1. Existential experiences in a clinical context – abortion as a case Maria Liljas Stålhandske, Maria Ekstrand & Tanja Tydén, Uppsala university

2. Källa: Ingelhart & Baker, 2000: 19-51 Maria Liljas Stålhandske

3. Existential questions in a secular context

4. Abortion in Sweden Every fourth pregnancy is ended with abortion Psychological distress related to abortion is uncommon Abortion is often related to strong and contradictory emotions: relief grief pride guilt Abortion is not included in social or ritual contexts

5. Attitudes to abortion Country Abortion not accepted Abortion accepted Italy52 %17 % United States39 %17 % Germany31 %25 % Finland26 %28 % Norway12 %47 % Sweden7 %65 %

6. Main results The abortion situation brought existential thoughts or experiences for allmost all women in the study – even those who found the decision easy to make however These thoughts and experiences mostly coexisted with satisfaction with the abortion decision and The interpretations and impact of the existential experiences varied greatly between the different women

7. Themes and categories Existential questions Life and death – what are the borders of human life? Meaning of life – what are the meaning and values of life? Morality – what is right and what is wrong? Self image – who am I and who do I want to be?

8. Existential questions Life and death ”It was first ’this is a lump of cells’ but then I started to feel sick and then I started to think ’well maybe this is a child’”. (IP10) Meaning of life ”Is it the meaning that I should work, work, work, or is there something that is more important than the job?” (IP15)

9. Existential questions Morality ”I felt guilty facing the doctor. Do I really have a good reason to have an abortion?” (IP16) Self image ”I felt ’what am I doing here, this isn’t me’”. (IP8) ”All of a sudden I started to feel very womanly, and it was such a nice feeling.” (IP14)

10. Distanced Pragmatic Involved Spiritual Abortion: a simple medical operation Abortion: a challenging life event

11. Impact of existential experiences ”I have never regretted it and feel that I was strong to go through with it. It wasn’t that difficult a choice, but it was a difficult experience.” (IP5) ”The first year I thought about it exactly each day of the week, when it was the same day of the week, and I think of it often now too. Very often.” (IP9) ”I felt like this ’shit, it is like this to be a grown up’. You have to make these kinds of hard decisions, and you’re forced to live with them. It feels like... that one maybe matures.” (IP18) Medium impact High impact To mature

12. Themes and categories Existential questions Life and death – what are the borders of human life? Meaning of life – what are the meaning and values of life? Morality – what is right and what is wrong? Self image – who am I and who do I want to be? Strategies to handle existential questions Labellings strategies – create distance from the pregnancy Meaning-making strategies – relate the experience to one’s worldview Social strategies – share the experience with others Symbolic strategies – deal with the abortion in ritual ways

13. Existential strategies Labelling strategies ”One can turn it in any direction, and I turned it to my advantage.” (IP13) Meaning-making strategies ”I prevented the soul from becoming an earthly person right now.” (IP6) ”I sacrificed my child to prove my love.” (IP4) Social strategies ”I am the kind of person who needs to tell people things.” (IP1)

14. Existential strategies Symbolic strategies ”I sat on a rock in the woods afterwards and felt that ’now I have done this and this is how it turned out, now I’m just breathing’”. (IP16) ”I didn’t drink alcohol at that time just to respect that which was there.” (IP14) ”Two days before I had five glasses of wine to think that now it’s too late anyway.” (IP7)

15. Distanced Pragmatic Involved Spiritual Sufficient individual resources Insufficient individual resources Abortion: a simple medical operation Abortion: a challenging life event

16. Existential homelessness IP2: ”I don’t know what you do if you don’t believe in anything. If you are to have some symbolic ritual, it has to be something that you believe in at least a little.” Lack of words to describe existential thoughts and experiences Lack of contexts for sharing and expressing existential experiences Lack of means to conclude an existential process

17. Distanced Pragmatic Involved Spiritual Abortion: a simple medical operation Abortion: a challenging life event Satisfied with clinical approach from Swedish abortion care: ”I felt respected and professionally cared for” Dissatisfied with clinical approach from Swedish abortion care: ”I felt ignored and insensitively cared for”

18. Impact of existential experiences Low impactMedium impactHigh impact The decision easy to make IP1, IP13, IP17 IP2, IP3, IP5, IP6, IP8, IP10, IP11, IP12 – The decision hard to make – IP4, IP14, IP15 IP7, IP9, IP16, IP18

19. What is the sollution for existential homelessness? Desecularization?...or can myths and rituals be reinvented within the shopping malls, internetcafés, airports, stock markets and backyards of the individualized fragmented materialistic constantly moving late modern society?