Journal of Philosophy of Education, Volume 56, Issue 1, Page 94-104, February 2022.

The article presents a portrait and analysis of the existential-psychocultural situation in postmodern Sweden. Drawing from recent research exploring psychology of religion and existential worldviews, and the Swedish findings from the international World Values Survey, an argument is made for thinking about existential function and dysfunction as public health issues. This is portrayed against the background of Sweden as one of the most secularized countries and simultaneously a country with one of the most encompassing welfare systems. (...) Psychology of religion's updated role here would be to take responsibility for identifying and assessing the categories of function and dysfunction for an existential public health system. This role would also include the planning of policy for societal existential wellbeing, as well as planning prevention and intervention efforts for avoiding existential epidemiology. This new role fits well with public health's third revolution agenda focusing on health, wellbeing and quality of life. (shrink)

This book offers cutting edge research on the modifications and disruptions of bodily experience in the context of anxiety, depression, trauma, chronic illness, pain, and aging. It presents original contributions in applied phenomenology, biomedical ethics, and the use of medical technologies.

Personal recovery entails the idea of learning to live a good life in the face of mental illness. It takes place in a continuous dynamic between change and acceptance and involves the existential dimension in the broadest sense. With cognitive self-regulation and empowerment as central elements, however, current models of recovery mostly have an individual focus instead of a relational one. Furthermore, there seems to be an emphasis on the component of change. Little attention is payed to the role (...) and integration of dealing with loss in personal recovery. In this paper, the role of loss in mental illness will be elaborated from an existential perspective. This will be done by relating existential changes to possibly disruptive experiences of loss in wider experience. With the help of several perspectives on dealing with loss it will be argued this can be integrated in processes of recovery. Then, it will be elaborated how reexperiencing a state of being surrounded, or being included, being held is a necessary part of recovery. The result consists of a refinement of the view on personal recovery. The aim of this paper is therefore twofold: (1) to arrive at a better understanding of what existential loss and loss in wider experience in the context of psychopathology entails, and (2) to further develop perspectives on recovery in mental health care. (shrink)

A subset of people with severe mental health conditions feels they are on the verge of losing control, even in the absence of external threats or triggers. Some go to extreme ends to avoid affective arousal and associated expectations of a possible, impending catastrophe. We have learned about such phenomenological, emotional challenges in a group of individuals with severe, composite mental health problems and psychosocial disabilities. These individuals have had long treatment histories in the mental health care (...) system. They have been encountered at a specialized inpatient ward offering exposure-based therapy that aims at restoring self-regulation and recovery. We describe the phenomenology of anxiety and fear presented by these service users, a fear we have coined existential catastrophe anxiety. We also suggest a set of underlying, interacting, psychological mechanisms that may give rise to ECa, before comparing ECa with three other constructs previously described in the literature—annihilation anxiety, ontological insecurity, and affect phobia. These comparisons show several similarities, but also unique qualities with ECa and its suggested underlying mechanisms. The conceptualization of ECa may aid clinicians in addressing extreme experiential turmoil and engage service users in empowering therapeutic projects. (shrink)

Journal of Philosophy of Education, Volume 56, Issue 1, Page 78-87, February 2022.

The embodied creative practice of dance facilitates a particular kind of awareness or attunement which can inform both the therapeutic and the intellectual work of the Health Humanities. This paper therefore considers dance as a way of ‘doing’ Health Humanities in two interlinked ways: dance as a way of healing and dance as a way of knowing. In bringing together carnal and the creative dimensions of human experience, dance offers us a way of making sense of our place (...) in the world that provides us both with much needed existential security and much needed epistemological freedom. (shrink)

Research has shown that addressing and integrating the existential dimension in treatment settings reduce symptoms like anxiety, depression and substance abuse. Healthcare chaplains are key personnel in this practice. A nationwide, cross-sectional survey influenced by a mixed-methods approach was used to examine the attitudes, practices, understanding and perceptions of mental health professionals, including healthcare chaplains, regarding the value of addressing the existential dimension in treatment programmes. The existential group practice was led by the healthcare chaplains as (...) an integrated part of specialist mental health services. A positive and open attitude towards addressing the existential dimension was identified among the informants. Despite this, a small gap between attitude and practice was reported. Existential, religious and spiritual concerns are reported as part of the existential dimension and as relevant topics to be discussed in specialist mental health services. The findings indicate that the existential group practice could have a positive influence on the co-leaders’ competence to address existential, religious and spiritual concerns; however, this should be further investigated. (shrink)

