Over the course of a lifetime, 90 percent of us will experience some kind of traumatic event. Some people have the ability to bounce back from these difficult experiences and engage with life again. For others, these setbacks are debilitating. Scientists say there are several key factors that make some people more resilient than others. These include an overriding sense of optimism, having a mission in life and a strong social network. While some of resilience is genetic, scientists say most of it can be learned, thanks to brain’s ability to grow and change. We look at the science of resilience and how we can learn to respond better to adversity.

Guests

  • Dr. Dennis Charney Dean, Icahn School of Medicine, Mount Sinai Hospital; president for academic affairs, Mount Sinai Health System
  • Dr. Steven Southwick Professor of psychiatry, post traumatic stress disorder and resilience, Yale University Medical School
  • Clare Ansberry Pittsburgh bureau chief, The Wall Street Journal; author, "Turning Points" column

Transcript

  • 11:06:53

    MS. DIANE REHMThanks for joining us. I'm Diane Rehm. Most people experience at least one traumatic event during a lifetime, but some are more resilient than others and can bounce back from adversity and even thrive afterwards. Scientist say the most resilient people are optimists who face their fears and have a strong mission in life.

  • 11:07:18

    MS. DIANE REHMHere to talk about the science of resilience and how we can learn to adapt to challenging situations, Clare Ansberry of The Wall Street Journal. Joining us from the NPR bureau in New York City, Dr. Dennis Charney of Mount Sinai Hospital. And from a studio in New Haven, Connecticut, Dr. Steven Southwick of Yale University Medical School. They are co-authors of a book titled "Resilience: The Science of Mastering Life's Greatest Challenges."

  • 11:07:52

    MS. DIANE REHMI hope you'll join us, questions, comments, 800-433-8850. Send an email to drshow@wamu.org. Follow us on Facebook or Twitter. And welcome to all of you.

  • 11:08:08

    MS. CLARE ANSBERRYThank you. Thank you for having us.

  • 11:08:10

    DR. DENNIS CHARNEYThank you.

  • 11:08:11

    REHMAnd Clare Ansberry, I'll start with you. This year, I know you began writing a column for The Wall Street Journal. It's called "Turning Points," which is a great title.

  • 11:08:26

    ANSBERRYThank you.

  • 11:08:26

    REHMTell me why.

  • 11:08:29

    ANSBERRYWell, I think everyone at every age throughout life experiences a transition and a turning point. And I wanted to explore and I think it's just so fascinating how we respond to those turning points and why. The biggest ones are sort of a loss or a setback. You know, people lose homes, they lose jobs, they lose loved ones. But what fascinated me is, you know, how even those why experience the most traumatic events manage to survive and why and how they can piece together their lives and be strengthened in unexpected ways.

  • 11:09:11

    ANSBERRYIt's really sometimes a matter of being able to transcend the hurt and not looking so much inward, but looking outward and providing help to others.

  • 11:09:21

    REHMOne of the people you've written about is Carolyn Moore. Tell us about her.

  • 11:09:28

    ANSBERRYCarolyn, she is a widow and she was a young widow. She was in her 20s. She had everything going for her, it seemed. Two beautiful young girls, a business with her husband and they went out for a Valentine's Day dinner. On the way home, they were in car accident and he died immediately. And her whole world was upended. She was in a fog. She didn't know what she would do and she never -- she didn't know whether she could ever be happy again and she almost felt like her whole life from then on was going to be one of duty.

  • 11:10:10

    ANSBERRYAnd she lost all hope and she lost all optimism.

  • 11:10:14

    REHMAnd?

  • 11:10:15

    ANSBERRYAnd you know, this was not a quick change for her or a linear process. There were a lot of turns and twists in her life and it was a real struggle for her for years. And one of the turning points in her life was when she met a rabbi who asked her -- well, actually confronted her with a question. He said, you know, you can't change what has happened in your life. You know, fate happened. It barged into your life.

