• Title/Summary/Keyword: unconscious desire

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Factors Influencing the Pros and Opposite of Life-Sustaining Treatment in the Elderly: Focusing on the Values of Cohabitation with Children and the Cost of Living in Old Age (노인의 연명의료에 대한 찬반 의견에 영향을 미치는 요인: 자녀동거와 노후생활비에 대한 가치관을 중심으로)

  • Mee-Ae Lee
    • Journal of Industrial Convergence
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    • v.21 no.3
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    • pp.159-169
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    • 2023
  • This study analyzed the factors affecting the opinions of life-sustaining treatment among the elderly in Korea. The study subjects were 10,097 people who responded to the survey on the condition of the elderly (2020), and using the SPSS 25.0 program, first, the demographic characteristics of the research subjects were identified through descriptive statistics and the average and normality of major variables were identified. Second, the chi-square was analyzed by conducting a cross-analysis of opinions on life-sustaining treatment according to the characteristics of the elderly. Third, a correlation analysis was performed to analyze the correlation between major variables. Fourth, the relative influence on the life-sustaining treatment of the elderly was identified through multiple regression analysis. The main research findings are as follows. First, 8,565 (84.8%) of the elderly were opposed to medical treatment (life-sustaining treatment) to save them even if they were unconscious or difficult to live. Second, as a result of cross-analysis on life-sustaining treatment for the elderly, the 𝑥2 values of education level, health status, living together with children, and cost of living in old age were found to be significant. Third, the educational level of the elderly, living together with children, and the cost of living in old age were found to have statistically significant negative effects on life-sustaining treatment. Such research results indicate that the elderly with a high level of education oppose life-sustaining treatment compared to those with a low level of education. In addition, in the case of the elderly with traditional values who responded that one of their children should live with the elderly (parents), the ratio of people in favor of life-sustaining treatment was high, and in the case of the elderly with modern values who responded that they did not have to live together, the ratio of opposition to life-sustaining treatment was high. appeared to be high. In addition, in the case of the elderly with traditional values who responded that the burden of living expenses in old age should be shared between the state and society and their children, the proportion in favor of life-sustaining treatment was high. This high figure expressed the desire for well-dying. Based on these research results, the value system was re-examined as a factor influencing the elderly's opinion on life-sustaining treatment, and basic data for welfare policies for the elderly were provided.

Psychotherapy for Somatoform Disorder (신체형 장애의 정신치료)

  • Lee, Moo-Suk
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.269-276
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    • 1996
  • A theroretical study was made on the psychodynamism of somatoform disorder. Somatoform disorder is caused by a defense mechanism of somatization. Somatization is the tendency to react to stimuli(drives, defenses, and conflict between them) physically rather than psychically(Moore, 1990). Ford(1983) said it is a way of life, and Dunbar(1954) said it is the shift of psychic energy toward expression in somatic symptoms. As used by Max Shur(1955), somatization links symptom formation to the regression that may occur in response to acute and chronic conflict. In the neurotic individual psychic conflict often provokes regressive phenomena that may include somatic manifestations characteristic of an earlier developmental phase. Schur calls this resomatization. Pain is the most common example of a somatization reaction to conflict. The pain has an unconscious significance derived from childhood experiences. It is used to win love, to punish misdeeds, as well as a means to amend. Among all pains, chest pain has a special meaning. Generally speaking, 'I have pain in my chest' is about the same as 'I have pain in my mind'. The chest represent the mind, and the mind reminds us about the heart. So we have a high tendency to recognize mental pain as cardiac pain. Kellner(1990) said rage and hostility, especially repressed hostility, are important factors in somatization. In 'Psychoanalytic Observation on Cardiac Pain', psychoanalyst Bacon(1953) presented clinical cases of patients who complained of cardiac pain in a psychoanalytic session that spread from the left side of their chests down their left arms. The pain was from rage and fear which came after their desire to be loved was frustrated by the analyet. She said desires related to cardiac pain were dependency needs and aggressions. Empatic relationship and therapeutic alliances are indispensable to psychotherapy in somatoform disorder. The beginning of therapy is to discover a precipitating event from the time their symptoms have started and to help the patient understand a relation between the symptom and precipitating event. Its remedial process is to find and interpret a intrapsychic conflict shown through the symptoms of the patient. Three cases of somatoform disorder patients treated based on this therapeutic method were introduced. The firt patient, Mr. H, had been suffering from hysterical aphasia with repressed rage as ie psychodynamic cause. An interpretation related to the precipitating event was given by written communication, and he recovered from his aphasia after 3 days of the session. The second patient was a dentist in a cardiac neurosis with agitation and hypochondriasis, whose psychodynamism was caused by a fear that he might lose his father's love. His symptom was also interpreted in relation to the precipitating event. It showed the patient a child-within afraid of losing his father's love. His condition improved after getting a didactic interpretation which told him, to be master of himself, The third patient was a lady transferred from the deparment of internal medicine. She had a frequent and violent fit of chest pains, whose psychodynamic cause was separation anxiety and a rage due to the frustration of dependency needs. Her symptom vanished dramatically when she wore a holler EKG monitor and did not occur during monitoring. By this experience she found her symptom was a psychogenic one, and a therapeutic alliance was formed. later in reguar psychotherapy sessions, she was told the relaton between symptoms and precipitating events. Through this she understood that her separation anxiety was connected to the symptom and she became less terrifide when it occurred. Now she can travel abroad and take well part in social activities.

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