Watch the replay of this event held December 8, 2020 (transcript below)

Trouble sleeping. Bad dreams. Cracked teeth. Increased alcohol intake. As cases of Covid-19 boom, the attendant stress of living in a pandemic persists. More than half of Americans say that worry or stress about the Covid-19 pandemic has affected their mental or physical health. And many of our usual ways of coping — seeing friends and family, for example, or exercising at the gym — have been curtailed.

What are the keys to building psychological resilience in the face of difficulties? What does research reveal about how coping strategies lessen or worsen the damage from stress and trauma? How do those recommendations need to shift, given the realities of Covid? And how might people cope with the double stress of the pandemic and the holidays?

One key, researchers say, may be focusing on flexibility.

Join a discussion of the science of resilience and coping with psychologists George Bonanno, who has studied how veterans and others respond to trauma and loss, and Judith T. Moskowitz, whose work with patients diagnosed with HIV and cancer has helped uncover the power of effective coping methods. The speakers will share their insights on what steps can be taken now to protect against the long-reaching assaults of stress on our physical and mental health.

Speakers

Judith T. Moskowitz, PhD, Professor of Medical Social Sciences, Feinberg School of Medicine, Northwestern University

Judith Moskowitz trained as a social psychologist and studies the impact of positive emotion on adjustment to health-related and other life stress. She is the Principal Investigator of several NIH-funded trials of an intervention designed to increase positive emotion and improve psychological and physical well-being in people experiencing various types of life stress. Her research team is currently conducting trials of the intervention aimed at improving health and health behaviors in dementia caregivers, high school students, people with type 2 diabetes, women with stage IV breast cancer, and people living with HIV.

George A. Bonanno, PhD, Professor of Clinical Psychology and Director, Loss, Trauma, and Emotion Lab, Teachers College, Columbia University

George Bonanno’s research and scholarly interests have centered on the question of how human beings cope with loss, trauma and other forms of extreme adversity, with an emphasis on resilience and the salutary role of flexible coping and emotion regulation. The author of The Other Side of Sadness: What the New Science of Bereavement Tells us about Life After Loss, Bonanno’s recent work has focused on defining and documenting adult resilience in the face of loss or potential traumatic events, and on identifying predictors of both psychopathological and resilient outcomes.

Moderator

Eva Emerson, Editor in Chief, Knowable Magazine

Eva Emerson is Editor in Chief and cofounder of Knowable Magazine from Annual Reviews. A graduate of the UC Santa Cruz science communication program with a background in biology, she was formerly Editor in Chief of Science News Magazine.

About

This event is part of Reset: The Science of Crisis & Recovery, an ongoing series of live events and science journalism exploring how the world is navigating the coronavirus pandemic, its consequences and the way forward.

Reset is supported by a grant from the Alfred P. Sloan Foundation. Knowable Magazine is a product of Annual Reviews, a nonprofit publisher dedicated to synthesizing and integrating knowledge for the progress of science and the benefit of society. Major funding for Knowable comes from the Gordon and Betty Moore Foundation.

Resources

More from Knowable

Related Annual Review articles

Join in Judy Moskowitz’s PARK Program — positive emotion skills for coping with pandemic stress – and anything else in your life that is causing stress 

The PARK program consists of 8 skills aimed at increasing the daily experience of positive emotion to help you cope with whatever stress you might be experiencing. The skills are presented over the course of 5 weeks and after learning each skill, there is the opportunity to practice the skill on the platform as well.  

It is safe to say that life right now is really hard for everyone - certainly for those who have lost loved ones, who are working on the front lines in healthcare and other essential services, and people who have lost their jobs and face significant economic insecurity. But even for those of us who have not been so directly affected, there is a lot of fear, uncertainty, and helplessness and we don’t know when or if things will ever get back to “normal.” By sharing these skills, we are not saying that positive emotion will magically make everything better. Instead, the program is based on the fact that even in the midst of really challenging and stressful circumstances, when distress is dominant, positive emotion can occur and there are things you can do to notice, create and savor the good things to increase your own experience of positive emotion. We offer one place where you can have some control – your positive emotions – which decades of research has shown can help buffer you from whatever stress you (and we all) are experiencing. 

So if you’d like to give it a try, please visit us here: https://is.gd/PARKstudy

Transcript

Eva Emerson: Hello, and welcome to “Stress and Resilience in the Pandemic and Beyond,” the third in our series of conversations about the pandemic and its consequences. I’m Eva Emerson, the editor in chief of Knowable Magazine from Annual Reviews.

People deal with stress all the time and most do so fairly well, but this year has been very unusual. In a Kaiser Family Foundation poll, more than half of Americans said worry or stress related to the pandemic had affected their mental or physical health. There’s been huge progress, but there’s just so many uncertainties about the virus. Our daily lives have changed, our decision-making is up in the air as we try to navigate risks and a lot of unknowns. People are sick, cases are going up, deaths are going up, people are losing their jobs. So, yes, there’s a lot of stressors this year, and now the holidays are just about here. Take a deep breath.

As a biology student, I tend to think of stress as a fear-related kind of thing where you have a physiological reaction, a condition that threatens, or challenges, or imposes severe demands on the body and mind. And maybe your heart rate goes up, your blood pressure goes up, your hormone levels are affected, your brain. The psychological definition of stress brings a new level of complication to that because it involves the word “feeling,” which that for me is where I’m really glad today that we have two psychologists here who can help me with those very complicated, how we feel and behave. Today we’re going to hear from them. They’ve both done extensive research on people living through or recovering from extremely stressful circumstances. Their work has helped to reveal the ways that people can cope with the stress of an HIV diagnosis or thrive after the loss of a loved one or the experience of a traumatic event.