This paper examines the existential context of physical and mental health. Hans Georg Gadamer and The World Health Organization’s conceptualizations are discussed, and current medicalized and idealized views on health are critically examined. The existential dimension of health is explored in the light of theories of selfhood consisting of different parts, Irvin Yalom’s approach to “ultimate concerns” and Martin Heidegger’s conceptualization of “existentials.” We often become aware of health as an existential concern (...) during times of illness, and health and illness can co-exist. The paper discusses how existential suffering in Western culture is described, to an increasing degree, as disorders or psychological deficits, and perfectionistic health goals easily can become a problem. We seek to avoid suffering rather than relate to it, with all the tension that may create. The paper argues that suffering is an unavoidable aspect of people’s experience of their lives, and actively relating to suffering must be regarded as a fundamental aspect of health. The need and usefulness of a concept of “existential health” is discussed. (shrink)

This chapter provides an overview of how existential phenomenology has influenced qualitative research methods across a range of disciplines across the social, health, educational, and psychological sciences. It focuses specifically on how the concepts of “existential structures,” or “existentials”—such as selfhood, temporality, spatiality, affectivity, and embodiment—have been used in qualitative research. After providing a brief introduction to what qualitative research is and why philosophers should be interested in it, the chapter provides clear, straightforward examples of how qualitative (...) researchers have used existentials to analyze qualitative data and design qualitative studies. The chapter is intended to introduce philosophers to existential approaches to phenomenological qualitative research, with the aim of facilitating interdisciplinary dialogue and collaboration. (shrink)

This article is about the therapeutic use of photography in mental health care. We will first describe the intelligent nature of perception as we understand on the basis of neurobiological research findings. We will link our interpretation of visual perception with the phenomenology of perception from the theory of Merleau‐Ponty.. Then we will discuss how patients in mental health care with mental health problems may profit by an experiential approach that is concomitant with the existential reality (...) described by Merleau‐Ponty. The experiential approach we go into more detail is Focusing. We will demonstrate the limitations and feasibility of Focusing in the procedures of working with photography as a therapeutic medium. (shrink)

Support in different modes, expressions and actions is at the core of the public welfare culture. In this paper, support is examined as an everyday interpersonal phenomenon with a variety of expressions in language and ways of relating, and its essential meaning is explored. The fulcrum for reflection is the lived experience shared by a young woman with mental health problems of her respective encounters with two professionals in mental health facilities. A phenomenological analysis of the contrasting accounts (...) suggests that, when the professional relationship includes openness and risk, a certain degree of freedom of action is possible for both parties involved in the inevitably asymmetrical relationship. Support as “given” eludes controllable and measurable objectives, but imposes itself on the lived experiences of both the giver and the receiver as subject to readiness for acceptance. By not making assumptions about what support is, we open ourselves to the possibility of reciprocally experiencing moments revealing the essential meaning of support as lived. (shrink)

A reductionist view of mental health tends to give limited results. While some important benefits are still achieved, other key elements are left unaddressed. These gaps tend to wipe out the gains which were made by focusing on the dominant aspects of mental health that are promoted by a reductionist view. This paper explores such gaps by looking at those healing traditions which view health and wellness from a broader perspective. Through the live experience of such traditions (...) the paper tries to illustrate how the deeper aspects of mental health are also relevant. The paper attempts to argue that diverse cultures have inbuilt repositories of existential wisdom which can help in promoting and maintaining positive mental health through a conceptual exploratory analysis. (shrink)

This study explores young people’s perceptions of their existential well-being during the transition after leaving care. We use the theoretical framework of ‘existential well-being,’ which is a relational approach. The study deploys participatory action research methodology and involves peer research with 74 young people leaving care aged 17–32 in Finland (2011–2012) and England (2016–2018). The data was gathered through semi-structured interviews and thematically analysed.We identified three inter-linking categories of existential well-being related to the basic issues of being (...) a person: who one is and where one belongs. Self-feeling involves the importance of how one feels about oneself and one’s physical and mental health and security. Self-realisation relates to one’s hopes and the means for making one’s own decisions in everyday life. Belonging concerns the confidence one expresses in one’s supportive social networks.The findings highlight that, alongside the practical issues of out-of-home care, attention should increasingly focus on young people's reflections on their own lives, and an ethics of care should be developed to better meet their needs. These findings argue for the need to further support young people’s psychosocial and mental health in child welfare policy and practice. (shrink)

