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PubMed1993

[Existential analytic psychotherapy of conversion neurosis in migrant workers].

After a brief introduction into some existential-analytic points of view of the body and of conversion syndrome the actual socio-cultural situation of the migrant workers is explained with many details. For the understanding of the meaning of the conversion symptoms it is necessary to search for the existential concept of the patient which is actually in danger. The therapeutic procedure following this concept is demonstrated on the base of four clinical cases.

Acculturation↗

PubMed1997

Nursing presence: an existential exploration of the concept.

Nursing presence emerged in the nursing literature in the 1960s as a coherent and consistent philosophical term based in the existentialism of Gabriel Marcel and Martin Heidegger, and the religious philosophy of Martin Buber. Since the mid-1980s, however, the precision in definition has deteriorated and presence has accrued multiple meanings, resulting in a weakened sense of the concept. After delineating the etymological and philosophical foundations of nursing presence, the concept is defined. The existential nature of nursing presence is explored and arguments for the indispensability of nursing presence are offered to counter the claims of bottom-line thinking. A definition is offered of nursing presence as an intersubjective encounter between a nurse and a patient in which the nurse encounters the patient as a unique human being in a unique situation and chooses to "spend" herself on his behalf.

Existentialism↗

PubMed1976

[Two kinds of dying--existential and psychodynamic aspects of a personal thanatology (author's transl)].

If we eliminate the area of biological and psychological methods, aspects of human death can be experienced which go far beyond understanding death as a defect, as simple cessation of physiological functions. Only then does the total structure of human death as one of the most important "border situations" (Jaspers) of human life become evident. For man, coming to grips with his finality is a task which he cannot escape. This task, which is connected with the ability to experience a future, is an essential characteristic (Scheler) which differentiates man from animals. This is due to the fact that man's spiritual structure has been set in a biological matrix. This double structure of man also implies the possibility of a double cessation of his true nature. In addition to biological death, there is also a spiritual death in human existence where the biological matrix is fully intact: A biologically intact organism, which presents no problem for the internist, is then no longer in a position to participate in a mode of existence with appropriate norms, human dignity and goal orientations. Basically the problem is that the full I-Thou form in terms of Buber and Gebsattel can no longer be realized. Man has isolated himself, maneuvered himself out of this anthropological constitutionality as Zoon Politicon in the sense of Aristotle and put himself on the side-lines. He then no longer lives through and in others and, therefore, no longer participates in the medium and sphere of his only possible existence. The paradox remains, however, that, in contrast to biological death, the man who is existentially dead is condemned to life as many existential philosophers have said. He is condemned to freedom and can use this freedom to manipulate his death, to degrade it by making it an object, to materialize it to a "'ready-to-hand' thing" in Heidegger's terms. It can be psychologically energized and used as a defensive weapon; its various forms can be either used against each other or against itself. This was demonstrated by examples taken from the daily practice and from literature.

Attitude to Death↗

PubMedDate not supplied

The contribution of religious and existential well-being to depression among African American heterosexuals with HIV infection.

The AIDS crisis has challenged black churches to examine how to provide spiritual support to individuals who are living with HIV. The dilemmas facing some black churches have been specifically related to providing support without embracing homosexuality. The doctrine guiding some black churches has caused psychological discomfort for both homosexual and heterosexual HIV infected individuals because of the stigma associated with HIV. Previous research showed that heterosexuals reported more distress than homosexuals. The purpose of this study was to examine a subset of African Americans (n = 49) who were heterosexual. Data were drawn from a larger data set (N = 117) collected in California. All participants were HIV seropositive or had AIDS. A questionnaire examining existential and religious well-being, demographic variables, and depression was administered. Religious well-being and existential well-being together explained 32% of the variance in depression. Implications for mental health nurses are discussed.

Adolescent↗

PubMed1999

Adolescent identity--a qualitative approach: self-concept, existential questions and adult contacts.

