Resiliencing in the face of adversity: Causes and consequences of psychoemotional stress, appraisal and coping from a neurobiological perspective

in gynecological practice, psychoemotional irritation, fear, anxiety and feelings of helplessness are much more often seen and play a much greater role than in may other somatic medical disciplines. Whether or not a certain diagnosis or treatment will trigger a psychoemotional stress response is primarily dependent on the subjective judgment and the appraisal of the situation by the individual patient. This response can only partly be influenced by the medical practitioners. It is governed by the previous experiences made by the individual patient in the course of her life. This contribution describes how such subjective experiences of failure and of success in mastering difficult situations are anchored in the brain. Alternating experiences of the controllability and the uncontrollability of stressors are required for the facilitation and stabilization of neuronal networks and synaptic connections. Based on the current knowledge about the use- and experience-dependent adaptive modification and reorganization of neuronal connectivity, the reasons are discussed which will make certain patients either more vulnerable or more resistant to stressful life events. it is described why the internalized attitudes and views of the individual patient are of uttermost importance for her appraisal. The prerequisites and conditions for the acquisition of resource-strengthening attitudes and views are discussed.