It is argued that the proper way to construct and deliver a therapeutic sermon is to take a theocentric approach. Preaching, rightly understood, is proclamation of the good news that God has redeemed the world through Christ in the power of the Holy Spirit. It is by definition theological. Feeling pressure to be relevant, engaging and contemporary, a significant number of preachers fall into administering mini-doses of psychological self-help from the pulpit. Hans Urs von Balthasar’s homily, ‘Joy in the Midst (...) of Anxiety’, is offered as a positive alternative. The sermon is theologically and homiletically analysed to show why it is an excellent example of theocentric therapeutic preaching. (shrink)

This paper reports on the findings of a study that considered how anxiety might function to organise nurses’ practice. With reference to psychoanalytic theory this paper analyses field notes taken during a series of nursing change‐of‐shift handovers. The handover practices analysed met all the criteria for a ritual, as understood in psychoanalytic theory, and functioned to alleviate anxiety in the short term while symbolically expressing a forbidden and unknown knowledge. We argue that the handover ritual contained certain prohibitions, (...) yet allowed some expression of the prohibited knowledge in a disguised way. The prohibition concerned how the patient affected the nurse, that is, moved the nurse to love and hate the patient. We argue that this prohibition is expressed, in disguise, via the displacement of affection for the patient onto other nurses and through negative stereotyping of some patients. We also argue that these prohibitions of the handover mirror broader prohibitions within nursing, and thus the rituals of the handover become an expression of how professional prohibitions are enacted in practice. We conclude that the important implicit function of the handover ritual is to keep anxiety at bay, thereby enabling the nurse to commence practice rather than being immobilised by the effect of potentially overwhelming anxiety. (shrink)

The nurses’ relationship to knowledge has been theorised in a variety of different ways, not the least being in relation to medical dominance. In this study, the authors report on one of the findings of a case study into nurses’ anxiety informed by psychoanalytic theory. They argue that the nurse’s subjection to the knowledge of the other health professional, inclusive of the doctor, can be a transference arising in the context of anxiety for the nurse. Grasped by (...) anxiety, the nurse finds their own knowledge insufficient and in this moment can operate a transference to their non‐nursing colleague, who obligingly, responds. This transference is not present in the change‐of‐shift handover report though, when the other’s knowledge is suspect, even open to derision. Thus, this reference to the knowledge of the other is not consistently present in nursing and can be seen to be just one way that nurses organise themselves in relation to anxiety. Therefore, those wanting to break down the medical dominance of the nursing profession might consider other ways nurses might organise themselves in relation to anxiety, so that the political dominance of the other is not reinforced via transference to that other. (shrink)

Negative emotions are often thought to lack value—they’re pernicious, inherently unpleasant, and inconsistent with human virtue. Taking anxiety as a case study, I argue that this assessment is mistaken. I begin with an account of what anxiety is: a response to uncertainty about a possible threat or challenge that brings thoughts about one’s predicament (‘I’m worried,’ ‘What should I do?’), negatively valenced feelings of concern, and a motivational tendency toward caution regarding the potential threat one faces. Given (...) this account of what anxiety is, I show it can be instrumentally valuable: in sensitizing us to uncertainty and prompting caution and risk assessment efforts, it’s an emotion that can help us better recognize and respond to uncertain threats and challenges. But anxiety can also be aretaically valuable—that is, it’s an emotion that can contribute positively to one’s character. For instance, your anxiety about how best to care for your aging mother not only prompts helpful brainstorming about what you should do, but also reflect well on you—your unease demonstrates both an admirable sensitivity and emotional attunement to what’s at stake. (shrink)

Cortex functional connectivity associated with hypnosis was investigated in a single highly hypnotizable subject in a normal baseline condition and under neutral hypnosis during two sessions separated by a year. After the hypnotic induction, but without further suggestions as compared to the baseline condition, all studied parameters of local and remote functional connectivity were significantly changed. The significant differences between hypnosis and the baseline condition were observable (to different extent) in five studied independent frequency bands (delta, theta, (...) alpha, beta, and gamma). The results were consistent and stable after 1 year. Based on these findings we conclude that alteration in functional connectivity of the brain may be regarded as a neuronal correlate of hypnosis (at least in very highly hypnotizable subjects) in which separate cognitive modules and subsystems may be temporarily incapable of communicating with each other normally. (shrink)

This article focuses on feelings of anxiety among radical young Muslims, not just as a result of radicalism and terrorism but rather as an important cause of both. In contrast to many other publications which mainly deal with the radicalization of Muslim youths without taking into account their personal experience, the feelings of fear and anxiety expressed by radical young Muslims are central to this research. On the basis of an ongoing case study of 23 young Muslims (...) who have participated in a lengthy de-radicalization program in Amsterdam since 2009, an attempt has been made to gain insight into the interaction between radicalization processes and feelings of anxiety among this target group. The case study suggests that the three forms of anxiety expressed by radical Muslim youths, namely, (1) fear of victimization, (2) fear caused by guilt feelings, and (3) fear of being controlled by hatred and revenge, are related to the three phases presented in the “staircase model to terrorism.” This research into the various forms of anxiety experienced by radical young Muslims provides a concrete starting point for the de-radicalization process. (shrink)

Aims: Attentional bias, alcohol craving, and anxiety have important implications in the development and maintenance of alcohol use disorder. The current study aims to test the effectiveness of a Virtual Reality Cue-Exposure Therapy to reduce levels of alcohol craving and anxiety and prompt changes in AB toward alcohol content.Method: A 49-year-old male participated in this study, diagnosed with severe AUD, who also used tobacco and illicit substances on an occasional basis and who made several failed attempts to cease (...) substance misuse. The protocol consisted of six VR-CET booster sessions and two assessment sessions over the course of 5 weeks. The VR-CET program consisted of booster therapy sessions based on virtual reality exposure to preferred alcohol-related cues and contexts. The initial and final assessment sessions were focused on exploring AB, alcohol craving, and anxiety using paper-and-pencil instruments and the eye-tracking and VR technologies at different time points.Results: Pre and post assessment sessions indicated falls on the scores of all instruments assessing alcohol craving, anxiety, and AB.Conclusions: This case report, part of a larger project, demonstrates the effectiveness of the VR-CET booster sessions in AUD. In the post-treatment measurements, a variety of instruments showed a change in the AB pattern and an improvement in craving and anxiety responses. As a result of the systematic desensitization, virtual exposure gradually reduced the responses to significant alcohol-related cues and contexts. The implications for AB, anxiety and craving are discussed. (shrink)

While individuals presented in central texts of the period are indeed often alone or separated from others, Yousef regards this isolation as a problem the texts attempt to illuminate, rather than a condition they construct as normative or ...

