A new paper written by Dr. Schwarz, a professor of media and communications at the Free University of Berlin, critiques the concept of resilience in psychology and psychiatry for putting forth the message that pathology and wellness occur at the individual level. This is risky, Schwarz argues, as it places a focus on fixing individuals rather than flawed social systems.
“Due to a decontextualizing tendency in Western mainstream psychologies, the concept of resilience may be at risk of reproducing power imbalances and discrimination within our society,” Schwarz argues.
Following a critical analysis of the term’s history, Schwarz pushes for a contextual model of resilience that seeks to address power imbalances, neoliberal economics, and discrimination, rather than aide in their oppressive reproduction.
“Only with this contextualized understanding of resilience, power differentials that account for an unequal distribution of health resources within our society become visible,” she adds.
Before the 1990s, psychology and psychiatry focused primarily on experiences of trauma and adversity that led to an individual’s suffering and difficulty in functioning. Later, the focus shifted with the recognition that people respond to trauma in diverse ways, and in many cases, they respond positively, writes Schwarz. Indeed, research by Dr. Bonnano at Columbia University demonstrates that only a small percentage of individuals who have experienced traumatic events go on to suffer from a severely disabling condition.
This focus on strength, adaptivity, and resilience, rather than risk and pathology, can interfere in a mental health market that revolves around treatment. Schwarz underscores the influence of the Western world’s neoliberal system, which pervasively shapes what resilience means. In a system that prioritizes individualism, commodification, and commercialization, resilience becomes an asset that promises a better life and a commodity worth buying and maintaining. As such, people grow less invested in connecting to a deep understanding of their problems and more concerned with how to reap the rewards of resilience. Schwarz writes:
“Commodification helps to de-contextualize subjective experiences from their structural embeddedness, from economic and political as well as cultural frameworks. It disconnects people from the possibilities they already possess to deal with a problem (referring to constructive as well as destructive coping attempts). Commodification contributes to a hierarchical relationship between a ‘patient’ and a psychiatric professional.”
Psychiatry and psychology inevitably play a role in this, too, Schwarz contends. Psychiatric and psychological perspectives originate and exist within specific cultures and, as a result, these fields cannot exist apolitically. Both fields have historically sought to assert legitimacy by claiming proximity to the natural sciences (e.g., physics, chemistry, biology), believing that constructs such as depression or resilience are separate, distinct entities that can be located and observed in the natural world and individual bodies. However, research fails to support the assumption that people’s psychological experiences and personal suffering can be reduced to a purely biomedical phenomenon at the individual level.
To observe physiological changes in a person that corresponds to their experiences is to be expected, yet this does not necessarily mean that the problem originated physiologically in neat and exact ways. In other words, Schwarz highlights that resilience is an experience very much informed by our contexts and situations, not just our personal attributes:
“Even when not applying a strong antipsychiatry standpoint like Szasz, the biomedical model in mental health contains problematic pre-assumptions: mental health problems are located within an individual person, understood as being biological in nature or due to faulty cognitive or emotional processing.”
Without recognizing this important interplay between our economic and sociopolitical surroundings and our risk and resilience, psychology and psychiatry risk reproducing power imbalances and problematic social structures. This is particularly true when these fields take on the task of defining normal and abnormal experiences, no less by the diplomatic process of voting on the inclusion of diagnostic constructs, Schwarz points out.
“The mental health system, with its division between sick and healthy, vulnerable and resilient, is considered as a key institution of social control,” she writes. “Psychiatric diagnosis, the labelling of resilience and vulnerability, functions as a political device legitimating a particular response to aberrant behavior. The mental health system, clinical psychology, and psychiatry, are the rule makers for acceptable behavior by naming and specifying what is ‘mad,’ ‘aberrant,’ and ‘vulnerable.’”
