Dying and the Near-Death ExperiencePTSD revisitedKubler-Ross’ Stage Model of DyingStages of dying according to Kubler-RossSlide 5Slide 6Stages of dying according to Kubler-Ross – Advantages and CriticismPattison’s Phase ModelSlide 9Slide 10Slide 11Slide 12Slide 13Humanistic psychologists such as Maslow were first to acknowledge higher needs - need for love, self-fulfillment, aesthetic and spiritual needs http://chiron.valdosta.edu/whuitt/col/regsys/maslow.htmlCorr’s Task-based Coping ModelSlide 16Final moments Sleep/Death analogiesNear-death ExperiencesDimensions of the Near-Death ExperienceSlide 20The Death-as-Door ThesisThe Death-as-Wall ThesisThe near-death event as a major life transitionDying and the Near-Death Dying and the Near-Death ExperienceExperienceDusana RybarovaDusana RybarovaChapter 3Chapter 32007 Psyc 4562007 Psyc 456PTSD revisitedPTSD revisited Most clinicians agree that victims of PTSD should face the original Most clinicians agree that victims of PTSD should face the original trauma to be able to cope with the debilitating effects of the disordertrauma to be able to cope with the debilitating effects of the disorderExposure TherapyExposure Therapy Helps PTSD Victims Overcome Trauma's Helps PTSD Victims Overcome Trauma's Debilitating EffectsDebilitating Effects–In the 1980’s, Dr. Terence M. Keane and his colleagues found that In the 1980’s, Dr. Terence M. Keane and his colleagues found that exposure therapy was effective in treating the PTSD symptoms of exposure therapy was effective in treating the PTSD symptoms of Vietnam War veterans. Exposure therapy, previously known as imaginal Vietnam War veterans. Exposure therapy, previously known as imaginal flooding therapy, involves carefully exposing the patient to prolonged and flooding therapy, involves carefully exposing the patient to prolonged and repeated imagined images of the trauma until the images no longer cause repeated imagined images of the trauma until the images no longer cause severe anxiety. In Keane’s randomized clinical trial involving 24 Vietnam severe anxiety. In Keane’s randomized clinical trial involving 24 Vietnam veterans, Keane found that exposure therapy was effective in reducing veterans, Keane found that exposure therapy was effective in reducing many of the veteran’s PTSD symptoms, including nightmares, flashbacks, many of the veteran’s PTSD symptoms, including nightmares, flashbacks, memory and concentration problems, and irritability.memory and concentration problems, and irritability. http://www.psychologymatters.org/keane.htmlhttp://www.psychologymatters.org/keane.htmlFor more on efficacy of psychological treatments for PTSD checkFor more on efficacy of psychological treatments for PTSD check–http://www.nimh.nih.gov/publicat/reliving.cfmhttp://www.nimh.nih.gov/publicat/reliving.cfm–http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_treatmentforptsd.htmlhttp://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_treatmentforptsd.htmlKubler-Ross’ Stage Model of DyingKubler-Ross’ Stage Model of DyingPioneered research with the dying in 1960sPioneered research with the dying in 1960s–Difficulty in access to dying patients hindered by Difficulty in access to dying patients hindered by physiciansphysicians–Patients were usually surprised, amazed, and grateful; Patients were usually surprised, amazed, and grateful; relieved to share their last concerns and expressing relieved to share their last concerns and expressing their feelingstheir feelings–Interviewed 400 dying persons over a 10 year periodInterviewed 400 dying persons over a 10 year periodHer work resulted in a bookHer work resulted in a book–On Death and DyingOn Death and Dying (1969) usual stages of dying (1969) usual stages of dyingStages of dying according to Stages of dying according to Kubler-RossKubler-RossShock/DenialShock/Denial–Numbness, shock, withdrawal and cognitive denialNumbness, shock, withdrawal and cognitive denial–Can take from few seconds to few months Can take from few seconds to few months –1% of terminally ill people stay in that stage1% of terminally ill people stay in that stageAngerAnger–Envy and resentment of those whose lives will continueEnvy and resentment of those whose lives will continue–Anger can be expressed towards everyone they Anger can be expressed towards everyone they encounter in various forms such as complaintsencounter in various forms such as complaints–Important to see the dying person as a unique human Important to see the dying person as a unique human being engaged in the process of grieving rather than being engaged in the process of grieving rather than somebody who is threatening or just a ‘patient’somebody who is threatening or just a ‘patient’Stages of dying according to Stages of dying according to Kubler-RossKubler-RossBargainingBargaining–Making promises (usually towards spiritual figures) in Making promises (usually towards spiritual figures) in exchange to more time to liveexchange to more time to live–It is natural and healthy way to cope with the reality of It is natural and healthy way to cope with the reality of approaching deathapproaching deathDepressionDepression–Acute depression, the dying regrets past failures and Acute depression, the dying regrets past failures and mistakes that can not be correctedmistakes that can not be corrected–Grief about the lost timeGrief about the lost time–Recognition of approaching deathRecognition of approaching deathStages of dying according to Stages of dying according to Kubler-RossKubler-RossAcceptanceAcceptance–Without anger or depressionWithout anger or depression–‘‘it’s my time now, and it’s all right’ without defeat or it’s my time now, and it’s all right’ without defeat or disappointmentdisappointment–In our culture the dying person is often drowsy, In our culture the dying person is often drowsy, withdrawn, drugged, and asleep much of the timewithdrawn, drugged, and asleep much of the time–Often does not like to engage in conversationOften does not like to engage in conversation–But, it is important to show that others care through But, it is important to show that others care through physical presencephysical presence–The dying often realizes our connectedness to all The dying often realizes our connectedness to all living/dying beings living/dying beingsStages of dying according to Kubler-Stages