Research & Science
June 20, 2022
· Written By
Ted Handler

Resilience to Stress: The Orchid and the Dandelion Theory

We recently laid the groundwork for understanding the effects of toxic stress by describing the foundational ACEs study. That study was one of the first to establish a connection between stressful childhood events and adult physical medical conditions such as high blood pressure and obesity. 

Not the Whole Story

This week, let’s dive deeper into understanding some of the proposed mechanisms behind the ACEs phenomenon. Why is it that an adverse childhood experience might be associated with poor health outcomes? The original hypothesis was that toxic stress leads to the chronic release of stress hormones, which weather the body and lead to hypertension. 

If that were the entire story, then it would be true that ACEs themselves could be used to predict poor health outcomes. Unfortunately, recent research has suggested that this isn’t the entire case. In two large scale longitudinal studies of environmental factors affecting health in Europe, researchers confirmed the previous finding that, on average, groups of people who suffered ACEs were more likely to develop chronic medical conditions than groups of people who did not. But, on an individual level, whether or not a person suffered from an ACE was insufficient to predict those same health outcomes better than a coin flip.

What Sets Someone Apart?

How can this be? There are a lot of possible explanations, from epigenetics to environment to parenting styles. It might be that environmental factors differentiate vulnerability to ACEs, such that those who live in heavily polluted communities are susceptible to the health effects of stress above and beyond the effects to those in less polluted communities. It could be that subtle genetic variations place only some people at risk to the effects of stress hormones. It could be (and probably is) a mix of both of these and a whole host of other variables.

One hypothesis that is gaining broad traction is referred to as the Orchid and the Dandelion. It’s been popularized by the UCSF Pediatrician and Author Dr. Thomas Boyce, who has studied the effects of stress on children for decades. 

According to Dr. Boyce, most children are like dandelions, fairly resistant to the effects of stress, but of course still susceptible to the most stressful of situations. Others are like orchids, incredibly sensitive to their environments and much more vulnerable to stressful childhood experiences. However, while orchids may be more likely to wither when not fostered correctly, they have the potential to grow taller and more beautiful than any nearby dandelion when raised in the right conditions. 

Cue the Resilience

The Orchid and the Dandelion framework is a reference to the concept of resilience: the idea that some people are innately robust to the harmful effects of stressful events. Resilience has been studied extensively in children. One possible explanation for the variation in responses to ACEs is that more sensitive children are less resilient to the effects of stress in childhood. We will dive deeper into the mind’s machinery at work in these differences in future posts. For now, the important lesson is simply that there is a broad range of responses to stress, and this might explain why two children exposed to the same stressful environment might grow up to experience different outcomes in adulthood.

The below quiz is derived from a validated study of diverse school-age and adolescent children (aged 10-19). Some of these questions read a little silly as an adult, but place yourself back in your mental state as a child. Remember, we’re trying to understand your sensitivity to stress as a child. The theory is that your sensitivity to stress and your environment is what determines whether or not you’re more of a “dandelion” or an “orchid.”

Ted Handler

Founding Pediatrician at Oath Care and general pediatrician in the San Francisco Bay Area.