Cancer Management

Common Coping Strategies

Coping strategies are commonly categorized as either approach versus avoidance strategies or problem-focused versus emotion-focused strategies. The coping literature indicates that in the context of an uncontrollable situation such as cancer, approach-oriented strategies such as cognitive restructuring, seeking social support, and information seeking tend to be more adaptive ways of managing one's disease than avoidant strategies like denial and disengagement. That said, because of each person's unique personal and situational attributes and the multidimensional nature of the cancer experience, researchers also conclude that there is no one right way to cope. Two seemingly similar coping responses may produce very different results or a strategy that is helpful in one context may not be helpful in another.

For example, two common, approach-oriented, emotion-focused strategies are positive reinterpretation and growth and focusing on and venting of emotions. Both involve the acknowledgment, processing, and expression of emotions. Positive reinterpretation and growth is related to adaptive outcomes and involves cognitively reprocessing distressing emotions resulting from a stressful event into a new framework that incorporates positive aspects as well; it is an individual's deliberate effort to take knowledge gained from a negative experience and use it to move forward in a positive direction. Focusing on and venting of emotions is a process of attending to and expressing typically distressing feelings. Research indicates that engaging in emotional expression may only contribute to positive adaptation when one is able to express him-or herself in the context of a receptive, supportive network of others who are willing and able to listen. In the absence of a supportive environment, this strategy may lead one to ruminate excessively, thereby compounding the stress already being experienced.

The stress and coping literature suggests that problem-focused coping strategies typically associated with managing external demands may not be effective in reducing the emotional distress generated by uncontrollable factors in situations such as facing cancer. Resolving the ambiguity inherent in living with an uncertain prognosis as well as some limitations resulting from treatment side effects are beyond one's ability to control. Taking action to resolve these types of problems is not possible, and attempting to do so may further emphasize the uncontrollable aspects of the situation and lead to more anxiety and worry. An important distinction here is the recognition that problem-focused coping doesn't necessarily imply taking action directed at the broad scope of the problem itself; it may also involve passive, approach-oriented strategies directed at consequences.

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