Definitions

1. Responding to loss
2. Contending with difficulties and acting to overcome them.
3. Ways of dealing with stressful situations.
4. Taking action to restore equilibrium.
5. The struggle to go on.
6. Solving problems.
7. Reducing stress.

Coping is our human approach to solving problems. For problems that are readily solved, for example fixing a flat tire, we cope by taking direct and effective action on the problem. In this case we decide how best to repair the tire, we repair or change the tire, and go on our way. The work is primarily external to our self. If the problem is prolonged or unsolvable, perhaps because it involves a permanent loss such as a broken relationship, chronic illness, or the death of a friend, then the focus of our coping is emotional. This may involve grieving or reappraisal or simply taking time to accept and integrate the change and restore ourselves to a new equilibrium. Here the focus of our work is internal to our self. Most problems are a blend of these extremes and require both problem-focused and emotion-focused coping efforts.

Related Terms

The English language has many words that describe various approaches to encountering and confronting problems. These include: battle with, carry on, confront, contend, deal, endure, face, get by, grapple, handle, live with, manage, struggle, suffer, survive, tangle, weather, and wrestle. These terms differ in the degree of success, effort, and discomfort they describe. Coping is easier sometimes than at other times.

We become inured to a persistent problem when we become accustomed to the annoyance after prolonged exposure to it. We become overwhelmed when our coping ability is overloaded. We are in denial when we decline to acknowledge an apparent and relevant problem.

We are failing to cope when we avoid, disregard, evade, flee, ignore, misdirect, mishandle, mismanage, neglect, retreat, or run away from our problems.

Solving Ordinary Problems

The simplest and most familiar form of coping is the problem solving we do every day. Consider this simple example. You wake up in the morning looking forward to having bowl of cereal for breakfast before driving to work. You get dressed, walk into the kitchen, grab a box of cereal, and look into the refrigerator while you are thinking more about your day ahead than preparing breakfast. You then notice there is no milk in the refrigerator. After quickly considering the alternatives of eating out, eggs for breakfast, orange juice on your cereal, skipping breakfast, or borrowing milk from the neighbor, you decide to drive to the local store to buy milk. You return home after a quick trip to the store, enjoy the bowl of cereal you have been looking forward to and then leave for work. Other than an the unexpected quick trip to the store, your morning is going about as well as it typically does.

Even this simple example proceeds through the following distinct stages of problem solving and coping:

• Orienting—Noticing something interesting and turning your attention toward it—In this example the ordinary morning routine was interrupted to focus attention on the contents of the refrigerator and the threat of no milk.
• Observing—Paying careful attention to what is going on—The contents of the refrigerator were carefully examined in search of milk in this example
• Appraisal—Evaluating the impact of the observations on your particular goals—In this example the lack of milk will impact your goal of having cereal for breakfast.
• Deciding—Creating alternatives, assessing their value, planning, and choosing your next actions—Here alternative breakfast plans were considered along with alternatives for obtaining milk. After brief consideration, the decision to run to the store was chosen as the best plan.
• Acting—Carrying out the decisions—Driving to the store to buy milk completed the plan.
• Reappraising—Reflecting on the appraisal, decision, actions, and result—You are satisfied with the good breakfast.

Things could have gone differently. If you expect your spouse to do the food shopping, then when you appraised the impact of the missing milk, you might have become angry at your spouse for not thinking of you and your breakfast needs and for failing to buy milk to meet your needs. Your goals or beliefs of: “Spouse shops” or “I deserve” or “We made a deal” or “We agreed I'm too busy” or “All I do for her” or “I deserve at least this much respect, what was she thinking” or “She never does anything around here” or “It's unfair that I have to be bothered now to get the milk” or “Here we go again” can all become important parts of the appraisal. The anger results from the appraisal that a deliberate unjust act has led to your loss.

