Nat Geo group at Kili Summit
We made it to the top - it felt so good
Mt. Kilimanjaro, Tanzania
Mt. Kilimanjaro, Tanzania (Photo credit: Wikimedia Commons)

Recently my wife and I climbed Mount Kilimanjaro in Africa. We saw the beautiful pictures in a National Geographic-Mountain Travel brochure and never thought twice. “It looks like fun,” we said, “let’s go!” And that was it. We paid for the trip, bought the tickets, and shopped for hiking and cold-weather gear.

But here is what we didn’t do…we didn’t train for it (unless you count my wife running up and down our rather steep driveway six or seven times—she said it was hard).

It was a grueling eight-day slog in rain, hail, and snow. There was slippery mud and treacherous rocks. And, on the last night when we camped near the glacier, it was bone-chilling cold regardless of our high-end cold weather clothes and equipment.

Despite the challenges, everyone in our group of fifteen made it to the top—we all summited. Some had second thoughts at about 13,000 feet, but the guides gave them some TLC (otherwise known as tender loving care) and they tromped on. Everybody experienced pain; knees that were aching, quads were quivering from exertion, and lungs were gasping for oxygen in the rarified environment above 15,000 feet—but nobody quit.

What kept us going? In a word: RESILIENCE.

 

What is resilience?

It’s hard to define resilience. The American Psychological Association defines resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat.” The definition leaves a lot to be desired in terms of precision and clarity. What sort of “process?” What exactly is “adapting well?”…as well as could be expected?

Resilience is not limited to withstanding physical stress only. Every soldier, every rape victim, every abused child who is psychologically functioning well is also resilient. Their counterparts, the ones who did not bounce back, are now defined as suffering from post-traumatic stress disorder (PTSD), depression and phobias.

So what is it that leaves one person unaffected by trauma and and another experiencing a lifetime of horror? As we say when we don’t have a simple answer, it’s a good question.

 

Genetics of resilience

Genetic factors play an important role. Twin studies (Nat. Rev. Neurosci. Vol.10, 446, 2009) have estimated a 32 -38% heritability of PTSD. But that’s not where the influence of genetics ends.

Parental care (positive or negative) can become heritable through epigenetic mechanisms. This refers to the non-genetic changes in gene expression through methylation of genes, or their regulators. Thus the influence of child abuse may not be limited to the victim; his or her genomes have been altered and transmitted by parents to their offspring.

Epigenetic_mechanisms
Graphic credit: Wikipedia

 

Is It All in the Genes? Definitely Not.

Developmental and protective factors have an enormous impact on brain development and on shaping neural circuits that regulate future responses to stress and adversity. Repeated episodes of child abuse can lead to “learned helplessness” and can cause exaggerated emotional, behavioral, sympathetic and hormonal responsiveness to future stressors, even in adulthood (Science, vol.338, 79, 2012).

On the other hand, mild to moderate stressors can have a “steeling effect” on the individual. A child who is exposed to moderate stress by her friends, or a student who is taking periodic evaluation tests, builds up coping mechanisms to deal with them. And, they will served well in facing future stresses in adulthood.

 

How Do You Build Up Resilience?

Exam stressLet me share some personal experience. During my tenure at UCSF, I was teaching Biochemistry to first-year students. There was always a certain group of students who, when taking a test, would freeze up, sweat profusely and blow the test.

Now, these were not dumb students. If I talked to them in a non-threatening environment, such as my office, and I would discover that they have mastery of the subject matter.

This led me to run a small experiment. I started giving the class weekly non-graded quizzes. The problems were not easy, but there was no threat of a bad grade. In fact, there was no grade at all, only my comments and suggestions for improvement.

The “sweaters” stopped sweating and nobody froze up. A few weeks later, I introduced grades, but with the assurance that they are meant only for self-assessment and will not count in determining the final grade. Nobody got rattled.

Finally, I introduced grades on subsequent quizzes that would count for only 20% of the final grade. Again, there were no real problems. And, what about the stressful final? As you could guess, the group that didn’t handle stress well at the beginning of the course were now “immunized” to the stress of the exam.

 

But Does This Work in “Real” Life?

A similar technique is being used in treatment of veterans with PTSD. It is called Prolonged Exposure Therapy. Traumatized individuals are asked to practice situations they have been avoiding because they are related to the trauma they experienced. An example from the National Center for PTSD, a part of the US Department of Veterans Affairs is asking a veteran who avoids driving since experiencing a roadside bomb while on active duty to begin driving again. Overtime, this type of exposure is supposed to held reduce the stress and build resilience. The exposure therapy is usually combined with stress reduction activities, such as breathing exercises, and a specific type of talk therapy, called imaginal exposure,  where the veteran talks through the trauma memory again and again with a therapist.

 

Back to Kilimanjaro

So what accounts for all fifteen ordinary people, non-athletes, making it to the summit of a 19,341- foot high mountain despite horrendous conditions? I haven’t interviewed in depth every member of the group. But after 8 days of struggle on the mountain and living together in close quarters, one can get a fairly good idea who your fellow travelers are. They were all “normal,” nothing remarkable. But they all proved to be resilient.

Nat Geo group at Kili Summit
Most of the group at the Summit of Kili

They faced the adversity knowing that however tough the challenge, they can make it. You look around and you see the other fourteen, people just like you, determined to reach the summit. It gives you enough confidence in your own resilience.

So, my friends, genetics is only partially responsible for resilience. Your upbringing, your life experiences, and your social support system are just as important. Or maybe even more so.


This post was first written Feb. 18, 2013.  It was updated on July 29, 2015.

Dov Michaeli, MD, PhD
Dov Michaeli, MD, PhD loves to write about the brain and human behavior as well as translate complicated basic science concepts into entertainment for the rest of us. He was a professor at the University of California San Francisco before leaving to enter the world of biotech. He served as the Chief Medical Officer of biotech companies, including Aphton Corporation. He also founded and served as the CEO of Madah Medica, an early stage biotech company developing products to improve post-surgical pain control. He is now retired and enjoys working out, following the stock market, travelling the world, and, of course, writing for TDWI.

18 COMMENTS

  1. Thanks for this overview about resiliency. Your Kilamanjaro analogy seems, however, oddly inappropriate. The mountain story would have been a fine stand-alone piece had you been intending to write about how a supportive hiking group can help motivate you to keep going up a tough slog that you voluntarily signed up for. But to compare what you call your “resilience” because you finished the hike despite your lack of training to the resilience shown by those who have survived actual trauma and are suffering through PTSD is a bit of a stretch.

    In fact, your decision sounds like an ill-advised adventure of privilege, much like those available to wealthy pseudo-adventurers who decide it “looks like fun” to complete the Seven Summit challenge (climbing the seven tallest mountains on each continent) despite not being trained mountaineers.

    The preventable results of such elitist whims can indeed be catastrophic, but not just dangerous for the climber (consider, for example, the evidence provided by Krakauer and others of Nepalese sherpas falling to their deaths because they were trying to save their rich untrained American clients).

    As another comment here from Marty already asks: “What were you thinking?”

  2. Thanks for sharing your vast experiences and insights, and making them easy to understand…..lots of food for thought.

  3. Thanks for this crisp and clear description of resilience. Worth thinking about and sharing. So thankful you and Pat made it to the mountain top and back! What were you thinking about not training for this?

    Marty

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