Basing ourselves on the writings of Hans Jonas, we offer to psychosomatic medicine a philosophy of life that surmounts the mind-body dualism which has plagued Western thought since the origins of modern science in seventeenth century Europe. Any present-day account of reality must draw upon everything we know about the living and the non-living. Since we are living beings ourselves, we know what it means to be alive from our own first-hand experience. Therefore, our philosophy of life, in addition (...) to starting with what empirical science tells us about inorganic and organic reality, must also begin from our own direct experience of life in ourselves and in others; it can then show how the two meet in the living being. Since life is ultimately one reality, our theory must reintegrate psyche with soma such that no component of the whole is short-changed, neither the objective nor the subjective. In this essay, we lay out the foundational components of such a theory by clarifying the defining features of living beings as polarities . We describe three such polarities: 1) Being vs. non-being: Always threatened by non-being, the organism must constantly re-assert its being through its own activity. 2) World-relatedness vs. self-enclosure: Living beings are both enclosed with themselves, defined by the boundaries that separate them from their environment, while they are also ceaselessly reaching out to their environment and engaging in transactions with it. 3) Dependence vs. independence: Living beings are both dependent on the material components that constitute them at any given moment and independent of any particular groupings of these components over time. We then discuss important features of the polarities of life: Metabolism; organic structure; enclosure by a semi-permeable membrane; distinction between "self" and "other"; autonomy; neediness; teleology; sensitivity; values. Moral needs and values already arise at the most basic levels of life, even if only human beings can recognize such values as moral requirements and develop responses to them. (shrink)

Psychosomatic medicine, with its prevailing biopsychosocial model, aims to integrate human and exact sciences with their divergent conceptual models. Therefore, its own conceptual foundations, which often remain implicit and unknown, may be critically relevant. We defend the thesis that choosing between different metaphysical views on the ‘mind–body problem’ may have important implications for the conceptual foundations of psychosomatic medicine, and therefore potentially also for its methods, scientific status and relationship with the scientific disciplines it aims to integrate: biomedical (...) sciences, psychology and social sciences. To make this point, we introduce three key positions in the philosophical ‘mind–body’ debate and investigate their consequences for the conceptual basis of the biopsychosocial model in general and its ‘psycho-biological’ part in particular. Despite the clinical merits of the biopsychosocial model, we submit that it is conceptually underdeveloped or even flawed, which may hamper its use as a proper scientific model. (shrink)

In recent years, there has been a rapidly increasing interest in self-management strategies in psychiatry and psychosomatic medicine. Among the conditions in which self-management is currently investigated in these contexts are bipolar disorder, depression, post-traumatic stress disorder, schizophrenia, attention deficit hyperactivity disorder, irritable bowel syndrome, chronic fatigue syndrome (Meng, Friedberg, &...

Combining theological and medical perspectives is indispensable for the historical study of the interconnections between mind, body, and soul. This article explores these relations through the history of Finnish psychosomatic medicine, and uses published and archival materials to examine the intellectual biography of the Finland-Swedish theologian turned psychiatrist Asser Stenbäck (1913–2006). Stenbäck's career, which evolved from priesthood to psychiatry and politics, reveals a great deal about the tensions between religion and medicine, the spiritual and scientific groups that impinged upon (...) psychosomatic medicine, and ideas on how health and Christian morality were interconnected. The biographical approach is adopted to unearth the values encoded in medical concepts, and through this, to point towards another, underexplored dimension of the health–religion relationship. In addition to their emotional aspect, religious doctrines are intended to organise life and give it meaning. Stenbäck's ideas tied these experiential and normative spheres together by defending an irrationalist substratum of the world in the secular age of medicine. His work illustrates how the inner experience of faith can become both medically and politically purposive. It is worth combining these perspectives in historical research as well in order to better understand how the theological, medical, and political worlds are in dialogue when it comes to human problems. (shrink)

