“The Therapy Groupie, Tough Guy, and the Doormat: A Study of Resilience in Post-Flood Peru” by Madeline Holland

“Resilience is all about being able to overcome the unexpected. Sustainability is about survival. The goal of existence is to thrive.” -Jamais Cascio

 

Introduction

In the past half of a century, the number of natural disasters and people affected by them have increased substantially. From 1967 to 1991 approximately 117 million people were affected by a natural disaster. From 2000 to 2010 it was projected that nearly 256 million people would be affected by a disaster in their locality (Perez-Salez 2001). Now in 2017, even more people are affected every year by natural disasters. With each trauma, psychological factors come into play. No one who experiences a disaster is untouched by it. According to the Center for Disease Control (CDC), reactions of stress and grief post-disaster are very prevalent in disaster victims, and have become normal coping responses to abnormal situations (2009). Although reactions of stress and grief are considered normal reactions, are they necessarily healthy? This leads to the larger question of ‘What is considered to be a healthy or unhealthy response to a natural disaster?’

For decades many areas of discipline have studied the effects of stress, though more recently the focus has been on extreme stress. In light of the number of increased disasters occurring, the literature and research on a term known as resilience has also had an upsurge. Resilience, put simply, is the ability to bounce back from a stressful situation. It is about not just coping, but coping well.

According to Masten and Narayan, resilience can be defined as “the capacity of a dynamic system to withstand or recover from significant challenges that threaten its stability, viability, or development” (2012). Resilience is a dynamic concept that can be applied to many systems across scales. From systems within an individual to whole ecosystems. In relation to humans, the systemic, relational perspective proposes that resilience is linked to internal, personal processes as well as external, environmental factors (Greene and Greene 2009).

Dr. Rachel Yehuda, Professor of Psychiatry and Neuroscience, has stated that regarding resilience, “for an inanimate object, the quality of never breaking despite exposure is a good definition, but for a person, perhaps it is better to conceptualize resilience as a process of moving forward and not returning back” (Southwick 2013). Her remark resonates most with me that resilience involves an active decision that must be frequently reevaluated and reconfirmed. That decision is to keep moving forward.

Resilience is a process. It is not a static objective trait that is stable across systems within the subject you are studying. Researchers could spend their careers trying to define resilience. Determinants of resilience include a myriad of biological, psychological, social and cultural factors that intermingle with one another to determine how one responds to stressful situations (Southwick 2013.)

Resilience is inherently hard to measure. There is some literature pointing to resilience as an emergent phenomenon. This suggests that it lies dormant and only reveals itself when people are under stressful situations. Roberta R. Greene et al. gives several examples of times when resilience can become active. This includes, but is not limited to: exceptionally challenging experiences, developmental transitions, individual adversity, collective adversity, organizational change, or large-scale sociopolitical change (Greene and Greene 2009). But, “resilience more likely exists on a continuum that may be present to differing degrees across multiple domains of life” (Southwick 2013).

Although there is a significant amount of literature on resilience, the majority are macro-levels studies and studies of children. Further research should focus on the individual and build from the ground up. It is through this that we can begin to grasp how individuals can foster resilience. By focusing on what can be controlled, the individual’s personal resilience, not what we cannot, the group with which they are placed or happen to be with during high-stress situations.

My focus is on the adults’ individual resilience, rather than community resilience, in the face of hardship in El Milagro, Peru. El Milagro is a community that has been severely affected by flooding caused by a recurring phenomenon called El Niño. I apply the Clinical Assessment Package for Client Risks and Strengths to my work in El Milagro to approximate resilience levels in community members, although I do not have the time nor means to apply the clinical assessment.

The group I travelled down to Peru with is a group of undergraduates who came for  the Anthropological Field School established through Utah State University (USU). In light of the recent flooding, our group created a donation campaign to bring water, sanitation, and hygiene (WASH) to those affected. We then had our groups’ in-country colleague and informant, Rafael, survey the flood area post-disaster. It was in this that he found the city of El Milagro and used the funds from the WASH campaign to provide basic needs such as food to the community members.

 

Background of the Olla Común

The flooding that occurs throughout Peru is a recurring natural phenomenon known as El Niño. Generally, it is a manageable occurrence. But, this year brought on a level of flooding the country has not seen in decades. This flooding was especially damaging to the city of El Milagro because portions of the barrier used to guide the normal flooding patterns were removed for people’s personal uses throughout the years.

