No human’s life is perfect, because human’s were not created to live in a ‘Garden of Eden’, but a ‘Garden of Hope for the Hereafter’.

Children and Youth are encouraged to understand that ‘Doing Life’ is not about blaming someone else for their mistakes.

Life is about Choices, Priorities, Determination, Dedication, Self-Sacrifice, Blood, Sweat and Tears, Never Doing Illegal Drugs, early to bed early to rise makes Children and Youth healthy, and wise.

Hard work overcomes obstacles. Everyone hits life’s bumps. It’s not how or why humans fall down. It’s how and when humans get back up that counts.

“”>  Quality of life (QoL) can be defined as to the extent certain desirable factors are attained or retained.

These include such factors as

· well-being,

· interpersonal relations,

· opportunity for personal growth and development,

· ability to exercise human rights,

· self-determination and

· healthy participation in society.

· Enhancement of quality of life is particularly important for those who suffer from chronic disease or developmental or physical disability.

[QUALITY OF LIFE: “A quality facility will always concentrate on quality of life issues for their residence and patients.”  Nugent, Pam M.S., in, April 28, 2013, (accessed February 26, 2018).]

“”>  Conclusion: Concerning the term general ‘Quality of Life’ (QoL), with regards to this term and the term ‘subjective well-being’, this research concluded that a distinction between them, proposed by Smith, is conceptually useful, and should be reinstated.

This research concluded that the objective and subjective (i.e., external and internal) dimensions of life need to be better accommodated in conceptualisations of these terms, both to facilitate and integrate research on what is clearly a multidisciplinary (if not trans disciplinary) concept.

The fact that the terms ‘quality of life’ as well as ‘subjective well-being’ are not differentiated in most cases may be related to the wide range of definitions for general QoL and Health Related Quality of Life (HRQoL)

Taking these definitions into account, HRQoL is defined as optimum levels of mental, physical, role (e.g. work, parent, carer, etc.) and social functioning, including relationships, and perceptions of health, fitness, life satisfaction and well-being.

It should also include some assessment of the patient’s level of satisfaction with treatment, outcome and health status and with future prospects.

It is distinct from QoL as a whole, which would also include adequacy of housing, income and perceptions of immediate environment.

[Europe’s Journal of Psychology, 2013, Vol. 9(1), 150–162, doi:10.5964/ejop.v9i1.337 Received: 2012-04-06. Published: 2013-02-28. *Corresponding author at: Centre for Research and Technology, 12 Eratous Str., 14568, Athens, Greece. E-mail:]

Characteristics of a Satisfactory General Quality of Life (QOL) and Well-Being

“”>  It is impossible to list all the attributes related to the concept of “Quality of Life”, but multiple sources in the literature has mentioned the following:

+↑ (Good or Positive for each of the following conditions) Ability Adaptation Appreciation Basic Needs Belonging Control Responsibilities Enhancement Enjoyment Environment Expectations Experiences Flexibility Freedom Fulfilment Happiness Health Hopes Identity Improvement Inclusivity Integrity/Intactness Judgements Knowledge Living Conditions Needs Opportunities Perceptions Pleasure psycological Religion Safe Satisfaction Secure Security Self-esteem Society Spirituality Status Calm Stresslessness  Truth Well-Being Wishes

Working Conditions [Global Development and Research Center]

“”>  There is little agreement about what constitutes good death or successful dying.

The authors conducted a literature search for published, English-language, peer-reviewed reports of qualitative and quantitative studies that provided a definition of a good death.

Stakeholders in these articles included patients, pre-bereaved and bereaved family members, and healthcare providers (HCPs).

Definitions found were categorized into core themes and subthemes, and the frequency of each theme was determined by stakeholder (patients, family, HCPs) perspectives.

36 studies met eligibility criteria, with 50% of patient perspective articles including individuals over age 60 years.

We identified 11 core themes of good death:

1.     preferences for a specific dying process,

2.     pain-free status,

3.     religiosity/spiritualty,

4.     emotional well-being,

5.     life completion,

6.     treatment preferences,

7.     dignity,

8.     family,

9.     quality of life,

10.    relationship with HCP,

11.     and other.

The top three themes across all stakeholder groups were preferences for dying process (94% of reports), pain-free status (81%), and emotional well-being (64%).