This paper illustrates how concepts of mental disorder have been deployed to medicalize negative emotions and, thereby, weaken the political agency of some individuals. First, I theorise the link between political agency and emotions, arguing that effective political action entails the transformation of emotions into public issues. Using the British referendum on membership in the EU as a case study, I then examine how medically loaded terms and rhetoric were used to describe suffering after the vote. Finally, I argue (...) that this generated conditions that interrupted or even reversed the transformation of subjective experiences into politically meaningful issues. (shrink)

There has been much discussion about what, if any, legal and moral duties professionals have to disclose relevant genetic information to the family members of someone with an identified disease predisposing mutation. Here, we present a case report where dissemination of such a genetic test result did not take place within a family. In contrast to previous literature, there appeared to be no deliberate withholding of information, instead distant relatives were unable to communicate relevant information appropriately. When communication was (...) facilitated through the follow-up of a chance remark, the patient was able to avoid planned major surgery, with its attendant morbidity, and her high anxiety levels were much reduced. We believe this case highlights the need for an ongoing debate on how genetic services can best support patients and their families with disclosing relevant genetic information to other family members. (shrink)

There are many reasons to worry about shame in moral development. Shame can be employed for bad ends, such as manipulation and making others feel powerless. Shame is often associated with denial and hiding behaviors, social phobia, and anxiety. It is also not a motivation suitable for performing virtuous actions. This article argues that, nevertheless, well-ordered shame plays an indispensable and constructive role, as part of a mixed-methods approach in the development of moral character. This article assesses various reasons (...) why shame has fallen out of favor among Western moral educators and demonstrates why each of these reasons falls short of providing a compelling case against employing shame. It defends shame on epistemic and virtue developmental grounds. Moreover, it proposes ways to employ shame in character education, while mitigating potential damages and avoiding the concerns raised by social scientists. (shrink)

This article examines how distrust drives exchange. We propose a theoretical framework integrating the literature of trust into cultural sociology and use a case of patients giving hongbao (red envelopes containing money) to doctors in China to examine how distrust drives different forms of unofficial exchange. Based on more than two years’ ethnography, we found that hongbao exchanges between Chinese patients and doctors were, ironically, bred by the public’s generalized distrust in doctors’ moral ethics. In the absence of institutional (...) assurance, Chinese patients drew on the cultural logic of particularism and its associated cultural repertoire to induce fidelity from their physicians. They mobilized interpersonal networks to function as assurance and presented hongbao as a return of favor to the doctors. This form of exchange is gifting-oriented. Alternatively, if there were no interpersonal networks to rely on, they proactively offered hongbao to doctors at arm’s length in an attempt to personalize the relationship to seek assurance and abate their anxieties. This form of exchange is bribery-oriented. Both forms of exchange co-existed when there was one-way generalized distrust manifested from patients to doctors. When doctors also developed generalized distrust in patients, arm’s length exchanges declined, leaving embedded exchanges as the dominant form. Our study asserts the central role of culture in constituting exchange behaviors and the importance of institutions in shaping the form of exchange. It contributes to the midrange theory of trust, generating a number of hypotheses for future research on the relationships among culture, institutions, distrust, assurance, and illicit exchange. (shrink)

The COVID-19 pandemic has caused tremendous loss starting from early this year. This article aims to investigate the change of anxiety severity and prevalence among non-graduating undergraduate students in the new semester of online learning during COVID-19 in China and also to evaluate a machine learning model based on the XGBoost model. A total of 1172 non-graduating undergraduate students aged between 18 and 22 from 34 provincial-level administrative units and 260 cities in China were enrolled onto this study and (...) asked to fill in a sociodemographic questionnaire and the Self-Rating Anxiety Scale twice, respectively, during February 15 to 17, 2020, before the new semester started, and March 15 to 17, 2020, 1 month after the new semester based on online learning had started. SPSS 22.0 was used to conduct t-test and single factor analysis. XGBoost models were implemented to predict the anxiety level of students 1 month after the start of the new semester. There were 184 and 221 students who met the cut-off of 50 and were screened as positive for anxiety, respectively, in the two investigations. The mean SAS scores in the second test was significantly higher than those in the first test. Significant differences were also found among all males, females, and students majoring in arts and sciences between the two studies. The results also showed students from Hubei province, where most cases of COVID-19 were confirmed, had a higher percentage of participants meeting the cut-off of being anxious. This article applied machine learning to establish XGBoost models to successfully predict the anxiety level and changes of anxiety levels 4 weeks later based on the SAS scores of the students in the first test. It was concluded that, during COVID-19, Chinese non-graduating undergraduate students showed higher anxiety in the new semester based on online learning than before the new semester started. More students from Hubei province had a different level of anxiety than other provinces. Families, universities, and society as a whole should pay attention to the psychological health of non-graduating undergraduate students and take measures accordingly. It also confirmed that the XGBoost model had better prediction accuracy compared to the traditional multiple stepwise regression model on the anxiety status of university students. (shrink)

Edgar Allan Poe’s eerie short story “The Facts in the Case of M. Valdemar” is a particularly noteworthy example of the sublime, a psychological state in which one is overwhelmed by the magnitude of that which is perceived by the mind. Valdemar exemplifies the sublime in that his death has somehow been suspended in time because he was under hypnosis as part of a medical experiment at the moment of his passing. However, the story also draws particular attention (...) to the means by which insight into the nature of death is acquired by the hypnotist who narrates the story. For a more comprehensive understanding of the sublime experience, one may turn to the psychoanalytic theory of Jacques Lacan and the postmodernist work of Slavoj Žižek, which lead to the conclusion that the dramatic chain of events in “Valdemar” is an example of the sliding signifier, and, moreover, that the instability of the signifier may explain the sublime effect. (shrink)

