Using Dynamic Systems Theory to Understand ...

Journal of Human Behavior in the Social Environment, 20:1038–1060, 2010 Copyright © Taylor & Francis Group, LLC ISSN: 1091-1359 print/1540-3556 online DOI: 10.1080/10911359.2010.494947

Seeing the Forest and the Trees: Using Dynamic Systems Theory to Understand ‘‘Stress and Coping’’ and ‘‘Trauma and Resilience’’ ELIZABETH KING KEENAN Department of Social Work, Southern Connecticut State University, New Haven, Connecticut, USA

Although research is beginning to capture the complex interactions of biopsychosocial variables operating within experiences of stressors and trauma, the bodies of research have remained largely separate and limited. This study describes a scaffold of factors and pathways based on principles from dynamic systems theories (DST) to organize the literatures on stress and coping and trauma and resilience. As a process model, DST provides the language to understand both impact and response to stressors and trauma: not as a list of symptoms but as interactive processes within persons and between persons and their surroundings. KEYWORDS Dynamic systems theory, complexity theory, stress and coping, trauma and resilience Although current research models are beginning to capture the complex interactions of numerous biopsychosocial variables operating within experiences of stress and coping and trauma and resilience (Fraser, Kirby, & Smokowski, 2004), social work lacks a framework that accommodates the complexity and multiple potential trajectories across disparate bodies of literature. This study describes a scaffold of factors and pathways based on principles from dynamic systems theories (DSTs; Thelen & Smith, 2006) to organize the literatures on stress and coping and trauma and resilience for use in assessment and interventions with individuals and families. Social workers’ and educators’ use of the DST framework will facilitate complex Address correspondence to Elizabeth King Keenan, Department of Social Work, Southern Connecticut State University, 101 Farnham Avenue, New Haven, CT 06515, USA. E-mail: [email protected] 1038

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understandings of experiences of stress and coping and trauma and resilience across populations. The article will first briefly describe the limitations of the existing literature on stress and coping and on trauma and resilience. Next, the key principles and concepts of DST will be described, drawing from the literatures on stress and coping and on trauma and resilience. Finally, the multiple pathways in response to stressors and trauma will be outlined, again using extant research as illustrations. Research in social work and psychology has generated separate bodies of literature describing impacts and responses to challenges in living: trauma, risk and resilience, stress and coping, positive psychology, and strengths perspective (see Bonanno, 2005; Harvey, 2007; Hobfoll, 2002a). Though detailed knowledge of each of these areas is needed, there are inherent limitations in each theoretical framework. First, there is a tendency to conflate an event with a particular meaning or psychosocial impact (e.g., traumatic event equals trauma). Ryff and Singer (2003) observed that when resilience is studied, there is often an assumption of stressors instead of empirical measurements. They find that studies of resilience across the life span ‘‘have given limited attention to the stressors and challenges that constitute what individuals actually rise above’’ (p. 28). Furthermore, personal and cultural interpretations of events also influence how a stressor is experienced. Hobfoll (2001) describes this as interactive effects of event, person, and sociocultural context, differentiating between subjective, sociocultural, and objective appraisals of stress. Thus, ‘‘vulnerability, resilience, and coping in children are not merely functions of health, sickness, or pathological behavioral reactions but also of beliefs and values’’ (Boyden & Mann, 2005, p. 17). Second, the particular meanings in the literature are often assumed to be universal, obscuring the differential ways that children learn to function effectively in their particular environments. Given the variation between environments, it makes sense, then, that ‘‘the classification of certain experiences or circumstances as ‘risky’ or ‘dangerous’ is thus not a straightforward, universal given’’ (Boyden & Mann, 2005, p. 5). Failure to recognize how sociocultural contexts frame conceptual definitions of such terms as risk, resilience, and competence can result in faulty assumptions regarding the nature of adversity and resilience for varying populations. Finally, Western psychological constructs tend to limit what research questions are asked, emphasizing individual and proximal factors more than collective and distal factors. For example, Skinner (1996) found more than 100 concepts regarding personal control that have been researched in the literature, reflecting the emphasis on autonomy within Euro-American culture. In addition, Wong, Wong, and Scott (2006), in their review of the stress and coping literature, found that Euro-American perspectives (such as Lazarus and Folkman’s psychological model, 1984) have dominated the literature at the expense of attention to collective, cultural, and spiritual

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coping responses. Dynamic systems theory (DST) addresses these limitations in existing theory and research by serving as a scaffold that integrates a range of concepts and research.

