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Adjustment Problems

adjustment, maladjustment, mind, mental, mental disorder, mental abberation, personality,

overview
Let us have an overview of Maladjustment as a social phenomenon and as a subject for psychological study.

Maladjustment may shortly be described as ‘inability to react successfully and satisfactorily to the demands of one’s environment’. It encompasses a wide range of physical, psychological and social conditions, but most often implies an individual’s failure to meet social or cultural expectations. In psychology, the term generally refers to unsatisfactory behaviour patterns that cause anxiety and require psychotherapy.

The term maladjustment is most simply defined as
1. Faulty or inadequate adjustment.
2. Inability to adjust to the demands of interpersonal relationships and stresses of daily living.
Let us try to see what ‘adjustment’ is.
In the very first instance, it should be seen as an honourable psychological term untainted by the contemporary derogatory colouring that attributes compromise and opportunism. It is a positive capacity to adapt to one’s circumstances and needs. This presupposes three things:
• a sensitive appreciation of reality
• some accommodation to environmental pressures
• continuing efforts at modifying the environment to suit one’s needs
According to ** ** psychological dictionary, Adjustment is “the variations and changes in behaviour that are necessary to satisfy needs and meet demands so that one can establish a harmonious relationship with the environment.”

If one fails to make these ‘variations and changes’, the ‘needs’ will not be satisfied, the ‘demands’ will not be met; thus he/she will not be able to ‘establish a harmonious relationship with the environment’. Thus, maladjustment is disharmony with one’s environment.
Relying again on Lazarus we can see that maladjustments arise because the individual
• fails to appreciate (acknowledge, admit and cope with) reality
• fails to accommodate (yield to some extent and adapt) to the environmental pressures
• lacks either the will or the skill to modify the environment to suit his needs.

Maladjustment indicates bad mental health

Mental Health
Mental health is not simply a state of happiness or contentment, of outgoingness or accommodation to circumstances, although it may involve these characteristics. To some, mental health implies living securely, enjoying life, being productive, and having a sturdy ego that is capable of withstanding stress. Others say that these properties are a prerequisite to mental health, but not mental health itself. Mental health consists, rather, in a set of goals, intimately related to social values. The characteristics of mental health will vary with individual and social values and may take on different forms in different societies.

Louis Kaplan in his “Education and Mental Health” (page 6) uses the term ‘mental health to signify the quality of the interacting process through which the individual relates to himself and to the world around him. He uses in not as a definition, but as an operational concept. It makes no distinction between the individual as a biological person and the individual as a social being.
(Page 7) No definition will satisfy everyone, since mental health is and individual and personal matter and the standards of normal behaviour may vary with time, place, culture, and the expectations of society. However, since no all-inclusive concept of mental health exists, we will have to get along with an operational understanding as well as we can.

The situation is not much better when we try to define mental illness and mental hygiene. The medical model of mental illness or disease does not fit because it implies a specific affliction which if diagnosed can be cured. Actually, mental illness is not a specific ailment but is related to an individual’s entire existence In dynamic terms, mental illness may be described as a condition or state of maladjustment where the processes of balance have ceased to function or are functioning ineffectively. The individual then is in disequilibrium within himself or in his relationships with others. Many terms are used to describe this condition, including emotional, social, or psychological maladjustment, psychiatric disability, mental illness, and psychological illness.

Symptoms of maladjustment
Louis Kaplan depended on hospital and clinic data, military service data and surveys conducted among the public for his studies on maladjustment. In addition to these data he lists other symptoms manifest in the society as indications of maladjustment prevalent there. These are: alcoholism, divorce and family disruption, suicide, crime, use of drugs, job failures, cost of mental illness. (ch. 1, page 14-18)

He classifies behavioural symptoms that reflect a deviation from normal patterns of response and adjustment as follows: (ch. 3, page 43)
• reality distortions
• mental aberrations
• affect distortions
• motor reactions
• personality disorganization
• somatic reactions

Reality Distortions
Man’s contact with reality is established through his perceptions. If these perceptions are faulty, then his behaviour will be unrealistic and distorted. Maladjusted people will have a variety of distorted perceptions because they unconsciously attempt to restructure their environment so that they can make some kind of purposeful response to it. An observer will not understand these responses if he cannot understand the perceptions these people are experiencing. Illusions and hallucinations are two forms of perceptual distortions that seriously affect an individual’s interpretations of reality. Illusions are sensations that are either misinterpreted by that individual or formed by him into inaccurate perceptions. Hallucinations are disorders of perception that are not founded on sensory experience but are created within the individual. He sees, hears and feels things that no one else can sense because no external stimuli are present.

Mental Abberations (Disorders of Thinking)
A disturbed person is likely to display a variety of defective patterns of thinking and disorders of consciousness and memory. Defective thinking may take the form of a flight of ideas where ideas pour out in great profusion, but without logical order. Another characteristic of disordered thinking is irrelevance. Delusions, paranoid ideas, and obsessions are additional forms of disordered thinking.