Self-management interventions are a heterogeneous group of interventions that are regarded as important tools for the management of chronic diseases. They consist of a broad range of techniques and are available for a large variety of chronic organic as well as mental conditions or illnesses, which are by definition generally chronic. These interventions aim that the individual concerned takes substantial responsibility for managing the symptoms, treatment, and physical and psychosocial consequences associated with having a chronic medical condition, disability or disease. (...) Alternate terms used in this context, among others, are self-care... (shrink)

THE ARTICLE CONSIDERS HOW THE CONCEPTION OF PSYCHOSOMATIC DISORDER FITS INTO THE DUALISTIC AND MONISTIC VIEWS OF DOCTORS ON THE MIND-BODY RELATIONSHIP, AND POINTS OUT HOW THE DIFFICULTY OF FITTING IT INTO THE CURRENT KIND OF MONISM WOULD BE LESSENED IF PSYCHOSOMATIC DISORDERS WERE DEFINED AS SOMATIC SYMPTOMS WHICH CAN BE SUCCESSFULLY TREATED BY METHODS USED TO TREAT PSYCHIC SYMPTOMS.

Modern socio?cultural studies of medicine demonstrate the symbolic character of much of medical reality. This symbolic reality can be appreciated as mediating the traditional division of medicine into biophysical and human sciences. Comparative studies of medical systems offer a general model for medicine as a human science. These studies document that medicine, from an historical and cross?cultural perspective, is constituted as a cultural system in which symbolic meanings take an active part in disease formation, the classification and cognitive management of (...) illness, and in therapy. Medicine's symbolic reality also forms a bridge between cultural and psychophysiological phenomena; the basis for psychosomatic and socioso?matic pathology and therapy. This in turn becomes a central problem for medical theory and for a philosophical reinvestigation of medicine. (shrink)

BackgroundStress is a major risk factor for the impairment of psychological well-being. The present study aimed to evaluate the empirical evidence of the Transactional Stress Model proposed by Lazarus and Folkman in patients with psychosomatic health conditions.MethodsA structural equation model was applied in two separate subsamples of inpatients from the Department of Psychosomatic Medicine for consecutive model building and confirmatory analyses using self-reported health status information about perceived stress, personal resources, coping mechanisms, stress response, and psychological well-being.ResultsThe initial (...) model was created to reflect the theoretical assumptions by Lazarus and Folkman about their transactional stress concept. This model was modified until a sufficient model fit was reached. The modified model was confirmed in a second sample. Perceived external stressors and personal resources explained 91% of the variance of the stress response, which was closely related to symptoms of depression. The attenuating effect of resources on stress response was higher than the impact of perceived stressors on stress response.ConclusionThe empirical data largely confirmed the theoretical assumption of the Transactional Stress Model, which was first presented by Lazarus and Folkman, in patients with a wide range of psychosomatic conditions. However, data analyses were solely based on self-reported health status. Thus, proposed inner psychological mechanisms such as the appraisal process could not be included in this empirical validation. The operationalization and understanding of coping processes should be further improved. (shrink)

This article explores the relationship between automatic and involuntary language in the work of Samuel Beckett and late nineteenth-century neurological conceptions of language that emerged from aphasiology. Using the work of John Hughlings Jackson alongside contemporary neuroscientific research, we explore the significance of the lexical and affective symmetries between Beckett’s compulsive and profoundly embodied language and aphasic speech automatisms. The interdisciplinary work in this article explores the paradox of how and why Beckett was able to search out a longed-for language (...) of feeling that might disarticulate the classical bond between the language, intention, rationality and the human, in forms of expression that seem automatic and “readymade”. (shrink)

On psychosomatics based on Jaina philosophy.

This special issue is a follow-up on a previous issue in this journal on self-management in psychiatry and psychosomatic medicine. It is the concluding chapter of a research project that sought to unpack and develop the implications of an understanding of self-management in psychiatry and psychosomatic medicine as “management of the self.”Over the last, 20 years, self-management has gained a central place in treatment programs across various medical disciplines. It positions patients as “expert-clients,” who share knowledge, responsibilities and (...) expertise with health professionals, and it actively involves them in the management of their own care (Crawford, Lee, May, & Active Self-Care... (shrink)

Using exemplary historical scenarios, the present cultural history traces the transdisciplinary development of a psychosomatic discourse between the 18th and 20th centuries, thus closing a gap in research.