OVERVIEW OF DYNAMIC SYSTEMS THEORY DST, based in developmental biology, describes how biological systems selforganize and move through fluctuations of continuity and change, particularly nonlinear forms of change (Lewis, 2000; Thelen & Smith, 2006). As a process model, it serves as a scaffold whereby one can insert relevant findings from the existing empirical literature and tailor it for a particular person and context. Such an approach addresses the aforementioned critiques while also accounting for the variation within and between people. DST describes multiple pathways to understand how a person responds to life challenges at a particular point in time based on current processes and the history of what came before. DST is in the family of theories emerging from mathematics and biology that address nonlinear dynamics, sometimes referred to as complexity theory or chaos theory. Though complexity and chaos theories are used to describe such things as weather patterns, group behavior, and other forms of social change, DST specifically focuses on human beings. DST extends and refines the principles of general systems theory (Bateson, 1972, 1979; von Bertalanffy, 1969; Watzlawick, Weakland, & Fisch, 1974), particularly in terms of the emergence of new forms of organization with the subsystems and system of a person. Recent findings in neuroscience either support or are grounded in dynamic systems principles (Cozolino, 2006; Schore & Schore, 2008; Siegel, 1999, 2007). These theories are also beginning to emerge within social work publications (Bolland & Atherton, 1999; Hudson, 2000a, 2000b, 2004; Warren, Franklin, & Streeter, 1998; Wolf-Branigin, 2006). Though DST holds promise as a theoretical framework for our profession, there are two limitations to consider: (1) As a newer set of principles, theoretical development and empirical research are still ongoing and, (2) as a process model, DST does not specify specific variables, levels, or areas of focus. When using DST to describe biopsychosocial experiences, one needs to draw upon extant research in those areas for the specific variables. DST provides the means to describe patterns, pathways, and the emergence of novel trajectories. Having briefly contextualized DST within the larger framework of nonlinear dynamics, we now turn to some of the primary ideas. There are two overarching principles of DST: (1) Human beings, as self-organizing systems, move through time and space in a soft assembly formed and reformed by processes and feedback, becoming more ordered and complex over time as multiple subsystems join together; and (2) human beings are acutely sensitive to the environment and have the capacity to respond with existing subsystem


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organizations, to respond by modifying a subsystem, and to respond by transforming a subsystem when at thresholds, or tipping points (Lewis, 2000). The remainder of the study will explain DST by describing the primary concepts, partializing the key principles, and illustrating the use of DST to organize the various pathways found in the stress and coping and trauma and resilience literatures. For a more detailed description of DST principles and concepts (see Keenan, 2010).

HUMAN BEINGS AS SELF-ORGANIZING SYSTEMS Biological Systems Fluctuate between Continuity and Change on Multiple Levels Research from neuroscience and developmental biology finds that human beings are far from static, stable entities. Human beings are made up of numerous subsystems (e.g., digestive system, central nervous system, cardiopulmonary system) that communicate and cooperate with one another, resulting in our subjective experience of being a person (Thelen & Smith, 2006). These subsystems occur on various levels nested within one another, from molecules to the entire person living within a sociocultural context. In social work, we tend to focus on psychosocial subsystems, such as memory, affect, cognition, attitudes, beliefs, intentions, and perceptions (Siegel, 2007). These, too, occur on different levels, from momentary experiences to patterns occurring in situation-specific contexts or repeatedly across contexts (states of mind) to a more enduring personality or identity (Lewis, 2002; Siegel, 1999). Complexity is the term used to describe this amazing confluence of fluid order, the human capacity to be both continuous and flexible (Siegel, 1999). Consistent with many ethnic and indigenous beliefs, well-being, then, is the ability to fluctuate between continuity and flexibility to attain harmony and balance (Comas-Diaz, 2006; Constantine, Myers, Kindaichi, & Moore, 2004; Heath, 2006; Levers, 2006; Portman & Garrett, 2006). Similarly, illness or disorder can be viewed as an imbalance, a constriction into too much continuity (rigidity) or expansion into too much flexibility (crisis and chaos; Siegel, 1999).

Human Development Is Self-organization without Directions We human beings self-organize as we grow, not with predetermined directions but emerging out of processes and feedback (i.e., the processes themselves organize a person’s functioning; Siegel, 1999). This occurs as ‘‘the individual parts [of a system], none of which contain any program or

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blueprints, produce a more complex organization as a result of their interrelations’’ (Thelen & Bates, 2003, p. 381). Self-organization is thus the formation of subsystems and the connections between subsystems through repeated activations of interactive processes. However, how does this self-organization emerge? How do subsystems form, continue, adapt, and cooperate? At the most basic level, self-organization occurs through the formation and continued activation of neuronal pathways. Neurons become activated by an internal or external stimulus. When the neurons are activated they fire: They send electrical energy down to the end of the cell where an activating (self-amplification through positive feedback) or inhibiting (negative feedback) neurotransmitter is released into the synapse, the space between two neurons (Siegel, 2007). When an activating neurotransmitter is released, the next neuron fires and proceeds in the same fashion. This process is commonly summarized in the adage: Neurons that fire together, wire together. As neurons repeatedly fire together, they form neural pathways or networks that carry out certain functions in the brain (Cozolino, 2006). Our contemporary understanding of neuroscience is one example of self-organization. This process of activation and connection through the sending and receiving of information also occurs on larger levels (e.g., with psychological subsystems, wherein associations are formed between perceptions, emotions, and interpretations; Lewis & Junyk, 1997). Internal and external processes influence the activation and connection within a person. For example, one’s sense of self as a caring person results from one’s perceptions of how one acts toward others, feedback from others, how one feels about caring for others, and the meaning of caring in relation to one’s purpose in life. At all levels, self-organization continues through the flow of information and energy in processes that guide and constrain action. Guiding occurs as a (sub)system self-amplifies with the energy (positive feedback promoting change). Constraint occurs as a (sub)system inhibits the energy (negative feedback dampens down change). DST describes how internal and external processes guide a person’s selforganization over time. When using DST as a process framework, one looks to the extant research to identify the specific internal and external processes associated with one’s focus. For example, the stress-and-coping literature identifies the internal processes of personal resources, appraisal and interpretation, and intention or goals and the external processes of instrumental, material, and social resources and cultural interpretations (Hobfoll, 2001, 2002a; Pargament, 1997). These processes from the literature, however, are not the only processes guiding self-organization. DST also specifies three internal processes that are always influencing the stability and change of a (sub)system: the history of the (sub)system, circular causality, and feedback (Lewis, 2002). The concept of feedback (the self-amplification of positive feedback and the inhibition of negative feedback) is a familiar one for social workers and was described earlier. The concepts of history and circular


