An introductory text describing the author’s approach to epistemology in terms of self-referential argumentation and self-validating proofs. The text emphasizes a skill-based, rather than content-based, approach to the study of epistemology. The book is a simply stated, basic text whose purpose is to introduce students to the technical approach to epistemology developed by the author in other publications. ●●●●● -/- 2022 UPDATE: The approach of this book has been updated and developed further in the author’s 2021 book _Critique of Impure (...) Reason: Horizons of Possibility and Meaning_. The book is available both in a printed edition (under ISBN 978-0-578-88646-6 from Barnes & Noble, Amazon, and other booksellers) and an Open Access eBook edition (available through Philpapers under the book’s title and other philosophy online archives). (shrink)

2022 UPDATE: The approach of this paper has been updated and developed further in the author’s 2021 book _Critique of Impure Reason: Horizons of Possibility and Meaning_. The book is available both in a printed edition (under ISBN 978-0-578-88646-6 from Barnes & Noble, Amazon, and other booksellers) and an Open Access eBook edition (available through Philpapers under the book’s title and other philosophy online archives). ●●●●● The author distinguishes between the “information-oriented” approach of conservative, traditional philosophy, and an approach to (...) philosophy as “conceptual therapy.” The former emphasizes scholarship, textual explication and criticism, and, in general, a knowledge of the views of traditional thinkers. Philosophy as conceptual therapy, on the other hand, seeks an improvement of intellectual skills, and fosters a therapy for concepts and, by inference, a therapy for thinkers. The major concern of the paper is to argue that the traditional information-oriented approach to philosophy does not help its students effectively to develop intellectual skills, and that a conception of philosophy as conceptual therapy can provide a valuable contribution to the teaching and to the subject-matter of philosophy. (shrink)

The idea of philosophy as a kind of therapy, though by no means standard, has been present in metaphilosophical reflection since antiquity. Diverse versions of it were also discussed and applied by more recent authors such as Wittgenstein, Hadot and Foucault. In order to develop an explicit, general and systematic model of therapeutic philosophy a relatively broad and well-structured account provided by Martha Nussbaum is subjected to analysis. The results obtained, subsequently, form a basis for a new model constructed (...) around the set of notions intrinsically connected with any, philosophical, psychological, or medical, form of therapy. The conceptual framework of: disease and its symptoms, the health ideal, the process of treatment with its techniques, therapeutic theory, physician, patient, and the physician-patient relationship is constructed and investigated in the context of its possible metaphilosophical use. An illustrative application of this scheme to philosophical therapy developed by Stoicism is, then, discussed. Finally, the issue of the therapeutic metaphilosophy's scope as well as the problem of therapeutic philosophy's specificity and integrity are briefly indicated. (shrink)

It is no exaggeration to say that the new topic of Korean philosophy in the 21st century is humanities therapy, more specifically philosophical therapy. However, criticism that the concepts and theories that make up humanities therapy are not clear can be raised. Therefore, I think that the conceptual clarification is necessary to establish this therapy academically against the this negative criticism. The problem, I have argued, is that because the concepts used in humanities therapy (...) are value-dependent, they are not free from the Open Question Argument implicated in the matter of fact-value gap elaborated by G. E. Moore. Therefore, it is necessary to objectify the epistemological uncertainty as a physicalistic epistemological perspective, in the diagnosis and treatment process of humanities treatment. To this end, I try to clarify the concept of humanities therapy through conceptual supervenience of mental causation, and to make the process and results of the therapy cognitively transparent. (shrink)

In his article Banicki proposes a universal model for all forms of philosophical therapy. He is guided by works of Martha Nussbaum, who in turn makes recourse to Aristotle. As compared to Nussbaum’s approach, Banicki’s model is more medical and less based on ethical argument. He mentions Foucault’s vision to apply the same theoretical analysis for the ailments of the body and the soul and to use the same kind of approach in treating and curing them. In his interpretation (...) of philosophical therapy, there are, however, some controversial issues, to which we would like to call attention: -/- Is restoring health by a philosophical method of treatment – health understood as a person’s ability to reach his/her vital goals – a convincing explication of philosophical therapy in general? In order to answer this question, it may be useful to look at Plato. It is not only Platonism (and especially Neo-platonism since Plotinus) that questions the idea that therapy is necessarily connected with „vital goals“. Buddhist and Gnostic philosophies are questioning „the vital“ in general. The immense effort in the history of philosophy to liberate the mind from the body casts doubt on the project to explain philosophical therapy solely in analogy to medical therapy. -/- According to Banicki a therapeutic philosophy has to identify the diseases it attempts at curing. There are, however, reasons for associating the term therapy with suffering/risk rather than disease. If a therapy aims at reducing the fear of death, as for example many classical philosophical therapies do, then there is no disease to be cured. A model based on chances and risks also has the advantage that the Buddhist and Stoic reinterpretation of desires/emotions as “diseases” can be dropped in contemporary philosophical therapy. -/- Banicki mentions the comparison of therapies as one of the primary goals of modelling. Methods should be verified by a statistical correlation between method and therapeutic success and/or by a theory which justifies the method. Some forms of therapies, however, avoid theory-specific terms and concepts in favor of an unprejudiced interpretation of the patient’s statements. Others share the (Nietzschean) aspiration to explore and change measures of value. If the therapeutic process is seen as a unique phenomenon, then there can be no theory and no statistics with co-occurrences. -/- According to Banicki philosophical therapy has to describe techniques which qualify as genuinely philosophical. Techniques like maieutics and hermeneutics, however, are antique philosophical “inventions”, which were later adopted by psychotherapy. If meditation is accepted as a therapeutic tool – as it was in ancient times – then there is not only a methodical but also an emotional relation to religion. If finally, the Socratic search for a good life is seen as one of the characteristics of philosophical therapy, then delimitation even turns into a criterion for non-philosophical therapies. The search for a good life requires an interdisciplinary approach. -/- For the concretization of the formal structure, we suggest a typology of therapies, which is based on chances and risks. Such a typology has the advantage, that it can model conflicting (and even opposing) forms of therapies. The variety of therapeutic goals and methods is a consequence of the historical development towards conceptual freedom. (shrink)

