H. G. & Callahan, E. H. (2003). Hardiness as a moderator of shame associated with childhood sexual abuse. The American Journal of Family Therapy, 31, 65-78. DOI:10.1080/01926180390167115 Feinauer, L. L., Mitchell, J., Harper, J. M. & Dane, S. (1996). The impact of hardiness and severity of childhood sexual abuse on adult adjustment. The American Journal of Family Therapy, 24, 206-214. Frazier, P., Steward, J. & Mortensen, H. (2010). Perceived control and adjustment to trauma: A comparison across events. Journal of Social and Clinical Psychology, 23, 303-324. Leung, Y. & Singhal, A. (2004). An examination of the relationship between qigong meditation and personality. Social Behavior and Personality, 32, 313-320. McClure, F. H., Chavez, D. V., Agars, M. D., Peacock, M. J., & Matosian, A. (2008). Resiliency in sexually abused women: Risk and protective factors. Journal of Family Violence, 23, 81-88. DOI:10.1007/s10896-007-9129-4 McCoy, J. A. (2007). Developing a supportive living envoronment for survivors of intimate partner violence and domesitc violence. (Doctoral Dissertation). Retrieved from University of Cincinnati Library: Full Text. McEwan, S. L., DE Man, A. F. & Simpson-Housley, P. (2005). Acquaintance rape, ego-identity achievement, and locus of control. Social Behavior and Personality, 33, 587-592. Messing, J. T., Flair, L. L., Cavanaugh, C. E., Kanga, M. R., & Campbell, J. C. (2012). Testing Posttraumatic stress as a mediator of childhood trauma and adult intimate partner
  • 22. Developing Resilience Skills 22 violence victimization. Journal of Aggression, Maltreatment, & Trauma, 21, 792-811. DOI:10.1080/10926771.2012.686963 Mendelsohn, M., Zachary, R. S. & Harney, P. A. (2007). Group therapy as an ecological bridge to new community for trauma survivors. Journal of Aggression Maltreatment & Trauma, 14, 227-243. DOI: 10.1300/J14v14n01_12 Niehaus, A. F., Jackson, J., & Davies, S. (2010). Sexual self-schemas of female child sexual abuse survivors: Relationships with risky sexual behavior and sexual assault in adolescence. Archive Sexual Behavior, 39, 1359-1374. DOI:10.1007/s10508-010-9600-9 Norman, G. J., Hawkley, L., Luhmann, M., Ball, A. B., Cole, S. W., Berntson, G. G., & Cacioppo, J. T. (2011). Variation in the oxytocin receptor gene influences neurocardiac reactivity to social stress and HPA function: A population based study. Hormones and Behavior, 61, 134-139. DOI:10.1016/j.yhbeh.2011.11.006 Orzeck, T. L. Rokach, A. & Chin J. (2010). The effects of traumatic and abusive relationships. Journal of Loss and Trauma, 15, 167-192. DOI: 10.1080/153250209033592 Phillips, G. (2008). Resilience in practice interventions. Child Care in Practice, 14, 45-54. DOI: 10.1080/13575270701733716 Regehr, C., Cadell, S. & Jansen K. (1999). Perceptions of control and long-term recovery from rape. American Journal of Orthopsychiatry, 69, 110-115. Reivich, K., & Shatte, A. (2003). 7 keys to finding your inner strength and overcoming life’s hurdles:The resilience factor. New York: Broadway Books Schumm J. A., Briggs-Phillips, M., & Hobfoll, S. E. (2006). Cumulative interpersonal traumas and social support as risk and resiliency factors in predicting PTSD and depression
  • 23. Developing Resilience Skills 23 among inner-city women. Journal of Traumatic Stress, 19, 825-836. Doi:10.1002/jts.20159. Seligman, M. (2006). Learned optimism: How to change your mind and your life with a new preface. New York: Vintage Books Thornton, B., Ryckman, R. M, & Robbins, M. A. (1982). The relationship of observer characteristics to beliefs in the causal responsibility of victims of sexual assault. Human Relations, 35, 321-330. Tollefson, D. R., Webb, K., Shumway, D., Block, S. H. & Nakamura, Y. (2009). A mind-body approach to domestic violence perpetrator treatment: Program overview and preliminary outcomes. Journal of Aggression, Maltreatment & Trauma, 18, 17-45. DOI: 10.1080/10926770802610657. Ullman, S. E. & Filipas, H. H. (2001). Correlates of formal and informal support seeking in sexual assault victims. Journal of Interpersonal Violence, 16,1028-1047. DOI: 10.1177/0886260006010004 Valentine, L. & Feinauer, L. L. (1993). Resilience factors associated with female survivors of childhood sexual abuse. The American Journal of Family Therapy, 21, 216-224. Wilkinson, D. L., & Hamerschlag, S. J. (2005). Situational determinants in intimate partner violence. Aggression and Violent Behavior, 10, 333-361. DOI: 10.1016/j.avb.2004.05.001 Wyatt, G. E., Notgrass, C. M. & Newcomb, M. (1990). Internal and external mediators of women’s rape experiences. Psychology of Women Quarterly, 14, 153-176.