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)

Complementary and alternative medicine research presents unique problems for research ethics committees which must be considered in some detail. Applying conventional research techniques to CAM raises a number of issues which ethics committees may find challenging. CAM is widely available and this will have a substantial effect on any proposed research strategy as so many individuals will have pre-existing opinions about these treatments. Whilst many complementary therapies may eventually be ‘validated’ by appropriate clinical trial methodologies other research (...) methods could be more appropriate in the early stages of a research strategy, particularly in view of the widespread availability in both the public and private sectors. Safety, efficacy, cost-effectiveness and patient preference also need evaluation; and these cannot be adequately assessed through double blind randomised placebo controlled trials. If the research question is clear, then thoughtful and often innovative evaluative processes can be designed to answer the socially and clinically relevant issues posed by this area of medicine. There are a number of agencies and organizations available to offer advice to ethics committees in this newly emerging field of CAM research including CAM Strategy Research and Development, the Foundation for Integrated Health and the Research Council for Complementary Medicine. (shrink)

In recent years so-called Complementary and Alternative Medicine practices have made significant political and professional advances particularly in the United Kingdom : osteopathy and chiropractic were granted statutory self-regulation in the 1990s effectively giving them more professional autonomy and independence than health care professions supplementary to medicine ; the practice of acupuncture is widespread within the National Health Service for pain control; and homoeopathy is offered to patients by a few General Practitioners alongside conventional treatments. These developments have had (...) a number of consequences: one is that both CAM and Conventional and Orthodox Medical professions have had to reappraise their professional identity. In manual therapy for example, questions have been asked about the differences between physiotherapy, osteopathy and chiropractic, and what the justification is for having separate professions. A wider question concerns the relationship between CAM and COM; are CAM distinct professions or should they, as has happened to a limited extent in the UK, be absorbed into the broader field of ‘ Medicine ’ or ‘Health Care’ as adjunctive therapies. CAM professions have also had to develop, implement and enforce codes of practice for practitioners and clarify the scope of practice within a profession. At the heart of these issues lies the need to identify and clarify professional values. A key claim of CAM professions is that their practice is distinct and the outcome of treatment at least as effective and in many cases more effective than with conventional therapies. In addition, what counts as effective outcome is often different from conventional medical understanding, involving more subtle humanitarian considerations, for example. Three values are identified as being commonly held across CAM professions. These are: offering ‘natural’ treatment; being patient rather than disease focussed; and being holistic. However, these may not be as distinctive of CAM as is claimed either because the meaning is unclear or because COM professions claim similar values. The paper argues that the values that inform ‘good practice’ and ‘effective outcome’ should be seen as distinct components of professional competence. This has implications for establishing professional identity and codes of practice. (shrink)

The more popular complementary and alternative medicine (CAM) has become, the more often it is demanded that the integration of CAM should be limited to those approaches that are scientifically proven to be effective. This paper argues that this demand is ethically and philosophically questionable. The clinical legitimacy being gained by CAM and its increasing informal integration should instead caution against upholding the biomedical framework and evidence-based medicine as conditions of acceptance. Patients’ positive experiences with CAM deserve a truly (...) scientific exploration of non-biomedical conceptualizations of health and illness. It is also problematic to request scientific evidence when there is proven resistance against CAM in research institutions, under-funding and a lack of suitable research methodologies. This is even more so, when much conventional medicine is not practiced with the same level of evidence as demanded from CAM. (shrink)

Religion can bring about social harmony as well as social conflict. Religious law is a key element in both cases. Scholars can explain how religious law changes according to historical and socio-cultural context. They can also help reengineering prescriptions that cause social conflict. Changes in religious law can be explained according to a chronological rhetoric (certain agents cause certain changes) or according to a logical rhetoric (a change acquires its meaning in opposition to other possible changes). The two approaches are (...) complementary, but the semiotics of religious law predominantly adopts the second one. In both cases, the explanation of how a religious law changes and the reengineering of a religious prescription are related activities. The semiotics of religious law is particularly equipped to propose alternatives for conflicting prescriptions. However, there is a difference between showing that some alternatives exist and advocating which alternatives should be taken. Whilst the latter position is similar to that of semiotic guerrilla warfare, the former rather configures the semiotics of religious law as a therapy. Semiotic guerrilla warfare stresses the need to demystify the discourse of power that subjugates individuals or groups to a certain religious law. Semiotic therapy does not focus on demystification but on reconciliation. The task of the semiotic therapy of religious law is to show that situations of social conflict generated by certain prescriptions can be decreased or eliminated by adopting alternative paths of meaning. The semiotic therapist of religious law can be effective in showing these alternatives only if some pragmatic and semantic preconditions are met: a correct involvement with the sets of religious core values at stake and an articulated analysis of the paths of meaning to which these values give rise. (shrink)

