Abstract
The social and emotional adaptation of 51 breast cancer patients was assessed four times during the first year after mastectomy according to Weissman and Paykel's Social Adaptation Scale (SAS)1 and judges' ratings. Openness of communication was measured by eight indices during the first two interviews. It was predicted that they would correlate positively with successful adaptation as measured at the third and fourth interviews. Most patients were aware of their diagnosis, and their communication about their plight was found to be multifaceted. Successful copers sought information; less successful copers avoided it. However, where emotions and not facts were the issue, palliative measures such as avoidance of speaking about the threat and refusal to accept its further implications were connected with better adjustment. The findings indicate that palliation is a prerequisite to good instrumental adjustment when the emotional reactions are intense and countermeasures are limited. More research is needed for assessing communication with specific others and change over time.