American Journal of Psychiatry and Neuroscience
Volume 6, Issue 3, September 2018, Pages: 61-66
Received: Jun. 19, 2018;
Accepted: Jul. 24, 2018;
Published: Aug. 28, 2018
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Jérôme Alric, Department of Palliative Care, University Center Hospital, Montpellier, France; The Research Laboratory Interdisciplinary Center, University of Paris Est, Marne-la-Vallée, France
Bénézech Jean-Pierre, Department of Palliative Care, University Center Hospital, Montpellier, France
Today within the sphere of chronic pain, the mechanism of fear avoidance is a well-known concept that has been substantiated through international literature in the field. As patients believe that work and physical activity will aggravate their pain, the logical response is to progressively implement avoidance strategies for particular physical movements. This will thus tend to perpetuate a feedback loop: pain - non-confrontation - weakening - pain. In this article, we aim to show that this concept is transferable to the field of serious illness and palliative care, even if the term is used differently on a therapeutic level. The idea of avoidance here relates to death and can be defined in the following way: fear of death/distress - non-confrontation regarding death – life/death instinct ambivalence. Because of this psychological life-saving mechanism, the subject who is ill remains in the stage of life/death instinct ambivalence, in other words, living. The implications of this model for clinical practice are completely new, whether applied at the moment of diagnosis, during the psychological experience that accompanies the illness or even in the aforementioned final phase of life. the mechanism of fear avoidance represents a real life-saving defence, whether from the moment of diagnosis of serious illness, during the psychological process that accompanies the illness, or in the final moment of death, allows the patient to die, psychologically speaking, more comfortably.
Fear Avoidance as the Body’s Defence Mechanism for Death, American Journal of Psychiatry and Neuroscience.
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