Dementia and existential threat: Negotiating the fear of a loss of control

Cheston, Richard

Abstract

Aim: Psychotherapy is increasingly being offered to people who are living with dementia, as a way of helping them to talk more openly about their illness without, at the same time being overwhelmed by the existential threat that dementia represents. The aim of this study was to explore the way in which accounts of dementia changed over the course of a 10-week psychotherapy group for people with mild levels of dementia.

Method: A consensus group of three psychotherapists used an adapted form of APES to rate each passage in which one participant (Robert) diagnosed with Alzheimer’s disease, referred to his dementia. Raters were blind to session order.

Results: Robert’s accounts of his dementia changed over the course of the group: at first, the dementia was warded off (“I don’t think anyone in this room has got Alzheimer’s” session 4), before its’ existence was acknowledged, first angrily (“Now the problem with Alzheimer’s as it affects me” session 5), then humorously (“So I asked, ‘well if it’s the onset, what happens when you’re there” session 7). Finally, Robert associated his initial reluctance to acknowledge his dementia as stemming from a concern that he had been going mad (“It frightened me because I thought, well, I’m going mad, I’m going crazy” session 9).

Discussion: Robert’s transition towards acknowledging his dementia appeared to be facilitated by hearing other group members articulate their concerns about dementia. The central role that a fear of loss of control plays in this process will be discussed.

Citation

Cheston, R. Dementia and existential threat: Negotiating the fear of a loss of control. Paper presented at European Chapter of the Society for Psychotherapy Research

• Presentation Conference Type: Conference Paper (unpublished)
• Conference Name: European Chapter of the Society for Psychotherapy Research
• Acceptance Date: Sep 21, 2017
• Publication Date: Jan 1, 2017
• Publicly Available Date: Jun 7, 2019
• Peer Reviewed: Not Peer Reviewed
• Keywords: psychotherapy, assimilation, dementia, Alzheimer’s disease, groups, threat
• Public URL: https://uwe-repository.worktribe.com/output/901522
• Additional Information: Title of Conference or Conference Proceedings : European Chapter of the Society for Psychotherapy Research