The 19th century saw the development of an eclectic medical marketplace in both the United Kingdom and the United States, with mesmerists, herbalists and hydrotherapists amongst the plethora of medical ‘sectarians’ offering mainstream (or ‘allopathic’) medicine stiff competition. Foremost amongst these competitors were homoeopaths, a group of practitioners who followed Samuel Hahnemann (1982[1810]) in prescribing highly dilute doses of single-drug substances at infrequent intervals according to the ‘law of similars’ (like cures like). The theoretical sophistication of homoeopathy, compared to other (...) medical sectarian systems, alongside its institutional growth after the mid-19th-century cholera epidemics, led to homoeopathy presenting a challenge to allopathy that the latter could not ignore. Whilst the subsequent decline of homoeopathy at the beginning of the 20th century was the result of multiple factors, including developments within medical education, the Progressive movement, and wider socio-economic changes, this article focuses on allopathy’s response to homoeopathy’s conceptual challenge. Using the theoretical framework of Berger and Luckmann (1991[1966]) and taking a Tory historiographical approach (Fuller, 2002) to recover more fully 19th-century homoeopathic knowledge, this article demonstrates how increasingly sophisticated ‘nihilative’ strategies were ultimately successful in neutralising homoeopathy and that homoeopaths were defeated by allopaths (rather than disproven) at the conceptual level. In this process, the therapeutic use of ‘nosodes’ (live disease products) and the language of bacteriology were pivotal. For their part, homoeopaths failed to mount a counter-attack against allopaths with an explanatory framework available to them. (shrink)

_Philosophical Delusion and its Therapy_ provides new foundations and methods for the revolutionary project of philosophical therapy pioneered by Ludwig Wittgenstein. The book vindicates this currently much-discussed project by reconstructing the genesis of important philosophical problems: With the help of concepts adapted from cognitive linguistics and cognitive psychology, the book analyses how philosophical reflection is shaped by pictures and metaphors we are not aware of employing and are prone to misapply. Through innovative case-studies on the genesis of classical problems (...) about the mind and perception, and on thinkers including Locke, Berkeley and Ayer, the book demonstrates how such autonomous habits of thought systematically generate unsound intuitions and philosophical delusions, whose clash with reality, or among each other, gives rise to ill-motivated but maddening problems. The book re-examines models of therapeutic philosophy, due to Wittgenstein and J. L. Austin, and develops an approach that may let us overcome philosophical delusions and the problems they engender. In this way, the book explains where and why therapy in called for in philosophy, and develops techniques to carry it out. (shrink)

This article is situated within the framework of schema therapy and offers a comprehensive and clinically useful list of schema modes that have been identified as being relevant to conceptualizing complex psychological problems, such as those posed by personality disorders, and, in particular, the way that those problems are perpetuated. Drawing on the schema therapy literature, as well as other literature including that of cognitive behavior therapy and metacognitive therapy, over eighty modes are identified altogether, categorized (...) under the widely accepted broad headings of Healthy Adult, Child modes, Parent modes and coping modes which are, in turn, divided into Surrender, Detached/Avoidant, and Overcompensator. An additional category is included: Repetitive Unproductive Thinking. This draws attention to the recognition by metacognitive therapists that such covert behaviors play a significant role in amplifying distress and perpetuating a range of psychological problems and symptoms. In addition to the modes themselves, several concepts are defined that are directly relevant to working with modes in practice. These include: default modes, blended modes, mode suites and mode sequences. Attention is also drawn to the way in which Child modes may be hidden “backstage” behind coping modes, and to the dyadic relationship between Child modes and Parent modes. Also relevant to practice are: the recognition that Critic voices may have different sources and this has implications for treatment, the concept of complex modes in which several submodes work together, and the fact that in imagery work and image of a child may not represent a Vulnerable Child, but a Coping Child. The modes and mode processes described are directly relevant to clinical practice and, in addition to being grounded in the literature, have grown out of and proved to be of practical use in conceptualizing my own cases, and in supervising the cases of other clinicians working within the schema therapy framework. (shrink)

Past life regression therapy is used by some physicians in cases with some mental diseases. Anxiety disorders, mood disorders, and gender dysphoria have all been treated using life regression therapy by some doctors on the assumption that they reflect problems in past lives. Although it is not supported by psychiatric associations, few medical associations have actually condemned it as unethical. In this article, I argue that past life regression therapy is unethical for two basic reasons. First, it (...) is not evidence-based. Past life regression is based on the reincarnation hypothesis, but this hypothesis is not supported by evidence, and in fact, it faces some insurmountable conceptual problems. If patients are not fully informed about these problems, they cannot provide an informed consent, and hence, the principle of autonomy is violated. Second, past life regression therapy has the great risk of implanting false memories in patients, and thus, causing significant harm. This is a violation of the principle of non-malfeasance, which is surely the most important principle in medical ethics. (shrink)

