We talk often about making patients more resilient, but do we actually want that? Or should we be helping patients to become #antifragile? 

The brilliant Nassim Taleb talks about this concept in his book with the same name, where he describes the opposite to being fragile, not as resilient, but actually “antifragile”.

Resilience refers to the ability to resist stressors or remain the same in response to stress, whereas being antifragile is the ability to improve in response to stressors, or actually get better in response to struggles!

We should be enforcing this in patients, and showing them that our bodies aren’t fragile, or even just resilient, they are antifragile. Our bones, muscles, joints, cartilage and discs, respond to the stressors we place on them and actually get stronger as a result. We are not fragile porcelain cups that crack or break with simple tasks. We not only bounce back, but we also come back better and stronger than before as a result. 

Why is this better than resilience? Because the challenges we face on a daily basis are unknown, resilience depends on knowing what kind of stresses you will be facing, whereas being antifragile means having the ability to adapt to stressors and become better as a result.

Of course it possible to break an antifragile structure with too much load or not enough recovery time (Poulter rule of too’s), but this is where we come in as HCP’s. Showing patients that they can stress their system with movements, load, or graded exposure but also showing them what to pay attention to, meaning it’s too much.

If we want patients to come back stronger, we must make them Antifragile. 

(Totally aware, we’ve been saying make people resilient for ages, but I’ve only just read the book…)

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