Suicidality, a significant problem in New Zealand for the past decade or so, has invited a substantial body of research into causes and prevention. However, given the effort, the prevention results do not appear to be sufficiently convincing when coroners’ views are considered. This paper focuses on two mainstream therapeutic approaches towards persons with borderline personality disorder, in which suicidal behaviour is a prominent feature demanding understanding and active attention. It is argued that dialectical behaviour therapy and psychoanalytically informed therapies (...) are lacking on two accounts. Firstly, the philosophical and methodological underpinnings of both approaches perpetuate what Heidegger refers to as the compound misunderstanding of ourselves as human beings. Secondly, what this translates into is a practice which forgets the human order and misunderstands the experience of the singular human present in despair. As an alternative approach towards dealing with suicide in practice, the author presents concepts central to Heidegger’s phenomenology of human existence and discusses how these may inform and enhance the treatment of suicidal patients. Indo-Pacific Journal of Phenomenology , Volume 7, Edition 2 September 2007. (shrink)

In this paper we offer an appreciation and critique of patient-led care as expressed in current policy and practice. We argue that current patient-led approaches hinder a focus on a deeper understanding of what patient-led care could be. Our critique focuses on how the consumerist/citizenship emphasis in current patient-led care obscures attention from a more fundamental challenge to conceptualise an alternative philosophically informed framework from where care can be led. We thus present an alternative interpretation of patient-led care that we (...) call ‘lifeworld-led care’, and argue that such lifeworld-led care is more than the general understanding of patient-led care. Although the philosophical roots of our alternative conceptualisation are not new, we believe that it is timely to re-consider some of the implications of these perspectives within current discourses of patient-centred policies and practice. The conceptualisation of lifeworld-led care that we develop includes an articulation of three dimensions: a philosophy of the person, a view of well-being and not just illness, and a philosophy of care that is consistent with this. We conclude that the existential view of well-being that we offer is pivotal to lifeworld-led care in that it provides a direction for care and practice that is intrinsically and positively health focused in its broadest and most substantial sense. (shrink)