Long-Term Adjustment and Adaptation Mechanisms in Severely Burned Adults

The adjustment problems and coping mechanisms of 20 adults suffering from severe burns were studied from 1 to 5 years after initial hospitalization. A majority of the patients (70 per cent) were found to be adjusting well, while 30 per cent had mild or moderate problems. The adjustment problems that the burn patient faces after discharge take the form of a multifaceted identity crisis. He must adjust to changes in his physical appearance, his bodily strength, his capacity to work, and the responses of others to him. Most patients resolve this identity crisis by using a fairly consistent set of adaptive mechanisms that help them redefine their sense of identity on a nonphysical foundation, using increased family ties, greater emphasis on inner worth, religiosity, etc. Factors influencing adaptation include amount of deformity, degree of immaturity and narcissism, sex of the victim, ability to ventilate, and attitude toward covering scarred areas.