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PubMed1983

[Existential events and psychopathology].

The stream of works in the English-language literature relating life stressful events and mental disorders is fifteen years old. In spite of differences in methodology and conceptualization, a review of works published in French and in English allows to draw the conclusion that there is a significant link between these two parameters. This is clearly established for the suicidal cases and the relapses of neurotic depression. A significant link does not signify, systematically a principle of causality.

Bipolar Disorder↗
PubMedDate not supplied

[Existential events and depression. Comparative study of several types of depressed patients].

The aim of the present study was to investigate the relationship between the occurrence of life events and depression with a special emphasis on their impact (assessed through a 0-100 point scale) on psychopathological risk. In order to assess this influence, three groups of 50 depressed patients and three groups of 50 controls filled up a 53 items life stressfull events schedule. Results show that the way in which life events were construed is more relevant than their actual number in explaining the subject vulnerability as well as in predicting high risk subjects.

Adjustment Disorders↗
PubMed1995

[Homicide crimes as irrational responses to existential crises exemplified by separation dates].

It is investigated whether killing delicts as a "solution" of conflicts between partners are the expression of a fateful situative restraint, or whether it is the personal disposition of the committer which entails killing. The fundamentals of the discussion are examinations of 98 criminals with killing delicts, 36 of whom "solved" a conflict in partnership by killing the partner. The 36 separation crimes can be subdivided into four groups according to the prevailing causes. 16 happened due to the partner's intention to leave, 14 due to humiliation and severe offence, 3 due to material self-interest, and 3 in states of delusion. For each of the four groups a typical representative in his constellation of situation and personality is described. Generalized, it will be questioned under which circumstances someone develops the will to kill the partner, and who possesses the capability to realize this will. It can be shown by systematical exploration of their personality by means of objective personality testing procedures that almost all criminals who have committed murder show a conspicuous structure of personality. Hysterical and/or sociopathic properties predispose a person to acts of personally-impertinent or personally-short-sighted violence.

Adult↗
PubMed2002

Spiritual needs as defined by Swedish nursing staff.

A study was undertaken to describe how Swedish nursing staff at six different units characterize spiritual needs in a broad context, including both religious and existential issues. Another aim was to study whether there are any special groups of patients for whom these needs are considered to be of utmost importance. A questionnaire comprising two open-ended questions (the focus of the study) and six background questions was mailed to 191 nurses. Data were obtained from 141 nurses who worked on the oncology, palliative, neurological, neurosurgery and psychiatric units or in nursing homes. Data from the open-ended questions were analysed using content analysis and classified into three categories: (i) (general) spiritual issues, (ii) religious issues, and (iii) existential issues. Sub-categories of the latter were (a) meaning, (b) freedom, (c) isolation and (d) death, i.e. the four central issues in existentialism as previously defined by existential philosophers. A majority of the nurses only had limited theoretical knowledge about definitions. Nevertheless, their suggestions for improved spiritual and existential support contained essential elements that could be allocated to the three main categories. They had some difficulty distinguishing between spiritual and psychosocial care. According to the nurses, special groups of interest for spiritual and existential support were severely ill, dying persons and immigrants who actively practiced their religion. We conclude that there is a willingness to pay attention to spiritual and existential needs, but nurses still have difficulty defining what such care should include. The study revealed that nursing staff needed, and also made inquiries about, more education in order to deepen their knowledge.

Attitude of Health Personnel↗
PubMed2004

Psychotherapeutic interventions at the end of life: a focus on meaning and spirituality.

Medical and psychological discourse on end-of-life care has steadily shifted over the years from focusing primarily on symptom control and pain management to incorporating more person-centred approaches to patient care. Such approaches underscore the significance of spirituality and meaning making as important resources for coping with emotional and existential suffering as one nears death. Though existential themes are omnipresent in end-of-life care, little has been written about their foundations or import for palliative care practitioners and patients in need. In this article, we explore the existential foundations of meaning and spirituality in light of terminal illness and palliative care. We discuss existential themes in terms of patients' awareness of death and search for meaning and practitioners' promotion of personal agency and responsibility as patients face life-and-death issues. Viktor Frankl's existential logotherapy is discussed in light of emerging psychotherapeutic interventions. Meaning-centred group therapy is one such novel modality that has successfully integrated themes of meaning and spirituality into end-of-life care. We further explore spiritual and existential themes through this meaning-oriented approach that encourages dying patients to find meaning and purpose in living until their death.

Attitude to Death↗
PubMed2000

Death anxiety in brain tumour patients and their spouses.

When a person is diagnosed with a severe disease, it seems plausible that existential questions and death anxiety are easily intensified. The aims of this study were to explore whether this is the case, to what extent patients and their next of kin experience death anxiety, and how these experiences are expressed. Following a purposive sampling technique, 20 patients with brain tumours and 15 of their next of kin took part in interviews. A content and context analysis were performed using a hermeneutic approach, in order to identify and analyse main categories. Six main categories common to patients and their next of kin emerged during the process: (1) emotional reactions that could be related to death anxiety and included general anxiety, anguish, sadness, hope and despair; (2) existential fear, existential anxiety and existential pain; (3) contradictions; (4) trigger situations; (5) coping strategies related to death anxiety; and (6) new values for life. Besides these categories, a further category emerged, experiences characteristic of the next of kin. The study shows that both the patients and their next of kin are preoccupied with existential thoughts and death anxiety. The problems are easily overlooked as the death anxiety is not always expressed directly. Staff need to be more aware of these situations in order to provide existential support.

Adult↗
PubMed1979

Paradoxes of psychotherapy. In honor and memory of Ludwig Binswanger.

