Facing the uncertainties of being a person: On the role of existential vulnerability in personal identity

This paper explores the role of existential vulnerability in the experience of personal identity and how identity is found and created. Existential vulnerabilities mark a boundary between what humans can bring about willfully or manipulate to their advantage and what is resistant to such actions. These vulnerabilities have their origin, on an ontological level, in fundamental conditions of human existence. At the same time, they have implications on a psychological level when it comes to self-experience and identity formation. Narrative and value-based identity depend on how a person relates to finitude and the ambiguous side of lived experience. Relational identity depends on how a person relates to existential aloneness and the fact that the meaning and value of our actions are partly out of our control; they are always also dependent on other people’s responses to us. Bodily identity makes us feel continuous and real, but at the same time vulnerable to death and the gaze and actions of others. Being ‘thrown’ into an arbitrary life context is also a form of existential vulnerability. Authentic psychological identities can develop by giving meaning to these circumstances and balancing acceptance of existential vulnerability with the courage to make choices and act.publishedVersio

The call of the unlived life: On the psychology of existential guilt

This paper examines the psychology of existential guilt with Martin Heidegger and Rollo May’s conceptualizations as the point of departure. The concept of existential guilt describes preconditions for responsibility and accountability in life choices and the relationship to the potential given in the life of a human. It might also be used as a starting point to examine an individual’s relationship to the potential offered in their life and life context and, in this way, the hitherto unlived life of an individual. The following questions are discussed in contexts of identity development, perfectionism, and current cultural shifts in conceptualizations of selfhood: How can humans relate to the fact that only limited parts of who they might be can ever be actualized? Moreover, how can they relate to the fundamental ambiguity and “groundlessness” in the contexts of life where choices are made? There are striking parallels between the role of exploration in the Eriksonian approaches to healthy identity development and the ontological groundlessness that stands out as a premise for existential guilt. There are also parallels between identity fore-closure and normative identity styles and “falling” into das Man in the existential framework. Perfectionistic ideals easily become an objectivization – and closure – of possible alternatives and choices. In contemporary theories of constructions of selfhood, the dangers of alienation from the community on the one hand and escape into what might become totalitarian collectivism on the other is pointed out. The contextualization of personal responsibility offered through the concept of existential guilt might address both dangers. It provides a perspective on how personal responsibility is embedded in contexts of human relationships, relationships to nature, and the finitude, freedom, uncertainties, and suffering that is given through human existence. Existential guilt can wake sorrow and regret over opportunities overlooked and lost. However, most of all, it can be seen as a drive toward repair in the relationship toward both oneself and the other. It takes the form of receptivity, an openness to a life not yet lived, and creative use of imagination.publishedVersio

Suffering a Healthy Life—On the Existential Dimension of Health

This paper examines the existential context of physical and mental health. Hans Georg Gadamer and The World Health Organization’s conceptualizations are discussed, and current medicalized and idealized views on health are critically examined. The existential dimension of health is explored in the light of theories of selfhood consisting of different parts, Irvin Yalom’s approach to “ultimate concerns” and Martin Heidegger’s conceptualization of “existentials.” We often become aware of health as an existential concern during times of illness, and health and illness can co-exist. The paper discusses how existential suffering in Western culture is described, to an increasing degree, as disorders or psychological deficits, and perfectionistic health goals easily can become a problem. We seek to avoid suffering rather than relate to it, with all the tension that may create. The paper argues that suffering is an unavoidable aspect of people’s experience of their lives, and actively relating to suffering must be regarded as a fundamental aspect of health. The need and usefulness of a concept of “existential health” is discussed.publishedVersio

The Psychometric Properties of the Frost Multidimensional Perfectionism Scale - Brief

Previous psychometric analyses of the Frost Multidimensional Perfectionism Scale and the abbreviated version (FMPS–Brief) have resulted in inconsistent findings regarding the scale’s bidimensionality or unidimensionality. Different studies evaluating the scale with different statistical analyses and comparative samples report different results and recommendations. This study assessed the FMPS-B’s psychometric properties by conducting both confirmatory factor analysis (CFA) and pure bifactor modeling in order to address previous findings and guide future use of the scale. The results indicate that the two-factor model is the best fit. Going forward, the FMPS-B’s subfactors “strivings” and “evaluative concerns” may be studied separately. Implications for future research and challenges in bifactor modeling are discussed.publishedVersio

Perfectionistic individuals' understanding of how painful experiences have shaped their relationship to others