In-depth interviews were performed with 12 adolescents (Swedish students, 16-19 years). Three questions were probed; what do adolescents say on the subjects of (a) themselves, (b) their existential questions, and (c) their adult contacts. The first two questions were aimed at elucidating the process of identity development, the last one at factors that may be influencing this process. The results showed that (a) balancing and controlling one's own needs and wishes in relation to others' was a central issue, (b) existential questions mainly concerned the personal future, (c) adult contacts outside the family were scarce and (d) all respondents expressed a need for adult contacts as sources of knowledge and experience. The conclusions are that identity formation during late adolescence consists of integrative issues where adults play a specific and important role.

Adolescent↗

PubMed2005

[Schizophrenia and the self--existential perspectives on comprehension and evaluation].

Schizophrenia remains mainly an enigma for clinicians and researchers, and all levels of possible further comprehension should be explored. A fundamental characteristic existential perplexity in schizophrenia has significant bearing on the patient's suffering and functional decline, and deserves the attention of mental health professionals. Early detection, diagnosis and treatment might all profit from an explicit focus on the subjective aspects of this disorder. We developed a phenomenological and existentially oriented patient-centered programme for the diagnostic process and diagnosis mediation in schizophrenia, consistently based on self-reported patient experiences. Conventional diagnostic criteria in combination with a firm focus on additional fundamental experiential alterations constitute a framework that facilitates an open dialogue throughout the evaluation between the patient, his or her family and the therapist. The programme has been developed, adjusted and applied over five years on some 120 patients. It has strengthened diagnostic skills, precision and goal-directedness, increased the interest in precise evaluation, and deepened the theoretical understanding of early diagnosis. It is well accepted by the patients, their families and the professionals. This explicit focus on the patients' inner reality and experiences seems to vitalise the patient-therapist relationship.

Early Diagnosis↗

PubMed2026

Meaning in Life in Palliative Cancer Care: Psychosocial and Existential Outcomes-A Systematic Review.

BackgroundExistential distress, marked by hopelessness, loss of meaning, and spiritual suffering, is prevalent among patients with advanced illness, and is associated with psychological burden and a wish to hasten death (WTHD).PurposeThis systematic review aimed to synthesize current evidence on meaning in life (MIL) in adult palliative care (PC) populations, focusing on its associations with quality of life (QOL), mental health, existential and spiritual well-being (SWB), and WTHD.MethodsMEDLINE, Web of Science, Scopus, and the Cochrane Library were searched for eligible studies (English, 2016-2024) involving adult cancer patients receiving PC. MIL was examined as a central intervention component or outcome. Risk of bias was assessed: findings were synthesized narratively. The review was registered in PROSPERO.ResultsEight studies (n = 1733 participants) were included: four cross-sectional, two randomized controlled trials, one longitudinal observational study, and one qualitative study. Several studies had small samples and substantial attrition. Risk of bias was high (n = 7), and moderate in one cross-sectional study. MIL was inversely associated with depression, anxiety, demoralization, and WTHD; and positively associated with QOL and SWB. MIL may also mediate psychological outcomes (eg, purpose, coherence, and personal values). However, heterogeneity in MIL conceptualization and measurement, combined with low methodological quality, limited comparability and certainty of findings.ConclusionMIL may be relevant to psychosocial/existential outcomes in PC. Conclusions are constrained by a small and methodologically weak evidence base. Further high-quality, longitudinal research is needed before MIL-centered interventions can be recommended for routine clinical practice.

Humans↗

PubMed1997

Cognitive-existential group therapy for patients with primary breast cancer--techniques and themes.

We describe a model of cognitive-existential group therapy designed to be integrated over 6 months with regimens of adjuvant chemotherapy given as conventional medical treatment to breast cancer patients with stage 1 and 2 disease. Our broad therapy goals are for members to develop a supportive network, work through grief over losses, improve problem solving and develop cognitive strategies to maximise coping, enhance a sense of mastery over life and re-evaluate priorities for the future. Specific group themes include death anxiety, fear of recurrence, living with uncertainty, understanding treatment with chemotherapy, radiotherapy and hormone regimens, the collaborative doctor-patient relationship, body and self image, sexuality, relationships with partner, friends and family, surgical reconstruction, life style effects and future goals. Active coping skills are developed through teaching formal problem solving and cognitive restructuring of automatic negative thoughts. Technical aspects of the therapy are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Seeking meaning and hope: self-reported spiritual and existential needs among an ethnically-diverse cancer patient population.

