Resilient

Resilient due to the job?
Three people died and many others were injured in a
multiple pileup on the A31 in North Rhine-Westphalia.
Emergency workers shielded the accident from those
who perhaps wouldn’t have been able to cope with it –
and ultimately needed to muster a lot of strength
themselves to come to terms with what had happened
The Strength of
Work-related stress, private problems, or other worries:
everyone finds themselves in a stressful situation at some point
in their lives. Resilient people MASTER CRISES MORE EASILY.
Some people are born with such abilities, while others acquire
them – people, companies, or even entire cities.
Text: Isabell Spilker
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MENTAL STRENGTH
FOCUS
PHOTO: DDP IMAGES
the Resilient
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MENTAL STRENGTH
T
The emergency call was received by the call center at
9:33 a.m. What happened in the hours that followed would require
thousands of workers and drive them to the limit of human
tolerance. In March 2009 a former student of a school in the
small town of Winnenden in Baden-Württemberg shot dead 15
people – and ultimately himself. Martin Luitjens was
also on the scene. As a leading emergency pastoral
care worker he took care of the survivors and emergency
crews by being there to talk to them. By the
time evening came, the man who usually helps others
to cope with traumatic experiences noticed that
even his strength was waning. Emergency crews who
have to recover children’s bodies, police officers who
witness their colleagues being gunned down – they
all work in these inhuman situations. Once everything
has calmed down, stress takes its toll. However, those
who do not possess the mechanism that psychologists
call “resilience” will have big problems coping with
their everyday lives. “People who come home after such a day at
work are not initially in a position to come to terms with what has
happened,” says Luitjens, who also works as a resilience coach.
“They are disoriented at first, because the psyche needs time.”
Some people pull themselves together within a few days, while
others need months, sometimes even years – or an entire lifetime.
Tolerance to disruptions
Resilience describes the psychological ability to cope with and
recover from difficulties. The concept can be assigned to systems,
organizations, infrastructures, materials, and entire societies.
Across a number of different disciplines it describes people’s
tolerance to disruptions – and the ability to take the measures
needed to ensure that the serious situation doesn’t even occur in
the first place or at the very least mitigate its impact. This works
in a hospital as much as within other complex systems. An example:
in recent years the impact of climate change on cities has
been analyzed. The focus of the analysis was on how the cities
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The noise was alarming, the scene incomprehensible:
on June 3, 1998 the high-speed ICE train “Wilhelm Conrad
Röntgen” derailed in Eschede near Celle. The train accident was
the first major catastrophe in Germany in which the emergency
crews received systematic follow-up care. A total of 700 of around
2,000 workers took advantage of the assistance over a period
of three years; 100 had long-term problems – they suffered from
internal unrest and could barely sleep
Resilience
can protect the
mind – like an
immune system
manage to brave the extreme weather and return to normality as
quickly as possible afterward. An aptitude for learning is a further
dimension of this robustness and capacity to cope. A resilient
system is in a position to learn and adapt to changing conditions.
“In relation to people, resilience describes the mechanisms
which ensure that they emerge stronger from stressful and demanding
situations,” explains Michèle Wessa, professor of clinical
psychology and neuropsychology at the Johannes Gutenberg
University in Mainz. Europe’s first center for resilience research
opened here in the summer of 2014 with the aim of understanding
the principles of resilience on a molecular and neuroscientific
level and by conducting animal experiments. The idea is to develop
new prevention methods on the basis of the findings.
The demand for effective concepts is rising. The psychological
constitution of man has become a popular subject. Despite
increased prosperity and (compared to bygone days) lower lev-
PHOTO: DPA/SÜDDEUTSCHE ZEITUNG PHOTO
els of physical exertion, many people are under enormous pressure
both at work and at home. If you are unable to keep up, you
lose – at least that’s how it seems to many people. General studies
of the mental health of employees in medical careers reveal,
for instance, that at least 20 percent of doctors suffer from burnout
syndrome. Work-related stress is one of the biggest challenges
of the present age. Resilience is the flip side of it all and the
thing that can protect people – like a callus.
“What doesn’t kill me only makes me stronger”
Yet how is this protection mechanism formed? Systems can be
made more resilient, but people? Resilience can protect the mind
and prevent illness after intensive negative experiences. And just
like an immune system it is more pronounced and effective in
some people than in others. So why are some people more resilient
than others? Is it genetic, is it acquired
during childhood, or does it develop during TOUGH SHELL
the transition to adulthood? Or can resilience
The American
evolve at any of these stages? The formula Psychological Association
could be simple. An essen tially optimistic child has developed a
is not wrapped in cotton wool by its parents, ten-point plan which
but is exposed to the oc casional crisis. He or can pave the way
she goes through life as a mentally strong adult to greater resilience:
and faces any adversity with an inner robustness.
