Resilience in the Face of Potential Trauma

Author(s): George A. Bonanno

Source: Current Directions in Psychological Science, Vol. 14, No. 3 (Jun., 2005), pp. 135-138
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 CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE

Resilience in the Face of Potential

Trauma
George A. Bonaniio

Teachers College, Columbia University

ABSTRACT?Until recently, resilience among adults exposed

RESILIENCE(NOTRECOVERY)ISTHEMOST COMMON
to
potentially traumatic events was
thought
to occur
rarely
RESPONSETO POTENTIALTRAUMA
and in either pathological or exceptionally healthy indi
research that the most Over a decade ago, my and I began an in
viduals. Recent indicates, however, colleagues ongoing
common reaction adults to such events is a of this rare response, and the means
among exposed vestigation supposedly by

stable pattern which people might achieve

such presumably superficial (or
relatively of healthy functioning coupled
with the enduring capacity for positive emotion and gen exemplary) functioning in the aftermath of a potentially traumatic
erative experiences. A surprising finding is that there is no event. The results of our research have consistently challenged
to be multiple the prevailing view on the We took as our
single resilient type. Rather, there appear subject. starting point
and sometimes to be and some the literature on resilience. Devel
unexpected ways resilient, burgeoning developmental
times resilience is achieved means that are not opmental researchers and theorists had for several decades
by fully
under normal circumstances. For highlighted various protective factors (e.g., ego-resiliency, the
adaptive example, peo
who use biases presence of supportive that promote tra
ple characteristically self-enhancing often relationships) healthy
incur social liabilities but show resilient outcomes when among children to unfavorable life circum
jectories exposed

confronted with extreme adversity. Directions for further stances such as poverty
(e.g., Garmezy, 1991; Rutter, 1987). We

research are considered. sought to adapt this body of research to the study of resilient
outcomes among adults in otherwise normal circumstances who
KEYWORDS?loss; grief; trauma; resilience; coping are exposed to isolated and potentially highly disruptive events.
Our research led to three conclusions, each
primary mirroring

Life is filled with peril. During the normal course of their lives, but also extending the insights gained from developmental re
most adults face one or more traumatic events search. First, resilience traumatic events
potentially (e.g., following potentially
or occurrences or a distinct outcome from that as
violent life-threatening the death of close represents trajectory typically
friends or such find it sociated with recovery from trauma. there have been
relatives). Following events, many people Historically,

difficult to concentrate; feel confused, and few attempts to distinguish subgroups within the broad category
they may anxious,
and not eat or Some of individuals to potential trauma who do not
depressed; they may sleep properly. people exposed develop
have such and reactions that are unable post-traumatic stress disorder (PTSD). When resilience had been
strong enduring they
to function for years afterward. It should come as no considered, it was often in terms of factors that "favor a
normally path

that these dramatic reactions have dominated the lit to recovery" & Yehuda, 1996, p. However,
surprise (McFarlane 158).
eratures on loss and trauma. Until the reac studies have now demonstrated that resilience and recovery are
recently, opposite
tion?the maintenance of a relative stable of healthy discrete and outcome follow
trajectory empirically separable trajectories
to a re a dramatic event such as the death of a spouse Bonanno,
functioning following exposure potential trauma?has ing (e.g.,
scant attention. a Wortman, et al., or direct exposure to terrorist attack
ceived When theorists have considered such 2002) (e.g.,

it either as an aberration Bonanno, Rennicke, & Dekel, in press). Figure 1 depicts the
pattern, they have typically viewed
from extreme denial or as a of exceptional emo resilience and recovery as well as tra
resulting sign prototypical trajectories,

tional strength (e.g., McFarlane & Yehuda, 1996). jectories representing chronic and delayed symptom elevations

