Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for October 26th, 2010

Resilience

Posted by Dr. Vollmer on October 26, 2010

     In line with https://shirahvollmermd.wordpress.com/2010/10/24/nowhere-boy/, Salvatore, forty-eight, is a story of remarkable resilience. Resilience, as a teacher friend of mine told me, is a concept that schools do not pay enough attention to. Educational institutions look to the lowest performing children and ask why are they failing, rather than looking at the high performing students and ask why are they succeeding? Michael Rutter MD, a British Child Psychiatrist, pioneered this exploration of resilience; the characteristics of children who thrive, despite what appears to be overwhelming trauma and neglect.

     Salvatore comes back to my mind. He is the youngest of nine children, born to an alcoholic mother and a physically abusive father. His maternal grandmother was schizophrenic. One sibling killed herself by hanging; another died tragically in a car accident when the sibling was ten and he was eight. Sal’s been married three times; he has one autistic son, Manuel, age twenty-four. Having seen Sal for many years, I have never experienced him as pessimistic, bitter, angry or resentful. By contrast, I see him accepting his life’s circumstances, while at the same time striving to have a better life than his parents had. Sal, in mid-life, took out college loans to get his degree. That landed him a good job, where he is financially solvent, and proud of it. He sees me because “it helps to talk,” he says. Sal has good friends, although there are times they disappoint him. Sal takes good care of Manuel. He is plugged into the Regional Center; he lives in a condominium with other autistic young adults, and together, they share in-home services so that they can live semi-independently. Sal feels good about that. Sal is dating, a “lovely” woman with two young kids. He is optimistic.

   Sal’s dad passed away recently so Sal had a family gathering at his house. Although I knew the story about his family of origin, he refreshed my memory, only this time with more detail. His six remaining siblings are all struggling, financially and emotionally. Sal helps them out occasionally, but by Sal’s account, none of them express gratitude. As I inquire about each sibling, their lives, their children, their physical and psychological struggles, I keep asking myself, what made Sal so different? I am impressed with Sal’s executive functioning skills. He is organized, thoughtful and diligent. He plans well. Maybe that is an important piece, but of course, I do not know the other siblings. Yet,  from what I hear, they all suffer from a lack of long-term thinking; they all sound impulsive.

      The frontal lobes, particularly the prefrontal cortex, is the area of the brain which is thought to be responsible for executive functioning skills. I am guessing that Sal lucked out in the frontal lobes lottery, but I also know that is not the whole story. Sal loved his mom, despite her persistent alcohol use throughout his childhood. Sal describes his mom holding him down while his father beat him with a belt buckle, but he tells me that tale with no anger towards his mom. “She had a hard life,” he says, with great compassion for her. “She should not have had children; reproduction was a bad idea for her,” he says, as I laugh, but he maintains a straight face. I am perplexed; how does Sal develop compassion for a woman who held him down while he was beaten? Maybe that was a relatively rare event, I wonder to myself. Maybe as I get to know Sal more deeply, I will understand this issue better, but I know that although I am deeply curious, that is not Sal’s agenda. Sal wants to “talk things out.” I understand. Some questions stay silent.

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