Around one-third of people exposed to stressful life events experience symptoms of psychological distress and mental health disorders1,2. One person in three is a striking proportion — especially when life-threatening events such as natural disasters, wars and pandemics impact millions of people.

The traditional view has been that, after experiencing potential trauma, a person either develops or does not develop a mental disorder and, if they do, the symptoms will remain relatively stable for the rest of their life. Despite the undeniable achievements that this binary view of psychopathology has so far facilitated (defining vulnerability profiles for specific mental conditions, identifying modifiable risks and developing effective therapies), a binary lens limits scientific knowledge about the array of potential psychological responses after exposure to risks or traumatic events. Two articles published in Nature Reviews Psychology question this view and show that the psychological consequences of potential risk or trauma are anything but binary or irreparable.

In a Review in this issue, Bonanno et al. describe seven possible trajectories of mental health response after exposure to trauma. This broad spectrum of possible outcomes suggests that responses to potential trauma are dynamic processes that depend on multiple influences. The authors identify that a stable trajectory of healthy functioning after exposure to a potentially traumatic event (which they define as resilience) is the most common of all potential responses. After examining possible predictors of this outcome, the authors conclude that interventions to promote resilience must shift their focus from single strategies (for example, avoiding a single risk exposure to prevent the onset of a given condition) to dynamic processes. Specifically, Bonanno et al. propose that regulatory flexibility — a process of dynamic adjustment to situational demands — is crucial to promoting resilience after potential trauma.

The focus on process rather than outcome is central to the discussion of the onset and course of psychosis in an article by Thakkar et al. that we published earlier this year3. In this Review, the authors propose a resilience-based approach to psychosis as an alternative to the risk-based binary approach that has traditionally guided psychosis research. Thakkar et al. review the assets and strengths that might help people thrive in the context of psychosis risk, and discuss how these factors support dynamic recovery, persistence, resistance or adaptation trajectories that vary throughout the lifespan. Thus, this shift from risk to resilience suggests an array of responses to risks that are not limited to the presence or absence of psychosis. From this perspective, understanding the factors that promote a good quality of life after a diagnosis of a mental disorder is one of the biggest gaps in the literature that requires urgent attention.

“the shift to a resilience-based approach will force psychology to revise its objectives — traditionally linked to psychopathology and curing — to include diversity and coping”

Bonanno et al. and Thakkar et al. demonstrate that psychological science is leaving behind a binary and risk-based view of mental health. The shift to a resilience-based approach reveals that individuals’ responses to risk or trauma are non-binary and change over time, and opens new avenues for research about the psychological processes that underlie these changes. Most importantly, this shift from risk to resilience has deeper implications for future psychological science. If individuals’ responses to risk and trauma are multiple and transitory, research about single transient pathological outcomes and their treatments might become irrelevant. Thus, the shift to a resilience-based approach will force psychology to revise its objectives — traditionally linked to psychopathology and curing — to include diversity and coping.