Resilience and thriving: issues, models, and linkages - Thriving: Broadening the Paradigm Beyond Illness to Health

Journal of Social Issues, Summer, 1998 by Charles S. Carver

The theme of this issue of the Journal is that the experience of adversity (serious stress or trauma, physical or psychological) can sometimes yield benefits to the person who experiences it. My contribution is to make conceptual distinctions among several related-but-not-identical experiences and to raise some issues about how to best conceptualize the topic under discussion. In the latter context I also consider one way of approaching the question of why some people seem to benefit from adversity whereas others do not. Finally, I review some constructs used in other areas of psychology that seem relevant to this topic.

Responses to Adversity: The Domain of Possibilities

When a physical or psychological downturn occurs in response to adversity, it has at least four potential consequences (O'Leary & Ickovics, 1995).(1) One possibility is a continued downward slide (cf. Aldwin, 1994) in which the initial detrimental effect is compounded and the individual eventually succumbs [ILLUSTRATION FOR FIGURE 1 OMITTED]. A second possible outcome is a weaker version of this one: The person survives but is diminished or impaired in some respect. A third possible outcome is a return to the pre-adversity level of functioning, a return that can be either rapid or more gradual. The fourth possibility - the focus of this collection of articles - is that the person may not merely return to the previous level of functioning but may surpass it in some manner.

O'Leary and Ickovics (1995) used the term thriving to refer to this fourth possibility (see also O'Leary, this issue). In discussing this concept, they argued for the broader utility of a model that postulates more than homeostatic health maintenance. They argued that theorists, researchers, and practitioners need to recognize that adversity can eventually bring about benefits (see also Affleck & Tennen, 1996; Aldwin, 1994; Park, Cohen, & Murch, 1996; Tedeschi & Calhoun, 1995). That is, sometimes the experience of adversity promotes the emergence of a quality that makes the person better off afterward than beforehand.

This principle is presumed to apply both to psychological and to physical well being. Most of the articles of this issue deal with thriving as a psychological phenomenon, but we should give at least brief consideration to how the concept applies to physical well being. How can adversity lead people to have better health, if they were healthy before the onset of the adversity?

A moment's reflection reveals that there are at least a couple of ways for this to happen. For example, a child who contracts chicken pox emerges from the experience with an immunity to subsequent chicken pox. Thus, in a sense this child's health is better afterward than it was before falling ill. Similarly, a sedentary person with poor nutritional habits who, after a serious illness, becomes dedicated to exercise and healthy eating is in better health afterward than beforehand. There are limits, however. Even an excellent athlete can improve his or her condition only to some asymptote. Perhaps there are analogous limits to psychological thriving as well.

Definitional Issues

To evaluate the possibility that a person can be better off after adversity than beforehand requires us to be as clear as possible in our discussions. I offer a few suggestions in that regard. I suggest that the term resilience be reserved to denote homeostatic return to a prior condition (which I believe this term is commonly understood to imply). I suggest we take care to use another term - and thriving seems as good a candidate as any - to refer to the better-off-afterward experience.

Another distinction should also be upheld, this one concerning the situations that people confront. Highly stressful circumstances are usually characterized by the possibility of harm. Sometimes, however, there is also an opportunity for gain. These conditions are often distinguished from each other by labeling the former threat and the latter challenge (Lazarus, 1966; Lazarus & Folkman, 1984). These conditions differ from each other conceptually, but they often co-occur. This has led several authors to propose that the two conditions fuse in the experience of crisis (Erikson, 1968; see also O'Leary & Ickovics, 1995).

Although it's important to recognize that these two conditions can co-occur, it is also important to keep the concepts (and the labels) distinct from one another. Sometimes stressors - especially traumatic events - begin as pure threats (or losses). Only later (if at all) does the sense of challenge emerge. To treat threat and challenge as equivalent and interchangeable blurs potentially important issues. Beyond the issue of conceptual clarity, honoring this distinction also suggests research hypotheses. For example, there may be merit in examining the time course of traumatic events and their aftermath, to determine whether there is a predictable time course within which challenge emerges from an experience that initally was only threatening or damaging.