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Chapter: 11th 12th std standard Class Nursing Health Care Hospital Hygiene Higher secondary school College Notes

Principles of psychology in nursing : Adjustment

Adjustment is the process by which living organism maintains a balance between its needs and the circumstances that influence the satisfaction of these needs,' says Lawrence F.Shaffer .



Adjustment is the process by which living organism maintains a balance between its needs and the circumstances that influence the satisfaction of these needs,' says Lawrence F.Shaffer .


Accordingly the process of adjustment has two primary main elements:


            One,the needs of the living organism and


            two   conditions   of   the   circumstances   that


influence those needs.


These needs can be biogenic, originating in society, personal or communal, On the other hand, the circumstances influencing these needs also can either be inside the individual or outside him.

Factors with in the individual that influence these needs are his physical and mental states capacity, attitudes, interests etc. For example most weakly constituted individuals cannot fulfill their own psychological motives and thus their needs are definitely affected by their lack of strength factors.


Arising within the environment are usually geographic conditions, social conditions, political and cultural influences. These conditions and circumstances can help as well as deter the fulfillment of the individual' s requirements.


In this manner, the nature of influences upon the person' s needs is of two kinds, where one is favorable and the other unfavorable. Positive or favorable influences help in the fulfillment of needs while unfavorable influences hinder their satisfactions.

These elements in adjustment are




            Thwarting conditions


            Varied Responses.




The very process of adjustment in the living being is set in motion by the presence of motive within him, or needs or requirement from outside.


When the environment does not present any features that tend to become obstacles in the fulfillment of these needs, then the adjustment is natural, facile and effortless and no problem result. But if circumstances create obstacles in the path of such fulfillment, then the process of adjustment progresses further.


Varied responses:


Once the fulfillment of a need has been obstructed, the individual indulges in various actions, which are reaction to the obstacle. Such a reaction can be normal just as much as it can be abnormal.




As a result of these reaction and responses, the individual achieves a degree of adjustment with the circumstances. The problem of adjustment in thereby solved.




A student is actuated by a strong desire to stand in his class and to do so by scoring very well. He works extremely hard but fails to achieve his objective because he has not the necessary mental equipment i.e. lack of the requisite intelligence.


This forms an obstacle to the satisfactory of this motive and hence as a result the student condescends to lower his aim some what by aiming at securing a second division. In order to accommodate this change of objective, the student changes the mode of study.

A change of response suitable modification of the objective and the objective prevails. Such a process of adjustment in an universal phenomenon and is seen to be at every level of life, at various times and under varied conditions.


Motives and adjustment


The process of adjustment can be set in motion by any motive. Physical needs do not have much importance for on the one hand they are easily satisfied.


On the other, in the event of their dissatisfaction, life itself ceases in the organism, thus obviating all further adjustment activity. Hence social motives and requirements have greater importance for the adjustment process.

Social motives are developed within a cultural environment. Individuals' of different cultures have different motives and different cultures do not generate identical motives.


Once they have been excited then can only have strong motives satisfied. Inability to satisfy them only leads to further dissatisfaction and this tension is not ended till the objectives have been attained.


Thwarting in adjustment


Many of the form that thwarting can take and is known to take one form in frustration. For an example if a person fails to catch a train and reach his destination because his wristwatch was not functioning properly, then he has to face frustration that arises out of the environment.


Another form is conflict. A state of conflict is precipitated when the individual is actuated by more than one motive arising simultaneously.


Among the classical examples of state of conflict and indecision is the state of the mind of Arjuna as described in the Geeta, when he was divided between war and peace.


The state of conflict and tension will continue till the individual decides upon one particular motive. And if the conflict continues the, individual shows signs of mental illness and other abnormalities of behaviour and conduct.


Frustration and conflict are closely related. If the child' s normal expression of aggression and violence restricted from some frustration it becomes repression and gives rise to feelings of fear and insecurity.


The individual with an adjustment and organized personality maintains a balance and practical outlook on life. Failures and frustrations do not disturb him and he persists in looking calm and master of the situation.


His emotions, needs thinking and other mental activities are adequately balanced and systematized. On the other hand, the personality of a mal adequate person is non-integrated.


Absence of adjustment results in the increase of tension, while its presence helps in reducing tension. Adjustment can be evaluated by the assessment of intensity of tension existing in mind.


The methods of adjustment are as follows


            Constructive adjustment: The main feature in this is that it offers a quality of facing the situation rather than running away from and of making efforts that solve the problem instead of merely postponing.


EG: When a trader is faced with some problem of his trade, he resorts to exercise economy in expenditure or some other constructive adjustment to solve that problem.


            Substitute adjustment A large number of individuals have recourse to substitute adjustments while facing difficult situations.


EG: Failure leads to school dropouts. The students start avoiding school since he is defamed and then this obstructs his social motives. Running away ends tension created through this obstruction. Thus for these reasons these reactions to difficult situations are called substitute reactions.


Defense mechanisms


Another mode of reacting to difficulties is that of mental mechanism or defense oriented reactions to stress aims chiefly at protecting the self from hurt and disorganizations.

Ego defense mechanisms



1 Withdrawal :  Protecting  self from unpleasant, reality  by refusal to perceive or face it.

2 Fantasy :  Gratifying frustrated desires by imaginary achievements.

3 Repression :  Preventing  painful  or dangerous thoughts from entering consciousness. 

4 Rationalism :  Attempting to prove ones' behaviour ' rational' and justifiable and thus project worthy  of  itself  and  social approval.   

5 Projection :  Placing blame for  difficulties upon other or attributing one' s own unethical desires to others.    

6 Displacement :  Discharging pentup feeling usually of  hostility or  objects less   dangerous than those, which initially aroused the emotions.   

7 Emotional insulation :  Reducing ego involvement and withdrawing  into  passivity to protect self from hurt. 

8 Intellectualization {isolation} : Cutting of affective charge from hurtful situations of separating  incompatible attitudes by logic -tight compartment.   

9 Undoing :  Counteracting immoral desires or acts.     

10 Regression :  Retreating  to  earlier developments; level  involving less mature  responses and usually   a   lower   level   of aspiration.    

11 Identification :  Increasing feelings of worth by identifying oneself with person or institution

12 Introjections :  Incorporating  external values and standards into ego structure so that the individual is   not   at   their   mercy   as external threats.  

13 Compensation :  Covering up weakness by emphasizing desirable  trait or making  up  for  frustration  in one  or  by  over  qualifying  in another.     

14 Acting out :  Reducing  the anxiety aroused by  forbidden or dangerous desires by permitting their expression.


It may be emphasized that the above defense mechanism are, learned. They are designed to deal with inner hurt, anxiety and self-devaluation.


They operate on relatively automatic and habitual levels and they typically involve some measure of self-deception and reality distortion. The excess use of the above defense mechanism will lead to mental illness.

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