Take care of yourself physically. — Some people might see this as a cliche but it’s really true. The trouble with thinking of it as a cliche is it makes it easy to swat it aside as new-age baloney. One reason we may dismiss the idea is that taking care of yourself often takes time, planning, effort, and, once again, resources. For example, I am dictating this piece while walking briskly outdoors, thereby getting my quota of daily exercise, and enjoying the lovely weather and brilliant colors of autumn leaves. I took advantage of a gap in my schedule. So, think of what you need to be mentally and physically fit and healthy and plan to make sure you take care of that. If you are healthy, you are more likely to be resilient, to have the strength and stamina to do what you need to do.
Resilience has been described as the ability to withstand adversity and bounce back from difficult life events. Times are not easy now. How do we develop greater resilience to withstand the challenges that keep being thrown at us? In this interview series, we are talking to mental health experts, authors, resilience experts, coaches, and business leaders who can talk about how we can develop greater resilience to improve our lives.
As a part of this series, I had the pleasure of interviewing Norman E. Rosenthal, M.D.
Norman E. Rosenthal, M.D. is the world-renowned psychiatrist, researcher and best-selling author, who first described seasonal affective disorder (SAD) and pioneered the use of light therapy as a treatment during his twenty years at the National Institute of Mental Health. A highly cited researcher, he has written over 200 scholarly articles, and authored or co-authored ten popular books. These include Winter Blues, the New York Times bestseller Transcendence, and the national bestsellers The Gift of Adversity, and Super Mind. His latest book is Poetry Rx: How 50 Inspiring Poems Can Heal and Bring Joy to Your Life.
Thank you so much for joining us! Our readers would love to get to know you a bit better. Can you tell us a bit about your backstory?
I have always been passionate about understanding the human mind and brain, two words that I use interchangeably as I see them as essentially the same vast and miraculous entity, no larger than a cantaloupe yet able to consider the universe in all its scope and complexity. At age 16, I decided I wanted to become a psychiatric researcher, a choice I have never regretted.
After completing my basic medical training in South Africa, I immigrated to the United States and did my psychiatric residency at the New York State Psychiatric Institute. My next stop was the National Institute of Mental Health (NIMH), where I pursued my goal of becoming a researcher. Other enterprises include running a clinical research organization, practicing as a clinical psychiatrist and coach, and writing professional articles and books for the general public. Throughout these adventures, I have given a lot of thought to resilience and have aspired to display it in my own life. I have also studied resilience both in my work and the people whom I have met along life’s journey — family, friends, colleagues, patients and clients.
Can you share with us the most interesting story from your career? Can you tell us what lessons or ‘take aways’ you learned from that?
When I was a fledgling psychiatrist, trying to find an idea that would engage my interest and become the foundation of a research career. I dabbled with research involving rats and platelets, those tiny cells responsible for clotting and preventing us from bleeding. These were both important areas of research but, for better or for worse, my passion lay in working with people instead.
At the NIMH my office was on a 12-bed clinical research unit on which there were more researchers than patients, all hungrily pursuing their own chosen research questions. As the most junior researcher, I was both outranked and outflanked. My colleagues and I were approached by an engineer, who had observed in himself winter depressions that he attributed to changing levels of light. We exposed him to bright light during one of his depressions and, to our delight, he felt better. At that point, I wondered where to go next with this promising line of research. I remembered something a wise old mentor had told me: “If you have no patients, you have no study.” We needed more patients to see whether our engineer’s response was generalizable to others or a flash in the pan. I approached local psychiatrists all of whom claimed that they had never seen such seasonal depressions. Yet I knew intuitively they must be out there, in part because I had experienced such seasonal changes myself. So I approached the media with a story of the engineer and one or two similar patients. At that time, advertising for patients through the media was frowned upon and regarded as akin to chasing ambulances. Now of course it is standard practice. The thousands of responses we got to the article filled up our 12-bed unit, thereby enabling me to claim priority for my research study.
Takeaway lessons: 1. Flag important observations that come your way, which can make all the difference. In this instance, the memorable observation was “no patients, no research study.” 2. Follow your intuition, which is fortified by a fresh examination of the world around you and the world inside yourself. 3. Don’t let rank over impress you. Sometimes the most junior person can have the best idea.