  • 11:10:50

    ANSBERRYBut you can change or you can control how you respond to that. And she began examining what she was doing in her life and she was so focused on the loss of her husband and the pain involved in that that she wasn't focused on his life and celebrating his life and making a life for her daughters. And she would look at them, and they're young girls, and she said, you know, if I want them to be happy, I have to be happy.

  • 11:11:25

    REHMAbsolutely. And Dr. Southwick, I gather you've studied many, many people like Carolyn Moore. Does she exemplify resilience?

  • 11:11:42

    DR. STEVEN SOUTHWICKYes, very much so. And I think one of the important issues is that these transformations, if you will, or these adaptations don't necessarily happy right away because death of a loved one and so forth is obviously extremely painful. But when individuals can take this pain and can reframe it in a way to find some opportunity in adversity, that's a real hallmark of resilience.

  • 11:12:12

    REHMDr. Southwick, I'm really, really interested in how or why you and Dr. Charney began this study of resilience, what it is, why some people have it and others don't. Give us a sense of what went into your own thinking.

  • 11:12:39

    SOUTHWICKWell, Dennis and I had been studying post traumatic stress disorder through the National Center For Post Traumatic Stress Disorder, which is part of the Veteran's Administration. And we'd been studying PTSD for years. We were clinicians and we were neuroscience researchers and we learned a lot about fear circuitry and the association between alterations in fear circuitry and post traumatic stress disorder.

  • 11:13:08

    SOUTHWICKThe individuals who we studied and learned from were coming to us at the hospital, but we began to wonder about individuals who might not be coming to the hospital and we began to wonder about individuals who, even though they might have PTSD symptoms, were fairing well and in some cases fairing extremely well. So we began by looking at extremely resilient individuals, former prisoners of war from Vietnam, Special Forces instructors, because we thought if someone can help us understand how to become more resilient emotionally and physically, these instructors could, and also civilian men and women and some children who had been through very trying circumstances and who were doing very well.

  • 11:13:53

    SOUTHWICKSo our hope was to learn as much as we could about the ways in which resilient people cope so that they could become teachers, if you will, for those of us who have more difficulty with stress.

  • 11:14:07

    REHMAnd turning now to your co-author, Dr. Dennis Charney, talk about exactly what resilience is in your mind, Dr. Charney.

  • 11:14:22

    CHARNEYYes. You know, there are several definitions of resilience. One is if somebody has been traumatized or faced major obstacles in their life, they were able to overcome them and be successful and not develop symptoms of post traumatic stress disorder and depression or problems with substance abuse. You know, that they overcome these obstacles and challenges without incurring those problems. On the other hand, another definition of resilience that we have also used is that sometimes the trauma is so severe and so difficult or the obstacles are so great that symptoms of depression and post traumatic stress do occur, but these individuals, by being resilient, are able to overcome them and ultimately lead a very production and in some cases an inspiring life.

  • 11:15:21

    REHMCan you, perhaps, be resilient in one part of your life and not another, Dr. Charney? For example, in work or family or vice versa?

  • 11:15:38

    CHARNEYYes. You know, there are some individuals who may be very resilient as it relates to personal struggles and related to their family and others and maybe not be so successful in their work life, however. The goal is to evidence resilience across the spectrum of life's experiences, both professional and personal. And one of the observations that Steve and I have made over the years by studying so many different kinds of individuals of all ethnic groups and also economic groups is that you can train yourself to be more resilient and be successful across the spectrum of life's challenges.

  • 11:16:22

    REHMTraining yourself to be resilient. Clare Ansberry, do you see that in some of the people you've spoken to and written about?

  • 11:16:36

    ANSBERRYI do, but I'm sure that they feel that they are undergoing a training as much as it is an evolution. And well, actually some of them, for example Carolyn, did have therapy because she, you know, she spent about five months in therapy because she was just -- she was struggling so much and she needed help reframing her thoughts and how she viewed what had happened. So that is a formal way. But, you know, other people that I've talked with, they just naturally and sort of organically figure it out, what they needed.