We explore how conspiracy beliefs change the effectiveness of gain- vs. loss-framed messages in promoting health-protective behavior. We focused on various recommended COVID-19 protective measures, not only vaccinations but also other preventive (like wearing masks) and detection behaviors (like testing). Our results indicate that conspiracy beliefs moderate the effectiveness of gain vs. loss framing. When participants endorse conspiracy worldviews above the average level, the gain frame may be more effective than the loss frame. In other words, in the loss frame (...) condition, conspiracy beliefs negatively and significantly predicted attitudes toward the behavior recommended. However, in the case of the gain frame, the relationship between conspiracist views and attitudes toward promoted behavior was weaker or even nonsignificant. We also found, although only in the case of one behavior, that when participants' eagerness to look for conspiracies almost does not exist, the loss frame may be a better option than the gain frame. Finally, neither of these effects was mediated by emotional reactance or anxiety. (shrink)

The essay offers an interpretation of psychedelic peak experiences. It criticizes the quasi-scientific naturalistic attempts to explain such experiences and offers an alternative ontology underlying a more complex sense of naturalism, thus defending an entheogenic view irreducible to mere psychological effects. First, the mainstream ontology in the paradigm of natural sciences is exposed as being a version of the ontology of presence. This fact is shown as the reason for the phenomenological gap and the impotence of the natural sciences to (...) address human experience. Next, existential anxiety is interpreted in terms of Heidegger’s ontology and is suggested as the core dimension of possible spiritual transformation. Finally, the phenomenology of mystical psychedelic experiences (MPE) is interpreted in terms of overcoming existential anxiety– a well-documented effect of MPE – and explicated in ontological terms. The psychedelic experience is shown to be mystical in a sense of transcending the everyday mode of existential denial of the enigmatic nature of the universe by facing the nothingness in a way that transforms one’s stand within it into a stand of original belongingness to the field of emptiness (Nishitani). Different aspects of psychedelic experience are explained and co-related in terms of such a transformation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Oxymorons of AnxietyOr the Influence of Baba Ram Dass on Harold BloomRichard Klein (bio)A REVIEW OF Harold Bloom. The Anxiety of Influence (New York: Oxford University Press, 1973).In 1974, when I initially submitted this article to diacritics, it was rejected, despite my being a member of the editorial board. I had previously agreed that the piece should first be sent to Harold Bloom for his reaction; he was (...) not pleased. The editor (and founder of diacritics) judged, I think correctly, that it was better to have Bloom well disposed toward the young journal than not. He had been very generous, since its inception, giving us articles and interviews, and lending his weight to this early attempt to translate French theory into America. I was naturally deflated by the rejection, but since I believe in institutions more than individuals, I acquiesced, gracefully I think. Perhaps I shouldn't have. It has been forty years and in that time Bloom has grown even more dismissive of major theoretical developments and contemptuous of efforts to expand the canon. In his latest work, his "virtual swan song," The Anatomy of Influence: Literature as a Way of Life (2011), he evokes the critical developments long championed by this journal, which have evolved over forty years, and lumps them together as: "what I shall call the New Cynicism (a cluster of critical tendencies which are rooted in French theories of culture and encompass the New Historicism and its ilk)."1 Note the ilk: making alike, in a single cluster of cynicism, what he will not differentiate. Currently, he is motivated to return to his earlier work on influence, "galvanized in part by the New Cynicism's reductio of all literary relationships to base self-interest."2 In The Anatomy of Influence, Bloom returns to the Bloom of The Anxiety of Influence to find and redefine a canonical interpretation of literary relationships that depends from his immense erudition. Against the cynics, he is excited by a nobler, disinterested perspective—a view more universally shared than what might be found, for example, in the pages of diacritics.In any case, I always hoped this article, excerpted from a much longer chapter, would one day be published. I didn't think the moment would wait forty years and for my retirement. For allowing this to see the light and for their kind indulgence of my valedictory vanity, I especially want to thank my colleagues deeply, as well as the editors of the new diacritics.Harold Bloom brings bad news. Geoffrey Hartman calls him a kakangelist; he calls himself a necromancer.3 The news is the death of poetry—an event, as Bloom at moments seems to believe, that began with Milton. Since then, things have only gotten worse and are no way bound to improve. What Bloom is saying may well be no news at all, if poetry in fact and in principle has always been dying, if its death were simultaneous with its birth—its possibility permanently implicated in its impossibility. But, if not what the man is saying, surely the way he kakangelizes, raises the most surprising questions about the possibility of something he continues to want to call "literary criticism." Hartman's carefully poised review neglects to insist on the question of Bloom's style. His opening sentence, however, does proceed straight to enumerate—with no further comment—the unwonted diversity of elements that compose Bloom's short theory of poetry: "Six essays emerge from this dense, eloquent and experiential brooding, flanked by two prose poems, and accompanied by a synoptic introduction and an interchapter on 'Antithetical Criticism.'"4 Hartman pretends to take all this perfectly for granted, as if we were quite prepared to understand, with no explanation, the nature and necessity of something called a synoptic introduction, or the status of an interchapter, or the force of a notion like [End Page 7] antithetical criticism, and, as if we should hardly be surprised to discover, the whole thing quite naturally flanked by two prose poems! Hartman picks up the new style, but for reasons not clearly readable in his text, chooses not to dwell on this most surprising news of... (shrink)

The issue of underrepresentation of women in information technology (IT) is of national interest due to the rapid growth of IT in recent years, the impact of IT on growth and productivity, the shortage of IT workers, and the gender equity in IT. Scholarly research has pointed its finger at bias in early socialization, math anxiety, masculinity of computers, the scarcity of role models, and women’s preference for relational work. A study of students majoring in computer science and computer (...) engineering in a minority-serving university found some additional factors such as tension between demands imposed by IT curricula and students’family and work responsibilities. (shrink)