Other appraisals would have led to other emotions.  If you interpreted the lack of milk as “She doesn't love me anymore” you might become jealous. If you were disappointed with yourself for not checking on the milk and shopping for it yesterday you might feel embarrassment or shame. If the delay makes you late for work you might be fearful or anxious about getting to work late. If you explained the lack of milk as “I just can't do anything right” and felt helpless or hopeless it could contribute to depression.

When we solve problems it is helpful to consider: Have we chosen the best, simplest, least intrusive, and most complete solution? What are all the contributing causes of this problem? What can we learn from this? How can similar problems be prevented in the future? What are the emotional consequences?

Ways of Coping

There are many ways to cope with the problems we face. Research by Richard Lazarus and Susan Folkman has identified and categorized the thoughts and actions people have used to cope with a specific stressful encounter. The various approaches used in the coping process are grouped into these eight coping factors measured by their Ways of coping questionnaire.

• Confrontive Coping: describes aggressive efforts to alter the situation and suggests some degree of hostility and risk-taking. (Anger)
• Distancing: describes cognitive efforts to detach oneself and to minimize the significance of the situation. (Denial)
• Self-Controlling: describes efforts to regulate one's feelings and actions.
• Seeking Social Support: describes efforts to seek informational support, tangible support, and emotional support.
• Accepting Responsibility: acknowledges one's own role in the problem with a concomitant theme of trying to put things right. (Acceptance)
• Escape-Avoidance: describes wishful thinking and behavioral efforts to escape or avoid the problem. Items on this scale contrast with those on the Distancing scale, which suggest detachment. (Bargaining)
• Planful Problem Solving: describes deliberate problem-focused efforts to alter the situation, coupled with an analytic approach to solving the problem. (Acceptance)
• Positive Reappraisal: describes efforts to create positive meaning by focusing on personal growth. It often also has a religious dimension.

Various stages in coping with grief are described in the The Kübler-Ross model. The model was introduced by Elisabeth Kübler-Ross in her 1969 book On Death & Dying. These well-known “Five Stages of Grief” are:

1. Denial—“It can't be happening.”—Ignore or discount the evidence.
2. Anger—“Why me? It's not fair!”—Highlight the injustice. Blame someone or something else for the loss.
3. Bargaining—“Just let me live to see my children graduate.”—Negotiate a better deal, gain time.
4. Depression—“I'm so sad, why bother with anything?”—Act helpless.
5. Acceptance—“It's going to be OK.”—Acknowledge the problem, understand and accept what you can and cannot change, and move on.

I added the names of the five stages at the end of the eight ways of coping above to emphasize similarities in the models.

It is instructive and fun to suggest responses at each stage of the missing milk problem that illustrate each of these styles. For example:

• a confrontive coping approach to discovering there is no milk might be: Shouting a profanity, slamming and kicking the refrigerator door before blaming (self, spouse, bad luck, always happens, the dog) for no milk.
• A distancing approach could be: reading the newspaper, turning on the TV, shining shoes, or doing other things to delay and distract from acknowledging the problem.
• A self-controlling approach is telling yourself: “now stay calm, missing milk is not the end of the world, it's really no big deal” as you calm down enough to take problem-focused action.
• In seeking social support you might ask your spouse for sympathy, understanding, or help. You might also ask her to go for milk or cook you eggs.
• Acknowledging: “Rats, I should have checked sooner; my bad”  accepts responsibility (blame) for the missing milk and leads quickly to accurately recognizing, acknowledging the solving problem.
• With the escape-avoidance approach you might shout  “give me milk” with the vague hope someone will hear and respond.
• Planful Problem Solving leads to the alternatives and solutions originally described.
• In positive reappraisal you might tell yourself that problems that don't kill you can make you stronger, or that God is testing you with this struggle.

Difficult Problems

While we easily cope with ordinarily problems such as the no milk for breakfast example, our coping skills are sometimes tested by much more difficult problems. These include problems that are difficult or impossible to solve, problems that require extensive resources to solve, chronic problems, sudden or irrevocable and permanent loss, and problems that have important personal meaning for us.

