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close this bookMental Health Services in Disasters: Manual for Humanitarian Workers (PAHO; 2000; 92 pages) [ES]
View the documentPreface
View the documentObjectives
View the documentIntroduction
open this folder and view contentsChapter 1: Historical Overview and Mental Health Role
close this folderChapter 2: Basic Mental Health Content
View the documentStress/Stressor Response
View the documentCoping and Adaptation
View the documentLoss and Mourning
View the documentSocial Support Systems
View the documentCrisis Response and Resolution
View the documentThe Bio-psycho-socio-cultural system*
open this folder and view contentsChapter 3: Developmental Stages of Survivor Behavior
open this folder and view contentsChapter 4: Post-disaster Intervention Programs
open this folder and view contentsChapter 5: Populations with Special Needs
View the documentMental Health Services in Disasters: Manual for Humanitarian Workers
 

Coping and Adaptation

Coping Behavior that protects the individual from internal and external stresses; coping behavior implies adaptation, defense, and mastery.

Another interrelated concept that helps to explain disaster behavior is coping and adaptation. This section will review the meaning of coping, the interrelationship of coping to stress and socioemotional support systems, and the elements of coping behavior directed toward adaptation.

Coping behavior protects us from becoming psychologically and physiologically disorganized. Coping usually incorporates action-oriented behavior responses, as well as cognitive, emotional, and perceptual appraisal processes. In coping, the individual may attempt to change the source of the stress or redefine the threat situation in terms of meaning or degree of severity. The individual also attempts to find an accommodation and compromise, such as passive acceptance, resignation, religious believe, or belief in destiny.

Protection behavior usually takes three paths:

1. Altering the conditions that are producing painful stress responses.

 

Example:
"Dr. Brown, if you insist that I remain in the hospital for a few more hours, I will follow your advice, even though I believe that I should go and check my home to see what the hurricane did to it."

2. Redefining the meaning of the stress-producing experience to downgrade its significance.

 

Example:
"We were lucky that no one in our family died and only a few members were injured when the roof fell in." Or, "It was lucky that the earthquake was at 4:30 a.m. when the highways were empty."

3. Manipulating the emotional consequences in order to place them within manageable bounds.

 

Example:
"I am ashamed to complain about my damaged home when others lost so much more."

COPING MECHANISMS

Coping is behavior that is designed to prevent, delay, avoid, or manage tension and stress. Coping is not unusual or rare behavior; in fact, all individuals employ coping at some time.

Most individuals learn individualized ways of dealing with stress. Although these ways vary, coping methods usually follow a pattern of:

 

• avoidance,
• alteration,
• management,
• prevention, and
• control of undue emotional expression.

Coping mechanisms may take three different forms:

1. The individual may attempt to change the source of strain or stress. This action presumes knowledge and perception of its causes. Attention is focused on changing the situation before strain or stress occurs. The aim of this strategy is to avoid a threatening situation.

 

Example:
"It is time for us to leave the house now."

2. The individual may attempt to redefine the situation so as to control the degree of stress and lessen or buffer its impact. Redefinition is a means of managing the significance and gravity of the problem situation. Cognition and perception are important in this process. Redefinition allows the individual to say that the problem situation is not important enough to be upset about. This may be done by making comparisons and then concluding that things could be worse or by selectively ignoring the negative aspects and emphasizing the positive.

 

Example:
"This storm appears to be diminishing in force and wilt not do extensive damage."

3. Coping responses may attempt to manage stress so the individual can continue to function as normally as possible. This action is essentially an effort to keep stress within controllable boundaries and bring about an adjustment to stress without being overwhelmed by it. This involves a variety of responses, including denial, withdrawal, passive acceptance, undue optimism, avoidance, or even magical thinking.

 

Example:
"Dr. Ross, as soon as the cast is dry, I think I can start helping other injured people. I always like to feel useful."

Coping accomplishes the following:

 

• Containment of the distress within limits that are personally tolerable,
• Maintenance of self-esteem,
• Preservation of interpersonal relationships, and
• Acceptance of the conditions of the new circumstances.

Positive Coping Skills

• Ability to orient oneself rapidly
• Planning of decisive action
• Mobilization of emergency problem-solving mechanisms
• Appropriate use of assistance resources
• Ability to deal simultaneously with the affective dimensions of the experience and the tasks that must be carried out
• Appropriate expression of painful emotions
• Acknowledgement of pain, without obsessing over troubled feelings
• Development of strategies to convert uncertainty into manageable risk
• Acknowledgement of increased dependency needs and seeking, receiving, and using assistance
• Tolerance of uncertainty without resorting to impulsive action
• Reaction to environmental challenges and recognition of their positive value for growth
• Use of non-destructive defenses and modes of tension relief to cope with anxiety

Coping is the behavioral response to stress and strain that serves to protect the individual from an incapacitating emotional overload.

Overwhelming stress is always associated with crisis and is the emotional discomfort felt by individuals experiencing persistent problems or undue demands. It emanates from unusual, uncommon, or unexpected pressures, such as the fear of undergoing surgery or the impact of a natural disaster. Associated with a particular event or situation, stress differs from anxiety or depression, both of which are also reactions to traumatic events.

Negative Coping Skills

• Excessive denial, withdrawal, retreat, avoidance
• Frequent use of fantasy, poor reality testing
• Impulsive behavior
• Venting rage on weaker individuals and creating scapegoats
• Over-dependent, clinging, counter-dependent behavior
• Inability to evoke caring feelings from others
• Emotional suppression, leading to "hopeless-helpless-giving up" syndrome
• Use of hyperritualistic behavior with no purpose
• Fatigue and poor regulation of rest-work cycle
• Addiction
• Inability to use support systems

Coping is intertwined with one's social and emotional resources. It is made easier, or it is hampered and prevented, by the nature of the individual's social matrix. This matrix may include the network of interpersonal relationships with family, friends, neighbors, co-workers, and small group associations. It is to this social system that the individual turns first when seeking support, understanding, or aid in problem resolution.

Coping also depends on the individual's emotional or psychological tools, including personal characteristics and individual strengths and weaknesses. These resources include the individual's ability to communicate a sense of self-esteem and a capacity for bearing discomfort without disorganization or despair.

Communication skills facilitate expression of the problem and provide the means for seeking help to resolve it. Self-esteem refers to the individual's positive feelings toward him/herself; its absence would indicate low self-image.

Coping strategies use a set of complex patterns of thinking and behavior to provide adequate responses to a situation so that the internal responses do not continue to be painful. If an individual is unable to achieve this objective, the response can be detrimental.

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