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Benevolence in palliative care: A crossover view of the caregiver ideal

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2019. Ressources en ligne : Abrégé : Benevolence is a pillar of care, which when taken to its extreme can carry the unexpected seed of serious violence. Where the temptation for altruism is strong, the question of our desire for the other must be raised. Is it always congruent with the subject’s aspirations and on what foundations does it stand? Faced with the phenomena of life and death, the excess of benevolence is similar to a quest for personal appeasement: a desire to sanitize death—along with impulsive mothering inherited from the fantasy of being an “ideal mother”—would be symptomatic of the need for reactive control over anxiety and powerlessness. Moreover, benevolence at its height can be understood as the expression of an unconscious desire for reparation. Whether real or symbolic bereavements, care teams are often confronted with the reminiscence of painful past bereavements. Poorly cauterized, they resonate with stressful professional situations, generating ambivalent attitudes. Desire for reparation also testifies to the deep guilt of some. Lastly, an excess of benevolence can be read as the translation of fragile self-esteem, the patient’s over-investment toward a narcissistic reparation. Benevolent obstinacy has its consequences: a grasp on the patient, the anguish of regression and abandonment, and a feeling of indebtedness that cannot be overcome. There are multiple motivations behind an excess of benevolence, and they are not very conscious ones. Sharing our thoughts within the team allows us to analyze our emotional movements and manage our frustrations related to our ideal of palliative care.
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Benevolence is a pillar of care, which when taken to its extreme can carry the unexpected seed of serious violence. Where the temptation for altruism is strong, the question of our desire for the other must be raised. Is it always congruent with the subject’s aspirations and on what foundations does it stand? Faced with the phenomena of life and death, the excess of benevolence is similar to a quest for personal appeasement: a desire to sanitize death—along with impulsive mothering inherited from the fantasy of being an “ideal mother”—would be symptomatic of the need for reactive control over anxiety and powerlessness. Moreover, benevolence at its height can be understood as the expression of an unconscious desire for reparation. Whether real or symbolic bereavements, care teams are often confronted with the reminiscence of painful past bereavements. Poorly cauterized, they resonate with stressful professional situations, generating ambivalent attitudes. Desire for reparation also testifies to the deep guilt of some. Lastly, an excess of benevolence can be read as the translation of fragile self-esteem, the patient’s over-investment toward a narcissistic reparation. Benevolent obstinacy has its consequences: a grasp on the patient, the anguish of regression and abandonment, and a feeling of indebtedness that cannot be overcome. There are multiple motivations behind an excess of benevolence, and they are not very conscious ones. Sharing our thoughts within the team allows us to analyze our emotional movements and manage our frustrations related to our ideal of palliative care.

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