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Loss of Life and Loss of Bodily Integrity: Two Different Sources of Threat for People who are Ill

Personal construct theory was used to generate some questions about the meanings that different types of threat–loss of life and loss of bodily integrity–hold for people who are severely ill. Content analyses of the responses of ill people and healthy people indicated that ill people expressed more concern with both types of threat than healthy people. Ill people who were suffering from acute rather than chronic illness, who were scheduled for surgery and who were hospitalized rather than being cared for at home expressed more concern about loss of life but not about loss of bodily integrity than other ill people. Each type of threatened loss was found to be associated with a different set of psychological states for people who were ill. Threat of loss of life was associated with indirectly expressed anger and uncertainty but also with the expression of many positive feelings. Threat of loss of bodily integrity was also associated with indirectly expressed anger, but with direct expression of it too, together with hopelessness and helplessness. Patients facing the first threat saw themselves as actively engaged in relationships with others, while those facing the second viewed themselves more often as passive participants. The value of this information about the meanings of threats of loss of life and loss of bodily integrity for the counseling of ill people dealing with these threats was illustrated by two case studies.