They are Judy Moskowitz, a professor of medical and social sciences at the Feinberg School of Medicine at Northwestern University. Judy is also the director of research at the Osher Center for Integrative Medicine and president of the International Positive Psychology Association. And also joining us today is George Bonanno, professor of clinical psychology at Columbia Teachers College. He’s the director of the Loss, Trauma, and Emotion Lab and author of the book “The Other Side of Sadness,” which looks at bereavement. Before we begin, I just want to remind everyone to add their questions to the chat and feel free to chat with each other. I know on our sourdough event people gave each other many baking tips, which was very fun. If we don’t address your questions during our conversation, we will take some 20 minutes or so in the last part to address as many as we can. Judy and George, thanks so much for joining us to talk about stress. I wonder if first you could each explain how you got interested in studying the response to stress. Judy, do you want to start?

Judy Moskowitz: Sure. Thank you. So this work started for me about 20, 25 years ago. I was a postdoc, I was studying stress and emotion and coping, and I was working on a study of men caring for the partners with AIDS. This was before the more effective treatment, so AIDS was essentially a terminal illness. So we were studying the caregivers and looking at what they were experiencing, the stress they were experiencing, and how they were coping with it. There were many interesting findings from the study, but one of the really interesting findings was that not everyone was devastated. There was a range of responses to this event. They were certainly depressed and distressed, but they were also managing to cope well and adaptively with it. And that started me on this path to looking at ways people can cope with both extreme stressful events, as well as more daily hassles, and looking at how they can do that adaptively.

Eva Emerson: OK. George, do you want to tell us about your experience? How did you find stress?

George Bonanno: Yes. Well, I think I found stress by accident. I took a position, somewhat reluctantly, in San Francisco also. Judy and I, I think, were in San Francisco at the same time before we met each other. And this was to study bereavement. As I mentioned, I wasn’t wildly enthusiastic about that; I didn’t know much about bereavement. But then I got, of course, very interested in it. We were finding, pretty early on, that a lot of people cope with loss remarkably well. We also felt that most people are not spared from stress when something really aversive happens, but they end up sort of working through it or getting through it in order to be resilient to that event.

That led to a very interesting idea really that, as we typically think about these events as some bad thing happens and bam, you have either PTSD, or some horrible response, or complicated grief or not. That in fact, there’s a period of time when most people are struggling with their reactions to that event they find a way through those reactions. So it transpires over a longer period of time. My work has then shifted, over time, to all kinds of other things. As we joke in my lab, anything bad that happens to somebody is what we want to study.

Eva Emerson: Presumably to help people through it. Great. Let’s start a little bit talking about some of that bad stuff, stress and its many forms. I think, I forgot, we had done a story maybe last year about 10 things to know about stress and health. And the list we got showing possibly stressful events in people’s life from the American Stress Institute was everything from divorce, job loss, death of a loved one, to changing the number of times you go to church a month. I mean, it was really just anything. I wonder if you guys could talk about that spectrum of stress and how you think about it in teeny, little, day-to-day stuff. Intense, short-lived, and then long-lasting.

Judy Moskowitz: Yeah, I mean, it’s interesting because there is a lot of individual variability in what is considered stressful. And two people can experience the objectively same event and have very different reactions to it. They’ll interpret it differently and then have different emotional reactions. One might find it very stressful and the other one might find it less so. So changing the number of times you go to church for one person could be very stressful for them and for another person it doesn’t even show up on their radar. There are definitely events that are pretty universally impactful and are perceived as stressful, so  I think the Covid pandemic is pretty much labeled as a stressor for everyone to some extent. But again, there’s variability within that. For some people, this is the worst thing that has ever happened to them, and it is extremely stressful. And for others, it’s hard and inconvenient, but it isn’t the worst thing that’s ever happened to them. There’s a lot of individual difference in how they perceive the pandemic and other types of events.

Eva Emerson: Right. George, did you want to say something about the spectrum?

George Bonanno: Yeah, I think, to add to what Judy had said, I think over time I’ve come to think of the way we confront stressors is really happens in a moment-to-moment basis in much more smaller moments than we, I think, typically think of them. Something happens to us and we feel uncomfortable or we feel something that could be stress or could be just momentary sense of unease, and we can manage that or we cannot manage it. But even in the big events that happen to us, they still occur in smaller pieces. And when we think about coping with a large event, we tend to, again, think of it as you’re coping with this thing. But in fact, this thing is moment, has its own small little pieces as well. So they’re constantly changing and constantly readjusting. I think that’s where you get a lot of the individual variation, is that how well people manage those constantly shifting moments in time when new challenges are confronting us, and we broke it down that way.

Eva Emerson: Judy, something you said that I thought was interesting, you said it’s about how people perceive it. Is that getting back into how we feel about it or how we label how we feel about it?

Judy Moskowitz: It does get back to how you feel about it, how you interpret an event determines, to a large extent, your emotional reaction. So again, going back to the example of two people experiencing the same event, the one I use a lot is, if you’re taking the bus somewhere and the bus is late, two people who are both waiting for that same bus might have very different interpretations. One person is going to be late for work and they’re going to be fired if they’re late for work. The other person is just going to the library. The consequence of them being late for the library is not nearly as significant. The second person is not going to be as stressed, is not going to have the same emotional reaction to the objectively same event. And what George was saying about big events, really there are a series of occurrences that we interpret, that we appraise, and then appraise as stressful or not, and then deal with it or not, and that these can accumulate as well. But again, there’s this individual difference in how people appraise the events and how they then cope with it and the emotional reaction from it.

