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For more than thirty years, the HIV pandemic has caused immense harm across sub-Saharan Africa. From the middle of the last decade, however, a treatment revolution has been underway, as effective antiretroviral drugs (ARVs) have become available to millions of ordinary people. This thesis examines the far-reaching consequences of this new reality in Northern Nigeria. It argues that the significance of the ARV era cannot be fully understood simply by monitoring how many patients are receiving treatment, but instead must be explained in terms of the multifaceted changes it has driven in institutions and the lives of HIV positive people. This study uses ethnographic case studies and participatory methods to understand this new historical moment from ‘below’. It provides new empirical perspectives on how the ARV era has profoundly altered the ways in which HIV positive people suffer. The difficulties of daily life when subjected to opportunistic infections, side effects from drugs, and social stigma are compounded by memories of past trauma and fears for an uncertain future. Previous studies have indicated HIV positive people often form new relationships (e.g. Rhine, 2009), but rarely have these post-HIV relationships been described. This study argues that these new relationships, often distant from conventional family supervision, have a unique character, blending traditional forms with ‘modern’ ideas about romance. After a HIV disclosure, incomes and assets (particularly those reliant on family relationships) are often reduced. Along with the cost of treatment (broadly defined to include a range of curative practices), this forces those living with HIV to adapt their livelihood strategies, often using networks of solidarity between positive people. The process of lobbying for improvements in medical care is also explored. Both doctors and NGOs advocate on behalf of HIV positive people, but do so with strikingly different tactics and results. This has important implications for continuing debates about working ‘with the grain’ (Crook and Booth, 2011) for development in patrimonial states. In summary, whilst HIV treatment has saved the lives of millions, inventing drugs and getting them to the people who need them are merely the first steps in alleviating suffering. The thesis traces the most important tasks in securing wellbeing in the ARV era – those pursued by HIV positive people themselves.

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I read witness poetry as a model of response to suffering. Compassion is feeling together with another. Compassion is, then, opposed to empathy’s feeling as another. Compassion can be better understood through the witness poetry that privileges metonymical relationships in which readers are contiguously positioned in relationship to a speaker. This emphasis on relationship can be contrasted to the collapse of relationship in identification in which a reader reads as though he or she is the lyric I, the poetic voice, rather than a listener. I discuss this reader-as-listener in contrast to the trauma studies-influenced discourse surrounding witness poetry, a discourse which focuses on indexical poetic evidence of a poet’s wounds and the transferability of the poet’s trauma to readers. Compassionate response, as demonstrated by this poetry, is premised on a recognition of one’s intimacy with or distance from that which one witnesses. Distance is not synonymous with disengagement, but rather with the space of relationship through which connection and consideration is possible. All intimacy involves some distance; the two are not opposites, but a continuum. Witness involves waiting: response derives from the time of relation through which it might form. This waiting has reflection as its retrospective partner. Together, they form commemoration, which brings reflection into future and communal celebration and remembrance. Com-memoration is linked to com-passion in this communal element. My project engages witness poetry as a communal form inviting feeling in community, response to widespread suffering, and the establishment of relationship and connection. / Thesis (Ph.D, English) -- Queen's University, 2013-06-18 10:21:39.793

