Psychological adjustment to a chronic illness, such as epilepsy, is not merely a function of severity or duration of the disorder. Several psychological factors have been identified as having an influential effect. We report here a study that explores one such variable, namely use of coping strategy. A total of 137 people with intractable epilepsy participated in the study. The duration of the epilepsy ranged from 1 to 51 years with a mean of 18.5 years. Seventy percent were experiencing at least weekly seizures. Coping style was measured using a questionnaire that tapped six different coping strategies. Psychological adjustment was assessed via measures of anxiety, depression, self-esteem, social avoidance, and acceptance of epilepsy. Few significant relationships were observed between seizure-related variables and psychological adjustment. The most consistent finding was between poor emotional adjustment and the coping strategy, "wish fulfillment." A relationship between better adjustment and the strategy, "cognitive restructuring," was also found. The implications of these results for psychotherapeutic interventions in epilepsy will be considered.