Eva Emerson: Yeah. I mean, that is one thing that I wonder just as I was preparing for this. I definitely was noticing all of the media stories about how we’re all stressed out and all of our emails from our HR department saying, “We know you’re stressed out.” And part of me feels really like, “Yeah, I am stressed out.” Then part of me thinks like, “Well, I’m doing OK.” And I wonder, what’s your sense of, does it help to kind of create a saying like, “People are stressed, it’s OK.” Or does it make us think, “Oh, yes, I am stressed.”

George Bonanno: I actually bristle at that idea because I think, I don’t want somebody telling me whether I’m stressed or not, you know. I think that’s way too presumptuous. I think also, we sometimes tell people... telling people that they’re stressed, it may be counterproductive because people might think, “Well, I’m not stressed. Should I be stressed? Am I supposed to be stressed?”

Judy Moskowitz: “What’s wrong with me?”

George Bonanno: “What’s wrong with me?” There’s lots of evidence that that happens actually. I often think of this more in terms of how would... Judy mentioned appraisal, which is a huge part of this, I think, it’s how you’re seeing the situation. And then I think there’s another huge part is what you actually do. You could just say, “I can’t deal with this. I don’t want to think about it,” put it out of your mind. Then you relax a little bit, but then you turn around the next day and it’s still there, right? So that didn’t work so well. Or you may try something else that in this moment in time, “I’m going to really think this through and ponder it a little bit, because I should be worried about this, because this is important.” But then maybe that’s the wrong strategy. It’s really about how people see what’s happening to them, what they do about it. All these things come together over time to determine whether or not we’re going to manage ourselves well or things are going to get worse. Yeah, it’s a multifaceted process.

Judy Moskowitz: Yeah. And I think a more productive message from HR instead of saying, “You’re stressed. We know you’re stressed,” is, “You may be stressed.” Some people are feeling very stressed, so you sort of normalize the whole continuum and give people…

Eva Emerson: Oh, they probably did say that…

[laughter]

Judy Moskowitz: ... but what you heard was different, so they need to say it better, right?

Eva Emerson: Right. Yeah.

Judy Moskowitz: But I think sort of normalizing it so that people aren’t like, they hear the message and they’re like, “I’m really stressed, I’m not supposed to be stressed,” or, “I’m not stressed. What’s wrong with me?” Right? So it’s normalizing the whole process. Again, I keep going back to this: people react differently. There are individual differences in this. What we don’t want to say is, “You’re doing it wrong. You’re feeling it wrong,” right?

Eva Emerson: Right. I guess without negating the people who really are struggling.

Judy Moskowitz: Right, right. Genuinely. Yeah, yeah.

Eva Emerson: Yeah. So I think when we spoke before you guys said you both have been just called in a little bit, just casually, to be on the stress frontlines. I wonder, I think Judy you said you were called into something in your department or something. I wondered if you... I’m just curious about that, how being a stress expert is... how you’re being called to help in this time of when everyone’s possibly having some stress.

Judy Moskowitz: Yeah. Well, yeah. I mean, being known as the stress expert, I get there’s press. In the department they were saying, “Well, what can we do to cope with this stress?” and my response is, “Well, here’s the program that I am doing research on. We know that it can work. So try these things.” So that’s more coaching people through things that they can do to maybe feel a little better in the moment versus, “Here’s the one way to fix it,” which there isn’t one way to fix it. There are some things you can do that may be helpful for you, so I coach people through that. I talk a lot about normalizing the stress and having self-compassion no matter whatever you happen to be feeling, it’s OK, and it’s normal, and there are things you can do to feel better.

Eva Emerson: George, I was just thinking when we were talking about messages that everybody’s stressed and then people feeling like, “Oh, no, what if I’m not stressed? What’s wrong with me?” That sounds a lot like a little bit of your work on bereavement and how people felt like there was a certain way you had to act. And then if they didn’t feel that or act like that, they felt somewhat, I don’t know, weird. What was that effect of having the expectation of feeling “right”?

George Bonanno: Yeah. Back in the day, I think it’s still popular models, there was the stages of grief model, which still is probably enormously popular. That perspective kind of tells people, “Here’s what you will go through. This is what you will experience,” and many people don’t experience those pieces. And in fact, there’s no empirical support for it really at all. It’s potentially harmful for this very reason that people assume they should be feeling something and they’re not. And I think at the broader level, something really interesting about all this is, and this is something that I’ve only in recent years really come to appreciate that there’s a couple of different things. I actually have been calling this the flexibility mindset, for lack of a better term. But it’s sort of this idea that I’ll be able to deal with this. I’ll survive this, I’ll cope with it, I’ll deal with it.

There’s various pieces that go in this, optimism. Sometimes people call this, another dimension, coping self-efficacy, how these things interact. It’s really important, I think, to communicate that... I mean, one of the things that my research has focused on for so long, for decades now, is that most people are actually resilient to even the worst things. Not everybody, and that’s very important, not everybody. But around two-thirds typically on average across all these events. We recently did a review and we found across all kinds of events, around two-thirds of the people show basically a pretty stable health. Even despite they went through something really, they still showed a stable health.

That means that people will be okay for the most part. Often when I’m on these... I’ve been invited to participate in a lot of webinars, or speak with the press, and that’s almost... sometimes when the press calls I tell them, “Just let’s cut to the end part where you’re going to stick me in at the end of the article.” Then they say, “Well, no. They’ll be …” It’s often where I end up in articles. I think that it’s, I mean, we don’t want to communicate that, “This is no big deal. You’ll be fine, don’t worry about it,” because we do have to struggle with these things. As Judy pointed out, the COVID crisis is really demanding in so many different ways, but by the same token, I think we can do it. I think for the most part we have done it. Human beings are adapting to this.

