Coping with Chronic Illness and Disability

Abstract

The study of coping has attracted a growing number of theoreticians, clinicians, and researchers for almost an entire century. Historically, coping (or more accurately, psychological defense) emerged largely as part of an emphasis on viewing human functioning within a pathological context, which typically included the terms mental illnesses, abnormal behaviors, maladaptive functioning, and impaired psychological structures and processes. It is only more recently that coping research has undergone a metamorphosis and has begun to focus more fully on coping modalities that seek to link psychological processes, operating in the aftermath of crises and traumatic events, with efforts that are reflective of searching for meaning, making sense of the loss, positive reappraisal, and benefit-finding. This growing trend has resulted in a substantive body of work that is strongly indicative of the benefits accrued from these, and related, coping strategies in fostering positive emotions, personal strengths, mental health, and successful human adaptation to stressful life events, personal losses, and traumatic experiences (Davis, Nolen-Hoeksema, &Larson, 1998; Folkman &Moskowitz, 2000, 2004; Holahan &Moos, 1991; Tennen &Affleck, 1999). The study of coping has indeed evolved from its original focus on intraindividual, trait-like, psychodynamic defense processes to include a more interactive view of coping as a process, which inevitably includes an individual's perception of events, as well as "extra- individual" influences, such as social support and environmental factors. While a dynamic model of coping explains that coping is differentially utilized according to circumstances, this view complicates efforts to research aspects of coping. Fortunately, multivariate statistical techniques are available to test the more sophisticated coping models and allow scientists to map common responses to challenging and traumatic events, such as those involving CID. Because the consequences of CID involve long-term stressors, a book that focused on the theoretical and empirical aspects of coping with CID is urgently needed to better understand how coping is differentially and effectively used with the myriad of challenges created by CID. Sharoff (2004) stated, in his insightful book about coping with chronic and terminal illnesses, that coping requires skills, which are often unknown to the person with a new CID and that: Disease and treatment invariably cause some degree of suffering, discomfort, bitterness, deprivation, helplessness, uncertainty, and rejection of the patient, but if appropriate coping abilities are present, these problems or situations will cause less harm and far less psychological pain (p. 4). As theory and research on coping with CID expands, hopefully the clinical applications (Guterman, 2006; Sharoff, 2004; Sperry, 2006; also see Devins &Binik, 1996, Table 27.1 for a summary of coping interventions for various CID) will also increase in quantity and effectiveness. Clinical interventions, and research on what works with whom, will help to provide knowledge about how individuals with CID find ways to cope and to develop positive meaning from unexpected, traumatic life-events, such as the onset of CID. © 2007 Springer Science+Business Media, LLC. All rights reserved.