There is a human tendency to want to categorize things simply. This is no different for therapists. We often want to understand certain outcomes or prescribe specific if-then scenarios for mental health. But research continues to find these patterns are not as predictable as we hope. It is clear that how people adjust to changes in life is not so straightforward.
How we adjust to events constitutes so much of mental health. Adjusting to change can be particularly difficult when it challenges our sense of self in dynamic ways. Our immediate response to difficult emotions and stress affects our mood, for better or worse. It also shapes how others respond to us following these events. For example, taking one’s anger out on others versus seeking support has a much different impact on our mental health outcomes.
Therapists understandably want to simplify or categorize this adjustment process. An example from the history of psychotherapy is “If someone does not progress through the stages of grief, they won’t adjust well.” Or that people have to take time to effortfully “process” their loss in order to adjust to it. Another example from emotional coping states that “Suppressing emotions is bad because it just bottles up your emotions inside. You should express everything.”
But mental health research is finding a more complex picture for adjustment. For example, research finds there are not stages of grief (even if stages could occur in any order) and that grief reactions are usually multi-faceted. Research also finds that effortfully “processing” the loss actually predicts worse outcomes and prolonged grief.
Research also finds suppressing emotion does not lead to emotional rebound. Sometimes, it is even an appropriate response, depending on the situation. Suppression can also impact some emotions, but has no effect on others (e.g., suppressing anxiety vs sadness). It also has different effects for those who experience depression versus those who do not.
Studies reveal adjustment is more nuanced and complex. A seminal study by George Bonanno at Columbia University followed individuals in New York who were adjusting to moving to college while the September 11, 2001 attacks occurred. This study examined the degree participants were able to both enhance and suppress emotions. Participants who could do both well (as opposed to suppressing emotions less often) showed increased well-being and decreased mental health difficulties in the first few years after these events.
Having a range of emotional coping tools allowed some participants to flexibly fit the demands of changing social contexts. This flexibility allows people to garner the most social support and social adjustment. The reliance on multiple strategies in differing contexts was the most helpful, as opposed to using or not using a specific strategy.
these and other findings on an episode of the popular “Hidden Brain” podcast. This is a great listen for therapists, but also for clients wanting to better understand adjustment and adjustment difficulties. The podcast speaks to adjusting to grief, trauma, break-ups/divorce, and other stressors
This research shows that adjusting to stressors and loss is not based on rules or on expectations about how other people “should react”. In many ways, effective therapy (especially in more advanced stages) helps clients utilize multiple coping tools for different situations, and in a flexible manner.
The human desire to categorize singular factors that lead to better or worse adjustment is strong. However, research finds few “rules” of adjustment. On the other hand, many factors influence adjustment and that context is key. This adds even more complexity to difficult experiences, but also helps us as therapists more effectively inform and help clients who struggle with adjustment.