Maybe we don’t want to go too far down that road because it’s a little crazy at times, but I think that it’s real important that people have a sense that they will get through this. Because that is a really important ingredient of actually doing that kind of coping, the more difficult part. If you feel like you can do it, you will do it. You will put the effort in to work out what it is you need to do, how you should do it. I think that’s really important. So maybe, getting back to HR example, maybe they could say something like, “We have the capability to do this. We can do this, but we need to do it together,” etc. Something like that.

Eva Emerson: Yeah. I think that’s a really good transition as much as I like to focus on the problem of stress. Because I think one of my coping mechanisms might be complaining. But…

Judy Moskowitz: Very effective.

Eva Emerson: Yeah. I wonder if …

George Bonanno: Wait, I have to take a phone call, HR is on the phone. I’m just kidding.

[laughter]

Eva Emerson: Oh, I really am going to get in trouble now. I mean, we’ve been focusing on, I mean, I think, on the problem. Maybe let’s start talking about what we can do to get to that end point that you were just talking about, George. And Judy, let’s start with you. I mean, I know you do a lot of research actually on interventions and helping people cope. What does the research say about some of the main ways that people do cope, healthy and unhealthy?

Judy Moskowitz: Yeah. So there are a lot of ways to look at the coping response, which is, when something is stressful and you’re experiencing those emotions associated with feeling stress. There are a number of cognitive and behavioral things that people do just to deal with that negative feeling, to deal with that stress. Sometimes it’s what we call problem-focused coping, where you identify the source of the stress and you really address that problem. That can work when it’s something you have control over, where you can actually do something. And then there’s a big group of types of responses that we call, emotion-focused coping that focuses on the emotions and the generally negative emotions that come out of the stressor, the stressful event. And this can be everything from distancing yourself from the stressor or distraction, which can be very adaptive. Escapism sometimes, just doing something to just forget about it for a while, again, can be adaptive. It really depends on the circumstance.

And then the types of emotion-focused coping that we’ve been focused on in my research team most recently are types of things you can do to increase your experience of positive emotion, even when you’re experiencing stress. This is something we learned from the AIDS caregivers early on, that even though they were in a very stressful situation that led to a lot of negative emotions, they were also able to experience positive emotions alongside it. So we’ve put together a program, a set of skills — you can think of them as coping skills — that have been shown to increase momentary experiences of positive emotion, which help you sort of take a break from the ongoing stress. It’s things like gratitude, noticing positive events and savoring them, acts of kindness. We have a program that we tested in groups experiencing different types of stress, all kinds of health-related stress, major life stress, less daily hassles or less stressful things. And we teach people how to use these sort of tools to have more positive emotion. And then we think this helps build up their resources for coping with stress in the moment and going forward.

Eva Emerson: Great. Are some of these… I wonder if you could talk about unhealthy versus healthy. I mean, are some ways we cope really get dangerous? I mean, I’m just thinking of like stress eating or...

Judy Moskowitz: There are definitely ways of coping that generally are unhealthy, but it really depends on the context and the situation. Sometimes eating a chocolate cake is a bad idea if you do it for a long time, but you know, once in a while chocolate makes you happy. I would say that can be adaptive. I don’t know. I mean, I think George, your model speaks to the context and when types of coping can be beneficial or not as well.

George Bonanno: Very much so. That’s in the work on flexibility that we’ve done. Very much, I think you said it, Judy, you said the key phrase, it depends on the context. Every situation is different and how we get through that particular situation. I often think of the story someone told me once of, they decided, “I’m going to just get this off my mind, so I can do what I need to do, get back in my life. I’m going to stop thinking about this bad thing that happened to me, and I’m going to drink tonight and watch bad movies. I’m just going to sit there and drink and watch a bad movie.” I’m not talking about myself by the way. And it actually didn’t work, which is interesting. It didn’t make that person feel any better. But he then said, “Well, but at least I was in control. I was deciding to do that and that made me feel better.” So even though it wasn’t necessarily effective in making him feel better, it did give him a sense that he was going to take charge of the situation.

It’s not anything you would typically be advised to do. But I would add one more component so there’s that kind of, what’s the situation? What’s happening, or what will work in this situation? But I think we also have to, we always need a kind of a feedback, some kind of mechanism for feedback, where we say, “I think this should work here. I’m going to do this to help myself,” and it doesn’t work. We need to be paying attention to that feedback. The feedback is that our own bodies will tell us if it’s working or not, but also other people around us might be telling us that as well. I think that’s a really crucial part of this whole process is paying attention to the results of what you try. And we learn from that and we also...

In something like the Covid crisis, I think that’s crucial because a lot of the stressors in the Covid crisis are so unique. They’re things we haven’t had to deal with, like lockdown is not something most of us have gone through. We try to find ways to deal with that and we find out what works and what doesn’t. But then two months later we find out maybe this isn’t working anymore because the game has changed a little bit. I think a great example was actually Zoom connection. People were reaching out to other people on Zoom a lot, or you  know, Zoom or any other vehicle for video chat. People were reaching out to other people, making those connections and all the research seemed to support that that was a really good thing to be doing. And it still is a good thing to be doing, except we all get a little tired of it, I think, right? And so we have to find other ways. We’re now at a different phase in this process.

Eva Emerson: I wonder, George, can you talk a little bit about the difference between coping and resilience?

George Bonanno: Yeah, sure. In at least the way I think about it, and I mean, I’m a little bit biased because I think the way I think about it is the right way to think about it. But I think that the idea of resilience, it’s really, it’s about time. We have to bring time into the question, because we’re resilient to something. We’re only resilient to something. Something happens to us and then we’re either resilient to it or not. And that is a matter of time, and it’s really an outcome. It’s the result of whatever we’ve done. Coping is kind of how we manage the challenge we face. It’s what we do in response to that challenge we face, and resilience is one of the possible outcomes. We’re either resilient to that challenge or we’re not. And it’s not… This is a really important point actually because resilience isn’t, it’s not a simple binary outcome of say resilience or depression, or resilience or PTSD, or grief.