What do you think makes your company stand out? Can you share a story?
Although I have supervised groups of people in both the public and private sector, currently I have a scaled-down organization and outsource necessary services, such as maintaining my website. This enables me to flexibly expand and contract my activities according to the project at hand. My coaching and clinical practice stand out for administering the quality of concierge services that I would wish to receive as a client. At the same time I’m always looking for creative projects that make a medical or social contribution. Examples of these are: 1. A study of Botox for treating depression; 2. A study of Transcendental Meditation for treating post-traumatic stress disorder; and 3. My 10 books, the latest of which is Poetry Rx: How 50 Inspiring Poems Can Heal and Bring Joy to Your Life (G & D Media, 2021). In order to make people aware of the book, I reached out to Jane Brody, a veteran New York Times columnist to see if she might be interested in writing a column on the topic. Although initially skeptical, the book persuaded her of the power of poetry, thereby bringing this surprising source of comfort to thousands of people.
What makes our company stand out is our emphasis on creativity, consistent quality, hard work and service, recognizing that the people who seek our help are expecting work of the highest caliber and attempting to meet those expectations.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story?
My friend and colleague Dr. Thomas A. Wehr, a superb psychiatrist and researcher, supported my research at the NIMH and has been the principal collaborator in my work on what I came to call seasonal affective disorder (SAD) and its treatment with light therapy. Over four decades later we remain fast friends.
Ok thank you for all that. Now let’s shift to the main focus of this interview. We would like to explore and flesh out the trait of resilience. How would you define resilience? What do you believe are the characteristics or traits of resilient people?
I would define resilience as the ability to cope effectively and even thrive in response to change, particularly adversity. In my book The Gift of Adversity (Tarcher Perigree, 2013), drawing on lessons from my own life and those of people I have encountered along the way, I point out that many of our most important discoveries and lessons arise from adversities. The first important trait of resilient people is the capacity to view change and adversity as opportunities for growth. Psychologist Carol Dweck has emphasized the importance of mindset in succeeding in life, distinguishing what she calls a fixed mindset from a growth mindset.
Other traits that predispose to resilience are good physical and psychological health, social supports, and education
Courage is often likened to resilience. In your opinion how is courage both similar and different to resilience?
Courage can be very important in resilience. For example, if you are under attack, it may pay to be brave and fight back physically, verbally or through the legal system. Whether to exhibit any of these responses in the face of threat or to stand down requires judgment. Good judgment can make all the difference to whether you are resilient or not. For example if we encounter a bear in the woods, we are advised to appear big and make loud noises. If we encounter a snake, however, we may do better to turn around and walk briskly in the other direction. The key quality required for survival in these instances is judgment, not simply courage.
When you think of resilience, which person comes to mind? Can you explain why you chose that person?
When I think of resilience, the person who comes first to mind is my late mother. Living in South Africa in her mid-seventies, she woke in the middle of the night to find three young men on top of her, assaulting her. Although she had been awakened from a deep sleep, she realized immediately that they were looking for money but were afraid that if she saw them, she would be able to bear witness against them. Therefore, she reasoned, once she gave them money she would be at risk of being killed. She kept calm and explained to them that she had money to give them and that, if they climbed off her, she would locate the money and give it to them without turning on the lights. Miraculously they followed her suggestion. She gave them the money and showed them how to exit her home and escape without being identified. Even as I write these words I marvel at the composure of an elderly woman, managing to negotiate with three young thugs after being woken in the middle of the night and under assault. When the police arrived, they observed that the crime was very common in Johannesburg at the time. The only exceptional thing about this case was that the victim was still alive. That’s what I call resilience.
Has there ever been a time that someone told you something was impossible, but you did it anyway? Can you share the story with us?
I can’t remember anybody ever telling me that something I wanted to do was impossible. If I judged something to be impossible, I would decline to pursue it. Sometimes, however, it is difficult to know whether a task is going to prove impossible or not until you try. For this reason, I am rarely discouraged by fears that something might be impossible until I put it to the test, especially if it is important to me and a lot depends upon it.
