14.5 Preventing Psychological Disorders and Building Resilience

LOQ 14-16 What may help prevent psychological disorders, and why is it important to develop resilience?

Psychotherapies and biomedical therapies tend to locate the cause of psychological disorders within the person. We assume that people who act cruelly must be cruel and that people who act “crazy” must be “sick.” We label people to separate them from “normal” folks. We try to treat “abnormal” people by giving them insight into their problems, by changing their thinking, by helping them gain control with drugs.

But there is another viewpoint. We could interpret many psychological disorders as understandable responses to a disturbing and stressful society. According to this view, it is not just the person who needs treatment, but also the person’s social context. Better to prevent mental health problems by reforming a sick situation, and by developing people’s coping skills, than to wait for and treat mental health problems.

Preventive Mental Health

A story about the rescue of a drowning person 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.”

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Preventive mental health care 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 use disorder, and suicide.

To prevent psychological casualties, said psychologist George Albee, caring people should 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 mosquitoes.

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. It means boosting parents’ and teachers’ skills at nurturing children’s competence and belief in their abilities. In short, “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 environment, 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.

Building Resilience

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resilience the personal strength that helps most people cope with stress and recover from adversity and even trauma.

We have seen that lifestyle change can lessen psychological disorders. Might such change also prevent some disorders by building individuals’ resiliencethe ability to cope with stress and recover from adversity?

Faced with unforeseen trauma, most adults exhibit resilience. This was true of New Yorkers in the aftermath of the September 11 terror attacks, especially among 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). Even most combat-stressed veterans, most political rebels who have survived torture, and most people with spinal cord injuries do not later exhibit posttraumatic stress disorder (Bonanno et al., 2012; Mineka & Zinbarg, 1996).

posttraumatic growth positive psychological changes as a result of struggling with extremely challenging circumstances and life crises.

Struggling with challenging crises can even 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). Out of even our worst experiences, some good can come, especially when we can imagine new possibilities (Roepke, 2015; Roepke & Seligman, 2015). Through preventive efforts, such as community building and personal growth, fewer of us will fall into the rushing river of psychological disorders.

Retrieve + Remember

Question 14.16

What is the difference between preventive mental health and psychological or biomedical therapy?

ANSWER: Psychological and biomedical therapies attempt to relieve people’s suffering from psychological disorders. Preventive mental health attempts to prevent suffering by identifying and eliminating the conditions that cause disorders.

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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 also hope you enjoyed the ride. We did. With every good wish in your future endeavors,

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David Myers

DavidMyers.org

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Nathan DeWall

NathanDeWall.com