It’s really, they’re different patterns and this is something we’ve done in our work for years now is that resilience is one of those patterns. That’s a relatively healthy trajectory, is somebody who’s gone through an event and they continue to function pretty well after it. Even though they feel the stress of it, they feel the challenge of it, but they continue to function in their life pretty well. They can concentrate when they need to, they can be close to other people when they need to. That’s what I would call resilience. At that particular moment in time, that’s resilience. But then some people struggle more. It takes them a while longer to sort of get beyond the event. Some people get worse over time and some people don’t recover for a long time. Those are all different patterns. And I see resilience as one of those patterns. A person is resilient to an event that doesn’t guarantee they’ll be resilient to the next major challenge they face.

Eva Emerson: Did you want to say a little bit more about context too? There are certain situations that resilience is really important whereas just coping, if that makes sense.

George Bonanno: Well, I always think of resilience as the outcome to an event. And the context is really where you get into the coping part of it. I think of coping, I’ve never done a lot of research per se on coping, so I don’t feel like I need the category at all really. I just think of the things we do. And so I think the context is really what the challenge is. Each event, even a major event, will have multiple context in it. The context of what one is dealing with right at this moment, that’s the context, and how you deal with the stressors, the challenges of that context, are really what matters. If it’s Covid, it could be I have to go to the doctor tomorrow, I have to go to the hospital, I need a procedure and I can’t avoid it. I don’t want to be in the hospital in the middle of a Covid crisis, so that’s the challenge of that moment.

Or I need to do a certain other thing, or I’m starting to feel a lot of stress because I haven’t been able to get any exercise. Any of these things that might be challenging. I’m now worried about a relative, or I’m worried about myself, or there’s tension in the household because my college students are back home, or something like that, which all these are... or my small children. It’s hard to go outside with my small children in a city or we don’t have a car. I’m sorry, these are all very New York-centric things I’m telling you. These are the kinds of things that people are struggling with at different times, or I’m worried about my job, the place I work is not doing well, I’m worried about money. That particular point in time, that might be the stressor and we have to find a way to manage that stress.

We both have to manage it practically but also emotionally, psychologically manage it. So all those things are a different context. I think of resilience in the broader sense, it’s a much broader timeframe of how we’re doing overall.

Eva Emerson: So when we’ve spoken before you basically said it’s really not a personality type though,  resilience.

George Bonanno: Yes. Yeah. Well, and the reason I think, it’s not really a personality type. I think that personality plays a role in resilience. The type of person we are maybe make us more or less resilient. But so many other things also make us more or less resilient. And when we look at these various predictors of resilience, these various correlates of resilience, we find, overwhelmingly, that they all are pretty small effects. If you try to make sense of who’s going to be resilient or not, you get a lot of little pieces. There are no big pieces, right? If I want to say, “I’m a resilient person,” and the evidence for that would be what I? My personality? No, it’s only going to explain a little bit because it all depends on how you respond to the next adversity.

So personality plays a little bit a role, your social behavior plays a little bit a role, the resources you have at your disposal play a role. There’s some genetic role. There’s some pretty solid evidence that there’s a genetic piece to this. There’s your physical health, your immune system, how well your immune system is doing, there are your belief systems. So many different factors come into play and the resources are not a small part of that. There are social resources, financial resources, all of these things play a piece of that process. And I think we tend to think that personality is the driving factor, but it really just simply is not. Statistically, in terms of the research evidence, it’s not. I think that’s because, I mean, I have...

My own personal view on this is this. Because we essentialize it, we think that resilience is kind of a thing that exists in nature and resilience is not a thing in nature, it’s an outcome. We may be a healthy person, but we still have to cope with the thing that happens to us. We still have to do it in a moment-by-moment basis.

Judy Moskowitz: One of the great things, just to add to that, one of the great things about not having resilience be a personality characteristic is, if it’s not my personality, if I’m not a resilient person, then there’s something I can do about it. If it’s a personality characteristic, you’re either resilient or you’re not, and no matter what you experience, you’re not going to be resilient no matter what you do. But if you think of resilience as the outcome, there are things you can do based on the context, and then you can have a resilient outcome. I think it gives hope to all of us who might think that we’re not so resilient. There’s always something you can do.

George Bonanno: Judy, it’s fantastic. The little bit you just said, Judy. That’s fantastic. You nailed it, I think, perfectly, because if we’re just resilient because of who we are, there’s no insight into why. It doesn’t tell us why, and we need to know what people do. Your work is so important in this regard, I think, because you are on to a piece of it and you teach people how to engage in that piece and you’re giving them tools to work with, that’s so important, regardless of who they are, regardless of their personality. Yeah.

Eva Emerson: I think we’re getting some good questions and some of them are matching up with mine, and they seem practical. But I think they tap into the whole flexibility and looking for feedback to see if your coping mechanism is working. One of them is basically, what should people do if their normal coping mechanisms aren’t available, the gym is closed, they can’t see their family and friends. What do you recommend?

George Bonanno: I would say, this is when we have to get creative. This is when we have to think. And I think, instead of thinking only about the coping mechanisms, we need to think about the context as Judy mentioned. We need to think, what is actually happening right now? What is it? I don’t mean in the concrete sense, but really, if I need to be coping, that means I’m not feeling well, or I’m feeling kind of upset, or I’m feeling stressed out. We can say, what is it that’s causing that? What’s the problem that I really need to solve? And then we can think creatively about that problem. We can try something new or try something we haven’t maybe done before. I experienced this personally because, for me, exercise is the go-to mechanism throughout this Covid crisis. I exercise many times a day almost obsessively because it was so helpful to me. It got me out of the house, it cleared my mind, and it made me physically feel good and strong.

