Demoralization of Severely Ill Patients with Death Hazard

Abstract

Background. In the article, the review of international special literature is exposed. The paper is dedicated to the concept of demoralization, which is an under-investigated realm in Russian psychological science. The notion of demoralization is applied in clinical psychologist practice, in order to make a holistic description of people’s complex of emotional struggle experience in different somatic nosology types, which may be connected to death hazard, for both inward and outward patients. The introduction of this concept is important for differential diagnosis and the selection of appropriate medication, psychotherapeutic and social-psychological support and follow-up measures. Objective. The aim is to define demoralization concept and its practical application referring to clinical psychologist practice with patients having different types of somatic disease. Results. Grounded on the analysis of international understanding of demoralization concept in clinical practice, the notion of demoralization as a holistic phenomenon having its specific content was established. It is shown, that diagnostic clues are distinct as compared to other notions. The paper presents demoralization concept as a significant one for clinical psychologist and psychiatrist, working with severely ill patients with death hazard. Conclusion. Difficult life circumstances, resulted from severe somatic disease, raise the problem of life and death. Demoralization can be understood as a state generated by actual crisis conditions of human existence in a particular situation and expressed in the subjective experience of failure to overcome it. Disclosure of specific features characteristic of the phenomenon of demoralization contributes to a deeper understanding of the content of psychological experiences in severely ill patients at risk for life. This allows to outline and implement more appropriate and targeted tactics of psychotherapeutic interventions.

Keywords

• demoralization
• depression
• severely ill patients
• somatic disease
• hazard to life
• clinical practice
• distress
• subjective incompetence