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PubMed1981

Existential dialectics in therapeutic groups.

The paper proposes that existential dialectics is one way of reaching clinically inaccessible material in group psychotherapy. Existential dialectics aims at fusing intra-personal, subjective reality with transubjective, social one, with the aid of face to face encounters with others. Its "techniques" include antithetical and synthetical questioning and attentive listening. The specific psycho-social dialectics outlined include participant-observation and the play of norms and counternorms. These dialectics are especially designed to help patients find meaning, reality, approval and feelings.

Emotions↗
PubMed1989

Transformations of identity: referent location, agency, and levels of integration in the progress from potential self to existential identity.

The study traces the genesis of existential despair and empty depression in personality disordered individuals to the impact of a premature definition of the self in terms of an other-centered referent. Three aspects of identity are discussed: self identity, role identity, and existential identity. Their respective potential contribution to self-integration is examined.

Depressive Disorder↗
PubMed1998

'Out of the sighs'--an existential-phenomenological method of clinical supervision: the contribution to palliative care.

This paper describes a method of clinical supervision that engages a Macmillan home care nurse in an existential-phenomenological exchange. A synthesis of Egan's method of problem management and phenomenological interviewing, is offered as an approach to clinical supervision considered appropriate for palliative care nursing. Through a case study approach the author affords glimpses into the life world of palliative care nursing. It is suggested that conflicts experienced in the field both manifest themselves in the supervisory encounter and parallel the nurse's and supervisor's own existential struggles. The discussion as such throws light on what is, frequently, the heart rending nature of palliative care nurses' chosen area of work and illuminates the mutual profundity of the experience of palliative care.

Existentialism↗
PubMed1992

"Existential" therapists and their group therapy practices.

Existential philosophical thought insists that human behavior is indeterminate and subject only to the individual's will. It is, therefore, skeptical of all dynamic psychologies based as they are on Freudian determinism. Group therapists imbued with this philosophy stop short of its extreme. Their existential position, however, does greatly modify treatment, and yet they preserve both the form and goals of therapy. They place properly selected and prepared patients in a group where their individuality and authenticity are highly valued. Finding most technical procedures irrelevant, the therapists themselves, that is, their evolving personalities are central. The key to patient change is the spontaneous meeting of members and the therapist which the therapist orchestrates. Instead of the usual interpretation, members are encouraged to confront the paradoxes in their lives, their humanness, and especially their finitude. Patients are to be brought up to the threshold of their self-knowledge so they can choose. Choice, therefore, along with action coupled with responsibility are frequent themes. Unless the individual is incompetent, decisions made for him or her by the therapist or by group consensus are thought to be nontherapeutic.

Existentialism↗
PubMed1997

An existential model of group therapy for chronic mental conditions.

A group therapy model for chronic mental patients based on existential principles is described. Focusing on the existential dilemmas of chronically ill patients accesses their inner life and acknowledges their immense strengths in tolerating the illness. These effects can improve the patients' motivation for and compliance with treatment and lower distressing secondary conditions such as shame, hopelessness, and suicidality. The model uses the methods of (a) linking, (b) differentiating the therapy team, and (c) addressing the core issues to counteract the negative processes of derealization, powerlessness and irrelevance that hinder group therapy with these patients. Therapists attempt to highlight divergent perspectives of irresolvable dilemmas, offering patients the opportunity to experience and to communicate the courage, tolerance and love required to carry the burden of chronic mental illness.

Adult↗
PubMed1991

Bereavement and heightened existential awareness.

"Ask not for whom the bells toll; they toll for thee." John Donne's admonition, though written 350 years ago, endures with astonishing freshness; it speaks to something self-evident, to a truth that is well known to many who have experienced bereavement--that the death of a significant other has the potential to hurl the survivor into a confrontation with his/her own death. A confrontation with death--should we seek it? There is evidence in the clinical literature that in terminally ill patients such a confrontation may lead to pronounced positive psychological changes. Research (Yalom 1980) has documented that terminally ill patients may undergo a series of positive personal changes; they communicate more openly with family and close friends, they experience fewer fears, they rearrange their life priorities, they are less preoccupied with the trivialities of life, they live life more immediately rather than postpone experience and pleasure into the future. Does spousal bereavement in our culture confront individuals with their own personal death? Does it cause some widow/widowers to regard their existence in a different manner? If so, might it be possible that those bereaved individuals who examine their life deeply may have a different course of bereavement than those who do not look within? Might it even be possible that bereavement, for some individuals, results in psychological shifts analogous to the positive changes reported by terminally ill patients? These are the basic questions of our research inquiry. We designed a project which would allow us to determine, in a nonclinical sample of bereaved spouses, differences in the degree of existential awareness and the consequences of such awareness on the course of bereavement. We also attempted to determine which subjects were more likely to develop heightened existential awareness. The participants studied were part of an intervention project on bereavement in which we studied a sample of widows and widowers in the first few months of bereavement and then offered them an opportunity to participate in an eight-meeting support group. Reports of the clinical issues emerging in our short-term bereavement groups and of the efficacy of these groups were published elsewhere (Yalom and Vinogradov 1988; Lieberman and Yalom 1991).

