From Both Sides of the Couch

A therapist reflects on her time with patients, and her time as a patient.

What Makes the Difference between Resilience and Relapse?

Resilience is both made and born.

I did not consider myself a resilient person. In my twenty seven year history of psychiatric illness, I have fallen from grace so many times after repeatedly fighting my way back, I have lost count. There have been slips, falls, relapses and outright collapses, but in the end they all ended up resulting in a step or two backwards. At times, I felt that I had lost my place.

I’m not only talking about relapse in terms of addiction, though I have succumbed in that area, but anorexia, depression and other self-harming behaviors.

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Some relapses resulted in hospitalization, a few I was able to work through as an outpatient, maybe with the addition of an extra session per week for a while. At times, a medication adjustment helped tremendously. All of these backslides left me with the feeling that I had failed. Failed myself, my therapist, my family, my friends, and if I was working at the time, my employers.

The questions I needed to look at each time included what happened, why now and how can I get out of this hell? Seemingly simple questions requiring complicated answers — answers that were too difficult to fathom -— especially when I was caught in the hazy cloud of illness.

What struck me, regardless of the number of times I went through this was that the fall seemed to happen so quickly, like a boulder gaining momentum as it flails down a hillside, but, to lift myself out of this abyss took significantly longer. That was always my perception; I could easily be wrong.

Was I born a non-resilient child? Certainly I was a sensitive one. In sixth grade, I raised my hand to ask permission to take the bathroom pass. “Gerri,” Mrs. Pearlman said, “You need to use the girls’ room quite often.” She caught me in mid-stride headed out of the classroom door. I stood in front of the class for a moment, frozen. Returning the pass to the blackboard railing, I headed back to my desk, where the tears began. “There she goes again,” Mrs. Pearlman announced to the class. She named an actress from the 1960’s who was known for her dramatic outbursts. Humiliated, I buried my face in my folded arms lying ready on the desk.

 I am repeatedly amazed by the resilience I see in many of my patients. Given the families in which they are raised, the neighborhoods in which they grew up, there is an underground spring in them as evidenced by their initial desire to seek treatment. That spring bubbles up as they continue to return week after week to work through difficult issues, as they make connections and detangle threads from their past which, when finally freed from the knot, illuminate old patterns of destructive behavior.

Not to say that for every two or three steps forward, there isn’t one step back. Change is frightening and people are reluctant to surrender perspectives and behaviors that may have worked for them in the past.

“Progress is not a linear path,” I tell all of my patients and I often drawn a zig-zaggy line on a legal pad to illustrate my point. “If you were making straight, astronomical progress, I’d be more concerned than if you were following this ziggy-zaggy line I just drew.” And they get it.

Riding this non-linear course, I believe, is what builds additional resilience even more than what nature may have given us. I still have difficulty considering myself a resilient individual. I continually face and struggle with life’s little and not-so-little “speed bumps” as I like to call them. Still in therapy, I regard the support and expertise of my psychiatrist as essential.

But I am making my way.

Gerri Luce is a licensed clinical social worker who publishes under a pseudonym.

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