Longing for existential recognition: a qualitative study of everyday concerns for people with somatoform disorders.
OBJECTIVE
Patients with somatoform disorders could be vulnerable to stressors and have difficulties coping with stress. The aim was to explore what the patients experience as stressful and how they resolve stress in everyday life.


METHODS
A cross-sectional retrospective design using 24 semi-structured individual life history interviews. Data-analysis was based on grounded theory.


RESULTS
A major concern in patients was a longing for existential recognition. This influenced the patients' self-confidence, stress appraisals, symptom perceptions, and coping attitudes. Generally, patients had difficulties with self-confidence and self-recognition of bodily sensations, feelings, vulnerability, and needs, which negatively framed their attempts to obtain recognition in social interactions. Experiences of recognition appeared in three different modalities: 1) "existential misrecognition" covered the experience of being met with distrust and disrespect, 2) "uncertain existential recognition" covered experiences of unclear communication and a perception of not being totally recognized, and 3) "successful existential recognition" covered experiences of total respect and understanding. "Misrecognition" and "uncertain recognition" related to decreased self-confidence, avoidant coping behaviours, increased stress, and symptom appraisal; whereas "successful recognition" related to higher self-confidence, active coping behaviours, decreased stress, and symptom appraisal.


CONCLUSIONS
Different modalities of existential recognition influenced self-identity and social identity affecting patients' daily stress and symptom appraisals, self-confidence, self-recognition, and coping attitudes. Clinically it seems crucial to improve the patients' ability to communicate concerns, feelings, and needs in social interactions. Better communicative skills and more active coping could reduce the harm the patients experienced by not being recognized and increase the healing potential of successful recognition.
Department of Clinical Medicine, Aarhus University, Denmark; Department of Psychology and Behavioural Sciences, Aarhus University, Denmark. Electronic address: annemettebondo@yahoo.dk.
Annemette Bondo
AB
Lind
Research Unit for General Practice, UiT, The Arctic University of Norway, Norway.
Mette Bech
MB
Risoer
Department of Psychology and Behavioural Sciences, Aarhus University, Denmark.
Klaus
K
Nielsen
Department of Clinical Medicine, Aarhus University, Denmark; Department of Public Health, Section for Nursing, Aarhus University, Denmark.
Charlotte
C
Delmar
The Research Unit for Primary Health Care, Aarhus University, Denmark.
Morten Bondo
MB
Christensen
Department of Clinical Medicine, Aarhus University, Denmark; Department of Public Health, Section for Nursing, Aarhus University, Denmark.
Kirsten
K
Lomborg
D000223:Adaptation, Psychological; D000328:Adult; D000342:Affective Symptoms / Q000523:psychology; D003142:Communication; D003430:Cross-Sectional Studies; D004644:Emotions; D005086:Existentialism; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D008960:Models, Psychological; D036301:Qualitative Research; D021641:Recognition, Psychology; D012189:Retrospective Studies; D012649:Self Concept; D012944:Social Support; D013001:Somatoform Disorders / Q000150:complications / Q000523:psychology*; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology*; D026712:Value of Life; D055815:Young Adult
Alexithymia; Coping; Existential recognition; Experienced stress; Qualitative research; Somatoform disorders