Social anxiety disorders (SAD) are among the most prevalent mental disorders (lifetime prevalence: 7–12%), with high impact on the life of an affected social system and its individual social system members. We developed a manualized disorder-specific integrative systemic and family therapy (ISFT) for SAD, and evaluated its feasibility in a pilot randomized controlled trial (RCT). The ISFT is inspired by Helm Stierlin’s concept of related individuation developed during the early 1980s, which has since continued to be refined. It integrates (...) solution-focused language, social network diagnostics, and genogram work, as well as resource- and problem orientation for both case conceptualization and therapy planning. Post-Milan symptom prescription to fluidize the presented symptoms is one of the core interventions in the ISFT. Theoretically, the IFST is grounded in radical constructivism and “Cybern-Ethics,” multi-directional partiality, and a both/and attitude toward a disorder-specific vs. non-disorder-specific therapy approach. SAD is understood from the viewpoint of social systems theory, especially in adaptation to a socio-psycho-biological explanatory model of social anxiety. In a prospective multicenter, assessor-blind pilot RCT, we included 38 clients with SAD (ICD F40.1; Liebowitz Social Anxiety Scale, LSAS-SR > 30): 18 patients participated in the ISFT, and 20 patients in Cognitive Behavioral Therapy (CBT; age:M = 36 years,SD = 14). Within-group, simple-effect intention-to-treat analyses showed significant reduction in social anxiety (LSAS-SR; ISFT:d = 1.67; CBT:d = 1.04), while intention-to-treat mixed-design ANOVA demonstrated the advantage of ISFT (d = 0.81). Per-protocol analyses supported these results. The remission rate based on blind diagnosticians’ ratings was good to satisfactory (Structured Clinical Interview, SCID; 78% in ST, 45% in CBT,p = 0.083); this has yet to be verified in a subsequent confirmatory RCT. The article will present the ISFT rationale and manual, including a special focus on multi-person settings, and the central findings from our pilot RCT. (shrink)

Case 1 reminds us that patients have duties too, while case 2 presents an instance of justified withholding of informationHow refreshing to read these two cases! No conjoined twins, fantastical chimeras, or other incredible scenarios at the fringes of medical reality. Each case highlights the practical and theoretical difficulties that doctors face in their everyday practice.Case 1: In case 1, the patient, who had declined an HIV test, changed his mind and requested an HIV test (...) on the request form without informing the doctor. The pathologist performed the tests and returned the results to the unsuspecting doctor, who duly investigated the matter. The doctor’s anxiety at the situation, as well as the worries of the entire practice and pathology laboratory, must have been deeply unpleasant. Thus the patient, no doubt unintentionally, caused much distress by requesting the HIV test. He was, at the very least, guilty of a lack of foresight and consideration. As a minimum, he should have informed the doctor of his last minute alteration. This would have enabled the doctor to discuss the implications of the test, to organise appropriate counselling, and, most importantly, to receive the results in full knowledge of the situation.As Dr Fraser points out, the experience of case 1 reinforces the importance of taking good medical notes. Even if the patient’s refusal had been documented in the notes, however, this would not have prevented him from requesting the HIV test, and indeed other tests, on the blood form. Pharmacists may still occasionally be faced with situations when they are unsure whether the doctor prescribed 10 capsules of a drug, or 110 capsules, as the patient may have added a “1” in front of the doctor’s original prescription. Similarly, how …. (shrink)

There are two competing accounts for a theory for human action proposed by Catholic theologians working within the received moral tradition today: a hylomorphic account and an intentional account. In this article, the author compares each of the rival theories for its ability to explain both the structure and morality of the human acts surrounding the elective termina­tion of the pregnancy of a woman with pulmonary arterial hypertension. This scenario of PAH is a superb test case to compare the (...) explanatory power of the two rival action theories. The author’s analysis reveals that the hylomorphic account is the superior account, which can explain better not only the norma­tive conclusions of the Catholic moral tradition but also our lived experience as acting persons in a world governed by cause-and-effect relationships. National Catholic Bioethics Quarterly 11.3 (Autumn 2011): 503–518. (shrink)

Harold Bloom's The Anxiety of Influence (1973) is now half a century old. Despite being one of the most important contributions to poetic theory in the twentieth century, its formal innovations remain understudied. This essay examines the legacy of The Anxiety of Influence through its relationship to the burgeoning genre of "creative criticism." It looks at the various formal genres that Anxiety draws on, including the fragment, parable, and manifesto, before providing a theory of creative criticism through (...) a reading of Susan Howe's My Emily Dickinson. (shrink)

BackgroundImplementation of quarantine and lockdown to COVID-19 pandemic has created dramatic negative psychological impact mainly the general population’s health worldwide. We aimed to assess the prevalence and predictors of anxiety and stress severity among the Palestinian population.MethodsA cross-sectional web-based survey was conducted. An anonymous online questionnaire and snowball recruiting technique were used to target the general public in Palestine between 6 and 16 April, 2020 during COVID-19 pandemic lockdowns. Multivariate logistic regression models were developed for the outcome variables.ResultsOf the (...) 2819 individuals who completed the questionnaire, more than two thirds of them were females. Nearly, were residing at the West Bank. The mean age of participants was 29.47 years. The anxiety prevalence was with had mild/moderate severity. The stress prevalence was with had mild/moderate severity. The prevalence of both anxiety and stress was. In multivariate analysis, exposure to confirmed case of COVID-19, inadequacy of food supply and jobs that acquire leaving home during lockdown were significantly related to higher anxiety degree. As for stress, low monthly income, cohabitation with a person of a high-risk group and inadequacy of food supply were significantly related to higher stress degree.ConclusionYoung adults with low socioeconomic status and inadequate food supply were more likely to have a higher degree of stress and/or anxiety. Providing alternative economical sources for those in need, and spreading more awareness regarding the pandemic, supporting the population’s psychological wellbeing, community connection and the availability of specialist mental health services are crucial to overcome the mental impacts of COVID-19 in Palestine. (shrink)

The demonstration that hypnotic suggestion can inhibit word/colour Stroop highlights one of the benefits of using hypnosis to explore cognitive psychology and in particular attentional processes. The compelling results using a rigorous design have particular relevance for the presumed automaticity of some forms of information processing. Moreover the results support the potential that hypnotic suggestion offers for creating clinically informed analogues of relevant psychological and neuropsychological conditions. As with all novel research, the results of Raz and Campbell raise further (...) operational and theoretical questions, relating in this case to the use of hypnotic, post-hypnotic and non-hypnotic suggestion and the utility of existing measures of hypnotizability. (shrink)