Desire is an important philosophical topic that deeply impacts everyday life. Philosophical practice is an emerging trend that uses philosophical theories and methods as a guide to living a eu‐ daimonic life. In this paper, we define desire philosophically and compare different theories of desire in specific Eastern and Western traditions. Based on the Lacanian conceptual–terminological triad of “Need‐Demand‐Desire”, the research of desire is further divided into three dimensions, namely, the subject of desire, the object of desire, and the (...) desire itself. The concept of desire is then an‐ alyzed from this triad and these three dimensions through different philosophical theories. This paper selects Buddhism as the representative of Eastern tradition, and Stoicism as the representative of the West, paying special attention to Stoicism’s “spiritual exercises” following Pierre Hadot. By exploring and comparing the Buddhist paths to liberation from suffering (i.e., the Four Noble Truths and the Noble Eightfold Path) and the two theoretical pillars in Stoicism (i.e., the notions of “living according to nature” and “the dichotomy of control”), practical guidance is then provided for un‐ derstanding and regulating desire in times of crisis. This understanding and regulation of desire constitutes a philosophical therapy for today’s troubles, particularly those caused by excessive or irrational desires. (shrink)

Abstract: In Mind and World, McDowell conceives of the content of perceptual experiences as conceptual. This picture is supposed to provide a therapy for skepticism, by showing that empirical thinking is objectively and normatively constrained. The paper offers a reconstruction of McDowell's view and shows that the therapy fails. This claim is based on three arguments: 1) the identity conception of truth he exploits is unable to sustain the idea that perception-judgment transitions are normally truth conducing; 2) (...) it could be plausible only from an externalist point of view that is in tension with the view of normativity that motivates conceptualism; 3) the identity conception of truth is incompatible with McDowell's recent version of conceptualism in terms of ‘non-propositional intuitive contents’. (shrink)

The article investigates the validity of two different versions of the slippery slope argument construed in relation to human gene therapy: the empirical and the conceptual argument. The empirical version holds that our accepting somatic cell therapy will eventually cause our accepting eugenic medical goals. The conceptual version holds that we are logically committed to accepting such goals once we have accepted somatic cell therapy. It is argued that neither the empirical nor the conceptual (...) version of the argument can provide a conclusive moral reason for banning somatic cell therapy. According to a third interpretation, referred to as the arbitrary result argument, the many apparent similarities between somatic cell therapy and eugenic-based human genetic engineering drive us to make principled choices concerning what differences and similarities between the two practices should be regarded as morally (ir)relevant. Decisions of this kind are likely to have unpredictable moral consequences. Thus formulated, the slippery slope argument has much plausibility. One objects to somatic cell therapy not so much because of what is at the bottom of the slope on which it lies, but because it is on a slope of which one does not know what is at the bottom. While the arbitrary result argument does not provide a conclusive reason for prohibiting human gene therapy, it reminds of a very important thing: when making bioethical decisions, we should be as specific and as consistent as possible about our basic moral and medical concepts. (shrink)

Although much has been written about the use of metaphors during psychotherapy sessions, the complementary question of how the therapeutic process might itself be metaphorically conceptualized is seldom asked. This article adopts the notion of ‘discourse metaphors’ and provides a case study of the metaphor THERAPY IS A JOURNEY across various levels of psychotherapeutic discourse, including the formulation of theoretical constructs, pedagogical frameworks and transcripts of actual therapeutic talk. I show how the inherent meaning stability as well as flexibility (...) afforded by conceptual metaphors renders them particularly suitable for conveying a necessary sense of theoretical continuity across the levels, while accommodating variations according to situated discourse objectives within each level. Answering calls for metaphor research to be more practically relevant, I also suggest how the present approach can contribute to the increasing therapeutic concern with establishing ‘feedback’ across the different participatory levels of psychotherapy. (shrink)

This article explores the development of therapeutic psychological techniques for emotional management as exemplified by Albert Ellis’s development of rational therapy (RT) in the 1950s and 1960s. A precursor to contemporary Cognitive Behavioral Therapy (CBT), rational therapy conceptualized emotion as manageable through scientific self-narration. The article examines how Ellis’s immersion in media techniques and forms accessible to a general audience shaped his focus on a new language for clinical practice inspired by behaviorist principles, and how much this (...) ‘clarified’ language exemplifies the application of ‘high modernist ideology’ to the treatment of the postwar American psychological subject. (shrink)

Gene therapy research and its clinical application raise a large number of ethical, legal, and social questions. Many of these are discussed in Nordgren's anthology. The contributions come from a number of different disciplines, including bioethics, genetics, social science, and theology. The book is divided into five main sections (following a short introduction): scientific aspects of gene therapy; the history of, and prospects for, gene therapy; conceptual issues; gene therapy in a German and Japanese context, (...) and a section on the uses of gene therapy in relation to, for example, testing and screening. The contributions are quite diverse and mostly well worth reading. From the perspective of medical ethics the contributions by LeRoy Walters, Eric Juengst, Karen Lebacqz, Nikolaus Knoepffler, and Christian Munthe are of particular interest. Walters's contribution focuses in part on the issue of …. (shrink)

In The Anticipatory Corpse, Jeffrey Bishop claims that modern medicine has lost formal and final causality as the dead body has become epistemologically normative, and that a singular focus on efficient and material causality has thoroughly distorted modern medical practice. Bishop implies that the renewal of medicine will require its housing in alternate social spaces. This essay critiques both Bishop’s diagnosis and therapy by arguing, first, that alternate social imaginaries, though perhaps marginalized, are already present within the practice of (...) medicine. And second, the essay argues that alternate social imaginaries in medicine can be reclaimed not through separatist communities but in the re-narration of conceptually underdetermined practices. Given Bishop’s invitation for theology to engage medicine, this essay then draws from theologian Dietrich Bonhoeffer for the kind of diagnosis and therapy currently needed, concluding with a contemporary example of how an alternate social imaginary is being instantiated in modern medicine. (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)