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causality, along with the specific internal and external processes associated with the stress-and-coping and trauma-and-resilience literatures will now be discussed in more detail. INTERNAL

PROCESSES

Internal processes are the variables that join together within a person to self-organize. As mentioned, there are internal processes specific to the stress-and-coping and trauma-and-resilience literatures, and there are DST processes that always affect self-organization. We will discuss how each of these influence how one responds to trauma and stress. IINTERNAL

PROCESSES SPECIFIC TO THE STRESS-AND-COPING AND

TRAUMA-AND-RESILIENCE LITERATURES

1. Biopsychosocial capacities (e.g., self-efficacy, constitutional factors, ability to seek help, proactive initiative, sense of mastery, and preparedness). Sometimes referred to as personal resources (Hobfoll, 2001) or protective factors (Fraser et al., 2004), these capacities tend to increase as one grows but vary between persons. Similarly, the loss of capacity or personal resources exerts a significant influence on how one copes with stress (Hobfoll, 2001). For example, Maria, a 50-year-old woman, was recently diagnosed with an advanced form of cancer. She has several personal resources to help her respond to that severe stressor: humor, initiative, sense of mastery in finding out information and advocating for others, selfefficacy to explore her options and decide what to do, and perseverance. 2. Appraisal and interpretation of the situation, resources, and coping methods. Lewis (2002) states that the connection between the components that make up appraisal (perception, associations, expectancies, plans, etc.) stabilize into a state of mind when joined with emotion. These are also joined together with values and shared beliefs, resulting in interpretations that ‘‘are constructed in terms of their significance to people’’ (Pargament, 1997, p. 91). Appraisals and interpretations are constructed for events (viewed as a threat, actual harm or loss, etc.), the internal and external resources available to respond, and available coping pathways (alone and/or with others). Although Maria views the diagnosis as severe, she sees many resources available to her, including access to health care, her internal capacities, her family and friends, and her belief that God is a powerful source of strength. Those resources create a sense of hope. 3. Intentions or goals guide responses to stress. Pargament (1997) notes that while we cope with stress, we ‘‘cope towards the values most important to us’’ (p. 108). This is supported by research that shows that our intentions influence how we perceive and act in stressful situations (Lewis, 2002). Maria values her faith and her family. Besides extended family and friends, she has a husband and two young adult daughters whom she wants to

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be with and love. These intentions mobilize her to do what she can to extend time with family. INTERNAL

PROCESSES THAT ALWAYS AFFECT SELF-ORGANIZATION

1. Circular causality is the bidirectional influence of system levels on one another, that is, both top-down and bottom-up influences between our self as a system and all the subsystems that are part of human beings (Lewis, 2002). The level of one’s personality affects how one responds in a specific situation of stress and the states of mind that one is likely to experience during stressful periods. This top-down influence of personality traits makes some responses more likely than others. At the same time, how we respond in a specific situation and the experiences of specific states of mind also affect one’s personality. The degree of influence is much stronger top-down than bottom-up, however, because so many subsystems join together to form the self-organization of one’s personality. Maria was initially shocked, worried, and angry about her diagnosis because she had not thought she would face the possibility of death at such a young age. Maria’s personality (easy-going, conscientious, passionate, humorous, faithful) shifted her appraisal of the stressor and available stress responses within a short period of time. Maria’s state of mind regarding coping with her illness and her specific responses to coping with each turn of events serve as the bottom-up influences that support the continued stability of her personality. In contrast, some people become bitter, resentful, and/or depressed in response to unexpected life events. If this continues for a period of time, a person’s state of mind will begin to alter aspects of one’s personality. 2. History refers to the organization and trajectory of one’s personality and subsystems up to the present (Lewis, 2002). We have stated that interactions between internal and external processes guide the self-organization of a person or a subsystem within that person. Variations in the presence or absence or strength of internal processes will result in different trajectories. The self-organization of a person at any given point is thus the product of interactions between specific values or qualities of internal and external processes. These particular self-organizations then serve as a condition that influences what is possible in future self-organizations. What biopsychosocial capacities and resources have formed over time? What are a person’s prior experiences and responses to stress and trauma? How flexible is a person in response to stressors? The resilience of a person or a person’s ability to cope with a new stressor is constrained by the history of the interactions between these processes up to the present moment. Persons who shut down or becomes highly anxious in the face of a stressor will likely respond in a similar manner even if they have the capacities to cope because of how they appraise and interpret stressful


