This concept describes the consequences of the subprocess of overcoming distress and using the strategies mentioned above. In a moment, the participants’ mind has the power or energy to move on and they feel brave enough to face any difficulties that arise as a
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consequence of having a will to live. In summary, the process of obtaining palangjai or a will to live take place when the participants build up the two ways of relationship: 1) establishing a strong bond or connection with oneself and others, and 2) receiving love and support from others. Then, both ways of relationship are counted by the participants as criteria of being wanted and/or accepted, thus losing the feeling of inferiority and relieving the oppression of being stigmatised as well as bringing a meaning and a purpose to living. After that, the sense of self-value is rising and their minds become strong. Lastly, they desire to move on with their life or having a will to live.
Thus, “the will to live” is demonstrated in two aspects: 1) having a sense of self-value, and 2) gaining strong mind (jaikemkang or jaikang). These lead them to feel brave enough to face any barriers in their life and feel ready to move on in their life or have a will to live. They change their focus from dying to living. This study also showed that people who have a will to live and are able to overcome their life crisis are those who have the following characteristics: 1) having a strong mind or inner strength, 2) having connectedness with oneself and others, 3) having a support system both within themselves and from others, and 4) realising a sense of self-value. All together these factors facilitate their “finding meaning and purpose in life”.
This is consistent with the process proposed by some researchers who found that having a meaning or purpose in life is grounded in the expression of love, forgiveness and trust (Stoll, 1989) and connection (connectedness with self, others, nature, or God) (Jensen & Allen, 1994; Sessanna et al., 2007) that bring hope to people (Chiu et al., 2004). Hope is an enduring presence because “without hope there is no reason to live” (Schaefer, 1995, p. 72). Thus, maintaining connectedness, a sense of meaning and purpose in life, and perspective is the strategy associated with longevity (the will to live). In addition, the long surviving people are those who refuse to perceive that their illness is a death sentence and they also cope well with their situation that is associated with a negative correlation with viral load and a positive correlation with CD4 count (Solomon et al., 2002). Moreover, once the participants have a strong sense of purpose in life and a will to live, these enhance the sense of well-being and reduce psychological distress (Lin &
Bauer-Wu, 2003) and, as well, may prevent the symptoms of depression (Lyon & Younger, 2001). A number of participants mentioned that the process of struggling with torment and turmoil came to an end (in a moment) once they gained palangjai from the
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conditions and strategies that they applied. In the aftermath of their struggling process, although some suffering still remained, the severity of suffering declined. Although they perceived and interpret that HIV/AIDS is life-altering situation, they have a driving force (strong mind) to fight, face, and deal with any situation.
5.3
Conclusion
Overcoming distress is the second subcategory in the category of struggling to survive
that builds toward the core category Achieving Harmony of Mind in people living with HIV/AIDS in a Thai context. This subprocess describes way in which the participants overcome their torment and turmoil that overwhelm their lives particularly in the early diagnosis or early period of HIV/AIDS. As a result, their minds come through the distress and become strong. There are two kinds of promoting conditions (feeling relief of mind and selective disclosure of HIV status) and the significant strategy “finding a meaning and purpose in life” that enhance the feeling of readiness to challenge HIV/AIDS and generate the process of overcoming distress.
As many participants reported, at first they are faced with the situation of their life being turned upside down and they feel close to dying – either by HIV/AIDS or by committing suicide. All participants have to deal with overwhelming unpredictable situations, including treatment, uncertainty of a cure and planning a life with HIV/AIDS. However, once they applied the unique strategies that promote their
palangjai or strengthen their mind these helped them to move from dying to living. This subcategory is a turning point from dying to living, because at the end of this process, the mind is strengthening and the struggle to survive comes to an end (until they are faced with future suffering). From this turning point they start to learn how to live with HIV/AIDS with balance and harmony (as discussed in the next two chapters). However, there is another concern in this process, struggling to survive, which is that the main source of palangjai to live comes from outsiders and is not manageable by the HIV patients themselves. Although some of them start to recognise their inner strength, some do not. Therefore, in the next stage of the process the participants not only have to learn to live with HIV/AIDS, but also they have to learn how to enhance their own inner strength – in particular, their mind – to augment their own palangjai. This is a challenging task for them.
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