Im Jahr 1926 veroffentlichte Viktor von Weizsacker im ersten Jahrgang der von ihm gemeinsam mit Martin Buber und Joseph Wittig begrundeten Zeitschrift "Die Kreatur" einen Essay unter dem Titel "Die Schmerzen." Als sprachliche Form des Umgangs mit dem Schmerz wird dieser Text gleichwohl zum Pladoyer fur das Problematische am Verhaltnis von Schmerz und Sprache. Die Not der Unsagbarkeit lasst den Schmerz zum Indikator fur den Verlust einer Ordnung werden, die Sprache wie Leben allererst ermoglicht. "So wird die Wahrnehmung des Schmerzes (...) verwandelt in eine Kritik der Wirklichkeit, in ein Instrument der Scheidung von echt und unecht in der Erscheinung des Lebendigen."Weder war bislang der literarische und philosophische Wert dieses Essays im Blick, noch ist gesehen worden, dass mit dem hier dargestellten besonderen Zusammenhang von Schmerz und Sprache eine Grundlegung der therapeutischen Kompetenz Medizinischer Anthropologie erfolgt.So wirft der vorliegende Band nicht nur neues Licht auf die Genese eines bedeutsamen Versuchs zur Revision der Grundlagen moderner Medizin, er gibt uberdies Einblicke in eine faszinierende geistige Konstellation zu Beginn des vergangenen Jahrhunderts. Ihrer antiken Herkunft entsprechend, werden Literatur, Philosophie und Theologie zu Gefahrten der Medizin in der Sorge um den Menschen.Der Band ist dem Andenken an den Heidelberger Philosophen Reiner Wiehl gewidmet. (shrink)

In 1956, Hans Selye tentatively suggested that the scientific study of stress could ‘help us to formulate a precise program of conduct’ and ‘teach us the wisdom to live a rich and meaningful life’. Nearly two decades later, Selye expanded this limited vision of social order into a full-blown philosophy of life. In Stress without Distress, first published in 1974, he proposed an ethical code of conduct designed to mitigate personal and social problems. Basing his arguments on contemporary understandings of (...) the biological processes involved in stress reactions, Selye referred to this code as ‘altruistic egotism’. This article explores the origins and evolution of Selye’s ‘natural philosophy of life’, analysing the links between his theories and adjacent intellectual developments in biology, psychosomatic and psychosocial medicine, cybernetics and socio-biology, and situating his work in the broader cultural framework of modern western societies. (shrink)

In Your Body Speaks Your Mind, renowned teacher and best-selling author Deb Shapiro shows you how mastering the language of your symptoms can actually increase ...

Between Sickness and Health is about illness rather than disease, and recovery rather than cure. The book argues that illness is an experience, represented by the feeling that 'I am not myself'. From the book's phenomenological point of view, feelings of illness cannot be 'unreal' or 'fake', whatever their biological basis, nor need they be categorised as 'physical', 'psychosomatic' or 'psychiatric'. The book challenges the disease-centred ethos of medicine and medical education. It demonstrates that a clearer conception of illness, (...) as distinct from disease, is therapeutic. The feeling that 'I am once again myself' can return, in some degree, whatever state the body is in. Resilience becomes more available when it is seen as a set of personal skills that can be developed, rather than as an inborn trait. Possibilities of wellness are enhanced by recognising that medical and other therapies can either support or impede recovery, as can human relationships and the socio-political environment. The book's many clinical examples are drawn from the author's broad experience as a neurologist, rehabilitation physician and systemic family therapist. Between Sickness and Health will be useful for students, practitioners and academics, and also for anyone who has been or might one day be ill. (shrink)