Difficult problems include: job change, having to move, too much to do, facing final exams, housing problems, illness, accidents. These require significant resources to resolve. They may also test your own competence.

Problems requiring extensive resources to solve include: Severe injury, prolonged poor health, accident recovery, recovering from disasters such as flooding or hurricane.

Stable but harmful life conditions present chronic problems including: ongoing poverty, chronic illness such as diabetes, permanent injuries such as spinal cord damage, persistent sources of fear such as living in a high crime neighborhood, and on-going daily hassles.

Irrevocable loss is common and permanent. This includes: death, permanent injury, divorce, job loss, aging, rejection from a job or romantic opportunity, being passed over for promotion, losing the game, car accidents, wasted time or money, retirement, and many other small and large losses.

In addition to the material losses, problems cause stress and emotional responses based on our own appraisal of the personal meaning of each. The missing breakfast milk could mean nothing, or it could mean you become angry, jealous, ashamed or depressed based on the meaning you attribute to it.

Coping Requires Resources

Our ability to cope depends on the resources we can apply to solving the problems. In the simple missing milk example the solution depended on having money to buy the milk, a store nearby, a way to get to the store, and time to spend shopping. A trivial issue for someone with these resources can become a matter of life and death for someone who is impoverished or is lost in the wilderness.

Resources to help in coping may include: intelligence, education, experience, creativity, money, tools, materials, social skills, emotional competency, perspective, perseverance, resolve, tranquility, serenity, tolerance, rest, supportive friends and family, charm, health and energy, optimism, time, patience, confidence, courage, judgment, ingenuity, and other personal strengths.

If resources are unavailable or become exhausted then coping becomes less effective, suspends, or stops altogether. Coping may resume if resources again become available. A simple example of this is regaining strength and resolve from a good night's sleep and hearty breakfast. A more complex example is the long wait for relief aid that refugees may face.

Stress is the word we use to describe the resources consumed by coping; these are the resources required to counteract a stressor.

Personal Meaning

The meaning you attribute to any particular event depends on three basic conditions, your goals, beliefs, and resources. These vary greatly from one person to the next and as a result the personal meaning attributed to the particular event also varies greatly. 

Without a goal at stake there is no potential for stress or emotion. Any particular event may advance your goals, thwart your goals, or be irrelevant to them. It may advance some goals while thwarting others. The impact on our goals determines the extent of the stress, the coping strategy, and the type and strength of emotions that are elicited.

What we believe determines how we interpret events. A given event may strengthen a belief, challenge it, or be irrelevant. Some particularly significant events cause us to reevaluate and change our beliefs.

Stress consumes resources to carry out our coping strategy and overcome the problem presented by the stressor. If we have abundant resources, the problem is easily overcome. If our resources are scarce, taxed, or exhausted, we may be unable to cope with even a minor problem. The nature of our resources determines our approach to coping. If we lose our house in a fire, a financially well off person, or someone with adequate insurance can readily replace the house. Someone without these financial resources cannot.

Managing Stress

The primary goal of coping is to manage stress—the resources required to counteract a stressor. Since stress is the cost of coping, it is sensible and efficient to reduce that cost. Effective coping reduces stress, either by removing or modifying the stressor, or by managing our reaction to it. Ineffective or insufficient coping does not reduce stress. Think of water pouring into the basement as a stressor and pumping out the water as coping. Stress is the energy it takes to run the pump. As long as the pump keeps up with the incoming water the basement stays dry; the pump is coping with the water. If the rate of incoming water increases or the pump slows down, the system is soon overwhelmed and the basement begins to flood. Effective coping describes the ability to continuously counteract the stressor with available resources. Ineffective coping exhausts resources before fully counteracting the stressor and the system becomes overwhelmed.

