Illness as adjustment: a methodology and conceptual framework

This paper describes a method for studying individual adjustment to illness. The methodology draws upon the conceptual framework offered by Herzlich (1973) and defines four modalities of adjustment ‐ accommodation, active‐denial, secondary gain and resignation. The relevance of these modalities for understanding how people come to terms with illness is indicated with reference to a variety of studies of chronic illness describing such adjustments. The technique, which invites free responses to a series of questions, engages respondents on a number of issues which have been designated salient in the literature on illness behaviour and is intended to be used (a) to distinguish between individuals in their adaptation to their condition, and (b) to relate personal experience of illness to changing social situations and relationships. The methodology is offered as a way of describing, within a single conceptual scheme, the ways in which individuals resolve the dual demands of bodily change and of cultural constraint during chronic illness.