However, some discrepancies among the respondent groups were noted in the core themes: Family perspectives included life completion (80%), quality of life (70%), dignity (70%), and presence of family (70%) more frequently than did patient perspectives regarding those items (35%–55% each).

In contrast, religiosity/spirituality was reported somewhat more often in patient perspectives (65%) than in family perspectives (50%).

Taking into account the limitations of the literature, further research is needed on the impact of divergent perspectives on end-of-life care. Dialogues among the stakeholders for each individual must occur to ensure a good death from the most critical viewpoint—the patient’s.

[Defining a Good Death (Successful Dying): Literature Review and a Call for Research and Public Dialogue by Meier EA, Gallegos JV, Montross-Thomas LP, Depp CA, Irwin SA, Jeste DV. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2016;24(4):261-271. doi:10.1016/j.jagp.2016.01.135.]

“”> Death is the only certainty in life and yet it remains the greatest cause of human anxiety. The reason remains a mystery. For a counter argument see de Vocht (2006).

One of the causes of Death Anxiety is the unkown nature of what lies beyond death (Parkes 1978).

·  Death is guaranteed

·  Yet unpredictable in its timing

·  Making it indiscriminate

·  May offer explanation for anxiety

·  human knowledge and science have failed to stop or control death

·  Makes death remain ill-understood

·  Thus humans construct their own image of death

·  The image is largely negative or destructive and therefore induces anxiety. <””

[Towards a definition of death anxiety by Brian Nyatanga and Hilde de Vocht, International Journal of Palliative Nursing 2006 12:9, 410-413]

Death Anxiety is anxiety which is caused by thoughts of death. One source defines death anxiety as a “feeling of dread, apprehension or solicitude (anxiety) when one thinks of the process of dying, or ceasing to ‘be’”.[1]

Death Anxiety is also referred to as thanatophobia (fear of death), and is distinguished from necrophobia, which is a specific fear of dead or dying persons and/or things (i.e. others who are dead or dying, not one’s own death or dying).[2]  [1. Definition by Farley G.: Death anxiety. National Health Service UK. 2010, found in: Peters L, Cant R, Payne S, O’Connor M, McDermott F, Hood K, Morphet J, Shimoinaba K (2013). “How death anxiety impacts nurses’ caring for patients at the end of life: a review of literature”(PDF). Open Nurs J. 7: 14–21. Archived from the original (PDF) on 2013-10-14]  [2. The American Heritage® Dictionary of the English Language, Fourth Edition 2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company]

“In his structural theory, Sigmund Freud described the ego as the mediator between the id and super-ego and the external world. The task of the ego is to find a balance between primitive drives, morals, and reality, while simultaneously satisfying the id and superego.

“Freudians saw the ego as forming from separate ‘nuclei’: ‘A final ego is formed by synthetic integration of these nuclei, and in certain states of ego regression a split of the ego into its original nuclei becomes observable’.”[7]

“The main concern of the ego is with safety, ideally only allowing the id’s desires to be expressed when the consequences are marginal.

“Ego defenses are often employed by the ego when id behavior conflicts with reality and either society’s morals, norms, and taboos, or an individual’s internalization of these morals, norms, and taboos. Freud noted however that in the face of conflicts with superego or id, it was always ‘possible for the ego to avoid a rupture by submitting to encroachments on its own unity and even perhaps by effecting a cleavage or division of itself’.”[8] [Sigmund Freud, On Metapsychology (PFL 11) p. 462]  [Sigmund Freud, On Psychopathology (PFL 10) p. 217]

One function of the ‘Ego Life’ is about sorting thru similarities and differences, evaluating and choosing. Ego Integrity depends on how the ‘Ego Life’ or ‘Ego Identity’ was framed.

“Ego identity is the attainment of a firm sense

·  of self,

·  who one is,

·  where one is headed in life,

·  and in what one believes.

“People who achieve ego identity clearly understand their

·  personal needs,

·  values

·  and life goals.

“Erikson coined the term identity crisis to describe the stressful period of soul-searching and serious self –examination that many adolescents experience when struggling to develop a set of personal values and direction in life. [Essentials of Psychology: Concepts and Applications by Jeffrey S. Nevid, Cengage Learning, Dec 5, 2016 – Education – 688 pages]

The International Dictionary of Psychoanalysis began the description of Ego Identity from Erik Erikson’s diagnosis of patient.