El Milagro is a city in the northern coast of Peru. It came to be through a term known as invasion. This term in Spanish translates to ‘squatting’ and is defined as living on land you have no legal right to occupy (Krueger 2003). Squatter settlements are found to be most vulnerable to urban hazards, such as flash floods, earthquakes, or landslides (Paul 2004). Due to the type of neighborhood this is, El Milagro is a city made up of immigrants who are most vulnerable to the flooding. They are vulnerable because they are originally squatters and that they are all immigrants with less than normal levels of social cohesion. According to Dr. Giles Greene of Cardiff University, this social cohesion can be beneficial in forging resilience (2015).

Natural disasters destroy, kill, and…bring people together? With the flooding that occurred in Peru in March 2017, the community of El Milagro was left with hardly anything. Most people left. But, those that stayed, whether because they chose to or had nowhere else to go, formed a community that was not previously present. They began a community kitchen with the food Rafael brought every week through the money we sent down to him. This kitchen was called the Olla Común or ‘soup kitchen’ and created more social cohesion within the group, thereby inherently increasing community resilience to this natural disaster.

In visiting this Olla Común, I found the residents of El Milagro all have to deal with the effects of the floods as a community. But, individually, some people cope better than others; some are more resilient than others. There is a myriad of factors that could contribute to this. In studying the people of this small area, I hope to better understand what makes a resilient individual. According to the Clinical Assessment Package for Client Risks and Strengths mentioned above, we can roughly calculate risk of vulnerability through someone’s (1) emotional expressiveness, (2) family relationships, (3) peer relationships, and (4) the family’s embeddedness in the community (Greene and Greene 2009). Due to the nature of these questions, we can form a basic understanding of how the residents fare with these questions through our interactions with observations of them.

 

Methods

Mixed-Methods

In our five week visit to Peru we visited El Milagro one-two times a week for a few hours and visited with the residents. We conducted a variety of methods including: a census questionnaire, a needs assessment, and an asset questionnaire. Our census included information such as age, sex, DNI, or national identity document, relationship status, their place of origin, and familial relations in and out of El Milagro. The needs assessment gathered basic information regarding the needs of the community post-flood. After these were conducted, our group worked together to create an asset questionnaire. This was used as a semi-structured interview form to gather information such as personal skills, tangible assets, education, and the desires of each resident of El Milagro who was both available and willing to participate.

In my personal research, I used this time to conduct unobtrusive and participant observation.

 

Case-studies: the therapy groupie, the tough guy, and the doormat

Through this I noticed three people in particular who seemed to have quite different reactions to the disaster. This story paints the picture of me choosing my case studies…

It is our second week in Peru and our USU group takes a bus over to the community in El Milagro. As we get closer to the city, there is a point where road turns into dirt and buildings turn into ruins. The bus parks us right next to the Olla Común. The Olla Común is a designated area in front of one of the few houses still standing. Long bamboo-looking poles tied together with string form the framework for the designated area of the Olla Común. A blue tarp weaving in and out of the poles form the shelter for residents to gather under. Children run in and out of the shelter playing with the tarp among the rubble as young mothers keep a watchful eye near the food-prep area. As we walk up to the house attached to the tarp there are two wooden tables with stools on each end for us to sit.

Within our USU group we have three fluent Spanish speakers plus our colleague, Rafael. Each Spanish speaker has a group assigned to them and the task to interview the residents with our asset questionnaire. It is during this time of asking people to participate that I notice three residents in particular who seem to have very diverse reactions to these interviews. One is eager to engage with us, giving as much information as she can and standing near the center of the kitchen. The second is a man standing on the outskirts of the scene leaning against the house, seemingly removed and scoffing at the whole ordeal. Lastly a young mother who is quite shy catches my eye. She seems to be exhausted as her young boy runs around in the rubble with the other children running under the tarp and tugging on the makeshift structure.

In this encounter I started to realize that each person here has had quite different experiences with the flooding and are coping very differently. It is at this point that I began to see the inequities that have been occurring not only physically, but psychologically.

I initially attempted to work from the top down, looking for trends in the community as a whole. But searching for trends with such a small community is near impossible. Realizing I did not have the right circumstances to look for trends in the community, I began to work from the bottom up, observing these three individuals who I perceived to have differing levels of resilience and then looking for factors that could contribute to the way they coped with this trauma.

