Healthcare Access and Quality

Healthcare resilience refers to the capacity of a healthcare system to anticipate, prepare for, respond to, and recover from adverse events, disruptions, or crises while maintaining its core functions and providing essential healthcare services. Resilience in healthcare is crucial to ensure that the system can effectively adapt and withstand challenges, ranging from natural disasters and public health emergencies to organizational or operational disruptions. This module will examine some factors affecting our global healthcare systems and what can be done to develop and maintain their resilience for the future. Social Determinates of Health The term "social determinants of health" refers to how people are born, grow, live, work, and age and how these conditions impact their health, well-being, and quality of life. These determinants are shaped by various social, economic, political, and environmental factors. Understanding and addressing social determinants of health is crucial for developing effective public health strategies and policies. Economic Stability Socioeconomic status, income, employment, and resource access can significantly impact health outcomes. Education Level of education and access to quality education are essential factors influencing health. Higher educational attainment is often associated with better health outcomes. Social and Community Context The social environment, including community support, social networks, and community safety, plays a role in health. Strong social connections and a supportive community contribute to better health. Healthcare Access and Quality Access to and quality of healthcare services are critical determinants. Barriers to healthcare, such as lack of insurance or transportation, can negatively affect health. Neighborhood and Physical Environment The physical environment, including housing, air and water quality, park access, and neighbourhood safety, can impact health. Living in environments with limited resources or exposure to environmental hazards can lead to health disparities. Biology and Genetics While biological factors and genetics contribute to health, social determinants significantly influence how these factors impact individuals and populations. Heath Equity Health equity refers to the absence of unfair and avoidable differences in health outcomes or access to health services among different groups of people. It is a concept rooted in social justice and human rights, emphasizing the ethical principle that everyone should have the opportunity to attain their highest level of health. Key elements of health equity are highlighted below. Equal Opportunities for Health – Health equity implies that all individuals have an equal opportunity to achieve their highest level of health, regardless of socioeconomic status, race, ethnicity, gender, age, sexual orientation, or other social determinants of health. Elimination of Health Disparities – Health equity seeks to eliminate health disparities or inequalities in health outcomes and access to healthcare services. It recognizes that certain groups may face systemic and avoidable disadvantages that result in differences in health status. Addressing Social Determinants of Health – Social determinants of health, such as income, education, housing, and employment, significantly impact health outcomes. Achieving health equity involves addressing these social determinants to create conditions that enable everyone to live a healthy life. Fair Distribution of Resources – Health equity requires a fair distribution of resources, including healthcare services, preventive measures, and public health interventions. It calls for policies and practices that prioritize those who are disadvantaged or marginalized. Cultural Competence – Cultural competence is essential for health equity, recognizing and respecting diverse cultural backgrounds, beliefs, and practices. Health systems and healthcare providers should tailor their services to meet the unique needs of different communities. Inclusive and Participatory Approaches – Health equity emphasizes inclusive and participatory approaches to decision-making. It involves engaging communities and individuals in designing, implementing, and evaluating health policies and programs. Intersectionality – The concept of intersectionality recognizes that individuals may experience multiple social identities simultaneously, leading to unique experiences of discrimination and privilege. Health equity takes into account these intersecting factors when addressing health disparities. Equitable Access to Healthcare – Health equity requires that individuals have equitable access to healthcare services based on their health needs rather than factors such as income or social status. This involves removing barriers to healthcare access and ensuring that services are available, affordable, and culturally competent. Global Health Inequities Health inequities, healthcare access disparities, and differing healthcare infrastructure levels among countries significantly impact our global healthcare system. Resilience requires addressing these inequities to ensure that all populations, regardless of socioeconomic status or geographical location, have access to essential healthcare services, preventive measures, and medical interventions. A global healthcare crisis like the COVID-19 pandemic highlighted the unequal distribution of resources, including vaccines, medical supplies, and healthcare infrastructure. Let's examine the resilience of healthcare systems through the lens of the COVID-19 Pandemic. Pandemics A pandemic is an epidemic of an infectious disease that has spread across a large region, for instance, multiple continents or worldwide, affecting a substantial number of individuals. On March 11th, 2022, the World Health Organization officially declared “that COVID-19 can be characterized as a pandemic,” and this is the day that the word 'pandemic' saw the single most significant spike in dictionary traffic in 2020, showing an increase of 115,806% over lookups on that day. Let's look more into pandemics and their characteristics. Frequently Asked Questions About Pandemics What is the difference between a pandemic and an epidemic? An epidemic is an outbreak of disease that spreads quickly and affects many individuals simultaneously. A pandemic has spread across a more comprehensive geographic range than an epidemic, involving a significant portion of the population. When does an outbreak become a pandemic? An outbreak is “a sudden rise in the incidence of a disease” and typically is confined to a localized area or a specific group of people. Should an outbreak become more severe and less localized, it may be characterized as an epidemic. If it broadens further and affects a significant portion of the population, the disease may be described as a pandemic. What are some examples of pandemics? Several pandemics have occurred since the beginning of the 20th century: the H1N1 pandemic of 2009, the Spanish flu of 1918/19, flu pandemics in 1957 and 1968, and the COVID-19 pandemic. Among the best-known pandemics is the Black Death, a plague that spread across Asia and Europe in the middle of the 14th century. How do Pandemics Spread? In our increasingly globalized world, an infected person can board a plane and spread a virus across continents. Then, the number of infected grows exponentially, not linearly. Various factors influence the spread of a virus. Here are four factors: the size of the population of opportunity; the number of days contagious; the number of people with whom an infected person comes in contact; and, the probability of contracting the virus from contact with an infected person. Coronavirus Disease The COVID-19 pandemic revealed both strengths and weaknesses in global healthcare resilience. While many healthcare systems demonstrated remarkable adaptability and responsiveness, several challenges were exposed. First, we will examine the Coronavirus Disease, specifically COVID-19, and then take a closer look at how it affected our healthcare system in Canada and globally. Coronavirus Disease Coronaviruses are a group of related RNA viruses that cause diseases in mammals and birds. In humans and birds, they cause respiratory tract infections that can range from mild to lethal. COVID-19 is caused by SARS-CoV-2, the coronavirus that emerged in December 2019 in Wuhan, China. COVID-19 can be severe and has caused millions of deaths around the world as well as lasting health problems in some who have survived the illness. The Effects of the COVID-19 Pandemic The COVID-19 pandemic exposed several challenges in the global healthcare system, revealing vulnerabilities and areas that require improvement. Some of the key challenges are outlined below. Addressing these challenges requires a collective and collaborative effort at local, national, and international levels. The lessons learned from the COVID-19 pandemic can guide future efforts to strengthen global healthcare systems, improve preparedness, and enhance resilience against emerging health threats. Global Health Inequities: – The pandemic highlighted disparities in healthcare access, resources, and outcomes between regions and socioeconomic groups. Low-income countries faced challenges in obtaining sufficient medical supplies, testing resources, and vaccines, exacerbating health inequities on a global scale. Healthcare Infrastructure Strain – Many healthcare systems faced unprecedented strain due to the surge in COVID-19 cases. Hospitals experienced shortages of intensive care unit (ICU) beds, ventilators, and other essential resources. The strain on healthcare infrastructure highlighted the need for increased capacity planning and resource allocation strategies. Health Workforce Burnout – The healthcare workforce experienced unprecedented levels of stress and burnout during the pandemic. Long hours, increased patient loads, and the emotional toll of dealing with a high volume of severe cases took a toll on healthcare professionals, emphasizing the need for support mechanisms and workforce resilience. Mental Health Impact – The pandemic had profound effects on mental health, with increased levels of stress, anxiety, and depression observed globally. The healthcare system faced challenges in providing adequate mental health support and resources to address the psychological impact of the pandemic. The COVID-19 Vaccine The development of the COVID-19 vaccine was an unprecedented global effort that involved collaboration between scientists, researchers, pharmaceutical