Awareness↗
PubMed1996

Experiencing existential changes: the lived experience of having cancer.

This phenomenological study was designed to explore the lived experience of having cancer, as perceived by people who have been diagnosed and treated for cancer. The aim of the study was to add to the knowledge and understanding of this complex human phenomenon. Data were collected through in-depth interviews with nine people who were in the remission or recovery phase of cancer. The interviews were tape-recorded and transcribed verbatim for each participant. Through intersubjective interactions and thematic analysis, the essential description of the lived experience of having cancer was constructed. The overriding theme of the lived experience of having cancer is "experiencing existential changes." Five basic subthemes were identified in the participants accounts, all of which are part of the existential changes involved in the lived experience of having cancer. These are: uncertainty, vulnerability, isolation, discomfort, and redefinition. The study can increase the understanding of what it is like to have cancer.

Adaptation, Psychological↗
PubMed2005

Existential meaning's role in the enhancement of hope and prevention of depressive symptoms.

The authors confirmed that existential meaning has a unique relationship with and can prospectively predict levels of hope and depressive symptoms within a population of college students. Baseline measures of explicit meaning (i.e., an individual's self-reported experience of a sense of coherence and purpose in life) and implicit meaning (i.e., an individual's self-reported embodiment of the factors that are normatively viewed as comprising a meaningful life) explained significant amounts of variance in hope and depressive symptoms 2 months later beyond the variance explained by baseline levels of hope/depression, neuroticism, conscientiousness, agreeableness, openness to experience, extraversion, and social desirability. The authors discuss implications of these findings for the field of mental health treatment and suggest ways of influencing individuals' experience of existential meaning.

Adolescent↗
PubMedDate not supplied

A holistic-existential model for psychiatric nursing.

The authors offer a holistic model for psychiatric nursing based on a existential concept of man. They assert that the biomedical model of health and sickness is not sufficient to understand the reality in which psychiatric nurses practice. Within this model, understanding clients in relation to their life contexts becomes the focus, as well as trying to comprehend what effects suffering has on their ability to function. The relationship between nurse and client is discussed from a point of view that considers central existential precepts, such as: equality, encounter/being present, self-esteem/significance, responsibility and choice, objectives, meaning and clarification of values, guilt and atonement, openness and insight, conformity versus rebellion and finally hope.

Existentialism↗
PubMed1990

The Tao, psychoanalysis and existential thought.

The purpose of this paper is to clarify some existing misunderstandings in the area of psychotherapy, existential approach and the Eastern Tao (Zen Buddhism, Confucianism, Lao-tzu, Chuang-tzu) by showing the common elements between Eastern Tao and psychoanalysis, and existential thought. The author compared the goal of Tao practice, namely, Zen Buddhism, Confucianism etc. with that of Western psychoanalysis, humanistic psychology and transpersonal psychotherapy. He concludes that these goals are the same and that the names are different. He also compared the procedures and processes of psychoanalysis and Zen practice. Sudden enlightenment and gradual training in Zen practice were compared with insight and 'working through' in psychoanalysis. Zen emphasis on relationship, ego strength and interpretation was linked with similar topics in psychoanalysis. The results of Zen practice and the central features of every psychoanalytic treatment were examined and found the same, that is, the resolution of, or transcending of, love (dependence) and hate (hostility). The description of a mature analyst and that of a Boddhisattva were compared and found the same. A trace of neurotic motivation remains but they are not influenced by it in helping others. The problem of theory and reality was discussed and strong emphasis on reality was described; in other words, the goal is directed at reality and theory is only a means pointing at reality. If you see the reality, you should forget the theory.

Buddhism↗
PubMed2004

Existential analysis and psychoanalysis: specific differences and personal relationship between Ludwig Binswanger and Sigmund Freud.

The concise curriculum vitae of the founder of existential analysis is followed by an exact comparison of the polarity (homo natura versus homo cultura) between Binswanger and Freud. Then the five stages in the development of (Existential Daseinsanalysis Analysis) are described: the stage of learning, of practice, of criticism, of the alternative to psychoanalysis, and of reconciliation. The criticism is aimed especially at Freud's naturalism and at the concept of drive. These concepts are opposed by ontoanalytic doctrines derived from Heidegger's ontoanalysis. The differences are further exemplified by the comparison of the existentialanalytical and the psychoanalytical view of the unconscious. A presentation of the treatment of a "hysterical phobia," which is first explained in psychoanalytic terms and later in existentialanalytic terminology (mainly concerning the world-projects) makes the difference between the two schools of thought explicit.

Austria↗
PubMed2006

Therapy for the middle-aged: the relevance of existential issues.

