Will to live

The will to live is a psychological force to fight for survival seen as an important and active process of conscious and unconscious reasoning. This occurs particularly when one’s own life is threatened by a serious injury or disease. The idea in which someone who is on the threshold of death may consciously or unconsciously try to stay alive through the belief that they have a reason or something to live for, along with giving up on the will to live. There are significant correlations between the will to live and existential, psychological, social, and physical sources of distress.[1] The concept of the will to live can be seen as directly impacted by hope. Many, who overcome near-death experiences with no explanation, have described concepts such as the will to live as a direct component of their survival.[2] The difference between the wish to die versus the wish to live is also a unique risk factor for suicide.[3]

Background

The will to live is considered to be a very basic drive in humans; but not necessarily the main driving force. In psychotherapy, Sigmund Freud termed the pleasure principle, which is the seeking of pleasure and avoiding of pain.[4] Viktor Frankl, after spending time in a German concentration camp, developed psychotherapy called logotherapy, or the will to meaning. Maslow's Hierarchy of Needs highlights the innate appetite that people possess for love and belonging but before all this there is the very basic and powerful will to live. Psychologists have established that human beings are a goal-oriented species. In assessing the will to live, it should be borne in mind that it could be augmented or diminished by the relative strength of other simultaneously existent drives. Psychologists generally agree that there is the will to live, the will to pleasure, the will to superiority and the will to connection. There are also usually varying degrees of curiosity with regard to what may be termed the will to identity or establishing meaningful personal responses. The will to live is a platform without which it would not be possible to satisfy the other drives.[5]

Concept

Medical definition: the sense of self-preservation, usually paired with future conceptions of the self such as dreams, aspirations, and future expectations of improvements in one's life.[6] The notion of the will to live is an important concept when attempting to understand and comprehend why we do what we do in order to stay alive, and for as long as we can. This can be related to either ones push for survival on the brink of death, or someone who is just trying to find a meaning to continuing their life. Some researchers say that people who have a reason or purpose in life during such dreadful and horrific experiences, will often appear to fare better than those that may find such experiences overwhelming.[7] Everyday, people undergo countless types of negative experiences, some to which may be demoralizing, hurtful, or tragic. An ongoing question continues to be what keeps the will to live in these situations. Some people that claim to have experienced instances of the will to live, have many different explanations behind it.[8]

Correlations

“Existential, psychiatric, social, and, to a lesser degree, physical variables are highly correlated with the will to live”.[9] Existential issues found to correlate significantly include hopelessness, the desire for death, sense of dignity, and burden to others. Psychiatric issues found to be strongly associated are such as depression, anxiety, and concentration. Physical issues that showed the strongest associations were appetite and appearance which did not show the same consistent degree of correlation. The four main predictor variables of the will to live changing over time are anxiety, shortness of breath, depression, and sense of well-being[10] which correlate with the other variable predictors as well. Social variables and quality of life measures are shown to correlate significantly with the will to live such as support and satisfaction with support from family, friends, and health care providers.[11] Findings on the will to live have suggested that psychological variables are replaced by physical mediators of variation as death draws nearer. The will to live has also proven to be highly unstable.[12]

Giving up the will to live

Losing one’s sense of meaning or purpose and experiencing life as becoming more redundant is important to the loss of the will to live among the dying which seems to correlate with how one perceives oneself to be seen and their appearance; which can leave people with depressive symptoms. Therefore, sensing that these qualities are no longer valued or appreciated or losing one’s sense of essence/personhood could undermine the will to live.

Research

Many studies have been conducted on the theory of the will to live. Among these studies are subject to the difference in gender and the elderly and also in the terminally ill. One study focused on a simple question that asked about rating one’s will to live and presented the findings that elderly participants reporting a stronger will to live and strengthened or stable will to live survived longer in comparison to those with a weak will to live. This study found that women were able to cope with life-threatening situations, but suggested that the participants could not have been stable and requires future replication.[13] The second study presented the idea of the will to live in the terminally ill specifically cancer patients termed as older. In this study researchers were able to suggest that patients who had tested as having a low sustained will to live died soonest, as opposed to having a moderate level of the will to live, lived the longest while high will to live could affect individuals in any direction. This study needs future replication that can show the effects of will to live in the terminally ill from different diseases and age categories.[14] Other accounts of the will to live exist in many extreme medical cases, where patients have overcome extraordinary odds to survive. The Holocaust has provided many instances of this phenomenon, and is a good example of this as well.[15] A proposed mechanism for the will to live is the idea that positive mental thinking tends to lower one’s risk for disease and health complications. One study showed that women who thought positively were more likely to carry more antibodies against certain strains of the flu, thus having a stronger immune system than those who were told to think negative thoughts.[16] Powerful examples of humans having a will to live can be seen in death records throughout history showing that people were more likely to die right after a major holiday, such as Christmas and Thanksgiving, and even birthdays, not actually on or before them, but passing shortly after.[17][18]

Criticisms

Critics of the will to live have posited alternate hypothesizes to explain accounts of when humans overcome death. One hypothesis states that when one has a specific goal in mind, they regulate their behavior to be healthier and more productive; thus, extending one’s life can be accomplished by simply eating better, or getting more exercise. In overcoming death in near-death situations, the fight-or-flight response is credited by those who negate the idea of the will to live.