companies, and governments. The distribution plan ensured global access, focusing on reaching high-risk populations first, such as healthcare workers, elderly populations, and those with underlying health conditions. Vaccine Inequities The uneven distribution of COVID-19 vaccines highlighted disparities between wealthier and lower-income nations. Some countries faced challenges in securing a sufficient supply of vaccines, leading to slower vaccination rates and increased vulnerability to the virus. A study on the vaccination data set of 178 countries until 31 March 2021 found that 80% of the world's population in developing countries had only about 5% of the world's COVID-19 vaccines, while the remaining 20% of the world's population in developed countries had about 95% of the world's COVID-19 vaccines. Heath Systems Resilience Health system resilience is the ability of health systems to prepare for shocks and minimize the negative consequences of such disruptions, recover as quickly as possible, and adapt by learning lessons from the experience to become better performing and more prepared. Critical components of healthcare resilience are outlined below: Preparedness – This involves activities and measures taken in advance to enhance a healthcare system's ability to respond effectively to various challenges. This may include planning, training, resource allocation, and developing robust communication strategies. Response – Healthcare resilience involves responding promptly and effectively when a crisis or disruption occurs. This includes mobilizing resources, implementing emergency protocols, and coordinating efforts across different sectors of the healthcare system. Adaptability – Resilient healthcare systems can adapt to changing circumstances and evolving challenges. This may involve flexible resource allocation, the ability to modify operational procedures quickly, and adoption of new technologies or practices to address emerging needs. Recovery – A resilient healthcare system can recover efficiently after a crisis or disruption. This includes restoring normal operations, addressing any lingering effects of the event, and implementing lessons learned to improve future preparedness. Coordination and Collaboration – Effective coordination and collaboration among healthcare entities, government agencies, nongovernmental organizations, and other stakeholders often enhance resilience. Collaboration enables a more comprehensive and cohesive response to challenges. Community Engagement – Engaging the community and incorporating its perspectives and needs into healthcare planning and response efforts is vital to resilience. Inclusive strategies that involve the community can contribute to more effective and culturally sensitive healthcare interventions. Healthcare Infrastructure Healthcare infrastructure refers to the foundational framework of physical, organizational, and technological components that enable healthcare services to be delivered. It includes various elements that contribute to the overall functioning of healthcare systems and the provision of medical care to individuals and communities. Below are some of the key components of healthcare infrastructure. Physical Facilities – The physical infrastructure includes hospitals, clinics, medical offices, laboratories, and other healthcare facilities. These spaces are essential for diagnosing, treating, and preventing illnesses. Human Resources – Healthcare infrastructure involves the presence of a skilled and diverse workforce, including doctors, nurses, technicians, administrative staff, and other healthcare professionals. A welltrained and sufficient workforce is critical for delivering quality care. Medical Equipment and Technology – The infrastructure includes the availability and maintenance of medical equipment, diagnostic tools, and technology required for medical procedures, surgeries, and patient care. This can range from simple instruments to advanced medical devices. Information Systems – Healthcare infrastructure uses information technology to manage patient records, facilitate communication among healthcare providers, support decision-making processes, and enhance efficiency. Pharmaceuticals and Medical Supplies – Adequate infrastructure includes the availability and proper management of pharmaceuticals, vaccines, and medical supplies required for treatment, prevention, and emergency response. Emergency Response Systems – An adequate healthcare infrastructure should have mechanisms to respond to public health emergencies, natural disasters, and other crises. This includes protocols for coordination, communication, and resource mobilization. Education and Training Programs – Healthcare infrastructure includes educational institutions and training programs that prepare and continuously update healthcare professionals with the necessary knowledge and skills. Regulatory Framework – A well-functioning healthcare infrastructure is supported by a robust regulatory framework that ensures compliance with standards, guidelines, and ethical considerations. Regulations help maintain quality, safety, and accountability within the healthcare system. Health Financing and Funding Mechanisms – Adequate funding is crucial for sustaining healthcare infrastructure. This involves financial mechanisms, insurance systems, and government funding to support the operation, maintenance, and expansion of healthcare facilities and services. Community Engagement and Public Health Programs – An adequate healthcare infrastructure considers the involvement of communities in healthcare decision-making and implementation. Public health programs for disease prevention, health promotion, and community well-being contribute to the infrastructure. The quality and accessibility of healthcare services in a region or country depend significantly on the strength and resilience of its healthcare infrastructure. Addressing infrastructure challenges to improve health outcomes, responding to emerging threats, and ensuring healthcare equity is essential. Healthcare Infrastructure Challenges Insufficient Access to Healthcare Services Inadequate healthcare facilities in specific regions or rural areas. Limited availability of healthcare professionals, including doctors, nurses, and specialists. Outdated Technology and Information Systems Lack of interoperability between healthcare systems. The use of outdated technology leads to inefficiencies and difficulty in data sharing. Inadequate Funding Limited financial resources for infrastructure development and maintenance. Budget constraints affect the availability of necessary medical equipment and facilities. Poorly Maintained Facilities Aging infrastructure and poorly maintained healthcare facilities. Lack of regular upgrades and maintenance leads to equipment failures and inefficiencies. Inadequate Emergency Response Systems Limited capacity for handling public health emergencies. Need for coordination and communication between healthcare providers during crises. Shortage of Skilled Healthcare Workforce Inadequate training programs and educational resources for healthcare professionals. High turnover rates and burnout among healthcare workers. Inefficient Supply Chain Management Challenges in procuring and distributing pharmaceuticals and medical supplies. Inconsistent supply chain processes lead to shortages or excess inventory. Inequities in Healthcare Access Disparities in healthcare access based on socio-economic factors, ethnicity, or geographic location. Unequal distribution of healthcare resources and services. Inadequate Data Security and Privacy Measures Concerns about the security and privacy of patient data. Risks of data breaches and unauthorized access to sensitive health information. Lack of Telemedicine Infrastructure Limited availability of telemedicine services in certain areas. There is a need for adequate internet connectivity and technology infrastructure for remote healthcare delivery. Regulatory and Compliance Challenges Complex and often changing healthcare regulations. Challenges in ensuring compliance with standards and guidelines. Environmental Sustainability Lack of environmentally friendly practices in healthcare facilities. High energy consumption and waste generation contribute to environmental issues. Hospital Infrastructure and Surge Capacity During the COVID-19 pandemic, many countries faced challenges ranging from constraints on our health system to difficulties in delivering and accessing health services and hospital bed capacities. Resilient healthcare infrastructure includes the ability to expand capacity rapidly, such as converting non-medical facilities into makeshift hospitals or creating temporary field hospitals. For instance, the construction of temporary hospitals in Wuhan, China, at the onset of the pandemic showcased the adaptability of healthcare infrastructure. Healthcare Systems Continually Adapt Healthcare systems continually adapted their response to COVID-19 during the first 16 months of the pandemic (March 2020 to June 2021) to find the balance between caring for COVID-19 patients and caring for patients with other health issues. Strategies included the following: Hospitals prioritized life-saving and more urgent treatments Hospitals retrained and shifted human resources to support areas of greatest need, such as Intensive Care Units Non-life-saving surgeries and medical procedures were cancelled or delayed Emergency Departments triaged people virtually, redirected people who could be treated elsewhere, and offered virtual visits to reduce crowding in waiting rooms. Virtual Patient Care or 'telehealth' has become a vital tool for primary care physicians and specialists and may be one of the enduring transformations of the pandemic Canadians Experienced the Effects of the COVID-19 Pandemic Differently. The pandemic highlights pre-existing inequities as Canadians experience the pandemic’s effects differently. Those who live in lower-income neighbourhoods were admitted in more significant proportions for harm caused by substance use, and young women were hospitalized more for self-harm than any other demographic. Older people, like those residing in long-term care homes, were more likely to have severe outcomes from COVID-19. Long-term care residents were disproportionately affected during the first two waves of the pandemic, with more deaths due to COVID-19 than other Canadians and more deaths from other causes compared with pre-pandemic rates. The Resilience of the Healthcare System The COVID-19 crisis has claimed