Middle age is a normative developmental stage. Although further research is still required, there is general agreement in the literature as to the principal changes, conflicts, and tasks that are characteristic of this stage in life, and in particular, as to the nature of the transition to the second half of life, or what is commonly known as "midlife crisis." The dynamic psychotherapeutic approach to the middle-aged patient does not differ in essence from that adopted toward adolescents or the elderly. The current paper suggests that introducing existential issues and the existentialist therapy approach into analytic-oriented therapy is especially appropriate to the psychotherapy of individuals in midlife. The central themes of middle-age psychology are presented, and the relevance of the existentialist therapy approach is discussed in this context, with reference to four fundamental elements of the "existential discourse": death, isolation, freedom, and meaning.

Adult↗
PubMed1998

The existential vacuum in treating substance-related disorders.

Clients in treatment for substance-related disorders are excellent candidates for discussing Frankl's concept of the existential vacuum as such people fill their existential vacuum with alcohol and other drugs. A keen therapist can make this connection and help clients fill their voids with meaningful activities.

Adult↗
PubMed2002

A palliative approach to existential issues and death in end-stage dementia care.

UNLABELLED: The aim of this study was to investigate how, in relation to the palliative philosophy of care, municipal staff caring for patients with dementia deal with existential issues, the dying process, and bereavement follow up with next of kin. METHODS: Thirty-one semi-structured interviews were performed and analyzed using a modified phenomenographic method. RESULTS: Those interviewed experienced existential issues as difficult to handle, and they felt lost. Three patterns of answers emerged: 1) attempting to minimize or ignore the issue, 2) pleading, in relation to the patient, that no one has control over issues concerning life and death, and 3) showing affection for the patient. When faced with dying patients, they made things easier for the family, and their goal was that the patient should not be left alone. No systematic bereavement follow up of next of kin occurred. DISCUSSION: Suggestions are made for improving municipal care, and applying palliative care principles for patients dying of dementia.

Adult↗
PubMed1992

[Preliminary comments on existential analytic psychosomatic medicine].

Existential analysis as a personal and meaning orientated psychotherapy describes a person in the performance of its existence. The anthropological and therapeutic concept of the existential analysis are presented in essential points (intentionality, self-transcendence, will to meaning, ability of self-detachment, corporability and responsibility) as a way of approach and interpretation. Psychosomatic illness is understood as a mode of personal existence. The integral "gestalt" of a person in its subjectivity, biography and corporality is reflected on with regard to its abilities and revealing of individual possibilities of meaning. The under determination of psychosomatic phenomena shows itself as an expression of a person's relative freedom to decide about its own development.

Adaptation, Psychological↗
PubMed2004

Existential encounter in the asylum: Ludwig Binswanger's 1935 case of hysteria.

This paper examines the Swiss psychiatrist Ludwig Binswanger's view of the doctor-patient relationship as a direct and trusting existential encounter in a 1935 clinical case of hysteria. Drawing upon unpublished materials from the patient record and correspondence, I show that his conception of existential encounter emerged from the Bellevue asylum context, where treatment choices were linked to maintaining order in a communal setting, and addressing a complex array of bodily and psychological symptoms. Binswanger touted the underlying, positive relationship with his patients as the critical factor in the efficacy of a wide variety of treatments, including some of the most forceful and authoritative. Sources from the patient's perspective, however, demonstrate that, in this case, a mutual relationship of trust was not clearly achieved.

Existentialism↗
PubMed2006

Existential pain: impressions from an American Indian reservation.

The existential suffering of members of the Havasupai Indian tribe are described by a physician-anthropologist who spent some time serving as an interim medical provider for the tribe. Pain is often described as having both physical and emotional dimensions. In this paper, the existential dimension is explored through a narrative of the author's experiences.

Anthropology, Cultural↗
PubMed1978

["Border-line states": psychodynamic and existential approach, apropos of 8 case reports].

This study attempts to determine the specific characteristics of this psychopathological concept, and demonstrate its operational interest. The traditional classification is clearly insufficient, and the clinical findings require metapsychological and existential references. The comprehensive approach to these morbid forms with polymorphic outlines, and variable symptoms, implies a deeper approach to the psychodynamic and structural planes. The experience of these subjects is characterised by sadness and lack of pleasure in life; they oscillate between a feeling of solitude, to which may be attached an anguish of separation and a flight from others when their relationship does not correspond to their special requirements and their modes of exchange with, in addition, an intrusion anxiety. Two references, one to Feeling alone by M. Klein and the other The ability to remain alone by D.W. Winnicott shed light on the psychogenetic basis and on the prevalence of phenomena of idealisation. The coexistence of sectors of mental function and defence mechanisms of different registers intervening together or alternately explain the "stability in instability". The existential continuum bears the traces of sudden ruptures. This paper includes the presentation of 8 cases.

Adolescent↗