Two Aspects of Coping

Effective coping address two different sources of stress: 1) solving the material or physical problem, and 2) addressing the accompanying emotions. The salience of the two depends on the nature of the stressor. If the problems caused by the stressor can be solved or eliminated, for example by buying milk in our simple missing milk example, then an effective problem-focused coping approach is emphasized. However if the stressor cannot be removed or modified, for example when caring for a loved one with incurable Alzheimer's disease, then an emotion-focused coping approach is adopted. In this case the fundamental problem of curing Alzheimer's remains impossible to solve in the time available and is appropriately ignored and abandoned. Coping usually requires a blend of these two approaches to address the full complexity of the problem. Effective coping accurately recognizes what you can change and what you cannot. Ineffective coping confuses the two.

Solving the Problem—Problem Focus

The fortunate among us routinely solve problems every day. For example:

• If we are out of milk or cereal we shop and buy more.
• If the car is out of gas we fill it up. If it is running poorly we take it to the mechanic and have it fixed.
• If we are assigned homework, we complete the assignments. If we have a test next Tuesday, we study for it.
• If we are overloaded at work, we stay late or bring work home to complete it.
• When bills arrive we pay them.

When we have the resources to solve problems we hardly give them a second thought. The stressor is routinely removed or overcome and the problems create little or no stress and elicit few if any emotions. We may feel some mild frustration at facing some of these or we may feel some joy or pride at overcoming them. Our competency is reassured. But coping is very different when resources are limited.

Consider the difficultly we have in coping with even simple problems if resources are inadequate, for example if we are unemployed or in substantial debt. Bills pile up, we may face eviction from our home, we may not have money to eat adequately, mounting stress disturbs our sleep, and there may be no relief in sight. Problem-focused solutions are not apparent, stress mounts, and emotions become intense. We may feel anxious or afraid because of the new dangers we face. We feel sad because of the on-going losses. We may feel angry at those we blame for our troubles. We may feel guilt or shame for losing our job or incurring debt. We may become depressed if we lose hope. Our competency is challenged. While our problem-focused coping efforts are frustrated, we also employ emotion-focused coping efforts to help quiesce and resolve our various emotions.

Ineffective methods for coping with mounting bills are especially plentiful. People ignore them, delay, burn them, shred them, mail them in the wrong envelopes, send unsigned checks, bounce checks, send them to friends and relatives, make partial payments, dispute them, deny responsibility, beg for time, insult or threaten the creditor, blame or attack anyone and everyone, cry, throw a tantrum, scream, get drunk, get stoned, gamble, shop, become violent, incur more debt, beg for money, or leave town. These are all ineffective approaches to solving the problem and they are also largely ineffective at coping with the emotions.

Other problems are complex and also emotionally charged. Consider the many problems a teenager who becomes unexpectedly pregnant faces. Addressing the problem requires making the difficult decisions of: Who does she confide in? Where does she go for advice and help? What is the best prenatal care? Does she want to have the baby or terminate the pregnancy? If she has the baby does she keep it or have it adopted? If she decides to keep it, what role does the father play? Who will raise the baby? Will she drop out of school? In addition, stress is high and emotions are running rampant. The joys and pride of motherhood are tempered by the many fears and anxieties of many new responsibilities. She may feel guilt, shame, or anger over the circumstances of the pregnancy. Her resources for coping may become overwhelmed by the magnitude and difficulties of these problems.

Addressing the Emotions—Emotion Focus

While the solvable problems described above have emotional aspects that need to be addressed, we also face many unsolvable problems. These often involve permanent loss such as destroyed property, serious injury, death of a friend, divorce, chronic illness, or death of a spouse or close relative. There is no effective problem-focused solution to these unsolvable problems. The problem-solving focus becomes internal as we reappraise or assimilate the personal meaning of the loss and we take the time required for changes to occur within ourselves. Others may also have to cope with the loss, their emotions, and new aspects of our relationships.