Ce livre propose une réflexion théorico-clinique sur un outil psychanalytique encore trop méconnu, que l'auteur intitule: Cet autre divan. Il traite d'une autre façon d'utiliser la méthode psychanalytique de Freud pour les pathologies non névrotiques actuelles. Cet autre divan peut éveiller la curiosité, car ici le divan lui-même est un outil de la cure. Ce concept de la Psychothérapie Psychanalytique Corporelle (PPC) est issu de la rencontre des travaux de Julian de Ajuriaguerra et des recherches post-freudiennes sur les pathologies des (...) limites. Avec de nombreuses illustrations, l'auteur montre que la PPC permet le dégagement de l'archaïque traumatique à l'aide de la médiation corporelle. L'originalité de cet abord psychanalytique est de faire travailler les paramètres oubliés parce que silencieux dans le cadre psychanalytique classique, qui est mis en difficulté par les patients non névrotiques. Ce livre, qui donne au corps toute son importance organisatrice pour la psyché, montre que nous pouvons innover à partir de Freud pour aider psychanalytiquement ces personnes qui présentent des souffrances identitaires et narcissiques et qui s'adressent à nous. (shrink)

This paper aims to interpret the role of the soul as ontological, intellectual or cognitive and as the moral principle within the frame of the holistic conception of human psychosomatic health that emerges from the context of Zalmoxian medicine in the proemium of Plato’s Charmides. It examines what the ontological status of the soul is in relation to the body and the body–soul complex of man considered as a psychosomatic whole. By comparing the presentation of the soul as (...) principle in the Charmides and the Phaedrus, the paper defends the thesis that in the former dialogue, Plato develops his own anthropological ontology, which paves the way for the salvation of human existence and health. The soul is bestowed with an ontological primacy that determines the philosophical and medical presuppositions for treating human illness under a holistic view. The interpretation of the ontological relation of the soul to the body and the entire human being in the context of Zalmoxian holistic medicine is based on Hermias Alexandrinus’ exegesis of the conception of the soul as principle in the Phaedrus. This paper demonstrates that, from both the medical holistic viewpoint and the anthropological philosophical perspective, the soul is the principle and πρῶτον with regard to the body and the body–soul complex without being the whole that the corresponding medical epistemology must apprehend. (shrink)

Montaigne’s writings on medicine and the body have always been seen as part of a larger project about knowing ourselves. Responding to medical developments that seemed to privilege the anatomical body over the mind or the emotions, Montaigne defended the humoral link between mind and body. His essays make use of word play, puns, and anecdotes based on his own experience and reports from antiquity to counter what he perceived to be an increasingly one-sided approach to medicine. The result is (...) a witty but nuanced argument for a more balanced outlook to what is now known as psychosomatic medicine. (shrink)

After nearly fifty years of mea culpas and explanatory additions, the biopsychosocial model is no closer to a life of its own. Bolton and Gillett give it a strong philosophical boost in The Biopsychosocial Model of Health and Disease, but they overlook the model’s deeply inconsistent position on dualism. Moreover, because metaphysical confusion has clinical ramifications in medicine, their solution sidesteps the model’s most pressing clinical faults. But the news is not all bad. We can maintain the merits of holism (...) as we let go of the inchoate bag of platitudes that is the biopsychosocial model. We can accept holism as the metaphysical open door that it is, just a willingness to recognize the reality of human experience, and the sense in which that reality forces medicine to address biological, psychological, and social aspects of health. This allows us to finally characterize Engel’s driving idea in accurate philosophical terms, as acceptance of consciousness in the context of medical science. This will not entirely pin down medicine’s stance on dualism, but it will position it clearly enough to readily improve patient care. (shrink)

The symbiotic resonance of the planetary and psychosomatic bodies was one of the most ancient religious and philosophical assumptions in ancient China. A number of contemporary scholars have explored this assumption in various branches of Chinese thought. Here, I would like to investigate this ancient assumption further in relation to the classical medical traditions, arguing that it was the medical thinkers who first attempted a systematic treatment and modeling of the macrocosm and the somatic body as a microcosm. Specifically, (...) I suggest that the mutual trust between cosmology and medicine yields a cosmological synthesis of.. (shrink)