Existential analysis has made us face the paradoxes, if not antinomies, in psychotherapy that we did not seem to be aware of. Existential philosophy is a highly elaborate, technical and linguisticly difficult field. In psychiatry, existential analysis of turned out to be just a set of hallowed commonplaces. As philosophy, its intent is the discovery of the grounds for our existence and in this way it seems to approach theology. In some instances it may turn into atheistic arrogance. With the stern zeal of philosophy and the pessimistic theology of existentialism, one hardly knows where to begin with psychotherapy. Often it fascinates the mediators, the writers who seem to offer us patterns helpful in our daily work. The effort, to take a radical stand to try to rewrite psychiatry, seems to be justified. And, if existential analysis hardly succeeds in bringing back into 'existence' (Dasein) some of our disturbed patients, it has aroused a review of our stale and abused terms and concepts. Psychiatry cannot exist, disciplined and sensible, without the enlightenment which philosophy offers. Some new departures could be attempted again. But if philosophy is not a way of talking and teaching but a way of living, is the psys goal. If he failed, his work remains a lighthouse in our time, warning us on our voyage.

Existentialism↗
PubMed2004

The role of spirituality in the psychological adjustment to cancer: a test of the transactional model of stress and coping.

Recent studies in the oncology literature have shown that spirituality, defined as the combination of existential and religious well-being (RWB), is related to both emotional well-being and quality of life. Indeed, spirituality may be particularly important in coping with the potential life threat of the disease. Based on Frankl's (1963) existential theory, in this study, we examined whether the relations between spirituality and emotional well-being are moderated by degree of perceived life threat (PLT). In addition, in this study, we examined the relative importance of religious versus existential well-being in relation to psychological adjustment. Patients diagnosed with various types of cancer (N = 95) completed questionnaires assessing spirituality, PLT, quality of life, and distress. Contrary to theoretical predictions, spirituality was associated with less distress and better quality of life regardless of PLT. Interestingly, existential but not RWB accounted for a major portion of the variance in these outcomes. Taken together, these findings suggest that spirituality, particularly the existential component, may be associated with reduced symptoms of distress in cancer patients regardless of life threat.

Adaptation, Psychological↗
PubMed2006

Relationship between spiritual well-being and binge eating in college females.

The aim of this study was to examine the relationship of spiritual well-being in college female non-binge, objective binge and binge-trait eaters. Therefore, this study aimed to measure spiritual well-being in non-binge, objective binge and partial/full-syndrome binge eating disorder college females. Survey research was conducted using a randomized sample of 809 female students. The sample was categorized into three binge eating categories: nonbinge, objective binge, and binge eating trait. Chi-Squares and Analysis of Variance determined binge eating group differences on demographics, global spiritual well-being, religious well-being, and existential well-being. Significant differences were found among groups for global spiritual well-being (p< or = 0.000), religious well-being (p< or = 0.000), and existential well-being (p< or = 0.000). Higher levels of binge eating severity were associated with lower global spiritual and existential well-being scores. On measures of religious well-being, significant differences existed between the non-binge and the binge eating trait groups. The results suggest that spiritual well-being and especially existential well-being may be indirectly associated with the severity of binge eating.

Adolescent↗
PubMed2000

Clinical supervision, death, Heidegger and Freud come 'out of the sighs'.

In his recent paper on clinical supervision, 'Out of the sighs' - an existential-phenomenological method of clinical supervision: the contribution to palliative care', in this journal, Jones weds psychoanalytical ideas with Heidegger's existential-phenomenological concepts to provide a theoretical framework for clinical supervision in palliative nursing. Although this is an interesting undertaking, theoretical diversity is not a simple matter of merely interchanging concepts. Rather, it is a complex process that must account for varying philosophical assumptions upon which any theory attempts to explain or understand reality. This paper examines the major themes identified by Jones. In particular, it focuses on the spirit of ontological hermeneutics and psychoanalysis, represented by their respective founders, Heidegger and Freud, and in general, refers to other thinkers and ideas mentioned by Jones - as for instance, Schön's reflective practice, Polanyi's personal commitment, Husserl's lived experience, Schutz's intersubjectivity and Yalom's existential disidentification. Here, discussion concerns the subject-object polarity. The paper argues that many of these philosophies are incompatible. In particular, psychoanalysis and existentialism imply inconsistent aims in that psychology does not equate with fundamental ontology - and Jones has not adequately distinguished between these in his supervision discourse. The implications of the accompanying conceptual problems for the practice of clinical supervision in palliative nursing are exemplified by Jones's case study of Lindsey, a dying patient.

Death↗
PubMed2005

Clinical holistic medicine: holistic treatment of mental disorders.

We believe that holistic medicine can be used for patients with mental health disorders. With holistic psychiatry, it is possible to help the mentally ill patient to heal existentially. As in holistic medicine, the methods are love or intense care, winning the trust of the patient, getting permission to give support and holding, and daring to be fully at the patient's service. Our clinical experiences have led us to believe that mental health patients can heal if only you can make him or her feel the existential pain at its full depth, understand what the message of the suffering is, and let go of all the negative attitudes and beliefs connected with the disease. Many mentally ill young people would benefit from a few hours of existential holistic processing in order to confront the core existential pains. To help the mentally ill patient, you must understand the level of responsibility and help process the old traumas that made the patient escape responsibility for his or her own life and destiny. To guide the work, we have developed a responsibility scale going from (1) free perception over (2) emotional pain to (3) psychic death (denial of life purpose) further down to (4) escape and (5) denial to (6) destruction of own perception and (7) hallucination further down to (8) coma, suicide, and unconsciousness. This scale seems to be a valuable tool to understand the state of consciousness and the nature of the process of healing that the patient must go through.

Anxiety Disorders↗