Volitional collapse (loss of the will to live) in patients with burn injuries. Treatment strategy

Volitional collapse, or loss of the will to live, remains one of the most vexing of the various system failures complicating serious illness or injury. It resembles, but is distinguishable from, major depression. Two features of volitional collapse may sometimes be turned to therapeutic advantage: it releases the patient from a struggle that may be dissipating already depleted energy reserves, and it transfers survival responsibility from one who has given up to others who have not. Preferred treatment involves carefully orchestrated initiatives from the patient's physician, closest friend, and spouse; their leverage derives from traditional sources, most importantly psychologic transference, bonding, and conjugal commitment. A burn unit provides an ideal environment in which to study the disorder and its response to treatment.