title: Searching for existential security: a prospective qualitative study on the influence of mindfulness therapy on experienced stress and coping strategies among patients with somatoform disorders.
abstract: OBJECTIVE
  The aim was to explore how mindfulness group therapy for somatoform disorders influenced the patients' stress experiences, coping strategies and contextual psychosocial processes.
  
  
  METHODS
  A longitudinal pre- and post-treatment design, using 22 semi-structured individual pre- and post-treatment interviews. Data-analysis was based on a thematic methodology.
  
  
  RESULTS
  Pre-treatment patients were struggling in an existential crisis, feeling existentially insecure about their social identity, the causes, consequences and management of their illness; experiencing difficulties identifying and expressing stress-related cognitions, emotions and feelings, and low bodily and emotional self-contact; often leading to avoidant coping, making these individuals highly stress-vulnerable. Post-treatment, the overall change was conceptualized as increased existential security, defined by patients being more self-confident; more clarified with their social identity, the nature, management and future prospects of their illness; generally using more flexible coping strategies to reduce their daily stress experiences. Four related subthemes were identified contributing to increased existential security: 1) more secure illness perceptions - feeling existentially recognized as "really" ill, 2) enhanced relaxation ability - using mindfulness techniques, 3) increased awareness - connecting differently to mind and body 4) improved ability to identify and express needs and feelings of distress - more active communicating. Patients suggested that mindfulness therapy could be expanded with more time for group-discussions followed by additional individual therapy.
  
  
  CONCLUSIONS
  Generally, treatment positively influenced the patients' illness perceptions, stress-experiences, body- and self-awareness, coping strategies, self-image, social identity and social functioning. However, patients identified potentials for treatment improvements, and they needed further treatment to fully recover.
authors.affiliation: Department of Psychology and Behavioural Sciences, Aarhus University, Denmark; Department of Clinical Medicine, Aarhus University, Denmark. Electronic address: annemettebondo@yahoo.dk.
authors.forename: Annemette Bondo
authors.initials: AB
authors.lastname: Lind
authors.affiliation: Department of Clinical Medicine, Aarhus University, Denmark; Department of Science in Nursing, Aarhus University, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Delmar
authors.affiliation: Department of Psychology and Behavioural Sciences, Aarhus University, Denmark.
authors.forename: Klaus
authors.initials: K
authors.lastname: Nielsen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001364:Awareness; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness; D011446:Prospective Studies; D011615:Psychotherapy, Group; D036301:Qualitative Research; D012063:Relaxation; D012649:Self Concept; D013001:Somatoform Disorders / Q000523:psychology* / Q000628:therapy*; D013315:Stress, Psychological / Q000517:prevention & control*
keywords: Alexithymia; Coping; Mindfulness therapy; Psychotherapy; Somatoform disorders; Stress