S-T. D. Fredriksen and T. Svensson fear of how their loved ones’ lives would develop without them. attitudes towards significant others: one seeking proximity, the other causing distance. How bodily proximity to significant others and inability to communicate may cause difficulty and conflict Two patients revealed that they were unable to communicate due to the fact that they were con- nected to life support. However, another patient who had sufficient strength could communicate via mobile phones to significant others who were there or physically somewhere else. This contact was important and created a sense of proximity. Those who were unable to directly take part in commu- nication in spite of the fact that they had their significant others physically present express a sense of difficulty and of conflict. ‘‘ . . . I could hear them talking among themselves . . . and I didn’t agree . . . but I couldn’t (talk) . . . it was horribly upsetting’’ (Female 54 years). In this dilemma one is physically close but distant, in the sense that the patient becomes an object by being unable to share and communicate. Patients feel excluded from planning or interacting with their significant others because of their illness and loss of communication. The sense of being excluded also involves being restricted from everyday verbal con- tact with their significant others and especially their children. ‘‘ . . . it is obvious that when you have been denied access to your family . . . you become so lost’’ (Female 34 years). It may seem as if ICU patients’ experiences not only refer to being excluded from individual situa- tions, but reflect a complete existential problem. This is not only a question of lack of communicative capacity but also involves distance between two sets of situations with different preconditions and pur- poses. Patients say they feel distance through limita- tions as if they were infants, unable to walk or talk. Those patients who have children feel exposed to demands that they are bodily incapacitated to fulfil. . . . he wanted to lie in my arms like he used to at home . . . a small kid with diapers in the nook of my arm . . . I wanted to but I was totally ex- hausted. (Female 34 years) The communication limitations in the presence of significant others can be seen as a situation in which body and consciousness exist separately*there is a will, but not a way for the body to follow-up on the intent of the will. For patients; they not only lack the strength to comfort and cuddle their close ones, but also lack the opportunity to communicate due to the loss of speech. This split situation seems to create an existence that is characterised by two sets of 6 (page number not for citation purpose) Comprehensive understanding The analysis shows that intensive care patients’ experiences with bodily presence from their signifi- cant others is noticeable in bodily reactions. Patients compare their own responses to situations with those of their significant others and dealing with the situation in a similar way. These reactions often occur in situations when the significant other tries to encourage the patient to get well from a serious condition. Situations become unpleasant confirma- tions of the patient’s situation as critically ill. When they are together with their significant others patients experience support. Such confirmations may be in the form of physical presence and verbal confirmation of family bonds, but these confirma- tions also significantly help the patient use the support from their significant others and understand conditions and contexts in the situation (s)he is in. Being with one’s significant others affects the pa- tients’ physical response patterns. It is visible when patients are in a situation where they feel the need to be active participants, but often end up feeling lonely and excluded. Sharing community with significant others brings out the patient’s fear that community, trust, and safety is at risk. In spite of the fear of separation, patients often feel that their significant others make an effort to prioritise them before other members of the family. Feeling personally respon- sible for their significant others is a strong character- istic among intensive care patients. They address their own situation by setting boundaries, but they also assume responsibility for their significant others, trying to protect them and by informing them of the situation. Sharing the bodily presence of significant others is important for the patient. The dichotomy of this position is a mental willingness to interact, limited by a situational and physical incapacity to respond. Discussion The dynamics between proximity and distance is a universal phenomenon and closely linked to human autonomy. This dynamic involves choices of a relational character (Retzinger, 1991). ICU patients face difficulties due to the limitation of choices they are subject to, since their situation contains elements that restrict their opportunity to chose their prefer- ences among significant others (Fredriksen et al., 2008). This mindset changes the patients’ experi- ence from freedom to choose, to a situation of Citation: Int J Qualitative Stud Health Well-being 2010; 5: 5120 - DOI: 10.3402/qhw.v5i4.5120