Occupational stress. Spice of life or kiss of death?

Work-related psychosocial stressors originate in social structures and processes, affect the human organism through psychological processes, and influence health through four types of closely interrelated mechanisms--emotional, cognitive, behavioral, and physiological. The health outcome is modified by situational (e.g., social support) and individual factors (e.g., personality, coping repertoire). The work-environment-stress-health system is a dynamic one with many feedback loops. There is little but increasing direct evidence of a causal relationship between work-related psychosocial stressors and the incidence and prevalence of occupational morbidity and mortality. But, a substantial body of indirect evidence strongly suggests that such associations exist and emphasizes the need to better understand their role. Accordingly, research and health action should aim at being systems-oriented, interdisciplinary, intersectorial, health- (and not only disease-) oriented, and participative.     

Oh death,where is thy sting? Reflections on dealing with dying patients

This paper examines the reactions of physicians and other health-professionals when they become involved in decisions about the death of their patients. The way people understand the condition of death has a profound influence on attitudes towards death and dying issues. Four traditional views of death are explored. The problem that physicians have in helping patients die (be it by hastening death through pain control, assisting patients in suicide or by more active means) is analyzed. Physicians, in dealing with such patients, must be mindful of their own, and their patients beliefs as well as mindful of the community in which such dying takes place. They must try to reconcile these often divergent views but can neither paternalistically deny patients their rational will, hide themselves behind an appeal to the law or go against their own deeply held moral views. When such views cannot be reconciled, compassionate transfer to a more compatible physician may be necessary.     

Organ donation terminology: are we communicating life or death?

The continued functioning of organ transplantation depends on obtaining the permission of the next of kin. This communication process between medical or transplant professionals and a donor family hinges heavily on the understanding of certain critical terms like brain dead, life support, and transplantation. Communication issues in obtaining organ donation consent were examined, with particular focus on what are literally life-and-death decisions. Using an experimental simulation methodology, data are offered in support of the claim that much miscommunication occurs in such situations. Directions for improving such communication by allaying latent fears and more carefully defining crucial terminology are offered.     

An event in medical life,or the advent of a belief?

Freud's ambivalent relations with medicine are well known. Based on his relatively unknown text, A religious experience, published in 1928, the authors present an analysis of the internal reasons for this conflict. Responding to a letter from an American doctor, who tells him about his reactions to an autopsy and the influence it had on his religious faith, Freud suggests an analysis that leads him to make a surprising slip. This slip reveals the conflicts inherent in the practice of autopsy, considered as a peculiar event in medical training that puts a strain on the future medical practitioner's subjectivity. Based on the analysis of unconscious impulses and fantasmatic activity, the authors demonstrate that Freud's theory is still surprisingly relevant today in the light of testimonies from contemporary doctors confronted with autopsy during their training or daily practice.     

Who self-initiates gratitude interventions in daily life? An examination of intentions,curiosity, depressive symptoms,and life satisfaction

Despite a variety of interventions to increase well-being, little is known about who is interested in and initiates exercises on their own. We explored individual differences that predict who is most likely to participate in a voluntary gratitude intervention. College students (n = 226) completed measures of curiosity, depressive symptoms, life satisfaction, and intentions to change their lifestyle. Afterwards, participants received a personalized invitation to take part in a web-based intervention to enhance their well-being (anonymous and strictly voluntary). Results suggested that 11.5% of participants started the gratitude intervention. Individuals endorsing strong intentions to change their lifestyle (+1 SD above mean) were 2.2 times more likely than their peers to start the gratitude intervention. People with greater trait curiosity endorsed greater intentions to start this intervention; people with greater depressive symptoms endorsed weaker intentions. Both curiosity and depressive symptoms indirectly influenced initiation of the gratitude intervention via intentions. These findings provide support for particular paths that lead to the initial behavioral effort towards healthy change. We discuss the implications for attempting to increase and sustain people’s well-being.     

HIV/Aids: an encounter with death or a journey into life?

This is an account of a panel discussion. It focuses on an encounter with the HIV/Aids virus. Such an encounter may result in a descent into despair, hopelessness and ultimately death, or it may offer the opportunity of possible transformation of consciousness to embrace a life lived productively and meaningfully with a chronic but manageable disease. A picture is provided of the dire situation that exists regarding the HIV/Aids pandemic in South Africa. The HI-virus is compared to a malevolent trickster type energy that uses ingenious means to gain access to the host. It is an impersonal agent seeking only its own survival but if left untreated will ultimately result in the death of the host. Reference is made to characters in the musical, The Lion King, to illustrate that it is the willingness to suffer the painful emotions evoked following a diagnosis of being HIV-positive more consciously that allows for a transformation from despair and hopelessness to a life lived productively and meaningfully. Two of the panelists who are HIV-positive share their experiences of this process. One recounts how, living with Aids, his connections with others and human relatedness helped to restore his dignity and self-worth. The other relates how his willingness to state his status publicly allowed him to overcome the stigma and shame that are evoked when diagnosed as HIV-positive. This has allowed him to seek appropriate treatment with ARV's. He now lives with a chronic but manageable infection and leads a creative and significant life. The difficulties encountered regarding the prevention of HIV/Aids when attempting to change potentially destructive sexual behaviours in teenagers are discussed. An inspiring account of work in treating those that live with HIV/Aids under difficult circumstances is also discussed.     

