The will to live (German: Wille zum Leben) is a concept developed by the German philosopher Arthur Schopenhauer, representing an irrational "blind incessant impulse without knowledge" that drives instinctive behaviors, causing an endless insatiable striving in human existence.
This is contrasted with the concept of the will to survive under life threatening conditions used in psychology[ citation needed ] since Schopenhauer’s notion of the will to live is more broadly understood as the “animal[istic] force to endure, reproduce and flourish.” [1]
There are significant correlations between the will to live and existential, psychological, social, and physical sources of distress. [2] Many, who overcome near-death experiences with no explanation, have described the will to live as a direct component of their survival. [3] The difference between the wish to die versus the wish to live is also a unique risk factor for suicide. [4]
In psychology, the will to live is the drive for self-preservation, usually coupled with expectations for future improvement in one's state in life. [5] The will to live is an important concept when attempting to understand and comprehend why we do what we do in order to stay alive, and for as long as we can. This can be related to either one's push for survival on the brink of death, or someone who is just trying to find a meaning to continuing their life. Some researchers say that people who have a reason or purpose in life during such dreadful and horrific experiences will often appear to fare better than those that may find such experiences overwhelming. [6] Every day, people undergo countless types of negative experiences, some of which may be demoralizing, hurtful, or tragic. An ongoing question continues to be what keeps the will to live in these situations. People who claim to have had experiences involving the will to live have different explanations behind it. [7]
The will to live is considered to be a very basic drive in humans; but not necessarily the main driving force. In psychotherapy, Sigmund Freud termed the pleasure principle, which is the seeking of pleasure and avoiding of pain. [8] Viktor Frankl, who spent time in German concentration camps, developed psychotherapy called logotherapy, which may be translated as the therapy focused on the "will to meaning". Maslow's hierarchy of needs highlights the innate appetite that people possess for love and belonging but before all this there is the very basic and powerful will to live. Psychologists have established that human beings are a goal-oriented species. In assessing the will to live, it should be borne in mind that it could be augmented or diminished by the relative strength of other simultaneously existent drives. Psychologists generally agree[ weasel words ] that there is the will to live, the will to pleasure, the will to superiority and the will to connection. There are also usually varying degrees of curiosity with regard to what may be termed the will to identity or establishing meaningful personal responses. The will to live is a platform without which it would not be possible to satisfy the other drives. However, this overlooks the possibility that there is a commonality among all creatures that drives all other urges.
Self-preservation is a behavior that ensures the survival of an organism. [9] Pain and fear are integral parts of this mechanism. Pain motivates the individual to withdraw from damaging situations, to protect a damaged body part while it heals, and to avoid similar experiences in the future. [10] Most pain resolves promptly once the painful stimulus is removed and the body has healed, but sometimes pain persists despite removal of the stimulus and apparent healing of the body; and sometimes pain arises in the absence of any detectable stimulus, damage or disease. [11] Fear causes the organism to seek safety and may cause a release of adrenaline, [12] [13] which has the effect of increased strength and heightened senses such as hearing, smell, and sight. Self-preservation may also be interpreted figuratively, in regard to the coping mechanisms one needs to prevent emotional trauma from distorting the mind (see: defence mechanism.)
Even the most simple of living organisms (for example, the single-celled bacteria) are typically under intense selective pressure to evolve a response that would help avoid a damaging environment, if such an environment exists. Organisms also evolve while adapting - even thriving - in a benign environment (for example, a marine sponge modifies its structure in response to current changes, in order to better absorb and process nutrients). Self-preservation is therefore an almost universal hallmark of life. However, when introduced to a novel threat, many species will have a self-preservation response either too specialised, or not specialised enough, to cope with that particular threat.[ citation needed ] An example is the dodo, which evolved in the absence of natural predators and hence lacked an appropriate, general self-preservation response to heavy predation by humans and rats, showing no fear of them.
