[0:11]Adversity sucks. I've seen it most of my life. When I was younger, I was crammed into the hall of a small fishing boat with 117 people to escape the oppression in Vietnam.
[0:26]That boat was a death trap. We got stranded in the middle of the South China Sea. We almost starved to death because we ran out of food, and we almost got killed during a pirate attack.
[0:38]somehow we managed to survive and landed at a refugee camp. That was a traumatic month in our lives.
[0:48]But the real struggles actually began when we got off the boat, because it took years for us to adapt to our new countries.
[0:57]There was the obvious culture shock, but the greatest challenge for us was how we saw ourselves. We were no longer the established members of society.
[1:08]Overnight, we became nobodies.
[1:12]Some people from our boat were able to adapt quite well. At first, they had to work multiple jobs and barely had enough money for food.
[1:21]But after 10 or 20 years, they were able to become highly respected members of their communities.
[1:28]Other people from the same boat broke down though. They wound up with broken families, in jail, or committing suicide.
[1:38]All of us from the same boat faced a similar form of adversity. So why were the outcomes so different?
[1:48]I kept on asking myself this question, and I guess the universe heard me because it led me to the field of chronic pain, which is one of the most extreme forms of adversity.
[1:59]Imagine that you have a severe headache that's always there and no end in sight, but nobody believes you.
[2:08]Chronic pain affects 20% of the world's population and is a major cause of our current opioid crisis.
[2:15]Well, for the better part of the last decade, I've had the privilege of leading a team at Mount Sinai Hospital in Toronto that specialized in chronic pain.
[2:23]We understood that it's a complex condition that can affect a person physically, psychologically, and socially.
[2:31]So we had a unique approach in which one patient could see a physician, psychologist, chiropractor, occupational therapist, pharmacist, or other health care provider in the same room at the same time.
[2:42]And our patients could see us for a few hours a day, five days a week, for several months. We got to know our patients really well, from multiple perspectives.
[2:54]So we were able to treat the entire person. Over the years, we saw some people who whose lives were completely destroyed by pain.
[3:01]But we've also seen some people who are resilient and able to return to a productive and meaningful life despite their pain.
[3:09]As we kept on seeing these results time and time again, we began to notice some key differences between the two groups. And what we learned revealed something astonishing.
[3:19]Our findings showed us that regardless of the adversity you face, suffering is actually a choice.
[3:28]I'm not saying that you can choose whether or not you want to have pain and adversity. I'm saying that you can choose how that adversity affects your life.
[3:38]So, what did we learn from our patients? Well, we learned that one of the worst effects of adversity is that it can make you feel as if you've lost control of everything.
[3:48]It can turn your life upside down unexpectedly and leave you in a situation that you don't want to be in and you don't know what to do with.
[3:56]We've seen two types of people in particular who cope poorly with this. Victims and catastrophizers.
[4:05]Victims are people who are in their situation because of somebody else's fault.
[4:14]And their attitude is, somebody else caused this, so somebody else should fix it for me.
[4:19]They feel that they don't have to be responsible for their lives or accountable for their actions because life's been unfair to them.
[4:26]Catastrophizers are constantly thinking about the what ifs of the future. They completely paralyze themselves from doing anything, because they're always worried that something bad is going to happen.
[4:36]Then when there is a self-fulfilling prophecy, it feeds back into the worries causing this vicious cycle.
[4:43]So, while victims are preoccupied with the past, and catastrophizers are obsessed with the future,
[4:50]resilient people take ownership of the present by doing something now to better their situation.
[4:56]There was a patient who really hit this home for me. Her name is Teresa.
[5:00]She grew up in an abusive family. She struggled with eating disorders and she was kicked out of the house when she became pregnant at 16.
[5:08]So she had to quit high school and work at any jobs available to support herself and her son.
[5:13]But then her knee starts giving out and she can't work anymore. So she goes for an operation, which fails, and then she comes to us with chronic knee pain.
[5:22]When we met her, Teresa was facing physical, emotional, interpersonal and financial problems.
[5:29]She was so overwhelmed that she purposely burned herself, because the pain from the burn took her mind away from all the other crap in her life.
[5:38]How bad is your life if you have to harm yourself to find relief?
[5:43]Well, we obviously had to provide her with some emotional support, but we were blown away by her amazing attitude.
