This August, my kids and I were among the millions of people watching the solar eclipse with awe. At the apex, in that moment of relative cold and darkness, I tried to lighten the mood with a bad mom joke: “It must be hard for the sun to feel so powerless today, huh?”
But rather than laugh or roll his eyes, my 10-year-old son replied with innocent wisdom.
“Don’t worry, Mom,” he said. “It will pass. All shadows do.”
He’s right. One thing I’ve learned from working with families facing childhood and adolescent cancer is that the shadow of cancer – that loss of control, that fear, that stress – does eventually lift. In fact, the history of human experience includes a myriad of examples of overcoming adversity. Think of the wars, natural disasters and other serious illnesses humans constantly encounter. In general, we recover, and ultimately learn from the experiences.
How do we do it? The answer is “resilience” and it is what I study. Allow me to share some of what I have learned through my conversations with patients and families.
Stress and adversity are characterized by feelings of powerlessness and lost control. Overcoming them requires us first to acknowledge what we cannot control, and then to recognize what we can.
One of the things we can control is how we interpret and write our own life stories. People who take the time to reframe their experience and find gratitude, benefit, meaning or purpose tend to recover quicker. Although different cultures vary in how they define and measure it, resilience almost always involves deliberate action. This action is the identification and harnessing of resources.
These “resilience resources” fall into three categories:
- Internal resources (i.e., individual characteristics like grit and personal skills like managing stress)
- External resources (i.e., community and social supports)
- Existential resources (i.e., faith, spirituality and the ability to make meaning from adversity)
Tools to navigate resilience
While most people have tremendous capacity for resilience in the long run, they often need help in the short run. Serious illness is hard and sometimes a few tools can help families navigate the challenge.
In a series of studies here at Seattle Children’s Cancer and Blood Disorders Center, we developed and tested an intervention that helps people identify, strengthen, and (when needed) build-from-scratch some of these resources. The intervention is called Promoting Resilience in Stress Management (PRISM) and it targets the internal resources of managing stress, mindfulness and setting goals, as well as the existential resources of catching negative self-talk, positively reframing difficult experiences and creating meaning from them.
Early findings from a randomized trial suggest teens and young adults who tried PRISM believed themselves to be more resilient than peers who did not get PRISM. They also reported higher quality of life and lower depression.
Putting resilience into practice
People often ask me (in the absence of something like PRISM), “How can I develop my own resilience?” The answer is simple and revolves around the same resources I mentioned above.
For internal resources, ask yourself: How do I usually overcome tough times? What has helped me in the past? What might help me more now? Champion resources you already have, and make an effort to develop the ones you don’t.
For external resources, ask yourself: Who is there for me when I need help? Who is my community? Reach out to those who are there and don’t resist unsolicited offers for support, even if it is from folks you don’t yet know. You may be surprised at the community you develop.
Lastly, for existential resources, acknowledge and normalize the hardness of adversity, but also be curious. Make efforts to identify good things. These may very well be some of the internal or external resources you just identified. Try to explore how this will impact your life and what will be your story. Remember, this part is under your control.
None of these are easy tasks and not all resources matter the same to all people. Try to know which ones are most important for you, and be willing to try the ones less familiar.
Also remember that some of these resources require lots of time and perspective.
Be patient. It is okay (and even normal) to be in the shadow for at least a little while. Being there doesn’t mean you are not resilient, it means that you aren’t quite ready to step out.
In the end, although they will never be forgotten, the shadows of adversities like cancer do clear. You will step out of the shadow and into the light. And your story, regardless of its pathway or its ending, will matter.
Dr. Abby Rosenberg is the medical leader of Seattle Children’s Adolescent and Young Adult (AYA) Cancer Program. She is also a researcher in Seattle Children’s Research Institute’s Center for Clinical and Translational Research. Watch Dr. Rosenberg talk more about resilience on Facebook.