Meaning, feeling and expression - the experience of inwardness - matter most in human existence. The perspective of biopoetics shows that this experience is shared by all organisms. Being alive means to exist through relations that have existential concern, and to express these dimensions through the body and its gestures. All life takes place within one poetic space which is shared between all beings and which is accessible through subjective sensual experience. We take part in this through our empirical (...) subjectivity, which arises from the experiences and needs of living beings, and which makes them open to access and sharing in a poetic objectivity. Biopoetics breaks free from the causal-mechanic paradigm which made biology unable to account for mind and meaning. Biology becomes a science of expression, connection and subjectivity which can understand all organisms including humans as feeling agents in a shared ecology of meaningful relations, embedded in a symbolical and material metabolism of the biosphere. (shrink)

Exploring the putative role of nature in human well-being has typically been operationalized and measured within a quantitative paradigm of research. However, such approaches are limited in the extent to which they can capture the full range of how natural experiences support well-being. The aim of the study was to explore personal experiences in nature and consider how they might be important to human health and well-being. Based on a descriptive phenomenological analysis of fifty descriptions of memorable moments in (...) nature from England, Indonesia, and Norway, our findings illustrate a common structure presented under three themes: 1. serenity that gives rise to a growing awareness of how the body is stimulated by the senses; 2. admiration and appreciation for the sensation of beauty; 3. an emerging sense of togetherness and deep emotional bonding. The findings are discussed using the concepts of ecological time and the ecological body, which foreground being in nature as constituted as an interdependent and dynamic human process. We conclude by understanding well-being in terms of human responsiveness to their surroundings and thus as rooted in the human condition. (shrink)

This book presents the first critical examination of the overlapping ethical, sociocultural, and policy-related issues surrounding disasters, global bioethics, and public health ethics. These issues are elucidated under the conceptual rubric: Public health disasters. The book defines PHDs as public health issues with devastating social consequences, the attendant public health impacts of natural or man-made disasters, and latent or low prevalence public health issues with the potential to rapidly acquire pandemic capacities. This notion is illustrated (...) using Ebola and pandemic influenza outbreaks, atypical drug-resistant tuberculosis, and the health emergencies of earthquakes as focal points. Drawing on an approach that reckons with microbial, existential, and anthropological realities; the book develops a relational-based global ethical framework that can help address the local, anthropological, ecological, and transnational dynamics of the ethical issues engendered by public health disasters. The book also charts some of the critical roles that relevant local and transnational stakeholders may play in translating the proposed global ethical framework from the sphere of concept to the arena of action. This title is of immense benefit to bioethics scholars, public and global health policy experts, as well as graduate students working in the area of global health, public health ethics, and disaster bioethics. (shrink)

For much of the 20th century, vulnerability to deprivations of health has often been defined by geographical and economic factors. Those in wealthy, usually ‘Northern’ and ‘Western’, parts of the world have benefited from infrastructures, and accidents of geography and climate, which insulate them from many serious threats to health. Conversely, poorer people are typically exposed to more threats to health, and have lesser access to the infrastructures needed to safeguard them against the worst consequences of such (...) exposure. However, in recent years the increasingly globalized nature of the world’s economy, society and culture, combined with anthropogenic climate change and the evolution of antibiotic resistance, has begun to shift the boundaries that previously defined the categories of person threatened by many exogenous threats to health. In doing so, these factors expose both new and forgotten similarities between persons, and highlight the need for global cooperative responses to the existential threats posed by climate change and the evolution of antimicrobial resistance. In this article, we argue that these emerging health threats, in demonstrating the similarities that exist between even distant persons, provides a catalyst for global solidarity, which justifies, and provides motivation for, the establishment of solidaristic, cooperative global health infrastructures. (shrink)

In this paper I explore health and illness through the lens of enactivism, which is understood and developed as a bodily-based worldly-engaged phenomenology. Various health theories – biomedical, ability-based, biopsychosocial – are introduced and scrutinized from the point of view of enactivism and phenomenology. Health is ultimately argued to consist in a central world-disclosing aspect of what is called existential feelings, experienced by way of transparency and ease in carrying out important life projects. Health, in (...) such a phenomenologically enacted understanding, is an important and in many cases necessary part of leading a good life. Illness, on the other hand, by such a phenomenological view, consist in finding oneself at mercy of unhomelike existential feelings, such as bodily pains, nausea, extreme unmotivated tiredness, depression, chronic anxiety and delusion, which make it harder and, in some cases, impossible to flourish. In illness suffering the lived body hurts, resists, or, in other ways, alienates the activities of the ill person. (shrink)

