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for preparation, as in chronic diseases of slow onset, appears to have
considerable utility, and where there is a time scale of many months or
a few years, as in the transitions of youth, then there are exceedingly
gradual, usually thorough, multifaceted preparations that occur.
The threatened person seeks to answer personal questions in many
ways and from many sources. Strategies for obtaining and utilizing such
information are formed at all levels of awareness and may be employed
over long periods of time. Strategies that were established earlier in a
person’s psychological repertoire and that have served similar functions
in earlier stress are likely to be employed first, but distress of high inten
sity and/or long duration is a powerful impetus to the formation of
new strategies that are effective and are likely to become available for
use in a future crisis. So individuals tend to build a behavioral repertoire
that through adolescent and young adult development can broaden the
individual’s problem solving capacity. To a certain extent, that continues
through the entire life span. Even at my age, I delude myself by thinking
that now and then I learn something useful in adaptation that I did
not know before. In any case, we studied stress in the framework of
human adaptation. We stimulated research at the NIMH and elsewhere
on the development of competence, of interpersonal problem solving,
and coping behavior.
This is another frontier on which psychiatrists are joining with other
behavioral scientists in interdisciplinary efforts to clarify important prob
lems. The work has had wide-ranging impact on clinical practice in
many ways. There were important contributors to the NIMH program
in the 1950s: George Coelho, Earle Silber, Roger Shapiro, Elizabeth
Murphey, Morris Rosenberg, Leonard Pearlin, Stanford Friedman, and
Fredric Solomon, with whom I later had five fruitful years of collabo
ration when I was president of the Institute of Medicine of the National
Academy of Sciences and he was chief of the Division of Mental Health
and Behavioral Medicine. This effort was highly interdisciplinary; there
were psychiatrists, psychologists of different breeds, sociologists, a
pediatrician, and endocrinologists. We were relating stress-hormone re
sponses to various coping variables over a wide range of situations.
Such studies across several decades have now illuminated successful
and unsuccessful coping patterns and some of the conditions that favor