Embitterment: Societal, psychological, and clinical perspectives PDF
Preview Embitterment: Societal, psychological, and clinical perspectives
Michael Linden Andreas Maercker Editors Embitterment Societal, psychological, and clinical perspectives Prof.Dr.Dipl.-Psych.MichaelLinden DepartmentofBehavioralandPsychosomaticMedicine, RehabilitationCentreSeehof,Teltow/Berlin,Germany Prof.Dr.Dr.AndreasMaercker DepartmentofPsychopathologyandClinicalIntervention, UniversityofZurich,Zurich,Switzerland Thisworkissubjecttocopyright. Allrightsarereserved,whetherthewholeorpartofthematerialisconcerned,specifi- callythoseoftranslation,reprinting,re-useofillustrations,broadcasting,reproductionby photocopyingmachinesorsimilarmeans,andstorageindatabanks. ProductLiability:Thepublishercangivenoguaranteeforalltheinformationcontainedin thisbook.Thisdoesalsorefertoinformationaboutdrugdosageandapplicationthereof. Ineveryindividualcasetherespectiveusermustcheckitsaccuracybyconsultingother pharmaceuticalliterature. Theuseofregisterednames,trademarks,etc.inthispublicationdoesnotimply,eveninthe absenceofaspecificstatement,thatsuchnamesareexemptfromtherelevantprotective lawsandregulationsandthereforefreeforgeneraluse. ©2011Springer-VerlagWien PrintedinGermany SpringerWienNewYorkispartof SpringerScience+BusinessMedia springer.at Typesetting:le-texpublishingservicesGmbH,04229Leipzig,Germany Printing:StraussGmbH,69509Mörlenbach,Germany Printedonacid-freeandchlorine-freebleachedpaper SPIN:12686407 With21(partlycoloured)Figures LibraryofCongressControlNumber:2010931381 ISBN 978-3-211-99740-6 SpringerWienNewYork Preface Thehistoryofthepresentbookonembittermentbeganadecadeago.Itreceived an importantimpulsewithinthescientificconferenceon “Embittermentand Mental Disorders” in April 2009, organized by the editors, Prof. Linden and Prof.Maercker.Theintentionistoenableabetterunderstandingofembittered personsbydiscussingdifferentaspectsofthiscomplexpsychologicalconstruct. Persistentembittermentisaratherinsufficientlydefinedmentalconditionand isnotyetregisteredasadisorderinthe10threvisionoftheInternationalSta- tisticalClassificationofDiseasesandHealthrelatedProblems(ICD-10).Nev- ertheless, persistent embitterment can result in severe impairment, suffering fortheindividualandhisorherenvironment,inabilitytoworkandprotracted litigation,sometimesinvolvingGermanPensionInsuranceaswell. Besidesthepaymentofretirementpensions,theresponsibilityofGerman PensionInsuranceistopreventillness-ordisability-relatedreductionofearn- ingcapacity.Thereasonsforpensionsduetoearningincapacityaremanifold. Inthesocialmedicalassessmentofaperson’scapacitytowork,fixedmedical diagnosticcategoriesarenotthemostimportantitems.Infact,thecentraltask istoassessthefunctionalcapabilityderivedfromtheindividualpsychophys- icalcondition.WithregardtothelegallydefinedtaskofGermanPensionIn- surance,thequestionisalwayswhetheraninsuredpersonisstillabletofulfill occupationalrequirements. Accordingtotheprincipleof“rehabilitationratherthanpension”,insured personsatriskoflosingtheirearningcapacitybecauseofhealthdisordersare eligibleforrehabilitationservicescoveredbyGermanPensionInsurance.These servicesareprovidedbyspecializedrehabilitationtreatmentcenters.Thetreat- ment focuses on improving the functional status of a person within a multi- professionalandmultimodalapproach,withspecialregardtoparticipationin working life. GermanPension Insurancenot onlyfinancesrehabilitation ser- vices,butalsocarriesouthighlydifferentiatedqualityassessment.Furthermore ithasaleadingroleinrehabilitationresearchandindesigningprogramsand guidelineswiththeaimofcontinuousimprovementofservices. EspeciallyafterGermanreunification,embittermentasaseverecondition ofpersistentmentalillnessseemedtoincreaseandbecamevisible.Manypeople vi Preface losttheirjobs,hadtomove,wereforcedtoworkfarawayfromtheirfamiliesor wereconfrontedwithanenormousamountofadaptation.Iftheindividualabil- itytocopewiththiskindofsocialimpactisoverstrained,embittermentcanbe onepossiblereaction.Embittermentitselfcanleadtowithdrawalfromsociety, includingwork.Experiencewiththetreatmentofpatientssufferingfromper- sistentembittermenthasshownthattheyaredifficulttotreat,theyareunable toworkforlongperiodsandoftenclaimpensionsduetoearningincapacity. Given thisbackground, it wasground-breakingworkto startresearchon embitterment,whichhadbeenaneglectedfieldinternationally.GermanFed- eral Pension Insurance provided generous research funding for several years which allowed the study of this problem in its own rehabilitation treatment centreSeehof inTeltow/Berlin.Theresultsareofgreatimportance:Posttrau- maticEmbittermentDisorders(PTED)havebeendescribedandclassified,in- strumentsfortheassessmentofsuchdisordershavebeendevelopedand–most