millions of lives, and many more are suffering ill health as a direct or indirect consequence of the virus. It has placed immense pressure on health care services, ones often already overstretched before the pandemic, and brought health inequities into the forefront. During a health crisis such as the COVID-19 pandemic, high-quality and resilient health systems have two tasks: respond to the situation and maintain the provision of other essential health services. But what steps can be taken to make our healthcare systems more robust and resilient to prepare them for the next crisis better? And how will we address health inequity and ensure everyone has reliable, high-quality healthcare in the future? Let's look at some organizations that are striving to do just that. Addressing Healthcare Infrastructure Numerous organizations and groups are working towards addressing global healthcare infrastructure challenges. These organizations, among others, play crucial roles in addressing the complex challenges faced by global healthcare infrastructure. They often collaborate with governments, local communities, and other stakeholders to create sustainable and impactful solutions. World Health Organization (WHO) As a specialized agency of the United Nations, WHO is dedicated to international public health, it provides leadership on global health matters, shapes the health research agenda, sets norms and standards, provides technical support to countries, and monitors health trends. Doctors Without Borders Médecins Sans Frontières, also known as Doctors Without Borders, was founded in 1971 by a small group of French doctors and journalists who sought to expand accessibility to medical care across national boundaries irrespective of race, religion, creed or political affiliation. This international humanitarian medical organization provides medical care to those facing health crises, including areas affected by conflict, natural disasters, and epidemics. It also works to improve healthcare infrastructure in some of the world's most challenging environments. Canadian Red Cross The Canadian Red Cross is involved in international humanitarian assistance, including healthcare initiatives. In collaboration with local partners, it works to strengthen healthcare systems, respond to emergencies, and build community resilience. Healthcare Workers A healthcare professional or worker provides treatment and advice based on formal training and experience in a healthcare or social care setting. This group includes healthcare students on clinical placement, frontline healthcare workers, and other healthcare workers not in direct patient care. Health systems can only function with health workers; however, the World Health Organization (WHO) projects a global shortfall of 18 million health workers by 2030, mostly in low- and lowermiddle-income countries. The chronic under-investment in education and training of health workers in some countries and the mismatch between education and employment strategies about health systems and population needs contribute to continuous shortages. These are compounded by difficulties in deploying health workers to rural, remote, and underserved areas. Moreover, the increasing international migration of health workers may exacerbate shortfalls in low- and lower-middle-income countries. Mental Health of Healthcare Workers Healthcare workers worldwide have risen to the demands of treating COVID-19 patients, potentially at a significant cost to their health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline workers and calls to provide psychosocial support for them. High-stress roles coupled with the unique demands of the COVID-19 crisis have undoubtedly placed frontline healthcare workers at additional risk for mental health problems, with early reports from around the world indicating elevated rates of depression, anxiety, post-traumatic stress disorder (PTSD), and suicidality. Healthcare Worker Concerns during COVID-19 Concern for Self- The predominant concern across most staff groups and all pandemics was becoming infected with the virus. Concern for Others- Workers were preoccupied about their families becoming ill and were particularly concerned that they might transmit the illness to their loved ones. Environmental Concerns- Workers feared not having enough PPE to be protected and reported that wearing PPE caused discomfort and impacted their communication with patients, their families, themselves, and other healthcare team members. Contributing Factors Healthcare workers faced, and continue to face, a significant number of challenges as they work to help their patients suffering from COVID-19. These challenges are a result of several contributing factors unique to the COVID-19 Pandemic, including: High Workload- Healthcare workers reported working up to 16-18 hour shifts with no breaks Lack of PPE- Healthcare workers repeatedly pointed out that PPE supplied by their hospitals was either inadequate or of low quality. Low Social Acceptance- Healthcare workers often reported that community members perceived them as a nuisance and usually avoided communication for fear of infection. Mental Health- Healthcare workers had to cope with different psychological challenges, including anxiety, depression, insomnia, and fear of sudden death during the COVID-19 pandemic. Lack of Incentives- Healthcare workers reported no extra incentive for them despite working extra hours. Lack of Coordination and Direction- Healthcare workers reported hospital policies and government guidelines were changing continuously given that COVID is new and previous knowledge regarding the infection's transmission is limited. Burnout Burnout is a significant problem in healthcare, threatening healthcare workers' well-being and the quality of care they provide to their patients. Burnout is characterized by emotional exhaustion, depersonalization, and diminished professional achievement. Burnout rates among healthcare workers can be influenced by various factors, such as workload, job demands, workplace conditions, and external stressors, which can vary across different regions and healthcare settings. Prior to the COVID-19 pandemic, severe burnout was typically found in 20%-40% of healthcare workers. By spring 2021, rates >60% were found in Canadian physicians, nurses, and other healthcare professionals. In Spring 2022, burnout has been reported in more than 80% of healthcare workers. Signs of Burnout in Healthcare Workers Feelings of alienation from work-related activities, including viewing their job as increasingly stressful and frustrating, feeling cynical about their work, or emotionally distancing themselves from their work Physical symptoms such as headaches, stomach aches, or intestinal issues Emotional exhaustion, including feeling drained, unable to cope, or unmotivated to get work done Underperformance, including difficulty performing everyday tasks at work or home, inability to concentrate, or lack of creativity. Post Traumatic Stress Disorder (PTSD) Post Traumatic Stress Disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a severe accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or severe injury. Less well-known is the incidence of PTSD among healthcare workers, especially those on the frontlines of a pandemic such as COVID-19. Health professionals are somewhat prepared to deal with the psychological trauma of witnessing illness and death at close quarters. However, the increasingly overwhelming conditions of a pandemic can leave many health providers unprepared for the mental health fallback. The need to make agonizing life-and-death decisions in a demanding and unpredictable environment, coupled with the fear of contracting the disease, can put healthcare workers at risk of developing PTSD. Consequences of PTSD PTSD symptoms can make it very challenging for frontline healthcare workers to do their job. Some of the consequences of PTSD in health professionals include: Depression and anxiety Emotional numbing and avoidance Sleep disturbance (insomnia) Excessive alcohol use Suicidal ideation Chronic pain and opioid dependence Healthcare Worker Resilience Healthcare worker resilience refers to the ability of individuals within the healthcare profession to cope with and bounce back from the various stressors, challenges, and demands inherent in their roles effectively. Resilience in healthcare is crucial for maintaining well-being, preventing burnout, and ensuring the delivery of high-quality patient care. Several factors contribute to healthcare worker resilience. Adaptability – Resilient healthcare workers can adapt to changes and uncertainties from evolving medical practices, organizational shifts, or external crises. Emotional Intelligence – Understanding and managing one's emotions and empathizing with patients and colleagues enhance healthcare worker resilience, facilitating effective communication and teamwork. Social Support – Strong professional and personal networks provide a crucial foundation for healthcare workers to share experiences, seek advice, and receive emotional support, fostering resilience. Self-Care Practices – Prioritizing self-care, including physical and mental well-being activities, helps healthcare workers recharge and manage stress, contributing to overall resilience. Training and Education – Ongoing professional development and training programs empower healthcare workers with the skills and knowledge to navigate challenges, enhancing their resilience. Workplace Culture – A supportive and inclusive workplace culture that recognizes and addresses the unique stressors of healthcare professions can positively impact the resilience of its workforce. Coping Strategies – Developing healthy coping mechanisms, such as mindfulness, problem-solving, and positive reframing, equips healthcare workers to handle stressors more effectively. Clear Communication – Open and transparent communication within healthcare teams helps build trust and collaboration, fostering an environment where resilience can thrive. Key Takeaways • Healthcare resilience and health equity are integral to a robust healthcare system. The system's strength relies on anticipating, preparing for, and responding to challenges for continuity during crises. Addressing social determinants of health enhances resilience, allowing policymakers to create effective public health strategies. Health equity, emphasizing fairness in outcomes and access, aligns with the goal of resilient healthcare systems. Resilient infrastructure ensures essential services and mitigates health