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experiences. Conversely, persons who have personal, social, and material resources that facilitated an interpretation such as ‘‘this is difficult but we’ll find a way’’ will most likely begin with that interpretation when a new stressor emerges. For example, Maria recently cared for her father throughout a surgery and recovery, including advocating with doctors for particular home care and organizing family members to provide ‘roundthe-clock home care. Though this was physically and emotionally exhausting, Maria effectively coped with that stressor. This experience became the history for her response to her cancer diagnosis, making it likely that she would respond with a similar pattern of ability and flexibility. In sum, internal processes guide and constrain self-organization and responses to stressors and trauma. These include the specific processes associated with stressors and trauma and the DST internal processes of positive and negative feedback, circular causality between levels, and the history of one’s personality and experiences with specific stressors. EXTERNAL

PROCESSES

External processes are variables in the environment that influence selforganization and action. External processes join with internal processes to activate particular pathways within an individual (Lewis, 2000). Support for this is found in attachment research (e.g., whereby particular caregiving responses activate or inhibit development; Cassidy & Shaver, 1999) and in human development (Lewis, 2000) and neuroscience (Cozolino, 2006). We will discuss two broad categories of external processes that enhance or constrain resilience and coping from those two bodies of literature. PRESENCE,

LOSS, OR LACK OF MATERIAL AND SOCIAL RESOURCES

The work of Hobfoll and others has broadened our understanding of various resources from a simple presence/absence consideration to the negative impact that the loss of instrumental, material, and social resources can have on coping and resilience (Hobfoll, 2001; Hobfoll, Johnson, Ennis, & Jackson, 2003; Hobfoll, Tracy, & Galea, 2006; Schumm, Stines, Hobfoll, & Jackson, 2005). Instrumental and material resources include adequate income, safe and stable housing, food security, health care, and access to information. Social resources include significant others who love, nurture, guide, support, and protect. When considering instrumental, material, and social resources, one considers the degree to which they function as risk factors (owing to a lack of or loss of a resource) or protective factors (owing to strength and accessibility; Fraser et al., 2004). For example, Maria’s instrumental, material, and social resources are largely protective factors. She has adequate income through her husband’s work, thus preserving the other material resources of housing, transportation, health care, and the like. Although she is not able to work full-time now, her employer has been flexible regarding expectations

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and work options, allowing Maria to work from home on some days. Maria also has several close friends and many family members who live within the geographic area who provide support, love, and nurturance. CULTURAL

INTERPRETATIONS

Cultural interpretations are the culturally bound understandings of events, resources, and available pathways (Hobfoll, 2002b). Boyden and Mann (2005) note that ‘‘how children respond to adversity cannot be understood without reference to the social, cultural, economic, and moral meanings given to such experiences in the contexts they inhabit’’ because experiences of such things as suffering, loss, and healing are constructed by social and cultural meanings (p. 15). For example, they found that the externalization of adversity (placing it outside a person) is a Western construction, whereas many nonWestern cultures view adversity as a seamless connection between what is perceived and what is created. Maria’s cultural interpretations come through her religious beliefs. The primary belief that has influenced Maria through her illness has been the belief that God will either heal her or give her the courage to stand the pain.

People are Sensitive to their Environments, Responding through Several Pathways The first principle of DST discussed earlier highlights the fluid nature of human beings’ existence, as the product of interactions between internal and external processes. This ‘‘soft assembly’’ of human beings means that we are sensitive not only to changes within ourselves but to what is going on around us (Lewis, 2000). Thus, the second DST principle emphasizes the factors that destabilize a person or subsystem and the various response pathways that may result. Each day, we encounter enormous amounts of information. Some we filter out; some we easily respond to. In these instances, the specific information, or the strength of what we are experiencing, does not result in the loss of one’s stable organization (or the stability of a subsystem, such as a state of mind). At other times, information destabilizes us or a subsystem within us to the point at which we are unable to respond with our current self-organization. This loss of stability begins with a disruption that comes from within or outside of a person (Thelen & Bates, 2003). Within the stress and coping literature, disruptions are disturbances that are experienced as acute, episodic, or chronic stressors. Schumm et al. (2005) state that events are experienced as stressful when they threaten or result in the loss of resources (personal, social, instrumental, or material). Thus, an event in and of itself may or may not be a stressor (although the more severe, the more likely it will be, particularly traumatic stressors). Rather,