importantly–treatmentstrategieshavebeenevaluated.Theseallowustotreat these patients with greater optimism today than a decade ago. We are very pleasedthatthisworkhasmeanwhilebeenrecognizedinternationally. Wewerethereforeverygladtohostaninternationalsymposiumonembit- terment,whichprovidedthebasisforthisbook.GoingbeyondPosttraumatic Embitterment as such, the subject is discussed here in a broader context. As amajorpublicinstitutionGermanPensionInsurancecarriesconsiderableso- cialresponsibility.Therefore,weseewithgreatinterestthevarioussocietalim- plicationsoftheresearchonembitterment,betheyinrespecttothereconcili- ationbetweenpartsofasociety,theorganizationofworkconditions,lifespan developmentofindividualsoreventheproblemofmurdersuicide. Wehopethatthisbookwillfindmanyreaders,helptowardabetterunder- standingof embittermentand –most important–stimulate furtherresearch onthissubject. Dr.AxelReimann DirectoroftheGermanFederalPensionInsurance Contents Listofcontributors............................................... xv 1 Introduction .................................................. 1 MichaelLinden,AndreasMaercker References .................................................. 3 2 Featuresofembitterment ........................................ 5 2.1 Embitterment–alargerperspectiveonaforgottenemotion .............. 5 HansjörgZnoj 2.1.1 Embittermentinthecontextofspecificstressors................... 5 2.1.2 Acircumplexmodelofembitterment............................ 7 2.1.3 Researchfindings ............................................ 10 2.1.4 Discussionandoutlook ....................................... 13 References .................................................. 15 2.2 Hopeandembitterment ............................................ 17 BeateSchrank,AstridGrantHay 2.2.1 Whatishope? ............................................... 17 2.2.2 Anoverviewonhopeconcepts ................................. 17 2.2.3 Whyishopeimportantinpsychiatry? ........................... 22 2.2.4 Hopeandembittermentdisorder ............................... 24 References .................................................. 26 2.3 Embitterment–fromtheperspectiveofjusticepsychology ............... 30 ClaudiaDalbert 2.3.1 InjusticeandPosttraumaticEmbittermentDisorder(PTED)......... 30 2.3.2 Thebeliefinajustworldconstruct .............................. 31 2.3.3 Functionsofthebeliefinajustworld............................ 32 2.3.4 Beliefinajustworldoperatesonanunconsciouslevel.............. 36 2.3.5 Conclusionsforposttraumaticembittermentdisorder .............. 36 References .................................................. 38 viii Contents 2.4 Revengeaftertrauma:Theoreticaloutline.............................. 42 IraGäbler,AndreasMaercker 2.4.1 Introduction:Embittermentandrevenge......................... 42 2.4.2 Revengeinthecontextoftrauma ............................... 43 2.4.3 Revengeasacopingstrategy ................................... 45 2.4.4 Towardadefinitionofrevenge.................................. 47 2.4.5 Atheoreticalprocessmodelofrevenge........................... 48 2.4.6 Thecourseoffeelingsofrevenge................................ 59 2.4.7 Revengeandhealth........................................... 60 2.4.8 Comingfullcircle:Therapeuticimplicationsandresearchperspectives 61 References .................................................. 64 2.5 “Shelooksbackwithoutbitterness”:Wisdomasadevelopmentalopposite ofembitterment? .................................................. 70 JudithGlück 2.5.1 Wisdom:Adevelopmentaloppositeofembitterment? .............. 70 2.5.2 Thepsychologyofwisdom:Aheterogeneousbutgrowingfield....... 71 2.5.3 Howdoeswisdomdevelop?.................................... 75 2.5.4 Canwisdomresearchinformbitternessresearch?.................. 78 References .................................................. 80 2.6 Personalityasriskandresilienceinembittermentreactions............... 83 AnjaDodek,SvenBarnow 2.6.1 Introduction ................................................ 83 2.6.2 Levelofpersonalitytraits ...................................... 84 2.6.3 Levelofsocial-cognitiveconstructs.............................. 85 2.6.4 EmotionregulationandCoping ................................ 86 2.6.5 Integration:Aheuristicmodelofriskandresiliencefactors.......... 88 2.6.6 Researchfindings ............................................ 89 2.6.7 Generaldiscussionandoutlook................................. 96 References .................................................. 97 2.7 Neurobiologicalcorrelatesofsocialexclusionandsocialpain ............. 101 AnnaK.Berkefeld,DieterF.Braus 2.7.1 Neuralnetworkofpainprocessing .............................. 