Idiscovered Martha C. Nussbaum and Saul Levmore's Aging Thoughtfully: Conversations about Retirement, Romance, Wrinkles, and Regret at the same time I was rereading the ancient Roman philosopher Cicero on living and dying well, a text I often used in teaching prior to my retirement. Nussbaum and Levmore's book addresses a series of concerns about aging, and these concerns are presented by the two authors as alternative personal and professional perspectives. The authors acknowledge at the outset that their focus is not (...) end-of-life matters, and they also concede that they are making their observations from a relatively privileged point of view. They both like their work, and personal health matters are not... (shrink)

The aim of the article is to present a very important phenomenon affecting human integrity and homeostasis that is Threat Prediction Process. This process can be defined as “experiencing apprehension concerning results of potential/ actual dangers,” oscillating in terminological area of anxiety, fear, stress, restlessness. Moreover, it highlights a cognitive process distinctive for listed phenomenon’s. The process accompanied with technological and organization changes increases number of health problems affecting many populations. Hard work conditions; changing life style; or many social (...) and political threats have influence on people’s quality of life that are even greater and more dangerous than physical and psychological factors, which, in turn, have much more consequences for human normal functioning. The present article is based on chosen case studies of a qualitative analysis of threat prediction process. (shrink)

This article describes the origin and the work of a volunteer run nonprofit agency designed to provide low cost psychotherapy. The agency was developed by psychotherapists connected with the Seattle University graduate program guided by the vision of psychotherapy as a healing relationship and in response to a growing crisis in the mental health system. We address the benefits and the challenges of this collaborative effort, and especially the difficulty involved in successfully running an agency while staying true to (...) a particular vision of therapy, collaboration, and community. (shrink)

This article describes the origin and the work of a volunteer run nonprofit agency designed to provide low cost psychotherapy. The agency was developed by psychotherapists connected with the Seattle University graduate program guided by the vision of psychotherapy as a healing relationship and in response to a growing crisis in the mental health system. We address the benefits and the challenges of this collaborative effort, and especially the difficulty involved in successfully running an agency while staying true to (...) a particular vision of therapy, collaboration, and community. (shrink)

Current health policy, high‐profile failures and increased media scrutiny have led to a significant focus on patient experience in Britain's National Health Service (NHS). Patient experience data is typically gathered through surveys of satisfaction. The study aimed to support a better understanding of the patient experience and patients' expression of it through consideration of the aspects of the patient experience on NHS wards which are by their nature impossible to capture through patient satisfaction surveys. Existential phenomenology was (...) used to develop an in‐depth exploratory narrative, expressed through the voices of the participants. Data collection involved in‐depth face‐to‐face interviews with 12 purposively sampled participants, with analysis by means of hermeneutics. Though the individuality of each experience was apparent and cannot be overemphasised, common factors emerging from the data included uncertainty and unexpectedness, suffering and finitude, the futility of feedback and bureaucracy and absurdity. Overall, participants demonstrated how their individual personalities and expectations affected their response both to illness or injury and to their hospital admissions, highlighting feelings of vulnerability and voicelessness as a response to hospitalisation. The findings of this study provide useful insight into the patient experience on British hospital wards, and the value of an existential–phenomenological approach is demonstrated. (shrink)

Increasing rates of psychiatric problems like depression and anxiety among Swedish youth, predominantly among females, are considered a serious public mental health concern. Multiple studies confirm that psychological as well as existential vulnerability manifest in different ways for youths in Sweden. This multi-method study aimed at assessing existential worldview function by three factors: 1) existential worldview, 2) ontological security, and 3) self-concept, attempting to identify possible protective and risk factors for mental ill-health among female youths (...) at risk for depression and anxiety. The sample comprised ten females on the waiting list at an outpatient psychotherapy clinic for teens and young adults. Results indicated that both functional and dysfunctional factors related to mental health were present, where the quality and availability of significant interpersonal relations seemed to have an important influence. Examples of both an impaired worldview function and a lack of an operating existential worldview were found. Psychotherapeutic implications are discussed. (shrink)

Objectives: Initially, we analyzed relations between the challenging working conditions of flight attendants with symptoms of depression, anxiety and stress. As the COVID-19 pandemic plunged airlines into an unprecedented crisis, its impact on the mental health of flying cabin crews became the focus of a second survey.Methods: Flight attendants were surveyed online with DASS-21 in May 2019 and April 2020, complemented with questions about working conditions and existential fears and fear of job loss.Results: Sample 1 revealed that symptoms (...) of depression, anxiety and stress highly correlated with the subjective assessment of working conditions, but not with objectifiable parameters. Sample 2 showed significant positive correlations between existential fears and fear of job loss with depression, anxiety and stress. Crew members, grounded in April 2020, showed significantly higher scores in depression and stress, while still flying individuals had more clinically relevant symptoms of anxiety. Mean value comparisons between sample 1 and 2 in DASS-21 revealed a significant increase in symptoms at the time of crisis with effect sizes of d = 0.63 for depression, d = 0.26 for anxiety, and d = 0.52 for stress. The incidence of clinically relevant symptoms among the respondents increased from 8 to 23%, from 6 to 14%, and from 8 to 24%.Conclusion: The COVID-19 pandemic and associated work restrictions coincide with severe impairment of mental health of flying cabin crews, consistent with a mental health protecting function of labor. (shrink)