And then I had two surgeries at two different times during this crisis. This was not my plan, to have two surgeries. For a period of time, about a month each, I could not exercise. I had to find new things I could do. I think I tried breathing exercises, which I could do despite my weakened body. I think I went back to trying meditative-type things. I watched a lot of bad movies. I did not drink, but I watched a lot of bad movies. I think that it really is about being creative, and we can be creative.

Judy Moskowitz: Yeah. I think that piece about, what’s the problem? What’s causing me to feel this way? Why am I feeling bad? Sometimes you can address the problem. Not being able to exercise was making you feel bad, so you found another way to be physically active or to have that physical reaction. Sometimes the problem can’t be addressed. You are forced to work from home and that’s stressful — you can’t be as productive as you normally will — but if you can find something in that event that you do have some control over. I’m forced to work from home, that’s really stressful. Maybe there’s a way I can arrange my workspace so it feels more like a workspace so that I can be somewhat productive. It’s like, if you can break it down into something that you can control, that can be really helpful.

Early on in the pandemic I had my college student home and my other son’s in high school, and my husband was here. So the four of us were all here. Every day I would set a list of attainable goals for myself. It would be really simple like, “I want to get outside once. I want to make a salad for lunch.” They were really simple things and I would text it to the family group chat. We’re all in the same house, so I would text them. They never really responded, but it made me feel better. I had said, “OK, here are the things I’m going to do today.” Then when I was able to do it, I could cross it off, and that gave me a hit of positive emotion. It wasn’t really hitting the stress of the pandemic, it wasn’t getting the vaccine to us any faster, but it was making me feel better, and that it gave me some sense of control in that I was doing something on my list that I had written down. Then actually crossing that off the list gives you a hit of positive emotion. So if you can, like George says, get creative, find something that you can control in this situation, that can be really helpful.

Eva Emerson: OK. This was a question I think that I’m interested in too. Someone asked, can a person be unconsciously stressed out and feel, in this pandemic especially, maybe they’re going, they’re going, but maybe it’s slipping out a little bit?

Judy Moskowitz: I would say yes…

George Bonanno: I think so. Yeah. There’s a really interesting concept called MUPS, medically unexplained symptoms. Do you know this word, Judy? MUPS. Or this phrase? It’s an acronym.

Judy Moskowitz: I know the phrase a little bit. Yeah.

George Bonanno: It’s basically when you’re experiencing stress, but you’re not fully aware of it or you’re only fleetingly aware of it. Consciousnesses, there is no defining point. But you feel, “I’m stressed out, but I’m just going to soldier on because I’m busy and I’ve got things to do or I don’t want to think about it.” But the stress wears us out and then these physical manifestations happen. And those are clear indicators. They’re a little bit abstract because say it’s a back problem, or a digestive problem, or a skin problem or anything else, or fatigue, or something that’s a result of the stress. But yeah, I mean, I wouldn’t use the word unconscious stress, but I think you can keep it pretty remote from your awareness. Yeah, definitely.

Judy Moskowitz: Yeah. I think this often comes out in just having negative emotions but not really being aware of why. I think a lot of people don’t have a lot of insight into why they’re feeling what they’re feeling. Sometimes you can just be, it’s like when you’re feeling angry and you kick the dog. I mean, the dog didn’t do anything, but you’re feeling this emotion and you’re attributing it to the dog. But really it’s something else that’s going on in your environment that you aren’t fully aware of why that’s causing you or that that’s the source of your negative emotions.

Eva Emerson: Right. This is kind of related to that, and it’s a little bit different from what someone asked. Let’s say maybe the person you’re sharing a house with seems to be having a lot of negative emotions, but maybe they’re not emotionally aware that they are stressed. Is there a way to talk to people in your house or in your family if you think they’re stressed?

Judy Moskowitz: Well, George, you’re the clinically trained one here, so you take this one.

George Bonanno: Oh my God. That’s really a tough question. Way above my pay grade, this one. I think this is really a complicated question because it really it’s about relationships and families and I feel I’m barely, barely, you know... I don’t have a great answer to that question. I really don’t. Because it really is so idiosyncratic, I think, within personalities and families. Although I think there’s probably some pretty good evidence — my memory’s a little vague here — that there’s a contagion around these kinds of emotions. Being around someone who’s feeling a lot of negative emotion makes life harder, basically. Especially over time. Some emotions like sad faces pull for sympathy from other people. We know this. There’s pretty good research on that. But it’s all very time-limited. If a person’s making a sad face and it makes me want to feel bad for them, after a while that’s going to wear on me and I’m going to stop doing that and I’m going to want to push them away. I mean, in terms of talking about it, I don’t know. I mean, I think it’s such a complicated question. I wouldn’t venture to an answer that. I think whatever I would say would probably be wrong.

Judy Moskowitz: Yeah. I mean, I think with some types of coping too it’s really hard, maybe even harder with people you’re close with, to say, “You know what you should be doing? You should really look on the bright side here. This is what you need to do.” That skill that I just said, that looking on the bright side, it’s called positive reappraisal, and it’s something that I teach as part of our program. My kids know what this is and they know what I do, but I would never try to positively reappraise anything for them. Like I wouldn’t say, “Sorry you didn’t make the team. Look on the bright side, now you have more time to do your homework.” I mean, you can’t do it for other people.

But what you can do with kids is you can role-model it. I’m not good at hiding how I feel or what I’m doing anyway so they see it. They see the way I cope with things. Over the years, they’ve started to adopt some of this. I’m happy to see it. But it wasn’t because I said, “I’m an expert in stress and coping, and here are the things you need to do.” I think it’s maybe particularly dangerous if you’re a psychologist, you don’t want to be going at your family and telling them what to do. But you can role-model it and do the things that you hope that they’ll do, and maybe that will work.