  • 11:17:23

    ANSBERRYAnd one widow whose husband had committed suicide and her own father had committed suicide and she felt so vulnerable and fragile that she just naturally circled herself with people that she trusted. Her family, she had a very big family, something like eight or nine siblings, and they all came around her and she knew that she needed that. And I think social support is very, very important and she knew that.

  • 11:17:58

    REHMClare Ansberry is bureau chief for The Wall Street Journal's Pittsburgh, Pennsylvania, bureau. She writes a column called "Turning Points" for The Journal. Your calls, your emails when we come back. Stay with us.

  • 11:20:02

    REHMAnd if you've just joined us, we're talking about an absolutely wonderful characteristic: resilience. And two MDs have written a book about it, which they call, "The Science of Mastering Life's Greatest Challenges." They are Dr. Steven Southwick and Dr. Dennis Charney. They both join us: one from New York, the other from New Haven. Here, in the studio, is Clare Ansberry. She writes a column for The Wall Street Journal. It's called, "Turning Points." And we have an email from Jake. Dr. Charney, Jake asks, "Are there any studies showing a link between religious belief, even general spirituality, and resilience?" What do you think?

  • 11:21:09

    CHARNEYYes, we have found that. One of the characteristics of some resilient people is that they have a sense of spirituality and, in some cases, have found religion to be very helpful in overcoming tough times. One of the groups that we studied was a group in inner-city Washington, D.C., that was facing challenges related to physical and sexual abuse and poverty. And we found, in that population, that attending religious services and the support that accrues by being part of a religious group was very helpful. It's not for everybody but definitely for certain individuals, religious belief, faith, a moral compass, is very helpful in overcoming tough times.

  • 11:22:00

    REHMDr. Southwick, how do we -- pardon me -- how do we actually measure resilience? Are there tests that we can take?

  • 11:22:14

    SOUTHWICKThere are. It's a complex construct and one that is actually difficult to measure. But the most commonly used scale is the Connor-Davidson. There's also a scale that we use, the Responses to Stressful Experiences Scale. And some of these scales look at the ways in which we characteristically respond to stresses in our life. For example, with resilient individuals, how do they typically think during difficult times? How do they regulate their emotions during difficult times? And how do they behave during difficult times? So there are scales to measure resilience. But, honestly, there's a lot more to be done with regard to researching this area.

  • 11:23:04

    REHMAll right. And I want to let our listeners know that we have one of those experience scale tests on our website, drshow.org., so you can test your own resilience by going up there. And here's an email from Karen in Missouri. "Does the age at which a traumatic experience happens, affect one's ability to be resilient?" What do you think, Clare Ansberry?

  • 11:23:50

    ANSBERRYWell, I don't -- I think it depends upon the type of loss. As, you know, someone who is older is experiencing physical loss and a loss of mobility and independence, that those are very difficult things to accept and to, you know, accommodate in their lives. But I also think that they also have gone through so much in their lives and have seen that they have survived so many losses that they can manage. So maybe not -- maybe the physical is a little bit more difficult. But the challenges throughout life, the losses of homes and loved ones, they have encountered those throughout their whole life and they have survived.

  • 11:24:37

    REHMBut, now, tell me about the man you interviewed who had just been diagnosed with cancer. How did he turn that around into a new life's mission?

  • 11:24:51

    ANSBERRYWell, it was interesting. He -- all his life he had been in the corporate world. But what he really wanted to do -- and he had tried twice, unsuccessfully, to do -- was open a diner. It was just a business that spoke to him. And he was diagnosed with cancer and decided...

  • 11:25:10

    REHMAt what age?

  • 11:25:12

    ANSBERRYHe was in his 50s.

  • 11:25:13

    REHMAha.

  • 11:25:14

    ANSBERRYAnd he had two children, one in high school and one in college. And at that age, he decided -- I may have one year left, I may have 10 years left, but if I only have one year, I want to be doing what I want to be doing. And talk about risks, he let go of his insurance, a steady paycheck…

  • 11:25:33

    REHMWow.

