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Heggdal D, Borgejordet S, Fosse R. "Existential Catastrophe Anxiety": Phenomenology of Fearful Emotions in a Subset of Service Users With Severe Mental Health Conditions. Front Psychol 2022; 13:766149. [PMID: 35360621 PMCID: PMC8960201 DOI: 10.3389/fpsyg.2022.766149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 02/21/2022] [Indexed: 12/03/2022] Open
Abstract
A subset of people with severe mental health conditions feels they are on the verge of losing control, even in the absence of external threats or triggers. Some go to extreme ends to avoid affective arousal and associated expectations of a possible, impending catastrophe. We have learned about such phenomenological, emotional challenges in a group of individuals with severe, composite mental health problems and psychosocial disabilities. These individuals have had long treatment histories in the mental health care system. They have been encountered at a specialized inpatient ward offering exposure-based therapy that aims at restoring self-regulation and recovery. We describe the phenomenology of anxiety and fear presented by these service users, a fear we have coined existential catastrophe anxiety (ECa). We also suggest a set of underlying, interacting, psychological mechanisms that may give rise to ECa, before comparing ECa with three other constructs previously described in the literature—annihilation anxiety, ontological insecurity, and affect phobia. These comparisons show several similarities, but also unique qualities with ECa and its suggested underlying mechanisms. The conceptualization of ECa may aid clinicians in addressing extreme experiential turmoil and engage service users in empowering therapeutic projects.
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Affiliation(s)
- Didrik Heggdal
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Synne Borgejordet
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Roar Fosse
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
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Scalabrini A, Mucci C, Angeletti LL, Northoff G. The Self and its World: A Neuro-Ecological and Temporo-Spatial Account of Existential Fear. Clin Neuropsychiatry 2020; 17:46-58. [PMID: 34908967 PMCID: PMC8629082 DOI: 10.36131/clinicalnpsych20200203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/05/2020] [Indexed: 11/25/2022]
Abstract
The current international crisis situation caused by the COVID-19 pandemic is having a strong psychological impact on our subjectivities. We are constantly threatened by the danger of i) being infected, ii) infecting other people, and (iii) by the loss of social relation. Departing from these premises, we here aim to investigate the psychological and neurodynamics of this complex phenomenon. First, we discuss about recent psychological and neuronal findings on fear and its disorders, related to an unbalanced intero-exteroceptive processing and emotional regulation. Secondly we move to the psychological and neuronal dynamics of self and others characterized by a temporo-spatial alignment with the world. Due to the neural overlap of emotion and self and the deep-reaching neuro-ecological layers of self, emotional feelings like fear and anxiety cannot be detached and dissociated from the world; they signify the world–brain relation, and, more specifically, our self-other relation. The deepest neuro-ecological and neuro-social layers of self are threatened by the loss of subjectivity, which is manifest in our loss of body and thus the fear of dying, and the loss of intersubjectivity that surfaces in our fear of infecting others, which reflect the intimate anchorage of the self with the world. In our opinion the pandemic of COVID-19 deeply affect our sense of self and its spatio-temporal neuronal dynamics providing the prerequisites for the manifestation of fear and existential anxiety, thus disrupting the brain-world relation with significant repercussions on our psyche and on our daily lives.
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Affiliation(s)
- Andrea Scalabrini
- Department of Psychological, Health and Territorial Sciences (DiSPuTer), G. d'Annunzio University of Chieti-Pescara, Via dei Vestini 33, 66100 Chieti (CH), Italy
| | - Clara Mucci
- Department of Psychological, Health and Territorial Sciences (DiSPuTer), G. d'Annunzio University of Chieti-Pescara, Via dei Vestini 33, 66100 Chieti (CH), Italy
| | - Lorenzo Lucherini Angeletti
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo G. Alessandro Brambilla 3, 50134, Florence, Italy
| | - Georg Northoff
- The Royal's Institute of Mental Health Research & University of Ottawa. Brain and Mind Research Institute, Centre for Neural Dynamics, Faculty of Medicine, University of Ottawa, Ottawa, 145 Carling Avenue, Rm. 6435, Ottawa, Ontario, Canada K1Z 7K4.,Mental Health Centre, Zhejiang University School of Medicine, Tianmu Road 305, Hangzhou, Zhejiang Province, 310013, China.,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Tianmu Road 305, Hangzhou, Zhejiang Province, 310013, China.,TMU Research Centre for Brain and Consciousness, Shuang Hospital, Taipei Medical University, No. 250 Wu-Xing Street, 11031 Taipei, Taiwan.,Graduate Institute of Humanities in Medicine, Taipei Medical University, No. 250 Wu-Xing Street, 11031 Taipei, Taiwan
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