In everyday life we take it for granted that we have conscious control of some of our actions and that the part of us that exercises control is the conscious mind. Psychosomatic medicine also assumes that the conscious mind can affect body states, and this is supported by evidence that the use of imagery, hypnosis, biofeedback and other ‘mental interventions’ can be therapeutic in a variety of medical conditions. However, there is no accepted theory of mind/body interaction and this (...) has had a detrimental effect on the acceptance of mental causation in science, philosophy and in many areas of clinical practice. Biomedical accounts typically translate the effects of mind into the effects of brain functioning, for example, explaining mind/body interactions in terms of the interconnections and reciprocal control of cortical, neuroendocrine, autonomic and immune systems. While such accounts are instructive, they are implicitly reductionist, and beg the question of how conscious experiences could have bodily effects. On the other hand, non-reductionist accounts have to cope with three problems: 1) The physical world appears causally closed, which would seem to leave no room for conscious intervention. 2) One is not conscious of one’s own brain/body processing, so how could there be conscious control of such processing? 3) Conscious experiences appear to come too late to causally affect the processes to which they most obviously relate. This paper suggests a way of understanding mental causation that resolves these problems. It also suggests that “conscious mental control” needs to be partly understood in terms of the voluntary operations of the preconscious mind, and that this allows an account of biological determinism that is compatible with experienced free will. (shrink)

Shortly before and during World War II many European psychoanalysts found refuge in South America, concentrated in Buenos Aires. Here, together with local professionals, they created a strong, creative and productive psychoanalytic movement that in turn gave birth to theoretical and clinical contributions that transformed psychoanalysis, psychology, medicine and culture in South America. _The Pioneers of Psychoanalysis in South America_ is a collection of those pioneers’ papers, and introduces the reader to a body of ideas and advancements, many of which (...) have had limited and piecemeal exposure within the psychoanalytic community in the rest of the world until now. The editors Nydia Lisman-Pieczanski and Alberto Pieczanski present original papers and essays, many of which have never before been published in English; those that have been translated were rarely presented in context. Each one of the chapters is accompanied by a scholarly introduction written by psychoanalysts, many of whom personally knew the pioneers and their oeuvres in depth, tracing the roots of their ideas in the European analytic schools. _The Pioneers of Psychoanalysis in South America _is divided into six main sections: Psychoanalytic process Psychoanalytic technique Metapsychology Psychoanalysis of children Culture and society Psychosomatic medicine. Nydia Lisman-Pieczanski and Alberto Pieczanski provide a coherent guide to the seminal ideas and practices of the South American psychoanalysts who have made major theoretical and clinical contributions to the advancement of the psychoanalytic discipline. The chapters present the material in a way that is accessible to psychoanalysts from across the globe and will enable them to incorporate the ideas and practices outlined here into their everyday psychoanalytic work. It will also be of interest to psychoanalytic psychotherapists, academics interested in the history and development of psychoanalytic ideas and psychoanalysis, and advanced students. The following link leads to an video interview featuring Nydia Lisman-Pieczanski and Alberto Pieczanski by the Washington Center for Psychoanalysis for the History Project, where they open up about their stories, their marriage, and their new book: https://www.routledge.com/posts/8996. (shrink)

