Monday, April 7, 2008

bersediakah aku secara psikologi?

Seminggu bertahan ingatkan sakit perut biasa, kot2 la gastrik ker...masuk angin ker....masih terngiang2 apa yg doktor ckp, adakah emosi aku bersedia?.....ada yang kata, "ada lagi yang lebih teruk"..... kata seseorang ini "kalau dah Allah tentukan macam tu, kita nak buat macam mana"....benar! memang benar! apa lagi yang boleh dikatakan kalau seseorang dah kata begitu....... bila surf2 internet malam tadi, just to share with all of u, Endometriosis and psychology, tulisan Vicki O'Donnell.

Psychology is the study of mind and behaviour. These two are closely linked, because what we think, feel and believe influences how we behave. Within the traditional “biomedical” approach to health and illness, psychology had a very small role to play. This approach viewed mind and body as independent. Physical illness may have had psychological consequences, but a person’s psychological state was not considered to be related to the progression of illness. Treatments were therefore aimed at bringing about physical changes.

The current view, though, is that it is possible to have an interaction between mind and body in which the mental can affect the physical, and so psychology has begun to be included in an understanding of health. Based on what we already know from psychology, we can make some guesses about its role in endometriosis.
Endometriosis is associated with chronic pain, and there is a wealth of research into the psychology of pain. It is generally accepted that psychology influences how we perceive pain, in that psychological factors, not just physical ones, can influence the amount of pain we feel.

Endometriosis can have an effect on fertility. Infertility has psychological effects in terms of anxiety and stress, depression and self-esteem. Many women with endometriosis must cope with infertility as well as the disease itself.

We know that impotence can affect feelings of masculinity and sexual identity for men (Gannon et al, 2004). Because endo can cause pain on intercourse, women with the disease may have to cope with lack of sex or sexual pleasure. This may have significant effects on women’s feelings of sexuality and femininity.

So, as well as all of the aspects of psychology which are involved in any illness, endometriosis presents a unique set of possible psychological issues to be taken into account in our understanding of the disease. We should begin, though, by exploring a bit of what we already know of the psychology of health and illness.

Health Psychology suggests that we should think about human beings as complex systems, and that health and illness should not be viewed as having a single causal factor (Ogden, 2000). Within Health Psychology, individuals are not viewed as passive victims of illness, but as participants in illness. Therefore, the whole person should be treated, not just the physical.

Within Health Psychology, health and illness exist on a continuum. At any given time we can place ourselves somewhere on that continuum. People progress from healthiness towards illness and back again. This is relevant to endometriosis because its cyclical nature means that we can move from being very ill, to potentially being quite well, on a monthly basis. In other diseases, the cycles of health and illness are often spread over longer periods. Health Psychology emphasises an understanding of our subjective experience of illness. Understanding the role that psychological factors play in our illness could help us to alleviate psychological symptoms which themselves exacerbate our physical symptoms.

If we ask different people “What does it mean to be ill?”, we discover great differences in their answers (eg. Lau, 1995). Each of us defines health and illness differently. These definitions stem from a set of underlying beliefs that each of us hold, and which give us a framework for understanding and coping with illness.
One set of beliefs that people have about illness relate to identity – its name and its symptoms. Some people might have difficulty in understanding that someone is ill, when there is no recognised name for their symptoms. With endometriosis, women often tolerate years of symptoms and misdiagnosis before finally discovering what is wrong with them. During that time we often encounter people who are unsympathetic to our situation because we do not yet have a name for it. In fact, we often encounter the same lack of sympathy even after diagnosis because the majority of people have never heard of endometriosis.

There is no right or wrong set of beliefs to have, and everyone is different. But it’s important to try and recognise what our own beliefs are. We should question whether those beliefs are valid or not, whether or not they are actually helping us to deal with our illness, because they do affect our behaviour.