Merleau-Ponty claims that the idea of objective knowledge is supported by "our reveries." My aim in this paper is to explore this argument with respect to the idea of health. As a case study, I focus on bioethical issues surrounding return of results of incidental variants with respect to the use of genetic and genomic screening technologies (GSTs) in newborn and pediatric contexts. Drawing on a range of Merleau-Ponty’s texts, I argue that this case suggests the modern idea of (...) health to turn largely on the desire for control over one’s fate. More specifically, this is a desire for control aimed at assuring that the meaning of one’s life will stay the same as indexed by one’s ability expectations. I term this a desire for existential homeostasis. I further contend that the desire for existential homeostasis is underwritten by multiple sorts of privilege and, insofar as it informs health as a reverie, it is a desire that is particularly apt to contribute to and maintain injustice in both theory and practice. (shrink)

The relevance of the work is due to the fact that the analysis of indicators of mental and physical health of a person and their mutual influence is little disclosed in the philosophical literature. There is a problem of studying the achievement of well-being in philosophical terms and the factors influencing it, including the connection of existential fullness (fundamental existential motivations) with various positive aspects of the functioning of the individual that make up well-being: autonomy, competence, personal (...) growth, positive relationships, self-acceptance, life goals. In this regard, we have undertaken a study related to the study at the theoretical level of the relationship between existential fulfillment and well-being. The purpose of the study: to identify the relationship between the components of life well-being and existential fulfillment. The degree of existential fullness shows whether there is a lot of meaning in life, whether a person lives in inner harmony, whether his decisions and actions correspond to his essence. Life well-being is a subjective feeling of wholeness of satisfaction with one's being. The study revealed significant connections between the components of such personal constructs as life well-being and existential fulfillment. As a result of the theoretical study, the following conclusions were made: The first fundamental existential motivation concerning the possibility of existence in the world is largely related to self-acceptance and competence. The second fundamental existential motivation concerning the value of life is largely related to self-acceptance and positive relationships. The third fundamental existential motivation concerning self-esteem is largely related to personal growth. The fourth fundamental existential motivation, crowning all the previous ones and concerning meaning, is essentially related to life goals and autonomy. (shrink)

Promoting recovery has become more and more important in the care of patients with severe mental disorders such as psychosis. Recovery is a personal process of growth involving hope, self-identity, meaning in life, and responsibility. Obviously, these components pertain, at least in part, to a psychotherapeutic care perspective. Yet, up to now, recovery has mainly been taken into account in transforming health services and as a general framework for supportive therapy. Existential phenomenology abdicates a theoretical stance and considers (...) issues such as death anxiety, isolation, responsibility, and meaning. Thus, it is likely to provide some insight into the psychotherapeutic aspects of recovery. Furthermore, existential psychotherapy allows powerful insights for adopting a recovery-oriented attitude and to provide useful themes for discussing issues allowing patients to gain meaning and hope. This paper describes these elements to give clinicians insights into this complex topic. (shrink)

Man suffers from a very particular fate, namely that of being besieged by questions which he cannot answer and cannot ignore either. The ability to pose questions like these is a key characteristic of the fundamental existential situation of mankind. Every person must find his or her own particular method of coping with such questions. This makes up a significant part of the human maturing process. People with dementia, having already found their personal solution to cope with the problem (...) of these unanswerable questions, radically stumble into this existential situation once again. The problem of this repetition is that the people with dementia can only make limited use, if indeed any use at all, of their previously successful biographical strategies. The drama of human existence as such thus repeats itself within a person with dementia. We must recognise the seriousness of this task. We thus must support people with dementia in coping existentially with this renewed task in the best possible way. The existential dignity of this task is no different from that of a young person. This insight is very important for the care of patients: people with dementia should be recognised as a people in an existential situation. (shrink)