Burnout is a well-documented entity in Care Workers population, affecting up to 50% of physicians, just as it is equally well established that managing an infectious disease outbreaks, such as confirmed in the COVID-19 pandemic, increases Post-Traumatic Stress Disorder and the psychological burden. Mental health support, in the form of formal or remote sessions, has been shown to be helpful to health care staff, despite the organizational difficulties in an emergency. During the first emergence of COVID-19 in Italy, the Scientific (...) Institute for Research, Hospitalization and Health Care Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Foundation, the Italian hospital that treated “patient 1,” has activated an agreement with the Soleterre Foundation, an international Non-Governmental Organization that manages health emergency projects, to provide psychological support. A task force of psychologists was created with the aim of designing and administering a Therapeutic Mental Health Assessment for COVID-19 Care Workers to evaluate and support health care workers’ mental health. The assessment battery was developed to evaluate symptoms and behaviors associated with trauma and the corresponding maladaptive behaviors. Once the TMHA COVID-19 CWs had been developed, the team of psychologists regularly visited healthcare staff in the ward to administer it. One hundred seven care workers across Intensive Care Units, the emergency room and medical ward were administered the TMHA COVID-19 CWs. PTSD symptoms were reported as severe by 13% of the population. Depressive symptoms as severe for 7% and Anxiety symptoms as severe for 14%. Severe psychotic symptoms were experienced by 2% and severe suicidal thoughts by 1% of the population. The possibility of acting upon the results of the TMHA COVID-19 CWs allowed an early intervention through individual session beyond the cut-off level for PTSD in NSESSS. In fact, 280 individual support sessions were offered. Therefore, we considered our project a protective and support factor for healthcare workers’ mental well-being and we recommend implementing a mental health screening program in ward involved in COVID-19 patients’ care. (shrink)

There are two competing accounts for a theory for human action proposed by Catholic theologians working within the received moral tradition today: a hylomorphic account and an intentional account. In this article, the author compares each of the rival theories for its ability to explain both the structure and morality of the human acts surrounding the elective termina­tion of the pregnancy of a woman with pulmonary arterial hypertension. This scenario of PAH is a superb test case to compare the (...) explanatory power of the two rival action theories. The author’s analysis reveals that the hylomorphic account is the superior account, which can explain better not only the norma­tive conclusions of the Catholic moral tradition but also our lived experience as acting persons in a world governed by cause-and-effect relationships. National Catholic Bioethics Quarterly 11.3 : 503–518. (shrink)

Mental health practitioners often come across a number of challenges in their clinical practice. One such challenge that posed a management dilemma presented with the history of reincarnation. This subject has been discussed in non-scientific literature at length but there is an absolute paucity in scientific literature. This paper describes a case where a boy presented with memories of previous life that started haunting him and caused significant anxiety. The subject of reincarnation needs extensive research in order to (...) understand and manage the resultant clinical challenges. (shrink)

The aims of this study were to examine the effectiveness of a range of smartphone apps for managing symptoms of anxiety and depression and to assess the utility of a single-case research design for enhancing the evidence base for this mode of treatment delivery. The study was serendipitously impacted by the COVID-19 pandemic, which allowed for effectiveness to be additionally observed in the context of significant community distress. A pilot study was initially conducted using theSuperBetter app to evaluate (...) the proposed methodology, which proved successful with the four finishing participants. In the main study, 39 participants commenced, with 29 finishing the intervention phase and completing post-intervention measures. At 6-month follow-up, a further three participants could not be contacted. This study used a digitally enhanced, multiple baseline across-individuals single-case research design. Participants were randomly assigned to the following apps:SuperBetter,Smiling Mind,MoodMission,MindShift, andDestressify. Symptomatology and life functioning were measured at five different time points: pre-baseline/screening, baseline, intervention, 3-week post-intervention, and 6-month follow-up. Detailed individual perceptions and subjective ratings of the apps were also obtained from participants following the study’s completion. Data were analyzed using visual inspection, time-series analysis, and methods of statistical and clinical significance. Positive results were observed for all apps. Overall, more favorable outcomes were achieved by younger participants, those concurrently undertaking psychotherapy and/or psychotropic medication, those with anxiety and mixed anxiety and depression rather than stand-alone depression, and those with a shorter history of mental illness. Outcomes were generally maintained at 6-month follow-up. It was concluded that a diverse range of evidence-based therapies offered via apps can be effective in managing mental health and improving life functioning even during times of significant global unrest and, like all psychotherapies, are influenced by client features. Additionally, this single-case research design is a low-cost/high value means of assessing the effectiveness of mental health apps.Clinical Trial Registration: The study is registered with the Australian and New Zealand Clinical Trials Registry, which is a primary registry in the World Health Organization Registry Network, registration number ACTRN12619001302145p. (shrink)

Neurofibromatosis type 1 is associated with peripheral and central nervous system tumors. It is noteworthy that the regions in which these tumors frequently arise are the optic pathways and the brainstem. Thus, we decided to trace the procedure of diffusion Magnetic Resonance Imaging alterations along with Short-Wavelength Automated Perimetry examinations of the OPs after surgery and chemotherapy over 1 year, which enabled us to evaluate chemotherapy's efficacy in an NF1 patient with an OP tumor. In this study, a 25-year-old woman (...) with NF1 and left optic radiation glioma underwent surgery to remove the glioma. Immunohistochemistry revealed a Pilocytic Astrocytoma WHO grade I. Post-operation chemotherapy done using nine treatment cycles of administering Temozolomide for 5 days every 4 weeks. Applying the region of interest differential tractography method and SWAP four times every 3 months allowed us to follow the patient's visual acuity alterations longitudinally. The differential deterministic tractography method and statistical analyses enabled us to discover the white matter tracts anisotropy alterations over time. Furthermore, statistical analyses on the SWAP results along time illustrated possible alterations in visual acuity. Then, we could compare and associate the findings with the SWAP examinations and patient symptoms longitudinally. Statistical analyses of SWAP tests revealed a significant improvement in visual fields, and longitudinal differential tractography showed myelination and dense axonal packing in the left OR after 1 year of treatment. In this study, we examined an old hypothesis suggesting that chemotherapy is more effective than radiotherapy for NF1 patients with OP gliomas because of the radiation side effects on the visual field, cognition, and cerebrovascular complications. Our longitudinal clinical case study involving dMRI and SWAP on a single NF1-OPG patient showed that chemotherapy did not suppress the OP myelination over time. However, it should be noted that this is a clinical case study, and, therefore, the generalization of results is limited. Future investigations might focus on genetic-based imaging, particularly in more cases. Further, meta-analyses are recommended for giving a proper Field Of View to researchers as a subtle clue regarding precision medicine. (shrink)