George Bonanno: Yeah. Yeah.

Eva Emerson: There’s someone who asked, “How can you help people who are isolated?” Because they feel like the stress of isolation is taking a very big toll actually on their clients, so that might be a therapist or something… The thing of trying to do for someone else, whereas they kind of need to come to it themselves.

George Bonanno: I think you could probably get people. If you’re having a conversation with somebody, you could probably help them brainstorm ways they could try to alleviate that loneliness. I had an interesting conversation with actually a colleague who is working. Some of the flexibility ideas that I’ve developed is trying to implement them in a hospital setting with people who are dealing with very serious stressors. And she had told me that she was using lists of possible coping behaviors. I had said, which is my typical response, “Well, I don’t really like the idea of list of behaviors because it applies these are the right behaviors, or these are the magic behaviors, or the key traits or whatever.” What I thought was very astute she had said, “Well, you know, when people are stressed out and really struggling, they’re not thinking real clearly, so giving them a list of options or even just, ‘Here. take a look at this list of things, try some of these things’ can actually be very helpful.”

It turns out if you Google “traits of resilience” or “lists of coping behaviors,” all kinds of stuff comes up and you get ideas of what you can try. Ways to combat loneliness. If you Googled that, probably lots of different things would come up right now, isolation. You can look through those things and go through these same steps we’ve been talking about. But what am I really struggling with here? If it’s isolated, I’m feeling isolated, well, are any of these things feasible? Let me try one of these things and see what happens. I’ll try it and see what happens, right? What is the result if I try this?

Judy Moskowitz: Yeah.

Eva Emerson: How do you evaluate if the coping mechanism isn’t working and it’s time to move on to try something new?

George Bonanno: I think that’s pretty basic. I mean, I always think of it in at least two basic, for lack of a better word, kinds of feedback. One is your own body. If you’re feeling uneasy, if you’re feeling like you need to cope with something, if you’re feeling isolated and lonely, do you feel less lonely when you try something? Does your own emotional reactions change? Then some other things are more amenable to what other people show you. If someone’s telling you, you look stressed out or you look unwell, that’s feedback that you’re not doing well. But if you get a different reaction out of people or people engage with you more, that’s other kinds of feedback. But I think really that our own bodies, our own inner state, is really the best source of information. Yeah.

Judy Moskowitz: Yeah. I was going to say your emotional reaction. If you have a certain level of awareness of the emotions you’re experiencing, you’re experiencing a negative emotion. You try some coping and it changes that emotion for the better, then that’s useful feedback. Or it doesn’t change it, but it’s also useful feedback. It’s the being able to be in touch with your emotions that you’re experiencing and be aware of how they’re changing in response to whatever you’re trying.

Eva Emerson: OK. Paying attention.

Judy Moskowitz: Mm-hmm [affirmative].

Eva Emerson: Let me see. This is an interesting question, I don’t know if, is there a way to move beyond? Someone asked, “Can you learn to be more flexible if you’re just naturally a rigid person?”

Judy Moskowitz: Yes.

George Bonanno: I think so. Yeah. I think so. Yeah. Actually, if I may, may I speak to that. One of the reasons I got into flexibility is because I’ve been studying resilience, the kind of resilience I’ve described, for about 25 years now. I got very tired of people talking about building resilience, which is a very nice idea. But I think it’s very hard to do that because resilience is such a complicated thing and it’s so momentary, from moment to moment. But I got very interested in flexibility about 15 years ago because I think flexibility, which is really what Judy and I have been talking about in a sense, is learnable. It’s something that we can break it down to these pieces and actually teach it. Funny thing is that, I don’t do much in the way of intervention now, but in the course of — I’m just finishing a book on these newer ideas — I got interested in self-talk. I don’t know if you’ve ever played around with self-talk, Judy, but I found it quite fascinating that you can make self-talk for...

I started thinking of these questions. What’s the problem here? What’s happening to me? What do I need to do? What am I able to do? Is it working? Those are all questions we can ask ourselves, self-talk questions. We can also give ourselves little pep talks, I can do it. Ethan Cross has this really interesting research on, it’s third-person pronouns or using your own name. You would say… Judy, you might just say, “Judy, come on, you can do this.” Or, “Judy, you know you know …”

Judy Moskowitz: Do it all the time.

George Bonanno: Yeah, exactly. It feels a little odd to use your own name, to talk to yourself that way. We can, I think, break it down to these pieces and practice these pieces. I really think people can learn these things, can move the needle to some extent. Yeah, definitely.

Eva Emerson: We just have about five more minutes. I wondered, what are some of the big questions about stress, coping, resilience, whichever, that you guys are hoping to answer in your work in the coming years. Judy, do you want to start?

Judy Moskowitz: Sure. Yeah. The big question driving my work now is, if we take this program that we’ve developed, how do we deliver it so that people will learn the skills and take them up as a habit and then carry them forward? So, what works? Which parts of this work? For whom? How do we have to tailor the program for different people to make it work? We’re delivering this set of skills or teaching this set of skills and when people do them they’re helpful. How do we tailor the program? How do we deliver it? How do we make it easy to take up and make a habit, so that it can work for people for whatever type of stress they’re experiencing? That’s the big driver for our research right now.

Eva Emerson: I thought you were doing a survey?

George Bonanno: I didn’t hear.