  • 11:25:34

    ANSBERRY...going to a business that he had failed twice before.

  • 11:25:37

    REHMHmm.

  • 11:25:37

    ANSBERRYAnd he has opened several diners. He works harder than he has ever worked. He said, but being inside those diners and having -- surrounded by the smell of coffee and the clatter of, you know, the forks against the porcelain plates and greeting people, he said he's never been happier. And so is his wife. She said the same about him. And, you know, going back to the social support, he, likewise, had the support of his wife and his two children, who -- and that was critical. His brother and his mother thought he -- said, "No, you shouldn't do this. Now is not the time." But he decided to do it. And that gave him a purpose.

  • 11:26:19

    REHMAnd is he still living?

  • 11:26:22

    ANSBERRYHe is still living. And he -- his latest checkups have been clear.

  • 11:26:27

    REHMRemarkable.

  • 11:26:29

    ANSBERRYYes.

  • 11:26:29

    REHMHow do you find these people?

  • 11:26:32

    ANSBERRYBoy, it's word of mouth, I read a lot. You know, it's -- there's really no -- everybody, everybody has a story and everybody has a turning point. And you could go on a bus and find 10 -- 10 stories, 20.

  • 11:26:48

    REHMDr. Charney, do we have any idea of how much a role genetics may play?

  • 11:26:57

    CHARNEYYes. There is now pretty good research on that question, of whether resilience is, in part, genetic. And the answer to that is yes. I'm sure all of us, you know, know people that seem to be born resilient, born optimistic, and have the capability of overcoming challenges in their life. It's about as genetic as the vulnerability to, on the other hand, anxiety disorders. So we would call it as a moderately genetic contribution to resilience. However, it's important to note that your genes are not destiny here. That, as we mentioned before, that you can become a more resilient person by challenging yourself and, you know, working on things that are out of your comfort zone. So that eventually you develop a psychological toolbox that help you overcome tough times.

  • 11:28:00

    REHMBut, Dr. Southwick, I would imagine, as Clare has said, that part of being resilient -- before, during, and after whatever it is, the turning point happens -- is having that group around you, that support network, that that has got to be at play.

  • 11:28:30

    SOUTHWICKI agree, that is huge. In fact, what comes to mind is our interviews with special forces soldiers. And I remember asking one, "Gee, you're engaged in many dangerous missions. That takes real bravery." And this particular gentleman said, "No, it's not me. It's my squad. That's what gives me courage. That's what gives me strength." Actually, as a result of this research, Dennis and I have become much more attuned to the importance of having a strong social network that -- from whom you receive and to whom you give. So giving is as important as receiving. It's a two-way street.

  • 11:29:14

    SOUTHWICKBut the effects of strong social support on physiology -- the way in which your body responds to stress in terms of self-esteem, in terms of the coping mechanisms that you end up using, being more active coping mechanisms, if you know you're covered, someone has your back -- social support is absolutely one of the first areas that I personally look into when trying to help someone, really literally sitting down and drawing a map of their social network to see if we can strengthen that.

  • 11:29:47

    REHMAnd what about your own social network, Dr. Southwick. Have you had that kind of support from colleagues, from personal friends, from family?

  • 11:30:03

    SOUTHWICKI do. And, in fact, I believe, as a result of our interviews, I've worked on strengthening that. Dennis and I, for example, are extremely close friends. My friendships from college and so forth, I've reached out again. And I have a very strong family as well. But I pay attention to this because the research is so strong and convincing.

  • 11:30:30

    REHMAnd, Dr. Charney, how about you?

  • 11:30:35

    CHARNEYYeah, the same thing. And, you know, the closeness of Steve and I has made a difference, you know, in our lives as we go through transitions in our life. And it's also had -- the research has had implications on how we even think about raising our children, such that, we want our children to have the right supports, both within and outside the family. And also, we have come to believe through the work, you know, with these special forces and women who've overcome sexual and physical abuse and so forth, that it's important, as you grow up, to challenge yourself.

