A search for mastery
A search for mastery is reflected in questions such as ‘How can I prevent a similar event
reoccurring?’, ‘What can I do to manage the event now?’ Taylor et al. (1984) reported
that a sense of mastery can be achieved by believing that the illness is controllable. In
accordance with this, 66 per cent of the women in the study believed that they could
influence the course or reoccurrence of the cancer. The remainder of the women
believed that the cancer could be controlled by health professionals. Taylor reported that
a sense of mastery is achieved either through psychological techniques such as develop-
ing a positive attitude, meditation, self-hypnosis or a type of causal attribution, or by
behavioural techniques such as changing diet, changing medications, accessing
information or controlling any side effects.
These processes contribute towards a state of mastery, which is central to the
progression towards a state of cognitive adaptation.The process of self-enhancement
Following illness, some individuals may suffer a decrease in their self-esteem. The theory
of cognitive adaption suggests that, following illness, individuals attempt to build their
self-esteem through a process of self-enhancement. Taylor et al. (1984) reported that
only 17 per cent of the women in their study reported only negative changes following
their illness, whereas 53 per cent reported only positive changes. To explain this result,
Taylor et al. (1984) developed social comparison theory (Festinger 1957). This theory
suggests that individuals make sense of their world by comparing themselves with
others. Such comparisons may either be downward comparisons (e.g. a comparison with
others who are worse off: ‘At least I’ve only had cancer once’), or upward (e.g. a com-
parison with others who are better off: ‘Why was my lump malignant when hers was
only a cyst?’). In terms of their study of women with breast cancer, Taylor et al. (1984)
reported that, although many of the women in their study had undergone disfiguring
surgery and had been diagnosed as having a life-threatening illness, most of them
showed downward comparisons. This indicates that nearly all the women were com-
paring themselves with others worse off than themselves in order to improve their self-
esteem. For example, women who had had a lumpectomy compared themselves with
women who had had a mastectomy. Those who had had a mastectomy compared them-
selves with those who had a possibility of having generalized cancer. Older women
compared themselves favourably with younger women, and younger women compared
themselves favourably with older women. Taylor and her colleagues suggested that
the women selected criteria for comparison that would enable them to improve their
self-esteem as part of the process of self-enhancement.The role of illusions
According to the theory of cognitive adaptation, following a threatening event indi-
viduals are motivated to search for meaning, search for mastery and to improve their68 HEALTH PSYCHOLOGY