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Objective: To explore the experiences of acculturation into secular Swedish society of former members of cults, with particular focus on mental health, needs and resources. Design: Qualitative method using the Cultural Formulation Interview (CFI) from the DSM-5 as an interview guide. Analysis of participants’ experiences of acculturation through systematic text condensation. Participants: Eleven Swedish former members of ideological or religion-based cults. Setting: Swedish mainstream, secular society. Results: Former cult members experience an ‘in-between time’ in the period after leaving the cult and find themselves in a confusing, chaotic state. They describe having lived in an honor culture where acts of violence were normalized. In the cult, they felt disconnected from themselves, and post-cult they try to regain access to their own values and feelings as well as create new bonds with family members and friends outside the cult. They find it hard to talk about their cult background and find relief in communicating with other former cult members. In their post-cult life, they eventually start seeing the world in a brighter, more hopeful way than before. However, they are also at risk of re-experiencing cult-related traumatic events and of new traumatic experiences within the post-cult acculturation process, and of persistent psychological distress. Conclusion: Former cult members face a challenging acculturation process, having lost a functioning worldview upon leaving the cult but not yet gained another to take its place. While the in-between time is often transient, they may need support from the healthcare system, especially regarding mental health concerns, while establishing themselves into mainstream society.

Empathy in the doctor-patient relationship is of great importance and has long been considered a true professional virtue for doctors. Despite the general agreement concerning the importance of empathy, there is no consensus regarding the definition of empathy in medical research. While several quantitative studies, measuring empathy as an individual trait, show a decline in empathy among medical students, other studies have shown that empathy is influenced by contextual factors as well as the availability of role models. Therefore, further studies about the transition from medical school to clinical work also including the perspective of senior doctors are needed. The study presented in this article aims to better understand the clinical conditions for empathy through interviews with senior doctors about their lived experience of empathy. Twelve senior doctors, from different specialities were interviewed using a semi-structured approach. The data was analysed using content analysis. The analysis resulted in the main theme: Empathy as a silent art–a doctor‘s daily balancing act. This main theme comprised three categories: “A tacit, yet language-dependent process”, “A daily balancing act” and “An unsupported path towards mastery”. Doctors face many challenges in their daily balancing act between individual and structural conditions that may affect empathy. In order to maintain and further develop empathy, doctors need working conditions allowing for collegial reflection and conversations that promote empathy.

Objective: This study explores former cult members’ perceptions of consultations with healthcareprofessionals for mental illness that they relate to their cult involvement. The study also aims toidentify the needs, obstacles, and facilitating factors related to these consultations. Design:Qualitative methods using semi-structured interviews that were analyzed using systematic textcondensation. Participants: Nineteen former cult members who had been in contact with Swedishhealthcare professionals due to mental illness related to their cult involvement. Results: Former cultmembers remain affected by cult belief systems, rules, and ideations even after leaving a cult. Thisleads to ambivalence and inner conflict for the former cult member in a healthcare consultation. Careproviders are perceived as ignoring cult experiences and lacking knowledge of a cult’s impact on anindividual. Conclusions: To understand, help, and work with former cult members, healthcareprofessionals need to know about cults and the possible impacts of cult involvement. Person- andpatient-centeredness in the form of non-judgmental attitudes, validation of experiences, andawareness of the psychosocial situation are important in consultations with these patients. Moreover, healthcare providers need to acknowledge cultural and existential aspects of a former cult member’slife, both in the present and from earlier experiences in the cult.