  • 11:31:13

    CHARNEYNot to traumatize yourself, but to give yourself experiences that are out of your comfort zone so that you ultimately develop the kinds of capabilities, and as I mentioned before, a psychological toolbox to handle the eventual challenges, loss of loved ones and so forth, that we all face during our life.

  • 11:31:31

    REHMAnd here's an email from Karen, who asks a question that gets right to this issue of neuroplasticity. She says, "Please talk about how childhood trauma affects the neurobiology of the developing brain and how we can help those children build resiliency." Dr. Charney.

  • 11:32:04

    CHARNEYYeah. That's an important question. Our research and others' have found that early childhood trauma is actually the most difficult to overcome, for several reasons. First, frequently, the trauma comes from someone, you thought, who loved you. And so in that context, it's the most difficult to understand and overcome. In addition, from a biological perspective -- and as the question posed, the issue of neuroplasticity -- when you're faced with stress early in life, as your brain is developing and the stress-response systems are developing, it has been shown that early childhood stressors can make the hormones and neurotransmitters that are involved in the stress response disordered or dysfunctional in a way that is more difficult to overcome than if you were stressed later in life.

  • 11:33:05

    CHARNEYAnd so neuroplasticity is a critical feature in how we view your chances of overcoming these stressors. So for that reason, would pay a lot of attention to early childhood stress and to intervene on behalf of the child as early as possible.

  • 11:33:24

    REHMAnd you're listening to "The Diane Rehm Show." I'm going to open the phones. We have some really wonderful callers' questions waiting. Let's go first to Kim in Ann Arbor, Mich. You're on the air.

  • 11:33:44

    KIMGood morning. I am so grateful to hear this kind of discussion. And I remember seeing a brief article about this subject in TIME. One thing that I want to know is, as you continue to do this research, how can other people participate? One of the skills I found out about myself is that I'm a resilient person. And as I hear you guys discuss the topic, many of the things that you found in the research I find alarming, because I almost feel like you know me and you're speaking directly to me in some of the characteristics and things. So how can one get involved in further study on resilience?

  • 11:34:19

    REHMDr. Southwick.

  • 11:34:21

    SOUTHWICKWell, I think one way is there are numerous research groups around the country and the world, in fact, that are studying the stress response and resilience, not just from a neurobiologic standpoint but for psychosocial, spiritual, et cetera. And if you're so inclined, to potentially participate in such studies and also to tell your story, which we found that these stories are extremely inspiring. And also provide role models or these individuals become actually, for us, role models.

  • 11:35:00

    SOUTHWICKSo after having the opportunity to meet and get to know a large number of highly resilient individuals and learning from them how they negotiated adversity and trauma, I now have role models in my head that I literally -- even when I don't necessarily expect it -- one of the individuals that we've come to know pops into my head and that helps me with whatever problem I'm having at that moment. So I think you can contribute in numerous ways, including being a role model for others, your friends.

  • 11:35:34

    REHMThat's really terrific advice, I think. And here's an email from Melissa in Arlington, who says her friend lost her two-an-a-half-year-old son in a drowning accident six years ago. She made a choice to continue living by moving forward. This seemed to be the harder choice. It's easy to stay put in your sorrow. She goes on to say, "I admire my friend for her resilience and we all admire her strength. As a result, her marriage has survived the tragedy. She gave birth to another daughter shortly after the loss of her son. I continue to be in awe of her incredible spirit." Clara Ansberry.

  • 11:36:37

    ANSBERRYYes. I mean, that loss is -- there's no way that you can explain it. And there's no way that anybody else could understand that. And so she has apparently, from what this listener has said, has decided not to focus on that loss but to focus on carrying on her own life and probably celebrating her child's life. You know, she has, you know, she didn't ask for this tragedy in her life. But she probably realizes she needs to continue living and being the best example she could be.

