Tuesday 4 December 2012

Control, Life-threatening Illness, Existential Crisis, New Meaning, Embeddedness in a Larger Whole

"1. For his functioning, a human being has to understand his world and bring it under his control as far as possible. This is mostly achieved by attributing some meaning to it, which is a rational activity directed by the autonomous self. The system of meaning that is constructed in that way directs the meaning of life, of the world and of events that happen within it. Within this system there is usually no place for death.

2. A life-threatening illness like cancer confronts patients with the possibility of death. In the first instance they will try to deal with it from within the existing framework of meaning. In most patients this happens first by considering the threat as temporary and the illness as curable, thinking that they will become healthy again. Then, time perspective shifts. Attention is focused on the here and now and thinking as little as possible about the future. This is an effective method to deal with the menace of death and accompanying insecurity. It is not a denial because one realizes that it can also turn out differently. One keeps it out of consciousness by concentrating on the present and the treatment.

3. When the physical condition deteriorates, a moment may occur in which one cannot deny that one will not be the same again. The changes are irreversible and death is approaching. Future is gone. The familiar framework of meaning is wrecked. This causes an existential crisis. In addition, loss of all control over the situation may cause an identity crisis. The awareness of having to let go of many things initiates a mourning process.

4. If a patient ventures to allow insecurity and the mourning process, space is created for the experiencing of meaning. When this experience manifests itself, the individual senses himself as being part of a larger whole. This reduces his fear of death. This experience of meaning cannot be consciously evocated. Nonetheless, conditions can be created that enhance the chance for it to happen.

5. If in this way patients experience a new meaning in their existence, it enables them also to cognitively attribute meaning to their new reality on the basis of a new and broader context of life, including the reality of death. The assignment of meaning and the experience of meaning are integrated at a higher level. This integration also implies a personal transformation, in which the individual lets go of his ego-centered worldview in favor of a deep sense of being embedded in a larger whole."
       Yang W et al. Existential crisis and the awareness of dying: the role of meaning and spirituality. Omega (Westport) 2010; 61(1): 53-69.
       See also: http://healthyhealers.blogspot.ca/search?q=Lesser

Photo: Jen003   www.dpreview.com

No comments:

Post a Comment