Attentional mechanisms associated with repressive distancing

'I cannot accept it' distressing experiences in parents of children diagnosed with cancer: A qualitative study

AIMS

To explore the distressing experiences of Chinese parents of children with cancer from the perspective of psychological inflexibility.

DESIGN

A qualitative study using a descriptive qualitative approach based on the model of psychological inflexibility was adopted.

METHODS

Individual semi-structured interviews through synchronized online video were conducted with 21 Chinese parents of children with cancer from October 2020 to May 2021. Data were analysed using content analysis.

RESULTS

Four themes and 11 subthemes were identified: (i) immersion in struggling and suffering, (ii) avoidance and suppression, (iii) blaming and complaint and (iv) helplessness and worthlessness. Parents were unwilling to accept the diagnosis and witness their children's suffering, trapped in uncontrollable negative emotions and thoughts. Avoiding emotions and socializing, blaming themselves or complaining of injustice were common. They felt helpless towards life and valueless without the child.

CONCLUSION

The research findings provide additional perspectives in understanding the distressing experiences in parents of children with cancer. Overall, the emotional and coping styles indicated the lack of psychological flexibility of parents when facing childhood cancer, which is profoundly influenced by Chinese culture.

IMPLICATIONS FOR THE PROFESSION

Healthcare professionals are recommended to provide culturally sensitive strategies or interventions for building psychological flexibility in addressing parental psychological distress.

IMPACT

The study provides insights into exploring distressing experiences and reveals the inflexible psychological and behavioural patterns in parents of children with cancer, which could benefit healthcare providers in managing parental psychological distress and helping these parents build flexible coping strategies.

REPORTING METHOD

The COREQ guideline was followed.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public involvement.

The Price of Needing to Belong: Neurobiology of Working Through Attachment Trauma

Belonging is fundamental to health and well-being. Complex relational trauma disrupts attachments, negatively impacting developing neurobiology and has significant implications for attachment behaviors, mental health, and treatment planning. We have developed a dynamic relational (DR) model of psychotherapy that aims to restore a healthy sense of belonging, targeting levels of activation and integration of large scale neural networks in the service of increasing the emotional capacities (attunement, processing, regulation, and expression) required to work through attachment trauma and establish healthy relationships. Our DR model provides an organizing framework through which to understand both the phenomenology observed in complex trauma and the mechanisms of therapeutic change. Our approach informs the weighting and timing of interventions to actively address capacity deficits, ego-syntonic symptoms, and unconscious resistance. The implications of this model also relate to the pathogenesis of mental disorder, and suggest prevention and early intervention efforts focus on modulation of subcortical (autonomic) responses and the encouragement of balanced cortical integration to enhance cognitive flexibility/psychological resilience. Ultimately, interventions based on our systematic model may modulate the genetic diathesis and comorbidities of relational trauma and increase psychological resilience.

Acceptance and Commitment Therapy as a Unified Model of Behavior Change

The present article summarizes the assumptions, model, techniques, evidence, and diversity/social justice commitments of Acceptance and Commitment Therapy (ACT). ACT focused on six processes (acceptance, defusion, self, now, values, and action) that bear on a single overall target (psychological flexibility). The ACT model of behavior change has been shown to have positive outcomes across a broad range of applied problems and areas of growth. Process and outcome evidence suggest that the psychological flexibility model underlying ACT provides a unified model of behavior change and personal development that fits well with the core assumptions of counseling psychology.