Homeostasis versus growth: A view of their roles in adaptation to adversity, trauma, chronic illness, and physical disability. Part II: Integrative views, unifying postulates, and a preliminary model.

Abstract

The primary goal of this two-part paper is to familiarize readers with a conceptual contrast (some may argue inconsistency or duality) inherent in the process of human adaptation to adversity, trauma, and the onset of disabling conditions. The two contrasting viewpoints include, first, the belief that the adaptation process is best understood through adherence to the notion of homeostatic (or equilibrium-like) principles that underlie human behavior. The opposing view, alternatively, promotes the belief that this process typically follows a trajectory of either disintegration or, more likely, growth, transformation, and transcendence into higher functioning levels. In this second paper, an attempt is made to elucidate and reconcile, when possible, this conceptual lacuna. In Part I of this paper the following steps were applied. First, the concept of homeostasis is reviewed as it is traditionally conceived in both the context of physics and biology, as well as in psychology and human behavior. The review includes historical and modern perspectives on the nature and dynamics of homeostasis. Second, an overview of growth and transcendence models, in the fields of psychology and human behavior, is provided. Discussed are both early contributions to the field and modern perspectives. In the present, second, paper, applications of growth and transcendence models to the domain of coping with adversity, trauma, and the onset of disabling conditions are discussed. Next, a preliminary conceptual model of adaptation, and its underlying postulates, seeking to integrate the homeostatic and growth models into a dynamically unified concentric model, while preserving each of the two models' main structural components, is offered. Part II concludes with relevant research directions necessary to validate the model's preliminary structure. Clinical Impact StatementThe concepts discussed, and the model proposed, in this two-part manuscript suggest two primary clinical impact venues, namely, conceptual goal planning, and clinical goal implementation:• The proposed model (see Part II), although admittingly in need of further theoretical elaboration and empirical support, nevertheless, provides clinicians with a broad conceptual framework on how to address issues pertaining to psychosocial adaptation to traumatic experiences and the onset of life-threatening medical conditions, using the concepts of homeostasis (regaining previously experienced functional levels) and personal growth (transitioning to higher levels of psychological, interpersonal and spiritual experiences following trauma onset).• The proposed model, and associated discussion, could prepare clinicians to better conceive and plan therapeutic strategies, being cognizant of the model's preliminary developmental stages, that examine whether resumption of previously experienced homeostatic life functioning is more plausible, or under which conditions transition, or transformation, to higher-level growth-producing functioning may be more appropriate, recognizing such factors ...

The Middle‐Out Approach to reconceptualizing, assessing, and analyzing traumatic stress reactions

“…This applies to medical contexts as well (e.g., disability, polytrauma/brain injury) in which traumatic stress reactions may present differently depending on an individual's background and persistent medical issues (Livneh, 2023; Tanev et al., 2014). For example, researchers have identified adverse posttraumatic neuropsychiatric sequelae (McLean et al., 2020) and, more specifically, Operator Syndrome (Frueh et al., 2020) to help describe concurrent issues of PTSD and traumatic brain injury (TBI) that largely include unique presentations of negative cognitions and mood, depressive, and hyperarousal symptoms in conjunction with several postconcussive and/or TBI‐related and physical symptoms.…”