Adjusting to Change / Life Transitions

Adjusting to change can be difficult, as even positive life transitions tend to cause some stress. Over the course of a lifetime, a person can expect to experience a significant amount of change. Some of these changes, such as marriages, births, and new jobs, are generally positive, although they may be accompanied by their own unique stressors. Other major life transitions, such as moving, retirement, or entering the “empty nest” phase of life may cause a significant amount of stress.

Those who find themselves experiencing difficulty coping with life transitions may find it helpful to speak to a therapist in order to become better able to adjust to changes they cannot control.

• How Can Change be Beneficial?
• The Holmes-Rahe Stress Inventory
• Coping with Change
• Adjustment Disorder
• Therapy for Change
• Case Examples

How Can Change Be Beneficial?

Certain changes, such as entering school, starting a new job, or starting a family, can often be exciting, even when they cause some amount of stress, because they are generally considered to be positive changes. Many people look forward to obtaining a degree, rising in their chosen field, or having a home and family.

Change can encourage the development of skills or knowledge, and might also bring about greater awareness of a condition or group. For example, the family of a person diagnosed with schizophrenia might become more aware of severe mental health conditions and their effects. Or the parents of a child who comes out as gay might become interested in LGBTQIA issues and equal rights and work to increase awareness. Change can also make clear what is important in one's life and allow for greater self-discovery and self-awareness.

The Holmes-Rahe Stress Inventory

In 1967, Thomas Holmes and Richard Rahe developed a social readjustment rating scale that was designed to roughly approximate a person’s likelihood of future illness based on his or her stress level. The scale is a list of common stressful events, both positive and negative, all of which are assigned a numerical value of “life-changing units.” For example, marriage, the basis for comparison, was assigned 50 life-changing units. Some other events on the scale include the death of a spouse, which has a value of 100 life-changing units, being fired (47), and revision of personal habits (24).

The scale was developed and validated by male subjects, but data from both male and female subjects in cross-cultural populations has provided fairly useful results and has shown correlations between stressful events and health concerns such as heart attacks, pregnancy complications, diabetes, and broken bones, as well as non-medical difficulties such as poor performance in school or work.

Because responses to stress can vary greatly between individuals, the scale is meant to be only an estimation of the ways that stress can affect life, not a predicting tool.

Coping with Change

Because change can cause stress, it can have an effect on one's daily life. A person facing a big change might, for example, experience depression, anxiety, or fatigue; have headaches; develop trouble sleeping or eating well; or abuse drugs and alcohol. Persistent symptoms of stress might improve with treatment in therapy, but an individual may also be able to prevent some of these symptoms by:

• Researching an upcoming change. Often, stress can develop out of fear of what is unknown. When one is well-informed about a change, it may be easier to face.
• Attending to one's physical and mental health. Being healthy in mind and body may make it easier to cope with changes in life. Sleeping well, exercising, and eating nutritional foods regularly may all be beneficial in improving both physical and mental health.
• Taking time to relax. Remaining calm in spite of stress may be easier when one's life is well-adjusted and includes time for leisure as well as work.
• Limiting change. It may be helpful to avoid making a large change immediately after another change. Generally, adjusting to a change takes some time, and making multiple changes at once, even smaller ones, may not allow enough time for an adequate adjustment period, which can cause stress.
• Discussing any difficulties adapting with another person. Family members may be able to help one adjust to change, but professional help may also benefit those experiencing difficulty or stress as a result of life changes.

Adjustment Disorder

A diagnosis of adjustment disorder can occur when a major life stress or change disrupts normal coping mechanisms and makes it difficult or impossible for a person to cope with new circumstances. According to the Diagnostic and Statistical Manual, symptoms of this condition tend to begin within three months of the stress or change and often include a depressed or anxious mood, changes in daily habits, feelings of overwhelming stress and panic, difficulty enjoying activities, and changes in sleeping or eating. For example, a man whose wife died suddenly might become anxious and panicked as he tries to cope with his new situation, finding it difficult to go on his typical daily walks or prepare meals.