  • 11:37:18

    REHMClare Ansberry, she writes The Wall Street Journal's column titled, "Turning Points." And short break here. More of your comments, your phone calls and email when we come back.

  • 11:40:01

    REHMAs we talk about resiliency in this hour, I must say that I think sometimes resiliency is a bit of a delayed reaction. Dr. Charney, you -- I'm sure you don't know that several years ago, I completely lost my voice to spasmodic dysphonia. I went into a really, really deep depression that lasted for a good four or five months, until finally my husband, my doctor and my friends all got me to the right doctor to treat what we didn't know was happening to my voice.

  • 11:41:02

    REHMWhat I'm trying to point out is that resiliency isn't often immediate, is it?

  • 11:41:11

    CHARNEYDiane, thanks for sharing that. In fact, I did know that story, and I've come to admire you as a resilient person.

  • 11:41:19

    REHMThank you.

  • 11:41:19

    CHARNEYYou're right, sometimes it takes time to dig yourself out of the depths of a depression, to overcome anxiety, overcome a physical challenge. And frequently to do that, you need help, you need to see the right doctor, take the right medicine so that your natural resilience, your natural sense of optimism and sense of never quitting can then take hold, after you've gotten the right help. And I think your story exhibits that.

  • 11:41:59

    REHMThanks so much. And let's go now to Pittsburgh, Pennsylvania, to Debbie. You're on the air.

  • 11:42:07

    DEBBIEHi Diane.

  • 11:42:09

    REHMHi there.

  • 11:42:09

    DEBBIEIt's a pleasure -- hi, it's a pleasure to talk with you.

  • 11:42:13

    REHMThanks.

  • 11:42:13

    DEBBIEAnd the reason I called -- you're welcome -- is that I have thought about you many times when you shared about your husband, who had Parkinson's disease, because my father had Parkinson's disease for 21 years.

  • 11:42:27

    REHMOoh...

  • 11:42:27

    DEBBIEYeah, and like your husband, he has some challenges and some good times, and he even had some similarities with some of the challenges with even end-of-life choices and decisions. And my dad, his name was Irving Potskin (sp?) , and he was actually featured in a book called "Surviving Adversity: Living with Parkinson's Disease." And the reason I wanted to talk to you is because I saw a lot of resilience in the way he handled the disease. And he actually, incredibly, even though he wasn't depressed when he first heard the disease, although he doesn't really know why, I think it just was tied to his optimistic nature.

  • 11:43:12

    DEBBIEAnd one of the things one of your speakers talked about was the importance of helping others, and that was something that he did. He got involved in a local Parkinson's group and led a support group, which made a big difference both for him and for others. And then the last thing I'll mention is that he had a great sense of humor, and I think that also helped with the resilience because he thought it was important to not self-obsess, and he literally would say you just have to smile and snap out of it.

  • 11:43:42

    REHMThat's a great story, Debbie, and Clare Ansberry, when we were off the air, I asked you about the qualities that a resilient person needs to have. You talked about realistic optimism. You talked about sense of purpose. And now Debbie adds a sense of humor.

  • 11:44:11

    ANSBERRYYes. I had a friend who, she was in her 80s, and she had three sons and a husband, and she lost all of them at different points in her life. And I said to her, I said Edna, how do you survive? How do you get through the days? And she said I learned -- I have learned to find something to laugh at every day. And I know that there are times when people are fresh in grief or in their trauma where laughter is just not possible, just getting through the day is enough, and that's okay.

  • 11:44:48

    ANSBERRYBut she was able to -- she accepted what had happened to her, but she wasn't defeated by it, and it was a sense of humor. It was also a sense of wanting to learn something every day. And she also had a very strong faith.

  • 11:45:06

    REHMNow David in North Carolina recalls an initial mention of the fear circuit. What is this? He says it sounds insurmountable if it's what I think it is. How can one learn or practice to turn it off? Dr. Southwick?

