I listened to the Geripal episode with Dani Chammas a few days ago and was inspired by her inclusive understanding of coping mechanisms. I was also slightly baffled at the peculiarity of what could be considered adaptive and maladaptive. In her article, “Should I Laugh at That? Coping in the Setting of Serious Illness” (which you quoted), Dani Chammas writes:
“Acceptance is not better than denial; humor is not better than anger; finding meaning is not better than renouncing all meaning.”
As stages of anticipatory grief that arise and pass, then this makes sense. But is a primary coping strategy of denial or anger truly “not better” than a primary coping strategy of genuine acceptance? Adaptive coping that reduces stress and aligns with one’s existential reality is important. Still, chronic denial or anger (or even relentless humor) could create a challenging environment for those caring for the individual, personally and professionally, and limit the individual's potential for well-being and spiritual growth.
As a Buddhist, I’m familiar with the traditional language of “skillful/unskillful” or “wholesome/unwholesome,” which translates the Pali word “kusala.” In Buddhism, there is an explicit goal to investigate and then move away from the sources of unnecessary suffering rooted in unskillful/unwholesome behavior and thinking. This is realized through the development of the Eightfold Path, which can be divided into three categories: wisdom, virtue, and meditation. Parallels have been drawn between the goals of early Buddhism (as a movement away from harm and unnecessary suffering toward peace, joy, and harmony) and the concept of eudaimonia, notably by Stephen Batchelor.
From this perspective, I find it hard to see the absolute equality of all coping mechanisms that may support a patient. Some seem less harmful — and create less additional suffering — for the sick person and to those who care for them. As a chaplain, I find myself walking the line between accepting and acknowledging a patient's coping mechanisms and gently challenging them when it seems they might be adding extra layers of suffering on top of their already heavy load.
Thank you so much for your clear elucidation of this issue.
Thank you for this thoughtful comment! I appreciate the work good chaplains do in supporting and also gently challenging patients.
I still struggle with this idea: "Adaptive coping that reduces stress and aligns with one’s existential reality is important." It may be the case that "stress" is giving someone useful information about their circumstances, and they shouldn't seek to handle it through "coping." Maybe they should listen to it. Likewise, it may be that some uncomfortable emotion is telling them something important about how they view the world. Maybe they shouldn't seek to simply align their coping with their existential beliefs, but have those beliefs challenged. "Amoral coping" would suggest, like Chammas, we should just do whatever floats our boats without tending to these deeper questions. But that just means you presume the deeper questions don't matter or have already been answered.
I agree with you, then, that not all coping is equal. It can't be. Some coping exacerbates suffering, even if a patient chooses it. Some coping harms other people. There is such a thing as bad coping - both in helping someone to hold together a life that's falling apart, but also in helping them move toward some ideal.
I like your point about the value of stress and how it shouldn’t be managed or “coped with” too quickly. At the risk of banging on about religion, for me, it is why I was drawn to the Buddhist teachings that emphasize the importance of getting to know stress and suffering and understand what its message is (such as allowing and feeling unwelcome emotions, bearing witness to that which is difficult, seeing the painful nature of fixed beliefs and perspectives.) Knowing stress and suffering intimately is a necessary and respectful step before working to disentangle oneself and others from all the extra layers of pain that we tend to add on.
I think from my own tradition, the psalms allow for this. No emotion is disallowed in the psalms, and they teach people how to pray when emotions are high. It also places those emotions in the tradition, rather than saying some emotions are off limits. Christ's own suffering situates our individual suffering within a broader narrative and orients it toward a richer telos than we ourselves can do on our own. There is a proximal meaning of suffering (e.g., cancer pain), but then there's a meaning that finally resolves in our relationship with God. We aren't alone in our suffering.
It's sad that many people feel excluded from Christian faith because they feel a certain way, although I can understand when people do bad things with their emotion people might push them away. I'm reminded of something I've commonly said to my kids: "It's okay to be angry. It's not okay to hit someone else when you're angry." And then we sort out something better to do with their anger.
I appreciate your response and hearing about your tradition. It would be helpful to me as an interfaith chaplain to understand more about the relationship between the psalms and working with the depth and breadth of emotions. Could you recommend any resources? Thank you!
I loved reading this and agree that there are often ethical and metaphysical assumptions underlying appeals to harm or whether a behavior is adaptive. But isn't there also some value in using language/concepts that will find wide agreement among those with different moral and metaphysical commitments? E.g. diverse perspectives can agree that reducing stress is a good metric by which to assess a patient's coping mechanisms?
Maybe. But that value could be enhanced by understanding where the other person is coming from. We may discover that the concepts/terms on which we thought there was agreement result in disparities when the rubber actually hits the road because of the different presuppositions we use to employ them. We may also discover that by helping each other better understand concepts/terms on which we thought there was disagreement could reveal there is more alignment than we once thought.
The devil's always in the details. Consider someone seeking psychotherapy for "stress" and "anxiety." The therapist soon learns the source of their anxiety is related to guilt they feel as they're cheating on their spouse. They want to continue the affair, but need help mitigating the stress. There may be perspective on this situation that would say reducing stress would be a poor metric because "stress" is giving this person useful information about a problem in their life.