This condition may also lead an individual to engage in reckless or dangerous behavior, avoid family and friends, or have thoughts of suicide. A diagnosed adjustment disorder generally indicates that a person is experiencing more emotional turmoil than others facing the same situation might experience. For example, a young woman who cries frequently after the death of her mother is likely experiencing distress typical to the major life change she has experienced, but a man who quits his job and stops speaking to his children after the death of his wife might be experiencing a significant amount of difficulty adjusting to his changed situation.

Therapy for Change

There is no particular treatment for adjusting to change, but several different tactics may be helpful. Talking about changes in life with a therapist, such as a marriage, the death of a family member, the loss of a job, or the approach of middle age, can be helpful to some. Any type of therapy is likely to be well suited to helping a person cope with dramatic changes in life.

When life changes prove difficult and lead to stress, anxiety, or depression, a therapist can also help treat those issues and help one explore coping strategies. When people know that they do not cope well with change, speaking with a therapist before any significant changes in life occur may be warranted. In this way, one can prepare for changes and become better able to face them in the future, even without prior knowledge of potential changes.

Support groups and group therapy sessions also might benefit some individuals who have experienced a particular type of change, such as a life-altering illness or disability or a divorce.

Case Examples

• Adapting to life after the death of a parent: Min, 22, is anxious about finding a job and developing as an individual after graduating college. The transition is made more difficult by the recent loss of Min’s father, who died of cancer the year before. Talking about feelings in therapy is hard for Min, but doing so begins immediately to help Min feel better. In therapy, Min is able to outline life goals, identify a support system, and discuss the spiritual beliefs Min was brought up with and still experiences feelings of guilt for rejecting. The therapist also helps Min normalize feelings of fear about the future, for which Min initially felt ashamed. Min does not yet feel ready to commit to a lifetime career, and the therapist validates this desire to first explore life’s many possibilities before seeking long-term employment.
• Adjusting to a sibling’s coming out: Jenna, 22, is in the process of transitioning from male to female and has decided to tell her family that she will begin taking hormones. Jenna’s younger sister, Emily, 18, is not surprised by the news, as she knows that Jenna often borrows her clothes and makeup to wear out, but she still experiences some difficulty understanding Jenna’s need to physically alter her body and thinking of Jenna as female instead of male. However, Emily wants to support her sister, and she tries to consistently use Jenna’s chosen name and correct pronouns, begins thinking of Jenna as her older sister, and corrects her parents when they refer to Jenna incorrectly. Emily’s parents do not reject Jenna, but they also struggle with acceptance, and this places some stress on Emily. At Jenna’s invitation, Emily accompanies her to a counseling session, where the therapist encourages Emily to ask any questions or discuss any stress she might be experiencing. Emily admits her reluctance to talk about Jenna to her friends and her fear of accompanying Jenna to public places that might not be so accepting. The therapist gives Emily some resources on combating transphobia and urges the sisters to discuss safety measures together. They also discuss ways they might further their parents’ acceptance.
• Seeking counseling to prepare for a child: Thom, 38, and Akemi, 36, have been married for six years, and they are now starting a family. Though they both are excited for the arrival of their child, they realize that a baby will have an impact on their lives, so they begin meeting with a therapist to prepare for the change. In therapy, they discuss the effects that parenthood will have on their leisure time, romantic activity, finances, and careers. The therapist also encourages them to discuss their individual thoughts on and approaches to parenting, so that they can resolve any areas of disagreement. After a few sessions, they both feel better prepared to become parents, and they decide as a couple to participate in biannual therapy sessions discuss any areas of concern they might have.

References:

1. Coping with Change. (n.d.). Ceridian Corporation. Retrieved from http://mil.ccs.k12.nc.us/files/2012/06/Coping-With-Change.pdf
2. Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.
3. Holmes, T., & Rahe, R. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11(2), 213-221.
4. Mayo Clinic Staff. (2011, March 17). Adjustment disorder. Mayo Clinic. Retrieved from http://www.mayoclinic.com/health/adjustment-disorders/DS00584/DSECTION=symptoms.
5. The Social Readjustment Rating Scale. (n.d.). Retrieved from http://www.emotionalcompetency.com/srrs.htm