I WILL NOT LEAVE YOU DESOLATE— LOSS, GRIEF, RESILIENCE
Ernesto Vasquez, MD
July 2, 2021
In John 14:18 Jesus promises us that he will not leave us desolate. When I look at that passage in the light of Christ’s commandment of loving one another in John 13:34, then I begin to surmise how, at least in part, the Lord may intend his promise to unfold—we are to be his instruments in the process.
Jesus seems to have given us a morally grave and inescapable responsibility to continually look after each other in love, not to leave one another desolate, that is, in emotional misattunement.
As a Christian and as a clinician, I have found a psychology called Intersubjective-Systems Theory extremely helpful in clinical work. Just like in the Scripture above, intersubjectivity theory considers the interplay of our subjective worlds of emotional experience foundational to our being-human-in-the-world. This psychology and Scripture can be in conversation seamlessly: spiritually and psychologically, we are human beings in the world in relationship with God and one another.
Attuned emotional interplay is of course what grounds the therapeutic relationship as well. It is what allows the clinician to fulfill the third requirement of the old medical injunction ‘To cure rarely, to treat often, to comfort always’. We do not leave our patients desolate. Compassion means ‘to suffer with’ which is what can give meaning to the patient’s suffering. It is together that we come to shared understandings of awful predicaments, and of how to alleviate them.
In my June 19, 2021 post in this blog, I illustrated how intersubjectivity works in the experiences of loss, grief, and trauma, and their mitigation. In that context, I referred to the ETHICAL NOTION in intersubjective psychology of being an emotionally attuned RELATIONAL HOME for the desolation of the bereaved or of the traumatized other. It is a notion that is applicable across the board. We are supposed to be an attuned relational home for the emotional life of one another ‘in SICKNESS and in HEALTH’.
Accordingly, in this communication I explore, on the health side, the relational notion of resilience. That is, how God may make provision not only for healing, but more generally for living, utilizing the capacity of intersubjectivity he has given us as part of the natural processes he created and through which he interacts with us.
The term resilience refers to the emotional ability or capacity to adapt well-enough to stress, trauma, and adversity, enabling us to avoid stress-induced difficulties such as posttraumatic stress disorder (PTSD).
One other foundational concept of intersubjectivity theory is that all psychological phenomena emerge from and are maintained in THE COMPLEX RELATIONAL SYSTEM formed by the interplay of our emotional worlds. Which is to say that our individual psychological life and functioning, including our sense of vulnerability and resilience, are actually thoroughly relational at all times. They do not exist in isolation, ever.
Resilience seems to involve a form of adjudication process, some way of figuring out, moment by moment, what the best emotional response to our relational circumstances might be, and then engaging in that response.
It can be understood as a form of PRACTICAL WISDOM we practice relationally to develop and nurture. It is not a thing that resides just inside us like the gallbladder.
But how would a person do this? How would a person determine, for example, when to seek support from others, when to use distraction, when to talk about the event, or try to make sense of it, or keep their spirits up, and so on?
Bonanno (2013) calls that process flexible self-regulation and suggests that it is what undergirds resilience. It is not a simple or one-dimensional process but, rather, it involves multiple interacting elements.
He envisions a sequence of THREE ELEMENTS OF WHAT I WOULD CALL BEING EMOTIONALLY FLEXIBLE in which propensities and abilities vary from time to time and from person to person:
-sensitivity to relational context,
-a rich repertoire of emotional regulatory strategies, and
–responsiveness to feedback.
Relational context sensitivity is the crucial capability to figure out the emotional demands of any given situation. Here was ask ourselves, explicitly or implicitly, “What is happening?” and “What do I need to do?”
In the next step, repertoire, we chose a regulatory response that will best meet the specific challenges we are facing at that moment from a set of emotional regulatory strategies we have come to use well-enough. In other words, here the question shifts from “What do I need to do?” to “What am I capable of doing?”
This leads to the third step, feedback monitoring. Flexible emotional responding requires ongoing monitoring. We do this essentially by asking ourselves, “Is it working?” and then either continuing, ceasing, adjusting or replacing strategies as necessary.
Depending on the nature of situational challenges, a person might cycle through the emotional flexibility sequence any number of times. For example, an especially difficult or demanding circumstance may necessitate repeatedly correcting and revising strategy use. We learn from experience.
Moreover, since emotional situational challenges are not static but constantly changing, the regulatory strategy likely to be most effective will tend to change over the course of the same stressor episode.
Simply put, what works at one moment may no longer be effective a short while later. It may often be necessary to cycle through the flexibility sequence multiple times within the same stressor episode.
Finally, for more enduring traumatic stress reactions, it may be necessary to cycle through the sequence repeatedly over a period ranging anywhere from a few hours to a few weeks or longer.
Practice makes better, not perfect. With practice we develop a motivational foundation for flexible emotional responding, we create an overall conviction, an emotional flexibility mindset, that helps us engage with the difficult tasks at hand. AND IT IS ALL BY GOD’S GRACE!
Bonanno, G. A., & Burton, C. L. (2013). Regulatory flexibility: An individual differences perspective on coping and emotion regulation. Perspectives on Psychological Science, 8(6), 591–612. doi:10.1177/1745691613504116.