Tying this back to neoliberal economics, Schwarz argues that psychiatry and psychology not only assume the power to define experiences but by doing so take part in a neoliberal culture that enables professionals to capitalize on selling ideas of pathologies and corresponding treatments that psychologists and psychiatrists provide. She writes:
“The brands of disorders develop a market including a variety of products and services: professionals with expertise in that brand and who apply certain techniques such as a particular medication or psychotherapy, books, courses, and so on. In a neoliberal logic, commodities tend to give only temporary experiences of satisfaction, markets need to keep selling, need to keep the monetary flow going. Therefore, concepts such as resilience offer a desire to convince consumers that there is a better product available or if they stop consuming a brand, their life may deteriorate.”
Schwarz takes the position that mental health concepts, like resilience, reflect the moral codes of current society. Even when specific pathologies change with cultural changes, such as the removal of homosexuality as a “mental health disorder,” those populations are still susceptible to being labeled as less resilient in a way that perpetuates psychiatry’s problematic binaries. A lack of resilience then becomes associated with internal shortcomings that need to be treated.
Interestingly, this pathologizes survival strategies and protective acts that are adopted by marginalized community members. For example, even when the diagnostic systems have moved homosexuality into the “normal” box, experiences of LGB individuals that resemble anxiety, BPD, and other diagnoses, are labeled as disorders, even though they arise in response to a culture of homophobia.
In response, Schwarz recommends that psychotherapy services expand beyond a “person-centered” framework to include systemic advocacy. She also acknowledges the strain therapists may experience as they too are operating within our culture’s values:
“The problem remains that those living in a neoliberal society may expect the delivery of an easy to consume commodity to solve whatever the difficulty they perceive they are experiencing. The pharmaceutical industry is successfully promoting this medicalization of mental suffering. Therefore, therapists need to answer a dilemma cautiously, a dilemma between over-critically questioning and passively accepting the neoliberal discourse which may expose the patient to unnecessary harm.”
Schwarz’s recommendation is to prioritize a psychotherapeutic relationship that centers on respect. Additionally, she makes a case for doing away with diagnostic constructs that too often fail to examine their political situatedness. Schwarz continues:
“Even though the current diagnostic systems used in psychiatry, like the DSM, have arguably failed to establish themselves as scientifically credible and clinically useful, patients are influenced by the neoliberal culture we live in, having internalized the hegemonic discourse.“
Given the various risk and drawbacks associated with Western psychiatric and psychological constructions, it is not surprising that Schwarz takes a position against globalizing Western frameworks:
“We export disease categories and risk to replace indigenous ways of coping with life hassles, thus opening up a lucrative new market for Western drug companies and psychotherapies. Furthermore, we risk imposing discriminatory praxes in a neo-colonial way if we do not contextualize our understandings of resilience and vulnerability.”
Finally, Dr. Schwarz promotes a model of resilience that is contextualized—one that considers how resilience is dictated by the opportunities available to individuals within their economic situations and potentially problematic systemic contexts.
“Applying a contextualized understanding of resilience translates into the acknowledgment that the access to and the control over health resources affect habitus, lifestyles, as well as health behavior throughout the lifespan,” she writes. “Therefore, resilience should be considered as a product of cultural, social, economic, political, and psychological factors, as well as its biological correlates, above all as a product of structurally embedded social inequalities along dimensions of gender, socioeconomic status, ethnicity, etc. (see Schwarz, 2013, for intersectional approaches within psychology).”
“When applying a contextualized understanding, resilience exists not only on an individual level, but also refers to the level of interactions, of communities, and larger social entities such as regions and states. It goes beyond the psychotherapeutic room and calls for communal interventions and (inter)national policies. It exceeds common social support approaches that are already acknowledged in the field of resilience. It includes analytical levels broader than the individual and accounts for local peculiarities.”
Schwarz analysis is unique in that it takes a critical approach, attending to the unquestioned assumptions that are often uncritically promoted in psychology and psychiatry. She addresses the multifaceted risks involved if psychiatry and psychology fail to acknowledge their political positioning.
“If psychology and psychological constructs remain apolitical, this not only privileges established social structures, which are often shaped by unequal power relations and injustice but also closes off wider questions of progressive social change which require interference with, and transformation of, established systems.”
Schwarz, S. (2018). Resilience in psychology: A critical analysis of the concept. Theory & Psychology, 28(4), 528-541. (Link)