This thesis will engage with the relationship between justice and suffering in order to more clearly understand what being just entails and how we can theorise justice as demanding in a desirable way. Theorising this relationship will focus on the role of various conceptions of self and community to show how justice, as contextual and communal, can be demanding in a way that does not drive the self that suffers apart from those that benefit from justice. Methodologically the thesis will follow in the tradition of self-reflection in the way it was described by Alan Blum and Peter McHugh. This means that the thesis will try to understand justice and suffering by looking at the foundations of justice, or, put differently, by trying to theorise what it is that makes some instances of suffering just. To this end the argument will begin by outlining a concept of community and of justice to then begin looking at various arguments that relate justice with suffering, either explicitly or implicitly and describe this relationship as desirable. Understanding community in a way that is based on Jean-Luc Nancy’s idea of being-with-others the thesis already sets out a way of conceptualising a social actor that is essentially related to other actors. This is then used as the foundation of a community in what will be called a place. This placing of the social self will also be used to place justice and move away from justice as relying on universal principles. The thesis challenges three main arguments: a) René Girard’s justification of excessive spectacular violence against a scapegoat as a means of controlling the violent desires of a community by performing sacred and public acts of violence; b) universal principles using individualist theories of justice by John Rawls and Immanuel Kant; c) benevolence as an alternative to justice as presented by virtue ethicists and also communitarians (specifically Michael Sandel). These three theories are shown not to appreciate various aspects of justice as fairness and a community (in Nancy’s sense); particularly the silencing of difference in Girard’s false utilitarianism, the ignorance of existing injustice and suffering in Rawls’ universalism and the antagonism between the self and the universal interest in virtue ethic’s benevolence (Christine Swanton and Aristotle in particular). The thesis concludes that, in order for justice to be demanding in a way that does not disrupt a community, and in order for members of the community to suffer as part of the demands of justice, the community needs to be able to engage with itself theoretically, allowing it to commit itself to achieving justice. In this process of recognizing injustice and then pursuing fairness, a community has to be able to bind itself to its commitment in such a way that it can affirm itself as a community that is committed to justice, even if this commitment will cause some members of that community to suffer.

Background: More people than ever before are now seeking refuge from war and terror in other countries (UNHCR, 2016). This has as a consequence that the health care in many Western countries faces new patient categories which don’t speak the language and are culturally different from what health professionals are familiar with. Ethical considerations are important, since being misunderstood and not met with dignity or respect can cause care-related suffering. This may increase the suffering already experienced due to loss of security, family and friends. Aim: To illustrate refugees’ experiences in the contact with health care. Method: This is a literature-based, qualitative study. 15 articles were selected to investigate refugees’ experiences of health care. The analysis resulted in 2 themes, each containing 3 subthemes. Results: The main themes that emerged were: Feeling acknowledged and respected, and Overcoming language and cultural barriers. The result mainly reveals that language barriers are common, and that refugees consider it important to be seen as individuals, which is not always the case in health care. Conclusion: The challenge in caring for refugees as a nurse consists in ensuring there is a common understanding. While being aware of a patient’s history, it is also important to see the individual in a person-centered approach. / Att bryta upp från familj och allt man känner sig trygg med försätter människan i en utsatt position. Den vilsenhet detta medför skapar ett lidande. Som sjuksköterska är det viktigt att vara medveten om detta. Författarna till detta litteraturbaserade arbete har studerat 15 vetenskapliga artiklar där flyktingars perspektiv av olika vårdmöten står i fokus. Resultatet visar att flyktingar upplever språket som det största problemet i mötet, men att även deras kultur och religion spelar in i vad de tycker är en bra vård. I många fall känner flyktingar sig förbisedda eller diskriminerade. Detta har i många fall att göra med att de inte blir bemötta som individer utan ses som en del av en annan kultur. För att undvika problem med språkförbistringar är det att föredra att anlita tolk. Detta är emellertid inte helt problemfritt. Tolkar påverkar mötet på olika sätt beroende på vem patienten är. Studiens resultat visar att många flyktingar föredrar en tolk av samma kön. Det bidrar till att de lättare kan öppna upp sig och att intima situationer, exempelvis avklädning, inte blir så svåra att hantera. Samma förhållanden råder när det gäller kön på vårdpersonal. Att undersökas av någon av motsatt kön kräver att detta upplevs som ofrånkomligt och väl förankrat. De upplevelser som har med kultur och religion att göra varierar mellan flyktinggrupper och enskilda personer. De berör hur man vill bli bemött och behandlad. Det visar sig att patienterna i många fall är ovana vid ett personcentrerat förhållningssätt. Att utveckla ett sådant förhållningssätt är dock viktigt, eftersom brister i detta gör att flyktingarna känner sig diskriminerade och förbisedda. Det kan även leda till att de går miste om viktig information om sin sjukdom och rekommenderade behandling. Om sjuksköterskor tillämpar personcentrerad vård där patientberättelsen och partnerskap ligger till grund kan vårdlidande undvikas.

