En teoretisk undersأ¸gelse af angst i forbindelse med brystkrأ¦ft 2015-09-15آ  En teoretisk undersأ¸gelse

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Text of En teoretisk undersأ¸gelse af angst i forbindelse med brystkrأ¦ft 2015-09-15آ  En teoretisk...

  • En teoretisk undersøgelse af angst i forbindelse

    med brystkræft set ud fra et eksistentielt og

    psykodynamisk perspektiv

    Maria Sederstrøm Kristensen , UK-V, Studienummer: 20104190

    Rapportens samlede antal tegn: 184.666 10.semester, Kandidatspeciale i

    Svarende til antal normalsider: 76,9 Psykologi

    Vejleder: Mette Thuesen Aalborg Universitet

    16. september, 2015

  • Dette speciale er udarbejdet af:

    __________________________________

    Maria Sederstrøm Kristensen

  • Abstract

    This study examines the understanding and treatment of anxiety related to breast

    cancer from an existential and a psychodynamic perspective.

    To explore the aspects of anxiety related to breast cancer this study makes use of a

    number of psychological theories with foundation in existential and psychodynamic

    theories. This is supplemented with the use of literature and empirical studies on health

    psychology, supporting the existential and psychodynamic theories, when

    investigating the understanding and treatment of women with anxiety caused by breast

    cancer.

    To investigate the existential perspective on anxiety related to breast cancer the focus

    is manly on the assumption that anxiety appears when the individual is confronted with

    four existential life conditions; death, freedom, isolation and meaninglessness.

    The psychodynamic perspective explores the anxiety experienced by women with

    breast cancer by focusing on different theories on anxiety. The development of anxiety

    in women with breast cancer can be understood to be caused by the reproduction of

    one or more traumatic experiences during early childhood, or as separation anxiety

    caused by separation or threat of separation from primary caretakers. Furthermore,

    anxiety can also be caused by a traumatic incident such as breast cancer, depending on

    the individual’s vulnerability. Another factor that potentially may increase the anxiety

    in women with breast cancer is the women’s own narcissistic traits as they feel an

    inability to live up to the ideals of the modern society.

    When treating women with anxiety related to breast cancer using existential

    psychotherapy, the focus is mainly on the therapeutic relationship. In addition to this,

    existential psychotherapy concentrate on the four existential life conditions mentioned

    above, in an attempt to decrease or confront the anxiety by increasing the client’s

    awareness of her own mortality and responsibility of her life situation, as well as

    confronting her with her isolation anxiety and encouraging her to involve herself in

    life, when the situation seems meaningless.

  • Psychodynamic psychotherapy in women with anxiety related to breast cancer centers

    around psychotherapeutic methods and phenomenons such as the unconscious mind,

    transference, countertransference and defense mechanisms. These methods are used to

    examine the anxiety and hidden feelings underneath the anxiety.

    The therapeutic alliance may face problems, when treating a woman with anxiety

    related to breast cancer e.g. if the client has narcissistic traits or the therapist takes on

    the role as the savior.

    Furthermore, it is found that the anxiety related to breast cancer can have positive

    effects if e.g. it helps to change the women’s view on life.

  • Indhold 1. Indledning ..................................................................................................................................1

    1.1. Introduktion........................................................................................................................ 1

    1.2. Problemformulering ........................................................................................................... 3

    1.3. Afgrænsning og problemfelt .............................................................................................. 3

    1.4. Begrebsafklaring ................................................................................................................ 4

    1.4.1. Angst ............................................................................................................................4

    1.4.2. Frygt .............................................................................................................................5

    1.4.3. Traume : .......................................................................................................................6

    1.5. Forekomst .......................................................................................................................... 6

    1.5.1. Forekomst af angst .......................................................................................................6

    1.5.2. Forekomst af brystkræft ...............................................................................................6

    1.6. Læsevejledning og disposition ........................................................................................... 7

    2. Metode .......................................................................................................................................9

    2.1. Metodiske overvejelser ...................................................................................................... 9

    2.2. Valg af teori ..................................................................................................................... 10

    3. Teori .........................................................................................................................................14

    3.1. Eksistentiel tilgang til angst i forbindelse med brystkræft ............................................... 14

    3.1.1. Døden .........................................................................................................................15

    3.1.1.1. Dødsangst i barndommen ....................................................................................16

    3.1.1.2. Forsvar og omformning af angsten .....................................................................17

    3.1.2. Frihed, ansvar og den dertilhørende isolation ............................................................21

    3.1.3. Meningsløshed ...........................................................................................................23

    3.2 Psykodynamisk tilgang til angst i forbindelse med brystkræft ......................................... 25

    3.2.1. Freuds angstteorier .....................................................................................................26

    3.2.1.1. Neurotisk angst ...................................................................................................26

    3.2.1.2. Signalangst ..........................................................................................................27

    3.2.1.3. Realangst .............................................................................................................29

    3.2.2. Separationsangst.........................................................................................................29

    3.2.3. Brystkræft som traume ...............................................................................................30

    3.2.4. Narcissisme ................................................................................................................32

    3.2.4.1. Psykodynamisk tilgang til narcissisme ...............................................................33

  • 3.2.4.2. Normal narcissisme .............................................................................................33

    3.2.4.3. Patologisk narcissisme ........................................................................................34

    3.3. Behandling med eksistentiel psykoterapi ......................................................................... 36

    3.3.1.Døden ..........................................................................................................................36

    3.3.1.1. Sikkerhed og mestring ........................................................................................38

    3.3.1.2. Problematikker i eksistentiel psykoterapi omkring døden ..................................40

    3.3.2. Psykoterapeutisk arbejde med frihed og ansvar .........................................................41

    3.3.3. Eksistentiel psykoterapi i forhold til isolation ...........................................................43

    3.3.3.1. Relationen mellem klient og terapeut .................................................................44

    3.3.4. Psykoterapi og meningsløshed ...................................................................................45

    3.4. Behandling med psykodynamisk psykoterapi .................................................................. 47

    3.4.1. Det ubevidste .............................................................................................................48

    3.4.2. Fri association ............................................................................................................49

    3.4.3. Overføring og modoverføring ........................................................................