Alkol kullanım bozukluğu tanısı olan bireylerde ölüm olgusunun varoluşçu perspektiften incelenmesi: Fenomenolojik bir araştırma
The phenomenon of DEATH in individuals diagnosed with alcohol use disorder from an existential perspective: A phenomenological study
Yazar: MERVE ÇETİNKAYA
Danışman: PROF. DR. HAKAN COŞKUNOL
Ege Üniversitesi / Sağlık Bilimleri Enstitüsü / Psikiyatri Ana Bilim Dalı / Bağımlılık Danışmanlığı ve Rehabilitasyon Bilim Dalı
Derece: Yüksek Lisans, 2022
Konu: Psikiyatri = Psychiatry ; Psikoloji = Psychology ; Uyuşturucu Alışkanlığı ve Alkolizm = Drug Addiction and Alcoholism
Dizin: Alkol içme = Alcohol drinking ; Alkolizm = Alcoholism ; Alkolle ilgili bozukluklar = Alcohol-related disorders ; Fenomenoloji = Phenomenology ; Varoluşçuluk = Existentialism ; Ölüm = Death

Özet:
Amaç: Bu tez çalışmasında alkol kullanım bozukluğu tanısı olan bireylerde ölüm olgusunun derinlemesine incelenmesi amaçlanmıştır. Katılımcılara ölüm deneyimleri, ölüme ilişkin düşünceleri hakkında sorular yöneltilerek ölüm olgusunun bireyin alkol kullanımı üzerindeki etkisinin incelenmesiyle alkol bağımlılığı ve ölüm olgusu arasındaki ilişkinin betimlenmesi amaçlanmıştır. Bu sayede alkol kullanım bozukluğu ve ölüm olgusu hakkında ayrıntılı bir anlayışa sahip olmak hedeflenmiştir.

Yöntem: Alkol bağımlılarında ölüm olgusunun varoluşçu perspektiften incelendiği bu araştırmada, basit ve doğal fenomenlerden biri olarak sözü edilen, aslında çok karmaşık olan ölüm olgusu, nitel araştırmaların bir türü olan fenomenolojik yöntemle çalışılmıştır. 

Bulgular: Analiz sonucunda "Bağımlılık Döngüsü", "Alkol Bağımlılarının Alkol Algısı", "Alkol Bağımlılığında Sorumluluk", "Bağımlılık Tedavisinden Beklenti", "Alkol Kullanımının Ölümle İlişkisi", "Ölüme Dair Düşünceler", "Ölüm Kaygısı ve Korkusu", "Alkol Bağımlılığı ve İntihar" ve "Ölümle Baş Etme Tarzları" olmak üzere 9 temaya ulaşılmıştır. Alkol kullanım bozukluğu tanısı olan bireylerin bağımlılık döngüsü içine girdikleri, alkole yönelik hem pozitif hem negatif algılara sahip oldukları, genellikle alkol kullanım bozukluklarının sorumluluğunu üstlendikleri, genellikle alkol kullanımını ölümle ilişkilendirdiği ancak alkol kullanımlarının kendi ölümlerine yol açmayacağını düşündükleri bulgularına ulaşılmıştır. Katılımcıların yüzde ellisinin intihar düşüncesine sahip olduğu veya intihar girişiminde bulunduğu görülmüş, alkol bağımlılarında intiharın oldukça yaygın olduğunu saptanmıştır. Ayrıca katılımcıların inkâr, öte dünya inancı ve yasın ardından gelen kabullenmeyle ölümle baş etmeye çalıştıkları bulgularına ulaşılmıştır. 

Sonuç: Alkol kullanım bozukluğu tanısı olan bireylerde ölüm olgusunun fenomenolojik yöntem kullanılarak varoluşçu perspektiften incelendiği bu çalışmayla bağımlılık ve alkol fenomenlerine ilişkin elde edilen detaylı bilgiler sonucunda kazanılan perspektif ile koruma ve tedavi yöntemlerinin daha faal hâle getirilmesi bağlamında bireylere katkı sağlanmıştır.

Abstract:
Objective: The present study aspires to explore the phenomenon of death in individuals diagnosed with alcohol use disorder. It is meant to describe the relationship between alcohol use disorder and the death phenomenon by examining the effect of death phenomenon on the individual's alcohol use by asking participants about their death experiences and thoughts on death. In this way, it is determined to acquire profound understanding of alcohol use disorder and death.