_The first part called the Preamble tackles: (a) the issues of silence and speech, and life and disease; (b) whether we need to know some or all of the truth, and how are exact science and philosophical reason related; (c) the phenomenon of Why, How, and What; (d) how are mind and brain related; (e) what is robust eclecticism, empirical/scientific enquiry, replicability/refutability, and the role of diagnosis and medical model in psychiatry; (f) bioethics and the four principles of beneficence, non-malfeasance, (...) autonomy, and justice; (g) the four concepts of disease, illness, sickness, and disorder; how confusion is confounded by these concepts but clarity is imperative if we want to make sense out of them; and how psychiatry is an interim medical discipline. The second part called The Issues deals with: (a) the concepts of nature and nurture; the biological and the psychosocial; and psychiatric disease and brain pathophysiology; (b) biology, Freud and the reinvention of psychiatry; (c) critics of psychiatry, mind-body problem and paradigm shifts in psychiatry; (d) the biological, the psychoanalytic, the psychosocial and the cognitive; (e) the issues of clarity, reductionism, and integration; (f) what are the fool-proof criteria, which are false leads, and what is the need for questioning assumptions in psychiatry. The third part is called Psychiatric Disorder, Psychiatric Ethics, and Psychiatry Connected Disciplines. It includes topics like (a) psychiatric disorder, mental health, and mental phenomena; (b) issues in psychiatric ethics; (c) social psychiatry, liaison psychiatry, psychosomatic medicine, forensic psychiatry, and neuropsychiatry. The fourth part is called Antipsychiatry, Blunting Creativity, etc. It includes topics like (a) antipsychiatry revisited; (b) basic arguments of antipsychiatry, Szasz, etc.; (c) psychiatric classification and value judgment; (d) conformity, labeling, and blunting creativity. The fifth part is called The Role of Philosophy, Religion, and Spirituality in Psychiatry. It includes topics like (a) relevance of philosophy to psychiatry; (b) psychiatry, religion, spirituality, and culture; (c) ancient Indian concepts and contemporary psychiatry; (d) Indian holism and Western reductionism; (e) science, humanism, and the nomothetic-idiographic orientation. The last part, called Final Goal, talks of the need for a grand unified theory. The whole discussion is put in the form of refutable points._. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Grounding Psychiatry in the Body and the Social WorldLaurence J. Kirmayer, MD, FRCPC, FCAHS, FRSC (bio)The sensing body is like an open circuit that completes itself only in things, in others, in the surrounding earth.—David Abram (2012)Giulio Ongaro has written an interesting set of papers that aim to advance our thinking about ‘externalist’ (i.e., social) approaches to psychiatry by rehearsing an enactivist account of mental disorder and elaborating an (...) ethnographic example of social explanation rooted in a different cultural ontology and system of healing. I am completely onboard with his calls for more attention to the social world in psychiatric theory, research, and practice. What is especially novel in his work is the use of ethnographic research to inform philosophical thinking about psychiatry.Despite my enthusiasm for this effort, I have three concerns with his argument that I can only briefly outline in this commentary: i) the lack of attention to a large body of work in social epidemiology, psychosomatics, and cultural psychiatry that speaks directly to the goals of the biopsychosocial (BPS) approach and that vitiates much of the recent critique of that model; ii) the use of an ethnographic example to idealize an ‘externalist’ system of medicine that patently cannot address the many social structural and sociophysiological processes that psychiatry needs to understand; and iii) most importantly from a philosophical perspective, the fact that the enactivist framework he endorses actually breaks down the distinctions between internalist/externalist psychiatry and naturalist/constructivist ontologies around which he organizes his critique and proposed remedy (Kirmayer & Ramstead, 2017).Integration and the BPS ApproachOngaro’s first paper begins by acknowledging the recent critiques of the BPS approach that claim the BPS leaves vague or underspecified the ways in which the biological, psychological and social domains interact to give rise to mental disorders and how they can be included in systematic case formulation to guide assessment and treatment [End Page 315] intervention. Ongaro notes that current efforts to elaborate an embodied, enactivist approach to psychiatry hold the promise of outlining a more systematic approach to the relationship between levels or domains in the BPS. However, he argues this still leaves psychiatry with excessive emphasis on ‘internalizing’ explanations that appeal to biological or psychological processes within the person to characterize mental disorders. He suggests that this needs to be complemented by an externalizing approach that gives due weight to social processes. The dominant approaches leave the social world underspecified and he notes psychiatry lacks an “ontology of the social.”To some extent, this recent critique—not by Ongaro but by some of the authors he cites—reveals a lack of familiarity or engagement with a rich literature in social epidemiology, psychosomatics and sociosomatics that has long demonstrated the close links between social and physiological processes (Krieger, 2021). This research has produced multiple examples of these relationships detailing their mechanisms and dynamics in ways that do not privilege internal processes. There is no problem identifying many specific instances of these links; for example, research has examined how exposure to racism and discrimination results in increased risk for psychiatric disorders (Kirkbride et al., 2024). We have listed many other such mechanisms related to depression in a recent paper (Gómez-Carrillo & Kirmayer, 2023). This work does not yield a single overarching model or explanation but reveals diverse kinds of mechanisms that interact in a multilevel system that includes both dynamic and linguistic modes (Gómez-Carrillo et al., 2023). Integration occurs in the functioning of this system and cannot be captured in any monolithic theory. This is not a limitation of the BPS, simply a reflection of the complexity of human beings.Can we have a general theory of the links between dimensions or domains in the BPS or will it always remain a piecemeal account that depends on the details of specific systems? Given the many different kinds of processes involved, it seems unrealistic to expect a totalizing theory. If so, both research and clinical work need practical ways to assess the myriad pathways and processes involved in psychiatric disorders in order to formulate cases efficiently, identify a manageable subset of factors to consider in a... (shrink)