Categorization-based diagnosis, which endeavors to be consistent with the third-person, objective measures of science, is not always adequate with respect to problems concerning diagnostic accuracy, demarcation problems when there are comorbidities, well-documented problems of symptom amplification, and complications of stigmatization and looping effects. While psychiatric categories have proved useful and convenient for clinicians in identifying a recognizable constellation of symptoms typical for a particular disorder for the purposes of communication and eligibility for treatment regimes, the reification of these categories has (...) without doubt had negative consequences for the patient and also for the general understanding of psychiatric disorders. We argue that a complementary, integrated framework that focuses on descriptive symptom-based classifications (drawing on phenomenological interview methods and narrative) combined with a more comprehensive conception of the human subject (found in the pattern theory of self), can not only offer a solution to some of the vexed issues of psychiatric diagnosis but also support more efficacious therapeutic interventions. (shrink)

Over 100 million Americans suffer from chronic pain, which causes more disability than any other medical condition in the United States at a cost of $560–$635 billion per year. Opioid analgesics are frequently used to treat CP. However, long term use of opioids can cause brain changes such as opioid-induced hyperalgesia that, over time, increase pain sensation. Also, opioids fail to treat complex psychological factors that worsen pain-related disability, including beliefs about and emotional responses to pain. Cognitive behavioral therapy can (...) be efficacious for CP. However, CBT generally does not focus on important factors needed for long-term functional improvement, including attainment of personal goals and the psychological flexibility to choose responses to pain. Acceptance and Commitment Therapy has been recognized as an effective, non-pharmacologic treatment for a variety of CP conditions. However, little is known about the neurologic mechanisms underlying ACT. We conducted an ACT intervention in women with chronic musculoskeletal pain. Functional magnetic resonance imaging data were collected pre- and post-ACT, and changes in functional connectivity were measured using Network-Based Statistics. Behavioral outcomes were measured using validated assessments such as the Acceptance and Action Questionnaire, the Chronic Pain Acceptance Questionnaire, the Center for Epidemiologic Studies Depression Scale, and the NIH Toolbox Neuro-QoLTM scales. Results suggest that, following the 4-week ACT intervention, participants exhibited reductions in brain activation within and between key networks including self-reflection, emotion, and cognitive control. These changes in connectivity strength were correlated with changes in behavioral outcomes including decreased depression and pain interference, and increased participation in social roles. This study is one of the first to demonstrate that improved function across the DMN, SN, and FPN may drive the positive outcomes associated with ACT. This study contributes to the emerging evidence supporting the use of neurophysiological indices to characterize treatment effects of alternative and complementary mind-body therapies. (shrink)

The main purpose of this article is to explore, from an ethical perspective, one particular branch of what is today called “spiritual medicine”: namely, prayer therapy. Several landmark studies in the literature will be thoroughly examined, respectively the classical study of Byrd (1988), the replica of Harris et al. (1999), and the controversial study of Leibovici (2001). Beginning with these studies and the related controversies surrounding them, the religious features and ethical consequences of prayer therapy are investigated. The ethical aspects (...) of prayer therapy – the informed consent issue, the issue of respecting bioethical principles, and the issue of medical competence in offering such techniques – are thoroughly addressed. Finally, an alternative way of framing the prayer therapy discussion is offered, in the context of public-private dichotomy. (shrink)

