Mindfulness based interventions are rapidly emerging in health care settings for their role in reducing stress and improving physical and mental health. In such settings, the religious roots and affiliations of MBIs are downplayed, and the possibilities for developing spiritual, even mystical, states of consciousness are minimized. This article helps rebalance this trend by using the tools of medical humanities and narrative medicine to explore MBI as a bridge between medical and spiritual approaches to health related suffering. My narrative medicine (...) method draws insights from the arts and humanities that are rarely used in standard clinical research but are increasingly common among medical humanities and narrative medicine scholars. The specific path I take will be to work through historical, linguistic, and philosophic dimensions of mindfulness and mysticism as relevant to illness, suffering, death, and dying. I close with two case examples in which mindfulness is used as an intentionally spiritual practice for health concerns. (shrink)

The contemporary brain disorders debate echoes a century-long conflict between two different approaches to mental suffering: one that relies on natural sciences and another drawing from the arts and humanities. We review contemporary neuroimaging studies and find that neither side has won. The study of mental differences needsboththe sciences and the arts and humanities. To help develop an approach mindful of both, we turn to physician-writer Anton Chekhov’s story “A Nervous Breakdown.” We review the value of the arts and humanities (...) as a coequal partner with natural sciences in the creation of a robust mental health humanities. (shrink)

Narrative medicine is one of medicine’s most important internal reforms, and it should be a critical dimension of healthcare debate. Healthcare reform must eventually ask not only how do we pay for healthcare and how do we distribute it, but more fundamentally, what kind of healthcare do we want? It must ask, in short, what are the goals of medicine? Yet, even though narrative medicine is crucial to answering these pivotal and inescapable questions, it is not easy to describe. Many (...) of its core claims go against the grain of common sense thinking about medicine. This article argues that the best way to understand narrative medicine is to tell a story that puts its emergence in historical context. (shrink)

The coronavirus pandemic has shattered our world with increased morbidity, mortality, and personal/social sufferings. At the time of this writing, we are in a biomedical race for protective equipment, viral testing, and vaccine creation in an effort to respond to COVID threats. But what is the role of health humanities in these viral times? This article works though interdisciplinary connections between health humanities, the planetary health movement, and environmental humanities to conceptualize the emergence of “planetary health humanities.” The goal of (...) this affinity linkage is to re-story health humanities toward promotion of planetary health and community well-being. Wellbeing is critical because the main driver of environmental destruction and decreasing planetary health is coming from non-sustainable definitions of wellbeing. We need the arts and humanities to help reimagine the possibility of a sustainable community wellbeing. For health humanities, a basic role and narrative identity starts to emerge—we should become a planetary health humanities. (shrink)

Psychiatry, as a subspecialty of medicine, is a quintessentially modernist project. Yet across the main campus, throughout the humanities and social sciences, there is increasing postmodern consensus that modernism is a deeply flawed project. Psychiatry, the closest of the medical specialties to the humanities and social sciences, will be the first to encounter postmodern theory. From my reading, psychiatry, though likely defensive at first, will eventually emerge from a postmodern critique, not only intact, but rejuvenated. Postmodern theory, at its best, (...) provides a liberating effect on modernist practices, freeing them from an enslavement to Method and Objectivity in order to allow the more human (all charges of antihumanism not withstanding) to emerge as valued and respected. The net result could be the evolution of a new postmodern psychiatry and a new model of medicine which would be much more enjoyable to practice and much more connected to the concerns of patients. (shrink)

This article introduces cultural studies of medicine to medical humanities readers. Rather than offer extended definitions of cultural studies of medicine or provide a detailed history of the domain, I have organized this introduction around a close reading and review of three recently published texts in the field. These three texts, dealing respectively with cyborg technology, AIDS, and the medical management of sexual identity problems, represent excellent examples of the opportunities and possibilities of applying cultural studies approaches to medical topics. (...) After working through these texts (and the semiotic theories which animate them), I devote my conclusion to a broader consideration of the role of cultural studies of medicine for both medical practice and medical humanities scholarship. (shrink)

