Coping with Chronic Illness and the “Just World Hypothesis”

By Dr. Madeline Altabe

My psychotherapy clients often share struggles in coping with illness. They have been reminding me to write about illness coping for a while now. For many of them, the challenge of living with illness is more than the symptoms themselves: pain, fatigue, and unpredictability. It is the social impact of the illness that leads them to sadness, isolation, and hopelessness.

For example, let’s imagine an individual, Thea, with chronic fatigue syndrome and migraines. At age 27, she is typically home on the weekends recovering from her workweek. Thea has friends who go clubbing and they often invite her to join in, but she has learned that it isn’t worth the energy expenditure. One Sunday afternoon, Thea has the beginning of a migraine, takes medication, and goes to bed. The next morning, she is still somewhat “out of it” and struggles to get ready for work. She manages, but arrives at work 20 minutes late. Her boss comes to her cubicle and has a tirade about the irresponsibility of the younger generation, how they just party and don’t care about their work. He tells her that if she continues to behave this way, she will not succeed at her job.

Poor Thea; now, in addition to not feeling well, she must manage anxiety about her job. She is acutely aware of how her reality—overcoming the obstacle of her illness to work—contrasts with how she is being perceived by her boss. Migraine symptoms or not, this is a tough interpersonal challenge.

Now let’s look at the Just-World Hypothesis and see how an understanding of this human thought process can help Thea manage what is occurring at work. During the mid-part of the 20th century, there was much research taking place on the irrational nature of human thought. In general, we take a large number of short cuts when thinking and, as a result, we sometimes distort perception to regulate our emotional state. During this period, social psychologist Melvin Lerner studied how people respond when interacting with victims—innocent people who experience negative events. Not surprisingly, most people are distressed to watch others suffer. The research showed something deeper: If observers can distort the facts to make the victim seem responsible for the suffering, their distress is relieved. For example, this blame-the-victim thought process is at the root of why rape victims have their hemlines scrutinized. As the research progressed, Lerner found that human beings actively work to maintain a sense of justice about the world, an understanding that good things come to good people and bad people are punished.

These thoughts help people cope with the unpredictability of life and, unfortunately, they do not lead people to feel compassion or justice when it comes to those who have been victimized by unforeseen circumstances. This includes attitudes toward the chronically ill, a growing population in the United States, according to research by the Milliken Institute.

So how can understanding the Just-World Hypothesis help Thea? The knowledge can help her avoid internalizing the negative feedback about her performance. After all, this was not an objective evaluation; this was her boss acting out of his own fears of vulnerability. If she does approach him to discuss her circumstances, she may be able to empower him to help her. Since the basis of the distortion is a fear of needless suffering, allowing someone to relieve suffering may hinder the distortion. She can say something like, “Can we strategize how I can best serve the company even with my illness? I really value being productive.” Or: “If I was slow in the morning due to my illness, would it help if I stayed later or worked from home in the evening?”

It may seem odd to suggest that the “victim” needs to work to help the blamer cope better.

However, if you think about it, Thea and those who live with chronic illness do have an advantage. They have experienced “when bad things happen to good people” and learned to live without a false sense of security.

Thea also can do some things to help herself feel better. First and foremost, she can avoid self-blame. Just-World distortions don’t just affect how we perceive others; they also can hurt us and negatively impact how we see ourselves. One approach is to make the distinction between immanent justice and ultimate justice, a tool that comes from Lerner’s research on reactions to severe illness. People who seek out an answer as to why a family member got cancer are engaging in a quest that leads to blame and pain. A believer in ultimate justice will cope better by focusing on thoughts like, “In the long run, we will find a cure and no one will have to suffer,” or “Good meaning/value can come from this bad experience.” Thea could remind herself that 30 years ago, people doubted that chronic fatigue syndrome was a real illness and, while there is still insensitivity, progress is being made.

Sometimes even that is not enough, and it may be better to accept the world as partially unjust. In those moments, perhaps it is best to focus on the justice that is at work in the world. Perhaps this is why stories of heroic altruism move so quickly through social media. More importantly, being an agent of justice can affirm a “just world.” What if Thea gave an extra tip to the pregnant waitress at lunch? Perhaps she could create an e-petition for an environmental cause she feels strongly about. Maybe there are things Thea could offer to do in the workplace to make it more sensitive to disabled workers. These acts foster hope for a just world.

Thea has many challenges in coping with her illness. She must avoid self-blame for the illness and for the social consequences of the illness. She must find her sense of justice in the world and manage the blame that others place on her for her suffering. I like to say that justice should be a verb not a noun; it is an action towards others and a thought process of the mind. Thea can use her understanding of blame the victim beliefs to deflect the injustice of others. She can act justly in the choices she makes in her world. Most importantly, Thea can empower herself by treating herself “justly.”

 

Dr. Madeline Altabe, a psychologist in Tampa, FL, provides psychotherapy addressing wellness, body image and eating disorders. Her practice is designed around well- researched, evidence-based interventions. Dr. Altabe has also taught graduate psychology students for 15 years most recently as an adjunct instructor online for the University of the Rockies. She was actively involved with the Ophelia Project in the Tampa area, a school-based curriculum on violence prevention, self-esteem and positive peer relations, girls’ health & leadership development. Dr. Altabe has co-authored books & articles to include: Exacting Beauty: Theory, Assessment, and Treatment of Body Image and Body Image: A Handbook of Theory, Research and Clinical Practice. Visit www.radianceconsult.com.

This article is a chapter from the book Transform Your Life! written by 60 real-life heroes and experts and available at Amazon.com, BN.com, www.Transformation-Publishing.com and all ebook formats.

Devol, R. & Bedroussian (2007). An unhealthy America: The economic burden of chronic disease. Milliken Institute. Retrieved from http://www.milkeninstitute.org/healthreform/pdf/AnUnhealthyAmericaExecSumm.pdf

Montada, L. & Lerner, M.J. (Eds.) (1998). Responses to victimizations and belief in a just world. New York: Plenum Press.

 

This entry was posted in Tips and Tools. Bookmark the permalink.