  • 11:45:32

    SOUTHWICKWell, I'm not sure you can -- I'm quite certain you can't turn it off because the fear circuitry is really there for survival purposes. It's warning us and allowing us to escape from dangerous situations. One of the problems is when that fear circuitry remains activated for long periods of time, even when we don't need to escape from some sort of danger.

  • 11:45:59

    SOUTHWICKHumans are different than most other animals in that not only do we feel afraid during a stressful situation, but we also have the capacity to ruminate and to anticipate. So oh my gosh, I can't believe that happened to me, what if it happens again? We can keep ourselves stressed 24/7. One of the most important aspects of resilience is learning to turn the stress response back to baseline.

  • 11:46:28

    SOUTHWICKSo the fear circuitry, the fear response is fine, but it's very difficult, or for some people extremely important, to think about and learn about how to recover, how to get your stress response back to baseline.

  • 11:46:44

    REHMWhat about the notion of facing into fear, Dr. Charney?

  • 11:46:53

    CHARNEYYes, facing fear is a critical component of resilience. You know, if you've had a trauma, and we have one story in our book where an individual had a minor plane accident, and he was concerned that he would -- if he didn't get back in the plane shortly thereafter, he'd never fly again. So if you don't face your fears, then you will end up having a restricted life, have less opportunities for enjoyment.

  • 11:47:27

    CHARNEYNow the way you face your fears is important. You want to face a serious fear one step at a time. We heard some very interesting stories from our Special Forces, who have to jump out of airplanes in the middle of the night into enemy territory, but the way you get to that point is one step at a time, and that's a good analogy for all of us, that if we have a fear, face it one step at a time, master one step at a time, and before you know it...

  • 11:48:00

    REHMHow do you mean? I think you need to be particular there, not so much as far as jumping out of a place but facing into some experience, some trauma that you have had. What does facing into it mean? Does it mean remembering it, allowing yourself to remember it by looking at it, examining it, as opposed to running away from it?

  • 11:48:40

    CHARNEYOne example is something like this, that if you've had -- if you've been sexually abused, and it's impacted negatively on your relationships, but you don't want to be impaired in your relationships with men, for example, for the rest of your life. So how do you overcome those fears? Well, first it might be in therapy, where you are role-modeling what relationships might be like as you want to have them move forward.

  • 11:49:11

    CHARNEYThen it might be developing friendships that are meaningful and not stressful. Then the next step might be developing, again, more intimate relationships, where trust is important. So you take one step at a time to ultimately overcome your fears.

  • 11:49:29

    REHMVery interesting. Here's an email from Theo, who says, here's a tough one for the panel. Imagine a situation where you don't have family and no friends, and you are not religious. Then how do you cope? Clare?

  • 11:49:53

    ANSBERRYWell, that would be an awful situation. But I guess I would think that if you don't have friends, you don't have family, and you don't have a faith, you're still able to surround -- you're still able to reach out to others. And, you know, after...

  • 11:50:15

    REHMYou can't wait for them to come to you.

  • 11:50:17

    ANSBERRYRight, right, and you can still help people. You can still do good. You can still -- you know, I don't want to sound trite or anything, but volunteering in any sort of way where the focus is not on your grief, your loss, your setback, your disappointment. You can still do that. That's something that one individual can do on their own.

  • 11:50:44

    REHMLet's go to Chris in Utica, New York. You're on the air. Go right ahead.

  • 11:50:49

    CHRISYes, good morning, Diane. Oh, this is wonderful being on your show, and this topic is so dear and near to me. I am a two-time cancer survival. Within -- and I -- someone mentioned support, and I was so fortunate to have support from a 12-step recovery group. And one of our individuals was a psychologist, and I went into therapy with him. I learned meditation. I learned self-hypnosis, and it was tremendous in getting me through these experiences.

