Psychoanalysis in the Palliative Care System

This dissertation is a summary of my work in palliative care. It presents a rethinking of my experience in a psychoanalytic way. Improving palliative care has long been one of the topical and important topics for our country, as the need for such care is growing and will continue to grow. As a rule, today medicine copes with physical pain successfully. But the majority of palliative patients pass away with a clear understanding of what is happening, experiencing severe psychological, mental and spiritual conditions. The main help in these cases is special psychotherapy. The most important and relevant factor in providing the best possible support is understanding that palliative care is not only a medical field of care (pain relief, symptom management), but also psychological and spiritual, and these fields are equal. Only through a multidisciplinary approach is it possible to provide quality support to the dying patient and his family. What is the role of psychological help in palliative medecine? - In the present work, I have tried to explore all aspects of the issue, to consider the application of psychology and to explore the promising collaboration between psychology and medicine to provide the most effective care for dying people. I have made a detailed analysis of palliative care for such patients and their relatives by the visiting palliative care team. I described the history of creation and experience of establishment of palliative care field service development with a multidisciplinary approach and identified the challenges faced by professionals in providing care to patients. I have also looked at several cases that describe how palliative care is organized and what foreign specialists pay particularly looking for attention to. An initial interview from my practice with a palliative care physician is presented. Touched upon the relationship between religion, psychoanalysis and palliative care and its impact on patient care. I also investigated the basic psychoanalytic concepts of dying, fear of death, suicidal thoughts, the work of grief. Death in our lives is considered a one-time elusive event. One lives as if it were eternal, another constantly thinks about its end and denies it in every thought and action. More often, in our physic, it is difficult to perceive in our mental state the absolute knowledge that life for everyone will someday end irrevocably. "In other words: "I conspires with self-preservation behind the back of the Unconscious in order to minimize the activity of the latter as much as possible, to prevent its penetration into new territories where he has been denied forms of being for so long" (Michel de M'Uzan, 1996). Freud believed that doubts always remain, up to the point that the idea of personal immortality sometimes manages to sneak into the consciousness of people, which allows day after day to act 'as if'. Summing up my final qualifying work, I concluded that psychological help is an essential and integral part of palliative care. In our country there is still not enough attention has been paid to psychotherapy, especially in such industry as medicine. Based on my experience in palliative care (supervising more than one and a half thousand families), and having made a detailed analysis of the multidisciplinary approach in palliative care, I have realized what a huge and undeveloped field of activity for psychoanalytically oriented psychologists and psychoanalysis in general lies in this field, because only a deep approach can provide the most effective help not only to the dying and their relatives, but also to all specialists who work with incurable patients.