inequalities, reinforcing the ethical principle of equal health opportunities. The synergy between healthcare resilience and health equity is critical for an adaptable, just, and inclusive healthcare system. • Healthcare infrastructure, encompassing physical, organizational, and technological elements, is crucial for delivering healthcare services. The quality and accessibility of healthcare rely on its resilience. Addressing challenges within healthcare infrastructure is imperative for improving health outcomes, responding to threats, and promoting equity. Organizations tackling global healthcare infrastructure challenges play pivotal roles by creating sustainable solutions through collaborations. Enhancing global healthcare infrastructure contributes to immediate medical care provision and the broader goal of fostering equitable and resilient healthcare systems worldwide. • Global health systems face a critical challenge as the World Health Organization projects a shortage of 18 million health workers by 2030, particularly in low- and lower-middle-income countries due to chronic under-investment in education and training. Deployment challenges, exacerbated by international migration, further strain healthcare resources. The COVID-19 pandemic has underscored the immense dedication of healthcare workers worldwide but has also heightened mental health risks. Frontline workers are at increased risk of depression, anxiety, PTSD, and burnout, with nearly 1 in 5 quitting their jobs during the pandemic. Recognizing the importance of healthcare worker resilience, institutions are urged to implement wellness programs and mental health resources to create a positive and supportive work environment, which is crucial for sustaining a robust healthcare workforce in the face of ongoing and future challenges. And once the storm is over, you won’t remember how you made it through, how you managed to survive. You won’t even be sure whether the storm is really over. But one thing is certain. When you come out of the storm, you won’t be the same person who walked in. - Haruki Murakami In the preceding nine modules of this course, we have examined many facets of resilience, including the history and science of resilience, resilience in nature, organizational resilience, cultural resilience, resilience with mental and physical illness, resilience in vulnerable populations, threats to resilience, and resilience in the face of a pandemic. Now, in the last Module, we will examine what personal resilience is (and what it is not) and then look inward to assess our level of resilience and explore some strategies to help us build our resilience through shifting our mindset, practicing resilience strategies, and implementing some healthy habits. Finally, we will challenge ourselves to create a resilience-building plan of action. What is Personal Resilience? Personal resilience, sometimes called individual resilience, involves behaviours, thoughts, and actions that enable us to recover and reshape following unique challenges or difficulties. We can adapt and flex when faced with adversity. We can cope with difficult periods or stressful events and manage new and different situations or changes. Life's adversity can be as simple as a disagreement with a friend, family member, or co-worker or as complex as living through a traumatic event or natural disaster. Our ability to cope can range from barely surviving to thriving in a time of change (i.e., enjoying a new experience or challenge by being stretched and learning from it). Personal resilience is about adapting to stressful situations and times of change (positive or negative, big or small). Let's look at what we know about personal resilience so far... Why is Personal Resilience Important? Resilience gives people the emotional strength to cope with trauma, adversity, and hardship. People who lack resilience are more likely to feel overwhelmed or helpless and rely on unhealthy coping strategies (such as avoidance, isolation, and self-medicating). Resilient people also experience stress, setbacks, failures, and complicated emotions, but they tap into their strengths and seek help from support systems to overcome challenges and work through problems. Resilience empowers them to accept and adapt to a situation and move forward. We are resourceful, adaptable, and energized when personal resilience is high. Our learning ability is better, and we are more likely to thrive, even when difficult. How we view adversity and stress strongly affects how we succeed, and this is one of the most significant reasons that having a resilient mindset is so important. Low Resilience Characteristics Knowing the typical characteristics of low resilience and what behaviours you may exhibit when your resilience is slipping is helpful. You will know when to engage in resilience-enhancing activities or assist others in addressing their resilience. Not everyone exhibits the same characteristics, which range from mild to severe and can last for varying durations. Let's look at the most common feelings of those with low resilience. People who have low resilience may feel: Depressed Victimized Demoralized Hopeless Disconnected Tired Stressed out Find it difficult to continue The Resilience Capability Index From the world of business, Roffey Park 2014 offers a statistically robust model of resilience based on five critical learnable capabilities: Perspective Purpose, values, and strengths Emotional intelligence Physical energy Connections Roffey Park Resilience Capabilities Model Let's look at each of the components of this model individually. Perspective – Resilient individuals have response-ability. They recognize that not events themselves undo us but our response to them. They can mentally step back from challenging circumstances and accept the negative side of things while finding opportunities amid adversity. They show cognitive flexibility and positively reframe negative experiences, expanding choices for action. Resilient individuals who accept what they cannot change focus on those things they can change. This focus promotes active striving and setting goals and plans to achieve them. While less resilient individuals may deny the existence of the adversity they face (a passive coping style), those in a more resilient frame of mind adopt an active coping style characterized by a problem-solving approach. Purpose, Values, and Strengths – Having a clear sense of our core – purpose, values, and strengths - can enhance our capacity for resilience in times of stress. Our values also give us a sense of right and wrong, a moral compass. Having a clear purpose in life gives us a sense of direction and a reason for being and enables us to manage challenging times and difficult situations better. To help stay focused and motivated, it is helpful to be mindful that life is a series of peaks and troughs. There will always be wins and losses. Understanding our purpose, values, and strengths will help us appropriately manage our successes and learn meaningful lessons from our failures. Emotional Intelligence – In times of stress, we can easily be pushed into a negative mindset of quick reaction rather than a considered response. This stems from an inherited sensitivity to physical threats and an instinct for survival based on fast thinking and action. However, these rapid responses may negatively impact us and those around us. Using emotional intelligence will temper reactions and create space to breathe, think and respond effectively for you and others. Understanding situations or circumstances that can trigger negative responses is a helpful place to start. Increasing awareness of these trigger-reaction situations identifies the moments of choice that exist. The choices we make in these challenging moments will influence how we communicate, our ability to think and plan, how we feel, and how well we interact with others. Physical Energy – Exercise can also contribute to the positive emotions we experience and our sense of optimism, enhancing our ability to find opportunities in adverse circumstances. Exercise has been shown to increase the concentration of endorphins and certain neurotransmitters such as serotonin (improves mood) and dopamine (lessens depression) in the brain. Regular exercise has also lowered cortisol production released in response to chronic stress. Getting enough exercise is only part of managing our energy and staying healthy. Rest and recovery go hand in hand with an active lifestyle and maintaining energy levels. A healthy diet and getting enough sleep support improved resilience and our ability to manage and recover from stress. Connections – In times of stress or challenge, we often respond by withdrawing. This is a human reaction: we do not want to share our vulnerability. Strong social support networks and connections are associated with resilience to stress and positive physical and mental health. Adequate social support typically involves communication that reaches beyond the superficial and consists of giving and receiving support. Providing support is as, if not more, important than receiving it. To be resilient, one must tap into personal strengths and the support of family, friends, neighbours, and faith communities. What are the Characteristics that Support Personal Resilience? Age, gender, health, biology, education level, cultural beliefs and traditions, and economic resources can be essential in psychological resilience. The following characteristics also contribute to personal resilience: Social support and close relationships with family and friends – People with close social support and strong connections with family and friends can get help during tough times and can enjoy their relationships during everyday life. The ability to manage strong feelings and impulses – People who manage strong emotions are less likely to get overwhelmed, frustrated, or aggressive. People who can manage feelings can still feel sadness or loss, but they can also find healthy ways to cope and heal. Good problem-solving skills – People problem-solve daily. Thinking, planning, and organizing problems are essential skills, and problem-solving skills contribute to feelings of independence and self-competence. Feeling in control – After the chaos of trauma or disaster, engaging in activities that help people regain control can be helpful. This will help support the healing and recovery process. Asking for help and seeking resources – Resourceful people will get needed help more quickly if they know how to ask questions, are creative in thinking