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The encounter of Navajo spirituality and healing practice with modernity in the present moment must be understood within an existential appreciation of temporality, tradition, domination, and immediacy. Examining the practical exigencies and experiential nuances in a performance of the Navajo Nightway ceremony allows us to elaborate this insight.
Women experiencing breast cancer are confronted with a live threatening disease and find themselves in a situation that changes and restricts their life psychologically, physically and socially. This qualitative investigation examined the experience of living with breast cancer from the perspective of newly diagnosed women. Ten women were interviewed at the end of their radiotherapy. The interviews are analysed with the method of content analysis. The findings show three domains. First domain: From living in fear of having breast cancer to the confirmation of its diagnosis. These women perceive the confirmation of the diagnosis as a shock and initially plunge into an existential crisis. The life threatening disease with an unpredictable future, feelings of vulnerability, uncertainty, hopelessness and anxiety often make them depressed. They need all their energy to maintain control over their life, by suppressing emotions to protect themselves from overwhelming feelings and suffering. Second domain: Experiencing the therapy. The women undergo weakening aggressive and invasive treatment regimes, leaving them in a condition worse than before. Physically exhausted, they sometimes don't know how to go through and overcome this time. Lack of energy, tiredness and fatigue are ongoing problems. Being diagnosed with breast cancer, the suddenly become patients, having to cope with a complex healthcare system. From doctors and nurses they expect empathy, caring and expertise. When in contact with health care, they often hide their suffering, while in fact, they are extremely vulnerable and in deep despair. Third domain: Hold out and live. Women living with breast cancer have no choice but to go through this situation. By motivating their self they regain and mobilise their vital energy. They try to suppress their suffering and dark, intrusive memories. Support from relatives is very important, however, such women tend to protect them from their suffering. The definition of the role of these relatives and their suffering remain unclear. In a future study, research is needed to determine precisely which psychosocial variables are effective in promoting greater health for women with breast cancer and their families, taking into consideration the dynamic of the relationship between women with breast cancer and their relatives as well as the influence of their mutual support.
The nurse-patient relationship has received particular attention in the relevant literature. For patients in life threatening and existentially challenging situations, nursing activities often require a close intimacy. A good nurse-patient relationship is a precondition for effective nursing interventions, but by itself also contributes to the healing process. How such a relationship is realized in everyday nursing situations remains, however, unclear Literature predominantly details normative expectations on the nurse-patient relationship that are based on nursing theory or concepts from humanistic psychology. The operationalisation of these concepts into nursing practice is not given. In order to answer the research question "How do nurses experience their relationship with the patient?" qualitative interviews were conducted. Thus, the nurse-patient relationship was explored from the perspective of the nurses and considered in the context of their specific working situations. Nurses related their experiences, emotions and stress resulting from different kinds of nurse-patient relationships. Data were collected, organised and analysed following Giorgi's 1985 phenomenological analysis. Results show an ambivalence by nurses between closeness and distance in their relationship with patients. These relationships also show a polar vascillation between, for example, "sympathy" and "antipathy", or "being able to help" and "helplessness". The development of the relationship is often not very professional and depends on the specific situation and those individual persons participating in it. It is also apparent that those models of the humanistic psychology which have been discussed in nursing contexts cannot serve as such as a basis for the development of the nurse-patient relationship. A particular aspect of developing relationships in nursing are nursing interventions which necessitate bodily contact and physical work with patients. Concepts including these aspects of nursing can serve as valid and concrete starting points in order to find a way unique to nursing to create effective relationships with patients.
Despite having a suicide rate that is consistently higher than the national Canadian average, our understanding of suicide within First-Nation Canadians is limited. Furthermore, our historical research endeavors in this area have tended to focus on clarifying characteristic symptoms, symptom clusters, and risk factors; establishing causal links; and identifying clinical phenomena associated with the presence of increased risk and have tended to use quantitative methods. The "voice" of the suicidal First-Nation person is largely "silent" within this literature and, as a result, any understanding we have of this issue is unbalanced and incomplete. Accordingly, this paper makes the case for adding a complementary (or shifting the existing) research emphasis for studying suicide within First-Nation Canadian communities. It suggests a complimentary strategic research activity that is more concerned with qualitative methods: A model that augments the current understanding of the "developmental-existential" model of suicide by accessing and articulating the "voices" of the First-Nation people themselves.
