What makes one person able to deal with a great deal of stress and another person fall apart under less pressure? Why is it that some people can grow up in seriously "dysfunctional" families and be somewhat okay as adults, while others can come out of an abusive childhood with severe, long-lasting scars?

Rather than focusing only on people's problems and vulnerabilities, clinical psychology should also address those factors which make people stronger, more resilient and more resistant to stress.

An article in the January, 1996 edition of the American Psychologist, entitled Vulnerability and Resilience, does just this. It pinpoints three factors which buffer people against stress.

The first factor is personality traits. Due to biology or temperament, some people are better able to handle stress than others. Some are more extraverted, more agreeable, more organized, less emotionally reactive and more intelligent than others - all of which makes them better able to cope with life's inevitable bumps and valleys.

A second factor which appears to buffer people against stress is attachment history. Early bonding with a consistent caregiver is what gives us a conscience, makes us human and provides us with an internal source of comfort and strength that can last us a lifetime.

My own belief is that the first three years of bonding history, when the sense of self is being formed, sets the foundation for later married life. Those with insecure attachments as infants and toddlers tend to have more marital difficulties than those with more secure attachment histories.

Because few of us can remember events before age three, these distant causes of marital difficulties are largely unconscious, however. Psychotherapy can help people become aware of these influences and thereby improve their marriages.

The third factor, according to this article, which buffers people against stress is high self-esteem. There is plenty of research evidence that good self esteem is imperative for good mental health and stable marriages. Without good feelings about ourselves, it is impossible to find consistent satisfaction in life.

I would add to this list some other factors I have found help people to deal with stress, especially childhood trauma. Again, research shows that social support helps us not only with emotional problems but with medical problems also. When we are under intense stress, it is critical we have supportive, caring people to whom we can talk about our troubles. This is why a good marriage is good for our mental health.

In asking someone about an abusive or neglectful childhood, I always ask if there was someone in the patient's childhood who was there for him or her in a loving, supportive way - a grandparent, uncle, aunt, teacher or clergyperson. Even though we may have been abused or neglected by our parents, it helps to realize there were some people back then who cared for us.

A strong religious faith can also buffer people against stress. Sometimes when everything else appears to be falling apart, faith can be the only reliable thing we can fall back upon. I remember one patient who was neglected as a child but who came to believe at age ten that God loved her unconditionally, a belief which has sustained her for thirty years.

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