From diseases, even those that can lead to death in a short time, no one is insured.
And each person's attitude towards severe illness may be different.
It depends on the nature, state of mental health, individual characteristics of the psyche. A. E. Lichko, a famous Soviet psychiatrist, identified a number of types of attitudes towards the disease.
This classification helps physicians find an approach to each patient.
Special features
Patient's attitude to the disease - This is a set of internal and external reactions that occur in his in the process of awareness of the presence of the disease, during the period of treatment, after recovery or remission.
If the disease was severe, even after healing a person may experience psychical deviations, significantly affecting his behavior, well-being, vision of the world, such as anxiety disorder, panic attacks, phobias, PTSD, depression.
Subjective attitude to the disease depends on factors such as:
- parents and close relatives, their upbringing (hyper-care or, on the contrary, detachment, various types of violence in the family or lack thereof);
- mental state (any mental illness, such as depression, anxiety disorder, bipolar disorder, schizophrenia, affect how a person perceives reality and himself);
- features of the relationship with the close circle (life attitudes of friends and a loved one, the absence or presence of violence in romantic relationships);
- childcare and education;
- age;
- gender identity;
- mental features (accentuation, congenital minor deviations, temperament, character);
- the amount of knowledge, the degree of development of intelligence (for example, a person who knows medicine and physiology at a basic level and has critical thinking, would hardly prefer to treat cancer with unconventional methods);
- the presence or absence of adequate support from loved ones during the detection of the disease and throughout treatment.
Therefore, the attitude of each person to the disease individually: where one closes in himself and refuses to be treated, the other may start to run around the doctors incessantly and dissuade his relatives.
Subjective attitude to the disease also referred to as the “internal picture of the disease” and is related to how a person, depending on his own characteristics and conditions mentioned above, will interpret information about the disease, how it will be treated.
Types of attitude to the disease
The most common and widely used classification is the one that A. E. Lichko. It includes the following types of attitudes towards illness:
- Harmonic. The most adequate response to the disease: the patient rationally assesses the disease and seeks to cure it, avoids overly burdening loved ones. His mental state is virtually unchanged.
- Anosognostic There is a desire to close the eyes to the presence of the disease: the patient refuses to assume that he has a disease, and may decide that he does not need to be examined and treated.
- Ergopathic. Work or favorite hobbies are for the patient the main outlet, as if he tries so to distance himself from the disease. The biggest fear of such patients is to lose the ability to work due to illness.
- Anxious. The patient is extremely anxious about his illness, constantly afraid of deterioration and that the treatment will not help. He carefully studies everything that is connected with the disease, can strike into the sphere of alternative medicine. Anxious patients tend to trust superstition, can invent their own signs.
- Neurasthenic. In such patients, irritability is often observed, especially during periods of exacerbation of the disease. They can break on any person, but later they feel shame, cry and ask for forgiveness. Hard to bear the pain.
- Hypochondriacal. A person focuses on his own state of health, is worried about his slightest deterioration, is worried about everything that can somehow negatively affect him: for example, a hypochondriac will carefully read the instructions for the drug and will listen fanatically to his feelings, over-exaggerating even insignificant negative ones changes. If something does not suit him, he may require to replace the medication.
Also, hypochondriacs usually visit doctors very often and willingly tell others about how sick and unhappy they are.
Their life revolves around the disease, and they are confident that their disease is much more serious than it actually is.
- Melancholic. The patient begins to doubt that recovery or improvement of the condition is possible, he withdraws into himself, his mood deteriorates significantly, depression develops with the threat of suicide.
- Sensitive. Patients have a pronounced anxiety associated with how others will react to the disease, whether they will not be treated worse, scoffed, mocked. They are afraid to be a close circle.
- Apathetic. The patient looks indifferent, not very emotional, obediently attends medical procedures, takes medicines. His own fate does not seem to interest him.
Apathy is also manifested in everyday life: the interest in favorite activities and communication disappears.
- Egocentric. Disease becomes the basis of life, a way to get benefits, so the patient diligently demonstrates to those around him how unhappy he is, purposefully demanding attention to his own person, constantly talking about his illness.
- Dysphoric. Characterized by the emergence of severe hatred towards those who are healthy. Patients tend to show aggression, oppress friends and relatives, demanding to carry out each order.
- Paranoiac The patient is convinced that the disease has arisen because of someone's actions, or believes that in fact he is not sick at all, and the symptoms are a consequence of the action of the drugs (HIV dissidents as an example). Fears of taking medication and going to the hospital.
- Euphoric (also called anosognosic). The patient shows a blatant carelessness, his mood is heightened (there may be tricky), he tends to take as much from life as possible and often ignores medical prescriptions, may refuse to be examined and treated, forgets to take medicines or does not drink them at all, does not follow the diet. His motto: "Somehow it will pass by itself."