After that, my time was spent observing these three individuals. I used the clinical assessment to approximate resilience levels and compare the subjects to one another. On top of that, by comparing census data and data gathered from the asset questionnaire, I searched for differences in these three people and how other factors we have learned about these particular residents might play into their resilience levels. As we were able to see a little bit more into these three resident’s lives we were able to see how some of their mannerisms could play into their background.

Through these observations, information gathered from others in the USU group, and information from the asset questionnaire, I was able to piece together information relating to their resilience and the factors that might contribute to this. As I began to organize this information on the residents in my notes, the information seemed quite familiar to me; I felt like I had seen it before. This case study of the three residents seemed to apply to many other situations I had seen in stressful situations. It even reminded me of the different characteristics each of my family members have exhibited in times of high stress and even some of the characteristics I have shown.

These three case studies seemed to form the basic coping mechanisms I had seen over and over again with different people. It was as if humans in general take on the roles of these different characters as they attempt to cope with a stressor. A combination of these case studies with the aforementioned methods (census, needs, asset questionnaire) allows me to compare these three case studies more easily in regards to factors that could be contributors to resilience levels and the differing stress responses.

 

Data

In melding together these markers of resilience through the information gathered from the asset questionnaire I ranked these three residents in order of highest resilience to lowest resilience and began to create characters based off the traits I found demonstrated by these individuals.

 

Therapy Groupie Narrative

The first resident exhibits the characteristics of what I like to call the “Therapy Groupie”. The “therapy groupie” is someone I find to be highly resilient. She knows how to deal with stress because she has gone through it many times before and is cognizant of her own coping mechanism. By normalizing the situation as much as possible while still trying to change the circumstance and rebuild her life again she is able to overcome her situation in a productive way.

The “therapy groupie” works through what has occurred and has the time and mental capacity to be able to move on and rebuild her life. She exhibits traits of a securely attached individual in relation to her reaction to the stressor.

 

Tough Guy Narrative

The “Tough Guy” refuses to show weakness and puts up a front attempting to prove that they are unaffected by the disaster that has occurred. Similar to someone with avoidant attachment, they prefer to try and figure things out on their own and avoid actually working through the trauma because that means admitting that they were affected by it. This avoidant coping style is ultimately the most detrimental and eventually the character will have to change in order to process what has happened to them. It means giving up control and that scares them.

I can easily relate to the “tough guy” character because this was the façade I wore throughout most of my teenage years during a bout of depression. Luckily my mom, being trained in psychology, saw right through that and was stubborn enough to push me in a better direction.

The “tough guy’s” resilience levels are lower than that of the “therapy groupie”.

 

Doormat Narrative

This is the type of individual who is too busy to deal with the effects of the disaster and in a seemingly perpetual state of being victimized. It is in this that I find resilience most difficult to find. She’s the shy person who goes along with what has happened and doesn’t work through it herself because she is too busy trying to move on with her life that she’s just stuck. She is a doormat for other people to use for their own gain without gaining anything for herself. She is too worried about others to care for herself and in the end they will both go down. This is somewhat reflective of someone with an ambivalent attachment style. The “doormat” can have the potential for high resilience but there is something blocking that; whether it be responsibilities taking time away from fully coping or people who block the way to recovery. Because there is no conscious effort to change, this is where the lowest levels of resilience occur.

People are complex and there is no way to place people in boxes. But, this categorization of these three residents is a way to visualize and grasp part of the complexities that occur within the human psyche. Any individual can cope in a myriad of ways; some may be outside of these three groupings or even a combination of the characters. These three characters are my experiences that I have seen people exhibit in response to stressful situations and what I could infer from these three community members in the five weeks the USU group has visited El Milagro.

Table 1 illustrates that the “therapy groupie”, my first informant, has the highest level of resilience. This is followed by the “doormat” and ends with the “tough guy” exhibiting the lowest levels of these markers of resilience.

Table 1: Measures of Vulnerability Markers for the Three El Milagro Residents

Measures of Vulnerability Emotional Expressiveness Family Relationships Peer Relationships Embeddedness in Community Ranked level of Resilience
Therapy Groupie average high high high Highest
Tough Guy low low average low Lowest
Doormat average low high average Average

 

Conclusion

Understanding people, especially their mental capacities, takes much more than five weeks to even begin to grasp. Due to this setback, this research is more of a precursor and proposal for further research on the cultivation of individual resilience and if placing more resilient people in groups with less resilience can increase the factor overall for the group.

