EXISTENTIAL MEDICINE

For most doctors, ‘diagnosis’ is solely about seeking biological causes for the patient’s symptoms. They focus only on the fleshly ‘text’ of these somatic symptoms – and not at all on the existential life ‘context’ within and from which they emerged. Hence whilst the  life of the human body is their professional specialism, they rarely ask questions regarding the individual’s life as a whole – for example by inquiring about any significant life events or situations of the sort that lay in the background and might have led up to a patient’s illness. There is a whole range of key ‘diagnostic’ questions – unasked by most doctors – which those schooled in Existential Medicine – as Life Doctoring – would begin with. Such key questions include:

When did your symptoms first occur?

Is there anything else distressing or bothering you in your life right now?

What was going on in your life in the hours, days, weeks, months or years preceding the onset of your symptoms?

What were the most significant life events, experiences, dilemmas and decisions that you confronted you in the period preceding the onset of your symptoms?

Was there any sort of underlying mood of discomfort or dis-ease you experienced in this period and if so how would you describe that mood?

What were the most dominant thoughts and emotions you experienced in this period?

Where and how or in what way did or do you sense these feelings in your body?

What sort of overall mood or state of consciousness accompanies your symptoms?

What do you tend to think about most when you are most aware of your symptoms?

What feelings accompany these thoughts?

What do you do with those thoughts and feelings when you have them?

What do you tend to do in response to your symptoms themselves?

At what times or in what situations do your symptoms tend to intensify or re-emerge?

At what times or in what situations do your symptoms tend to diminish?

Have you experienced similar symptoms in the past, and if so at what times and in what circumstances?

How do your symptoms, and the thoughts and feelings you have around them, affect your life, work and relationships?

What do your symptoms either force you to do or stop you from doing?

Is there any positive benefit can you see from the way your symptoms affect your life?

How do your symptoms make YOU feel – in what way do they affect your sense of who you are?

Is there any positive side to the different mood and sense of self accompanying your symptoms?

What are the most important things you miss in your current life and relationships?

What are the most important potentials you feel have been left unfulfilled in your life up to now?

What changes in your life situation do you feel would most help you to alleviate your symptoms?

What would make you most happy or content – independently of any improvement in your condition?