Did you have a time in your life where you had one of your greatest setbacks, but you bounced back from it stronger than ever? Can you share that story with us?
One of my greatest setbacks was followed by one of my greatest comebacks. Once again it came in the form of a physical attack that I sustained when I was a medical intern in my 20s in Johannesburg. While visiting with a friend in my car one evening, I was attacked by two men, one of whom stabbed me four times in the chest and abdomen with an 18 inch sharpened screwdriver. I managed to chase the men away by grinding the one man’s hand against the broken glass of the side window and honking the horn, thereby attracting the attention of neighbors. In the weeks that followed I felt a surge of energy, part adrenaline and endorphin, part gratitude for having survived, which impelled me to make major life decisions in the ensuing year. I met and married my wife, who gave birth to our son within the year. I served my year of obligatory military service in South Africa and immigrated to the United States. It felt as though I was carried by forces beyond my control, determined by the thousands of years of survival and evolution that have brought me — and all of us — to the present day. It is these forces that I encourage people to tap into because they are there within each of us.
How have you cultivated resilience throughout your life? Did you have any experiences growing up that have contributed to building your resiliency? Can you share a story?
I learned at an early age to look around and identify resources that could help me at times of difficulty or challenge. I was bullied in elementary school, but found protection through friendships I had developed. Likewise, I found that a ready wit often saved me in embarrassing situations. The school I attended had mandatory prayers as part of a daily ritual, but I found the prayers repressive and stultifying. I somehow found a way to avoid the prayers and was assigned, along with a like-minded friend, to patrol the school in search of miscreants. I can’t remember finding any, but recall clearly the joy of walking around the landscaped school grounds in the early morning, free to let my mind wander and think my own thoughts. In retrospect I could view those hours as my own type of prayer, though such a possibility never occurred to me at the time.
Resilience is like a muscle that can be strengthened. In your opinion, what are 5 steps that someone can take to become more resilient? Please share a story or an example for each.
- Accept reality — A great deal of suffering occurs when you deny reality. Thoughts such as, “I wish this were not the case” or “If only this hadn’t happened” are unhelpful and counterproductive if something really is amiss. Much better to say, “Ok, this has happened. What can I do about it?” After I had been attacked, as I mentioned above, I needed a transfusion from which I developed Hepatitis-C, which gradually began to affect my liver. I realized that I would have to go through a year of arduous treatment if I was to have any chance of overcoming the illness. The substance I injected into myself, interferon, causes disability and depression in certain people. I determined that I would start the treatment and wait and see. I consulted a psychiatrist and friend who knew a lot about the area and he agreed with my approach. I was fortunate that my body handled the chemical quite well and I got through the year without stopping work with the help of my friend and others who supported and encouraged me. That would not have been possible had I not assessed the situation and accepted the reality. I have seen many people deny their illnesses, whether physical or psychological. By doing so, you deprive yourself of the benefit of available treatments, as well as the support of a medical or psychological team and trusted family and friends. By accepting your problem, this team will be rooting for you and able to provide you with concrete help and emotional support.
- Assess your situation and evaluate your options. — Even the word “options” offers strength and hope because it means you have choices as to how you respond to adversity or threat. Once you realize you have choices, your thoughts will immediately turn to ask, “What are the choices?” and “How do I prioritize them?” As I mentioned above, when I first began as a researcher, I evaluated my choices. I chose to work with people and have never regretted it. The alternative prospects (animal or cellular studies) were more fashionable at the time but by following my calling, I have the privilege and joy of being fascinated by my work on a daily basis. In addition, we do our best work when we are engaged and intrigued by what we are doing. Part of resilience is choosing what works best for you rather than what others think you should do.