about situations, are good problem solvers and communicators, and have an excellent social network to reach out to. Seeing yourself as resilient – After a disaster or trauma, many people may feel helpless and powerless, especially when there has been vast damage to their life or their community. Being able to see yourself as resilient rather than as weak or as a victim can help build psychological resilience. Coping with stress in healthy ways – Doing things well gives people feelings of pleasure and self-worth. Strategies that use positive and meaningful ways to cope are better than harmful ones, such as drinking too much or smoking. Helping others and finding positive meaning in life – Helping others can elicit positive emotions like gratitude, joy, kindness, love, and contentment. Acts of generosity can add meaning and purpose to one's life, even in tragedy. What Are the 7 Cs of Resilience? Pediatrician Ken Ginsburg, MD, specializing in adolescent medicine at the Children’s Hospital of Philadelphia, developed the 7 Cs model of resilience to help kids and teens build the skills to be happier and more resilient. The 7 Cs model is centred around two key points: Young people live up or down to the expectations set for them and need adults who love them unconditionally and hold them to high expectations. How we model resilience for young people is far more critical than what we say about it. The American Academy of Pediatrics summarizes the 7 Cs as follows: The 7 Cs of resilience illustrate the interplay between personal strengths and outside resources, regardless of age. Let's examine the 7 Cs in more depth. Competence This is the ability to know how to handle situations effectively. To build competence, individuals develop skills to help them trust their judgments and make responsible choices. Confidence True self-confidence is rooted in competence. Individuals gain confidence by demonstrating competence in real-life situations. Connection Close ties to family, friends, and community provide security and belonging. Character Individuals need a fundamental sense of right and wrong to make responsible choices, contribute to society, and experience self-worth. Contribution Having a sense of purpose is a powerful motivator. Contributing to one’s community reinforces positive reciprocal relationships. Coping When people learn to cope with stress effectively, they are better prepared to handle adversity and setbacks. Control Understanding internal control helps individuals act as problem-solvers instead of victims of circumstance. When individuals learn that they can control the outcomes of their decisions, they are more likely to view themselves as capable and confident. Emotional Intelligence Emotional intelligence (EI) refers to the ability to recognize, understand, manage, and effectively use one's own emotions, as well as the ability to perceive, interpret, and respond to the emotions of others. It involves emotional and social skills that influence how individuals perceive, understand, and navigate their emotions and those around them. Psychologist Daniel Goleman popularized the concept of emotional intelligence in the 1990s. Goleman identified five critical components of emotional intelligence as follows: Self-Awareness: – Recognizing and understanding one's own emotions Being aware of the impact of emotions on thoughts, decisions, and behaviour Self-Regulation: – Managing and controlling one's own emotions in various situations Exhibiting self-discipline and adaptability in response to changing circumstances Motivation: – Being driven to achieve personal and professional goals Demonstrating initiative, persistence, and a positive attitude in the pursuit of objectives Empathy: – Understanding and sharing the feelings of others Being able to see a situation from another person's perspective Social Skills: – Building and maintaining positive relationships Communicating effectively, resolving conflicts, and working collaboratively with others Emotional intelligence is considered crucial for personal and interpersonal effectiveness. Individuals with high emotional intelligence are often better equipped to handle stress, navigate social complexities, and make sound decisions. They can also be more empathetic and influential in their interactions with others. What Things Do Resilient People Do? The main two characteristics of resilient people have been shown as: Resilient people are empathetic and compassionate. However, they don't waste time worrying about what others think of them. They maintain healthy relationships but don't bow to peer pressure. Resilient people never think of themselves as victims – they focus their time and energy on changing the things they control. They are optimists and believe that things will always get better. Attributes Associated with High Personal Resilience Bouncing back and recovering from adversity A 'where there's a will, there's a way' attitude Seeing problems as opportunities Staying tough when things get difficult Making and carrying out realistic plans Confidence in personal strengths and abilities Ability to manage strong feelings, emotions, and impulses Good problem-solving and communication skills an optimistic view of life A deep-rooted faith in a system of meaning A healthy social support network A wide comfort zone Ability to recover from panic-inducing or traumatic experiences Traits, Qualities, and Characteristics of the Resilient Person Viewing change as a challenge or opportunity Commitment Recognition of limits to control Engaging the support of others Close, secure attachment to others Personal or collective goals Self-efficacy Strengthening effect of stress Past successes Realistic sense of control/having choices Sense of humour Action-oriented approach Patience Tolerance of negative affect Adaptability to change Optimism Faith Resilience as a Continuum As you know, the concept of resilience is a complex one. It is not simply something you have or don't have. Resilience is more likely to exist on a continuum that may present itself in differing degrees across multiple domains of life. For example, someone may be very resilient in the workplace but not as resilient personally. In other words, resilience is relative and depends upon the situation. A person's level of resilience may also change over time depending on their interactions with others, their environment, and the resources available to them. The good news is that the more I learn about building resilience, the more potential for integrating these concepts into relevant areas of one's life. What does it mean to build resilience? Developing resilience skills can help you face challenges and difficulties in life, which can help you feel better and cope better. Being resilient can improve your mental health and overall wellbeing. But developing your resilience is a personal journey. An approach to building resilience that works well for one person may only work for one person, which is one of the biggest reasons why learning multiple techniques for enhancing your resilience is essential. Developing a Strategy for Building Resilience The following pointers help develop your strategy for building resilience. Make connections – Good relationships with close family members, friends or others are essential. Accepting help and support from those who care about you and will listen to you strengthens resilience. Some people find that being active in civic groups, faith-based organizations, or other local groups provides social support and can help reclaim hope. Assisting others in their time of need can also benefit the helper. Avoid seeing crises as insurmountable problems – You can’t change the fact that highly stressful events happen, but you can change how you interpret and respond to these events. Try looking beyond the present to see how future circumstances may improve. Note any subtle ways you might feel better when dealing with difficult situations. Accept that change is a part of living – Specific goals may no longer be attainable as a result of adverse situations. Accepting circumstances that cannot be changed can help you focus on circumstances you can alter. Move toward your goals – Consider possible solutions to your problems and decide what realistic goals you want to achieve. Do something regularly – even if it seems like a small accomplishment – that enables you to move forward. Focus away from tasks that seem unachievable. Instead, ask yourself, “What’s one thing I know I can accomplish today that helps me move in the direction I want to go?” Many people find it helpful to track their progress by recording any accomplishment that moves them toward their goals. It is essential to reflect that you are taking action and achieving what you believe you need to do. Keep things in perspective – Even when facing harrowing events, consider the stressful situation in a broader context and keep a long-term perspective. Avoid blowing the event out of proportion. Strong emotional reactions to adversity are normal and typically lessen over time. Maintain a hopeful outlook – An optimistic outlook enables you to expect good things to happen. Try visualizing what you want rather than worrying about what you fear. Take care of yourself – Pay attention to your own needs and feelings. Engage in activities you enjoy and find relaxing and contribute to good health, including regular exercise and healthy eating. Taking care of yourself helps keep your mind and body primed to deal with situations that require resilience. Take decisive actions – Act on adverse situations as much as you can. Take decisive actions rather than detaching from problems and stresses and wishing they would disappear. Being active instead of passive helps people more effectively manage adversity. Find positive ways to reduce stress and negative feelings – Following a stressful event, many people feel they need to turn away from the negative thoughts and feelings they are experiencing. Positive distractions such as exercising, going to a movie, or reading a book can help you renew so you can refocus on meeting challenges in your life. Avoid numbing your unpleasant feelings with alcohol or drugs. Look for opportunities for self-discovery – People often learn something about themselves and may find that they have grown in some respect due to their struggle with loss. Many people who have experienced tragedies and hardship have reported better relationships, a greater sense of strength while feeling vulnerable, an increased sense of self-worth, a more developed spirituality, and a heightened