Spiritual beliefs and practices are believed to promote adjustment to cancer through their effect on existential concerns, including one's personal search for the meaning of life and death, and hope. This study sought to identify the nature, prevalence, and correlates of spiritual/existential needs among an ethnically-diverse, urban sample of cancer patients (n=248). Patients indicated wanting help with: overcoming my fears (51%), finding hope (42%), finding meaning in life (40%), finding spiritual resources (39%); or someone to talk to about: finding peace of mind (43%), the meaning of life (28%), and dying and death (25%). Patients (n=71) reporting five or more spiritual/existential needs were more likely to be of Hispanic (61%) or African-American (41%) ethnicity (vs. 25% White; p<0.001), more recently diagnosed (mean=25.6 vs. 43.7 months; p<0.02), and unmarried (49% vs. 34%; p<0.05), compared with those (n=123) reporting two or fewer needs. Treatment status, cancer site, education, gender, age, and religion were not associated with level of needs endorsement. Discriminant analysis found minority status to be the best predictor of high needs endorsement, providing 65% correct classification, p<0.001. Implications for the development and delivery of spiritual/existential interventions in a multi-ethnic oncology setting are discussed.

Adolescent↗

PubMed2003

Self-disclosure in psychoanalytic-existential therapy.

This article is an effort to integrate contemporary psychoanalytic and existential perspectives on intentional therapist self-disclosure. It offers a two-stage decision-making model that considers self-disclosure from the vantage points of style and internalization. Clinical and research findings are presented to support the notion that the meanings a patient attributes to a particular self-disclosure, and its power to move him or her towards greater health, is the product of a fluctuating matrix of interpersonal and intrapsychic variables. Special consideration is given to the challenges that arise during the early and termination stages of treatment and to the psychotherapy of therapists.

Decision Making↗

PubMed2003

Cognitive-existential group psychotherapy for women with primary breast cancer: a randomised controlled trial.

BACKGROUND: We conducted a randomised, controlled trial of cognitive-existential group therapy (CEGT) for women with early stage breast cancer receiving adjuvant chemotherapy with the aim of improving mood and mental attitude to cancer. METHODS: Women were randomised to 20 sessions of weekly group therapy plus 3 relaxation classes or to a control arm receiving 3 relaxation classes. Assessments, independently done at baseline, 6 and 12 months, included a structured psychiatric interview and validated questionnaires covering mood, attitudes to cancer, family relationships, and satisfaction with therapy. RESULTS: Three hundred and three of 491 (62%) eligible patients participated over 3 years. Distress was high pre-intervention: 10% were diagnosed as suffering from major depression, 27% from minor depression and 9% from anxiety disorders. On an intention-to-treat analysis, there was a trend for those receiving group therapy (n=154) to have reduced anxiety (p=0.05, 2-sided) compared to controls (n=149). Women in group therapy also showed a trend towards improved family functioning compared to controls (p=0.07, 2-sided). The women in the groups reported greater satisfaction with their therapy (p<0.001, 2-sided), appreciating the support and citing better coping, self-growth and increased knowledge about cancer and its treatment. They valued the CEGT therapy. Overall effect size for the group intervention was small (d=0.25), with cancer recurrence having a deleterious effect in three of the 19 therapy groups. Psychologists as a discipline achieved a moderate mean effect size (d=0.52). CONCLUSION: CEGT is a useful adjuvant psychological therapy for women with early stage breast cancer. Interaction effects between group members and therapists are relevant to outcome. Group-as-a-whole effects are powerful, but the training and experience of the therapist is especially critical to an efficacious outcome.

Adaptation, Psychological↗

PubMed1990

[What are the existential bases of living systems? A new paradigm].

Biology is searching for a paradigm of life and is proceeding from an inductive, empirical to a deductive, formal science. All life phenomena result from the efficacy of a principle, i.e., systemic information, which is not reducible to physics and chemistry. Systemic information, together with genetic information engraved on macromolecules and matter described by physics and chemistry, represents the existential basis of life. A strategy is developed which makes it possible to determine the systemic information of a living organism provided there is enough knowledge of the organism concerned.

