There is no time like the present to discuss resilience-based chronic disease care, including in the effective management of Inflammatory Bowel Diseases (IBD) such as Crohn’s Disease and ulcerative colitis, which together affect more than 3 million US adults, many of whom are diagnosed before the age of 35. My research has shown that low resilience, or difficulties in bouncing back from stress or adversity, is associated with poorer IBD disease outcomes, poorer quality of life, more psychological distress and higher costs of care. The good news is that resilience can be learned with a growth mindset, or the belief that people can change and grow from negative experiences. Even better, when we teach our IBD patients new skills to build their resilience in the GRITT program at Mount Sinai, we see significant improvements in their outcomes, physically, emotionally, and even economically!
Here are 3 of my favorite ways to grow resilience, chronic disease or not:
1. Savor positive emotions.
Positive emotions such as joy, pride, love, gratitude and excitement are often fleeting and can be less memorable than negative emotions. However, studies show that people who have emo-diversity, or who experience a wider range of emotions throughout the day have less inflammation and better health than people who do not. Need help savoring the good stuff when you aren’t feeling well or living through a pandemic? Keep a gratitude journal (we are approaching Thanksgiving after all), look through photos from a favorite vacation, or practice random acts of kindness.
2. Nurture relationships.
Positive relationships are very important for health, particularly during times of high stress or adversity such as when our disease is in flare, or when we are planning for surgery or a change in medication. During the pandemic, it may feel difficult to nurture positive relationships when we must physically distance, hide our smiles under masks, and have fewer activities to engage in. Make a commitment to check in on the people you care about, respond and appreciate when others check in with you, and find new ways to connect with your family, neighbors, or roommates such as playing games or cooking together online. Time with pets can also reduce loneliness.
3. Choose optimism.
Are you a glass half full or glass half empty person? Science shows that while pessimists may sometimes be more accurate in their interpretation of events, optimists live longer, have healthier hearts, and are overall happier people. The difference between pessimists and optimists is in how they interpret the cause of good and bad events. To shift your perspective during a tough time, consider the “3 P’s”-
Permanent: Think of bad things as being temporary or changeable. “Once we get a vaccine for sars-Cov2, we will see each other again.” “Once my medication kicks in, I will be able to go on vacation again.”
Pervasive: Don’t let one bad experience bleed into other experiences. “Being furloughed from work doesn't mean I can’t be a good parent.” “Having a bowel accident on the subway doesn't mean I am a disgusting person.”
Personal: Be careful about taking on too much blame or responsibility for things that are out of your control. Not being able to find a new job during the pandemic is not necessarily a sign that you are not qualified. Being diagnosed with IBD doesn't mean you did something wrong (e.g. got too stressed out, didn't eat healthy enough).
Watch Dr. Keefer's video on how to choose optimism...
Finally, as we move into the holiday season in a year where we may not be able to celebrate as we ordinarily would, focus instead on building resilience by taking extra good care of yourself and your loved ones, savor positive emotions whenever you can, and look forward to a safer and healthier world in 2021!
About the Author
Laurie Keefer, PhD, is a clinical health psychologist and Professor of Medicine and Psychiatry at the Icahn School of Medicine at Mount Sinai in New York City. Dr Keefer is the Director of the IBD Subspecialty Medical Home at the Susan and Leonard Feinstein IBD Clinical Center, one of only a handful of fully integrated IBD Centers in the country. She is the inventor of the GRitTTM method, an evidence-based approach to building resilience among patients with Crohn’s Disease and ulcerative colitis. She has specialized in the application of behavioral interventions and positive psychology principles for chronic digestive disorders for the past 20 years, having sustained National Institutes of Health funding for her work since 2008. She is a sought-after speaker, mentor and consultant related to all things psychogastroenterology. She has more than 130 publications and recently edited the first handbook of psychogastroenterology for adults. In addition to her academic role, she is also the Co-Founder of Trellus Health, Inc., a connected health solution for people living with complex chronic conditions. She lives in Northern NJ with her husband and two children.