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Journal of Counseling Psychology 2000 Vol 47 No 2 251 265 Copyright 2000 by the American Psychological Association Inc 0022 0167 00 5 0O DOI 10 1037 0022 0167 47 2 251 Goal Instability and Adjustment to Physical Disability Timothy R Elliott Gitendra Uswatte Lucy Lewis and Andrew Palmatier University of Alabama at Birmingham Few studies have examined psychoanalytic constructs in the adjustment of individuals with physical disability According to H Kohut 1977 optimal adjustment during life transitions is contingent on the individual s capacity for maintaining and pursuing meaningful goals which reflects a stable sense of self A series of studies was conducted to determine if goal instability would predict adjustment and health following disability Goal instability was predictive of depressive behavior and acceptance of disability among individuals with recent onset disability Goal instability predicted subjective well being 1 year later Among community residents with a disability goal instability was associated with life satisfaction this relationship was not mediated by perceived stigma or community mobility These findings indicate that a flexible yet durable goal orientation is associated with optimal psychological adjustment among individuals with a physical disability Psychoanalytic thought has historically dominated clinical conceptualizations of adjustment following the onset of physical disability Many early thinkers believed that individuals who incurred a disability should rationally accept the permanence and severity of their injury Mueller 1962 Nagler 1950 Nemiah 1957 This reality would take some time to digest as the ego would be likely to feel a sense of castration at the loss of a limb or motor function The losses accompanying the disability would deal a severe blow to the narcissism inherent to the individual Cubbage Thomas 1989 Grzesiak Hicock 1994 Gunther 1971 Most individuals would use denial to defend against the anxiety precipitated by the loss of



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