Disseminating conclusions about the impact of this pandemic on the Individual is premature since the result will not be uniform or predictable. Studies on the issue are few and very specific, predominantly on Chinese health professionals who faced the situation in its initial phase, in a very critical context, with great ignorance of the complexity of the situation and with a future that was just a guess. (Lai J, Ma S, Wang Y et al. JAMA Netw Open 2020;3: e 203976)
We have all fallen headlong into an unexpected, profoundly life-altering global attack, beyond our control, for which there are no medicines. In this context, the risks to which the most vulnerable people are exposed are greater. There is nothing better to confirm our impotence.
Thus, we must try to understand the human dimension of these times and, from my role as a psychiatrist who listens to intimate experiences, I can’t fail to observe that we are facing a situation in which the word Resilience is at stake in all its dimensions. This concept, very present in the clinical dialogue, does not yet have a full scientific conceptualization that integrates the unique aspects of psychopathology: biological, psychological, social, cultural and anthropological.
The development of resilience in mental functioning dates back to ancient times in the evolutionary chain of mammals, and its protective character has played an essential role in the process of natural selection. It is defined by three parameters. Plasticity is the ability to be constantly changing and adapting. Sociability is a competence that keeps us in a one-to-one relationship with our environment and, finally, the facility of attributing Meaning to each situation, thus resorting to the cultural, spiritual and emotional concepts that we carry within. All this has a brain/body capable of creating a linkage, an endocrine system that produces substances that trigger adaptive physical proper Meaning to each situation is only human.
As a consequence of this perspective now focused on the experience of trauma, our attention is directed towards the importance of links within and outside of social groups; where some maintain and others construct and value the meaning that we attribute to relationships as the factor that will stimulate our ability to support or even direct our behaviour when experiencing a traumatic situation.
That said, today we are experiencing a momentum, a perhaps unrepeatable drive for people, with or without a diagnosis of psychiatric illness, to reinforce Resilience by building and maintaining ties, but with Meaning, which we will not find on social networks, and in a more vulnerable emotional state, recognizing and valuing a Resilience that we did not know and that has surprised us through the capabilities it has shown.
If we can extract any lesson from this pandemic, it is that now more than ever, the practice of medicine is an act of humility: we know very little, we have to keep learning and change.
From Lourdes Santos
Bachelor of Medicine from the Faculty of Medicine of the University of Porto.
Psychiatry specialist. Sisters Hospitallers’ Clinical advisor, Portuguese Province.