# Resilience in Haiti: is it culturally pathological?

Daniel Derivois, Jude Mary Cénat, Amira Karray, Nathalie Guillier-Pasut, Jeff Cadichon, Baptiste Lignier, Nephtalie Joseph, Lisbeth Brolles, Yoram Mouchenik

<figure><img src="image_1.png" /></figure>

## To cite this version:

Daniel Derivois, Jude Mary Cénat, Amira Karray, Nathalie Guillier-Pasut, Jeff Cadichon, et al. Resilience in Haiti: is it culturally pathological?. BJPsych International, 2018, 15 (4), pp.79-80. 10.1192/bji.2017.25 . hal-03119926

HAL Id: hal-03119926

https://ube.hal.science/hal-03119926v1

Submitted on 3 Feb 2025

HAL is a multi-disciplinary open access
archive for the deposit and dissemination of sci-
entific research documents, whether they are pub-
lished or not. The documents may come from
teaching and research institutions in France or
abroad, or from public or private research centers.

L'archive ouverte pluridisciplinaire HAL, est
destinée au dépôt et à la diffusion de documents
scientifiques de niveau recherche, publiés ou non,
émanant des établissements d'enseignement et de
recherche français ou étrangers, des laboratoires
publics ou privés.

<figure><img src="image_2.png" /></figure>
THEMATIC
PAPER

Resilience in Haiti: is it culturally
pathological?

Daniel Derivois,<fnref n="1" /> Jude Mary Cénat,<fnref n="2" /> Amira Karray,<fnref n="3" /> Nathalie Guillier-Pasut,<fnref n="4" /> Jeff M. Cadichon,<fnref n="5" /> Baptiste Lignier,<fnref n="6" /> Nephtalie E. Joseph,<fnref n="7" /> Lisbeth Brolles<fnref n="8" /> and Yoram Mouchenik<fnref n="9" />

Not for the first time in recent history, the people of Haiti have been obliged to fall back on their resilience strategies in the aftermath of Hurricane Matthew. Following the powerful earthquake that struck the country on 12 January 2010, the entire population had to find the resources to survive in the face of extensive material damage and loss of life: over 222 000 dead, more than 300 000 injured and between 4000 and 7000 amputees (UNDP, 2010).

Paradoxical resilience

Several post-disaster studies (Cénat & Derivois, 2014a, 2014b; Derivois et al, 2014b) found that there was a marked prevalence (varying between 30 and 50%) of post-traumatic stress disorder and depression symptoms in the population. These studies show that these traumas are complex and not just related to natural disasters (Derivois et al, 2014a). Furthermore, the research showed that the resilience levels of survivors in Haiti were superior to those of other countries with experience of similar natural disasters such as China, Armenia, Japan, Italy and Taiwan (Cénat & Derivois, 2014b; Derivois et al, 2014a, 2014b). The same studies also highlight a paradox: the most vulnerable populations in Haiti have the highest resilience scores. Children living in the street with no schooling have higher resilience levels than children who go to school and have a house in which to live. A more recent study (Cadichon & Derivois, 2016) conducted 6 years after the seismic event has revealed that resilience levels are higher among: (a) children and adolescents whose parents

do not work (compared with those of working parents), and (b) people with disabilities following the earthquake (compared with those with no disability). Although a high level of resilience does not imply an absence of trauma (as emphasised by Almedom & Glandon, 2007), it is surprising that children and adolescents who live in the street, do not go to school, have a disability or whose parents are unemployed have more resources to cope with adversity.

Halfway resiliency or a pathological
resilience?

How can we make sense of these findings, is resili-
ence the central issue? Various studies (Cénat &
Derivois, 2014a, 2014b) have postulated that
resilience goes beyond dealing with and adapting
to traumatic experiences, i.e. being able to absorb
or resist them. Resilience is, above all, the capacity
to bounce back and develop in a positive way
following traumatic events and adversities. But
does this definition remain valid in light of the
outcomes of sociological studies that reported
day-to-day life in post-earthquake Haiti (Farmer,
2012)? Although these studies reported that
people were able to cope with the quake's
aftermath, they have not experienced a 'positive
development'. Indeed, they did not collapse psy-
chologically, but they did not rebound either.
The data from studies cited above indicate that
the more difficult the conditions are, the more
likely people are to invent paradoxical coping
strategies. They were not more ready, however,
for new natural disasters.

Hurricane Matthew, which left hundreds dead
in Haiti, has recently shown that although the
population was completely unprepared to tackle

<footnote n="1">¹Professor of Clinical Psychology, Laboratoire de Psychologie, Psy-DREPI, EA-7458, Université Bourgogne Franche-Comté: email daniel.derivois@u-bourgogne.fr</footnote>

<footnote n="2">²Postdoctoral Fellow, Université du Québec à Montréal</footnote>

<footnote n="3">³Lecturer in Clinical Psychology, LPCPP EA 3278, Université Aix-Marseille</footnote>

<footnote n="4">⁴PhD, Laboratoire de Psychologie, Psy-DREPI, EA-7458, Université Bourgogne Franche-Comté</footnote>

<footnote n="5">⁵PhD in Psychology, Laboratoire de Psychologie, Psy-DREPI, EA-7458, Université Bourgogne Franche-Comté</footnote>

<footnote n="6">⁶Lecturer in Clinical Psychology, Laboratoire de Psychologie, Psy-DREPI, EA-7458, Université Bourgogne Franche-Comté</footnote>