Working through the lens of Donna Haraway's cyborg theory and directed at the example of Prozac, I address the dramatic rise of new technoscience in medicine and psychiatry. Haraway's cyborg theory insists on a conceptualization and a politics of technoscience that does not rely on universal “Truths” or universal “Goods” and does not attempt to return to the “pure” or the “natural.” Instead, Haraway helps us mix politics, ethics, and aesthetics with science and scientific recommendations, and she helps us understand (...) that (without recourse to universal truth or universal good) questions of legitimacy in science come down to local questions of effect and inclusion. What, in the case of my example, are the effects of Prozac? And for whom? Who is included and empowered to create legitimate psychiatric knowledge? Who is excluded and why? And, what political strategies will increase the democratic health of psychiatric science and practice? (shrink)

George Engel designed his biopsychosocial model to be a broad framework for medicine and psychiatry. Although the model met with great initial success, it now needs conceptual attention to make it relevant for future generations. Engel articulated the model as a version of biological systems theory, but his work is better interpreted as the beginnings of a richly nuanced philosophy of medicine. We can make this reinterpretation by connecting Engel’s work with the tradition of American pragmatism. Engel initiates inquiry like (...) a pragmatist, he understands theory and philosophy like a pragmatist, he justifies beliefs like a pragmatist, and he understands the world like a pragmatist. By drawing out these similarities, medical and psychiatric scholars can revitalize the biopsychosocial model, and they can open medicine and psychiatry to a rich philosophic heritage and a flourishing interdisciplinary tradition. (shrink)

Ginger Hoffman and Jennifer Hansen’s study of gender dynamics in psychiatric disability memoirs makes several fruitful moves for the study of psychic diversity. Perhaps the most important is that the article encourages analytic philosophers to contribute to understanding how individual mental life is affected by the larger cultural context—which we can think of as the “mind/culture” problem. This is an important move because, for the most part, analytic philosophers have paid more attention to the mind/body problem than they have to (...) the mind/culture problem. Hoffman and Hansen are right that it would be valuable for analytic philosophy to join in the study of this equally complicated conceptual problem.... (shrink)

Inspired by a passage from Kate Chopin’s The Awakening, this article considers the possibility of a “medical sublime.” It works through a history of the sublime in theory and in the arts, from ancient times to the present. It articulates therapeutic dimensions of the sublime and gives contemporary examples of its medical relevance. In addition, it develops the concept of sublime-based stress-reduction workshops and programs. These workshops bring the sublime out of the library and the museum into the lives of (...) the healthcare community—patients, families, clinicians, staff, concerned others—in the service of better navigating human vulnerability and finitude. Opening the cannon of aesthetic theory and the arts as resources for the human condition is at the heart of health humanities. The sublime can be an invaluable tool in this task. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:George Engel’s Legacy for the Philosophy of Medicine and PsychiatryBradley Lewis (bio)KeywordsBiopsychosocial model, George Engel, pragmatism, philosophy of medicine, philosophy of psychiatryEach of the respondents to this paper raises critical and important concerns. I am grateful for the quality of their insights. David Brendel’s response, along with his recent book, Healing Psychiatry: Bridging the Science/Humanism Divide, resembles my efforts in several ways. Like Brendel, I too believe that the (...) American pragmatic philosophy can be helpful in healing the splits and divisions within psychiatry. And, like Brendel, I believe that psychiatry would benefit from what he calls the “four ps” of pragmatism. Where we differ with regard to George Engel and his biopsychosocial model seems to be less about philosophy and more about strategy. Brendel argues that Engel was too scientistic in his manifest reasoning to be considered a pragmatist. I agree with this description of Engel. But, strategically, we can go beyond Engel’s manifest reasoning to draw out the implications of Engel’s writings in a pragmatic fashion. I am not saying that Engel did this himself; I am only saying that it is very possible to reinterpret Engel along these lines.Brendel also argues that the biopsychosocial model itself needs improvement. But, just as it is possible to update Engel’s theoretical scaffold, we can also update Engel’s biopsychosocial model. Along the lines of Brendel’s concerns, we can easily revise the model so that we remember that not all problems need complex analysis and interventions. Some problems are relatively simple and can have a simple solution. We can also revise the model so we include questions of consumer participation and the provisional nature of the clinical encounter. I see nothing in the biopsychosocial model that contradicts either of these concerns. Yes, the biopsychosocial model needs to be updated, refurbished, expanded, and reimagined. That is my point in the paper.The traction of Brendel’s concerns is not can we reinterpret Engel? or can we refresh the biopsychosocial model?—of course we can. The traction of his concern seems to be “should we?” To this strategic question, Brendel’s answer is no and my answer is yes. I argue that it is a good idea to refresh and refurbish Engel and his biopsychosocial model because it helps to create a connection with an important tradition within both medicine and psychiatry: the tradition of balanced, broadminded, nuanced, patient-centered and anti-reductionistic [End Page 327] care. This tradition is important because medicine and psychiatry seem perpetually vulnerable to the temptations of reductionist approaches and to what Engel, and Nassir Ghaemi more recently, call “dogmatism” (Engel 1977, 130; Ghaemi, 2003, 301). Whether reductionism and dogmatism take the form of biopsychiatry, or psychoanalysis, or antipsychiatry, or cognitive-behavioral therapy, the problems of dogmatism are the same.I am sure Brendel would agree with this, which is why he raises pluralism to such a prominent position in his own reasoning. The difference is that Brendel believes we can better get to this kind of balanced clinical care by letting go of the past figures like Engel and moving into the bright light of the twenty-first century. Maybe so. But my thinking when I wrote the paper goes the other way around. For me, if clinical medicine and psychiatry more carefully tended to its history and tradition, it would be less likely to fall sway to the next Johnny-come-lately reductionistic model.Jeffery Spike’s memories of George Engel during the years they worked together at the University of Rochester School of Medicine provide a good sense of why Engel is an important figure to remember and to pay homage. As Spike puts it, Engel was not only a “legendary figure” with an “almost mythical diagnostic ability,” Engel “probably had more influence on the philosophy of medicine in the United States than any other person, physician, or philosopher.” Both of these accomplishments help to explain why Engel is worth remembering.Those of us in medicine and psychiatry all know mythical clinicians and teachers—the ones who seem like Michael Jordan used to seem on the basketball court, able to somehow make even... (shrink)