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stressors induce stress because the relationship between a particular person and the event ‘‘is appraised by the person as taxing or exceeding his or her resources and endangering his or her well-being’’ (Schwarzer & Taubert, 2002, p. 21). Stressors can, therefore, be categorized as actual harm or loss or the threat of harm or loss. Some examples of stressors in North America for harm or loss include job layoff, sexual/physical trauma, divorce, discrimination/harassment, chronic financial insecurity, acute or chronic illness, and death of a loved one and, for the threat of harm or loss, include crime in high-crime neighborhoods, illness due to presence of risk factors, floods or hurricanes in geographic locations, and job uncertainty due to potential forced retirements, layoffs, outsourcing, or business closure. Maria’s stressor was the diagnosis of an advanced stage of cancer. How persons are affected and how they respond to the disruption is based on the history and the current conditions of their personality and subsystems that regulate stress responses (those internal and external processes, including risk and protective factors that join together to form who one is and how one acts at any given point in time; Lewis, 2002). Thus, it is not risk and protective factors alone that determine particular trajectories. Rather, it is the history and current conditions of a person or subsystem, inclusive of risk and protective factors that determine whether a particular person or subsystem is destabilized and the response pathway that is followed. These factors collectively affect what a person is likely to consider and find meaningful, thus shaping the options available to each person at particular points. In addition, because human beings ‘‘cope toward the values most important to us’’ (Pargament, 1997, p. 108), our first response is often that of conservation (i.e., to maintain what we find significant, what we care most about). Resource loss is so difficult (besides practical survival challenges) precisely because people ‘‘strive to obtain, retain, protect, and foster those things that they value’’ (Hobfoll, 2001, p. 341). For example, Maria wanted to conserve her ability to be with her family, so she began searching for treatments that would extend her life as long as possible. Though we human beings are innovative and creative, we first use that innovation in the service of conservation. Transformation is typically chosen only when what we currently have available no longer serves us, or we reach a point where what we value is not valued in the same way, creating the need for a new purpose, coping pathway, and/or resource (Pargament, 1997). Therefore, there are three primary response pathways to various disruptions (stressors): (1) we respond with our existing (sub)system organization, (2) we modify an existing (sub)system, or (3) we transform one or more subsystems when at thresholds or transition points (Thelen & Smith, 2006). RESPONSE

PATHWAYS TO STRESSORS AND TRAUMA

This last section of the study will continue to discuss the sensitivity that people have to their environments, particularly the range of ways that people

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respond to disruptions of stressors and traumatic events through the various pathways outlined earlier, drawing on existing research. RESPONDING

WITH EXISTING FORMS OF (SUB)SYSTEM ORGANIZATION

Self-organization provides continuity and the ability to flexibly respond to one’s environment. In response to a disruption, continuity leads to efforts that preserve what people value through the pathways they value. DST describes two possible response pathways that can take place within an existing form of (sub)system organization: (1) A period of brief destabilization settles back into an existing organization, and (2) a person shifts from one state of mind to another existing state of mind that adequately addresses the disruption (Siegel, 1999; Thelen & Smith, 2006). In both instances, a person uses existing internal and external capacities and resources to effectively cope. In addition, and depending upon the impact of a stressor, a person may not feel destabilized because he or she currently has the resources to cope with the stressor. All of these various pathways emerge because events are not viewed as harmful stressors and/or because a person has the ability to respond within his or her existing configuration of internal and external resources and beliefs. Resilience is the most frequently described example of brief destabilization that settles back into an existing organization of a subsystem or a person’s overall functioning. According to interactive models of resilience, protective factors either buffer the effect of risk factors or interrupt a risk chain through which risk factors operate (Fraser et al., 2004). For example, religious forms of coping can buffer the effects of stressors, particularly for people who already have religious beliefs (Pargament, 1997; Spilka, Hood, Hunsberger, & Gorsuch, 2003). Similarly, Johnson, Elbert-Avila, and Tulsky (2005) found that spiritual beliefs and practices facilitated healing and coping with illness for African Americans in a review of 27 studies. Constantine, Alleyne, Caldwell, McRae, & Suzuki (2005), in a study of coping responses of Asian, Black, and Latino/Latina New York City residents after the 9/11 terrorist attacks, found that multiple coping responses helped buffer the effects of this traumatic event, including: religious or spiritual activities, resuming ‘‘normal’’ daily activities, keeping busy, seeking or giving support, expressing a range of emotion, and seeking additional information about the event. In addition, Yeh, Inman, KIm and Okubo (2006), in a study of Asian American families’ collectivistic coping strategies in response to 9/11, found that seven coping strategies were used by participants: individualistic, familial, intracultural, relational universality, forbearance, fatalism/spirituality, and indigenous healing. Tummala-Narra (2007) extends this notion of collectivistic coping in her description of the ways communities serve as protective factors with adults. For example, Hobfoll, Jackson, Young, Pierce, & Hobfoll (2002), in a study of Native American young adult women,


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found that a sense of communal mastery (distinguished from self-mastery and social support) was inversely related to negative effects of stressors. These studies demonstrate that internal and external processes can serve as protective factors, dampening down the disruption and supporting the ongoing continuity of self-organization. This does not mean, however, that a person remains unaffected by an event. Potentially traumatic events (PTE) can be destabilizing. Although there is no consensus on how resilience may influence adults in their recovery from trauma (Bonanno, 2005; Harvey, 2007; Ryff & Singer, 2003), both resilience and recovery describe pathways of brief destabilization with a return to initial conditions. Resilience can be viewed as the capacity to manage minor disruptions in functioning within a broader context of competence (Bonanno). Recovery can be viewed as a return to prior levels of functioning after moderate disruptions. Both speak to the impact that the PTE has on the individual and the strength of the connections between internal and external processes to dampen down the disruption through negative feedback. For example, studies of spouses, parents, and gay men have found a pattern of resilience for many participants after the loss of a loved one (Bonanno, Moskowitz, Papa, & Folkman, 2005; Bonanno et al., 2002). Using the definition of resilience as the capacity to manage minor disruptions in functioning, a study of people living in the tri-state region surrounding New York City found that 65% of participants (N D 2,752) met this criterion for resilience after the 9/11 terrorist attack (Bonanno, Galea, Bucciarelli, & Vlahov, 2006). Finally, state shift is a pathway that can be used to describe more discrete events. This pathway activates subsystems of the person, as shifts from one state of mind to another seek to respond to the disruption. These state shifts can be subjectively experienced on a continuum from fluid to jolting, depending upon the degree of integration established between states. For example, in the face of acculturative stress, persons who have coalesced into a bi- or multicultural identity respond to a situation by shifting into the state that supports their functioning (e.g., shifting from a state of mind associated with dominant cultural practices to a state of mind associated with their ethnic or religious cultural practices, or vice versa; Berry, 2006). This pathway can also be used to describe one’s efforts to cope with racial micro-aggressions, as one shifts into a protective or vigilant state (Heath, 2006; Miller & Garran, 2008). Though beyond the scope of this study, individuals will at times not become destabilized in the face of a disruption when indeed, destabilization is indicated. Examples include internal processes of misperception associated with addictions, intimate partner violence, or illness. RESPONDING