Since the Vietnam War, graphic novels about war have shifted from simply representing it to portraying avenues for survivors to establish psychological wellness in their lives following traumatic events. While modern diagnostic medicine often looks to science, technology, and medications to treat the psychosomatic damage produced by trauma, my article examines the therapeutic potential of the comics medium with close attention to war comics. Graphic novels draw trauma in a different light: because of the medium’s particular combination of words (...) and images in sequence, war comics represent that which is typically unrepresentable, and these books serve as useful tools to promote healing among the psychologically wounded. Graphic narratives, both fictional and non-fictional, illuminate the ways that the unseen wounds of traumatic experience affect public health by compromising the ability of communities, individuals, and survivors to create and maintain meaningful relationships with others. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 35.3 (2002) 208-222 [Access article in PDF] Writing, Illness and Affirmation Jeremiah Dyehouse My formula for greatness in a human being is amor fati: that one wants nothing to be different, not forward, not backward, not in all eternity. Not merely to bear what is necessary, still less conceal it—all idealism is mendaciousness in the face of what is necessary—but love it. —Friedrich Nietzsche In her (...) widely circulated book On Death and Dying, Elisabeth Kübler-Ross, M.D., addresses herself to a changed historical context for work in medicine. In societies with increasingly effective medical care, she argues, doctors and nurses find themselves working with patients whose health problems range from imperceptible yet terminal sicknesses to psychosomatic ailments. Today, especially, it is easy to see the reality of her description of this situation: forms of terminal cancer can be detected earlier and earlier in a patient's life, rendering the disconcerting reality of a terminal illness with few or no symptoms. Equally strange for doctors and patients today are forms of environmental illness like chronic fatigue syndrome, a condition suffered by many but still disputed by doctors and researchers. To this situation of medical risk, personal suffering, and therapeutic care, Kübler-Ross prescribes a communicative engagement with the dying. This engagement, she argues, not only teaches doctors about death and dying, but it also provides respite for those who must experience these events.The problem of communicating with the dying, the main focus of Kübler-Ross's book, is nevertheless eclipsed by the other, more notable aspect of On Death and Dying. For out of this book emerged the now very popular understanding of the stages of death, the normal sequence of an individual's emotional reconciliation to dying: the processes of denial and isolation, anger, bargaining, depression—the whole series of intrapsychic processes leading up to a final acceptance of death and dying. Now we live amongst a whole panoply of staged progresses towards the acceptance of trauma: trauma associated not only with death and dying but also with substance abuse, catastrophe, and forms of violence. It is perhaps worth recalling, however, that the most famous of these stage models, the five stages [End Page 208] of death, emerged out of Kübler-Ross's attempt to learn what the dying can teach the living about communication.In what follows, I assume that writing about illness is another, more popular form of Kübler-Ross's descriptive and communicative project. To write pathography, as Anne Hunsaker Hawkins calls narratives of illness and dying in her survey of these texts, Reconstructing Illness: Studies in Pathography, is to engage with what sickness and dying teach about life and writing. As might be guessed, most pathographies orbit familiar centers of gravity: agency for the dying, reconciliation for the living, the whole leaden project of acceptance. Even so, pathography is not always and everywhere engaged in such projects. Pathography, as Hawkins demonstrates, is a highly variable project. Literary pathography is quite different from popular pathography, and texts within these categories differ with respect to the purpose of their writing. Pathography is conceived as a communicative engagement with sickness and dying, with the sick and the dying, but is hardly unified in its aims or its functions. It is a form of writing that not just potentially but actually admits a diversity of purposes and produces a variety of effects.It is my purpose here to propose a typology for pathographies. Although pathography as a genre of writing takes a bewildering variety of forms, these writings can be grouped according to their effects. I divide pathography into three types, according to the kind of response they offer to sickness and dying, to the sick and the dying. First, I treat pathography as a process of passive acceptance, the bearing of a burden proposed by the necessities of illness and death. Next, I characterize pathographies that approach the writing of illness or dying as a process of active acceptance. This type of pathography uses writing about illness and dying as a process for the... (shrink)