(discussed later).
In this is defined to severe
Address to George A. Bonanno, Clinical framework, recovery by moderate
correspondence Psychology
525 West 120th St., Box 218, Teachers Columbia initial elevations in psychological symptoms that significantly
Program, College,
University, New York, NY 10027; e-mail: [email protected]. normal and that decline over
disrupt functioning only gradually

Volume 14?Number 3 Copyright ? 2005 American Psychological Society 135

 Resilience in the Face of Potential Trauma

Manhattan residents the September 11 terrorist attack

following

(Bonanno, Galea, Bucciarelli, & Vlahov, 2005). Following con

Chronic 10-30%
S ? ventions established in the study of subthreshold depression, we
.2 s defined a mild to moderate trauma reaction as two or more PTSD
u and resilience as one or no PTSD in the first
?=! symptoms symptoms
6 months following the attack. Over 65% in the New York met
Delayed 5-10%
area were resilient. with more concen
ropolitan Among people
trated exposure (e.g., those who had either witnessed the attack in
'''
A person or who were in theWorld Trade Center during the attack),
NA /\
V \ the proportion showing resilience was still over 50%. Finally,
S |E Recovery 15-35%
even among people who were physically injured in the attack, a
?
group forwhom the estimated proportion of PTSD was extremely
Resilience 35-55% high (26.1%), one third (32.8%) of the individuals were resilient.
-1 In establishing the validity of the resilient trajectory it is im
Event 1 year 2 years
Time since event
perative to distinguish stable, healthy functioning from denial or
other forms of superficial adjustment. To this end, several studies
1. Prototypical of disruption in normal functioning dur
Fig. trajectories have now documented links between resilience and generally
ing the 2-year period following a loss or potential trauma.
high functioning prior to a potentially traumatic event (Bonanno,
Wortman, et al., 2002; Bonanno, Moskowitz, et al., Several
2005).
the course of many months before returning
to pre-trauma levels. studies have also documented resilient outcomes
using relatively
In contrast, resilience is characterized by relatively mild and objective
measures that go beyond participant self-report, in

short-lived disruptions and a stable trajectory of healthy func cluding structured clinical interviews and anonymous ratings of
across time. A is that even resilient in from friends or relatives Bonanno,
tioning key point though functioning participants' (e.g.,
dividuals may an initial, brief spike in distress
experience Rennicke, & Dekel, in press; Bonanno, Moskowitz, et al., 2005).

(Bonanno, Moskowitz, Papa, & Folkman, 2005) ormay struggle for For example,
we
(Bonanno, Rennicke, & Dekel, in press) re

a short to maintain several cruited the friends and relatives of high-exposure survivors of the
period psychological equilibrium (e.g.,
weeks of sporadic difficulty concentrating, intermittent sleep World Trade Center terrorist attack and asked them to assign the
lessness, or daily variability in levels of well-being; Bisconti et al., survivors to either the resilience trajectory
or one of the other

in press), they nonetheless manage to keep functioning effectively outcome trajectories depicted in Figure 1. The assignments of
at or near their normal levels. For resilience has been friends and relatives matched the survivors' actual
example, closely
linked to the continued fulfillment of personal and social re symptom levels over time, and thus provided important valida

sponsibilities and the capacity for positive emotions and genera tion for the resilience trajectory.
tive experiences (e.g., engaging in new creative activities or new

both and in the months ex THE HETEROGENEITY OF RESILIENCE: FLEXIBLE

relationships), immediately following
posure to a traumatic event & Keltner, 1997; AND PRAGMATIC COPING
potentially (Bonanno
Bonanno, Wortman, et al., 2002; Bonanno, Rennicke, & Dekel, in

press; Fredrickson et al., 2003). A third conclusion to emerge from our research, again extending
A second conclusion that emerges from our research is that the conclusions of developmental researchers, is that there are

resilience is typically the most common outcome ex and sometimes factors that might a
following multiple unexpected promote
posure to a potentially traumatic event. It has been as resilient outcome. At the most level, many of the same
widely general
sumed in the literature that the most common response to such an characteristics that promote healthy development should also
occurrence is an initial but sizeable elevation in trauma symp foster adult resilience. These would include both situational
toms followed by gradual resolution and recovery (McFarlane & factors, such as
supportive relationships, and individual factors,