Delusions are false or improbable beliefs having no relation to experience or reason.

Delusion of persecution may become organized into paranoid ideas. The paranoid person is extremely sensitive humorle3ss, and rigid. He thinks no one likes him and that everyone is out to do him harm. He may not wait until this harm actually occurs but may try to prevent it through physical verbal, or legal action.

Obsessions are another characteristic of disordered thinking. It is a condition in which an individual is disconcertingly haunted by one single subject/ thought. It so crowds his mind that all other things are pushed out and it disturbs him even in dreams. At times in order to overcome this obsession one may resort to some compulsive forms of behaviour.

Another thinking disorder is difficulty to focus attention on anything.
All these symptoms may occur without any identifiable organic damage tot the brain.

Affect Distortions
Feelings and emotions are affective aspects of behaviour. Among the many affective disorders that may occur among maladjusted people are exultation, transient range, depression and phobias. Each is an uncontrollable form of reaction producing significant alteration of behaviour.

Exultation is an exhilarated effusive response to stimuli that are either not observable to other people or would have little effect on a normal person. . The exulted individual is over stimulated, hyper active, and often talks endlessly and loudly.

Transient range is an exaggeration of the temper tantrums seen among children. This uncontrollable temper reactions in adults result in strong emotional upheaval that can lead to destructive action.
Depression is a disorder of emotion that may serve the needs of the individual by enabling him to manipulate others through forcing them to be concerned over him. The depressed person would deny that his reaction have any utility since he feel so miserable. Yet he clings to his feelings and symptoms and resists efforts to alleviate them.
Phobias are affective disorders with persistent irrational fears.

Motor Reactions
Many of the perceptual, mental and emotional symptoms we have discussed are accompanied by deviations in motor behaviour or overt actions. We have mentioned hyperkinesis or overactivity seen in states of exultation and the psychomotor retardation or slowing down of muscular activity and coordination during depression. Compulsive acts are a form of motor behaviour indicating that a person is having difficulty maintaining control over his volition and actions. Compulsions are irresistible impulses to perform certain acts that in some way relieve anxiety. Often they are associated with obsessions; hence the term obsessive-compulsive reactions.

Personality Disorganization
Some disturbed people undergo a depersonalization process in which their sense of self is undermined. They think of themselves as worthless and hopelessly inadequate and present a picture of gross self-neglect.

Another form of personality disorganization is a separation of roles to the point where the individual is a different person at different times. This is what is known as multiple personality – like in the fiction Dr. Jekyll and Mr. Hyde. Few people undergo such complete personality reversals as in fiction, but every disturbed person passes through phases when he/she feel that one aspect of his/her personality becomes dominant for a while.

Somatic Reactions
Disturbances of body functions usually accompany any of the above symptoms. Typical are impairment of appetite, high blood pressure, migraine, head aches, persistent diarrhea, gastro intestinal pains and upsets, heartburn, ulcers and others.

Varieties of Psychological Disorders
We have discussed maladjustment without attaching them to any specific disorders. It is not possible to fit people into definite categories of disorder on the basis of the symptoms they exhibit.
Psychological disorders are usually classified as medical ailments and given psychiatric labels. Karl Menninger points out that maladjustments are not specific diseases but various forms of organismic disequilibration and disorganization. He classifies emotional disorders on five levels of disorganization. Louis Kaplan simplifies these and classifies aspects of maladjustment under the three categories: Character or personality disorders, neuroses and psychoses.

Maladjusted behaviour is reflected in a variety of symptoms indicating deviations in a person’s mental and emotional orientation in his actions and relations with other people and in his personality structure. A disturbed person may experience reality distortions in which the world is interpreted through unreal perceptions such as illusions and hallucinations. He may exhibit mental aberrations in which the flight of ideas irrelevance verbal dissociation and elusions make it difficult for him to communicate with other people. Paranoid delusions obsessions disorders of consciousness and memory disorders may create for him a world quite different from that experienced by normal people. Affective disorders usually accompany these mental aberrations. Exultation, transient range, depression and phobias are some of the more extreme forms in which affective disorders are expressed. Motor reactions in the form of hyperkinesis, psycho motor retardation and manias are some ways in which inner disturbance are expresse in behaviour. Maladjustment may also affect the personality and particularly the ego structure of the individual resulting in feelings of depersonalization, or in extreme role shifts described as multiple personality. All these symptoms do not occur at the same time nor with the same intensity in maladjusted people. They occur in various combinations sometimes dramatically and openly, sometimes subtly and insidiously. As maladjustment becomes more accentuated, these symptoms are more prominent, behaviour is more erratic and there is disorientation of reality. The end point of this process is extreme form of maladjusted behaviour called psychosis. Between normality and psychosis are several gradations of maladjustment that cannot be categorized accurately in terms of their symptoms but which lend themselves to rough classification into the personality disorders and the neuroses. People having these problems function under a considerable handicap but attempt to maintain control over their behaviour and to remain in contact with reality. Many of them continue to perform their roles in home and community while labouring under severe emotional pressure. With proper treatment, a large number of these people can be rehabilitated and returned to useful and productive life.