<footnote n="7">⁷PhD, Laboratoire de Psychologie, Psy-DREPI, EA-7458, Université Bourgogne Franche-Comté</footnote>

<footnote n="8">⁸PhD in psychology, associate researcher, CRPPC, University of Lyon</footnote>

<footnote n="9">⁹Professor of Intercultural Psychology, Université Paris 13</footnote>

<footnote>Conflicts of interest. None.</footnote>

<footnote>doi:10.1192/bji.2017.25</footnote>
© The Authors 2018. This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.

a natural disaster, it resulted in paradoxical indicators of resilience. For example, while the south was cut off from the rest of the country and thousands of deaths were feared, the inhabitants of Port-au-Prince took to the streets to dance the *rara* (traditional music band) in the rain. Given these circumstances, is it appropriate to talk about ‘pathological resilience’ (Derivois, 2012)? That is, a form of resilience that sublimates setbacks and makes it possible to ‘roll with the punches’ without the ability to bounce back in the long term? There are two possible hypotheses: The Haitian people are genuinely resilient and exploit this memory of resilience, which is inherited and has developed progressively in response to traumatic events (particularly in the country’s cultural, colonial and traumatic history). The development of this resilience could also be explained by the Haitian social configuration where there is an interconnection between social supports and resources such as family, school, religion, collective spirituality, community networks and personal resources developed by individuals to deal with adverse living conditions (Cénat et al, 2013; Clermont-Mathieu et al, 2016). Alternatively, the people turn to ‘marronnage’ (see below), i.e. they evade the methodological and conceptual tools used to study their fragility and resilience, and – in more general terms – they ‘run away’ when faced with the international, humanitarian and scientific community that claims to understand and assist them or help them grow. Historically, marronnage was a technique used by slaves in the plantations to escape the watchful eye of their colonial masters (Fouchard, 1988). Is it possible that the legacy of marronnage might induce the Haitian people to organise themselves to escape the theoretical tools employed to assess their trauma and resilience? In both of the above cases, the hypothesis of pathological resilience should prompt us not only to question the tools we use but also to seek out the hidden sense of the outcomes. Unless, that is, the concept of ‘resistance’ that resonates more profoundly with the collective history and psyche of Haiti would be a more effective way of thinking about this hidden meaning. The culture could then be a profitable means of analysing the paradoxes of resilience.

The ideas outlined above should help researchers and practitioners work towards a better assessment

of the risk factors, defence strategies and traumatic consequences arising from natural disasters in Haiti and other low- and middle-income countries. They should then be in a position to improve the assistance offered to surviving populations by using their own cultural heritage as a therapeutic tool and to potentially reinforce resilience.

## References

Almedom A. M. & Glandon D. (2007) Resilience is not the absence of PTSD any more than health is the absence of disease. *Journal of loss and Trauma*, 12, 127–143.

Cadichon J. M. & Derivois D. (2016) Vulnérabilité et résilience des élèves haitiens dans le contexte post séisme en Haïti. [Vulnerability and resilience of Haitian students in the post-earthquake context in Haïti.] 57ème congrès annuel de la Société Française de Psychologie, 5–7 September 2016. Paris, France.

Cénat J. M. & Derivois D. (2014a) Psychometric properties of the Creole Haitian version of the Resilience Scale amongst child and adolescent survivors of the 2010 earthquake. *Comprehensive Psychiatry*, 55, 388–395.

Cénat J. M. & Derivois D. (2014b) Long-term outcomes among child and adolescent survivors of the 2010 Haitian earthquake. *Anxiety and Depression*, 32, 57–63.

Cénat J. M., Derivois D. & Mérisier G. G. (2013) Ecole et résilience chez les enfants et adolescents dans l’Haïti post-séisme. [School and resilience in children and adolescents in post-earthquake Haiti]. *Revue québécoise de Psychologie*, 42, 189–201.

Clermont-Mathieu M., Jean-Jacques R. & Derivois D. (2016) Les Tuteurs de résilience des enfants et adolescents vivant dans des camps à Port au Prince et dans les villes avoisinantes. [Tutors of resiliency of children and adolescents living in camps in Port-au-Prince and surrounding cities.] *L’Encéphale*, 42, 470–475.

Derivois D. (2012) L’hypothèse d’une résilience de l’Esprit et des esprits en Haïti. [Reflection about Resilience of Spirit and of religious spirits in Haïti.] *Sciences croisées*, 11, 1–9. http://sciences-croisees.com/N11/Derivois.pdf.

Derivois D., Cénat J. M. & Mérisier G. G. (2014a) Multi-natural disasters in Gonaïves Haïti: long-term outcomes among child and adolescents and social support. *International Journal of Emergency Mental Health and Human Resilience*, 16, 292–297.

Derivois D., Mérisier G. G., Cénat J. M., et al (2014b) Symptoms of posttraumatic stress disorder and social support among children and adolescents after the 2010 Haitian earthquake. *Journal of Loss and Trauma: International Perspectives on Stress and Coping*, 19, 202–212.

Farmer P. (2012) *Haiti After the Earthquake*. PublicAffairs.

Fouchard J. (1988) *Les Marrons de la Liberté* [The Maroons of Freedom]. Editions Henri Deschamps.

United Nations Development Programme (UNDP) (2010) Human Development Report 2010. Palgrave Macmillan.