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Symbolic Immortality with Life Tapes |
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An Existential Intervention for Cancer Patients That Increases Family Social Support and Symbolic Immortality with a Brief Existential Intervention for Cancer Patients and Their Families (Existential - dealing with existence - life and death).
The Life Tapes Project (LTP) helps bring families closer together by increasing communication and also acts as an existential intervention, leading to a greater sense of legacy, meaning of life, and increased self awareness. It involves the symbolic immortality that is an aspect of existential coping and social support factors, which benefit patients and their families and meet patient and family needs.
Introduction
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A diagnosis of cancer poses a powerful threat to the emotional equilibrium of both patients and families. It poses an existential threat, coupled with the fear of arduous treatments and possible painful decline, which haunts both patients and families despite the current improved effectiveness of treatments and the prospects of improved survival. With the possible prospect of dying, isolation becomes especially distressing (Yalom, 1980). A key role of both family and medical team is to provide a supportive environment for the patient to live and confront the potential reality of death. Often, communication paralysis and denial exist; although, often, family members want to talk freely.
In order to address the psychological needs of patient and family, adjuvant cancer supportive programs have been developed both locally and worldwide. Often, these address the existential needs and concerns of patients and families. The LTP was created as one of these interventions to help bring families closer together, as well as act as an intervention, leading to a greater sense of meaning, self awareness, identity and connection for the patient. Speigel and Bloom found that expressiveness in an open forum of group support helped patients improve adjustment. The quality of family support is very important to decrease distress and support immune function. Helping to allay patient fears about illness and its affect on themselves and their family members is another benefit of supportive care.
The LTP has proven to be a suitable way of addressing these issues, which enhance both social support and help in understanding existential factors that may underlie some of the psychological benefits of family support. This existential coping has been exemplified in a concept called symbolic immortality. In 1977, using audio taping of family histories, we showed benefits for family cohesion and support through improved communication. Cancer was viewed as a life-changing event, happening to the entire family not simply the affected individual. The life tape interview also promoted meaningful self-reflection and the mutual sharing of authentic emotions ensconced in the history and legacy of the family.
Symbolic Immortality
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Being conscious of our own mortality is a fundamental aspect of being human, with the consequent anxiety we all attempt to manage - to a greater or lesser extent - across the span of our lives. Yalom, discussed our approach to life being tied to our relationships and to our philosophy about death. Successfully confronting death will enhance our appreciation of, and satisfaction with, life.
Robert Jay Lifton, 1979, 1996, and Becker in 1973, discussed our propensity to identify with things greater and more enduring than ourselves in the form of symbolic immortality. Lifton recognized our connection to an enduring human reality. He described five domains: Biological and bio-social, religious or theological, creative, nature, and transcendental.
The LTP interviews are most closely related to the biological and creative domains, reflecting a continuous chain of life, where values, achievements and philosophical thoughts are passed on to future generations. Thus, some important part of the individual continues to exist symbolically, even after death.
Symbolic Immortality in the Biological Domain
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Symbolic immortality in the biological domain is found in the continuity of family across time - through one's family and subsequent generations and in the sense that our lives are reflected in the continuation of our thoughts and values in our family, children, and grandchildren. Thus, cultural traditions are continued in future generations, identified in the chain of predecessors and in the children and generations to come. Traditions, values and a sense of common heritage, as well as political beliefs, and even humor continue beyond the mortality of a single family member. These become symbolic as part of the family culture, and their continued existence in others contributes to the sense of symbolic immortality.
In the LTP interview, a discussion of family genealogy and history about one's forbearers, as well as one's family, are discussed.
Symbolic Immortality through Creativity
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In the creative domain, symbolic immortality is readily apparent in great works of art, such as the Mona Lisa, or literature, music, or science that will last many generations beyond the creator.
Although few people will be known by their works, most of us will leave a creative mark on the world through unaccountable human interactions that fill our lives and in particular by "every day offerings of nurturing or even kindness - in relationships of love, friendship and, at times, even anonymous encounters. Indeed, any form of acting upon others contains important perceptions of timeless consequences." (Lifton, 1996, pg. 22)
Thus, through living, one can make a lasting difference in the lives of others as a form of symbolic immortality in the creative domain. This could be exemplified during an LTP interview, when patients recall their proudest moments or acts of kindness or selflessness. A person in the room during an LTP interview, who is a recipient of such a kindness, can experience the impact of human kindness, which promotes appreciation, as well as being taught something about being a model he hopes to emulate. Also it could be exemplified by how the patient has coped with cancer and expressing and discussing feelings about dying.
This kind of symbolic immortality through creating changes in others can also contribute to bio-social symbolic immortality. Also, passing down lessons learned through one's life struggles or experiences can add to the family heritage. This is also reflected in the way a patient has lived with cancer and how behavior and values affect the survivors. It also reflects how a patient can serve as a model to others in the family and how to face and hear about dying and death. It helps counteract fears and also helps family members counter their sense of helplessness and loss at the prospect of their loved one's death. This has become one of the strengths of the LTP interview process - that is - to think of oneself as if a piece of me becomes a part of one's family history.
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