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Perception of Helplessness
Helplessness is defined in the dictionary as a "powerlessness revealed by an inability to act." Alternative definitions are: "a feeling of being unable to manage" or "the state of needing help from something." Helplessness is part and parcel of human existence. Given the natural order of life's process, helplessness is a reaction to traumatic events in our own lives. These are mental, emotional and physical anguish. In addition, helplessness is also caused by sensitivity to the sufferings of others. After the events of September 11, 2001, most Americans felt helpless. This helplessness was from the recognition of the fragility of life. Helplessness was also the inability to seek immediate retribution to the grievous loss to those even far removed from most of us. In most cases however, helplessness comes from events that are associated with self and those very near. Illness is a prime example. This is particularly stark in cases of suffering from incurable diseases like cancer and AIDS. The feeling of helplessness has been implicated as a hindrance to cure and remission. The antidote to helplessness is coping. In a study of several Norwegian women whose husbands were recently deceased, it was found that coping with a problem, the health of the individual and anxiety and depression were strongly correlated. (Lindstrom, 1997) The author, Lindstrom, averred that these three factors were at the vertices of a triangle. This essay will deal with aspects of helplessness and coping as shown by the current literature.
Helplessness is generally characterized by the idea that the person has lost control of his or her life and is merely dependent upon fate. This loss of a sense of personal power is particularly strong. A person thus "debilitated" cannot make plans or set well defined goals for his or herself. Depression is common place; as is the absence of self-reliance. Such a person generally is possessed of a negative outlook of life. He or she never meets life head on. He or she is generally passive when challenged. A helpless person looks to or perceives that surroundings and other people have greater control of their lives. Such a person does not see many reasons to live. There is a definitive lack of self-fulfillment and self-actualization.
In understanding helplessness, one must be able to differentiate between actual helplessness and learned helplessness. Actual helplessness is the feeling that there is no recourse. The best example of truly helpless is a person who has to jump from a burning ship into frigid waters. No matter what the choice, death is inevitable. Even within actual helplessness, the acuity of the feeling will vary between individuals based on age and culture. In explicating helplessness, a distinction should be made between actual helplessness and a mere feeling of helplessness. The latter is imagined to be real. One might consider that the first is objective and the second, subjective.
The perception of helplessness cannot be determined as a specific disorder. It is often a combination of factors some of which might be emotional disorders like depression. In addition, culture (suicide is considered honorable in Japanese society), physical illness and a complacent attitude can all contribute. Sometimes, perceived helplessness then goes into the realm of learned helplessness. This is an extension of the experiment made famous by Ivan Petrovich Pavlov's dog. (Seligman, 2000) He provided a negative stimulus to dogs. These dogs were placed in a shuttle box whose floor produced a harmless shock. The dogs were restrained to prevent escape. A bell tone accompanied this shock. After the learning phase, when the dog was placed in a situation where escape was possible, it did not respond to the bell that signaled the administration of a shock. Even when shocked the dog made no attempt to escape. When an "unlearned" dog was placed in the shuttle box and shocked, it immediately jumped over the fence.
Very often, with learned helplessness the "helpless" is used as an excuse for not taking charge of oneself. The person often uses helplessness to manipulate others into providing for him or her. Evocation of sympathy by presenting a sense of incompetence or a fear of succeeding is characteristic of learned helplessness. Learned helplessness is often a mask for failure to take responsibility.
Knowing that there is a psychological component to helplessness, one must explore phobias, which are irrational fears. In a sense therefore, phobias go hand in hand with helplessness. Agoraphobics are afraid of placing themselves in positions where they might be judged. Simple phobias are those in which the source of the fear can be readily defined or identified. These are simple not because the feeling of helplessness is less acute. They are simple because the source of the fear is easily identified. Helplessness can also be tied in to a condition called Anhedonia, (Parker, Snowdon, & Parker, 2003) which is not, per se, a mental disorder. It is however, often associated with schizophrenia and depression. Basically, the symptoms of anhedonia are associated with what is referred to as "loss of pleasure." Feelings of helplessness are also tied in with the stages of grief, namely, denial, anger, guilt, depression, reactions and reconciliation.
The stages of grief naturally are also the steps in coping with helplessness. A psychiatrist might aver that coping should include maintaining a regular schedule with the avoidance of unrealistic expectations. Coping mechanisms also include free expression. One has to ensure that physical necessities like rest and nutrition are not ignored. A doctor's help should be sought as should activities that put one in social situation. Coping with helplessness also involves making changes that will enhance self-confidence.
Cancer patients are generally typical of those afflicted by helplessness in addition to any symptoms of the disease. There are different schools of thought when it comes to determining whether psychological and behavioral methods are responsible for holding of recurrence or cancer and permitting remission. Some meta-analyses aver that there isn't. Other studies show that psychological coping strategies are called for. These coping strategies are in the form of behavioral therapy, supportive-expressive therapy and psycho-educational therapy. Basically, researchers bemoan the fact that there is not enough work done on coping mechanism for disease like cancer. Researchers agree that patients meet stress with defensive postures such as withdrawal, denial, regression, anger, anxiety and depression. They suggest that in addition to physical treatment, care should be taken that coping can be enhanced with pain relief, prevention of sensory deprivation; help calming and restoring of sleep patterns, reassurance and the provision of familiar surroundings.
In the case of learned helpless (as has been described above), two modalities are indicated as coping mechanisms. They are extrinsic and intrinsic motivation. Extrinsic motivation involves a system of rewards as positive reinforcement. (Stipek & DeCotis, 1988) Extrinsic motivation suggests a move away from threats or punishment. Extrinsic motivation urges the person to gain recognition and eventually conform to socially acceptable behavior and self sufficiency. Intrinsic motivation in the other hand focuses on creativity and changes in levels of cognition. Intrinsic motivation deals with factors that create an internal positive tone, such as the development of high self-esteem (Minor & Hunter, 2002) which results in loss of the motivation to escape the shock stimulus.
A meta-analysis, which also reviewed both positive and negative coping methods, showed that there was no correlation with psychological coping with survival. (Petticrew, Bell, & Hunter, 2002) It is important to understand this research if only to understand different techniques that is used to help patients cope. The researchers unfortunately, fail to differentiate the need to separate coping with survival vs. coping with the need to help "cope" with the problem and avoid needless suffering. Consider the sprouting of hospice services for the terminally ill. The only role that hospices play is pain management and providing a comfortable environment for those that suffer and their near and dear ones. Surviving is not the issue. Dying with dignity is an important facet of coping.
One of the coping mechanisms is to meet the problem head on. Often dubbed fighting spirit, this mode has had mixed results. Of ten studies conducted which measured fighting spirit with survival from cancer, two studies linked this to longer survival, of the remaining studies, there showed that there was a reduced risk. The problem with assessing a subjective instance like "fighting spirit" is how one measures fighting spirit. An important consideration is if all patients had the same disease, whose progress was exactly the same. One of the larger groups in this study that tested 578 patients did not report any statistically significant positive outcomes.
While one can study coping methods, one can conduct research in the opposite direction. How hopelessness or helplessness contributed to reduced survival-rates were measured. Of twelve studies, two studies reported that helplessness affected survival rates, negatively. Five studies reported inconsistent results. In other studies, the same problems with measuring a subjective term like hopelessness. When denial and avoidance as coping mechanisms were studied, there was no indication that it…[continue]
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