Adjustment to physical illness and the theory of
cognitive adaptation
In an alternative model of coping, Taylor and colleagues (e.g. Taylor 1983; Taylor et al.
1984) examined ways in which individuals adjust to threatening events. Based on a
series of interviews with rape victims and cardiac and cancer patients, they suggested
that coping with threatening events (including illness) consists of three processes: (1) a
search for meaning; (2) a search for mastery; and (3) a process of self-enhancement.
They argued that these three processes are central to developing and maintaining
illusions and that these illusions constitute a process of cognitive adaptation. Again, this
model describes the individual as self-regulatory and as motivated to maintain the status
quo. In addition, many of the model’s components parallel those described earlier
in terms of illness cognitions (e.g. the dimensions of cause and consequence). This
theoretical perspective will be described in the context of their results from women who
had recently had breast cancer (Taylor et al. 1984).
A search for meaning
A search for meaning is reflected in questions such as ‘Why did it happen?’, ‘What impact
has it had?’, ‘What does my life mean now?’ A search for meaning can be understood in
terms of a search for causality and a search to understand the implications.
A search for causality (Why did it happen?) Attribution theory suggests that
individuals need to understand, predict and control their environment (e.g. Weiner
1986). Taylor et al. (1984) reported that 95 per cent of the women they interviewed
offered an explanation of the cause of their breast cancer. For example, 41 per cent
explained their cancer in terms of stress, 32 per cent held carcinogens such as the birth
control pill, chemical dumps or nuclear waste as responsible, 26 per cent saw hereditary
factors as the cause, 17 per cent blamed diet and 10 per cent considered a blow to the
breast to blame. Several women reported multiple causes. Taylor (1983) suggested that
no one perception of cause is better than any other, but that what is important for the
process of cognitive adaption is the search for any cause. People need to ask ‘Why did it
happen?’.
Understanding the implications (What effect has it had on my life?) Taylor
(1983) also argued that it is important for the women to understand the implications
of the cancer for their life now. Accordingly, over 50 per cent of the women stated that
the cancer had resulted in them reappraising their life, and others mentioned improved
self-knowledge, self-change and a process of reprioritization.
Understanding the cause of the illness and developing an insight into the implica-
tions of the illness gives the illness meaning. According to this model of coping, a sense
of meaning contributes to the process of coping and cognitive adaptation.
ILLNESS COGNITIONS 67