Yehuda, 1996). However, although symptom levels tend to vary such as the capacity to adapt flexibly to challenges (Block &
for different potentially traumatic events, resilience has con Block, 1980). The capacity for adaptive flexibility was mirrored
sistently
as the most common outcome trajectory. In one in a recent resilience among New York
emerged study associating City

study, for example, over half of the people in a sample of middle

college students in the aftermath of September 11 with flexibility
aged individuals who had lost their spouses showed a stable, low in emotion regulation, defined as the ability to effectively
level of and stable low symptoms were observed in enhance or suppress emotional when instructed to do
symptoms; expression
more than a third of a group of gay men who were bereaved after so (Bonanno, Papa, LaLande, Westphal, & Coifman, 2004).
providing
care for a partner dying of AIDS, a
considerably
more In addition to these factors, however,
general health-promoting
stressful context Moskowitz, et al., 2005). Resilience our research also underscores a crucial of departure from
(Bonanno, point
was also readily observed in a random phone-dialing survey of the developmental literature. Childhood resilience is typically

136 Volume 14?Number 3

 George A. Bonanno

understood in response to corrosive environments, such as pov unaware of the critical reactions can evoke in others, and this
they

erty or enduring abuse. By contrast, adult resilience is more often type of self-serving bias evidently plays a crucial role in their
a matter of coping with an isolated and usually (but not always) ability tomaintain stable levels of healthy functioning in other
brief traumatic event. The is that whereas areas a traumatic event.
potentially key point following potentially
corrosive environments require longer-term adaptive solutions,
isolated events often oblige
a more
pragmatic form of coping, a DIRECTIONSFOR FUTURERESEARCH
"whatever it takes" which may involve behaviors and
approach,

strategies that are less effective or even

maladaptive in other The study of adult resilience is nascent and there are myriad
contexts. For instance, considerable research attests to the health for future research. An obvious is to learn
questions imperative
benefits of expressing emotions. most resilient how the various costs and benefits of resilience across dif
negative Although vary
bereaved individuals express at least some emotion ferent and durations of potentially traumatic events. Is
negative types
while talking about their loss, they nonetheless express relatively there a
point, for example, when the long-term
costs of a partic

less negative emotion and greater positive emotion than other ular type of coping whatever crucial short-term
might outweigh
bereaved individuals (e.g., Bonanno & Keltner, 1997), thereby advantages it provides? Might such trade-offs vary by gender or
minimizing the impact of the loss while "increasing continued culture? Western, independence-oriented societies, for example,
contact with and support from important people in the social tend to focus more heavily than collectivist societies on the
environment" (p. 134). personal experience of trauma. However, little is known about the

Another example of pragmatic coping is illustrated by trait extent that loss and trauma reactions vary across cultures. A

self-enhancement, the tendency toward self-serving biases in recent comparative study showed that bereaved people in China
perception and attribution (e.g., overestimating one's own
posi recovered more quickly from loss than did bereaved Americans
tive qualities). People given to self-serving biases tend to be (Bonanno, Papa, et al., 2005). However, as is typical of Chinese
narcissistic and to evoke reactions in other culture, Chinese bereaved also more
negative people. reported physical symptoms
However, they also have high self-esteem and cope well with than Americans. These data raise the of
intriguing questions
isolated potential traumas. Our research team examined self whether resilience has different meanings in different cultural
enhancement among with two Stressor contexts and, even more whether different
people dealing powerful perhaps important,
events, the premature death of a spouse and exposure to urban cultures may learn from each other about effective and not-so