E. Haavi Morreim's book, Holding Health Care Accountable , insightfully describes several features of the current crisis in malpractice in relation to the health care marketplace. In this essay, I delineate the key and eminently practical guide for reform that she lays out. I argue that her insights bring us to more fundamental aspects than immanent medical economy and accountability - aspects that are ignored at present. I describe the features of immanent economy and how they tend to (...) cover over epistemological and existential finitude in medicine, show how economy can in fact create new medical knowledge, and show that necessary error is a real feature of day-to-day medical practice. The current system, even with Morreim's reforms, remains at the level of immanent economy, but with modifications may point to the features of medicine that transcend medical knowledge and economy. The gifts of medicine cannot be reduced to the immanent medical economy, and any attempt to do so results in crisis. A health care that points to finitude and fallibility is one that points to the mystery of human existence and mortality. Any health care financing system that helps to delineate finitude - both epistemological and existential - is one that will give patients a new lease on living and dying. (shrink)

Spirituality and spiritual care have long been kept separate from patient care in mental health, primarily because it has been associated with psycho-pathology. Nursing has provided limited spiritual care competency training for staff in mental health due to fears that psychoses may be activated or exacerbated if religion and spirituality are addressed. However, spirituality is broader than simply religion, including more existential issues such as providing non-judgmental presence, attentive listening, respect, and kindness. Unfortunately, healthcare personnel working in (...) mental health institutions are not well prepared to address spiritual concerns or resources of their patients. Therefore, a mixed-method pilot study was conducted using a self-assessment survey tool to examine spiritual care competencies of mental health staff in Norway and to understand the perspectives of mental health staff in the Scandinavian context. Five questions and comments related to survey items provided rich qualitative data. While only a small pilot with 24 participants, this study revealed a need for spiritual care educational materials targeted specifically for those who work in mental health, materials that address the approach of improving attitudes, enhancing skills, and increasing knowledge related to spirituality and spiritual care of patients. (shrink)

Since its inception, existential psychotherapy has been the principal ‘site,’ whereat philosophy, psychiatry, and psychology join hands. The Swiss psychiatrist, Ludwig Binswanger, is among the first psychiatrists to develop a philosophically grounded vision of psychiatry and psychology. Binswanger is indebted to Heidegger, Husserl, and Buber and becomes the pioneer and founding father of Daseinsanalysis, an existential–phenomenological anthropology for the study of psychoses. Later, in the hands of Medard Boss and under the guidance of Martin Heidegger, Daseinsanalysis evolves as (...) the first and, so far, only psychotherapeutic approach crafted in direct collaboration between a philosopher and a mental health.. (shrink)

The most common response to the challenge of protecting health through law is to focus on protecting the rights of vulnerable individuals and to enhance their access to health care. Each one of us is vulnerable or potentially vulnerable because of the fragile, existential nature of the human condition. Catastrophic and unexpected events could instantaneously transform us from a state of total independence and potential vulnerability to one of extreme vulnerability and complete dependence. Some legal provisions have (...) the potential to provide a modicum of protection when we find ourselves in those situations. There are also legal provisions that contribute to beneficial social circumstances; for example, legislation enabling universal access to medical care, and operationalizing respect for the individual’s right to health care, as advocated for by other authors in this issue. (shrink)

This study investigated the relationships between selected emotional aspects of mental ill-health and mental well-health experienced during the COVID-19 pandemic. The theoretical model of the study was based on Martin Seligman’s positive psychology and PERMA theory and Paul Wong’s Existential Positive Psychology 2.0 Theory, which postulates that negative experiences contribute to well-being and personal growth. The static approach was complemented by exploring the mediating role of psychological flexibility in the relationship between negative emotions and well-being. The data (...) were collected during the initial phase of the COVID-19 pandemic from 277 participants, aged M = 33.83, SD = 12.77. The results confirmed that negative emotions correlated negatively with various domains of well-being, except for accomplishment. Moreover, negative emotions were related to the general well-being through psychological flexibility in that higher depression, anxiety, and stress were associated with lower psychological flexibility, which decreased general well-being. Finally, negative emotions were shown to be beneficial, having an adaptive effect that allows individuals to maintain their ability to cope with the situation, reach goals, and fulfill daily duties and responsibilities despite critical, stressful situation that limit their psychological flexibility. This observation confirmed the positive potential of negative aspects of life postulated within Existential Positive Psychology. (shrink)

