You hadn’t been feeling quite right so you went to the doctor to find out what was wrong. After a thorough exam and visits to various specialists, you were told that you have a terminal illness and you have only a limited amount of time left on this earth. Once the letters “ALS” spilled out of the doctor’s mouth, you hardly heard anything else he said. except he couldn’t tell you if you had a few months or a few years to live. However, you’ve read enough to know that this is a death sentence - there is no cure for amyotrophic lateral sclerosis (ALS or Lou Gehrig’s Disease). You think to yourself: “How can this be happening to me?” You always expected to live longer than this. There are so many things left you wanted to do and see. What do I do now? Panic begins to sink in as you realize you are suddenly faced with a myriad of things to do, decisions to make, and demands to be met. The stress of it all is overwhelming as you realize that there is no light at the end of this tunnel, at least not until you’re dead! You know you’ll have to figure out a way to manage, i.e., to cope, with this unbelievable situation. Of course, you are not the only one who has to cope with this, so does everyone else who is involved, including friends, family, and eventually, professional caregivers.
R.H. Moos and J.A. Schaefer have helped us better understand coping by dividing it into three categories, each with three skills.
Appraisal-focused CopingThese skills involve how we understand the stressful situation
- Logical analysis and mental preparation - Breaking down an overwhelming problem down into manageable parts, taking advantage of past similar experiences, evaluating and rehearsing plausible "what-if" scenarios
- Cognitive redefinition - Restructuring or re-framing the situation to find something favorable
- Cognitive avoidance or denial - Denying or minimizing the severity of the situation
Problem-focused CopingThese skills involve doing something about the problem itself
- Seeking information and support - Getting information about the situation and evaluating any possible courses of action
- Taking problem-solving actions - Taking deliberate action to deal directly with the situation
- Identifying alternative rewards - Trying to replace any losses or setbacks with new sources of satisfaction
Emotion-focused CopingThese skill involves what we do with our reactions to the situation
- Affective regulation - Working to maintain hope and to control emotions
- Emotional discharge - Expressing feelings and using humor to help reduce strain
- Resigned acceptance - Accepting the situation for what it is, realizing the circumstances cannot be altered and submitting to fate
- different people have their own sets of skills and, of those skills, they are better at using certain ones at certain times; and
- each person perceives the same situation uniquely. Therefore, everyone's reaction to extreme stress must be considered according to what he/she is actually doing or thinking.