Viktor Frankl published Man’s Search for Meaning in 1946, documenting the horrors of the concentration camps. Based on his prison experience in the camps, Frankl (1984) believed that meaning in life could be found in suffering. The theoretical framework for this research study was based on Frankl’s theory of logotherapy, an extension of existentialism. In today’s society, we can find many parallels to Frankl’s descriptions of suffering in the natural and human-made disasters that have occurred such as the 1999 shooting at Columbine, the levee failure in 2005 following Hurricane Katrina, the floods in the spring of 2011 in the South, and in 2011 the earthquake, tsunami, and nuclear power failure in Japan. The purpose of the present study was to explore if graduate counseling students’ (GCS) meaning in life is related to their crisis experiences.Data collection was completed electronically. Qualtrics™, a web-based service, was used to distribute the researcher-designed survey, Graduate Counseling Student Crisis Experience Questionnaire (GCSCEQ) and the Purpose in Life (PIL) test. Results of this study indicated that there was no relationship between meaning in life and overall experiences, number of experiences, or intensity of GCS’ crisis experiences. Additionally, results indicated that GCS’ crisis experiences and meaning in life are impacted by the category of their disaster experiences, the intensity of their experiences and their age.

This dissertation argues that the comparative method in the academic study of religion can be a valuable missiological tool for Christians. Chapter 1 explains the need for Christians to have an in-depth understanding of the Sunni worldview in order to better contextualize the gospel. Chapter 2 provides a history of the comparative method in the academic study of religion, and discusses the seven most common objections to the approach. Chapter 3 responds to the seven most common objections to the comparative approach, proposes a method of comparison, and presents this dissertation's case study. Chapter 4 begins with an overview of the Reformed worldview, and presents the themes found in the OT and NT concerning God's purposes behind the suffering of his people, and how his people should respond. Chapter 5 includes an overview of the Sunni worldview, and presents the themes found in the Qur' an and Sahih Al-Bukhiiri concerning God's purposes behind the suffering of his people, and how his people should respond. Chapter 6 compares the themes found in the Sunni and Reformed texts, and ends with a brief discussion of some missiological implications from the study. Chapter 7 summarizes the overall arguments and findings of the dissertation.

Thesis advisor: M. Shawn Copeland / This dissertation investigates God’s salvific response to contemporary experiences of depression. The inquiry affords both constructive and critical insights for Christian theologies of suffering and salvation. Constructively, it offers a theological interpretation of depression and an account of salvation in relation to it. I argue that depression is an instantiation of bodily difference with unique difficulties and limitations to which God responds with the life-giving possibilities of survival and situational flourishing. These possibilities are a heuristic for an eschatological vision of salvation. The glorified body is characterized by an expansion of possibilities amid the persistence of some creaturely limitations, including many that constitute depression. Critically, my proposal about depression and salvation challenges the prevailing treatment of suffering and soteriology in political and liberation theologies. I argue that an “infralapsarian logic” shapes the predominant vision of salvation in these movements. I adopt the framework of infralapsarian logic from Edwin Chr. van Driel, who uses it to denote theologies that are primarily governed by the principle of sin. This is largely because negative suffering—that is, suffering that results from sin and evil—has been the primary object of concern in recent theologies. My argument about salvation in the context of depression illuminates the anthropological and theo-logical shortcomings of infralapsarian logic, and it reveals the need for alternative accounts of God’s salvific response to suffering. To this end, I advocate for the retrieval and development of soteriologies shaped by “supralapsarian logic,” and I point to my constructive account of depression and salvation as one example of this way of thinking about salvation. Chapter 1 introduces readers to Christian soteriology, my methodology, and a project overview. Chapter 2 examines suffering and salvation in the early work of Johann Baptist Metz, Gustavo Gutiérrez, James Cone, and Rosemary Radford Ruether. This analysis illuminates the infralapsarian logic shaping their influential liberation soteriologies. Chapter 3 explores critiques of liberation soteriology that have arisen from within political and liberation theologies in recent decades—namely, from feminist theology, theologies of disability, black and womanist theologies, theologies of trauma, Latin American feminist theology, and theologies engaged with postmodern conceptions of power. Together, chapters 2 and 3 present the recent landscape of theological discourse on suffering and salvation. Chapter 4 is a cross-disciplinary survey of depression that presents the affordances of narrative and phenomenological accounts of this condition. Based on these accounts of depression, chapter 5 develops a theological interpretation of depression as a particular instantiation of bodily difference—not a form of suffering that results from sin or evil. Chapter 6 offers an account of God’s saving work in relation to depression. I argue that salvation in this context is not primarily liberation from suffering but rather survival and an expansion of possibility that enables an improved quality of life amid depression. Together, chapters 5 and 6 illuminate the inadequacy of infralapsarian logic for envisioning salvation in relation to depression. I conclude the dissertation with chapter 7, where I argue for the development of soteriologies that reflect a supralapsarian logic. I close the project by naming the implications of this argument for further theological reflection on depression, in particular, and suffering and salvation, more broadly.