The current medical approach to erectile dysfunction (ED) consists of physiological, psychological and social components. This paper proposes an additional framework for thinking about ED based on phenomenology, by focusing on the theory of sexual projection. This framework will be complementary to the current medical approach to ED. Our phenomenological analysis of ED provides philosophical depth and illuminates overlooked aspects in the study of ED. Mainly by appealing to Merleau-Ponty’s Phenomenology of Perception, we suggest considering an additional etiology of ED (...) in terms of a weakening of a function of sexual projection. We argue that sexual projection can be problematized through cognitive interferences, changes in the ‘intentional arc’, and modifications in the subject’s ‘body schema’. Our approach further highlights the importance of considering the ‘existential situation’ of patients with ED. We close by reflecting briefly on some of the implications of this phenomenological framework for diagnosis and treatment of ED. (shrink)

How philosophy is educating humanity will be explained regarding an actual example concerning the new public health paradigm or health promoting research. The central point of reference is the discussion of the decisive substantiation of the work of medical sociologist, Aaron Antonovsky; his approach to salutogenesis is opposed to the usual approach of pathogenesis. Here, emphasis is put on "Sense of Coherence". It will be shown that, in contrast to Antonovsky's original intention, the relation to the natural sciences (...) and scientific medicine is sufficient to substantiate neither his central arguments nor the relation to the continental traditions of philosophy, especially to existential philosophy and to philosophical hermeneutics mentioned in his latest works. Therefore, referring to a prominent sociological representative of modern health science, means-end rationality is no longer able to assert its dominant position in this field, but must be legitimized by value rationality. Antonovsky's concept of SoC also inevitably includes the argument that methodologically oriented explanation of health related problems can never be replaced by sense-oriented understanding. (shrink)

A distinguishing characteristic of the biomedical model is its compartmentalized view of man. This way of seeing human beings has its origin in Greek thought; it was stated by Descartes and to this day it still considers humans as beings composed of distinct entities combined into a certain form. Because of this observation, one began to believe that the focus of a health treatment could be exclusively on the affected area of the body, without the need to pay attention (...) to patient’s subjectivity. By seeing pain as a merely sensory response, this model was not capable of encompassing chronic pain, since the latter is a complex process that can occur independently of tissue damage. As of the second half of the twentieth century, when it became impossible to deny the relationship between psyche and soma, the current understanding of chronic pain emerges: that of chronic pain as an individual experience, the result of a sum of physical, psychological, and social factors that, for this reason, cannot be approached separately from the individual who expresses pain. This understanding has allowed a significant improvement in perspective, emphasizing the characteristic of pain as an individual experience. However, the understanding of chronic pain as a sum of factors corresponds to the current way of seeing the process of falling ill, for its conception holds a Cartesian duality and the positivist premise of a single reality. For phenomenology, on the other hand, the individual in his/her unity is more than a simple sum of parts. Phenomenology sees a human being as an intending entity, in which body, mind, and the world are intertwined and constitute each other mutually, thus establishing the human being’s integral functioning. Therefore, a real understanding of the chronic pain process would only be possible from a phenomenological point of view at the experience lived by the individual who expresses and communicates pain. (shrink)

In response to cancer, patients may be thrown into precarious processes of remaking their purpose, identity, and connections to the world around them. Thoughtful and thorough responses to these issues can be supported by person-centered phenomenological approaches to caring for patients. The importance of perspectives on illness offered by theoretical phenomenology will become apparent through the example of the experience of nausea, or perhaps more accurately put—chemo sickness. The focus here is on how chemo sickness alters one's way of relating (...) to the world. I will examine the phenomenon of nausea through the lens of the phenomenological concept of mood—an existential feeling that engenders a diffused tone permeating through one's world and shapes the envisioned possibilities on one's horizon. (shrink)

The dominant unspoken philosophical basis of medical care in the United States is a form of Cartesian reductionism that views the body as a machine and medical professionals as technicians whose job is to repair that machine. The purpose of this paper is to advocate for an alternative philosophy of medicine based on the concept of healing relationships between clinicians and patients. This is accomplished first by exploring the ethical and philosophical work of Pellegrino and Thomasma and then by connecting (...) Martin Buber's philosophical work on the nature of relationships to an empirically derived model of the medical healing relationship. The Healing Relationship Model was developed by the authors through qualitative analysis of interviews of physicians and patients. Clinician-patient healing relationships are a special form of what Buber calls I-Thou relationships, characterized by dialog and mutuality, but a mutuality limited by the inherent asymmetry of the clinician-patient relationship. The Healing Relationship Model identifies three processes necessary for such relationships to develop and be sustained: Valuing, Appreciating Power and Abiding. We explore in detail how these processes, as well as other components of the model resonate with Buber's concepts of I-Thou and I-It relationships. The resulting combined conceptual model illuminates the wholeness underlying the dual roles of clinicians as healers and providers of technical biomedicine. On the basis of our analysis, we argue that health care should be focused on healing, with I-Thou relationships at its core. (shrink)

Human existence is structured as an interruption that is forever calling us into question (interrupting our everyday routinized ways of being) and confronting us with the related challenges of having a conscience, being open to and acknowledging others, striving to better ourselves when improvement is necessary for maintaining our well-being, and enacting our rhetorical competence to disclose the truth of the matters at hand.