This study examined the relationships between clients' reasons for depression and the process and outcome of a cognitive therapy (CT) and a behavioral activation (BA) treatment for major depression. Reason giving was conceptualized as the tendency to offer multiple explanations for a problem. Different reasons for depression were also thought to match or mismatch the theoretical model underlying each treatment. Reasons for depression were assessed pretreatment with a previously developed questionnaire. Process variables including homework compliance and perceived treatment helpfulness were measured early in treatment. Results demonstrated that perceived helpfulness of the treatment was associated with positive outcomes in BA. Reason giving was associated with worse outcomes in BA. Specific reasons also predicted differential outcome in the 2 treatments. Clients who endorsed existential reasons for depression had better outcomes in CT and worse outcomes in BA. Relationship-oriented reasons were consistently associated with negative process and outcome in CT. Results are discussed in terms of the function of reason giving and the role of specific explanations for depression in treatment process and outcome.
This study examined whether our conception of wisdom has a psychological bias, by focusing on a group of distinguished individuals nominated as being wise. The comparison groups included older clinical psychologists and highly educated old and young control groups. Wisdom-related knowledge was assessed by 2 tasks and evaluated with a set of 5 wisdom criteria. First, old wisdom nominees performed as well as clinical psychologists who in past research had shown the highest levels of performance. Second, wisdom nominees excelled in the task of existential life management and the criterion of value relativism. Third, up to age 80, older adults performed as well as younger adults. If there is a psychological bias to our conception of wisdom, this does not prevent nonpsychologists from being among the top performers.
Quality of life (QOL) is increasingly assessed in cancer patients. In this article, the authors examined the psychometric performance of a commonly used QOL questionnaire, the Quality of Life Questionnaire--Cancer 30 (QLQ-C30; N. K. Aaronson et al., 1993), in multiethnic cancer patients. Content validation studies in patients and clinicians identified possible new items. Multiple-group confirmatory factor analysis supported equivalent structure across ethnic groups (Caucasians and Asian/Pacific Islanders [APIs]). A higher order QOL factor appeared to directly affect functioning scales and symptom count. Exploratory factor analysis examined effects of new items. Ten factors were extracted, 6 consistent with the original instrument and 4 reflecting potentially new aspects of QOL: Positive Social Support, Coping, Existential Well-Being, and Sexuality/Intimacy. The QLQ-C30 appears appropriate for use in API cancer patients. Further work needs to ensure that it includes all important domains.
The author interprets parasuicidal behavior as a means certain individuals use to sustain patient careers. Contrary to the current trend to identify this behavior solely as the defining symptom of borderline personality disorder, the author argues that parasuicidality often emerges from the symbiotic relationship between individuals with particular existential needs and the medicalized institutions that serve them.
The cognitive interview (CI) was modified for use in an epidemiological study in which respondents were asked to recall their daily physical activities from the distant past (35 years ago). In comparison to a traditional epidemiological interview, the CI elicited many more responses and also more precise responses. Several practical costs, however, were incurred by the CI: additional time to train interviewers and to conduct interviews and difficulties in coding the responses. The costs and benefits of conducting the CI are addressed, along with conceptual and methodological challenges. The article ends with an existential question: Is the CI a singular technique if it can be modified so radically for different settings?
On the basis of terror management theory, the authors hypothesized that reminders of mortality (mortality salience) should promote the desire for offspring to the extent that it does not conflict with other self-relevant worldviews that also serve to manage existential concerns. In 3 studies, men, but not women, desired more children after mortality salience compared with various control conditions. In support of the authors' hypothesis that women's desire for offspring was inhibited as a function of concerns about career success, Study 3 showed that career strivings moderated the effect of mortality salience on a desire for offspring for female participants only; furthermore, Study 4 revealed that when the compatibility of having children and a career was made salient, female participants responded to mortality salience with an increased number of desired children. Taken together, the findings suggest that a desire for offspring can function as a terror management defense mechanism.
Analyzing political conservatism as motivated social cognition integrates theories of personality (authoritarianism, dogmatism-intolerance of ambiguity), epistemic and existential needs (for closure, regulatory focus, terror management), and ideological rationalization (social dominance, system justification). A meta-analysis (88 samples, 12 countries, 22,818 cases) confirms that several psychological variables predict political conservatism: death anxiety (weighted mean r = .50); system instability (.47); dogmatism-intolerance of ambiguity (.34); openness to experience (-.32); uncertainty tolerance (-.27); needs for order, structure, and closure (.26); integrative complexity (-.20); fear of threat and loss (.18); and self-esteem (-.09). The core ideology of conservatism stresses resistance to change and justification of inequality and is motivated by needs that vary situationally and dispositionally to manage uncertainty and threat.
Presenting an impressive model based on a large body of evidence, J. T. Jost, J. Glaser, A.W. Kruglanski, and F. J. Sulloway (2003) proposed that political conservatism uniquely serves epistemic, existential, and ideological needs driven by fears and uncertainties. The authors offer an alternative view based on conceptual considerations, historical events, features of communist ideology and practice, and additional social science research not reviewed by Jost et al. (2003). First, the authors take issue with Jost et al.'s (2003) description of the two core components of political conservatism. Second, they propose that the motives in the model are equally well served by rigid adherence to any extreme ideology regardless of whether it is right wing or left wing.