combat during the recent civil war in Bosnia (Bonanno, Field, effective ways of coping with extreme
adversity.
Kovacevic, & Kaltman, 2002). In both samples, trait self-en These in turn raise and
questions multiple practical philo
hancement was positively associated with ratings of functioning sophical uncertainties about whether resilience can or should be

made by mental health experts. In the bereavement study, how learned. On the one hand, the observed link between resilient
ever, untrained observers rated self-enhancers un outcomes and variables that resilient
relatively personality suggests

favorably (lower
on
positive traits, e.g., honest; and higher
on traits may be relatively fixed and not easily inculcated in others.
negative traits, e.g., self-centered). Yet, these negative impres And, the social costs associated with some of the traits
given
sions did not appear to interfere with self-enhancers' to found in resilient the advantage
ability people (e.g., self-enhancement),
maintain a high level of functioning after the loss. of simply imitating resilient individuals is questionable. On the
This same of findings was observed among other a more avenue for to
pattern high-ex hand, promising training people
posure survivors of the September 11 attack (Bonanno et al., in cope with trauma is suggested the evidence
resiliently by linking
press). Trait self-enhancement was more
prevalent among indi resilience to flexible adaptation (Block & Block, 1980; Bonanno
viduals exhibiting the resilient trajectory, whether established by et al., 2004). Because adaptive flexibility can be manipulated
or from friends or relatives. Self to engage in various
self-reported symptoms ratings experimentally (e.g., people's ability cog
enhancers also had greater positive affect and were rated by their nitive or emotional processes can be measured under different
friends and relatives as levels of Stressor Bonanno et al., 2004), it should be possible to
having consistently higher conditions;
mental and physical health, goal accomplishment, and coping systematically examine the stability of such a trait over time and

ability. However, self-enhancers' friends and relatives also rated the conditions under which itmight be learned or enhanced.
them as
decreasing
in social adjustment
over the 18 months after A related question pertains to how resilient individuals might
September 11 and, among those with the highest levels of expo view their own effectiveness at
coping with potential
trauma.

Although at least some resilient individuals are surprised at how

sure, as less honest. This mixed of findings
pattern suggests again
that self-enhancers are able to maintain
generally high levels of well they cope (Bonanno, Wortman, et al., 2002), it seems likely
in most areas their social relations. Interest that others overestimate their own
functioning except (e.g., self-enhancers) might

ingly, however, self-enhancers themselves perceived their social resilience. This issue is particularly intriguing in relation to the
in relatively more terms than other par distinction between stable resilience and reactions.
relationships positive delayed
ticipants, and this factor fully mediated their low levels of PTSD Although delayed reactions are not typically observed during
symptoms. In other words, self-enhancers appear to be bereavement Bonanno, Wortman, et a small
blissfully (e.g., al., 2002),

Volume 14?Number 3 137

 Resilience in the Face of Potential Trauma

subset of individuals exposed

to
potentially traumatic events (5? Block, J.H., & Block, J. (1980). The role of ego-control and ego-resil

10%) typically exhibit delayed PTSD. Preliminary evidence iency in the organization of behavior. In W.A. Collins (Ed.), The
Minnesota on Child
Symposia Psychology (Vol. 13, pp. 39-101).
indicates that delayed-PTSD responders have higher initial
Hillsdale, NJ: Erlbaum.
symptom levels than do resilient individuals (e.g., Bonanno
Bonanno, G.A., Field, N.P., Kovacevic, A., & Kaltman, S. (2002). Self
et al., in press). Further evidence of this distinction would hold as a buffer against
enhancement extreme adversity: Civil war in
potentially important diagnostic implications for early inter Bosnia and traumatic loss in the United States. Personality and
vention. Social Psychology Bulletin, 28,184-196.