Eva Emerson: Oh, I asked Judy if she was doing a survey about the pandemic stress, or trying to use your points…

Judy Moskowitz: We are doing a test of this program. Yeah. We are doing a test of this program in the general public. We do a survey at baseline to see how they’re doing, look at depression, anxiety, emotions, and then they can learn this program through, it’s an online self-guided program. And then we measure their well-being at the end again. We’ve just been doing it for a few months, but it looks like people who go through the program are doing better in terms of depression, anxiety, social isolation, positive emotion, meaning and purpose — so, all the things. They’re improving over time if they practice these skills. It doesn’t mean that we’re fixing everything, but it looks like we’re able to teach people these skills and that it is helpful when they do them.

Eva Emerson: Are you going to send me a link to that, that I could put on our page at the end of this? Yes, so…

Judy Moskowitz: Yes, I will do that.

Eva Emerson: George, you tell us a little bit about what questions you’re hoping to answer. I know you just finished a book, so you have a little more time to do research on “The End of Trauma”? Is that what it was called?

George Bonanno: The book is called “The End of Trauma.” Yes. I think what I’m working on right now is I’m really trying to... we’ve been doing a lot of research throughout the Covid crisis in whatever way we can, but I’m really interested in how the pieces fit together. So we’ve talked about a lot of different pieces of this problem, of how people deal with stress and how they come out on the other end of it, and how they come out OK. I’m particularly interested in these different pieces. The preliminary work we’ve done with flexibility, where we’ve looked at reading the context, having a repertoire of coping behaviors, monitoring and adjusting, we’ve actually found that most people are reasonably good at all of these things, because most people are resilient and it makes sense. Most people would be reasonably good.

But then of course we have variation. And one of the things we found was that reading the context, paying attention to the context, is more important even than the other pieces of this puzzle. I think that’s not something that has received much attention. You really have to figure out, “What is it that I’m dealing with right now in order to deal with it best?” It almost doesn’t matter how good your coping is if you’re not reading the situation properly, if you’re not paying attention to what’s happening to you. That’s what we saw. We find that it was a little bit of a newer finding. As a researcher, I want to replicate this, really make sure that this is correct. But also there’s so much more to it. I think that this...

Eva Emerson: What’s an example? Oh, you can’t hear me. I was just asking if there’s an example of that?

George Bonanno: Of what? Of reading the context?

Eva Emerson: Yes.

George Bonanno: Well, say, OK, you go into a situation with friends and you’re feeling uneasy, say, or you didn’t have a good evening in a gathering with friends or you’re at your job or something and... there’s so many examples, I’m struggling to actually name one. It’s any time really we’re in a situation we’re just not dealing with it well, we’re feeling uneasy. You meet a new friend or you meet a new relative or you’re with a person you haven’t been with before, there’s just something that’s not working or you’re feeling not so good. Often you hear people say they’re just not feeling great some day, but they don’t know why. I think we can pay attention to, “What actually is happening to me? What is making me feel uneasy like this, or why?”

I think a couple of weeks ago I was outside running in a park in New York and I almost ran into a couple of very strange characters who wanted to fight with me. I wasn’t exactly sure why that was, and I still am not 100 percent sure, but then I found myself being uneasy about this for a few days later, but I wasn’t sure what it was that I was uneasy about. Was it my own safety? Was it that I didn’t understand the situation? Was it that I didn’t do something I should have done? I think thinking that through it helped me realize what the actual problem was that I could then address. There are so many possible examples it’s almost even hard to name one. Because every time we’re feeling somewhat uneasy, it’s usually something’s happening to us that’s causing it. Often we don’t know what it is, we’re not paying attention.

Paying attention is more than just... it means really trying to think, “What is it that’s bothering me and then what can I do about it?” Et cetera. But I think all of this is still at a very simple level. That’s one of the things I’m very interested in now is trying to get as many of these pieces together, and we have the tools now. We have machine learning and we have these other approaches and we’re playing around with machine learning a lot now because it has surprises in it. What is it that’s driving the situation? But, I mean, this will keep me busy for a long time.

Eva Emerson: OK. My last thing, I know we’re over time, is, any specific tips for the holidays? Because I know for me it’s just a stressful time of year. Anything people can do?

George Bonanno: I think Judy’s probably got the answer to this one because it’s something …

Judy Moskowitz: I would start with self-compassion. Know that everyone’s having a hard time. Many people are really suffering. It’s OK if you’re feeling bad. Don’t have the same expectations that you might normally have for the holiday season for feeling festive and joyful. Just know that we’re all in this together. There is reason for hope and that you can focus on that. But cut yourself some slack this holiday season is my No. 1 tip.

Eva Emerson: That sounds like a good one. Thanks you guys so much for joining us today. That was really fun. I know that there was way more questions. We will be posting this video today probably or tomorrow on our website, knowablemagazine.org. Eventually we’ll also get the transcript posted. And if there’s any chance to answer additional questions we’ll try to do that. It’s been really great having you here. Thank you so much. Oh, I am supposed to give a little talk. Thanks to the Alfred P. Sloan Foundation and the Gordon and Betty Moore Foundation for the wonderful support of Knowable Magazine, and of course, special thanks again to Judy and George. We will also be posting on our website on the page with this video, additional resources, including articles that Judy and George have authored for the Annual Reviews journals that will be available for free to read from that page.

I wanted to remind you as well that this is a series of conversation is part of our “Reset: The Science of Crisis and Recovery.” The next one will be held December 16th, and we’re going to be talking about the origin of spread of viruses from animals to humans and preventing the next spillover event. The best way to keep up with everything that we’re up to is to sign up for our weekly newsletter. Also, if you enjoyed what you saw today and you enjoy reading Knowable, we just launched our first donation campaign to gain supporters, even $5 a month can help us. Please go to our website and donate. That’s all for me. Please stay flexible, cope well and enjoy the rest of your day. Thank you.

Judy Moskowitz: Thank you.

George Bonanno: Thank you, all.