Prevention and Amelioration of Maladjustment
The prevention of maladjustment has been described under the categories of primary, secondary and tertiary prevention. Primary prevention is concerned with biological, social and psychological factors that induce stress in the human organism and the ways in which these stresses may be modified or reduced. It includes proper care and concern in prenatal, infancy, schooling stages and strengthening home atmosphere and economic conditions.

The values and goals of a community, its form and quality of government, the freedom and opportunity accorded to its citizens, and the attention devoted to the welfare of individuals – all influences the community climate and its social health. Well-adjusted individuals are not readily produced in a sick community. A community where thoughtlessness, discrimination, greed, selfishness, prejudice, hate, and strife flourish will have a high incidence o delinquency, divorce, crime, strikes and other evidences of personal and social disorder. In fact, it has been argued that actions that modify the conditions of whole communities have a better chance of reducing the rate of mental illness than does psychotherapy with its limited applicability.
School factors: Schools provide children with social and intellectual experiences which they can get nowhere else and which have a powerful formative influence on personality. To focus attention on children who are most vulnerable to emotional stress, a conceptual model of personality development called crisis model has been suggested. Schools should give special care at critical junctures such as entrance to school, puberty and changes from elementary to junior high school and from junior high school to senior high school.

Secondary Prevention involves the early detection and treatment of behavioural disorders that cannot be prevented, but may be deterred from becoming more serious. Secondary prevention is an essential supplement to primary prevention. It depends first upon discovering maladjustment before an individuals behaviour has deteriorated too seriously. Through the efforts of various official and volunteer agencies, concerted campaign of public education is being conducted to acquaint people with the nature and symptoms of mental illness so that they will seek treatment when it is needed. Television , radio, newspapers, popular magazines and other channels of communication have been used extensively to make the public aware of mental disorder as a treatable illness and to combat the superstition and fatalism with which this ailments have been viewed. This educational programme has had the effect of increasing the public’s willingness to provide care and treatment for mentally ill instead of hiding them away in remote state institutions. Another phase of educational programme in secondary prevention is the orientation of professional people toward mental health goals and concepts. This is being done through training programmes, workshops, institutes, lectures and other devices aimed at the service professions.

Tertiary prevention, more properly called therapy, is the modern treatment of maladjustment so that the people do not become chronically disabled. The major forms of treatment used in the rehabilitation of maladjusted persons may be classified into two broad categories – somatic therapy and psychological therapy.
Somatic therapy is the treatment of emotional disorders by physical methods such as drugs, shock or surgery which are meant to modify physiological processes. This treatment is based on the theory that behaviour deviations are symptoms of disturbed physiological processes and that restoration of physiological homeostasis will result in improved behaviour.

Psychological therapy is aimed at strengthening the individuals mental and emotional resources so that he can function more effectively. The simplest form of psychological therapy is counseling where the problems are worked out on an operational level without attempting to alter the psycho-dynamic functioning of the individual. Psycho-therapy goes beyond the solving of current problems and tries to restore the individual’s functional capacities. Insight therapists do this through attempting to rebuild the personality structure where as behavioural therapists seek to alter a person’s reactions and habits so that he experiences less emotional stress. A number of aids or adjuncts to psychological therapy may be used to facilitate diagnosis or treatment. This include hypnotism, narco-analysis, clinical tests, books, films, art, music, psycho-drama and television. The somatic therapies, particularly drugs and shock treatment are used usually in conjunction with psychological therapy in the treatment of seriously disturbed patients.

Environmental of Milieu Therapy is an adjunct to psycho-therapy that has grown in importance. As a form of treatment it consists in structuring the environment so that the personality changes are brought about in an individual. Milieu therapy is used extensively in psychiatric hospitals and other institutions where it is possible to regulate the lives of patients and provide them with therapeutic experiences. Despite the variety of treatments available, personality is not easily changed and the process of readjustment is lengthy and expensive. This has led many people to seek quick cures through the advice offered by various media of public communication. There has also been considerable quackery practiced by untrained people who use suggestion and persuasion to affect temporary relief of symptoms. The hazard of such pseudo therapy is that it may cause a person to delay getting proper treatment for his real problems.
Published: 2006-09-12
Author: Benoy Jacob

About the author or the publisher
Senior Copy Editor, http://indiasyndicate.com
 Selecting and editing stories for “MSN India” (msn.co.in)
 Reviewing content for Windows XP - Malayalam Language Interface Pack, its tutorials and newsletters

Sub-Editor, Malayala Manorama www.manoramaonline.com with the additional responsibility of ISO certifications coordinator at Manorama for seven years.

Published translations
Short Stories Of Anton Chekhov
Our Father - spiritual contemplations of Cardinal Simonis, Netherlands

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