Groups we are placed in are rarely a choice. But, the literature does point out that during times of community adversity, an increase in levels of social cohesion allows for greater communication, which “reduce individual self-reliance and perceived inequity.” (Greene 2015). But, rather than focusing on creating good, intentional groups, let’s focus on the individual and fostering good interpersonal skills and skills that can help the group as a whole. By working on the individual level, we can create more resilient people and at that point it does not matter as much who is placed with whom. By building from the ground up this will lead to resilient groups and communities who can learn to create social cohesion regardless of the people they are placed with.

Resilience can best be thought of as a process that can be learned and fostered naturally by the microcultures involved in an individual’s life. The theme of the increased focus on resilience is that the experience of trauma does not merely submit to pathology. Through increasing the knowledge database regarding this topic, we can begin to create a competence-based model of mental health. One that focuses on prevention and strengthening the individual. As we move into this model of trauma related mental well-being we see that an effort “to sustain dignity, rather than simply to alleviate misery, is the key to a hopeful future.” (Southwick 2013).

Broader Impacts

I like to think of these three characters as comparable to the three main attachment styles found in the strange situation. The strange situation was a study done by Mary Ainsworth on attachment relationship between caregiver and child and how it affects your relationships later in life. In this she purported three initial ways in which humans attach in relationships. These main attachment styles are known as secure, avoidant, and ambivalent. “Much of resilience, especially in children, but also throughout the life span, is embedded in close relationships with other people” (Southwick 2013). Strange attachment styles are all about close relationships with other people and, with my background in psychology, I found it easiest to compare these characters to the characters explained through the strange experiment.

The study of resilience can be applied to many disciplines as shown by this bridging of anthropology and psychology. Resilience studies in El Milagro can resonate with many people’s coping styles and their ability to move forward in the face of traumatic experiences. This model  can be utilized in similar situations that bring about the coping mechanisms exhibited by these three case studies. This can bring about further understanding between the researcher, clinician, or disaster relief group and the individual affected. Through this understanding we can begin the road to recovery by promoting skills to increase their ability to move forward.

We need further research on individual resilience. I hope for a future where we can have training programs available to foster resilience. This way, when disaster situations occur, the millions of people projected to be affected will be able to have a better grasp on coping with disaster and stressful situations.

Works Cited

Pérez-Sales, Pau, et al. “Post-Traumatic Factors and Resilience: The Role of Shelter Management and Survivours’ Attitudes After the Earthquakes in El Salvador (2001).” Journal of Community & Applied Social Psychology, vol. 15, no. 5, Sep/Oct2005, pp. 368-382. EBSCOhost, doi:10.1002/casp.827.

Greene, Giles, et al. “Resilience and Vulnerability to the Psychological Harm from Flooding: The Role of Social Cohesion.” American Journal of Public Health, vol. 105, no. 9, Sept. 2015, pp. 1792-1795. EBSCOhost, doi:10.2105/AJPH.2015.302709.

Svendsen, Erika S., et al. “Recognizing Resilience.” American Journal of Public Health, vol. 104, no. 4, Apr. 2014, pp. 581-583. EBSCOhost, doi:10.2105/AJPH.2013.301848.

Greene, Roberta R. and David G. Greene. “Resilience in the Face of Disasters: Bridging Micro- and Macro-Perspectives.” Journal of Human Behavior in the Social Environment, vol. 19, no. 8, 20 Dec. 2009, pp. 1010-1024. EBSCOhost, doi:10.1080/10911350903126957.

Masten, Ann S. and Angela J. Narayan. “Child Development in the Context of Disaster, War, and Terrorism: Pathways of Risk and Resilience.” Annual Review of Psychology, vol. 63, no. 1, Feb. 2012, pp. 227-257. EBSCOhost, doi:10.1146/annurev-psych-120710-100356.

Southwick, Steven M. et al. “Resilience Definitions, Theory, and Challenges: Interdisciplinary Perspectives.” European Journal of Psychotraumatology 5 (2014): 10.3402/ejpt.v5.25338. PMC. Web. 28 June 2017.

Paul, Bimal Kanti. “Evidence against Disaster-Induced Migration: The 2004 Tornado in North-Central Bangladesh.” Disasters, vol. 29, no. 4, Dec. 2005, pp. 370-385. EBSCOhost, doi:10.1111/j.0361-3666.2005.00298.x.

Krueger, Alan B. “Economic Scene; A Study Looks at Squatters and Land Titles in Peru.” The New York Times. The New York Times, 08 Jan. 2003. Web. 23 June 2017.

 

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