Understanding Hope. Persons in the Process of Dying

Changes both within the profession of psychoanalysis and in society as a whole have affected our psychoanalytic training programs and presented new ethical challenges. Whereas in earlier decades training programs needed to be concerned primarily about the inviolability of the training analysis and the choice of appropriate analytic candidates, today there is little support for psychoanalysis as a treatment modality. Institutes are experiencing greater competition in attracting quality candidates and in providing them with adequate training experiences. This strain encourages institutes to operate in unethical ways to attract candidates. On the other hand, within the profession itself we are experiencing much theoretical ferment and the increasing feminization of the profession. These changes are affecting our training institutes and our ethical values in both positive and negative ways.     

The Pain of Dying

SUMMARY

Dying can be a painful and difficult business. Fears, hopes, losses, questions, and uncertainty result in a form of pain that lies beyond the therapeutic reach of science and pharmacology. Efforts to preserve and prolong life or to make things better can sometimes result in this pain being overlooked or remaining unheard. To search the deepest part of oneself is the journey that beckons us all as we are dying. Within this space resides the source of our own suffering but also the seeds for healing. This exploration has a momentum of its own but requires conditions not often found within the biomedical paradigm. If this model of care remains the only source of hope for those with a life-threatening illness, ‘the pain of dying’ may not be addressed.     

The emotional geographies of the ‘livingdying’

This paper engages with Madge's (2016; 2018) notion of the ‘livingdying’ through an analysis of three recent autobiographies of death and dying. Dying: A Memoir by Australian author, Cory Taylor (2016), In Gratitude by British writer, Jenny Diski (2016), and The Bright Hour by American memoirist, Nina Riggs (2017), provide insight into the sometimes contradictory emotional responses to the different spaces traversed by the ‘livingdying’. We identify how the emotions of fear and anxiety, sadness and grief, anger and frustration, and isolation and loneliness infuse the liminal spaces that the ‘livingdying’ occupy. In doing so we highlight how the normative dualism of ‘the living’ and ‘the dying’ shapes emotional vulnerabilities. Finally, hoping to further advance Madge's (2016; 2018) provocation to acknowledge, account for and honour the intrinsic entanglement of living and dying and life and death, we propose a reframing of her notion of ‘livingdying’ that includes the ‘ordinary’ living, that is, those not dealing with a terminal illness.     

Defining ‘Dead’ in Terms of ‘Lives’ and ‘Dies’

What is it for a thing to be dead? Fred Feldman holds, correctly in my view, that a definition of ‘dead’ should leave open both (1) the possibility of things that go directly from being dead to being alive, and (2) the possibility of things that go directly from being alive to being neither alive nor dead, but merely in suspended animation. But if this is right, then surely such a definition should also leave open the possibility of things that go directly from being dead to being neither alive nor dead, but merely in suspended animation. I show that Feldman’s own definition of ‘dead’ (in terms of ‘lives’ and ‘dies’) does not leave this possibility open. I propose a new definition that does.     

The temporality of intimacy: Promise,world, and death

This paper explores the temporal character of intimacy. I begin by examining the significance of “promise” and “habit” in intimate relationships. These themes are developed through the work of M. Merleau-Ponty and J.H. van den Berg to reveal the embedded or en-worlded character of intimacy. These analyses help to articulate and to problematize the sense we often have of “established” relationships as possessing a fixed, already determined character. The final section discusses the issues of intimacy that surround the situation of dying. Specifically, it analyses (1) ways in which the issue in death is the stripping away of one's world, but also ways in which the meaning of one's death is still something futural, and thus “to be shaped”; and, (2) ways in which the shaping of this meaning with intimate others is significant both for the one manifestly dying and for those whose death seems distant.     

Medical ethics in Poland

The work related to medical ethics written by Polish authors are reviewed and some topics concerning teaching and various other activities in this field are presented. The attention is centered on the opinions and attitudes concerning the essence of medical profession and the personal model of the physician, doctor-patient relationship (including duties of the doctor), medical research on humans, abortion and other problems. The role of medico-ethical tradition in Poland is described. Main trends in polish ethical thought in relation to medicine are taken into consideration. General aspects of medical ethics in present-day Poland are tentatively characterized.     

临终心理的理论和研究综述

死亡是人生生老病死必经的最后历程,对临终病人心理的研究,临终护理的探索有重大意义,本文从临终病人的心理及其发展状况,以及临终心理的调适等角度出发,对国内外的临终心理研究进行回顾,并对其中的理论和研究结果做出总结性分析,并对今后研究需要注意的方向加以讨论。     

Caring for Dying Children and Their Families: MFTs Working at the Gates of the Elysian Fields

The constant comparison method was used to analyze seven in-depth interviews with Marriage and Family Therapists and some of their colleagues working with dying children and their families. The findings of the study revealed that working in these settings can encourage shifts in priorities, relationships, and beliefs about life and death, and can elicit professional growth. Also, it can carry with it significant costs such as emotional exhaustion, and hypervigilance about death. Implications for practice and training are discussed. In the Greek mythology, the Elysian Fields is the place where the souls of the heroes and the virtuous dwell in the afterlife. It is the equivalent of the Christian Heaven. Portions of this paper were presented at the 65th Annual Conference of the American Association for Marriage and Family Therapy, Long Beach, CA, 2007.