ЕМОУШЪНЪЛ КОНСУЛТ
Adjustment Disorder: How Stress and Change Affect Mental Health
Adjustment disorder is a psychological condition that arises during a period of adaptation to a difficult life situation, following a stressful event or cultural shock. When a person changes their job, home, or school, leaves their parents, or returns to their homeland after a long stay abroad, they are exposed to greater stress, psychological burden, and the risk of interpersonal conflicts. The likelihood of finding themselves in the "land of Adjustment Disorder" becomes very real. This is a different place from the land of Depression, Stress, or Low Mood — even though many people fall into exactly this trap of confusion.
How Does Adjustment Disorder Manifest?
The anxieties arising from uncertainty about the future and the difficulty of orienting oneself in an unfamiliar situation can materialise physically — for example through headaches, stomach pain, nausea, chest tightening, or skin reactions — as a way for the body to "store" and "displace" psychic pain while the mind does not yet have the means to think about these experiences symbolically (Klein, 1946).
Ogden emphasises that these bodily symptoms are especially visible in people experiencing cultural shock or a drastic change in their social environment, adding that the body sometimes becomes the primary carrier of psychic pain when thinking and verbal processing are insufficient (Ogden, 1989, 2009). Stress and anxiety have their physical manifestations:
"The emotions that the individual cannot contain and make sense of are 'placed' onto the body, and sometimes onto the objects and people around them."
(Bronstein, 2010)
Beyond bodily signals, a person who has entered the land of Adjustment Disorder may:
feel sadness, despair, and a sense of failure;
become increasingly tense and anxious;
experience sleep disturbances;
have difficulty concentrating;
display aggression;
be absent more frequently from school or work;
ignore tasks and responsibilities;
misuse alcohol or psychoactive substances.
These symptoms are not simply "low mood." They are the psyche's way of signalling insecurity in the new environment — they are the "hidden meaning of stress," translated into body and behaviour (Peseschkian, 2003).
How Does Psychotherapy Help?
The therapist plays the role of an emotional guide, helping the individual to:
understand and name their emotions;
connect bodily reactions to their inner world;
express feelings in a safe and healthy way;
restore a sense of control and the capacity for adaptation.
In this way, the person gradually frees themselves from anxiety, restores contact with their inner life, and learns to function effectively in the new environment.
The hidden meaning of symptoms is revealed when we find the appropriate psychic space for them. Then the body stops "speaking for us" and begins to serve our ability to live fully.
— The Global Psychotherapist
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington.
VASILEV, S. (2021). Contemporary Kleinian Psychoanalysis. Sofia: Kolibri. [in Bulgarian]
Catalina Bronstein. (2010). On psychosomatics: The body as a target of primitive attacks. International Journal of Psychoanalysis, 91(5), 1077–1095. https://doi.org/10.1111/j.1745-8315.2010.00276.x
Melanie Klein. (1946). Notes on some schizoid mechanisms. International Journal of Psycho-Analysis, 27, 99–110.
Thomas Ogden. (1989). The primitive edge of experience. Northvale, NJ: Jason Aronson.
Thomas Ogden. (2009). Rediscovering psychoanalysis: Thinking and dreaming, learning and forgetting. London, UK: Routledge.
Peseschkian, N. (2003). Psychosomatics and Positive Psychotherapy – Volume 2. Varna: Slavena. [in Bulgarian]
World Association for Positive and Transcultural Psychotherapy. (2020). Articles on psychosomatics and positive psychotherapy. Retrieved from https://www.positum.org