Stephen Joseph carries out research in 2. Avoid seeing
1. Make connections.
precisely this area. He coordinates the psychotherapeutic
and practical psychology course problems.
crises as insurmountable
at the School of Education at the University
of Nottingham and was head of the Cen-
is a part of living.
3. Accept that change
tre for Trauma, Resilience and Growth there
4. Move toward
your goals.
until 2013 as professor of psychology: “Many 5. Take decisive actions.
of the skills that adults possess are the result 6. Look for opportunities
of training during childhood. We must learn for “self-discovery.”
how to cope with difficult situations. Those 7. Nurture a positive
who are confronted with adversity and catastrophe
will show a higher degree of resilience
view of yourself.
8. Keep things in
perspective.
9. Maintain a hopeful
outlook.
10. Take care
of yourself.
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“The culture
within the organization
will also
determine how
resilient emergency
workers are”
if they have learned from early experiences.” Accordingly,
he also essentially sees the positive side of crises
and concurs with Friedrich Nietzsche’s Twilight of
the Idols: “What doesn’t kill me only makes me stronger.”
Stephen Joseph borrowed from Nietzsche for the
title of his book (What Doesn’t Kill Us) and tells stories
of people who have managed to emerge stronger
from setbacks. “Post- traumatic growth also means
learning from trauma: setting new priorities and finding
out what is really important.” However, those who
have no positive experience of coping with crises, that is to say
those who have been unable to come to terms with previous experiences,
will be more vulnerable. This has also been shown by
a study in which Joseph was involved in 1987 following the ferry
disaster near the Belgian port of Zeebrugge in which 193 people
died. Survivors who had to deal with further crises (such as
a severe illness or the loss of a relative) in the three years afterward
proved to be even more vulnerable than a reference group.
“Those who are as cool as a
cucumber are by no means resilient”
Something else became clear from the study: people who were
unable to show their feelings and who lacked social support fared
especially badly. A finding also shared by resilience coach Luitjens:
“Social support is a driving factor. Resilience has a great deal to
do with the personal environment – as in the case of emergency
crews, for instance. The culture within the organization will
also determine how resilient they are.” Is it not possible to simply
talk to one another after a callout and just say that something
didn’t go so perfectly? “Structures which live by the myth
of being invulnerable and in all probability being able to remain
as cool as a cucumber make it difficult to deal with demanding
situations. In such an environment hardly anyone has the courage
to admit to a supposed weakness.” In his opinion and experience,
social resources – in other words, the support within the
group – are the crucial factors which lead to greater resilience.
The researcher Michèle Wessa goes one step further here: “The
link is not as strong as people thought. Although these attributes
and factors (optimism, social support, and early experiences) do
have a significant influence, they are not sufficient to predict how
resilient an individual will be in a situation.” Resilience is probably
a combination of different factors and mechanisms. “If it were
merely attributes that made us resilient, then somebody would remain
resilient throughout their entire life. But that isn’t the case.
An example: many emergency workers go through their professional
lives without suffering any damage – and then something
suddenly knocks them off their feet. This seems to confirm that
there are resources which are somehow built up over time, but
can also be exhausted at some point.
Inherent feature of many training courses
The German Resilience Center is trying to catch this moment
with a specially established outpatient clinic. It is not aimed at
people who are in the middle of a crisis and are in desperate need
of resilience; it is more for stressed people and institutions before
the first serious situation occurs so that it can be countered
Entering the
water with the
hope of finding
survivors,
only to recover
bodies:
the Costa
Concordia maritime
accident off
the Italian coast
demanded mental
strength from
the diving team
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Interview
Resilient
equipment
Five years ago Dräger set up a
division which tests medical-technical
equipment in more practice-based
settings, making it more resilient to
adverse environmental influences.
Dirk Zumtobel is head of the product
reliability division.
Mr. Zumtobel, quality assurance
is taken for granted these days.
What do you do to go further?
Zumtobel: The conventional standards
applied to functional testing in
the area of quality assurance were
no longer sufficient for us. We
also test system stability over a longer
period of time – and under “clinical
conditions.” Flawless components do
not necessarily produce a perfect
system. This is precisely what we work
on: we make sure that our components
are free from defects and function within
the overall system in everyday use.
Have you built a small hospital
for this purpose?
Zumtobel: Yes, kind of. In our
quality lab we are technically in
a position to simulate everyday
clinical situations. We subject 25 or
more devices of a certain type
to stress under various conditions,
record the results, and evaluate
them statistically. This makes it
possible to give statements
about the robustness and reliability
of our systems in the field.
What conditions do you subject
the equipment to?
