The role of the fear-of-loss-of-control marker within the accounts of people affected by dementia about their illness: implications for psychotherapy

Abstract

One way research can explore the psychological and social factors underlying the awareness of people affected by dementia about their illness is by intensive examination of the process of psychological change as it occurs both within psychotherapy and in ordinary life. The assimilation model describes a series of stages through which clients' problematic experiences are hypothesized to progress during successful psychotherapy. Markers of assimilation stages are recognizable types of events in psychotherapy discourse that are linked to those stages and which may be useful both clinically and in research. This paper describes how the fear-of-losing-control marker may operate in the accounts of people affected by dementia. Analysis of examples of the fear-of-loss-of-control marker suggests that it is associated with avoidance of referring to dementia by name (referred to here as the Voldemort phenomena), the experiences of shame and fears of the loss of self, for instance expressed as concerns about becoming mad. Implications for dementia care and for post-diagnostic therapy are considered