The issue of anxiety has been thoroughly debated in Kierkegaardian scholarship from multiple standpoints and traditions, but not so much when it comes to the hermeneutic undertone. This article is primarily concerned with tackling the concept of anxiety as a hermeneutical concept, or working with it through hermeneutical lenses; nevertheless, the implications go deeper—making a case for an original hermeneutic anxiety, an agonistic trait of hermeneutics. By exploring the hermeneutical dimensions of the Kierkegaardian anxiety we (...) unravel a whole genealogy of the agonistic phenomena—a hermeneutical way that thrives in the paradox. The scope of it all is to break with the conciliatory ways of an epistemic hermeneutics, by regaining the Kierkegaardian hermeneutics of anxiety: preferring the fertile struggle over the passionless synthesis, paradox over soundness and agony over apathy. (shrink)

In recent years, it was notorious the presence of a persistent interpretation of the political field in terms that find in the notion of crisis its main narrative. In order to assess this historical sensitivity ―which is an effect of the rupture of the grand narrative of progress― the analysis of Janet Roitman has been particularly relevant. Her critical perspective on this historical matrix is based on her assumption that such sensitivity leads to a strong paralysis in terms of political (...) agency, mainly through its claim of being the same incarnation of moments of truth. The central aim of this paper is to challenge this interpretation of the narrative of crisis as a case of post-historical meaning through the analysis of the transhumanist philosophy as deployed by Nick Bostrom. It is thanks to the scrutiny of the affective dimension involved in this sort of historical meaning focused in the role played by anxiety, that is possible to explore the kind of agency that may result from this framework. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Proof and Persuasion in Black Athena:: The Case of K. O. MüllerJosine H. BlokNon tali auxilio.Virgil, Aeneid II, 521When in 1824 the German classical scholar Karl Otfried Müller (1797–1840) set down to write a review of Champollion’s first Letter to M. Dacier (1822), he was profoundly interested. 1 For several years he had been working on Egypt, and as he told his parents in 1820, “I have come (...) to love Egyptian antiquity so much, that, if I were not constricted by the schedule of my classes, I would have set myself to the decipherment of the hieroglyphs, which I would not deem impossible by the clues I have found.” 2 During the same years (1820–25) that he wrote his early books on ancient Greece, he [End Page 705] reviewed sixteen studies on Egypt alone. 3 In his review of the Letter, then, he wanted to draw “the attention of [the] readers to this, certainly not unfounded, discovery,” 4 though he feared the author was inclined to jump to conclusions. But in August 1824 he reviewed Champollion’s more complete publication of his findings of the same year and, recalling his previous anxiety, commented:Now, however, the reading of the present work has totally convinced me, that the usage of hieroglyphs to indicate sounds is as ancient as this writing system itself. [... This discovery should also mean that...] the history of Egyptian religion and state will be reconstructed and expanded. 5From that moment he sided unequivocally with Champollion, politely but clearly reminding German colleagues who still stumbled on with decipherments of their own, that this would not do. 6With these facts in mind, Martin Bernal’s rendering in his Black Athena, volume I, is bound to surprise: “[U]nlike Humboldt, Niebuhr and Bunsen [Müller] disregarded the sensational scholarly developments between 1815 and 1830. There is no indication that he paid any attention to Champollion’s decipherment” (316). The contradiction between Bernal’s statements and the sources on Müller’s life and work turns out not to be an incidental error but part of a larger pattern. To understand this pattern and its objectives, let me first summarize Bernal’s argument and my own.In his challenging book Bernal argues that the ancient Greek world was founded on the colonization of Greece by Phoenicians and Egyptians in the second millennium bc. 7 The material which is to prove his thesis is offered in volume II, though volume I includes a summary. In this first volume Bernal observes that from late antiquity until the eighteenth century, awareness of the Afroasiatic roots of ancient civilization had been retained as the heritage of ancient Greece itself. Hence Bernal labels this perception underlying Western classical scholarship of the early modern period the “Ancient Model.” By or soon after the 1820s, however, it was replaced by the “Aryan Model,” which took Greek civilization to be partly autochthonous and partly [End Page 706] shaped by invasions coming from the North. To reveal that the fall of the Ancient Model was not the result of internal developments in classical scholarship but of externalist influences, notably the belief in progress, the defense of Christianity, Romanticism, and most importantly racism, is the core theme of volume I. Bernal sustains his argument by contending that historical source criticism was not really or entirely an internal development but created to serve the external ends, and by presenting Müller as the embodiment of Romanticist racism, who was responsible for overthrowing the Ancient Model and inaugurating its Aryan successor. Hence, by thus designating Müller as the axis around which the overall turn of classical scholarship revolved, he wants to prove that the fall of the Ancient Model was unjustified in terms of scholarship but only occurred due to dishonorable ideologies.Through a limited number of representative issues I want to argue that Bernal’s rendering of Müller and the context of his work is untenable in the light of the source material and that Bernal’s explanation of the fall of the Ancient Model is untenable as well. My aim is not just to clear Müller’s name... (shrink)

Deep Brain Stimulation is an invasive device-based neuromodulation technique that allows the therapeutic direct stimulation of subcortical and deep cortical structures following the surgical placement of stimulating electrodes. DBS is approved by the U.S. Federal Drug Administration for the treatment of movement disorders and obsessive-compulsive disorder, while new indications, including Major Depressive Disorder, are in experimental development. We report the case of a patient with MDD who received DBS to the ventral internal capsule and ventral striatum bilaterally and presented (...) with 2 weeks of voltage-dependent Tourette-like symptoms including brief transient episodes of abrupt-onset and progressively louder coprolalia and stuttered speech; tic-like motor behavior in his right arm and leg; rushes of anxiety, angry prosody, angry affect; and moderate amnesia without confusion. We describe the results of the inpatient neuropsychiatric workup leading to the diagnosis of iatrogenic voltage-dependent activation of cortico-subcortical circuits and discuss insights into the pathophysiology of Tourette as well as safety considerations raised by the case. (shrink)