I listened to the Geripal episode with Dani Chammas a few days ago and was inspired by her inclusive understanding of coping mechanisms. I was also slightly baffled at the peculiarity of what could be considered adaptive and maladaptive. In her article, “Should I Laugh at That? Coping in the Setting of Serious Illness” (which you quoted), Dani Chammas writes:
“Acceptance is not better than denial; humor is not better than anger; finding meaning is not better than renouncing all meaning.”
As stages of anticipatory grief that arise and pass, then this makes sense. But is a primary coping strategy of denial or anger truly “not better” than a primary coping strategy of genuine acceptance? Adaptive coping that reduces stress and aligns with one’s existential reality is important. Still, chronic denial or anger (or even relentless humor) could create a challenging environment for those caring for the individual, personally and professionally, and limit the individual's potential for well-being and spiritual growth.
As a Buddhist, I’m familiar with the traditional language of “skillful/unskillful” or “wholesome/unwholesome,” which translates the Pali word “kusala.” In Buddhism, there is an explicit goal to investigate and then move away from the sources of unnecessary suffering rooted in unskillful/unwholesome behavior and thinking. This is realized through the development of the Eightfold Path, which can be divided into three categories: wisdom, virtue, and meditation. Parallels have been drawn between the goals of early Buddhism (as a movement away from harm and unnecessary suffering toward peace, joy, and harmony) and the concept of eudaimonia, notably by Stephen Batchelor.
From this perspective, I find it hard to see the absolute equality of all coping mechanisms that may support a patient. Some seem less harmful — and create less additional suffering — for the sick person and to those who care for them. As a chaplain, I find myself walking the line between accepting and acknowledging a patient's coping mechanisms and gently challenging them when it seems they might be adding extra layers of suffering on top of their already heavy load.
Thank you so much for your clear elucidation of this issue.
Thank you for this thoughtful comment! I appreciate the work good chaplains do in supporting and also gently challenging patients.
I still struggle with this idea: "Adaptive coping that reduces stress and aligns with one’s existential reality is important." It may be the case that "stress" is giving someone useful information about their circumstances, and they shouldn't seek to handle it through "coping." Maybe they should listen to it. Likewise, it may be that some uncomfortable emotion is telling them something important about how they view the world. Maybe they shouldn't seek to simply align their coping with their existential beliefs, but have those beliefs challenged. "Amoral coping" would suggest, like Chammas, we should just do whatever floats our boats without tending to these deeper questions. But that just means you presume the deeper questions don't matter or have already been answered.
I agree with you, then, that not all coping is equal. It can't be. Some coping exacerbates suffering, even if a patient chooses it. Some coping harms other people. There is such a thing as bad coping - both in helping someone to hold together a life that's falling apart, but also in helping them move toward some ideal.
I like your point about the value of stress and how it shouldn’t be managed or “coped with” too quickly. At the risk of banging on about religion, for me, it is why I was drawn to the Buddhist teachings that emphasize the importance of getting to know stress and suffering and understand what its message is (such as allowing and feeling unwelcome emotions, bearing witness to that which is difficult, seeing the painful nature of fixed beliefs and perspectives.) Knowing stress and suffering intimately is a necessary and respectful step before working to disentangle oneself and others from all the extra layers of pain that we tend to add on.
That's really important. Thanks for sharing.
I think from my own tradition, the psalms allow for this. No emotion is disallowed in the psalms, and they teach people how to pray when emotions are high. It also places those emotions in the tradition, rather than saying some emotions are off limits. Christ's own suffering situates our individual suffering within a broader narrative and orients it toward a richer telos than we ourselves can do on our own. There is a proximal meaning of suffering (e.g., cancer pain), but then there's a meaning that finally resolves in our relationship with God. We aren't alone in our suffering.
It's sad that many people feel excluded from Christian faith because they feel a certain way, although I can understand when people do bad things with their emotion people might push them away. I'm reminded of something I've commonly said to my kids: "It's okay to be angry. It's not okay to hit someone else when you're angry." And then we sort out something better to do with their anger.
I appreciate your response and hearing about your tradition. It would be helpful to me as an interfaith chaplain to understand more about the relationship between the psalms and working with the depth and breadth of emotions. Could you recommend any resources? Thank you!
I loved reading this and agree that there are often ethical and metaphysical assumptions underlying appeals to harm or whether a behavior is adaptive. But isn't there also some value in using language/concepts that will find wide agreement among those with different moral and metaphysical commitments? E.g. diverse perspectives can agree that reducing stress is a good metric by which to assess a patient's coping mechanisms?
Maybe. But that value could be enhanced by understanding where the other person is coming from. We may discover that the concepts/terms on which we thought there was agreement result in disparities when the rubber actually hits the road because of the different presuppositions we use to employ them. We may also discover that by helping each other better understand concepts/terms on which we thought there was disagreement could reveal there is more alignment than we once thought.
The devil's always in the details. Consider someone seeking psychotherapy for "stress" and "anxiety." The therapist soon learns the source of their anxiety is related to guilt they feel as they're cheating on their spouse. They want to continue the affair, but need help mitigating the stress. There may be perspective on this situation that would say reducing stress would be a poor metric because "stress" is giving this person useful information about a problem in their life.
Yes, this makes sense. Thanks for responding.