“It is too easy to see a patient only as a group of symptoms” he commented.

“According to Erik Erikson, the main issue is to determine whether it is a question of a person having a neurosis, or of the neurosis ‘having’ the person. The former is a ‘physical life’ and the latter is the ‘psyche life’. The psyche is the totality of both the conscious and unconscious human mind, the part of the brain that does all the thinking, dreaming and feeling.  .

“Erikson insisted fears and anxieties as two very different neuropsychiatric problems. Fears and apprehensions focus on realistic responses to dangers, whereas anxieties, provoked by dysfunction in the internal controls, magnify obstacles without providing the means to surmount them.

“Adaptive responses that are appropriate to reality are all too likely to be discounted if one understands the ego as being essentially a collection of defenses against the internal drives.

“The key, according to Erikson, is to seek in the ego the organizational capacities that create the strength necessary for reconciling discontinuities and ambiguities.

“Like Sigmund Freud, Erikson envisioned an unconscious ego. But like other post-Freudians, he emphasized that the ego has a unifying function and ensures coherent behavior and conduct.

“The ego does not only have a negative function, that of avoiding anxiety; it plays as well the positive role of ensuring efficient functioning.

“The ego’s defenses are not necessarily pathogenic: Some are adaptive, while others are the source of maladaptations.

“It is true that anxiety and feelings of guilt can disrupt adaptation. Moreover, the external environment has its own inherent deficiencies. But in attempting to measure the strength of the ego, Erikson did not limit himself to the earlier psychoanalytic norm and seek, in a personality, only that which is denied or cut off.

“Rather, Erikson was interested in measuring the limit that the individual’s ego is capable of unifying.

“The ego protects the person’s indivisibility, oneness, and everything that underlies the strength of the ego adds to its identity. If Freud understood identity as being in part acquired, this was due to the very particular types of patients he had treated.

“For Erikson, identity is what maintains in the individual inner solidarity with the ideals and aspirations of social groups.

“The ego has a general balancing function: It puts things in perspective and prepares them in view of possible action.

“The strength of the ego, as Erikson conceived it, explains the difference between the feeling of being whole and the feeling of being fragmented. In the best of cases, it enables the individual to understand that the feeling of being at one with oneself comes through growth and development.

In addition to a feeling of continuity, according to Erikson, every individual needs a sense of novelty, obtained only through the leeway inherent in an assured identity. By “leeway,” he meant maintaining in our experience a centrality, an evident self that, alone, enables us to make fully aware choices.

Early in his work Erikson called this identity “ego identity” after the model of Freud’s “ego ideal.” “Ideal is a standard of perfection, beauty, or excellence” [Merriam-Webster}

As a subsystem of the ego, identity’s task is to choose and integrate self-representations derived from childhood psychosocial crises. Too often, in the history of psychoanalysis, there has been a tendency to forget that on the clinical level, the ego was posited as an enduring agent of selection and integration that plays a central role in the sound functioning of the personality.

“This inner “synthesizer,” which silently organizes a coherent experience and guides action, is precisely what is so often lacking in present-day patients.

“By contrast, the patients of the earliest psychoanalyses were for the most part suffering from inhibitions that prevented them from being what they were, or what they believed themselves to be.

[Erikson, Erik H. (1950). Childhood and society. New York: W. W. Norton. (1959). Identity and the life cycle. New York: International Universities Press. (1968). Identity: Youth and crisis. New York: W. W. Norton]  [Roazen, Paul. (1976). Erik H. Erikson: The power and limits of a vision. Northvale, NJ: Jason Aronson]  [Ego Identity, International Dictionary of Psychoanalysis. . 17 Jan. 2018 < ]

Following are Erik Erikson’s Stages of Psychosocial Human Development

Stage One – Trust vs Mistrust. …

Stage Two – Autonomy vs Shame and Doubt. …

Stage Three – Initiative vs Guilt. …

Stage Four – Industry vs Inferiority. …

Stage Five – Identity vs Role Confusion. …

Stage Six – Intimacy vs Isolation. …

Stage Eight – Ego Integrity vs Despair.

[Erik Erikson by Saul McLeod, updated 2017, Simply Psychology]

[At The End Of Life, Ego Ideal or Death Anxiety, see:]

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