This article explores the ethical concept of neutrality through use of a psychiatric clinical vignette. In this case a psychiatry resident is faced with the treatment of a patient who was found by the FBI to be in possession of child pornography. Although not accused of any other crimes, the patient was a fugitive from the law and requesting treatment for pedophilia. Faced with the pressures of limited resources and anxiety about the patient's dangerousness to others, the resident (...) and his supervisor tried to strike a balance between the ethical principles of neutrality and beneficence. Through this vignette, the importance of neutrality, as well as how it can be compromised by other pressures such as expediency and anxiety, is explored. (shrink)

This paper argues that vice-charging, the practice of charging other persons with epistemic vice, can itself be epistemically vicious. It identifies some potential vices of vice-charging and identifies knowledge of other people as a type of knowledge that is obstructed by epistemically vicious attributions of epistemic vice. The hazards of vice-charging are illustrated by reference to the accusation that parents who hesitate to give their children the MMR triple vaccine are guilty of gullibility and dogmatism. Ethnographic and sociological research is (...) used to make the case that this charge is, in a significant range of cases, epistemically unjust and hinders attempts to make sense of vaccine hesitancy. This epistemic injustice consists in the representation of vaccine hesitant parents as less than full epistemic agents. A case is made for a more tolerant and inclusive approach, not only to vaccine hesitancy but also to other forms of unorthodoxy or non-compliance. The primary objective in these cases should be to achieve Verstehen of seemingly alien outlooks and practices so that policy makers and practitioners in public services can more effectively educate a sceptical public about the risks of vaccine hesitancy. (shrink)

Veterinary medicine has undergone dramatic, rapid feminization while in many ways remaining gendered masculine. With women constituting approximately half of its practitioners and nearly 80 percent of students, veterinary medicine is the most feminized of the comparable health professions. Nevertheless, the culture of veterinary medicine glorifies stereotypically masculine actions and attitudes. This article examines how women veterinarians understand the gender dynamics within the profession. Our analysis reveals that the discursive strategies available to women sustain and justify the status quo, and (...) thus preserve hegemonic masculinity. Women use strategies previously used toward female tokens in nontraditional jobs, such as role encapsulation, and strategies previously used by male tokens in traditionally female jobs, such as distancing from the feminine. Through this discursive “gender work,” women help to maintain the institutionalized inequality and the masculine ethic of the profession. Veterinary medicine illustrates the importance of considering organizational context in studies of feminization. (shrink)

When Oxford published Emotion and Adaptation, the landmark 1991 book on the psychology of emotion by internationally acclaimed stress and coping expert Richard Lazarus, Contemporary Psychology welcomed it as "a brightly shining star in the galaxy of such volumes." Psychiatrists, psychologists and researchers hailed it as a masterpiece, a major breakthrough in our understanding of the emotional process and its central role in our adaptation as individuals and as a species. What was still needed, however, was a book for general (...) readers and health care practitioners that would dispel the myths still surrounding cultural beliefs about emotion and systematically explain the relevance of the new research to the emotional dramas of our everyday lives.Now, in Passion and Reason, Lazarus draws on his four decades of pioneering research to bring readers the first book to move beyond both clinical jargon and "feel-good" popular psychology to really explain, in plain, accessible language, how emotions are aroused, how they are managed, and how they critically shape our views of ourselves and the world around us. With his co-author writer Bernice Lazarus, Dr. Lazarus explores the latest findings on the short and long-term causes and effects of various emotions, including the often conflicting research on stress management and links between negative emotions and heart disease, cancer, and other aspects of physical and psychological health. Lazarus makes a strong case that contrary to common assumption, emotions are not irrational--our emotions and our analytical thought processes are inextricably linked.While not a "how-to" book, Passion and Reason does describe how readers can interpret what lies behind their own emotions and those of their families, friends, and co-workers, and how to manage them more effectively. Exploring fifteen emotions in depth, from love to jealousy, the authors show how the personal meaning we give to the events and conditions of our lives trigger such emotions as anger, anxiety, guilt, and pride. They provide fascinating vignettes to frame a "biography" of each emotion. Some are composite case histories drawn from Dr. Lazarus's long career, but most are stories of people the Lazaruses have known over the years--people whose emotional fears, conflicts, and desires mirror readers' own. The Lazaruses also offer a special chapter on the diverse strategies of coping people use in managing their emotions, and another, "When Coping Fails," on psychotherapy and its approaches to emotional stress and dysfunction, from traditional Freudian psychoanalysis to continuing research into relaxation techniques, meditation, hypnosis, and biofeedback.Packed with insight and compellingly readable, Passion and Reason will enrich all readers fascinated by our emotional lives. (shrink)

Heidegger's primary concern in Being and Time is the question of the meaning of being—a distinctly ontological concern. Yet, with discussions of death, guilt, conscience, anxiety, uncanniness, authenticity, and inauthenticity, Heidegger seems to end up in existential territory. The ontological import of these existential excursions is difficult to discern—indeed, it has not been identified in leading interpretations. In this paper, I aim to highlight the ontological import of Heidegger's analysis of anxiety—it manifests the inadequacy of Dasein's fallen and (...) inauthentic self-understanding, which is motivated by the inadequacy of Dasein's fallen and inauthentic, average understanding of being. In making this case, I will clarify the sense in which anxiety involves an experience of world-collapse and show how it functions to reveal the possibilities of authenticity and inauthenticity. (shrink)

This paper analyzes and evaluates the 2007 majority opinion of the German National Ethics Council which seeks to establish new information (as to the inferior quality of legally procurable human embryonic stem cells) as a sufficient reason for a relaxation of the 2002 Stem Cell Law. A micro-level analysis of the opinion’s central section is conducted and evaluated vis à vis the strongest known opponent position in the national debate at that time. The argumentation is claimed to rely on an (...) unsupported semantic assumption regarding the parthood relation of the 2002 compromise and to misconstrue the strongest known opponent position. (shrink)