BackgroundBurnout is a major societal issue adversely affecting employees’ health and performance, which over time results in high sick leave costs for organizations. Traditional rehabilitation therapies show suboptimal effects on reducing burnout and the return-to-work process. Based on the health-promoting effects of nature, taking clients outdoors into nature is increasingly being used as a complementary approach to traditional therapies, and evidence of their effectiveness is growing. Theories explaining how the combination of general psychological support and outdoor-specific elements (...) can trigger the rehabilitation process in outdoor therapy are often lacking, however, impeding its systematic research.AimThe study aims to develop an intervention and evaluation model for outdoor therapy to understand and empirically evaluate whether and how such an outdoor intervention may work for rehabilitation after burnout.Methodological ApproachWe build on the exemplary case of an outdoor intervention for rehabilitation after burnout, developed by outdoor clinical psychologists in Netherlands. We combined the generic context, process, and outcome evaluation model and the burnout recovery model as an overarching deductive frame. We then inductively specified the intervention and evaluation model of outdoor therapy, building on the following qualitative data: semi-structured interviews with outdoor clinical psychologists and former clients; a content analysis of the intervention protocol; and reflective meetings with the intervention developers and health promotion experts.ResultsWe identified six key outdoor intervention elements: physical activity; reconnecting body and mind; nature metaphors; creating relationships; observing natural interactions; and experiential learning. The results further showed that the implementation of these elements may facilitate the rehabilitation process after burnout in which proximal, intermediate, and distal outcomes emerge. Finally, the results suggested that this implementation process depends on the context of the therapist, therapy, and of the clients.ConclusionThe intervention and evaluation model for outdoor therapy shows how key outdoor intervention elements may contribute to the rehabilitation process after burnout. However, our model needs to be further tested among a larger group of clients to empirically evaluate whether and how outdoor therapy can support rehabilitation. (shrink)

The aim of this exploratory study was to examine client demographics and expectations, reasons for use, sensations during treatment, and perceived outcomes of Pranic Healing, an energy healing system lacking in scientific documentation but whose use in the general population is becoming more widespread internationally. This study consisted of a cross-sectional survey of adults (18+ years of age) receiving care from 12 Pranic Healing practices in four different states in the U.S. (N = 179) completing online questionnaires. Closed-ended response sets (...) were analyzed descriptively, while qualitative data were analyzed using content analysis. Reasons to use the therapy included physical, mental/emotional, and metaphysical issues, dissatisfaction with conventional care, and overall well-being. Expectations of care included enhanced abilities, cure or relief, or unsure. Respondents were more likely to cite a specific problem from which they needed alleviation than to cite overall health or wellness as their goal. Sensations experienced were reported to be of a relaxing nature and not, as was hypothesized, of an energizing nature. Results show that those who use Pranic Healing fit the sociodemographic profile of CAM (complementary and alternative medicine) users in the United States, that their reasons for use are not homogeneous, and that preliminary descriptive data from a selective subsample of respondents indicated that some respondents are experiencing positive outcomes attributed to this modality. (shrink)

The significant social and cultural transformations which took place in recent decades brought about significant changes in the way couples interact and deal with “the risk of bonding”. The vulnerability that characterizes the couple in post-modernity is the consequence of these changes. The application of a co-therapy model with couples in crisis is based on the premise of mutual gift, which has to be understood as both an exchange of expertise and professionalism to the benefit of the couple, and as (...) a bond of unity between co-therapists. The work that follows suggests some reflections which originate from the co-therapy model. The novelty of this model originates from the fact that the clinical work is based on two connected and complementary aspects: a deep attention towards the patient and a deep attention towards the relationship between the co-therapists. Both of these aspects are characterized by the dimension of gift. In this clinical model therapists transform any specific suffering lived by the couple in a positive relational experience between themselves which then becomes an example for the couple. Thus, for example, the inability to understand each other that the couple lives is contrasted by the capacity to listen to each other in a deep and authentic way by the therapists; the attitude of prevailing over each other in the couple, is counterbalanced by the therapists’ attention towards each other. And so on. This act of “overturning the limit” seems to reveal the therapeutic potential that a model of co-therapy, based on a new humanism, can offer to the clinical work with couples in crisis. (shrink)

This study argues that the effect envisaged by the Christian sacrament of the sick consists of the healing of the rupture provoked by scientific medical procedures. The anointing of the sick re-establishes the fundamental unity of the human person as a symbolic completion of what other partial procedures may have begun to do as a result of illness : a symbolic completion that marks the Christian for the resurrection. We begin by highlighting the placebo as an ally of the medical (...) sciences, while noting that research on placebos points to the importance of ritual performance in treatment as well as the reformulation of the mind-body dualism. Then, in order to develop the dialectic between rite as therapy and therapy in its ritual aspects, we report on two complementary contributions : one from a specialist in ritual studies, Ronald L. Grimes, and the other from a theologian, Andrea Grillo. The utopian key of Gregory Baum is added, understood as a — reflexive — second-order discourse in relation to the first-order — symbolic, ritual and performative — articulation of the sacrament of anointing of the sick. The latter thus appears as a symbol of the future, that is, as an anticipation of eschatological salvation in the marking of the believer’s body for the resurrection. (shrink)

