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The drama of medicines
Published in Peri J. Ballantyne, Kath Ryan, Living Pharmaceutical Lives, 2021
Karen C. Lloyd, Paul Bissell, Kath Ryan, Peri J. Ballantyne
Telling stories about living with illness and the place of medicines in managing that illness is an important form of embodied meaning making. We posit that treating these stories as dramas (Frank, 2007) enables us to understand the place and significance of medicines in people’s lives. We describe how stories about medicine taking can be conceived as dramas of (1) medicines in the body, (2) signification and the self, and (3) experimentation in accounts of living with postural tachycardia syndrome, a rare dysfunction of the autonomic nervous system. We do this to demonstrate the value of studying stories and to make a case for the narrative potential of storytelling about medicines.
Sense of safety dynamics – what processes build, protect and reveal Humpty’s sense of safety?
Published in Johanna Lynch, A Whole Person Approach to Wellbeing, 2020
Meaning-making is a creative, integrative human experience (Neimeyer 2001) that is often disrupted by overwhelming experiences, confusion, double binds, paradoxes, shattering of assumptions (Janoff-Bulman 1985) or hopelessness (Lester 2012). Dissociative processes due to trauma cause a loss of internal coherent meaning (Meares 2012) in response to overwhelming threat: ‘the organism gives up its unity in order to save itself’ (Heller and LaPierre 2012, 147) causing fragmented inner experiences. This loss of unity of self in the face of threat is discussed in more depth in the domain of sense of self in Chapter Seven. Loss of sense-making, or a realisation of the ‘menacing meanings of their symptoms’ (Frank 1986, 345), can lead to depression or the activation of defences, which some see as a natural adaptive withdrawal response to chaos, demoralisation, loss of self-organisation or loss of safety (Blazer 2005, Gilbert 1993, O'keeffe and Ranjith 2007, Cramer 2000). For example loss of sense-making can occur due to loss of culture or ‘lore’ (Atkinson 2002) as a result of colonisation or migration. It can also occur with disordered morality or moral injury (Jinkerson 2016, Eisenberg 2000), as can occur in combat veterans and other citizens placed in threatening no-win situations. Disorganisation, or loss of calm sense-making can be both a result and a cause of loss of sense of safety.
Cancer-Related Pain
Published in Andrea Kohn Maikovich-Fong, Handbook of Psychosocial Interventions for Chronic Pain, 2019
Jinsoon Lee, Amy Wachholtz, Beverly S. Shieh, Michael Tees
Meaning-making is a specific spiritual-based intervention useful for cancer pain management (Park, 2010a; Park, 2010b). With chronic illnesses, patients often experience distress as they struggle with questions of mortality and questions regarding the impact of the illnesses on their lives. It can be challenging for patients to make meaning of their illness, and meaning-making intervention can assist patients who strive to assimilate or accommodate their current experiences with their pre-illness understandings of life (Lepore, 2001). Helping a patient incorporate his or her experiences with cancer-related pain into a greater sense of purpose may help decrease overall distress (e.g., “I am experiencing pain because it is my body’s way of telling me that it is going through changes”).
Vicarious resilience: traversing the path from client to clinician through a search for meaning
Published in Social Work in Health Care, 2022
Resiliency in the face of adversity is not a fixed personality trait but a phenomenon, and the degree to which an individual shows resilience may fluctuate throughout a lifetime based on experiences, strengths, and stressors at a given time (Luthar et al., 2014). Resilience research indicates that the phenomenon encompasses both negative and positive adjustments (Luthar et al., 2000), thus the usage of the term by mental health professionals is more nuanced than how it has been used vernacularly, as the latter often focuses on positivity, strength, and constructive adjustment. As used by mental health professionals, resiliency is closely tied to meaning-making: changes in how the experience of suffering and trauma are interpreted can “decrease individuals’ perceptions of violation … facilitating psychological adjustment to the trauma and promoting resilience” (Park, 2017, p. 162). Like the resilience it facilitates, meaning-making is much more profound than simplistic optimism. Meaning-making is not a quest for happiness and should not be understood as a search for a “silver lining” or a positive within a negative (Piccolino, 2020, p. 35). Rather, meaning-making comes from the awareness that we have the freedom to find meaning in our existence and we choose our attitude toward suffering (Frankl, 1946). Trauma, loss, and adversity are not terms that incite optimistic thoughts. They are heavy and often laden with pain and suffering, and yet difficult times can lead to growth and strength through the process of attributing meaning to the suffering.
Ethics education in clinical pastoral education: prevalence and types
Published in Journal of Health Care Chaplaincy, 2022
David W. Fleenor, Paul Cummins, Jo Hirschmann, Vansh Sharma
Since the mid-20th century, health care chaplaincy has emerged as a profession (Cadge, 2019). In the past, health care chaplains tended to be volunteers from local religious communities. They are now typically members of the health care team paid from the health care institution's budget. The Joint Commission's requirement that palliative care programs have a chaplain on the team for advanced certification demonstrated their importance to and integration into health care systems (Croney & Clark, 2015; Handzo, Cobb, Holmes, Kelly, & Sinclair, 2014). Chaplains address patients' spiritual, emotional, religious, and existential needs. This includes helping patients and their loved ones with values-exploration, decision-making, and meaning-making within the context of their medical treatment (Jacobs, 2008). In this way, chaplains have served as a bridge between patients and their loved ones and other clinicians on the health care team (Mohrmann, 2008).
Joining, belonging, and re-valuing: A process of meaning-making through group participation in a mental health lifestyle intervention
Published in Scandinavian Journal of Occupational Therapy, 2019
Kristine Lund, Elisabeth Argentzell, Christel Leufstadius, Carina Tjörnstrand, Mona Eklund
How does meaning-making then fit with therapeutic group factors? Are they the same thing, or different? Yalom and Leszcz [[18], p.1] describe therapeutic group factors as human experiences that interact in order to affect the complex process of therapeutic change. These therapeutic factors have also been described as the mechanisms that make therapeutic groups work [57]. Meaning-making, on the other hand, appears to be more of an existential change. Yalom and Leszcz [18] briefly mention that a sense of meaning can be experienced through finding a purpose and being useful to someone, which is in agreement with our findings, though they do not go into much further detail about meaning. Meaning-making as conceptualized in the current study could suggest a more positive existential approach, that meaning is found in realizing one is not alone (universality), and that self-worth and purpose can develop through helping others (altruism). Along these lines, one study suggests that giving emotional support to loved ones may be more important to longevity and well-being than receiving support [58]. They conclude that instead of solely focusing on the support aspect, interventions could be strengthened by exploring ways in which participants can help others.