DR. Indria L. Gamayanti, MSi
We are ”burnt” by our
anger
“trembling” caused of
fear
Being ”chocked” by our
sadness
Anger
• Boiling the blood, …
• Causes the body releasing chemicals and
hormones : adrenaline and noradrenaline,
alter the function of the heart, degree of
constriction of dilation of arteries.
• Effecting blood pressure, headache, heart
attack, stroke and kidney problems.
Worry, anxiety and fear
• Worry causes the body produce chemical
acetylcholine which causes the airways to contract.
Fear causes the body to secrete epinephrine or
adrenaline
• Uncertainty creates devastating kind of stress
response
• Shortness of breath, palpitations, chest pain or
discomfort, chocking or smothering sensation,
dizziness, vertigo
• Create negative expectations
Depression and Despair
• Much more than occasional sad mood,
involves quitting or giving up
• Cause the disruption of normal life balance,
loss, conflict or trauma.
• Can be a symptom of an illness or a
medication side effect, PMS
• A clinical syndrome based on neurochemicals
Loneliness
• Being alone doesn’t necessary mean lonely,
but many people who are alone are lonely.
• Connected to premature death, physical and
mental disorder, bodily immune function.
Altruism and Optimistm
• Protect person from stress
• Stimulates the brain to release endorphins,
powerful natural painkiller.
• Optimists related to better health, better
immune and live longer
Causal Attributions, feelings of control, and recovery
from myocardial infarction
Studies of patients recovering from myocardial infarction
(MI) illustrate the importance of both causal attribution for
illness and feelings of control.
In one study, patients were asked
(1) Why they thought they had a heart attack and
(2) What health measures they planned to take as a
result of the attack
Several months later, their work and social functioning were
measured.
Patients who attributed the cause of their MI to modifiable
factors under their personal control ( such as stress or
smoking) were more likely to have initiated active plans for their
recovery. For example changing jobs or starting exercise, and
to have returned to work and resumed other activities.
In contrast patients who attributed the MI to external factors
beyond their personal control ( such as bad luck or fate, for
instance ) were less likely to have generated active plans for
recovery or to have returned to work; they were also less likely
to have resumed other activities.
Another research by Bar- On ( 1987) :
If the patient’s attributions were to external, uncontrollable
factors or if the patient denied the infarct, the progress on
long term rehabilitation were less.
If the attribution to internal and controllable factors may have
counter-acted the patients’ tendency toward denial, nudging
him in the direction of becoming more aware of the things he
could do to reduce his risk for a second heart attack.
The result suggest that when illness condition are
perceived as being modifiable and under one’s
personal control, the process of recovery from
chronic disease is enhanced.
Moreover, these kinds of perceptions may be even
more important predictors of successful
rehabilitation than more traditional physical cues
employed by physicians in predicting rehabilitation
( Affleck et al and Bar – On in Taylor, 1995 )
A fifty five years old woman who was admitted to the
hospital with a lesion in the upper lobe of her lung. She is l
dynamic, vigorous and friendly.
When the woman underwent biopsy, it revealed a deadly
cancer that had already invaded the nodes; the surgeons
could not remove it, so they close the incision. The next day
a group of residents and interns surrounded her bed. One of
them looked down and said’ : Well, it’s cancer, and we
couldn’t really operated, so we just opened and closed.
The patient kept repeating the question, “ opened and
closed?” “ You mean you left the cancer there?”. “Yes.” he
replied. She closed her eyes and told the interns she was
tired. They left the room
The woman died that night. When she was taken to
autopsy, there was no specific cause of death – just
the cancer, but it had been there for months.
Alexandra M. Levine Los Angeles physician wrote :
“I don’t really know why she died, but to be honest, I
will always believe that she died because all hope had
been taken away from her……… “
“The resident’s words took away her hope, and I
honestly believe, as crazy as it may seem, that those
words took away some of her potential lifetime”.
Two oncologists on their discussion of metastatic
lung cancer :
One of the physicians complained bitterly : “ You know, Bob, I
just don’t understand it. We used the same drugs, the same
dosage, the same schedule and the same criteria. Yet I got a
22 % response rate and you got 74 %. How do you do it ? “
The other responded : “We’re both using Etoposide, Platinol,
Oncovin and Hydroxyurea. You call yours EPOH. I tell my
patients I’m giving them HOPE. Sure, I tell them this is
experimental, and we go over the long list of side effects
together. But I emphasize that we have change. As dismal the
statistics are for non-small cell, there are always a few percent
to do really well.”
Hope
• Hope is a pragmatic, goal-oriented attitude, a stance
a person assumes in the face of difficulty
• Hopeless is marked by negative future expectations
and the belief that the future holds nothing good or
positive. People who feel hopeless also usually feel
despondent, desperate and despairing. They feel that
they have lost control and feel helpless about what
the future holds.
The impact of hope on health
Is not just a mental state : it causes specific
electrochemical changes in the body that not
only the strength of the immune system but
can even influence the working of individual
organs in the body
Real hope, unlike false hope
• It is not a tranquilizer for creating a mood of
synthetic calm”.
• It is a way of putting the human spirit to work; a way
of respecting the desire of a patient to confront a
new challenge: a way of summoning all one’s
strength and resources in the most important fight of
one’s life.
No one would argue against the logic and necessity
for a patient to reach out for the best medical help
available
Patient’s hope
• Hope for being cured and having “normal” life
again
• Hope for the other attitude toward him/her
Likeable or favorite
supporting doctor ?
Hope, faith, love and a strong will to live offer no promise
of immortality, only proof of our uniqueness as human
beings and the opportunity to experience full growth even
under the grimmest circumstances.
The clock provides only a technical measurement of how
long we live. Far more real than the ticking of time is the
way we open up the minutes and invest them with
meaning.
The ultimate tragedy is to die without discovering the
possibilities of full growth.