"A potent source of inspiration for anyone interested in the therapeutic potential of Buddhism. David Brazier writes with clarity and authority about the Zen way."—Mark Epstein, M.D. author of Thoughts Without a Thinker: Psychotherapy from a Buddhist Perspective. "Comprehensive and readable... should appeal to anyone broadly interested in Buddhism."—Helen Sieroda psychosynthesis psychotherapist. In this book, psychotherapist David Brazier offers readers in the West a fresh perspective on Buddhist psychology and demonstrates how Zen Buddhist techniques are integrated into psychotherapy. Writing from (...) the viewpoint of a Western psychotherapist, Dr. Brazier successfully demystifies Buddhist psychology, explains the conceptual foundations of Buddhist thought, and with the help of vivid case studies, clearly demonstrates how a Buddhist approach can provide a practical path to personal growth. (shrink)

Drama therapy has been found to improve various facets of mental health while aging. It provides opportunities for personal growth and creative expression and enhances group relationships. Drama therapy is a widely acknowledged way to explore the life stories in late life. However, only a handful of studies have empirically explored the value of drama therapy for the aging population. This conceptual analysis was designed to address this need by developing a new integrative model of drama (...) therapy. The analysis is based on the review of the results of four studies that explored the integration of life-review and playback theater as a drama therapy approach for older adults. The therapeutic process focused on the exploration of life-crossroads stories, a short unique technique which enables the participants to craft a harmonious view of their life stories in a short-term dramatic creative group process. Combining the four results yielded a multidimensional model which points to three potential transformative routes: the evolution of the life story, the evolution of improvised dramatic expression, and the expansion of social engagement. The transformative routes are described through the lens ofrole theoryin drama therapy. (shrink)

It has become increasingly clear that there is a vast array of microorganisms on and in the human body, known collectively as the human microbiome. Our microbiomes are extraordinarily complex, and this complexity has been linked to human health and well-being. Given the complexity and importance of our microbiomes, we struggle with how to think about them. There is a long list of competing metaphors that we use to refer to our microbiomes, including as an “organ” containing our “second genome,” (...) as a “symbiont” in the human “holobiont,” and as an ecological “community” in the human “ecosystem,” among others. Each of these makes different assumptions about the fundamental biology of the human-microbe system, with important implications for how we choose to study microbiomes, and the therapies we envision for correcting microbiome-linked disorders. We believe that it is time to move beyond metaphors, and we propose a scientifically pluralist approach that focuses on characterizing fundamental biological properties of microbiomes such as heritability, transmission mode, rates of dispersal rates, and strength of local selection. Such an approach will allow us to break out of the confines of narrow conceptual frameworks, and to guide the exploration of our complexity as chimeric beings. (shrink)

The purpose of this scoping review is to investigate the value of creative arts therapies in healthy older adults. This article aims to shed light on current knowledge concerning the effectiveness of art therapies for the prevention of common age-related conditions using the definition of art therapy provided by the American Art Therapy Association, as well as Cohen’s conceptual framework for the psychological conceptualization of the relationship between the arts and health in later life. The objective is (...) to carefully capture subthreshold situations of distress, which are often not taken into account and primarily involve psychological aspects that are crucial in the multidimensional perspective of healthy aging. Twelve articles were selected and examined following an initial electronic search on 3 databases. A thematic analysis of the results identified four major themes: improving cognitive performance and proprioception; enhancing self-identity and meaningful life; reducing feelings of loneliness and depressive symptoms; and the importance of socialization. All these aspects constitute the basis for preventing psychological distress and enhancing mental well-being for healthy aging. (shrink)

Materialism as a doctrine is, of course, a part of the history of philosophy, even if it was often a polemical construct, and it took until the 18th century for philosophers to be willing to call themselves materialists. Difficulties also have been pointed out in terms of “continuity,” i.e., does what Democritus, Lucretius, Hobbes and Diderot have to say about matter, the body and the soul all belong in one discursive and conceptual frame? Interestingly, materialism is also a classic (...) figure in the history of medicine, often intersecting with philosophical considerations. Notably, the question of body-soul relations. This is apparent in Galen’s treatise on body and soul and then much more massively in the early modern period (with reference to Galen, but also Lucretius, and Aristotelian naturalism). In the following essay I reflect on the exact nature of early modern medical materialism, its philosophical status and contribution. (shrink)

In recent decades, phenomenology has been utilized not only as a conceptual framework from which to understand medical encounters in healthcare settings, but also to guide medical professionals in providing care. In the realm of physical therapy, phenomenology has been touted as a philosophically-based avenue to aid in helping to understand what it means to be a patient. The works of Edmund Husserl and Martin Heidegger have been utilized as paths to approach phenomenologically-informed care in physical therapy. (...) However, to our knowledge, no significant connection has been made in regard to the work of Hans-Georg Gadamer’s phenomenology and hermeneutics in the realm of physical therapy. The authors aim to close that gap by showing the ways in which Gadamer’s philosophy can help physical therapists provide phenomenologically-informed patient care. They begin by outlining some of the touchpoints between phenomenology and healthcare and then introduce Gadamer as a figure who deserves attention in the question of how to apply phenomenology to healthcare settings. Upon analyzing Gadamer’s account of what it means to experience an altered body, they outline Gadamer’s understanding of tact, practical knowledge, and good sense in order to show how to understand at a conceptual level what it means to empathize with patients on the path to building therapeutic alliance, that is, a cooperative working relationship. They then look closely at Gadamer’s hermeneutics and particularly his comments on how to cultivate a fusion of horizons in order to attempt to help guide physical therapists in theoretically understanding how to empathize with their patients. Ultimately, they argue that physical therapists who practice phenomenologically-informed care, which they call “hermeneutical healing,” are positioned well to form strong working relationships with their patients. (shrink)