Reading the illness narratives of my professional collogues was a moving experience, which reminded me of my own vulnerability and made clear the wisdom of connecting the dots between lived experience and scholarship. Though this wisdom is compelling, it is far from clear how it might be done. Including lived–sexperience in medical humanities scholarship exposes researchers to the vulnerability and isolation that goes with illness. Disability studies analysis offers powerful tools for understanding this vulnerability and isolation. The next step is (...) to take that analysis into applied medical scholarship. These articles provide a valuable start in that direction. (shrink)

Dependent Rational Animals consists of a revision of the three Paul Carus Lectures delivered by MacIntyre at the 1997 Pacific Division meeting of the APA. The book is rather different from MacIntyre's work since After Virtue in that it proceeds systematically rather than historically to develop a Thomistic-Aristotelian view of ethics that takes its departure from the continuities in human and nonhuman animal nature and the role of dependence in human life. These issues lead to a consideration of the distinctive (...) virtues required of us if we are to become independent practical reasoners able to acknowledge our dependence on others in arriving at that state of independence as well as continuing dependence on others with whom we participate in the relationships of giving and receiving through which we pursue the goods that constitute human flourishing. The argument proceeds in roughly three stages. (shrink)

In this paper, we propose analogies between medical discourse and Edward Said's “Orientalism.” Medical discourse, like Orientalism, tends to favor institutional interests and can be similarly dehumanizing in its reductionism, textual representations, and construction of its subjects. To resist Orientalism, Said recommends that critics—“intellectuals”—adopt the perspective of exile. We apply Said's paradigm of intellectual-as-exile to better understand the work of key physician-authors who cross personal and professional boundaries, who engage with patients in mutually therapeutic relationships, and who take on the (...) public responsibility of representation and advocacy. We call these physician-authors “medical intellectuals” and encourage others to follow in their path. (shrink)

This concise and well-written volume consists of a detailed interpretation of the first book of Plato’s Republic and a somewhat less detailed interpretation of the beginning of the second book. The interpretation is meant to show the superiority of the Socratic-Platonic inquiry into justice to those undertaken by Kant, on the one hand, and postmodernist antifoundationalism, on the other. The deep problem that the beginning of the Republic forces us to confront is the tension between our ordinary understanding of justice (...) and our understanding of our own good. It is precisely justice’s requirement that we honor it at the expense of our own good that seems to constitute its nobility. Yet that also renders it problematic. We know that justice is concerned with the good of all, yet we also want it to be good for us as individuals. Stauffer’s interpretation sees the first book of the Republic as an unfolding of this tension in its manifold complexity, thus revealing the depths of the problem with our ordinary understanding of justice that Kant takes as his measure. (shrink)