Background: Perfectionism is increasing over time and associated with various mental health problems. Recent research indicates adverse childhood experiences may play a role in the development of perfectionism. In addition, perfectionism is marked by interpersonal problems with implications for treatment outcome. Aim: This study aimed to fill an important gap in the predominantly quantitative literature field by exploring how individuals with perfectionism understand the relationship between painful experiences and how they relate to others. Method: Nine individuals with perfectionism were interviewed using McAdam's life-story interview. Thematic analysis was used to analyze the interviews. Results: Four themes emerged: “A childhood with big responsibilities,” “I am still the responsible one,” “Keeping others at a distance to protect the inner self,” and “Achieving physical distance to get a fresh start.” These themes are grouped into two overarching themes: “You can't always trust people” and “A distancing from others.” Conclusion: Findings highlight taking responsibility and social distancing serve an important function for perfectionistic individuals in response to painful relational events. We discuss how themes of control and agency impact individuals' relationship to mental health and turning toward others for help. The findings provide greater complexity to understanding perfectionism as a “barrier to treatment.”publishedVersio

Do we understand children’s restlessness? Constructing ecologically valid understandings through reflexive cooperation

Attention-deficit/hyperactivity disorder (ADHD) is the most widely used children’s mental health diagnosis today, but the validity of the diagnosis is controversial, for instance, because it might conceal relational and ecological dimensions of restlessness. We invited parents and professionals from one local community in western Norway to participate in cooperative group discussions on how to conceptualize and understand children’s restlessness. We carried out a thematic and reflexive analysis of the cooperative group discussions on ADHD and children’s restlessness, and present findings related to three ecological levels inspired by Bronfenbrenner’s ecological systems model. At the level of the individual, restlessness was discussed as individual trait, as the expectation to be seen and heard, and as a result of traumatization. At the level of dyad, group or family, restlessness was discussed as a relational phenomenon and as parents’ problems. At the level of community, restlessness was discussed as lack of cooperation and lack of structures or resources. Our findings show how contextualized and cooperative reflexivity can contribute to more valid understandings of children’s restlessness, and how cooperative inquiry can stimulate reflections about solidarity and sustainability in relation to adult’s actions.publishedVersio

‘Holding on to regret as a kind of enrichment’–a qualitative exploration of the role that work-related regrets play in therapists’ clinical practice

In this reflexive thematic analysis, we explore 17 psychotherapists’ accounts of work-related regrets. Based on individual interviews with experienced clinical psychologists, we report how they describe these regrets as emotionally intense experiences with potential for development. To communicate how participants view work-related regrets to impact on their clinical practice, we formulated an overarching theme called “holding on to regret as a kind of enrichment.” Three subthemes summarize different aspects of this process: (a) increased awareness; (b) working to accept and model fallibility; and (c) the process of making changes based on regret experiences. We discuss our findings in relation to theory and research, and explore methodological strengths and limitations.publishedVersio

Mindfulness Based Stress Reduction for Academic Evaluation Anxiety: A Naturalistic Longitudinal Study

Mindfulness based stress reduction (MBSR) for academic evaluation anxiety and self-confidence in 70 help-seeking bachelor’s and master’s students was examined. A repeated measures analysis of covariance on the 46 students who completed pretreatment and posttreatment measures (median age = 24 years, 83% women) showed that evaluation anxiety and self-confidence improved. A growth curve analysis with all 70 original participants showed reductions in both cognitive and emotional components of evaluation anxiety, and that reduction continued postintervention. Although more research is needed, this study indicates that MBSR may reduce evaluation anxiety.publishedVersio

Agency in avoidant personality disorder: a narrative review

Objectives: Avoidant personality disorder (AvPD) is a highly prevalent personality disorder, especially in clinical settings, yet scarcely researched. People diagnosed with AvPD have severe impairments in functioning and suffer greatly, yet we still lack meta-analytic evidence for therapy and only a few RCTs are conducted. Patient factors are the most important for outcome in therapy, in general. Lack of agency might be a core deficit in people diagnosed with AvPD. Their conditions might be improved if we understand their agency better. We review previous research regarding psychological mechanisms and interpersonal relationships that facilitate or hinder agency in AvPD in daily life and psychotherapy. Methods: Summarizing original literature in a narrative review with reflexive thematic analysis. Results: People diagnosed with AvPD seem to have significant impairments in their sense of agency due to a lack of emotional awareness, an overweight of inhibiting vs. activating emotions, and difficulties regulating emotions. Difficulties also seem related to high levels of attachment avoidance and fear, creating strong ambivalence in social needs, in addition to a strong tendency to subordinate to others. A weak sense of self with a poor narrative, self-doubt, and harsh self-critique makes a reflexive and intentional stand increasingly difficult for these people. Conclusion: This review gives a clinically meaningful understanding of core strengths and deficits in the personality functioning of AvPD that can help clinicians map out important therapeutic work, identify barriers to client-agency in therapy, and work through relational difficulties in the therapeutic alliance.publishedVersio