The Psychology of Chronic Illness

CHRONIC ILLNESS encompasses a variety of disorders and includes any impairment of bodily function over a period of time. Contrasted to an acute illness which is of limited duration the patient is faced with long standing conflicts, adjustments, and psychosocial situations to which he must adapt. In this presentation I shall examine some of the modes of adaptation (or maladaptation) to such physical illnesses as chronic heart disease, renal failure, lung disease, and diabetes mellitis. The meaning of the illness to the patient, defensive maneuvers for handling underlying psychological conflicts, reactions to the illness, and the attitudes of 'care-giving' personnel will receive particular attention. Although each patient looks upon his illness in an individual and unique manner, there are some broad generalizations which can be drawn from observing and working with chronic illness. Basically the patient perceives the illness as a threat to his bodily integrity. Thus, how the patient accepts this loss and the personal meaning of the loss to him become of prime importance. Secondarily, the illness affects the interpersonal aspects of his life and his relationship with the world about him. Life style often must change, and the illness or its treatment may place restrictions on the patient. These changes and restrictions frequently become pivotal in the patient's overall adaptation and, as commented upon later, at times lead to neurotic behavior. Likewise the patient's physician, family, and others closely involved with him affect and are affected by the patient's illness. Their response to him may directly or indirectly influence his adaptation in a significant fashion.