WITH MODIFICATIONS

When a person’s current resources do not adequately respond to the disruption (stressor or PTE), he or she often seeks out additional information,

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resources, or experiences. As the new information, resources, or experiences connect with other subsystem processes, the subsystem becomes modified. Modifications can include expanding resources, transferring existing coping skills to a new situation or stressor, or slightly altering one’s understanding of self, others, or stressors. As modifications occur, the fundamental organization of the subsystem, state of mind, or person continues. For example, when Maria was diagnosed with cancer, she gathered her family together a few days later and told them how she wanted them to act with her (grateful for the day, encouraging, and supportive). Maria was acting similarly to the way she had organized her family with her father’s illness, but she had not done so previously on her own behalf. The modification was extending her initiative to respond to her own needs. Proactive coping is the expansion of resources before an event occurs. Proactive coping has a future orientation, as individuals seek to build up or develop resources to respond to future or chronic stressors (Schwarzer & Taubert, 2002). Studies of Canadian, Polish, and German employees have found that proactive coping is inversely related with job burnout and positively associated with self-efficacy and professional engagement (Schwarzer & Taubert). Modifications also occur in response to acute stressors. For example, a study of elder women found that they enhanced their well-being after a community relocation (Ryff & Singer, 2003). Tumalla-Narra, (2007), in her discussion of trauma in racially diverse communities, states that an expansion of opportunities within social networks (altering external processes) can result from various traumatic events. Researchers have also found that external events can precipitate turning points, where individuals learn something about themselves, view themselves or a situation differently, or deepen a significant relationship (McAdams & Bowman, 2001; Wethington, Kessler, & Pixley, 2004). Furthermore, the use of positive religious coping strategies in response to stress (e.g., spiritual connectedness, benevolent religious reappraisals, collaborative religious coping, seeking spiritual support or support from clergy or other members) was positively associated with stressrelated and spiritual growth with a variety of stressors (Ano & Vasconcelles, 2005). Finally, in coping with the 9/11 terrorist attack, several modifications were identified: obtaining new information about a stressor, providing an expanded understanding, using new activities to respond to a stressor, expanding one’s coping repertoire, or extending existing coping activities to a stressor/trauma of great magnitude (Constantine et al., 2005; Yeh et al., 2006). THRESHOLD

TO RIGIDITY, CHAOS, OR TRANSFORMATION

As we see from the literature, people cope with stressors with existing resources or through modifications. Many times, however, a disruption is


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so destabilizing that a person moves to a tipping point wherein coping is significantly challenged. Garmezy (1993) notes that even resilient children have a threshold or ‘‘breaking point’’ when risk factors have accumulated to a certain point that exceed their resources, what is physiologically now being called ‘‘allostatic load’’ (McEwen, 2002). The exact threshold point varies, for it is the function of the complexity of one’s self-organization with the severity of the stressors (Pargament, 1997). When someone has moved to the threshold, or tipping point (such as a crisis), one becomes more open to change (Thelen & Smith, 2006). This is owing to the increased positive feedback that self-amplifies with new information, overriding the negative feedback that maintains stability. One or more internal or external processes shift to allow new energy and new connections to potentially occur. This is why it can be easier to make changes when in crisis than when one is stable. However, the experience of destabilization at thresholds is not comfortable and can be quite distressing (Mahoney & Moes, 1997). Thus, though change is easier at tipping points from a biological systems perspective, our subjective experience (including our beliefs, feelings, and degree of flexibility) tells us otherwise. We human beings are capable of transformational change, but this is often the last choice because of our subjective experience of it. When people reach a threshold, they need to seek and connect with new information or resources, not by modifying a subsystem but by transforming the subsystem in a manner that allows a new self-organization to emerge. Given the specific history and self-organization (including internal and external resources), a person may be unable to tolerate the destabilized experience and move into a constricted, rigid organization. Or, after obtaining new energy or resources, one may have difficulty reorganizing oneself, resulting in chaos. DST describes three pathways that are therefore possible from tipping points: rigidity, chaos, and transformation (Mahoney & Moes, 1997; Siegel, 1999). These three pathways will be described separately, along with brief examples of their occurrence in combination. RIGIDITY When people encounter stressors without adequate resources, the disruption, experienced through their history and current configuration of internal and external processes, can result in the conservational pathway of a constricted version of self-organization. Recent research is beginning to articulate processes that can result in self-organizational constrictions. Material, mastery, and social-resource loss led to increased rates of depression and anger with inner-city women (Hobfoll et al., 2003), whereas personal, social, and material-resource loss predicted probable posttraumatic stress disorder (PTSD) and depression in those potentially exposed to the terrorist attacks on 9/11 (Hobfoll et al., 2006).