appreciation for life. Nurture a positive view of yourself – Developing confidence in your ability to solve problems and trusting your instincts helps build resilience. Additional ways of strengthening resilience may be helpful. – For example, some people write about their deepest thoughts and feelings related to trauma or other stressful events in their lives. Meditation and spiritual practices help some people build connections and restore hope. The key to developing an effective personal strategy is to identify ways to build your resilience that will likely work well for you. Where to look for help – Getting help when you need it is crucial to building your resilience. Many people turn to family members, friends, and others who care about them for the support and encouragement they need. Self-help and community support groups can aid people struggling with hardships, such as the death of a loved one. By sharing information, ideas, and emotions, group participants can assist one another and find comfort in knowing they are not alone in experiencing difficulty. At times, however, an individual might get stuck or have difficulty progressing to resilience. A licensed mental health professional, such as a psychologist, can assist people in developing an appropriate strategy for moving forward. How to Build Your Resilience Building resilience is a very personal process. Each of us reacts differently to stress and trauma. Some people bounce back quickly, while others tend to take longer. There is no magic formula. That being said, fundamental principles drawn from neuroscience and positive psychology can help us 'strengthen our resilience muscle.' Key Principles in Building Resilience Building personal resilience combines shifting your mindset, practicing resilience strategies, and implementing healthy habits. Recent advances in neuroscience have shown us that the brain is far more malleable than we ever knew. Research on brain plasticity has shown how connectivity between neurons can change with experience. With practice, neural networks grow new connections, strengthen existing ones, and build insulation that speeds the transmission of impulses. These neuroscientific discoveries have shown us that our actions can increase neural growth now and in the future. Let's look at building personal resilience by examining the critical concepts of shifting your mindset, practicing resilience strategies, and implementing healthy habits. Shifting Your Mindset Your mindset and belief system affect everything in your life, from how you think and feel to how you act and react to any situation. Your mindset shapes how you make sense of the world and yourself and plays a critical role in coping with life's challenges. Growth Mindset vs Fixed Mindset Over 30 years ago, Dr. Carol Dweck and her colleagues in the field of education became interested in students' attitudes about failure. They noticed that some students rebounded while others seemed devastated by minor setbacks. After studying the behaviour of thousands of children, Dr. Dweck coined the terms fixed mindset and growth mindset to describe the underlying beliefs people have about learning and intelligence. When students believe they can get more imaginative, they understand that effort strengthens them. Therefore, they put in extra time and effort, leading to higher achievement. This work has been further studied to relate to one's resilience. It has been shown that how you perceive a stressor or difficult situation tends to be a good indicator of how well you will be able to adapt and recover from those challenges. Reviewing the resources below, ask yourself if you tend to have more of a growth or a fixed mindset. Developing a Growth Mindset See your challenges as opportunities. Life will always find a way to throw something difficult at you. Try not to see these challenges as obstacles or setbacks that you dread. Instead, try to view them more positively. Try to view them as opportunities to overcome something difficult and grow. The more complex the challenge, the better the chance of learning and growth. Reflect each day on what you’ve failed at (and learned from)- Many of us reflect on our successes at the end of the day. While this is a valuable habit, try adding a few minutes to reflect on the areas where things didn’t go as well. What did you learn from that experience? The point isn't to dwell or beat yourself up but to recognize and lock in the learning. Stop seeking approval from others- When we seek the approval of others, we take on the wrong objective. We start taking being suitable as our goal rather than learning and growing. Become aware of the difference. Pause to recognize when you are pursuing approval rather than growth and remind yourself, kindly, to stop seeking approval from others. Identify opportunities to celebrate the success of others- When others around you succeed, celebrate! More than this, get curious about what made them successful. Even better, ask them. Connect with others to understand their actions and how they approached the challenge to get there. Start using the word "yet" more often. This is a simple one. Whenever you catch yourself thinking, “I’m not very good at this,” add the word "yet: “I’m not very good at this yet.” bundance Mindset vs Scarcity Mindset In his best-selling book, The 7 Habits of Highly Effective People, Stephen Covey coined the term Abundance Mindset vs Scarcity Mindset in 1985. Someone who has a scarcity mindset believes that resources are all finite. To be the one to get them, you have to be better, work harder, and be the best. Think “survival mode.” Someone with a scarcity mindset sees someone else doing what they want to do or getting what they want and takes it as defeat. Because someone else has already succeeded, there isn’t enough room for them to do or have those things. This person isn’t likely to take on more considerable risks or challenges because if they fail, how will they prove their worth to their family, friends, or the world? When you have a scarcity mindset, you feel you are 'never enough.' However, a person with an abundance mindset knows there is enough to go around. And again, we’re not only talking money here. This can mean money, opportunities, success, happiness, dream jobs, significant others, etc. They believe that whatever it is that they desire exists in abundance. So when they see another person succeed or get offered a great opportunity, they can be fully happy for them because they know it doesn’t take away from their chances of getting similar excellent opportunities. They can even be inspired by the successes of others and use them to help fuel their motivation and creativity. When you have an abundance mindset, you know that at your core, you are enough, and everything else is a bonus. Shifting to an Abundance Mindset Regarding scarcity and abundance, changing what you focus on can make a huge difference. If you are always focusing on lack (the things you don’t have), you can easily miss all the fantastic things already in front of you. It is perfectly okay to dream and to want to grow and change; make sure it isn’t causing you to 'never be satisfied' in the present moment. Let's look at some ways you can develop an abundance mindset. Developing an Abundance Mindset Practice Gratitude- Gratitude is a huge part of changing your mindset to focus on abundance. Make it a habit to write down (or consciously notice) at least three things you are grateful for daily. (Try to switch them up and look for new things to be thankful for each day to make this even more powerful) Make it fun, and think of this practice like a hunt throughout your day to find those things that make you smile, those moments that make you happy, those people you love and appreciate, and allow yourself to bask in the gratitude for it all. Celebrate Wins- Big and small; by celebrating your wins, you are affirming to yourself that you are making progress. Keep in mind there are always wins to celebrate. Whether it’s something big like getting a new job or something relatively more minor, like getting out of bed that day or even being gentle with yourself when you don’t hit your goals the first time around, taking little steps consistently over time will get you much further than occasionally taking one more significant step. Don't forget also to celebrate the wins of others and be happy for them and their success. Observing others is just as important, maybe even more so, than celebrating ourselves. Someone Else’s Success Isn't Your Failure- When it comes to abundance, it’s essential to note that someone else’s success does not equate to failure. There is so much temptation to compare ourselves to others, but self-comparison is dangerous. First of all, we’re all different and on our unique paths. We can’t measure our success using someone else’s timeline or ruler. Instead of comparing, feeling jealous, or getting overly competitive, choose to be happy for others and see their success as motivation and evidence that you can do/have/get whatever it is, too! How Do You Begin To Change Your Mindset? Changing your mindset is easier said than done. Years of life experiences made you who you are today. Still, this article looks at a few simple exercises that you can use to change an unhealthy mindset into a frame of mind that better serves you and your overall well-being. Remember, like any exercise, it takes repetition and practice to see results. STEP ONE: PINPOINT THE BELIEF- Take a moment to pinpoint a belief or mindset you have that is holding you back from achieving your goals or overcoming a challenge. Is a fear associated with this belief consistently stopping you from taking a risk and going for it, even though you know it’s what you want or need to do? Are you afraid to fail? Or perhaps, afraid to succeed? Consider your goals or challenges and the internal narrative or limiting belief that continuously stops you from moving forward. Write them down in column one once they’re fresh in your mind, and let’s move on to step two. 2 STEP TWO: FIND EVIDENCE TO PROVE THESE BELIEFS WRONG- As long as you believe these limiting narratives to be accurate, they will have power over you. But, if you find evidence to prove that they aren’t universally true, that’s where you can begin to regain control. If you currently have a job, do you ever doubt you would find one? Did you get into the school you wanted against the odds? Was there a time something broke in your house, and you fixed it? A time you doubted you’d finish a project or presentation on time to get it done at the last minute? Write down all your wins, everything that adds up as accomplishments you ever doubted. As “small” as some of these things may seem, they each show what you’re made of and that you can show up for yourself, and therefore, this limiting belief isn’t true after all. 3 STEP THREE: REWRITE IT- Now that you have evidence that your belief isn’t 100% true, let’s rewrite it into something more empowering and will propel you forward instead of holding you back. The important thing is that this new statement feels good to you and lights your fire. Something like, “With hard work and determination, I can accomplish anything I put my mind to,” or “I can get through this challenging time and come out the other side of it even stronger.” When you start taking steps to rewrite your internal narrative, you can replace limiting thoughts with statements that support self-compassion. 