Sir—In their editorial, Hall, Carter & Morley [1] present an incorrect interpretation of my central argument. The point of my paper [2] is that there are solid reasons to suspect that the capacity of heroin addicts to consent to heroin therapy is compromised because of their addiction. As one medical commentator on my paper states, if active heroin addicts can give voluntary and competent consent to heroin therapy without any problems, then we need a new conceptualization of addiction: (...) they are not addicted, almost by definition [3]. Yet obviously there are problems and grey zones. The solution is to investigate the issue empirically in order to determine the extent of the problem. (As we have done for consent to research on depression and other mental illnesses.) Ultimately, the question can only be solved on a case by case basis, using standardized assessment tools adapted for this purpose. The MacArthur Competence Assessment Tool (MaCAT‐T) is the particular assessment tool I chose to discuss. [4] It is the most promising candidate available, and it has proved its merits in the areas of depression and schizophrenia. -/- At no point do I condemn heroin therapy and endorse an abstinence model of treatment, as the authors state. On the contrary, I note the success of heroin therapy and make suggestions about how to facilitate the consent process. Ironically, it may be Hall et al . who have oversimplified the issues. What we need here are empirical studies on the decisional capacity of heroin addicts to consent to heroin therapy. Only then will we be able to refute the naive view they have no ‘free will’, or say how much they have; but really my paper is not about ‘free will’ at all. This is a philosophical concept. The topic I chose to discuss is ‘decisional capacity’, also called ‘mental competence’. This is a clinical concept with complex legal and ethical associations that often vary across jurisdictions. My point was that although the Swiss Heroin Trials were approved in Europe, they probably would not be approved in Canada or the United States under existing regulations. Interested readers might want to consider the wide variety of reactions to my paper, published in the same issue [5]. Unfortunately, the editorial by Hall et al . does little to advance this debate. (shrink)

Four couple therapy first consultations involving clients with diagnosed narcissistic problems were examined. A sociologically enriched and broadened concept of narcissistic disorder was worked out based on Goffman’s micro-sociology of the self. Conversation analytic methods were used to study in detail episodes in which clients resist to answer a therapist’s question, block or dominate the development of the conversation’s topic, or conspicuously display their interactional independence. These activities are interpreted as a pattern of controlling practices that were prompted by (...) threats that the first couple therapy consultation imposes upon the clients’ self-image. The results were discussed in the light of contemporary psychiatric discussions of narcissism; the authors suggest that beyond its conceptualization as a personality disorder, narcissism should be understood as a pattern of interactional practices. (shrink)

A work likely to attract readers more by the seriousness of the author’s central theme and purpose than by his detailed analyses and arguments. His theme is the contest between reason and the passions; in the more technical version Neu sometimes prefers this becomes the question whether or not judgments are intrinsic to the structure of passions and emotions. His purpose is to follow this and ancillary issues through a study of Hume, Spinoza and Freud. The book ends with a (...) useful summary and three appendices that extend the diagnosis of Hume offered in chapter 1. Throughout Neu is quite appropriately concerned with the influence disparate philosophical theories have, or ought to have, on actual therapeutic practices. Not only does he trace modern-day behaviorism and psychoanalysis back to their roots in Hume and Spinoza, respectively; he also argues for the conceptual inferiority of the Humean position to its Spinozist rival: the latter, but not the former, enables one to see that "reason has a place in our efforts to control and to live actively our emotional lives". (shrink)

"Meeting strangers" is a metaphor for the increasingly common experience of working with diversity in family therapy. This book offers a model of cultural family therapy for working with families across cultures, particularly immigrants, refugees, and minorities in mainstream society. -/- The author draws together several emerging trends in therapy and the human sciences: narrative approaches, transcultural psychiatry, studies of autobiographical memory and the distributed and saturated self, translation theory and sociolinguistics. He offers an understanding of the (...) "situated nature" of human problems and tools for translating the family's culture and idioms into a common language in a culturally responsive and collaborative way. -/- Each chapter is both theoretical and practical, far-reaching and grounded in the experiences of families in therapy. The chapters of Part I, Meeting Strangers, introduce themes of cultural family therapy, a synthesis of family therapy and transcultural psychiatry that reframes the presenting issue in therapy as the "presenting culture." Here DiNicola both critiques family therapy's unexamined use of cultural concepts and introduces fresh conceptual tools, such as spirals, masks, and roles, that facilitate the therapist's engagement with the family culture. -/- Part II, On the Threshold: Language, Identity, and Cultural Change, introduces a number of "changelings," "liminal people," and "orphans." Between or on the thresholds of two or more cultures, they struggle with issues around language and translation, identity and cultural change. The overbearing influence of Western concepts is seen in DiNicola's examination of the psychological, social, and cultural implications of the myth of independence. -/- Part III, Families as Storying Cultures, demonstrates in extended cases the power of narrative and of metaphor to transform experience. The final chapter is a moving memoir of the author's fascinating journey to Brazil to meet his father for the first time. -/- The author's aim is "to open space for people who have been treated like minor characters in the drama of family therapy." In doing so, he puts onto center stage all sorts of strangers in society, families of diversity, and their human predicaments, inviting his readers to engage in the full richness and complexity of culture, families, and therapy. (shrink)

This analysis presents an epistemological and moral examination of suffering. It addresses the specific questions: (1) What is suffering? (2) Can one's suffering be assessed by another? and (3) What is the moral significance of suffering? The epistemological analysis is orientated by Peter Hacker's framework for the investigation of emotions, demonstrating that suffering is an emotion. This leads to a discussion of whether suffering is a phenomenon that can be evaluated objectively by another person who is not experiencing the suffering, (...) questioning the validity of some decisional models for limiting life-sustaining therapies with the aim of preventing suffering. This analysis highlights that understandings of suffering are value laden. It is conventionally implied that suffering is `bad' and that it should be eliminated. Suffering is commonly regarded as a moral wrong that needs to be made right by health care. This article concludes with a recommendation for a paradigm shift in how suffering can be better understood, through the practice of empathic attunement. (shrink)