102 2.7.2 Affiliation,exclusionandneuronalcorrelatesofthesocialpainsystem 105 2.7.3 Majorinfluencefactorsonthepainsystem ....................... 109 2.7.4 Conclusion.................................................. 113 References .................................................. 114 Contents ix 3 Contextofembitterment ........................................ 119 3.1 Relationshipsandembitterment ..................................... 119 KurtHahlweg,DonaldH.Baucom 3.1.1 Introduction ................................................ 119 3.1.2 Infidelity.................................................... 120 3.1.3 PrevalenceofPTEDinaffair-couples ............................ 121 3.1.4 Treatmentforinfidelity........................................ 123 3.1.5 Conclusion.................................................. 127 References .................................................. 127 3.2 Self-regulationofbitternessacrossthelifespan ......................... 129 CarstenWrosch,JesseRenaud 3.2.1 Goalfailure,bitterness,andqualityoflife......................... 129 3.2.2 Controlattributionsandtheexperienceofbitterness ............... 130 3.2.3 Self-regulationofbitterness .................................... 132 3.2.4 Bitternessinthecontextoftheadultlifespan...................... 135 3.2.5 Conclusion.................................................. 137 References .................................................. 138 3.3 Cancerpatients:Lossofmeaning,demoralizationandembitterment....... 142 AnjaMehnert,SigrunVehling 3.3.1 Cancersurvivorsandtheiremergingpsychosocialproblems......... 142 3.3.2 Conceptualframeworkformeaningandlifepurpose............... 144 3.3.3 Existentialissuesincancer..................................... 145 3.3.4 Demoralizationandembittermentincancer ...................... 147 References .................................................. 151 3.4 Embittermentandtheworkplace..................................... 154 BeateMuschalla,MichaelLinden 3.4.1 Stressorsintheworkplace ..................................... 154 3.4.2 Injusticeatwork ............................................. 157 3.4.3 Employeereactionstoinjusticeatwork .......................... 159 3.4.4 Embittermentinthecontextofwork-relatedconflicts .............. 160 3.4.5 Conclusion.................................................. 162 References .................................................. 163 x Contents 3.5 EmbittermentinAsia:Losingface,inequality,andalienation underhistoricalandmodernperspectives ............................. 168 ChangsuHan 3.5.1 HaanandHwa-Byunginaculturalperspective.................... 168 3.5.2 Honorsuicide ............................................... 171 3.5.3 NorthKoreandefectors(talbukja)............................... 172 3.5.4 OccupationalinjuriesandAsianeconomiccrisis .................. 173 3.5.5 Conclusion.................................................. 175 References .................................................. 175 3.6 Embittermentandpersonalitydisorder................................ 177 MaxRotter 3.6.1 Bitternessandembitterment ................................... 177 3.6.2 Reactiveembittermentinpatientswithdifferenttypes ofmentaldisorders........................................... 178 3.6.3 Embittermentasintegralemotionofpersonalitydisorders .......... 180 3.6.4 PersonalitydisordersasriskfactorforPTED...................... 182 3.6.5 Embittermentpronepersonalitydisorder......................... 183 References .................................................. 184 4 Contextofembitterment ........................................ 187 4.1 Embittermentsyndrome:Optionsforpsychopharmacologicalmanagement 187 BorwinBandelow 4.1.1 Casevignette ................................................ 187 4.1.2 Medicalmanagementofpost-traumaticstressdisorder(PTSD) ...... 189 4.1.3 Symptomandsyndrometargetedtreatmentoptions................ 190 4.1.4 Pharmacodynamicconsiderations............................... 192 4.1.5 Conclusion.................................................. 195 References .................................................. 195 4.2 Forgivenesstherapytotreatembitterment:areviewofrelevantresearch .... 197 NathanielG.Wade,BrianC.Post,MarilynA.Cornish 4.2.1 Understandingforgiveness..................................... 197 4.2.2 Embittermentandforgiveness.................................. 199 4.2.3 Interventionresearchonforgiveness............................. 202 4.2.4 Researchimplications......................................... 205 References .................................................. 206
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