This paper first distinguishes governance (collective, autonomous self-regulatory processes) from government (externally-imposed mandatory regulation); it proposes that the second of these is essentially incompatible with a conception of the medical humanities that involves imagination and vision on the part of medical practitioners. It next develops that conception of the medical humanities, as having three distinguishable aspects (all of them distinct from the separate phenomena popularly known as “arts-in-health”): first, an intellectual enquiry into the nature of clinical medicine; second, an (...) important dimension of medical education; third, a resource for moral and aesthetic influences upon clinical practice, supporting “humane health care” as the moral inspirations behind organised medicine. Medical humanities sustains these three aspects through paying proper attention to the existential and subjective aspects of medicine. By encouraging authentic imagination among health care practitioners, medical humanities aligns well with both humane health care and governance in the sense of self-regulation. However, it can neither be achieved mechanistically nor well-measured through proxies such as patient satisfaction. Above all, it should not be allowed to supply, through inappropriate qualitative “targets,” new forms of management tyranny. (shrink)

Objective To study how doctors care for their patients, both medically and as fellow humans, through observing their conduct in patient–doctor encounters. Design Qualitative study in which 101 videotaped consultations were observed and analysed using a Grounded Theory approach, generating explanatory categories through a hermeneutical analysis of the taped consultations. Setting A 500-bed general teaching hospital in Norway. Participants 71 doctors working in clinical non-psychiatric departments and their patients. Results The doctors were concerned about their patients' health and how (...) their medical knowledge could be of service. This medical focus often over-rode other important aspects of the consultations, especially existential elements. The doctors actively directed the focus away from their patients' existential concerns onto medical facts and rarely addressed the personal aspects of a patient's condition, treating them in a biomechanical manner. At the same time, however, the doctors attended to their patients with courteousness, displaying a polite and friendly attitude and emphasising the relationship between them. Conclusions The study suggests that the main failing of patient–doctor encounters is not a lack of courteous manners, but the moral offence patients experience when existential concerns are ignored. Improving doctors' social and communication skills cannot resolve this moral problem, which appears to be intrinsically bound to modern medical practice. Acknowledging this moral offence would, however, be the first step towards minimising the effects thereof. (shrink)

This discussion paper offers a critical provocation to my mental health nursing colleagues. Drawing upon David Graeber's account of bullshit work, work that is increasingly meaningless for workers, I pose the question: Is mental health nursing a bullshit job? Ever‐increasing time spent on record keeping as opposed to direct care appears to represent a Graeberian bullshitisation of mental health nurses' work. In addition, core aspects of the role are not immune from bullshit. Professional rhetoric would have us (...) believe that mental health nursing is a therapeutically beneficent occupation organised around ideals of care and compassion and providing fulfilling work for practitioners. Yet, there are some key characteristics of the experience of mental health nursing work that afford alternative judgements on its value and meaningfulness. Not least of these is the fact that many mental health nurses feel quite existentially unsettled in the practise of their work and many service users do not recognise the professional ideal, especially when compelled into increasingly coercive and restrictive services. In this context, Graeber's thesis is explored for its applicability to mental health nursing with a conclusion that many aspects of mental health nursing work are commensurate with bullshit but that mental health care can possibly be redeemed from bullshitisation by authentically democratising reforms. Engaging with posthumanist ideas, this exploration involves a flexing of aspects of Graeber's theory. (shrink)

Youth sport is habitually promoted as an important context for learning that contributes to a person’s broader development beyond sport-specific skills. A growing body of research in this area has operated within a life skills discourse that focuses on useful, positive and decontextualised skills in the production of successful and adaptive citizens. In this paper, we argue that the ideological discourse of life skills, underpinned by ideas about sport-based positive youth development, has unduly narrowed the research on learning in sport (...) to only what is deemed functional, teachable, and economically productive. After considering the problems associated with the currently dominant life skills approach, we explore existential learning as an alternative perspective on conceptualising and studying learning in sport. An existential approach provides a non-instrumental theory of learning with an emphasis on discontinuity, relational self and ‘becoming’, opening an avenue for exploring various forms of informal learning under-explored in sport. We discuss the applications of this alternative approach for future research and practice in learning in youth sport. (shrink)