Enhancing body awareness has been described as a key element or a mechanism of action for therapeutic approaches often categorized as mind-body approaches, such as yoga, TaiChi, Body-Oriented Psychotherapy, Body Awareness Therapy, mindfulness based therapies/meditation, Feldenkrais, Alexander Method, Breath Therapy and others with reported benefits for a variety of health conditions. To better understand the conceptualization of body awareness in mind-body therapies, leading practitioners and teaching faculty of these approaches were invited as well as their patients to participate (...) in focus groups. The qualitative analysis of these focus groups with representative practitioners of body awareness practices, and the perspectives of their patients, elucidated the common ground of their understanding of body awareness. For them body awareness is an inseparable aspect of embodied self awareness realized in action and interaction with the environment and world. It is the awareness of embodiment as an innate tendency of our organism for emergent self-organization and wholeness. The process that patients undergo in these therapies was seen as a progression towards greater unity between body and self, very similar to the conceptualization of embodiment as dialectic of body and self described by some philosophers as being experienced in distinct developmental levels. (shrink)

Letheby’s naturalistic theory of psychedelic therapy argues that the therapeutic power of psychedelics lies in their ability to allow individuals “to discover the contingency, mutability and simulatory nature of their own sense of identity and habitual modes of attention.” The general shape of this project is persuasive; it is hard to see how the claim that successful therapy must involve changes to the self could be objected to, and Letheby sketches a consistent, if speculative, picture of psychedelic experience. (...) But the role of affect in psychedelic therapy is insufficiently explored by Letheby as a comparison to MDMA-assisted therapy indicates. This comparison further suggests that Letheby’s reliance on a particular conceptualization of ego dissolution experiences is in need of further explanation and justification. (shrink)

As neuroethics continues to grow as an established discipline, it has been charged with not being sufficiently sensitive to the way in which the identification, conceptualization, and management of the ethical issues raised by neuroscience and its applications are shaped by local systems of knowledge and structures. Recently there have been calls for explicit recognition of the role played by local cultural contexts and for the development of cross‐cultural methodologies that can facilitate meaningful cultural engagement. In this article, we attempt (...) to fill this perceived gap by providing a culturally situated analysis of the practice of electroconvulsive therapy (ECT) in Argentina. ECT was introduced as a psychiatric treatment in Argentina in the 1930s but it is largely underutilized. While the use of ECT remains low in several countries, what makes the Argentinian case interesting is that the executive branch of government has taken a stance regarding both the scientific and moral appropriateness of ECT, recommending its prohibition. Here, we begin with a recent controversy over the use of ECT in Argentina and explain the legal recommendation to ban its application. Next, we offer an overview of some of the salient aspect of the international and local discussions on ECT. We argue that the governmental recommendation to ban the procedure should be rethought. While acknowledging the role that contexts and local conditions play in shaping the identification and assessment of the relevant ethical issues, we caution against using contextual and cultural considerations to avoid a necessary ethical debate on controversial issues. (shrink)

A broad sociocultural perspective defines trauma as the result of an event, a series of events, or a set of circumstances that is experienced as physically or emotionally harmful or life threatening, with lasting impacts on an individual’s physical, social, emotional, or spiritual wellbeing. Contexts and practices that aim to be “trauma-informed” strive to attend to the complex impacts of trauma, integrating knowledge into policies and practices, and providing a sanctuary from harm. However, there is a body of critical and (...) decolonial scholarship that challenges the ways in which “trauma-informed” practice prioritizes individualized interventions, reinscribes colonial power relations through its conceptualizations of safety, and obscures the role of systemic injustices. Within music therapy trauma scholarship, research has thus far pointed to the affordances of music in ameliorating symptoms of trauma, bypassing unavailable cognitive processes, and working from a strengths-based orientation. In critiquing the tendency of the dominant trauma paradigm to assign vulnerability and reinforce the individual’s responsibility to develop resilience through adversity, this conceptual analysis outlines potential alternatives within music therapy. Drawing on a case example from a research project with young people in school, I elucidate the ways in which music therapy can respond to power relations as they occur within and beyond “trauma-informed” spaces. I highlight two overarching potentials for music therapy within a shifting trauma paradigm: (1) as a site in which to reframe perceived risk by fostering young people’s resistance and building their political agency and (2) in challenging the assumption of “safe spaces” and instead moving toward practices of “structuring safety.”. (shrink)

The object of this essay is to discuss Ludwig Wittgenstein's remarks inPhilosophical Investigationsand elsewhere in the posthumously published writings concerning the role of therapy in relation to philosophy. Wittgenstein's reflections seem to suggest that there is a kind of philosophy or mode of investigation targeting the philosophical grammar of language uses that gratuitously give rise to philosophical problems, and produce in many thinkers philosophical anxieties for which the proper therapy is intended to offer relief. Two possible objectives of (...) later Wittgensteinian therapy are proposed, for subjectivepsychologicalversus objectivesemanticsymptoms of ailments that a therapy might address for the sake of relieving philosophical anxieties. The psychological in its most plausible form is rejected, leaving only the semantic. Semantic therapy in the sense defined and developed is more general and long-lasting, and more in the spirit of Wittgenstein's project on a variety of levels. A semantic approach treats language rather than the thinking, language-using subject as the patient needing therapy, and directs its attention to the treatment of problems in language and the conceptual framework a language game use expresses in its philosophical grammar, rather than to soothing unhappy or socially ill-adjusted individual psychologies. (shrink)

In this book, authors from a wide interdisciplinary spectrum discuss the issue of care. The book covers both philosophical and therapeutic studies and contains a three-pronged approach to discussing the concepts of care: vulnerability, otherness, and therapy. Above all, it is a matter of combining, in a plural form, a path with multiple theoretical and conceptual bifurcations, but which always point to an observation of society from the perspective of human vulnerability.

