Cancer patients: Loss of meaning, demoralization and embitterment

Abstract

In the following chapter we outline the variety of psychosocial problems among patients during the course of cancer and provide a conceptual framework for the study of existential concerns in chronic illness. While referring to the newly proposed psychiatric syndrome of embitterment disorder, we shall introduce the concept of demoralization, a clinically relevant syndrome of existential distress and despair. Furthermore, we discuss psychotherapeutic interventions helping to sustain or enhance a sense of meaning and purpose in life. Despite some conceptual overlap, demoralization can be clinically differentiated from embitterment disorder characterized by intrusive memories, blame, dysphoria, and somatic complaints as reactions to a stressful life event, since demoralization refers to the human search for meaning in the face of serious illness including feelings of incompetence and failure, being unable to cope, helplessness, hopelessness, dysphoria, disheartenment and loss of meaning. © 2011 Springer-Verlag Vienna.