Thursday, Oct. 19
10:45 – 11:45 (1 hr)
Meeting Room: Port McNeill (4th floor – North Tower)
Joseph Burley*, M.D; Casimiro Cabrera Abreu, MD.

CanMEDS Roles:

1. Communicator
2. Professional
3. Collaborator

At the end of this session, participants will be able to: 1) Understand the importance of meaning in diagnosing and treating mental disorders; 2) Be aware of their beliefs about meaning and suffering; and 3) Recognize the importance of whole person–centered lived experience in exploring meaning.

The experience of mental illness is often (always?) immersed in the existential reality of suffering. It is accompanied by feelings of passivity, helplessness, and puzzlement. Jasper’s limit situations describe paradoxical life events (antimonies) through which there appear to be no solutions. Mental illness can be seen as a limit situation, which Jaspers considered an underlying cause of mental illness. Manualized psychotherapy and our DSM diagnostic approach encourages us to make a diagnosis and apply some form of therapy. However, patients come to us with underlying questions that need to be addressed, such as, “Why is this happening?”; “Have I done something to deserve this?”; “Should I just die?”. Suffering without reason leaves us feeling trapped and robs us of meaning.
Jaspers and Frankl interpreted limit situations as related to existential themes, including guilt, randomness, suffering, conflict, love, death, illness as punishment etc. These are common themes underlying the suffering in our patients’ illness experience and beliefs related to developmental and life-world experience. Jaspers and Frankl believed that healing occurs via understanding the inner experience of the whole person. Although not always explicit, we often wrestle with these meaning-related issues as part of psychiatric care. Psychiatry requires that we be willing to explore these issues in ourselves and our patients.
This workshop will discuss finding and understanding meaning through relationship, dialogue, creativity, and responsibility as a way through their suffering.

References:

1. Slade M, Oades L, Jarden, A, editors. Wellbeing, recovery and mental health. Cambridge (GB): Cambridge University Press; 2017.
2. Mundt C. Jasper’s concept of limit situation. In: Fuchs T, Mundt C, Breyer T, editors. Karl Jaspers’ philosophy and psychopathology. Springer (NY): 2014.