The will to live resides primarily in the mind for most of one's lifetime. During the late stages of life, the will to live is physiologically based, which explains why hospice patients often linger in a state of suffering in spite of their conscious desire for life to end.

See also

References

  1. "Understanding the Will to Live in Patients Nearing Death". The Academy of Psychosomatic Medicine (2005)
  2. No Author (2003). What is the Will to Live. Retrieved from http://www.wisegeek.com/what-is-the-will-to-live.htm
  3. Brown, Gregory K.; Steer, RA; Henriques, GR; Beck, AT (1977-1979), "The Internal Struggle Between the Wish to Die and the Wish to Live: A Risk Factor for Suicide", American Journal of Psychiatry (Am J Psychiatry) 162 (10): 1977–1979, doi:10.1176/appi.ajp.162.10.1977, PMID 16199851
  4. Snyder, C. R.; Lopez, Shane J. (2007). Positive Psychology. Sage Publications, Inc. p. 147. ISBN 0-7619-2633-X.
  5. Oster, C. (). How Do We Define "The Will to Live". Retrieved from http://healingwithdrcraig.com/blog/how-do-we-define-the-will-to-live
  6. McGraw-Hill Concise Dictionary of Modern Medicine (2002). Will to Live: Medical Definition. Retrieved from http://medical-dictionary.thefreedictionary.com/Will+to+Live
  7. Frankl, V. E. (1963). In Man's search for meaning. Boston: Beacon Press.
  8. Grohol, J. (2009). The Power of the Will to Live. Psych Central. Retrieved on November 21, 2012, from http://psychcentral.com/blog/archives/2009/12/28/the-power-of-the-will-to-live
  9. Chochinov, H. M.; Hack, T.; Hassard, T.; Kristjanson, L. J.; McClement, S.; Harlos, M. (2005). "Understanding the Will to Live in Patients Nearing Death". Psychosomatics. 46 (1): 7–10. doi:10.1176/appi.psy.46.1.7.
  10. Chochinov, H. M.; Tataryn, D.; Clinch, J. J.; Dudgeon, D. (1999). "Will to Live in the Terminally Ill". The Lancet. 354: 816–819. doi:10.1016/s0140-6736(99)80011-7.
  11. Chochinov, H. M.; Hack, T.; Hassard, T.; Kristjanson, L. J.; McClement, S.; Harlos, M. (2005). "Understanding the Will to Live in Patients Nearing Death". Psychosomatics. 46 (1): 7–10. doi:10.1176/appi.psy.46.1.7.
  12. Chochinov, H. M.; Tataryn, D.; Clinch, J. J.; Dudgeon, D. (1999). "Will to Live in the Terminally Ill". The Lancet. 354: 816–819. doi:10.1016/s0140-6736(99)80011-7.
  13. Chochinov, H. M.; Hack, T.; Hassard, T.; Kristjanson, L. J.; McClement, S.; Harlos, M. (2005). "Understanding the Will to Live in Patients Nearing Death". Psychosomatics. 46 (1): 7–10. doi:10.1176/appi.psy.46.1.7.
  14. Tataryn, D.; Chochoniv, H. M. (2002). "Predicting the trajectory of will to live in terminally ill patients". Psychosomatics. 43 (5): 370–377. doi:10.1176/appi.psy.43.5.370.
  15. Goldenberg, J. Retrieved from http://www.councilforrelationships.org/resources/goldenberg-survival.pdf
  16. Goode, E. (2003, September 02). Power of positive thinking may have a health benefit, study says. Retrieved from http://www.nytimes.com/2003/09/02/health/power-of-positive-thinking-may-have-a-health-benefit-study-says.html
  17. Shimizu, M. & Pelham, B.W. (2008). Postponing a date with the Grim Reaper: Ceremonial events and mortality. Basic and Applied Social Psychology, 30(1), 36-45.
  18. Grohol, J. (2009). The Power of the Will to Live. Psych Central. Retrieved on November 21, 2012, from http://psychcentral.com/blog/archives/2009/12/28/the-power-of-the-will-to-live
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