4 STEP FOUR: TAKE ACTION- Remember that changing your mindset doesn’t mean just sitting around and thinking about change. When it comes to mindset work, it’s easy to get caught up in organizing and planning, ensuring everything is perfect for when you finally decide to take that first step. The goal is not perfection but to 'walk the talk,' make mistakes, learn, and try again. Strategies for Resilience We have already discussed how shifting your mindset can help you see opportunities in challenges and persevere when 'the going gets tough.' Now, let's examine how practicing the resilience strategies of showing gratitude, practicing self-compassion, enhancing mindfulness, goal-setting, and implementing healthy habits can help you develop and maintain your resilience. Showing Gratitude Gratitude is a thankful appreciation for what an individual receives, whether tangible or intangible. With gratitude, people acknowledge the goodness in their lives. In the process, people usually recognize that the source of that goodness lies at least partially outside themselves. As a result, being grateful also helps people connect to something larger than themselves as individuals — whether to other people, nature, or a higher power. In positive psychology research, gratitude is strongly and consistently associated with greater happiness. Gratitude helps people feel more positive emotions, relish good experiences, improve their health, deal with adversity, and build strong relationships. People feel and express gratitude in multiple ways. They can apply it to the past (retrieving positive memories and being thankful for elements of childhood or past blessings), the present (not taking good fortune for granted as it comes), and the future (maintaining a hopeful and optimistic attitude). Ways To Cultivate Gratitude Here are some simple ways to cultivate gratitude regularly in your everyday life. Writing a thank-you note can make you happier and nurture your relationship with another person by writing a thank-you letter or email expressing your enjoyment and appreciation of that person's impact on your life. Send it, or deliver and read it in person. Make a habit of sending at least one gratitude letter a month. Once in a while, write one to yourself. Thank someone mentally- No time to write? It may help to think about someone who has done something nice for you and mentally thank the individual. Keep a gratitude journal- Make it a habit to write down or share with a loved one your thoughts about the gifts (no matter how small) you've received each day. Count your blessings- Pick a time every week to sit down and write about your blessings, reflecting on what went right or what you are grateful for. Sometimes, it helps to pick a number — such as three to five things — that you will identify each week. As you write, be specific and think about the sensations you felt when something good happened to you. Pray- Religious People can use prayer to cultivate gratitude in a meaningful way. Meditate- Mindfulness meditation involves focusing on the present moment without judgment. Although people often focus on a word or phrase (such as "inner peace"), it is also possible to focus on what you're grateful for (i.e. the warmth of the sun on your face). Self-Compassion Fears and adversity can make us feel alone; we wonder why we’re the only ones feeling this way and what is wrong with us. Practicing self-compassion and recognizing that everyone suffers can be a gentler and more effective road to resilience. Self-compassion involves offering compassion to ourselves: confronting our shortcomings and suffering from an attitude of forgiveness, warmth, and kindness, without judgment, rather than ignoring our pain or flagellating ourselves with self-criticism. The practice of self-compassion yields several physical and mental health benefits. Self-compassionate people recognize when they are struggling and are kind to themselves at these times, which improves their overall well-being and reduces their symptoms of anxiety and depression. Low self-compassion can also relate to perfectionism: People who feel they must be perfect all the time tend not to be forgiving of their failures and may only feel worthy of love, acceptance, and respect when they achieve success. Practicing Self-Compassion There are many ways to practice self-compassion outlined in the work of positive psychology. Let's look at three of the most common practices below. The Self-Compassion Break – One practice, The Self-Compassion Break, is something you can do whenever you feel overwhelmed by pain or stress. It has three steps, which correspond to the three aspects of selfcompassion: Be mindful: Notice what you’re feeling without judgment or analysis. Say, “This is a moment of suffering,” “This hurts,” or “This is stress.” Remember that you’re not alone: Everyone experiences these deep and painful human emotions, although the causes might differ. Say to yourself, “Suffering is a part of life,” or “We all feel this way,” or “We all struggle in our lives.” Be kind to yourself: Put your hands on your heart and say something like “May I give myself compassion,” or “May I accept myself as I am,” or “May I be patient.” How Would You Treat a Friend? – If being kind to yourself is a challenge, an exercise called How Would You Treat a Friend? Could help. Here, you compare how you respond to your struggles—and the tone you use—with how you respond to a friend’s. Often, this comparison unearths some surprising differences and valuable reflections: Why am I so harsh on myself, and what would happen if I weren’t? Self-Compassionate Letter – Once we develop a kinder attitude toward ourselves, we can crystallize that gentle voice in a Self-Compassionate Letter. This practice asks you to spend 15 minutes writing words of understanding, acceptance, and compassion toward yourself about a specific struggle. In the letter, you might remind yourself that everyone struggles and you aren’t solely responsible for this shortcoming; if possible, you could also consider constructive ways to improve. Mindfulness Mindfulness means being fully present and paying conscious attention to one's thoughts, feelings, and emotions without judgment or criticism. The aim of mindfulness is not to clear the mind of thoughts intentionally. Instead, it is about understanding how the mind works. Practicing mindfulness allows people to engage with life actively. We all naturally possess mindfulness instead. While we all intrinsically have mindfulness, it’s more readily available to us when we practice daily. Whenever you bring awareness to what you’re directly experiencing via your senses or to your state of mind via your thoughts and emotions, you’re being mindful. And there’s growing research showing that when you train your brain to be aware, you’re remodelling the physical structure of your brain. You’ll probably feel kinder, calmer, and more patient as you practice mindfulness. These shifts in your experience will also generate changes in other parts of your life. Enhancing Mindfulness Pay full, conscious attention to whatever you are doing. Paying attention is the key to becoming present, to becoming grounded in the present moment, neither living in the past nor worrying about the future, but simply living life as it was meant to be lived. And when you once again begin paying attention, you kickstart profound changes that ripple across your life. You begin to see the world with all the excitement, freshness, and joy you did as a child. Anxiety, stress, unhappiness, and exhaustion melt away in the face of such awareness. Meditation is only one type of mindfulness. Instead of meditating, try these simple practices to incorporate mindfulness into your everyday life. • The next time you catch sight of your partner or a close friend, notice five new things about them. Please pay attention to how they move, their facial expressions, and how their voice rises and falls, with its pitch and timbre. Can you sense their aroma? And their hair? Is it the same as you expected? Do they look tired or energized? Are they wearing their everyday clothes? Please pay attention to what they wear and how the clothes follow or hide their contours. Do not judge them in any way, but accept them for who they are. The aim is not to think but to observe. You find what you find. Do they become newly alive to you? • Please consider its textures, flavours, and aromas when eating or drinking. Tease them apart and focus on each one in turn. Then, pay attention to the food's taste, aroma, and texture. Tea and coffee contain many different flavours, and chocolate has over 300. See if you can sense some of them, and then see how they combine to produce the overall flavour of "tea," "coffee," or "chocolate." Try also to focus on enjoying the warmth or coolness of your food or drink. How does it feel in your mouth, as you swallow, and finally in your tummy? Does the food or beverages give you any overall sensation of warmth or coolness? • The next time you are in a line, notice how your body reacts. Does it take on a mind of its own? Do your arms and legs want to move of their own accord? Are the impulses surprisingly powerful? Do you feel compelled to walk to the front? Is your mind swirling with annoyance or impatient thoughts? Pay attention to all the sensations in your body, the ground beneath your feet, and how your chest rises and falls with each breath. Close your eyes if that helps. After a while, begin to pay attention to the world around you. What can you see? Do the people around you look angry, stressed, unhappy, or serene? Please pay attention to their faces and their body language. After a