title: [Topics in clinical thanatology. Autopathothanatobiographies, -diaries, -epistulographies in comparison with Angloamerican clinical thanatologic experiences].
abstract: Extensive results of thanatologic sciences since the first decades of 20. century and multivarious practical knowledge in clinical thanatology are discussed--relating to the central problem of understanding different forms of "realisation of death". Possibilities of thanatologic information, forms of dialogue, communicative engagement and self-attitude in care-situations are critically conferred--this even in regard to mourning, grief and sorrow of the bereaved. The confrontation of thanatologic data in short-time illness until death to autopathothanatobiographic insights in long-time illness until death seems comparable in respect to relations between present clinical findings and anamnestic data. Awareness of approaching death seems not seldom due to "presentiment", averbal-communicative "preinformation" or impressions in face to progressive illness without successful therapy. Not only this is to think over in treatment and care, but also some new thanatologic experiences of the last years--for instance in respect to the question of timing, various circumstances and possible forms of informations and clearing up. Apart from individual forms of "living until death" there are certain pithy types in awareness, feeling, thinking, exposition or attitude. Some autobiographic, diaristic or epi-stulographic dates to long-time illness until death are characterized by striking limited possibilities of self-description and verbalization in situations of vital-existential distress. Silent suffering can be caused by loss of possibility in verbalization. Autothanatobiographic insights and experiences in thanatologic praxis in long-time illness until death lead to more differentiated insights than short-time illness until death--especially in respect of changing and contrary courses. Insight "evidences" of life continuities in the face of danger of death, changes in awareness of time, intensifications in intensities of perception, of feelings of the own life and changes in perception of the own ill organism, just as intensivation of partnership-relations ("synchronisation") can pass in the foreground. The last seems especially evident in special forms of "partnerautobiography" with alternating informations of the two. This illustrates the "two-sided aspect of death" death as a "dyadic event" (A. Toynbee), which is an important view relating to care of bereaved with changes in personal identity and awareness of time. Processes of dying and reactions of bereaved are integrated in complex anthropologic, psychologic, psychosociologic and psychosomatic factors. Certainly it is not possible such catastrophic incidents merely to interpret in psychoanalytic categories.
authors.affiliation: Universitätsnervenklinik, Marburg.
authors.forename: H
authors.initials: H
authors.lastname: Jacob
mesh_terms: D001293:Attitude to Death; D006117:Grief; D006801:Humans; D012803:Sick Role; D013727:Terminal Care / Q000523:psychology*; D013795:Thanatology
vernacular_title: Fragen zur klinischen Thanatologie. Autopathothanatobiographien, -diarien, -epistulographien gegenüber angloamerikanischen klinisch-thanatologischen Erfahrungen.