Zumtobel: As many predictable ones
as possible – severely obese patients,
premature babies (who need to be
gently ventilated), regular disinfection
measures (with various detergents
and methods), temperature and pressure
changes, power supply fluctuation,
and many more besides.
What were the initial findings?
Zumtobel: After the first test runs
with prototypes we were surprised at
how many events were actually
recorded. Not everything is immediately
noticed by the user. It revealed to use
the areas where the system architecture
is still “shaky” – in a similar way to a
PC system which can also occasionally
hang during an application.
So the equipment is made
resilient against itself in
the first instance. What kind
of external influences must
it also be protected from?
Zumtobel: The biggest challenge
confronting technology is actually the
user. Everything is generally OK
as long as the equipment is used in
accordance with the operating
instructions, if there were no “foreseeable
misuse.” To this end, we regularly
let people with clinical and technical
knowledge operate our new technologies
without formal product training. In
addition, we subject the equipment
to further unpredictable situations: the
use of unsuitable accessories, switching
it off suddenly, incorrect cleaning, and
much more besides. This gives us
more insight which helps us to make
the equipment even more resilient
during the development phase.
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PHOTO: PICTURE ALLIANCE/DPA

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MENTAL STRENGTH
accordingly with stress management and relaxation techniques
as well as a social network which offers assistance. Measures
that promote resilience are often an inherent feature of training
courses for firefighters, police officers, and pilots. It is important
to realize the following: “There is no such thing as resilient or not
resilient! Every individual has a certain limit which is
sometimes sufficient for the challenges they face –
but sometimes they go beyond this limit,” says Martin
Luitjens. It took three days for him to regain his composure
after his experiences in Winnenden. “Naturally
I know about the coping process and what I need to
do to get back on my feet.” Luitjens is well equipped.
However, he also knows that even though an individual
reacted resiliently to a certain situation last year,
it doesn’t necessarily mean that they will do so again
on the next occasion. Nothing can be predicted, but
everyone can arm themselves against it.
LITERATURE AND LINKS
Stephen Joseph: What Doesn’t Kill Us.
288 pages, Jackson/TN, USA, Basic Books, 2013
Karen Reivich, Andrew Shatte: The Resilience Factor:
7 Keys to Finding Your Inner Strength and Overcoming Life’s Hurdles.
352 pages, Harmony Publishers, New York, 2013
American Psychological
Association:
www.apa.org/helpcenter/road-resilience.aspx
Resilence Training Institute
(Branches throughout the USA)
www.resiliencetraininginstitute.com
“There is no such
thing as resilient or
not resilient!”
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Even though the job requires a certain
robustness, the image of the tough firefighter has
changed in recent years. Nowadays, emergency
workers can admit that callouts lasting several hours,
such as this major fire, can really get to them
HOW STRONG IS YOUR MENTAL IMMUNE SYSTEM?
People react very differently to demanding experiences. This
is primarily due to their individual mental resilience. Take this
test to determine how resilient you are. Mark the box which
generally indicates the extent to which the following statements
apply to you. Add up all the points at the end – you can
check your score below.
1. When I have plans, I see them through.
1 2 3 4 5 6 7
2. I usually manage to do everything somehow.
1 2 3 4 5 6 7
3. I am not thrown off
course that easily.
1 2 3 4 5 6 7
4. I like me.
1 2 3 4 5 6 7
5. I can multitask.
1 2 3 4 5 6 7
6. I am decisive.
1 2 3 4 5 6 7
7. I take things as they come.
1 2 3 4 5 6 7
8. I take an interest in many different things.
1 2 3 4 5 6 7
9. I can usually see a situation from more
than one perspective.
1 2 3 4 5 6 7
10. I can also force myself to do things that
I don’t really want to do.
1 2 3 4 5 6 7
11. When I am in a difficult situation, I usually
find a way out.
1 2 3 4 5 6 7
12. I have enough energy to do all the things
I have to do.
1 2 3 4 5 6 7
13. I can accept the fact that not everybody
likes me.
1 2 3 4 5 6 7
Based on: Karena Leppert et al, Klinische Diagnostik und
Evaluation magazine, 2008, pp. 226–243; with permission.
SCORE
58 points or less: You are not very
resilient. However, this does not
mean that you are at the mercy of
life’s difficult situations, but you
are more likely to need help working
through a challenging situation
than others who are confronted with
the same difficulties.
59 to 82 points: You have average
resilience. You can normally
deal with difficult situations and get
back on your feet after a little while.
83 points or more: Nothing throws
you off course easily. You have
the ability to react flexibly to adversity
and find a strategy appropriate
to the situation. If you are unable to
change a difficult situation,
you are generally able to accept it.
PHOTO: ULLSTEIN BILD – CARO/MARIUS SCHWARZ
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