PSYCHOSOCIAL FACTORS
AFFECTING PHYSICAL ILLNESS
Dr Tabassum Alvi
Assistant Professor Psychiatry/Behavioural Sciences
Majmaah University
OUTLINE
• Objectives
• Brain storming
• Acceptance of illness-stages
• Non-acceptance
• Defense mechanism
• Factors in acceptance of illness
• influence of culture on disease and treatment
• Q&A
• Conclude
OBJECTIVES
• At the end of session the student should be able to:
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Explain the concept of “acceptance of illnesses”
Explain the “non acceptance of illness” and defense mechanisms.
Identify Psychological factors affecting the acceptance of mode of treatment
Discuss the influence of other members of the society on disease
Discuss the influence of culture on disease and treatment
BRAINSTORMING
ACCEPTANCE OF ILLNESSES
Denial
Acceptance
Grief
Anger
Fear
NON-ACCEPTANCE OF ILLNESS
• Not uncommon phenomenon
• Delays help seeking
• May worsen outcome
• Increases risk of Depression
• Indicates hopelessness
• May need more education/awareness
• Challenge for health provider
DEFENSE MECHANISM
“ Manners in which we behave or think in certain ways to better
protect or “defend” ourselves. Defense mechanisms are one way of
looking at how people distance themselves from a full awareness of
unpleasant thoughts, feelings and behaviors”
Its and unconscious phenomenon!
DEFENSE MECHANISMS
• DENIAL: Refusal to accept reality.
Example?
• ACTING OUT: extreme behavior in order to express thoughts or
feelings the person feels incapable of otherwise expressing.
Example?
• DISSOCIATION: Disconnect from the real world
Example?
Contd…
• INTELLECTUALIZATION:
using knowledge and jargons to think/show otherwise. Separating an
emotion from an idea or thought because the emotional reaction is too
painful to be acknowledged.
Example?
• RATIONALIZATION: offering a different explanation for one’s
perceptions
Example?
• COMPENSATION: counterbalancing perceived weakness with strength
in other areas.
Example?
Displacement
Discharging pent-up feelings on people less dangerous
than those who initially aroused the emotion.
Example ?
Identification
Unconscious assumption of similarity between oneself
and another.
Example ?
Projection
Unacceptable feelings disguised by repression of the real
feeling and by reinforcement of the opposite feeling.
Example?
FACTORS IN ACCEPTANCE OF ILLNESSES
• Universal phenomenon
• Individualized responses
• Nature of illness
• Stigma related to illness
• Past personal experience
• Family history
• Coping skills
• Comorbid psychiatric problem
INFLUENCE OF CULTURE ON DISEASE AND
TREATMENT
“Culture is a pattern of ideas, customs and behaviors
shared by a particular people or society”
Contd….
• Evil spirit VS Germ theory
• Depression VS Crazy/Mad
• Strong VS obese
• Epilepsy/Jadoo
• Expressing pain means “you are weak”
• Doctor VS Alternative care providers
• Doctor: Helper or a Master
• Antibiotics are “heavy” or acidic in nature
• Treatment means ‘injection’ and drips
Contd….
• Please do not tell my mother she may not tolerate this news.
Family VS patient OR both
• Vaccine conspiracy theory: Polio is for infertility!
• Having TB is shameful
• HIV means this person was involved in inappropriate activities.
• “Gas syndrome” British Pakistani women
• Cold and hot concept of food
Q&A
CONCLUDE
Students to summarize!