Wisdom at the end of life: Hospice patients’ reflections on the meaning of life and death

The processes of aging and confronting mortality are often accompanied by unique psychological challenges. From the perspective of positive psychology, such challenges can yield opportunities for growth, including increased wisdom. This qualitative study explored 15 terminally ill hospice patients’ perspectives on wisdom, the dying process, and the meaning of life using consensual qualitative research methods. Most participants cited humility as a key component of wisdom, emphasizing that “Wisdom is when we realize ‘I don’t really know much’.” Other components of wisdom included self-knowledge, rationality, experiential learning, listening to and learning from others, and sharing knowledge with others. Participants also suggested that the process of facing illness and death presents opportunities for positive growth, including changing priorities and learning to appreciate life more fully in the present moment. In considering the sources of meaning in their lives, participants emphasized relational connections, personal growth, spirituality, vocational fulfilment, and living a full life. Participants also shared their reflections on important past experiences and regrets. Lastly, participants offered advice to others based on their experiences facing illness and mortality. Implications for psychological care of the dying and future research are discussed.     

Behavioral control or income? An analysis of saving attitudes and behavior,credit card use and buying on installment

Introduction

The Turkish economy has gone through multiple economic crises, marked on the one hand by a volatile trend in the national financial system, and on the other, by the introduction of credit cards and payment facilities for consumer goods that are extremely easy to obtain.

Carving,taming or gardening? Plutarch on emotions,reason and virtue

This article attempts to provide an overview and discussion of Plutarch’s views in his Moralia about emotions and their relation to moral virtue and reason. By tracking different clusters of imagery – artisanal, zoological and botanic – that Plutarch uses in his essays to articulate the relationship between emotions and reason, it explores three philosophical perspectives on emotions: emotions of a virtuous person are likened to a well-shaped piece of material; to animals that need to be guided or reined in by their master; and to wholesome plants in a garden. Each of these imageries is used to support a different account of moral virtue: virtue as the emotional disposition to feel moderately; virtue as the obedience of emotions to the commands of reason; and virtue as the absence of bad emotions and flourishing of the good ones. This analysis enables us to weigh the influences of major philosophers on Plutarch’s account, and to elucidate his commitment on both metriopatheia and apatheia.     

Marriage—and its alternatives: An Anglican perspective,yesterday and today

This article looks first at how the institution of marriage has been, and currently is, understood by Anglican Christians, with a particular focus on the Church of England. It contrasts the ‘older’ understanding of marriage, as expressed in the Book of Common Prayer, with more contemporary liturgies. It then seeks to explore whether this clear development during the last 100 years in the understanding of marriage means that there is scope for opening up discussion about alternatives to marriage such as intentional singleness, cohabitation and same-sex relationships. Particular attention is given to the discussion at the Lambeth Conference of Anglican bishops, meeting in 1998, and to a key Church of England report, Issues in Human Sexuality.     

Being seen or being watched? A psychoanalytic perspective on body dysmorphia

The focus of this paper is on individuals who present as excessively preoccupied with their body, perceiving some aspect(s) to be 'ugly' such that they feel compelled to alter and/or conceal this 'ugly' body part. These difficulties are understood as symptoms of an underlying narcissistic disturbance. The author suggests that the relative pervasiveness of an identification with a 'super'-ego accounts for the degree of severity of the disturbance (increasing the compulsion to alter and/or conceal the hated body part) and that it has implications for the patient's accessibility in analytic treatment. Understanding the vicissitudes of the development of the body–self in the context of the earliest relationship with the 'object of desire' is core to helping these patients because of the quality of the identifications that ensue and that are then enacted the transference.     

Are life satisfaction and self-esteem distinct constructs? A black South African perspective

As part of a longitudinal project on Quality of Life, a study was undertaken to extend the applicability of the 5-item Satisfaction With Life Scale, developed in the USA, in South Africa. Data on basic sociodemographic characteristics, the scale, and the 10-item Rosenberg Self-esteem scale were available for 360 Black South Africans (151 men and 209 women), ages 21 to 83 years (M = 38.6 yr., SD = 10.3). Factor analysis applied to scale scores gave two factors, accounting for 71% of the variance. Factor I was loaded by 10 Self-esteem items and Factor II by four of the five Life Satisfaction items. Coefficient alpha was .77 for the Satisfaction With Life Scale and .97 for the Rosenberg Self-esteem Scale. Life Satisfaction was related to Self-esteem (r = .17, p < .01). It was concluded that Life Satisfaction and Self-esteem appear to be distinct, unitary constructs, but responses to Item 5 on the Satisfaction With Life Scale require cautious interpretation and may contribute to the weak r, although so may the collectivist culture of Black South Africans.