Method: Mentioned as one of the simple and natural phenomena, but in fact, a very complex phenomenon, death is examined in this study from an existential perspective in individuals diagnosed with alcohol use disorder, using the phenomenological method, which is a type of qualitative research.

Results: Nine superordinate themes emerged from the analysis. These themes were as follows: "Cycle of Addiction", "Alcohol Perception of Individuals Diagnosed with Alcohol Use Disorder", "Responsibility in Alcohol Addiction", "Expectation from Addiction Treatment", "Relation of Alcohol Use with Death", "Thoughts on/about Death", "Anxiety and Fear of Death", "Alcohol Addiction and Suicide" and "Styles of Coping with Death". It was concluded that individuals diagnosed with alcohol use disorder go through a cycle of addiction, have both positive and negative perceptions towards alcohol, generally take responsibility for alcohol use disorders. Furthermore, the findings of the research demonstrated that individuals diagnosed with alcohol use disorder often associate alcohol use with death, but do not think that their alcohol use will cause their own death. The research also yielded that fifty percent of the participants had suicidal tendencies or attempted suicide, and suicide is quite common among individuals diagnosed with alcohol use disorder. 

Conclusion: With this study, in which the phenomenon of death in individuals diagnosed with alcohol use disorder is examined from an existential perspective using the phenomenological method, the perspective gained as a result of the detailed information acquired about addiction and alcohol phenomena has contributed to individuals in the context of making prevention and treatment methods more active. Moreover, in the light of the experiences conveyed by the participants, the findings of this study have contributed to the development of programs within the scope of combating addiction.

Method: The research sample constitutes of voluntary participants who was treated in the Addiction Service of Medical Faculty of Ege University Hospital Psychiatry Department between March 1th, 2021 and March 1th, 2022 and was diagnosed with alcohol use disorder according to DSM-5. Eight individuals (2 females and 6 males) whose ages ranged between 19 and 66 and who did not drink alcohol for 1 week participated in this study. Mentioned as one of the simple and natural phenomena, but in fact, a very complex phenomenon, death is examined in this study from an existential perspective in individuals diagnosed with alcohol use disorder, using the phenomenological method, which is a type of qualitative research.

Results: Nine superordinate themes emerged from the analysis. These themes were as follows: "Cycle of Addiction", "Alcohol Perception of Individuals Diagnosed with Alcohol Use Disorder", "Responsibility in Alcohol Addiction", "Expectation from Addiction Treatment", "Relation of Alcohol Use with Death", "Thoughts on/about Death", "Anxiety and Fear of Death", "Alcohol Addiction and Suicide" and "Styles of Coping with Death". It  was concluded that individuals diagnosed with alcohol use disorder go through a cycle of addiction, have both positive and negative perceptions towards alcohol, generally take responsibility for alcohol use disorders, and have expectations of continuing to use alcohol or ending alcohol use completely after their treatment. Furthermore, the findings of the research demonstrated that individuals diagnosed with alcohol use disorder often associate alcohol use with death, but do not think that their alcohol use will cause their own death. 
In addition, it was observed that the participants described death as nothingness, an event that is inevitable, that is unexperienced, that could happen suddenly and would happen to everyone, and emphasized the obscurity of the afterlife. It was found out that the participants experienced numbness and loneliness due to death, and that death was approached from a religious perspective. In addition, it was also concluded that the participants experienced death anxiety and fear, explaining this anxiety and fear as the possibility of killing themselves, the possibility of the death of their relatives, the death of their relatives, the position of alcohol addicts, belief in the afterlife, parental responsibilities, physical ailments and the uncertainty of death. The research also yielded that fifty percent of the participants had suicidal tendencies or attempted suicide, and suicide is quite common among individuals diagnosed with alcohol use disorder. In addition, it was found out that the participants tried to cope with death with denial, belief in the afterlife and acceptance after mourning.
Conclusion: With this study, in which the phenomenon of death in individuals diagnosed with alcohol use disorder is examined from an existential perspective using the phenomenological method, the perspective gained as a result of the detailed information acquired about addiction and alcohol phenomena has contributed to individuals in the context of making prevention and treatment methods more active. Moreover, in the light of the experiences conveyed by the participants, the findings of this study have contributed to the development of programs within the scope of combating addiction.

Keywords: Alcohol Use Disorder; Death; Existentialism; Phenomenology; Qualitative Research