The Danish healthcare system must meet the need for easy and equal access to healthcare for every citizen. However, investigations have shown unfair prioritization of cancer patients and unfair prioritization of resources for expensive medicines over care. What is needed are principles for proper prioritization. This article investigates whether American ethicists Tom Beauchamp and James Childress’s principle of justice may be helpful as a conceptual framework for reflections on prioritization of expensive biological therapies in the Danish healthcare system. We (...) present an empirical study exploring the principles for prioritizing new expensive biological therapies. This study includes qualitative interviews with key Danish stakeholders experienced in antibody therapy and prioritizing resources for expensive medicines. Beauchamp and Childress’s model only covers government-funded primary and acute healthcare. Based on the interviews, this study indicates that to be helpful in a Danish context this model should include equal access for citizens to government-funded primary and acute healthcare, costly medicine, and other scarce treatments. We conclude that slightly modified, Beauchamp and Childress’s principle of justice might be useful as a conceptual framework for reflections on the prioritization of expensive biological therapies in the Danish healthcare system. (shrink)

In this essay I explore the notion of philosophy as a way of life as a recovery pathway for individuals in addiction recovery. My hypothesis is that philosophy as a way of life can be a compelling, and legitimate recovery pathway for individuals in addiction recovery, as one of many recovery pathways. I will focus on logic-based therapy applied in the context of addiction recovery. The aim of presenting a case study is to show how a client receiving LBT (...) is provided with techniques and a worldview that can contribute to a philosophically oriented recovery program. In the case study the client was advised to apply the moral philosophy of Friedrich Nietzsche as an uplifting philosophical framework to counteract his unproductive worldview and fallacious thinking. Considering that there is an ostensibly low efficacy rate for the treatment of addiction, articulating the value of philosophy as a way of life as a recovery pathway provides a conceptual and methodological framework for the development of novel philosophically-based addiction treatment and recovery-oriented programs—thus expanding the treatment and recovery options available for those seeking recovery from addiction. (shrink)

The recognition and incorporation of evidence-based neuroscientific concepts into creative arts therapeutic knowledge and practice seem valuable and advantageous for the purpose of integration and professional development. Moreover, exhilarating insights from the field of neuroscience coincide with the nature, conceptualization, goals, and methods of Creative Arts Therapies, enabling comprehensive understandings of the clinical landscape, from a translational perspective. This paper contextualizes and discusses dynamic brain functions that have been suggested to lie at the heart of intra- and inter-personal processes. Touching (...) upon fundamental aspects of the self and self-other interaction, the state-of-the-art neuroscientific-informed views will shed light on mechanisms of the embodied, predictive and relational brain. The conceptual analysis introduces and interweaves the following contemporary perspectives of brain function: firstly, the grounding of mental activity in the lived, bodily experience will be delineated; secondly, the enactive account of internal models, or generative predictive representations, shaped by experience, will be defined and extensively deliberated; and thirdly, the interpersonal simulation and synchronization mechanisms that support empathy and mentalization will be thoroughly considered. Throughout the paper, the cross-talks between the brain and the body, within the brain through functionally connected neural networks and in the context of agent-environment dynamics, will be addressed. These communicative patterns will be elaborated on to unfold psychophysiological linkage, as well as psychopathological shifts, concluding with the neuroplastic change associated with the formulation of CATs. The manuscript suggests an integrative view of the brain-body-mind in contexts relevant to the therapeutic potential of the expressive creative arts and the main avenues by which neuroscience may ground, enlighten and enrich the clinical psychotherapeutic practice. (shrink)

This article presents a conceptual framework within feminist therapy theory for viewing overt and covert racist behaviors as forms of unethical action. Using the personal as theoretical and political, the author traces her process of having her consciousness raised regarding the issue of racism in psychotherapy. Racism is then conceptualized as an ethics problem in terms of lack of mutuality and respect, violation of boundaries, and unethical imbalance of power in the therapy relationship. The concept of antiracism, (...) a proactive stance to address overt and covert racism in therapy, is presented as a strategy for moving toward more ethical therapy practice. (shrink)

This article offers a conceptual analysis of self-respect and self-esteem that informs the ethics of psychotherapy in palliative care. It is focused on Chochinov’s Dignity Therapy, an internationally recognized treatment offered to dying patients who express a need to bolster their sense of self-worth. Although Dignity Therapy aims to help such patients affirm their value through summarized life stories that are shared with their survivors, it is not grounded in a robust theory of self-respect. There is reason (...) to be skeptical about deathbed narratives, and Dignity Therapy can unintentionally encourage distorted representations at odds with the self-respect it aims to affirm. Dignity therapy can also encourage distortions of self-esteem that are in conflict with self-respect. Although Chochinov does not address it, the distinction between self-respect and self-esteem is relevant to deathbed accounts. Dillon’s feminist revisioning of self-respect can inform the practice of Dignity Therapy by encouraging honest life stories through a reckoning with one’s moral complexity, especially in moral generativity cases where patients seek forgiveness, relate atonement, or present their lives as examples to be followed. Her concept of self-esteem allows for therapeutic benefits that are less demanding, but no less significant, than those derived from a moral reckoning. Appropriate affirmations of self-esteem can provide much-needed solace when self-respect is damaged beyond adequate repair. Dillon’s account of self-respect and self-esteem enables a richer understanding of the kinds of personal evaluation and disclosure that Dignity Therapy accommodates. As such, their place in Dignity Therapy needs more critical evaluation than it has received. (shrink)

The ‘born this way’ movement for sexual orientation minority rights is premised on the view that sexual orientation is something that can neither be chosen nor changed. Indeed, current sexual orientation change efforts appear to be both harmful and ineffective. But what if ‘high-tech conversion therapies’ are invented in the future that are effective at changing sexual orientation? The conceptual basis for the movement would collapse. In this chapter, we argue that the threat of HCT should be taken seriously, (...) motivating a change in tactics for proponents of sexual orientation minority rights. We also discuss some of the practical-ethical and public-policy issues surrounding HCT, in case the technology is one day developed. (shrink)