while, broaden your awareness to encompass the whole scene. What can you see? Pay attention. What can you hear? Chattering, the sound of machinery, or a keyboard being tapped? Pay attention to the whole soundscape. What can you smell? What can you feel? Can you feel the air flowing over your skin or hair? Breathe. Pay attention to whatever surrounds you. Goal-Setting Goals play a dominant role in shaping the way we see ourselves and others. A focused and goal-oriented person will likely have a more positive approach toward life and perceive failures as temporary setbacks rather than personal shortcomings. Incorporating goal-setting strategies into one’s work and personal life has positively impacted stress and anxiety. By setting goals, we prioritize what is essential, clearly establish what we want to achieve, and identify the benefits we expect to experience. We then plan and demonstrate purposeful actions aligned with achieving the goal. Finally, we will establish accountability measures to track and celebrate our progress. Goal setting is a skill. As with learning any new skill, starting small and building capability through practice over time increases our chances of success. As we become more confident and adept at setting goals, we can improve the level of challenge. SMART Goals S.M.A.R.T. is a mnemonic acronym that gives criteria to guide in setting goals and objectives for better results, for example, in project management, employee performance management, and personal development. George T. Doran first proposed the term, a commonly used version that includes alternative words, in November 1981. He suggested that goals should be SMART (specific, measurable, assignable, realistic, and time-related). Since then, other variations of the acronym have been used; a commonly used version includes the alternative words achievable, relevant, and time-bound. Additionally, SMART Goals have further developed into SMARTER Goals with the addition of E for Evaluate and R for Re-adjust. Specific – Your goals need to be specific. They need clarity and a concise aim for where you are going with your objective. Ask yourself some of these questions to flush out what your goal is: What do I want to achieve? Is anyone else involved? Will I likely face any challenges, and what may they be? How will I achieve this? Measurable – Your goals need to be measurable. Giving yourself a metric to work alongside makes achieving your goals easier. You can create benchmarks for your progress to see if you are meeting your goals. Ask yourself: How will I know when I have accomplished this goal? Achievable – Your goals need to be achievable. Are your goals realistic? Can you achieve them in the given timeframe? Make your goals big enough to push yourself when trying to achieve them. But don’t make them unachievable. Ask yourself: Is this goal realistic? Relevant – Your goals should be relevant. Every goal should have a reason behind it. Ask yourself: Do my goals align with my core values and beliefs? Is the task worthwhile? Time-Bound – Make sure you set deadlines for your goals. It is easier to achieve timely goals with one. You are breaking down your superordinate goal into smaller ones so you can track your progress. Ask yourself: When is my task deadline? Should I create a timeline? If so, what are my smaller goals? What can I achieve in 6 months? Evaluate – Some people may want to evaluate the progress of their goal daily, some weekly, and some bimonthly. Whatever you prefer, ensure you continuously assess your goals to help you achieve them. Re-adjust – If you are continuously having trouble with your goals, it’s time to take a step back and re-adjust. Re-adjusting doesn’t mean throwing away the goals and getting new ones; it’s making any changes necessary to either reach your goal or your approach to reaching your goal. Developing Emotional Granularity Emotional granularity refers to the ability to identify and distinguish between different emotions accurately. It involves having a nuanced and detailed understanding of one's own emotional experiences and the ability to recognize subtle variations in the feelings of others. High Emotional Granularity This means that an individual can precisely pinpoint and articulate specific emotions. For example, rather than simply feeling "happy" or "sad," someone with high emotional granularity might be able to identify more particular emotions like "joy," "contentment," or "frustration." Individuals with high emotional granularity tend to have more effective emotional regulation and interpersonal skills. They can better navigate social situations, communicate their feelings more accurately, and respond appropriately to the emotions of others. Implementing Healthy Habits Healthy habits, such as getting enough sleep, daily exercise, eating nutritious food, managing stress, engaging in healthy relationships, and having fun, can help you manage stress, keep your life balanced, and build resilience. enjoy healthy eating get adequate sleep be creative exercise connect with those you care about get some fresh air breathe spend time in nature have some quiet time laugh disconnect from technology help others Everyday Resilience Strategies There are many simple ways to build resilience so that it becomes your natural tendency. Try some of these strategies the next time you feel your resilience needs a boost. • Turn off the news or your news feed and seek other sources of inspiration. Allow yourself to express and feel your emotions. Sometimes having a good cry can be emotionally cleansing. • Take a walk and get moving. Exercise and movement can increase your energy level and release endorphins. • Talk with someone you love and trust. Have a meaningful and honest conversation. • Take some time off to recharge. Unplug the electronic devices and give yourself a moment to rest and reflect. • Think of someone who exudes resiliency and model their behavior. • Go within and connect with your higher power through meditation or prayer. • Listen to empowering music or podcasts. • Take some deep breaths. Breathing deeply is very healing and cleansing. • Take some inspired action. When you’re overwhelmed, doing one small thing can help you move forward. Motivation for Building Personal Resilience Here are some of my favourite motivational videos on resilience. I hope you enjoy them and that they inspire you to build resilience and achieve your goals. Reflection Moment Take a moment to reflect on the material in this last module that outlines several tips and suggestions to help you develop and maintain your resilience. I hope you find something that speaks to you and that you will consider adopting it into your life. Key Takeaways • Personal resilience sometimes called individual resilience, involves behaviours, thoughts, and actions that enable us to recover and reshape following unique challenges or difficulties. We can cope with difficult periods or stressful events and manage new and different situations or changes. Resilient people also experience stress, setbacks, failures, and complicated emotions, but they tap into their strengths and seek help from support systems to overcome challenges and work through problems. The 7 Cs of resilience illustrate the interplay between personal strengths and outside resources, regardless of age. They include competence, confidence, connection, character, contribution, coping, and control. Attributes associated with high personal resilience include bouncing back and recovering from adversity; a 'where there's a will, there's a way' attitude; seeing problems as opportunities; staying tough when things get difficult; making and carrying out realistic plans; confidence in personal strengths and abilities; ability to manage strong feelings, emotions, and impulses. Good problem-solving and communication skills; an optimistic view of life. A deep-rooted faith in a system of meaning, a healthy social support network, a wide comfort zone, and an ability to recover from panic-inducing or traumatic experiences. • Resilience is more likely to exist on a continuum that may present itself in differing degrees across multiple domains of life. For example, someone may be very resilient in the workplace but not as resilient personally. In other words, resilience is relative and depends upon the situation. A person's level of resilience may also change over time depending on their interactions with others, the environment, and the resources available around them. Building personal resilience combines shifting your mindset, practicing resilience strategies, and implementing healthy habits. Your attitude and belief system affects everything in your life, from how you think and feel to how you act and react to any situation. Developing a growth mindset involves seeing your challenges as opportunities, reflecting each day on what you’ve failed at (and learned from), stopping seeking approval from others, identifying opportunities to celebrate the success of others, and starting using the word "yet" more often. When developing an abundance mindset, you must practice gratitude, celebrate wins, and know that someone else’s success isn't your failure. • With gratitude, people acknowledge the goodness in their lives. In the process, people usually recognize that the source of that goodness lies at least partially outside themselves. As a result, being grateful also helps people connect to something larger than themselves as individuals — whether to other people, nature, or a higher power. In positive psychology research, gratitude is strongly and consistently associated with greater happiness. Self-compassion involves offering compassion to ourselves: confronting our shortcomings and suffering from an attitude of forgiveness, warmth, and kindness, without judgment, rather than ignoring our pain or flagellating ourselves with self-criticism. Low self-compassion can also relate to perfectionism. Mindfulness means being fully present and paying conscious attention to one's thoughts, feelings, and emotions without judgment or criticism. Practicing mindfulness allows people to engage with life actively, and you’ll probably feel kinder, calmer, and more patient. SMARTER goal-setting will enable us to focus on what is important to us and help us to perceive failures as temporary setbacks rather than personal shortcomings. Healthy habits such as getting enough sleep, daily exercise, eating nutritious food, managing your stress, engaging in healthy relationships, and having fun can help you manage stress, keep your life balanced, and build resilience.