Also, experts highlight nosophilic attitude to the disease, in which the patient associates the disease with something pleasant, because they will take care of him, he will receive attention and will be unable to do almost nothing, and nosophobic - The patient is afraid of the disease, sometimes panicky, exaggerating his feelings.
"Clean" Types of attitudes towards the disease are rare, usually each person has several types of traits.
To determine the relationship to the disease, psychologists use TOBOL method, which is a questionnaire, which consists of tables. The patient chooses the statements that best suit him, and the psychologist counts the points and draws conclusions.
It is important to note that the most pronounced reaction to the disease is present in cases when the disease is serious. And the more dangerous it is, the brighter the reaction is, as a rule.
The most significant in this regard are the reactions of people with cancer, since this group of diseases most unpredictable and has an increased mortality. Fear of these diseases is extremely strong in society.
There is no specific typology of reactions to oncological disease: the same classification, developed by A. E. Licko, is applied when assessing the relationship.
The harder the oncological disease the fewer people treat him harmoniously.
Anxiety, apathy, and depression are common in cancer patients.
About 22% of people with malignant neoplasms suffer from post-traumatic stress disorder, which developed after information about the presence of a diagnosis.
Stages
There are the following steps:
- Pre-medical stage. A person first appears symptoms of the disease, and he may ignore them, ignore, for example, drink painkillers instead of visiting a hospital, come up with explanations like these: “Well, this is the weather has changed, so the head and hurts”, “It's just fatigue". This period can be both very short and long, depending on the decisions of the person and the characteristics of symptomatic manifestations.
- Stage of destruction of the usual living conditions. A person goes to the hospital or gets into it through an ambulance, he is diagnosed and hospitalized. All his usual life crumbles, he can feel a massive gamut of negative feelings, such as fear, anxiety, depression, melancholy, anger, helplessness, doubt, uncertainty.
- Stage adaptation. Negative emotions become less pronounced as the discomfort has decreased due to the actions of the doctors. The patient gradually becomes accustomed to the fact that he has a disease, but may, during this period, begin to actively seek information about the disease, treatment methods and prognosis.
- Capitulation, humility. The patient feels melancholy, ceases to seek information about the disease and humbly complies with the medical prescriptions.
- Stage of development of mechanisms to help live on and cope with the disease. There may be installations associated with seeking benefits from the current situation.
At each stage, there may be a definite relationship to the disease, which may vary, depending on projections and physical well-being.
How are relatives related to the child's illness?
Many parents sincerely want their children to grow up happy and healthy, and do everything in their power to do this. But, unfortunately, some children have certain problems with somatic health. The more serious the illness of the child, the harder it is for a parent to stay calm.
When parents find out that their child is seriously ill, they go through the following steps:
- Shock. Parents are experiencing the strongest stress, unconsciously begin to look for someone to blame for the fact that the baby is sick, they can start blaming each other. Also, parents may begin to experience disgust and hatred for a child that is different from healthy children.
- Negation. Parents can not recognize that their child is sick, trying to deny this fact in the process of dialogue with other people.
- Bargain. They begin to look for information about the disease, look at information about experimental and non-traditional methods of treatment.
- Depression. When it becomes clear to them that it is impossible or extremely difficult to cure a child, they feel helpless, feel grief, depression, as if their child has already died.
- Adoption. Parents accept the fact that the child is sick, support him and continue the treatment.
Attitude towards a sick child father and mother may not be the same. Mothers are characterized by the desire to be more often with the child, to help him in everything, including hyper-care, and fathers tend to move away from the family.
A fairly significant percentage of fathers may decide to leave the mother and child.
Connection with its overcoming
Of course, the more sensible the patient’s attitude to the disease, the easier it will be for him to cope on the road to recovery or remission.
But in practice, quite a significant percentage of patients have reactions far from the harmonic type.
These features make it difficult for medical personnel to work, make close people move away from the patient.
Risks of developing mental illness or exacerbation of those that were previously increase.
Change the attitude to the disease help psychologists and psychotherapists.
But the main problem is that many patients do not believe that they need to go to such specialists. Therefore, it is important for loved ones to try persuade them to make an appointment.
- Try to explain to the person that he needs professional support and that receiving it is normal;
- let him know that they are ready to help;
- offer specific help: tell us which psychotherapist helped you or another loved one, preferably to someone the patient knows, show specific websites, books designed for self-help;
- Tell us about the positive experience of people who turned for help and how attitude to the disease increases the likelihood of a positive outcome (for example, the oncological mortality rate for people with depression is 26% higher, and for those who suffer from severe forms, by 39-40%).
Adequate attitude to the disease will help a person to cope with it, to maintain composure and be happy.
Types of people at the time of illness:
