Resilience, Trauma and Coping (Friedberg and Malefakis, 2018)

Since the publication of “Resilience, Trauma and Coping,” resilience as a subject of study and focus of treatment has become more central to psychodynamic psychiatry. During the COVID-19 pandemic with its acute traumatic shock and post-acute phases with their long tail of chronic stress, there have been a multitude of mental health issues, such as anxiety, depression, posttraumatic stress, and grief. The disturbance has been profound in terms of psychiatric symptoms, impairment to social and occupational functioning, and exposure of societal inequities. During this time, the need for people to adapt to significant stress and deal with adversity has been highlighted by health problems, family and relationship issues, and work and financial concerns.

Correspondingly, enhancing a patient's resilience has become especially important for the treatment and care of patients—helping them adapt to challenges and change and deal better with uncertainty and doubt. The central principles of resilience-based treatment remain clear. Factors related to resilience include making connections with people and building relationships, seeing crises as surmountable, accepting reality and changing circumstances, moving toward realistic goals, gaining insight and nurturing a more confident and positive view of oneself, maintaining a hopeful outlook, taking care of oneself emotionally and physically, developing realistic optimism, and having sound beliefs and a strong moral compass. It has been found that resilience is fostered by empathy and altruistic practices.

Much is still to be learned about the factors impacting resilience in terms of genetic and epigenetic causes, neurochemistry, and developmental and psychosocial influences. However, psychopharmacological research has confirmed the efficacy of beta-blockers and continues to advance the integration of medication into various stages of psychodynamic