Orientador: Carmen Maria Bueno Neme / Banca: Manoel Antonio dos Santos / Banca: Diana Pancini de Sá A. Ribeiro / Resumo: As profundas transformações sócio-culturais pelas quais atravessa o mundo têm sido acompanhadas de diversas formas de manifestações de sofrimento psíquico. Observa-se o aparecimento de novas configurações subjetivas e modalidades de sofrimento psíquico e, simultaneamente, sua ressonância e impactos na clínica psicológica, exigindo compreensão e manejos singulares. As condutas que ocorrem n contexto da intersubjetividade são organizadas a partir de campos psicológicos inconscientes, que influenciam as práticas individuais e coletivas. Portanto, considera-se relevante identificar os sentidos subjetivos acerca do sofrimento psíquico contemporâneo no imaginário dos estudantes de psicologia que comporão o contexto intersubjetivo da clínica em seu exercício profissional ou que, de diferentes formas, devem refletir sobre as novas manifestações da subjetividade humana. O objetivo deste estudo foi investigar psicanaliticamente o imaginário coletivo d estudantes ingressantes e em fase de conclusão de curso em Psicologia acerca do sofrimento psíquico contemporâneo. À luz do método psicanalítico, esta investigação foi realizada por meio do uso do Procedimento de Desenho-Estórias com Temas como recurso mediador-dialógico em entrevista grupal para a abordagem da pessoalidade coletiva em ambos os grupos de estudantes. Posteriormente, a cada entrevista, foram confeccionadas narrativas interativas e sob a compreensão de que as manifestações simbólicas regem as condutas humanas, o cojunto das produções dos desenhos-estórias, com base nas narrativas, foi interpretativamente analisado em busca da apreensão dos campos de sentido afetivo-emocional. O cenário geral admite a organização das produções subjetivas em campos psicológicos emergentes, dentre os quais se apresentam: "Solidão"... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Profound socio-cultural transformations the world has undergone have been followed by various forms of manifestations of psychic suffering. One notices the appearance of new subjective configurations and model of psychic suffering and, simultaneously, their resonance and impacts on the psychology clinic, demanding especial understanding and management. The conducts taking place within the context of inter-subjectivity are organized within unconscious psychological fields, which have influence on individual and collective practices. Therefore, one considers relevant the identification of subjectives senses formulated about contemporary psychic suffering within the imaginary of psychology students who will provide the inter-subjective context of the clinic in the exercise of their profession or who, in different ways, should ponder on the new manifestation of human inter-subjectivivty. The aim of this study was to investigate psychoanalytically the collective imaginary of freshmen and senior psychology students about contemporary psychic suffering. In the ligh of the psychoanalytic method, the present research was carried out by using the Procedure of Drawings-Stories with Themes as a mediating-dialogic resource in group interview to broach collective personal nature in both groups of students. Subsequently, interactive narratives were generated for each group interview. By understanding that symbolic manifestations govern human conducts, the set of productions of the drawings-stories, based on the interactive narratives, was interpretatively analyzed trying to apprehend the fields of affective-emotional meaning. The general setting acknowledges the organization of subjective productions within emerging psychological fields, among which on suggests the following: "Loneliness", "Essays on suffering", "Grieves... (Complete abstract click electronic access below) / Mestre