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A prior history of child physical or sexual abuse can lead to increased sensitivity to current stressors and an increased likelihood of depression or PTSD (Schumm et al., 2005; Schumm, Briggs-Phillips, & Hobfoll, 2006). Finally, negative religious coping strategies that reflect an insecure relationship with God or interpersonal struggles with other believers are associated with such psychological difficulties as depression and PTSD (Pargament, Ano, & Wachholtz, 2005). CHAOS The second pathway is on the other end of the continuum, wherein a destabilization self-amplifies into chaos (flexibility is dominant and continuity is lacking). A person has difficulty reorganizing and decompensates, resulting in problems in functioning. Severe stressors can lead to brief psychotic episodes in reaction to an event, significant regressions in functioning (Perna, 1997), or dissociative identity disorder (Derrikson-Kossmann & Drinkard, 1997), all of which reflect too much flexibility and an inability to reorganize. Traumatic stressors and/or the uncertainty of future stressors triggers intense anxiety (e.g., PTSD, obsessive-compulsive disorder, social phobias, agoraphobia). Although chaos provides the fertile ground for a new reorganization to emerge (Masterpasqua, 1997), human beings tend to change most effectively with moderate levels of arousal (Cozolino, 2006). Unfortunately, in a chaotic state, negative feedback gets overshadowed, so one is unable to dampen down the energy into a more moderate level. Thus, one can oscillate between chaos and rigidity (e.g., PTSD, obsessive-compulsive disorder, moving between intense fear and responses to avoid or control outcomes) or move into a more rigid organization. Basham (2008) speaks of the oscillation between anxiety and ‘‘rage storms’’ and maladaptive control efforts with some who have returned from deployments in active military assignments. Similarly, Farber (2008) speaks of the use of self-harm to regulate intense anxiety or other chaotic emotions. Self-harm brings order but in a rigid and damaging manner. Thus, we see that chaotic destabilization leads people to consciously and unconsciously seek ways to become more cohesive because their current organization lacks the information or resources needed to adequately respond (Bütz, Chamberlain, & McCown, 1997). When such transformational change pathways are not forthcoming, rigidity provides a more constricted possibility. TRANSFORMATION Finally, transformation of a subsystem (or occasionally the entire person) emerges when a tipping point destabilizes someone to the edge of chaos, activating processes to connect with new information or resources and resulting in the emergence of a new subsystem organization. Transformation


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is thus the reorganization of the subsystem into a new form of that subsystem, including its organizing principles. For example, some victims of intimate partner violence experience a transformation of schemas of self and partner/perpetrator that often appear to come ‘‘out of nowhere.’’ Out of the history of distress, confusion, anxiety, and uncertainty emerges a view of self as someone deserving of safety and respect, resulting in actions that reflect this view for themselves and their children. The difference between a modification and a transformation of a subsystem is one of quality, not quantity: A modification preserves the existing organization whereas a transformation entails a reorganization. Returning to the preceding example, a schema modification would be along the line of exceptions or particular situations wherein victims viewed themselves as respectable or lovable or competent. One might hear comments such as ‘‘My kids love me so maybe I’m not so terrible after all’’ or ‘‘I can do the laundry OK but I tend to mess everything else up.’’ Both of these comments reflect an overarching view of self as unlovable or incompetent that includes a modification limited to a particular task or perceptions of some people (one’s children). Conversely, a schema transformation reorganizes one’s views of self into a new formation wherein the overarching view is, for example, one of worth, dignity, and capability across people, tasks, and situations. Many other examples of transformation abound in the literature. Wong et al. (2006) describe the personal transformations that are achieved by some in various countries in Asia who adopt proactive coping efforts to respond to chronic stressors out of their control. Unlike cognitive reframing with a specific stressor, personal transformation is a more global change in perception and action that leads to a reduction or elimination of a subjective stress response. Examples include practices from Buddhism and Taoism, along with research results from Lee’s (2006) biosocioexistential model of posttraumatic response. Tedeschi & Calhoun (2004) describe posttraumatic growth (PTG) as a transformational change in functioning that occurs as one struggles with living after a major crisis. PTG is differentiated from resilience, an increase in well-being, or a decrease in distress. Rather, PTG involves new formations of one’s beliefs about the world in the face of trauma that alter one’s worldview. Quantum change, defined as ‘‘sudden, dramatic, and enduring transformations that affect a broad range of personal emotion, cognition, or behavior’’ is yet another transformation that can occur out of an inner disruption (Miller & C’de Baca, 2001). In a follow-up study 10 years later, C’de Baca & Wilbourne (2004) report that participants still remembered their quantum change experience and had maintained the changes that had taken place. Finally, transformation can occur in spiritual growth, particularly through conversion experiences whereby one identifies with the sacred and alters one’s ways of living to align with one’s new beliefs and life purpose (Mahoney & Pargament, 2004; Pargament, 1997).