- Find the resources necessary to proceed. — Necessary resources can involve both people and things (notably money). In our complex and interlinked world, human resources are often most important. I remember for example when I lost a great deal of money by trusting a dishonest investor. My first response was shame and an inclination to scold myself: “How could I have been so stupid?” It was an understandable reflexive response but in retrospect, quite useless. My next instinct was much more helpful. Putting aside the shame, I reached out to other people and told them of my predicament. As I think about the outpouring of help that I received, I am once again moved by the kindness of family and friends. A cousin, for example, handed me a large check and insisted I take it, which fortunately I did not have to do. My accountant, a man I respected, told me how he had lost a very large sum of money when he had made a similar bad business decision. That made me feel less stupid. A savvy friend thought up a legal strategy that in the end enabled me to retrieve all the lost money. And a canny lawyer helped me implement the strategy successfully. So, never forget the human beings in your world. Some may be able to help you in concrete ways and others to give you the comfort and fortitude to rebound from adversity. Of course, it goes without saying that recovery from adversity often requires resources. And there again, thinking through your choices and pursuing them thoughtfully with energy and optimism can often succeed.
- Take care of yourself physically. — Some people might see this as a cliche but it’s really true. The trouble with thinking of it as a cliche is it makes it easy to swat it aside as new-age baloney. One reason we may dismiss the idea is that taking care of yourself often takes time, planning, effort, and, once again, resources. For example, I am dictating this piece while walking briskly outdoors, thereby getting my quota of daily exercise, and enjoying the lovely weather and brilliant colors of autumn leaves. I took advantage of a gap in my schedule. So, think of what you need to be mentally and physically fit and healthy and plan to make sure you take care of that. If you are healthy, you are more likely to be resilient, to have the strength and stamina to do what you need to do.
- Take care of yourself spiritually — Think of what gives you the courage and strength to deal with life’s difficulties. For some people, this may be formal religion, for others, non-denominational spiritual practices.
Practices that improve your spiritual well-being without requiring participation in formal religion include yoga, of which there are many varieties, and meditation. A popular group of meditations are known collectively as mindfulness. In mindfulness the emphasis is placed on being present in the moment. There are many specific ways of doing this, which include focusing on the breath, an image or a thought, such as loving-kindness. In placing emphasis on the present moment, mindfulness practitioners point out that you can do nothing about the past, so there’s no point in being depressed about it. Likewise, worrying about the future may cause anxiety without any gain. On the other hand, being in the present moment may free up the mind and enable you to access your resources to tackle the problem at hand, which can foster resilience.
In my own experience, a different type of meditation, which has had an enormous impact on my resilience, is Transcendental Meditation (TM). The practice requires the meditator to sit comfortably twice a day for 20 minutes and think a mantra In a certain way. It sounds so simple, yet the effect can be powerful. I have written two books on the subject. One of them, Super Mind, specifically documents how the practice can improve your resilience, based on a survey I conducted on over 600 seasoned meditators. While exercise strengthens your sympathetic nervous system, which mediates the so-called flight or fight responses, meditation strengthens the parasympathetic nervous system which promotes the relaxation response. It is important to be able to fight or flee in some circumstances and to rest and recover in others. The threatened lion needs his sympathetic nervous system to mount an attack, whereas the wounded lion has to return to his den to recover. Your resilience will be strongest when you maintain both your sympathetic and parasympathetic nervous systems in peak condition.
One last unexpected source of comfort and resilience can be the written word in the form of prayer or poetry. In researching my book Poetry Rx, I spoke with a 94-year old woman, who has been a poetry lover all her adult life. Every night she sits down with a favorite anthology and opens it at random to read one of its inspirational poems. It helps her settle down for the night and face the morning with renewed vigor.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)
I would try to network with people in all different areas, with various skills and expertise to solve the most pressing problems of our time. Many such problems come to mind, but among these climate change must surely stand in the first rank. Let us not leave all the solutions to our children and grandchildren, instead, I would work towards a coalition to sensitize all people of the gravity of the problem and marshall their efforts towards effective solutions.
We are blessed that some very prominent leaders read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this, especially if we tag them :-)
I would enjoy having breakfast or lunch with Elon Musk, a fellow ex-South African. I have been very impressed with his skill in developing Tesla and his other ventures. I see him as someone who could make terrific contributions to the world and would enjoy hearing his thoughts as to how he might go about doing so.
How can our readers further follow your work online?
This was very inspiring. Thank you so much for joining us!