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Brief Psychotherapy at the Bedside: Countering Demoralization From Medical Illness

Received Oct. 11, 2003; revision received May 18, 2004; accepted June 15, 2004. From the Department of Psychiatry and Behavioral Sciences, The George Washington University Medical Center. Address correspondence and reprint requests to Dr. Griffith, Burns Building, 8th Floor, Department of Psychiatry and Behavioral Sciences, The George Washington University Medical Center, 2150 Pennsylvania Ave., N.W., Washington, DC 20037.

Bedside psychotherapy with medically ill patients can help counter their demoralization, which is the despair, helplessness, and sense of isolation that many patients experience when affected by illness and its treatments. Demoralization can be usefully regarded as the compilation of different existential postures that position a patient to withdraw from the challenges of illness. A fruitful interviewing strategy is to discern which existential themes are of most concern, then to tailor questions and interventions to address those specific themes. Illustrative cases show how such focused interviewing can help patients cope assertively by mobilizing existential postures of resilience, such as hope, agency, and communion with others.

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