Extensively updated to include clinical findings over the last two decades, this third edition of A Practitioner's Guide to Rational-Emotive Behavior Therapy reviews the philosophy, theory, and clinical practice of Rational Emotive Behavior Therapy. This model is based on the work of Albert Ellis, who had an enormous influence on the field of psychotherapy over his 50 years of practice and scholarly writing. Designed for both therapists-in-training and seasoned professionals, this practical treatment manual and guide introduces the basic principles of (...) rational-emotive behavior therapy, explains general therapeutic strategies, and offers many illustrative dialogues between therapist and patient. The volume breaks down each stage of therapy to present the exact procedures and skills therapists need, and numerous case studies illustrate how to use these skills. The authors describe both technical and specific strategic interventions, and they stress taking an integrative approach. The importance of building a therapeutic alliance and the use of cognitive, emotive, evocative, imaginal, and behavioral interventions serves as the unifying theme of the approach. Intervention models are presented for the treatment of anxiety, depression, trauma, anger, personality disorders, and addictions. Psychologists, clinical social workers, mental health counselors, psychotherapists, and students and trainees in these areas will find this book useful in learning to apply rational-emotive behavior therapy in practice. (shrink)

Volume 23, Issue 3-4, November - December 2024, Page 251-263.

Introduction: In The Netherlands, physicians have to be convinced that the patient suffers unbearably and hopelessly before granting a request for euthanasia. The extent to which general practitioners (GPs), consulted physicians and members of the euthanasia review committees judge this criterion similarly was evaluated. Methods: 300 GPs, 150 consultants and 27 members of review committees were sent a questionnaire with patient descriptions. Besides a “standard case” of a patient with physical suffering and limited life expectancy, the descriptions included cases (...) in which the request was mainly rooted in psychosocial or existential suffering, such as fear of future suffering or dependency. For each case, respondents were asked whether they recognised the case from their own practice and whether they considered the suffering to be unbearable. Results: The cases were recognisable for almost all respondents. For the “standard case” nearly all respondents were convinced that the patient suffered unbearably. For the other cases, GPs thought the suffering was unbearable less often (2–49%) than consultants (25–79%) and members of the euthanasia review committees (24–88%). In each group, the suffering of patients with early dementia and patients who were “tired of living” was least often considered to be unbearable. Conclusions: When non-physical aspects of suffering are central in a euthanasia request, there is variance between and within GPs, consultants and members of the euthanasia committees in their judgement of the patient’s suffering. Possible explanations could be differences in their roles in the decision-making process, differences in experience with evaluating a euthanasia request, or differences in views regarding the permissibility of euthanasia. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Toward a Fictionalist Psychiatry?Sam Wilkinson, PhD (bio)I am deeply sympathetic to what Giulio Ongaro (2024a, 2024b, 2024c) writes in these three excellent interlocking papers. I will argue that there is a slightly more efficient way of approaching these issues. It involves adopting fictionalism rather than externalism (although fictionalism can accommodate externalist insights). Fictionalism is something that Ongaro briefly, and approvingly, mentions, in the final paper, but there is an (...) implicit realism in the initial approach. I am not sure there is much disagreement, however, and perhaps we end up in the same place, having approached from different starting points. The fictionalist approach is largely compatible with all of the substantive things Ongaro wants to say, but is, strictly speaking, in tension with the most natural interpretation of externalism, namely, construed as a form of descriptivism and realism (two notions I unpack later).Externalism, Evaluativism, and Social IntegrationA major theme of the first paper is that mainstream internalist Western psychiatry is bad at integrating the social dimension of mental illness. I agree. Furthermore, recent externalistic (enactive and predictive processing) approaches, while better, are still lacking in that they collapse the “social” into the “psychosocial.” Again, I agree. But my diagnosis (excuse the pun) is slightly different. The social dimension of illness concerns in large part the evaluative nature of illness, not the need to descriptively, causally capture a complex, objectively real phenomenon called “illness.”Having said this, in integrating this evaluative social dimension, we need to tread carefully lest we fail to meet the “demarcation challenge” (Murphy, 2008). This concerns the challenge of demarcating different kinds of problem. Humans have always had problems, for which they have needed help, accommodation, allowances made, and so on, but how do you distinguish mental health problems, from other kinds of problems? How do you distinguish money woes, or marital strife, both of which certainly cause unhappiness, or even psychological states that look like psychiatric symptoms (e.g., anxiety, low mood), from properly mental health problems?The biomedical “internalist” says: Easy! Either there is something objectively wrong with you, or there is not. However, notice that this is exactly [End Page 337] what externalists can say too, to the extent that they are trying to describe and define disorder in value-free terms. The only difference is that the internalist will talk about what is wrong within the biological boundaries of the organism, whereas the externalist will go beyond that.Externalism about a particular phenomenon, if it is to be a non-trivial position, needs to be sensitive to the distinction between cause and constitution (or what Adams & Azaiwa [2001] call “coupling-constitution confusion”). We see this in externalism about the mind in general. In the Extended Mind Hypothesis (Clark & Chalmers 1998), the claim is not that Otto’s notebook causally contributes to Otto’s mind (his belief about where MOMA is). Nobody would deny that. The interesting claim is that the notebook is constitutive of his belief: it is literally part of his mind. Similarly, nobody is denying that external (e.g., social) factors cause mental health problems, the question is: Do they constitute those problems? Externalism takes this question seriously and answers in the affirmative, at least in some cases. But the articulation of this has to be nuanced.Suppose I have crippling anxiety over financial concerns. Anxiety can be a mental health problem, but if, in this case, you transferring money into my bank account makes my anxiety disappear, then one might think this is not a mental health problem. It is a money problem. Or is it? Enter fictionalism (Wilkinson, 2022).Fictionalism is the view that calling someone mentally ill is not describing them as having a particular property, but involves something like engaging in a fiction, a fiction that has been constructed in order to encourage certain courses of action. According to fictionalism, given the facts, there is a lot of wiggle room about how we are to think of, and respond to, people’s problems.To borrow some insights from meta-ethics, when we examine normative discourse (one canonical domain being ethics) we can ask: what does the discourse do? And what... (shrink)