[5:49]She worked extremely hard to get her knee stronger, and once she was able to stand and walk easier, she began to focus on finding a good job.
[5:57]At first, she was rejected from a lot of positions, but she never felt entitled, like she deserved a good job because of all the negative things she's been through.
[6:05]She simply asked us to help her with her resume and interview skills and kept on plugging away until she got a job that she wanted.
[6:13]Then once her finances were more settled, she began to deal with her relationship problems.
[6:18]Ten years later, I meet her again and I find out that she's happily married with two kids and living a very productive life.
[6:25]Teresa taught me that no matter how out of control your life might seem, you will always have control over your actions right now.
[6:33]So do one thing. And take responsibility of the outcomes, so that you can steer your life in a positive direction.
[6:42]Now, everything that you do takes time and energy, which we all have a limited supply of.
[6:48]So you can't always concentrate on just one thing, because life happens. You still need to meet your deadlines at school or work.
[6:56]You still need to tend to your kids, or take the car to the shop if it needs repairs.
[7:01]Some people get overwhelmed by all of their activities, because they don't manage their time and energy properly, so they aren't able to handle or cope with any problems.
[7:12]These are the Yes People and the Go Getters.
[7:15]Yes people are like everyone's doormat. They'll do everything for everyone else and leave themselves with no time or energy left.
[7:23]On the other hand, Go Getters try to do everything all the time, so they deplete their resources.
[7:30]Resilient people accept that their their time and energy are limited and they understand that in order for them to take care of others, they have to first take care of themselves.
[7:40]So they make their own well-being a priority.
[7:44]One of our patients, Curtis, is the nicest person you'll ever meet.
[7:49]His work is physically demanding, which isn't great for his chronic low back pain. But on top of that, his supervisors takes advantage of his good nature and keeps on telling him to do extra work, which Curtis always agrees to.
[8:03]Then after work, his son asks him to play, but he's in so much pain that all he can do is lie down.
[8:10]When Curtis came to us, he was constantly on the verge of tears, because his pain was getting progressively worse, and he felt guilty about neglecting his son.
[8:19]It was pretty obvious that all of his extra work for his supervisor was perpetuating his pain.
[8:24]So we asked him why he kept on doing it. And we find out that it was because he felt intimidated by his supervisor.
[8:31]So, we trained him to be more assertive and got him to practice standing up for himself.
[8:37]Eventually, he was able to develop enough confidence to finally say no to his supervisor's unreasonable demands.
[8:43]The very first time he did this, his supervisor's jaw dropped. We were so proud of him.
[8:51]Ever since then, Curtis has been setting aside time for himself to relax so that his body could recover and rest.
[8:59]Over time, his back pain improved and he was able to play with his son again.
[9:03]So Curtis taught me that if you want enough time and energy to do the things that are meaningful in your life, then you have to establish your boundaries and take care of yourself.
[9:14]Now, there are some people who take this to extremes because they feel so miserable. They'll either push everyone away,
[9:20]or they'll become completely dependent on others to take care of them.
[9:25]These are the Recluses and the Perpetual Patients.
[9:28]Reclusive people push everyone away, because they just want to be left alone. But by doing that, they cut themselves off from any emotional support.
[9:38]On the opposite end of the spectrum, perpetual patients take on the sick role and do nothing for themselves. So they lose the chance to develop any coping skills.
[9:49]Effectively, what both are doing is they're removing themselves as active participants in society.
[9:55]Resilient people understand that no matter what state they're in, they're still a valuable part of the human collective.
[10:00]So they make themselves an interdependent part of society by using their relationships to get their needs met, while finding different ways to give back to others.
[10:11]There was a patient named Lily, who lived as a recluse because of chronic pain in her legs, and because she felt bitter toward her family for deserting her.
[10:19]She'd been divorced for many years and her adult children don't talk to her. So, over time, she gained weight, she got weaker, and she became so depressed that she was at risk for suicide.
[10:31]It turns out that during her marriage, she cheated on her husband, and it was her guilt about this that made her feel unworthy of any relationship for all these years.
[10:41]When this fundamental issue finally came to light, it became clear to Lily that she needed people in her life again.
[10:49]So, she reached out to a support group for divorcees and began to volunteer with school kids. She teaches them how to knit so that it doesn't aggravate her leg pain.
[10:58]Well, once she got the proper support from her group, and something to look forward to in her volunteer work, her pain and mood improved.