Psychological universals, or core mental attributes shared by humans everywhere, are a foundational postulate of psychology, yet explicit analysis of how to identify such universals is lacking. This article offers a conceptual and methodological framework to guide the investigation of genuine universals through empirical analysis of psychological patterns across cultures. Issues of cross-cultural generalizability of psychological processes and 3 cross-cultural research strategies to probe universals are considered. Four distinct levels of hierarchically organized universals are possible: From strongest to weakest claims for universality, they are accessibility universals, functional universals, existential universals, and nonuniversals. Finally, universals are examined in relation to the questions of levels of analysis, evolutionary explanations of psychological processes, and management of cross-cultural relations.
Beginning around 1879, a Neoscholastic psychology developed, an experimental psychology with a soul. Opposed to materialism, it sought to renew Scholastic philosophy by incorporating the findings of the natural sciences. Neoscholastic psychology is an important chapter in the history of the relationships between science and religion in the 20th century. Neoscholastic psychology was both experimental and philosophical. This article presents the main accomplishments of North American Neoscholastic psychology in academic and applied areas. Neoscholastic psychologists championed scientific psychology while insisting on a better conception of human nature. Philosophical critiques led to a decline of Neoscholasticism; after the 1960s it was no longer official Catholic philosophy. Neoscholasticism gave psychologists concerned with philosophical questions impetus to turn to phenomenology, existentialism, and humanistic psychology.
The present research joins previous efforts to define more clearly the phenomenon of perceived time as an important social-psychological dimension. In this study, time was considered a socially existential variable that can most meaningfully be measured by comparing two or more subjectively experienced durations, each with the other(s). Combining this view of time judgment with the adaptation level/optimal arousal principle, two hypotheses were tested: (a) that test stimuli differing in degree of complexity elicit from the individual differential degrees of affect, and (b) that intervals during which the individual is exposed to either overly simple or overly complex stimuli are judged as comparatively longer than objectively equal durations filled with moderately complex stimuli. Both hypotheses were affirmed.
Sedation in the context of palliative medicine is the monitored use of medications to induce varying degrees of unconsciousness to bring about a state of decreased or absent awareness (i.e. unconsciousness) in order to relieve the burden of otherwise intractable suffering. Sedation is used in palliative care in several settings: transient controlled sedation, sedation in the management of refractory symptoms at the end of life, emergency sedation, respite sedation, and sedation for refractory psychological or existential suffering. Sedation is controversial in that it diminishes the capacity of the patient to interact, function, and, in some cases, live. There is no distinct ethical problem in the use of sedation to relieve otherwise intolerable suffering in patients who are dying. Since all medical treatments involve risks and benefits, each potential option must be evaluated for its promise with regards to achieving the goals of care. When risks of treatment are involved, to be justified these risks must be proportionate to the gravity of the clinical indication. Some aspects of management, such as the need for hydration in patients undergoing sedation and the use of sedation in the management of psychological and spiritual suffering, remain controversial.
Self-neglect is a recognised, but poorly emphasised, complication of spinal cord injury, with a prevalence in this study of 9% of a consecutive sample of 400 patients. Self-neglect may be the presenting symptom of problems related to adjustment to disability, a major depressive disorder (DSM III criteria), or a clear and rational wish to die (existential self-neglect). Management is discussed, emphasising the importance of respecting spinal injured patients' autonomy.
Eleven men with prostate cancer were randomly chosen and interviewed during an in-patient period at a southern Swedish hospital. The interview focused on functional health status in relation to daily life and life quality. In addition the sense of coherence scale was used, as well as the European Organization or Research and Treatment of Cancer (EORTC) QLQ C-30 questionnaire. The interview findings were analysed from a phenomenological-hermeneutic perspective and interpreted within the concept of transition. The entry to transition was marked by the men when experiencing an altered life continuum in terms of physical and existential fatigue, pain, micturition problems and an altered sex life. The passage phase was marked by descriptions of a new lifestyle where hope was a central internal resource, creating a positive illusion of life in order to endure. Their external resources were wives and family who supported physically (household matters, gardening) and psycho-logically (comfort, encouragement). The exit phase meant continuously adapting to a new life style, living with a slowly deteriorating functional health status, a new sense of dependency on others, daily life routine broken by in-patient hospital periods and contacts with primary health care. Thus the findings pointed more at continuously facing new passages than a stable exit, i.e. an ongoing transition. The areas of life imbalance described may serve as a basis for care assessment and intervention as well as supplying support of the transitional process.