Mental and biological resilience in wartime

What is mental resilience?

According to Prof. Gadron, the American Psychological Association defines resilience as the process of adapting well in the face of a threat, trauma, or stress. The term includes both the process and the outcome, meaning the ability to recover and return to functioning. He notes that there are questionnaires to measure personal resilience, such as the CD-RISC questionnaire, which assesses, among other things, the ability to adapt to change and recover quickly from setbacks. In addition to personal resilience, there is also community resilience, which includes physical infrastructure (like water, electricity, and hospitals) alongside strong social networks and welfare services. Prof. Gadron distinguishes resilience from related concepts. One concept is “Sense of Coherence,” which describes the ability to understand difficult situations, manage them, and find meaning in them. Another concept is “Coping,” which refers to the set of thoughts and behaviors a person employs to solve a problem or adapt to it. He rejects the cliché that any way of coping is good, explaining that the coping strategy must be adapted to the situation. For example, in an uncontrollable situation like an air raid siren, effective coping would actually involve denial, humor, or relaxation, not an attempt to solve the problem.

Israeli resilience

Boris Gorelik asks why Israeli society has not collapsed despite the ongoing war. Prof. Gadron explains that Israeli society is well prepared for emergencies. From a young age, citizens practice going to shelters, and most of the population completes military service, which provides coping tools. According to him, many other countries do not have such preparation. He cites a study by Avi Bleich from the period of the terror wave of the 2000s, which found a unique combination in Israel: very high levels of distress alongside a strong belief in the ability to cope. This combination, of acknowledging distress together with a high sense of capability, is a key component of Israeli resilience.

The biological measure of resilience: The vagus nerve

Prof. Gadron specializes in the vagus nerve, also known as the “wandering nerve.” This is a nerve that descends from the neck to the internal organs and transmits information about the body’s state to the brain. Its activity can be measured using a metric called “heart rate variability” (HRV). Contrary to popular belief, a completely stable pulse is not a good sign. Rather, small and constant changes in the intervals between heartbeats indicate flexibility and adaptability. According to him, high heart rate variability is associated with a reduced risk for a wide range of mental health problems, including anxiety, depression, and post-traumatic stress disorder (PTSD), as well as physical illnesses like diabetes, stroke, heart attacks, and cancer. A study he conducted among pre-military academy students showed a direct link between high heart rate variability and higher levels of resilience and fewer physical and post-traumatic symptoms. People with high vagal activity (activity of the vagus nerve) respond to stress more moderately and recover from it more quickly.

How to increase resilience?

Prof. Gadron suggests several simple ways to increase vagal activity and thus resilience:

1. Mediterranean diet: Consumption of olive oil, fish, fruits, and vegetables.
2. Moderate physical activity: The activity itself lowers heart rate variability, but in the long run, it contributes to an increase in this metric at rest.
3. Slow, rhythmic breathing: Lowering the breathing rate to about five or six breaths per minute. The technique is simple: inhale through the nose (“smell a flower”), pause for a moment, and exhale slowly through the mouth (“blow out a candle”). Practicing for a few minutes, several times a day, can raise heart rate variability almost immediately. One can use biofeedback apps that show the change in real time.

Psychoneuroimmunology: The link between stress and illness

Prof. Gadron’s field of research, psychoneuroimmunology, examines the mechanisms that link psychological stress to physical illnesses. He explains that stress causes changes in the immune system. In stressful situations, parts of it are suppressed, but other parts become overactive, creating a chronic inflammatory response. This inflammation is a major risk factor for many chronic diseases. The vagus nerve acts as a regulator or “thermostat” for the inflammatory response. When it functions well, it helps calm the inflammation after the threat has passed.

Short-term trauma treatments

Prof. Gadron argues that it is time for mental health treatment in Israel to be based more on scientific evidence and less on dogmatism. He presents two short and effective methods for treating trauma. One is the Memory Structuring Intervention (MSI), which he developed. In the treatment, which lasts one or two sessions, the therapist helps the patient, after practicing calming breathing exercises, to organize the traumatic memory chronologically and to name the sensations and emotions. The goal is to shift the memory processing from emotional and primitive areas of the brain to more frontal and rational areas, thereby restoring the patient’s sense of control. Another method is Dr. Moshe Farchi’s SIX C’s model, designed to help people return to functioning immediately after a traumatic event. A study conducted by Gadron and Farchi showed that the method can also “inoculate” adolescents against the effects of future events.

Social resilience

Finally, Boris Gorelik asks if there is a social equivalent to the vagus nerve, meaning a mechanism that calms the community. Prof. Gadron speculates, while stressing that this is not a scientific assertion, that focusing on a common goal and on what unites people can build social resilience. He calls for remembering what the different groups in society have in common and acting together, based on the understanding that there is more that unites than divides.