[11:07]So, Lily showed me that if you want to move forward from adversity, you need a strong social network, so that you can draw strength, as well as a sense of meaning from others.
[11:20]But some people still struggle to move forward, even though they have the best support network.
[11:24]This is because they have very rigid expectations of how their lives ought to be.
[11:30]We call them doctor shoppers.
[11:33]They believe that their lives should be the way it was before their pain began. So they put their lives completely on hold while they jump from doctor to doctor to find an immediate cure for themselves, so that they can go back to their normal lives.
[11:46]But chronic pain is multifaceted, and most of the time, they can't find a quick fix.
[11:52]So their condition worsens, because they feel more and more hopeless with every failed course of treatment.
[11:58]Resilient people are able to let go of their expectations of how things should be, and they're open to different possibilities.
[12:08]A great example of this is the story of Candace.
[12:11]She's a talented painter who many years ago decided to put her art aside in exchange for a stable job at a factory.
[12:19]She figured that once she got her retirement package, she'd be financially secure enough so that she can return to her passions full-time.
[12:27]At least, that was the plan. But just a couple of years before retirement, she injures herself.
[12:33]And winds up with chronic pain in her arm that prevents her from doing her job.
[12:38]Since she had already invested so many years into her plan, she was determined to fix it.
[12:45]But every course of therapy and every return to work attempt fails, so her pain and her mood got worse.
[12:55]An important piece of information you should know is that Candace also has a keen interest in wigs, because her wig helped to boost her confidence when she experienced hair loss due to a thyroid issue.
[13:06]Well, one day she's visiting Toronto and she happens to walk into a busy wig shop. Then she begins thinking to herself, "Hmm.
[13:13]This type of a service would really be helpful in my hometown of Sarnia.
[13:18]Now, if she had been stuck in trying to find a cure for herself, that might have just been a passing thought, and she may still be looking for a cure today.
[13:26]But instead, she was able to let go of her original life plan and began talking to the store owner about her idea.
[13:35]It was risky for her to start something new at this stage of her career, but she found it easy to dedicate her time and energy to, because she was so excited about it.
[13:43]With that much passion and hard work, it seemed inevitable that her store would be successful.
[13:49]She still has pain in her arm, but it doesn't affect her that much, because she has a fulfilling job, improving the lives of cancer survivors and other people who've experienced hair loss.
[14:02]So, the final lesson that my patients taught me is that life doesn't always lead you where you want to go. But that's okay.
[14:09]Because there are other, potentially better paths, if you're open to them.
[14:15]I'm personally thankful for all of these lessons, because a few years ago, they really helped me to better deal with some significant struggles in my life.
[14:24]My wife and I had three miscarriages while trying for a second child.
[14:28]It was an emotionally challenging time for us, and it could have caused a lot of damage.
[14:33]But knowing what I did for my patients, I chose to be interdependent by getting support from my friends and family and by helping my wife in any way that I could.
[14:44]Talking about our miscarriages was hard, and I see why a lot of people don't do it. But it was comforting to find out that others had gone through it too.
[14:52]While I was processing everything that was going on, I still had to work, do the house chores, and take care of my toddler son.
[15:00]So in order to prevent myself from being overwhelmed, I chose to make my own well-being a priority.
[15:06]I set aside time each night so that I can relax and laugh with my wife. I also set limits at how much work I would take on each day.
[15:15]Work was stressful. But the biggest stress for us at that time was our sex life.
[15:21]Because it was always, it's time, let's go. Or, don't touch me. I'm not ready yet.
[15:28]The first one was her, the second one was me.
[15:34]So we let go of our fixation with conceiving a child, and became open to adoption.
[15:43]We already did have an amazing son. And our miscarriages made us even more grateful for him.
[15:50]So I held him tighter and played with him more often.
[15:55]I had to take ownership of the present because I didn't want to regret losing time with him while I was trying for another kid.
[16:05]Well, after about a year, we were able to hold on to a pregnancy, and now I have two amazing boys.
[16:19]Everyone of you will face some form of adversity in your life.
[16:23]In those pivotal moments, if you're feeling overwhelmed and maybe even hopeless, remember that you do have a choice.
[16:31]You can't control what life throws at you, but you can control whether adversity will bend or break you.
[16:38]I hope you choose the path of resilience.