Finally, another question pertains to how resilient individuals Bonanno, G.A., Galea, S., Bucciarelli, A., & Vlahov, D. (2005). Psy
an extreme Stressor chological resilience after disaster: New York City in the aftermath
experience the crucial early weeks after
of the September 11th terrorist attack. Manuscript submitted for
event. A recent study by Bisconti, Bergeman, and Boker (in press)
publication.
shed some welcome light on this issue by examining daily well
Bonanno, G.A., & Keltner, D. (1997). Facial expressions of emotion and
in the months after the death of a spouse.
being ratings early the course of conjugal bereavement. Journal of Abnormal Psy
Although resilient bereaved typically show only mild and rela chology, 106,126-137.
short-lived overall decreases in well-being, examination of Bonanno, G.A., Moskowitz, J.T., Papa, A., & Folkman, S. (2005).
tively
their daily ratings indicated marked variability across the first Resilience to loss in bereaved spouses, bereaved parents,
and bereaved men. Journal and Social
3 weeks and then a more stable but still variable period that gay of Personality
Psychology, 88,827-843.
endured through the second month of bereavement. Perhaps
Bonanno, G.A.,
Papa, A., Lalande, K., Nanping, Z., & Noll, J.G. (2005).
similar research using and Internet methods
larger samples Grief and deliberate
processing grief avoidance: A prospective
illuminate how resilient individuals manage to continue in the United
might comparison of bereaved spouses and parents States

functioning and meeting the ongoing demands of their lives while and China. Journal of Consulting and Clinical Psychology, 73,
nonetheless at least for a short to maintain 86-98.
struggling, period,
Bonanno, G.A., Papa, A., LaLande, K., Westphal, M., & Coifman, K.
self-regulatory equilibrium.
to both en
(2004). The importance of being flexible: The ability
hance and suppress emotional expression predicts long-term ad

justment. Psychological Science, 15,482-487.

Recommended Readings
Bonanno, G.A., Rennicke, C, & Dekel, S. (in press). Self-enhancement
G.A. trauma, and human resilience: Have we
Bonanno, (2004). boss, survivors of the September 11th terrorist
among high-exposure
underestimated the human capacity to thrive after extremely
attack:Resilience or social Journal
maladjustment? of Personality
aversive events. American Psychologist, 59, 20-28.
and Social Psychology.
Bonanno, G.A., & Kaltman, S. (2001). The varieties of grief experience.
Bonanno, G.A., Wortman, C.B., Lehman, D.R., Tweed, R.G., Haring, M.,
Clinical Psychology Review, 21, 705-734.
Sonnega, J., Carr, D., & Neese, R.M. (2002). Resilience to loss
Gilbert, D.T., Pinel, E.C., Wilson, T.D., Blumberg, S.J., & Wheatley, T.
and chronic grief: A prospective study from pre-loss to 18 months
Immune source of durability
A bias in affective
(1998). neglect: and Social Psychology,
post-loss. Journal of Personality 83,1150?
forecasting. Journal of Personality and Social Psychology, 75,
1164.
617-638.
Fredrickson, B.L., Tugade, M.M., Waugh, CE., & Larkin, G.R. (2003).
Uuthar, S.S. (in press). Resilient adaptation. In D. Cicchetti & DJ. Cohen
What good are positive emotions in crisis? A prospective study of
(Eds.), Developmental psychopathology: Risk, disorder, and adap resilience and emotion following the terrorist attacks on the United
tation. New York: Wiley.
States on September 11th, 2001. Journal of Personality and Social

Psychology, 84, 365-376.

research was from to adverse
Acknowledgments?This supported by grants Garmezy, N. (1991). Resilience and vulnerability develop
the National Institutes of Health (R29-MH57274) and the Na mental outcomes associated with poverty. American Behavioral

tional Science Foundation (BCS-0202772 and BCS-0337643). Scientist, 34, 416-430.

McFarlane, A.C., & Yehuda, R. (1996). Resilience, vulnerability, and
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Bisconti, T.L., Bergeman, C.S., & Boker, S.M. (in press). Social support New York: Guilford.
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138 Volume 14?Number 3