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Published on: January 15, 2017
The 'chessboard of healing strategies': A cardiological application
Drew Leder1, Mitchell W Krucoff2
1Philosophy Department, Loyola University Maryland, Baltimore, Maryland, USA.
Insights
Patients and clinicians can improve coping with chronic illness by understanding adaptive strategies for bodily impairment. This involves exploring diverse healing approaches beyond standard biomedical treatments for better resilience.
Area of Science:
- Medical Humanities
- Philosophy of Medicine
- Psychology
Background:
- Adaptive coping with chronic illness, aging, and bodily impairment is vital but often secondary to biomedical treatments.
- Understanding patient and clinician strategies for managing long-term health conditions is crucial.
Purpose of the Study:
- To examine the range of strategies available for patients and practitioners facing bodily breakdown.
- To explore how clinicians can facilitate existential healing and adaptive resilience in patients with chronic conditions.
Main Methods:
- A detailed case study of a patient with myocardial infarction and chronic heart failure.
- Analysis of effective and suboptimal care scenarios.
- Philosophical and clinical perspectives on patient experiences.
Main Results:
- Introduction of a "chessboard of healing" framework outlining constructive coping strategies.
- Strategies are grounded in the phenomenology of the lived body.
- Identified patient responses include 'moving towards' (listening, befriending) or 'moving away' (ignoring, detaching) from the body.
Conclusions:
- The "chessboard of healing" offers a structured approach to managing chronic impairment.
- Existential healing involves fostering adaptive and creative resilience.
- Patients can navigate bodily changes through restoration or transformation, potentially leading to new life narratives.
Rationale:
The question of how to adaptively cope with chronic illnesses, aging, and other sources of bodily impairment is crucial for patients and clinicians alike, though sometimes overlooked in the focus on biomedical treatment.
Aims And Objectives:
To examine the array of strategies available to patients and their practitioners, to employ in the face of bodily breakdown.
Method:
Co-written by a philosopher and cardiologist, this article uses a detailed case study of a patient suffering a myocardial infarction leading to chronic heart failure, with examples of effective or suboptimal care. This enables a discussion of how the clinician or clinical team can best facilitate existential healing, that is, adaptive and creative resilience in the face of chronic impairment.
Results And Conclusions:
We outline a "chessboard of healing," involving the possibility-spaces for dealing constructively with bodily breakdown. This set of strategies is shown to be nonarbitrary, drawn directly from contemporary work on the phenomenology of the lived body. For example, as we both experience the body as that which 'I am', and as that which 'I have', separable from the self, patients can react to illness by moving towards their bodies in modes of listening and befriending, or away from their body, ignoring or detaching themselves from symptoms. Then too, as the body is ever changing in time, one can seek restoration to a previous state, or transformation to new patterns of bodily usage, including passage into a whole new life-narrative.
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