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IMPLICATIONS FOR SOCIAL WORK PRACTICE AND EDUCATION DST provides a process framework to describe the various ways that people experience and respond to disruptions (mild, moderate, or traumatic stressors) in their lives. DST orients social workers’ thinking to factors that affect possible trajectories in response to a stressor, namely the history and current conditions of a (sub)system, and the actions of positive and negative feedback and circular causality. In addition, DST illustrates the fluid nature of living, as human beings fluctuate between continuity and flexibility within and between subsystems in response to interactions between internal and external processes. Finally, DST articulates that all of the foregoing factors result in particular trajectories of conservation, modification, and/or transformation. This focus on the individual’s experience of stressors helps social workers avoid the tendency to conflate traumatic event and specific trajectory. DST also provides more specificity than the trauma-and-resilience literature of risk and protective factors alone by including internal processes that are always interacting within a person. The DST process framework also provides the scaffolding for examining two bodies of literature (stress and coping and trauma and resilience) together. DST, therefore, assists social workers to assess a client’s functioning within cultural meaning systems without prescribing particular interpretations of well-being or pathology. This is possible because DST encourages social workers to listen for how clients’ history, cultural frame(s), personality, and external processes influence their experience of and responses to events. DST also helps social workers develop more complex descriptions of functioning across levels. The ability to describe subsystems and the person with the same framework allows social workers to describe variable functioning between subsystems. In contrast, current diagnostic manuals, such as the DSM-IV TR, focus on symptom lists without subsystem specificity (American Psychiatric Association, 2000). In addition to diagnostic manuals, resilience and well-being are often described in a global, dichotomous manner throughout theory and research literatures (Harvey, 2007; Keyes, Shmotkin, & Ryff, 2002). Harvey has found that this does not reflect the experiences of many trauma survivors who function well in some areas but are challenged in others. DST can capture this variation by describing pathways in multiple subsystems (states of mind). To illustrate, a trauma survivor might function well at work because the internal and external processes that join together into that state of mind are not affected by the disruptions of child sexual abuse. This would not carry over, however, into her relationship with a current partner, wherein difficulties engaging in a sexual relationship are disrupted by certain sensations (internal processes) and her partner’s tone of voice (external process), resulting in periods of chaos (anxiety and terror).


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DST thus provides the language to describe multiple pathways within and between levels. Social workers are helped to understand both impact and response to disruptions, not as a list of symptoms but as dynamic, interactive processes within a person and between a person and his or her surroundings. Finally, the DST trajectories can be used to differentiate between wellbeing and maladaptive functioning within and between a person’s subsystems by using the DST principles as indicators (i.e., assessing the degree to which a person is able to respond to disruptions with flexible continuity). First, maladaptive functioning: People are not always able to seek or make use of new information or resources when current pathways are found wanting. This may be owing to a lack of personal or material resources or difficulty with social resources. Maladaptive functioning therefore emerges when one (1) denies or ignores essential environmental information, (2) has difficulty accessing or connecting with new resources to address current stressors, or (3) has difficulty reorganizing (owing to cascading risk chains, insufficient protective factors/resources) and moves into a constricted (e.g., depression) or chaotic (e.g., decompensation) space. Had Maria lacked some of her personal (e.g., initiative, perseverance) or material resources (e.g., access to health care), or had conflictual relationships with her loved ones, she may not have received some cancer treatments, may have become depressed or been in a constant state of anxiety. Conversely, well-being is the ability to (1) notice and respond to essential environmental information, (2) access and connect with new information and resources when existing patterns are lacking, and (3) flexibly transform one or more subsystems when modifications are not sufficient. Although Maria was already a faith-filled person, living with cancer has led to a transformation of her life purpose. Instead of long-term plans, Maria now seeks to notice and share the joys of each day with loved ones. She is currently living 2.5 years after initial diagnosis. Social work educators can use the DST scaffold to organize other bodies of human behavior literature. After presenting the DST frame, educators could instruct students enrolled in a course in human behavior in the social environment (HBSE) to review the literature on a given topic and organize it according to internal and external processes and possible trajectories. Examples include the various pathways of psychosocial functioning associated with such topics as religious and spiritual beliefs, child abuse and neglect, elder abuse and neglect, and divorce/remarriage. In addition to HBSE topics, the DST scaffold can serve as a complementary frame to child development theories because DST describes how children shift from one phase/stage to another: Changes in internal processes due to physiological growth destabilize one or more subsystems and bring the child to a threshold wherein new abilities become possible and fluctuate with existing abilities. As these internal processes become joined with changes in external processes, particularly changes in interactions with

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caregivers as they support the burgeoning abilities, and the availability of material resources pertinent to what is developing (such as books or assignments for cognitive functions), a new developmental pathway emerges out of the fluctuations, becomes more stable over time if the internal and external processes continue to interact in this new manner, and then becomes the history for the next developmental shift. Most child development theories fail to describe how these shifts occur, leaving social work students without adequate guidance for assessment and intervention efforts with children and families. In sum, DST holds promise as a process scaffold to frame disparate bodies of literature that address the many challenges in living that social work seeks to ameliorate in practice. By focusing on the interactions between a person’s history, current internal and external processes, positive and negative feedback, and circular causality, along with specific factors associated with a particular stressor or life challenge, social workers can develop a more complex understanding of the multiple trajectories that people may potentially follow in response to the disruptions of stressors and trauma and other life challenges as well.

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