Contemporary hormonal therapy for the menopause has its conceptual origins in the ancient tradition of organotherapy. The popular but pharmacologically inactive precursors of hormonal therapy were developed as part of a resurgence of interest in organotherapy in the 19th century, which coincided with increasing medicalization of the menopause and the view that the ovaries were responsible for the ‘feminine’ identity and wellbeing of women. The subsequent chemical identification of oestrogens allowed the development of pharmacologically active hormonal (...) class='Hi'>therapy for the menopause, which was probably first used clinically in the late 1920s. Around this time, emphasis shifted from the ovaries to oestrogen as being responsible for femininity and health, with the menopause and ageing increasingly defined as oestrogen deficiency diseases. Hormonal therapy for the menopause was first used predominantly for women who had a premature menopause. In the 1960s, universal prescription was increasingly promoted as a way of preventing diseases of later life and the perceived ‘defeminization’ of women by menopause. Scientific evidence regarding the risks and benefits of hormonal therapy for the menopause has been accruing over the last 70 years; its interpretation has been affected by background beliefs regarding the effects of oestrogen and the menopause on women. (shrink)

Background: The classical symptom specificity hypothesis (Blatt, 1974) links obsessional symptoms to autonomous interpersonal behavior. Inconsistent findings from cross-sectional group studies on symptom specificity have previously been associated with several conceptual and methodological limitations intrinsic to nomothetic research. Previous empirical case research reported ambivalences between autonomous and dependent interpersonal behavior in obsessional pathology. Aim and Method: The present ‘theory-building’ case study specifically aims at further refinement of the classical symptom specificity hypothesis by testing specific operationalizations within an empirical single (...) case design. Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of a psychodynamic therapy. Interpersonal functioning is assessed by means of the Core Conflictual Relationship Theme method. The classical symptom specificity hypothesis is contrasted to an alternative hypothesis of interpersonal ambivalences as determinants of obsessional symptoms. Results: Close associations between obsessions and interpersonal dynamics are observed. Findings predominantly affirm the ambivalence hypothesis rather than the classical symptom specificity hypothesis. Psychodynamic interventions focusing on interpersonal conflicts are related to symptomatic changes. Conceptual and methodological considerations, limitations and future research indications are discussed. (shrink)

Definition of the problem: Doctor-patient-conversation is still a great challenge for doctors and patients despite intense discussion, legal normation, and multiple efforts. It seems to be particularly difficult in cases of telling the truth about diagnosis or prognosis which can be threatening to the patient.Method: It is shown by two case studies that the patient directs a specific need to the doctor which has been neglected in both the ethics discourse and in practical medicine: the need to evaluate the patient's (...) options for action at an argumentative-critical level. Derived from a general theory of language functions a model of doctor-patient-conversation is developed which allows for both ideal case typology as well as for problem analysis. Referring to a Three-Stages-Model of Doctor-Patient-Dialogue, an integrative model “Language and Relationship Between Doctor and Patient” is formulated which permits a better understanding of the processes and difficulties between doctor and patient.Conclusion: The integrative model presented may help to realize a more comprehensive doctor-patient-conversation. It may help as well to decide which of the components of this conversation may be selectively sufficient. Consequences for the conceptualization of the physician's role as well as the scope of the model in practice are discussed. (shrink)

I-BLOCKS are an innovative concept of building blocks allowing users to manipulate conceptual structures and compose atomic actions while building physical constructions. They represent an example of enabling technologies for tangible interfaces since they emphasise physicality of interaction through the use of spatial and kinaesthetic knowledge. The technology presented in this paper is integrated in physical building blocks augmented with embedded and invisible microprocessors. Connectivity and behaviour of such structures are defined by the physical connectivity between the blocks. These (...) are general purpose, constructive, tangible user interface devices that can have a variety of applications. Unlike other approaches, I-BLOCKS do not only specify a computation that is performed by the target system but perform at the same time the computation and the associated action/functionality. Manipulating I-BLOCKS do not only mean constructing physical or conceptual structures but also composing atomic actions into complex behaviours. To illustrate this concept, the paper presents different scenarios in which the technology has been applied: storytelling performed through the construction of physical characters exhibiting emotional states, and learning activities for speech therapy in cases of dyslexia and aphasia. The scenarios are presented; discussing both the features of the technology used and the related interaction design issues. The paper concludes by reporting about informal trials that have been conducted with children. It should be noted that, even if both trials represent application scenarios for children, the I-BLOCKS technology is in principle open to different kinds of applications and target users like, for example, games for adults or brainstorming activities. (shrink)

The discovery of neurogenesis and neural stem cells (NSC) in the adult CNS has overturned a long‐standing and deep‐routed “dogma” in neuroscience, established at the beginning of the 20th century. This dogma lasted for almost 90 years and died hard when NSC were finally isolated from the adult mouse brain. The scepticism in accepting adult neurogenesis has now turned into a rush to find applications to alleviate or cure the devastating diseases that affect the CNS. Here we highlight a number (...) of methodological, technical and conceptual drawbacks responsible for the historical denial of adult neurogenesis. Furthermore, we discuss old and new issues that need to be faced before NSC or endogenous neurogenesis can safely enter into the doctor's bag for therapies. BioEssays 30:135–145, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

In this book, authors from a wide interdisciplinary spectrum discuss the issue of care. The book covers both philosophical and therapeutic studies and contains a three-pronged approach to discussing the concepts of care: vulnerability, otherness, and therapy. Above all, it is a matter of combining, in a plural form, a path with multiple theoretical and conceptual bifurcations, but which always point to an observation of society from the perspective of human vulnerability.