A conceptual model of a partnership in ‘like-minded thinking’ consists of the following components: a relationship, a shared goal with mutual agreement to work toward that goal, and reciprocal encouragement between two people. A like-minded alliance is a relationship that offers support while at the same time encourages hope and establishes a reciprocating emotional attitude of hopefulness.The discussion focuses on the principles of such a model that is designed primarily as a lay intervention for anyone who has a close friend (...) with cancer and who wants to assist the friend in maintaining a hopeful attitude in the face of illness. While this model is not directed at healthcare professionals it may be transferable into psychosocial interventions to assist persons toward sustaining hopefulness in the context of the cancer trajectory. Much has been written in the literature about how hopelessness spawns despair for individuals who have cancer and in those near the end of life; it may even create a desire for hastened death (Breitbart W., Heller K.S.: 2003, ‘Reframing Hope: Meaning-Centered Care for Patients Near the End of Life; Journal of Palliative Medicine 6, 979–988; Jones J.M., Huggins M.A., Rydall A.C., Rodin G.M.: 2003, ‘Symptomatic distress, hopelessness, and the desire for hastened death in hospitalized cancer patients’ Journal of Psychosomatic Research 55, 411–418).Therefore, the aim of this paper is to explore how like-minded thinking for a person with cancer and his or her support person provides a framework for a personal shared worldview that is hope-based, meaningful and coherent. (shrink)

ABSTRACT In this article, the first author provides a summary and translation from the Latin of an important early medical lecture on vampires by Nils Retzius. The lecture was delivered in Sweden, at Lund University, in 1737, and was published almost immediately thereafter. This important text has been overlooked by modern scholars of vampires. This article will bring the lecture back into circulation in its first English translation. The second author then offers an analysis of the intellectual background to this (...) rational debunking of vampires. He demonstrates how Retzius’s attempt at a comprehensive rational explanation for vampires, typical of much Enlightenment thinking, nevertheless employs a fusion of Galenic medical thinking with more modern medical and psychosomatic notions of medicine, as well as certain Lutheran notions concerning the devil and the spirit world. His argument scotches the belief in the idea of sympathetic magic affecting the dreams of the living, while emphasising the psychosomatic effects of the imagination on the physical body. (shrink)

Uncovering the wealth of traditional African knowledge and techniques has direct implications for the future development of the continent. This book is written against the background of the tragedy that most Africans are profoundly ignorant of the achievements of the past, let alone the traditions that are still upheld today. It is an exploration and analysis of Africa's historical roots, and the editor is one of Africa's most distinguished philosophers. Rich in detailed and original field research, the volume covers a (...) wide variety of topics, from the probability theory of cowry shell diviners, to hydrology and rainmaking, and the links between sorcery and psychosomatic medicine. Chapters include the use of number systems, ingredients used in pharmaceutical practice, and the mysterious phenomena of foreign objects projected into human bodies. (shrink)