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Ponderings of a therapist’s mind: what’s maladaptive?

I’ve been thinking about the word ‘maladaptive,’ and how it is used in mental health. Meriam Webster online suggests the following definition of the word: marked by poor or inadequate adaptation.

Alternatively, the Oxford Dictionary online describes maladaptive as failing to adjust adequately to the environment.

While I am drawn to debate the matter of a) adaptation to what? in reference to Merriam Webster’s, and b) a definition of ‘adequate’ adjustment in the case of the latter, I shall forego the urge to do either in favour of making an argument against use of the term in mental health.

On one hand, while a failure to adjust to ones environment is certainly characterized as maladaptive, this can cause a real predicament. Why? Because perhaps the environment wasn’t actually adequate, such as has happened when children were placed into say, a detention centre for bad behaviour, where they may have been subjected to no end of possible harms, yet, when and if they did not adequately adjust they were not only be labelled, but they were likely further harmed by their peers.

Or, as in todays schools, where there can often be bullying, and other difficulties; yet the child’s adjustment is pathologized unless they can just ‘get along’ with everyone.

The same can and does happen in the mental health arena, especially when you add in differences – cultural, economic, religious, etc.

But why do I want to resist this terminology? We have to look a little deeper. Often, as I have learned over the years, no matter what a persons symptoms, there is always a story behind those symptoms – often a story of abuse, neglect or other injury that manifests into behaviours, attitudes and beliefs, etc which are deemed to be those of a maladjusted  individual; however, I would propose that in fact, the behaviour – however odd or unusual – is generally a natural response to unnatural events or  experiences, and is thus not maladaptive.

In mental health, the term may be used to characterize how well a person functions in the present – or not, but it seems that we need a different description of the difficulties the person experiences.

Maladaptive lends itself to another word seen among the various meanings ascribed to the word ‘maladaptive’ in online dictionaries: faulty. Herein lies the issue: to label a human as faulty, if only due to ‘poor adaptation’ in spite of how they got to where they are IS to pathologize!

It is true that in mental health, the focus on improving functioning is generally at the heart of attempts to overcome difficulties associated with functioning, yet I would argue that characterizing functioning as maladaptive is like seeing a cup half empty or half full…..with this in mind, perhaps we need new words that reflect strengths and areas that could be further developed.

Just thinking…..

I look forward to hearing from you.
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Dr Barbara Harris, PhD, MSW, RSW

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