Implications for using the MEAH
The MEAH has important implications for; (1) people who face a significant threat or challenge. This includes chronic and palliative illness but also includes situations and experience which are difficult to experience and overcome. And (2) for people who are listening to and responding to this experience.
1. For people who face a threat or challenge
The MEAH highlights the importance considering emotions, hope and psychological adaptation to a threat or challenge which is deemed significant and important to the teller of the experience. The experience of a threat or challenge is relative and unique to the person, because it depends on circumstances and many other factors which may be impacting the teller (e.g., having other illness present, being a parent, losing a job as a result of the threat or challenge , needing money to pay the bills, having experienced difficulty with a member of staff before seeing the listener, not being able to park before a meeting etc). Thus, we can't assume to judge what we are initially told, however, whilst the response is unique, psychological reactions to TOC and illness contain common features. These common features represent: (a) how hope is regarded and change seen, (b) whether acknowledgement of what is happening is possible or not and (c) the particular emotion that is represented by the experience (e.g., sadness, frustration, embarrassment).
The MEAH reveals that a response to illness can be captured or mapped by an individuals story. Research has identified that the common illness story plots (e.g., heroic, restorative, tragic, faith) can be mapped by their common psychological features. The importance of this is that as people share their story they are revealing a different psychological response to a threat or challenge . This is particularly important when peers share stories that provide a way to overcome the threat or challenge . Given this, it can be stated that sharing stories provides a non-confrontational way to influence psycho-emotional adaptation. This is important because it reveals that having access to different stories provides a basis for psychological adaptation. I have been able to illustrate this on the section of the website that is labelled 'the MEAH and story plots'.
2. People who respond to hearing the experience of living with a threat or challenge
The listeners' reaction to hearing experiences of relating to a threat or challenge can have a powerful impact on the teller. The response given may be positioned to achieve a certain outcomes. These could be valued, known, expected or wanted outcomes from the listeners perspective. The danger is that the listener classifies reactions as good or bad, wrong or right, denied or embraced, realistic or unrealistic. There may be reasons which explain this response. For instance culture, pressure or training may reflect a consistent response from listener e.g., a health care professional in a particular way using a classification of that response.
The MEAH provides a reason not to classify responses. Singular words often classify reactions in terms of a stage of adaptation (denial, acceptance, anger) or judgement on the hope represented (realistic vs unrealistic). The MEAH provides evidence of why listening to experiences and stories relating to a TOC is so important and evidence of why moving away from assessments of adaptation using singular words is required. Singular words often imply or categorise reactions as being right or wrong, useful or useless. The MEAH confirms that responses are relative and specific and represented by hope, adaptation and emotions. To limit understanding of psychological adaptation to just one category or response may buy into stereotypical responses to illness, it may represent what response the listener wants to hear. The MEAH provides an illustration of the greater representation of psychological adaptation and identifies a need to focus on illness stories.
The MEAH can be in the following ways:
To enhance the understanding common story plots of illness
As a part of training to increase empathy in health care professionals
Provided to people facing threats using it as a screening tool
Please consider the specific sub-sections of the website for more details of the MEAH and details of the development of training for different groups.