The Four Domain Model of Resilience

When I work with patients, I do a lot of the typical things that psychiatrists do:  I ask a lot of questions and I listen really hard to find out what's going on.  However, as you may have gathered from my last post, when I ask and listen, I'm also doing so with the goal of trying to understand what kinds of things are already working for the person sitting across from me.

Using a model developed by Dr. Nathaniel Laor, I look for specific strengths that fall within one or more of the four "Domains of Resilience."    By using this model, I am better able to map out where a person is thriving in addition to getting a direction for where and how to intervene.  Intervention can be as simple as supporting and encouraging a person to continue doing what they're already doing or helping them to develop new skill sets that may help them better address their concerns.

Here are the four "Domains" as I have interpreted them:

1) Biological - Simply put, this domain contains all of the ways our physical body deals with the stress of life.  It includes a huge range of factors that can be as small as the tiny molecules of inflammation that our body creates to deal with environmental and emotional toxins, or as big as the variability of our heart rate that reflects how easily our body relaxes after stress.  Though not easy to see on the outside, I can often get a sense of what a person's state of resilience is in this domain by asking about their diet, their exercise routine, whether they have any mindfulness practices and even how long they sit during a normal work day.  Interestingly, all of the other domains of resilience are ultimately translated back into the biological.  This means that people who are able to cultivate other kinds of internal strength can boost their biological resilience as well.

2) Psychological - How do we relate to ourselves?  The mind can be a powerful ally for helping us deal with the stressors we encounter in our daily lives.  The way we take in information, process the meaning of what we experience, express to ourselves and others what we think and feel, and behave in response to these thoughts and feelings says a lot about how well we are able to deal with stress.  Do you filter out certain types of information without knowing it?  Do you see new things as threats or as challenges?  How well do you understand the way your mind works?  Do you think positively about yourself?  The answers to these questions say a lot about how well a person is able to deal with the stressors of life.

3) Interpersonal - How do we relate with others?  We live in a world filled with other beautiful and complicated human beings.  How well we create, nourish, draw strength from and, if necessary, end relationships with others is one of the most important and
central tasks of living.  In times of ease, these relationships add richness and joy to our lives.  In times of stress, the stability and support of relationships can get us through hard times with a whole lot less wear and tear.  As relationships are so common, one would think that we'd be pretty good at negotiating the ins-and-outs of being in one.  Not so surprisingly, this is rarely if ever the case.  Given how fundamental relationships are to our lives, figuring out how to build and sustain a strong network of people we trust and who trust us is one of the most powerful resilience factors we have.

4) Transcendent - Why are you here?  I don't mean reading my blog (though if you're enjoying it, please let me know what you think), but here in this world.  That's a very big question, but by asking yourself and taking some time to answer that question, you can have a pretty powerful impact on how well you deal with whatever else may come your way.  Some of the healthiest folk I've worked with over the years were able to overcome what seemed to be insurmountable challenges and hardships through an awareness that their lives had a greater purpose.  They found this awareness in a number of areas, though most commonly through faith, through a commitment to service to the world and through creativity.

Please let me know what you think in the comments section.

-B