Caregivers to the chronically and terminally ill face the chronic stress and wrenching emotions of unsolvable problems every day. In their book Coping with Chronic Stress researchers Cignac and Gottlieb describe the various approaches such caregivers use to cope with their emotions as they endure the on-going stress of their difficult duties. These illustrate a wide range range of emotion-focused strategies.

• Making Meaning—The caregiver reminds themselves that the patient's behavior is the result of the disease and suffering and does not represent the intent, character, or personality of either the caregiver or the chronically ill person. They don't take anything personally.
• Acceptance—The caregiver accepts that the disease is continuing, the chronically ill person needs their help, it won't get better, and everyone is doing their best.
• Positive Framing—The caregiver focuses on the most positive aspects of the situation and minimizes, ignores, or dismisses the negative aspects. They recognize what they can change and what they cannot and choose an optimistic explanatory style.
• Wishful Thinking—The caregiver wishes things were different and fantasizes about how things could be better.
• Avoidance / Escape—The caregiver physically or mentally leaves the patient or postpones their responsibilities and emotional involvement for some short period of time.
• Vigilance—The caregivers continually and carefully watch the ill person and remain mentally alert and preoccupied with providing the best care and comfort to the patient.
• Emotional Expression—Caregivers openly express and display their emotions.
• Emotional Inhibition—Caregivers suppress or refuse to display or discuss the emotions they are feeling.
• Optimistic outlook—Caregivers become optimistic about the course of the disease and outlook for the future
• Pessimistic outlook—Caregivers become pessimistic about the course of the disease and outlook for the future. They may fear suffering a similar fate.
• Humor—Caregivers tease or joke with the ill person, especially when they display the more troubling symptoms and behaviors. 
• Seeking Help—Caregivers seek practical and emotional help from others
• Verbally managing symptoms—Caregivers seek to manage the ill person's behavior verbally with explanations, changing the subject, reassurance, making requests, and providing directions and instructions.
• Behaviorally managing symptoms—Caregivers seek to manage the ill person's behavior with actions such as assisting with tasks, interrupting difficult behavior with distracting activities, rearranging the room, or taking over tasks or decisions.

When the stressor is an unsolvable problem, then any coping strategy that relieves stress and resolves emotions without causing further problems or destruction is a good choice.

Denial as Coping

I typically look away whenever a nurse draws my blood. It seems to help; I don't like seeing myself getting pierced with a needle and I don't like the sight of blood, especially my own. More importantly, my watching closely won't help; the nurse is drawing the blood and does it quite well without my help.

When we are unable to face the truth, we may take refuge in denial—failing to acknowledge evidence. This can be an effective and beneficial coping strategy if there is no (further) action to take that can alleviate the problems caused by the stressor. Avoidance, even in the extreme form of denial, can help us accept those things we cannot change.

But denial only delays effective action and prolongs the harm if there are steps we can take to address the problem. If an internal locus of control is warranted, then denial is not appropriate.  We cannot change what we do not acknowledge, and denial is a refusal to acknowledge the truth and face the facts.

Quotations

• “You cannot change what you do not acknowledge.” ~ Dr. Phil McGraw
• “Denial: Don't even know I am lying.” ~ Clever bacronym
• “Life is not what it's supposed to be. Its what it is. The way you cope with it is what makes the difference.” ~ Virginia Satir
• “Peace is not the absence of conflict, but the ability to cope with it”
• “All living souls welcome whatever they are ready to cope with; all else they ignore, or pronounce to be monstrous and wrong, or deny to be possible.” ~ George Santayana
• “Every human being must find his own way to cope with severe loss, and the only job of a true friend is to facilitate whatever method he chooses” ~ Caleb Carr
• “Political history is largely an account of mass violence and of the expenditure of vast resources to cope with mythical fears and hopes” ~ Murray Edelman

References

Stress and Emotion: A New Synthesis, by Richard S. Lazarus

Coping Theory and Research: Past, Present, and Future, Richard S. Lazarus, Psychosomatic Medicine 55:234-247 (1993)