“Existential, psychiatric, social, and, to a lesser degree, physical variables are highly correlated with the will to live”. [14] Existential issues found to correlate significantly include hopelessness, the desire for death, sense of dignity, and burden to others. Psychiatric issues found to be strongly associated are such as depression, anxiety, and lack of concentration. Physical issues that showed the strongest associations were appetite and appearance which did not show the same consistent degree of correlation. The four main predictor variables of the will to live changing over time are anxiety, shortness of breath, depression, and sense of well-being [15] which correlate with the other variable predictors as well. Social variables and quality of life measures are shown to correlate significantly with the will to live such as support and satisfaction with support from family, friends, and health care providers. [16] Findings on the will to live have suggested that psychological variables are replaced by physical mediators of variation as death draws nearer. The will to live has also proven to be highly unstable. [17]
Several studies have been conducted testing the theory of the will to live. These studies varied in their focus, but broadly sought to understand the will to live as it differs by demographics, especially as it concerns the elderly and the terminally ill. A study conducted in 2005 asked elderly participants to rate their will to live and tracked this data across time. It found that those who reported a high or stable will to live generally lived longer than those who reported a weak will to live. Additionally, this study proposed that women were generally better able to cope with life-altering or life-threatening conditions and situations than men. However, it also suggested that the participants may not have been of stable health, and that further study was required before drawing any definite conclusions. [18] An earlier study conducted in 2002 tested the idea in terminally ill cancer patients, with most participants being elderly. This study found that those with the weakest will to live typically died sooner than those with a moderate will to live. Those with a high will to live could either die sooner or live as long as those with a moderate will to live. The authors went on to specify that further research is required, testing this theory against other terminal illnesses and in different age categories. [19]
Anecdotal evidence also suggests a correlation between the individual will to live and survival in traumatic situations that include maltreatment. The Second World War and the Holocaust provide concrete examples of this, where many individuals survived years of malnourishment and mistreatment in concentration camps, and cited their will to live as a key part of their survival. [20] A study conducted in 2003 suggested that positive thought (i.e., having a positive outlook on ones' future and life in general) could lower ones' risk for health complications and diseases. This study posited that women who had a more positive outlook were more likely to carry a greater number of antibodies for certain flu strains, which suggested a stronger immune system more generally than those who had a negative outlook. [21] Further anecdotal evidence can be found through quantitative analysis of death records, which consistently show many people dying shortly after major holidays, suggesting that people will themselves to live until the holiday (or in other cases, a birthday), and then passing shortly thereafter. [22] [23]
Factitious disorder imposed on self, also known as Munchausen syndrome, is a factitious disorder in which those affected feign or induce disease, illness, injury, abuse, or psychological trauma to draw attention, sympathy, or reassurance to themselves. Munchausen syndrome fits within the subclass of factitious disorder with predominantly physical signs and symptoms, but patients also have a history of recurrent hospitalization, travelling, and dramatic, extremely improbable tales of their past experiences. The term Munchausen syndrome derives its name from the fictional character Baron Munchausen.
In psychology, trait theory is an approach to the study of human personality. Trait theorists are primarily interested in the measurement of traits, which can be defined as habitual patterns of behavior, thought, and emotion. According to this perspective, traits are aspects of personality that are relatively stable over time, differ across individuals, are relatively consistent over situations, and influence behaviour. Traits are in contrast to states, which are more transitory dispositions.
Psychological pain, mental pain, or emotional pain is an unpleasant feeling of a psychological, non-physical origin. A pioneer in the field of suicidology, Edwin S. Shneidman, described it as "how much you hurt as a human being. It is mental suffering; mental torment." There is no shortage in the many ways psychological pain is referred to, and using a different word usually reflects an emphasis on a particular aspect of mind life. Technical terms include algopsychalia and psychalgia, but it may also be called mental pain, emotional pain, psychic pain, social pain, spiritual or soul pain, or suffering. While these clearly are not equivalent terms, one systematic comparison of theories and models of psychological pain, psychic pain, emotional pain, and suffering concluded that each describe the same profoundly unpleasant feeling. Psychological pain is widely believed to be an inescapable aspect of human existence.
Alexithymia, also called emotional blindness, is a neuropsychological phenomenon characterized by significant challenges in recognizing, expressing, sourcing, and describing one's emotions. It is associated with difficulties in attachment and interpersonal relations. While there is no scientific consensus on its classification as a personality trait, medical symptom, or mental disorder, alexithymia is highly prevalent among individuals with autism spectrum disorder (ASD), ranging from 50% to 85% of prevalence.
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced heart disease than for injury. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply as being terminal. There is no standardized life expectancy for a patient to be considered terminal, although it is generally months or less. Life expectancy for terminal patients is a rough estimate given by the physician based on previous data and does not always reflect true longevity. An illness which is lifelong but not fatal is a chronic condition.
A nocebo effect is said to occur when negative expectations of the patient regarding a treatment cause the treatment to have a more negative effect than it otherwise would have. For example, when a patient anticipates a side effect of a medication, they can experience that effect even if the "medication" is actually an inert substance. The complementary concept, the placebo effect, is said to occur when positive expectations improve an outcome. The nocebo effect is also said to occur in someone who falls ill owing to the erroneous belief that they were exposed to a toxin, e.g. a physical phenomenon they believe is harmful, such as EM radiation.
Suicidal ideation, or suicidal thoughts, is the thought process of having ideas, or ruminations about the possibility of completing suicide. It is not a diagnosis but is a symptom of some mental disorders, use of certain psychoactive drugs, and can also occur in response to adverse life events without the presence of a mental disorder.