  • 11:51:34

    DEBBIEAnd I am 10 and 12 years cancer-free, and I face fear, fear of fear. Luckily, I have a very pain-free body. If I had a lot of pain, I would be really in a tough situation, but I've learned to cope. And I also wanted to mention how my life has thrived after having cancer. Three years ago, I married a man who went to hundreds of doctors' appointments with me. I have learned to scuba dive. I travel extensively. And I am pursuing an art career.

  • 11:52:12

    REHMOh Chris, that is just wonderful. I'm so glad for you. And it's clear that your spirit is strong, and your body is following suit. I'm so glad you called. And here's a tweet from Bobby , who says, I wouldn't dispute the need for human support, but I also find my 11 cats are a tremendous source of comfort to me. What do you think, Clare?

  • 11:52:53

    ANSBERRYI think wherever you feel comfort and support and joy, that's great.

  • 11:52:59

    REHMAnd there's no question that these animals can give us exactly that.

  • 11:53:02

    ANSBERRYOh absolutely.

  • 11:53:05

    REHMAnd you're listening to the Diane Rehm Show. And let's go to Alyssa in Jacksonville, Florida. You're on the air.

  • 11:53:18

    ALYSSAHi Diane, thank you so much for taking my call.

  • 11:53:22

    REHMSure.

  • 11:53:22

    ALYSSASince I was in high school, I've been battling depression on and off, and one person that always helps me with that was my mother. She always kept me grounded. A few years ago, about three and a half years, she became the victim of domestic violence. She was very critically injured. She, as a matter of fact, is in a nursing home now. She's 56. She will be in the care of a home for the rest of her life.

  • 11:53:49

    REHMOh my goodness.

  • 11:53:52

    ALYSSASo when that happened, I was 24. So I knew that going through this traumatic experience would kind of propel me into a depressive episode, and it did for quite a while, for about two years. And then my sister and I just started talking about it, just started talking about domestic violence and really advocating for the prevention and, you know, telling women about the warning signs. And I'm really just talking about our experience and our mother's experience, and that has really, really helped to kind of bounce back from that.

  • 11:54:32

    DEBBIEYou know, and seeing my mom every day really helps. You know, she's unable to speak or anything, but she still laughs, she still smiles. She still -- she is a very, very resilient woman. So I have her to thank for that, but...

  • 11:54:43

    REHMAnd she is a very lucky woman, Alyssa, to have you as a daughter. Thank you for sharing that story. Dr. Southwick, a comment from you, please.

  • 11:55:00

    SOUTHWICKYes, I'm very sorry to hear what happened to your mother. Your response is what many of us would call a survivor mission, and this is a very positive response, I know it has taken a while, I know the depression is there and has been there, but this survivor mission response is a way to take the pain that you felt and feel and turn it into a social mission, as Clare was saying, a way to help other people because you understand, and you can convey this understanding and use this very unfortunate circumstance to help others.

  • 11:55:47

    REHMAnd Dr. Southwick, someone did mention sort of meditation and mindfulness, which is something you've written about, to help the brain's muscles to build resilience.

  • 11:56:09

    SOUTHWICKYes, one of the things that -- and mindfulness, these traditions have been around for centuries and centuries. Most major religious traditions and meditative traditions, there are some similarities with these approaches. But with mindfulness, one of the major things that you are doing while practicing is you are practicing to attend to one stimulus, so for example a mantra or your breath. And you're training the attention circuits in your brain partially so that during the rest of your life, you can focus more on the present moment because most of us, our minds are wandering all over the place. People call it monkey mind. It kind of drives you crazy. It feels as if your mind is running you, or your brain is running you, and you're not running your brain. And mindfulness is a practice, and it takes a lot of practice, learning to attend to the present moment.

  • 11:57:12

    REHMAnd it does recall, for me, the work of Dr. Herbert Benson at Harvard. And I'm so sorry we have to leave it at that. What a wonderful program, and I thank all of you for your contributions, Clare Ansberry, Dr. Dennis Charney and Dr. Steven Southwick. Thanks for listening. I'm Diane Rehm.

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