Preventing Psychological Disorders

14-16 What may help prevent psychological disorders?

We have seen that lifestyle change can help reverse some of the symptoms of psychological disorders. Might such change also prevent some disorders by building individuals’ resilience—an ability to cope with stress and recover from adversity? When trauma blindsides us, most adults exhibit resilience. This was true of New Yorkers in the aftermath of the September 11 terror attacks, especially those who enjoyed supportive close relationships and who had not recently experienced other stressful events (Bonanno et al., 2007). More than 9 in 10 New Yorkers, although stunned and grief-stricken by 9/11, did not have a dysfunctional stress reaction. Among those who did have such reactions, the stress symptoms had mostly gone away by the following January (Person et al., 2006).

Similar resilience has been observed among other groups. One study that followed 233 people for up to 2 years following a spinal cord injury reported that most experienced few psychological problems (Bonanno et al., 2012, p. 243). Even combat-stressed veterans and political rebels who have survived dozens of torture episodes usually do not later exhibit posttraumatic stress disorder (Mineka & Zinbarg, 1996).

This resilience also appeared among Holocaust survivors, most of whom went on to live productive lives. “It is not always true that ‘What doesn’t kill you makes you stronger,’ but it is often true,” psychologist Peter Suedfeld (1998, 2000) reported. “What doesn’t kill you may reveal to you just how strong you really are.” Suedfeld speaks from experience. As a boy, he survived the Holocaust, though his mother did not. Fellow survivor Ervin Staub has described “altruism born of suffering” (Staub & Vollhardt, 2008). Although nothing justifies terror and victimization, those who have suffered, he reports, often develop a greater-than-usual sensitivity to suffering. They have greater empathy for others who suffer, an increased sense of responsibility, and an enlarged capacity for caring. Staub is a living example of his own work. He was spared from being sent to the Auschwitz death camps, thanks to a heroic intervention. Since that time, his lifelong mission has been to understand why some people perpetrate evil, some stand by, and some help out.

Struggling with challenging crises can lead to posttraumatic growth. Many cancer survivors have reported a greater appreciation for life, more meaningful relationships, increased personal strength, changed priorities, and a richer spiritual life (Tedeschi & Calhoun, 2004). Americans who tried to make sense of the 9/11 terrorist attacks experienced less distress (Park et al., 2012). Out of even our worst experiences some good can come.

How might we foster such growth and human flourishing? One option might be to adopt a preventive view of human disorders.

A story about the rescue of drowning persons from a rushing river illustrates prevention. Having successfully given first aid to the first victim, the rescuer spots another struggling person and pulls her out, too. After a half-dozen repetitions, the rescuer suddenly turns and starts running away while the river sweeps yet another person into view. “Aren’t you going to rescue that fellow?” asks a bystander. “Heck no,” the rescuer replies. “I’m going upstream to find out what’s pushing all these people in.”

Preventive mental health is upstream work. It aims to prevent psychological casualties by identifying and wiping out the conditions that cause them. Poverty, meaningless work, constant criticism, unemployment, racism, and sexism can undermine people’s sense of competence, personal control, and self-esteem (Albee, 1986, 2006). Such stresses increase the risk of depression, alcohol abuse, and suicide.

To prevent psychological casualties, said George Albee, caring people should therefore support programs that control or eliminate these stressful situations. We eliminated smallpox not by treating the afflicted but by vaccinating the healthy. We conquered yellow fever by controlling mosquitoes. Better to drain the swamps than just swat the mosquitos.

Preventing psychological problems means empowering those who have learned an attitude of helplessness and changing environments that breed loneliness. It means renewing fragile family ties and boosting parents’ and teachers’ skills at nurturing children’s achievements and resulting self-concept. Indeed, “everything aimed at improving the human condition, at making life more fulfilling and meaningful, may be considered part of primary prevention of mental or emotional disturbance” (Kessler & Albee, 1975, p. 557). Prevention can sometimes provide a double payoff. People with a strong sense of life’s meaning are more engaging socially (Stillman et al., 2011). If we can strengthen people’s sense of meaning in life, we may also lessen their loneliness as they grow into more engaging companions.

Among the upstream prevention workers are community psychologists. Mindful of how people interact with their environments, they focus on creating environments that support psychological health. Through their research and social action, community psychologists aim to empower people and to enhance their competence, health, and well-being.

That brings us to the end of this book. Your introduction to psychological science is complete. Navigating through the waters of psychological science has taught us—and you, too?—about our moods and memories, about the inner nooks and crannies of our unconscious, about how our biology and culture in turn shape us. Our hope, as your guides on this tour, is that you have shared some of our fascination, grown in your understanding and compassion, and sharpened your critical thinking. We hope you enjoyed the ride. We did.

With every good wish in your future endeavors,

David G. Myers www.davidmyers.org

Nathan DeWall www.NathanDeWall.com