Biology↗

PubMed1992

Existential ecology: the human/natural world.

Medicine and ecology share the concern for reconciling human aims and natural processes. That reconciliation is attempted through analogous approaches in the two fields. A dialectical model, described here, provides conceptual organization of those approaches into a coherent progression of paradigms, both existential and theoretical: (1) vulnerability, the immediacy of human exposure to nature's power and the futility of human ascendancy; (2) disengagement, the rational and the romantic objectification of nature; (3) dissection, the scientific and cultural reduction of nature to specimens; (4) holism, the conceptualization of the ecosystem; (5) inherence, the human involvement with nature as home, entailing a local rather than colonial ethic and epistemology. Culmination of the dialectic in ecology, as in medicine, is reconcilation with the otherness of nature, recovering both environment and embodiment as forms of human existence.

Conservation of Natural Resources↗

PubMedDate not supplied

An existential model for promoting life change. Confronting the disease concept.

This paper outlines an existentially based psychoeducational model for dealing with substance abuse clients' questions concerning the possibility of successful behavior change. Clients frequently misinterpret the "disease model" as meaning that they are powerless victims of addiction. Clients' readiness to change can be enhanced by providing them with a coherent method of conceptualizing the task of rehabilitation, one that explains how change is possible in spite of the "disease model" of addiction, rather than the confusing mix of self-help, "bootstrap" philosophy and "disease" talk presented in many rehabilitation programs. Productive methods of dealing with clients' guilt are presented, along with the need to develop a positive purpose in life as an essential aspect of effective relapse management.

Behavior, Addictive↗

PubMed2001

The complementarity of phenomenology, hermeneutics and existentialism as a philosophical perspective for nursing research.

The focus of this paper draws on the thinking of Husserl, Dilthey and Heidegger to identify elements of the phenomenological movement that can provide focus and direction for qualitative research in nursing. The authors interpret this tradition in two ways: emphasizing the possible complementarity of phenomenology, hermeneutics and existentialism, and demonstrating how these emphases ask for grounding, reflexivity and humanization in qualitative research. The paper shows that the themes of grounding, reflexivity and humanization are particularly important for nursing research.

Data Collection↗

PubMed1993

[Similarities and differences of existential analysis and psychoanalysis].

The concise curriculum vitae of the founder of existential analysis is followed by an introduction to the five stages of the development of that psychotherapy: the stage of learning, of practice, of criticism, of the alternative to psychoanalysis and of reconciliation. The criticism aimed especially at Freud's naturalism and at the concept of drive. These concepts were opposed by ontoanalytic doctrines derived from the Heidegger's ontoanalysis. The differences between both psychotherapies were exemplified by a presentation of the treatment of a "hysterical phobia" which was originally explained in psychoanalytic and later in ontoanalytic terminology.

Adult↗

PubMed1995

How to work with dreams in psychodrama: developmental therapy from an existential-dialectical viewpoint.

As Moreno has shown, the method of psychodrama can be effectively used to work on dreams. The first part of this article describes the theoretical framework. Special reference is made to a personality model based on self-reflection in relation to dialectic processes, existential questions, self-evaluations, and personality development. The theoretical introduction is followed by a description of the basic elements, techniques, and stages associated with classic psychodrama and psychodramatic dream work. After situating this approach in the wider context of dream analysis in the field of group therapy, the different stages of the working model are illustrated by means of a "dream session" conducted with an adolescent therapy group. Finally the session is analyzed from the perspective of a number of basic Morenian tenets and from the point of view of developmental therapy.

Adolescent↗

PubMed1984

Pathological modes of human relating and therapeutic mutuality: A dialogue between Buber's existential relational theory and object-relations theory.

There is, in my opinion, a rapprochement between the theories of psychoanalysis and existential-phenomenology. It is my major theoretical interest to articulate the points at which true dialogue between these different perspectives is possible. Such an effort is not an attempt to merge the two theories or subordinate one to the other; rather, I hope that the theoretical positions of both will be clarified and that the therapeutic dialogue of practitioners who represent both perspectives will be benefited.

Adult↗