Post-stroke depression (PSD) is considered the most frequent and important neuropsychiatric consequence of stroke. Approximately one-third of stroke survivors experience major depression. Moreover, this condition can have an adverse effect on cognitive function, functional recovery and survival.
Somatization is a tendency to experience and communicate psychological distress as bodily and organic symptoms and to seek medical help for them. More commonly expressed, it is the generation of physical symptoms of a psychiatric condition such as anxiety. The term somatization was introduced by Wilhelm Stekel in 1924.
Type D personality, a concept used in the field of medical psychology, is defined as the joint tendency towards negative affectivity and social inhibition. The letter D stands for "distressed".
Somatosensory amplification (SSA) is a tendency to perceive normal somatic and visceral sensations as being relatively intense, disturbing and noxious. It is a common feature of hypochondriasis and is commonly found with fibromyalgia, major depressive disorder, some anxiety disorders, Asperger syndrome, and alexithymia. One common clinical measure of SSA is the Somatosensory Amplification Scale (SSAS).
Amplification is used to describe a judged tendency of a person to amplify physical symptoms based on psychological factors such as anxiety or depression. Distinct interpretations of this type of presentation could be sensory processing disorder involving differences in the way a person reacts to sensory input which is regarded as a pervasive developmental disorder related to the autism spectrum; or there is an alternative psychological concept of 'innate sensitiveness' as a personality trait coined by Carl Jung later developed into the highly sensitive person trait. In one instance where amplification is used as a handle or point of reference or diagnosis it is said "somatosensory amplification refers to the tendency to experience somatic sensation as intense, noxious, and disturbing. What may be a minor 'twinge' or mild 'soreness' to the stoic, is a severe, consuming pain to the amplifier."
William S. Breitbart, FAPM, is an American psychiatrist in Psychosomatic Medicine, Psycho-oncology, and Palliative Care. He is the Jimmie C Holland Chair in Psychiatric Oncology, and the Chief of the Psychiatry Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, He is a Professor of Clinical Psychiatry at Weill Medical College of Cornell University. He was president of the Academy of Psychosomatic Medicine, and the Editor-in-Chief of Palliative and Supportive Care.
Muhamad Aly Rifai is a Syrian American internist and psychiatrist who was accused by the government with fraud but exonerated in a jury trial. He is a clinician researcher known for describing the association between psychiatric disorders and hepatitis C. He co-authored a clinical report detailing the association between hepatitis C infection and psychiatric disorders.. He is the President and CEO of Blue Mountain Psychiatry which has locations in Pennsylvania.
Denial of pregnancy is a form of denial exhibited by pregnant women or girls to either the fact or the implications of their own pregnancy. One study found that those who denied their own pregnancy represented 0.26% of all deliveries. A later study cited an incidence at 20 weeks gestation of approximately 1 in 475, and said that the proportion of cases persisting until delivery is about 1 in 2500 pregnancies.
Somatic symptom disorder, also known as somatoform disorder, or somatization disorder, is defined by one or more chronic physical symptoms that coincide with excessive and maladaptive thoughts, emotions, and behaviors connected to those symptoms. The symptoms are not deliberately produced or feigned, and they may or may not coexist with a known medical ailment.
Codeine-6-glucuronide (C6G) is a major active metabolite of codeine and may be responsible for as much as 60% of the analgesic effects of codeine. C6G exhibits decreased immunosuppressive effects compared to codeine. During its metabolism, codeine is conjugated with glucuronic acid by the enzyme UDP-Glucuronosyltransferase-2B7 (UGT2B7) to form codeine-6-glucuronide.
Attachment and health is a psychological model which considers how the attachment theory pertains to people's preferences and expectations for the proximity of others when faced with stress, threat, danger or pain. In 1982, American psychiatrist Lawrence Kolb noticed that patients with chronic pain displayed behaviours with their healthcare providers akin to what children might display with an attachment figure, thus marking one of the first applications of the attachment theory to physical health. Development of the adult attachment theory and adult attachment measures in the 1990s provided researchers with the means to apply the attachment theory to health in a more systematic way. Since that time, it has been used to understand variations in stress response, health outcomes and health behaviour. Ultimately, the application of the attachment theory to health care may enable health care practitioners to provide more personalized medicine by creating a deeper understanding of patient distress and allowing clinicians to better meet their needs and expectations.
Harvey Max Chochinov is a Canadian academic and psychiatrist from Winnipeg, Canada. He is a leading authority on the emotional dimensions of end-of-life, and on supportive and palliative care. He is a Distinguished Professor of Psychiatry at the University of Manitoba and a Senior Scientist at CancerCare Manitoba Research Institute.
Body image disturbance (BID) is a common symptom in patients with eating disorders and is characterized by an altered perception of one's own body.