Mental well-being as a cycle of hope enablement

Maintaining mental well-being within chronic illness and palliative illness can often be related to an ability of the individual to enable responses that act against the perceived loss of control, uncertainty and hopelessness resulting from the illness. The idea of succumbing versus coping was generated by Wright (1983). She contrasts the positions on several fronts as she categories expressions following illness for individuals; (a) focus or posture of statements with emphasis of either what can be done versus what cannot be done, (b) identification of value of participation in accessible activities or no value, (c) active versus passive role in (re)construction of one’s social identity, (d) the ability to manage the experience of suffering versus no ability, (e) the willingness to use functional aid versus no willingness. (F)identification of the ability to live meaningful lives versus no ability. More recently past work (Soundy, Stubbs and Roskell, 2014; Soundy and Condon, 2015) has divided the idea of coping versus succumbing into an internal response represented by cycles of hope enablement versus cycles of succumbing to the illness. An adapted version of the model of hope enablement can be seen in Figure 1. The Figure illustrates cycles of living with the effects of a TCC and suffering. The first response to suffering is captured as a psycho-emotional response. This represents internal processes that lead to an adaptive or succumbing response are illustrated initially and defined by how an individual’s hope, emotions and psychological adaptation are expressed. This response is captured by the model of emotion, adaptation and hope (MEAH; Soundy et al., 2016). 

Cycles within the model

Cycles (red, blue and green) of coping or succumbing are presented within Figure 1. The underlying principles of the models is the individuals’ orientation towards hope creates cycle that provides some a perceived sense of control (internal/blue or external/red) over an illness that allows the initiation or continuation of activities and periods of coping. Alternative a loss of control and disease dominate response (green) provides period of isolation, dependency and succumbing. The red cycle of coping with an external sense of control and hope represented hope could be defined by a waiting period before an intervention like a drug or other forms of support and provision are gained. The blue cycle of coping with an internal sense of control hope illustrates hope in ability to cope or value changes. This is an active internal response which represents the importance of the individuals choice to actively respond to the illness and respond to the illness. The green cycle of coping represents an illness dominant response where hope disabled and a succumbing response to illness.

Recent research has been able to illustrate that the plot of an illness story can be mapped onto the psycho-emotional expression as well as being representative of the cycles of coping or succumbing to illness (Soundy, 2018). The importance of this is that if we understand why different illness stories are so valuable they can be used to support the mental well-being of individuals suffering from a TCC or illness. 

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