Illness and personality maturation: The search for meaning in severe illness

Abstract

Background In scientific literature, when the consequences of illness are discussed, one finds that the deficit perspective is prevailing: Illness as the cause for loss of abilities and a loss of contentment. On the other hand, particularly with creative people, an increase of creativity can be observed, following a confrontation with and having endured a period of illness. When one considers the occurrence of illness retrospectively in a biographical context, one may find often a biographical standstill. Although illness and disease are considered as a collapse, one may observe also psycho-spiritual maturation processes during the confrontation with illness. In several cases illness can thus result in personality maturation and a higher level of psychological health. Aims Despite of the fact that this phenomenon is known and communicated, little attention is paid to this aspect within the professional health care system. Thus we interviewed patients with respect to their opinion on the meaning of serious illnesses (narrative interviews; content analysis/structural hermeneutics), and run empirical investigations using the BioBeKe and AKU questionnaire. Methods The BioBeKe was developed to address the biographical consequences of chronic disease and consists of 2 item pools: The negative impact of disease is described by 2 factors (19 items, Cronbach′s alpha=0.96): Constraints of Life and Development; Resignation. The positive impact is described by 3 factors (20 items, Cronbach′s alpha=0.94): Life Reflection; Appraisal of Life; Social Contacts. Results Among the 96 individuals investigated so far, the positive factors were ranked higher than the negative factors. Univariate variance analyses revealed that age had a significant influence on Constraints (F=3.4), the educational level on Resignation ( F =4.8), the educational level and disease on Appraisal ( F =2.5), and age and education on Social Contacts, while none of these variables had a significant impact on Life Reflection. The negative factors correlated strongly with Escape from illness ( r >0.6), and negatively with life satisfaction ( r >−0.5), while the positive factors correlated with Reappraisal: Illness as Chance ( r >0.6). Particularly, Reflection and Appraisal correlated with intrinsic religiosity ( r =0.4). Preliminary results from 8 narrative interviews indicated that several patients believe that their illness experience triggered a ‘learning process’, resulting in a reconsideration of their lives and ascribed values to it. The process entailed also an opening towards transcendental/religious aspects, helping them to ‘make sense’ of their experience. Conclusions Although the study is still ongoing, the first results encourage to include biographical aspects into the doctor–patient discourse, and to learn how to address the topic of the search for meaning.