In Singapore’s multicultural society, a sizable proportion of the population subscribes to complementary and alternative medicine. In this article, we discuss the impact this has on medical practice in the context of the four principles of medical ethics. To uphold the principle of autonomy, we propose a non-judgmental approach towards patients who use CAM. Nevertheless, in order to promote health and prevent harm, the safety profiles of CAM must be studied through systematic research. In addition, the principle of justice (...) is one concerned with the fair distribution of scarce healthcare resources, while granting equal access to healthcare regardless of beliefs. Understanding CAM from an ethical perspective allows for the provision of safe, holistic, and culturally relevant care. (shrink)

Questioning reality -- The hair of the dog -- Good/bad -- Resistance and the side effect -- Putting resistance on the couch -- Modern medicine : a health report -- Psychotherapeutic paradox -- Loops -- Dialectics -- Paradox within the home -- The staying-with-it principle -- Immunization and immunotherapy -- A little poison is good for you -- The strange obsession of Dr. Hahnemann -- From gods to genes -- RPM -- Such stuff as dreams -- The attack of the (...) evil things -- Becoming well. (shrink)

Neurofeedback has been suggested as a potential complementary therapy to different psychiatric disorders. Of interest for this approach is the prediction of individual performance and outcomes. In this study, we applied functional connectivity-based modeling using electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) modalities to (i) investigate whether resting-state connectivity predicts performance during an affective neurofeedback task and (ii) evaluate the extent to which predictive connectivity profiles are correlated across EEG and fNIRS techniques. The fNIRS oxyhemoglobin and deoxyhemoglobin concentrations and (...) the EEG beta and gamma bands modulated by the alpha frequency band (beta-m-alpha and gamma-m-alpha, respectively) recorded over the frontal cortex of healthy subjects were used to estimate functional connectivity from each neuroimaging modality. For each connectivity matrix, relevant edges were selected in a leave-one-subject-out procedure, summed into “connectivity summary scores” (CSS), and submitted as inputs to a support vector regressor (SVR). Then, the performance of the left-out-subject was predicted using the trained SVR model. Linear relationships between the CSS across both modalities were evaluated using Pearson’s correlation. The predictive model showed a mean absolute error smaller than 20%, and the fNIRS oxyhemoglobin CSS was significantly correlated with the EEG gamma-m-alpha CSS (r = −0.456, p = 0.030). These results support that pre-task electrophysiological and hemodynamic resting-state connectivity are potential predictors of neurofeedback performance and are meaningfully coupled. This investigation motivates the use of joint EEG-fNIRS connectivity as outcome predictors, as well as a tool for functional connectivity coupling investigation. (shrink)

The use of complementary and alternative medicine (CAM) by US consumers has grown in recent years. CAM therapies often utilize medicinal herbs as part of the treatment process; however, research on US practitioner preferences for medicinal herbs is limited, despite growing concern surrounding the sustainability of wild-harvested medicinal herbs. In order better to understand consumer preferences for this emerging market, a mail survey of US practitioners (licensed acupuncturists) was conducted to examine the importance of five herb attributes in (...) practitioners’ herb selection decisions: (1) country of origin, (2) freshness, (3) production method (organic versus conventional), (4) price, and (5) traceability. The significance of these five traits is investigated using discrete choice analysis, and the implications for US medicinal herb growers are discussed. (shrink)

Increasing European co-operation must take place in many areas, including medical ethics. Against the background of common cultural norms and pluralistic variation within political traditions, religion and lifestyles, Europe will have to converge towards unity within the field of medical ethics. This article examines how such convergence might develop with respect to four major areas: European research ethics committees, democratic health systems, the human genome project and rules for stopping futile treatments.

In this paper, the theory and practice of therapeutic touch (TT) is scrutinized from a number of perspectives. Firstly, the alleged close relationship between TT and Martha Rogers’ Science of Unitary Human Beings is evaluated. Secondly, the employment of the language of modern physics in Rogers’ theory and TT is critically examined. The authors then review the research literature on TT's efficacy, completing their critique by discussing the ethical issues involved in the practice of TT. As each of the perspectives (...) considered reveals some concerns, the paper concludes that TT is a questionable intervention, underpinned by a very weak theoretical, clinical and research base. (shrink)

Are there any characteristics by which we can reliably identify and distinguish quackery from genuine medicine? A commonly offered criterion for the distinction between medicine and quackery is science: genuine medicine is scientific; quackery is non-scientific. But it proves to be the case that at the boundary of science and non-science, there is an entanglement of considerations. Two cases are considered: that of homoeopathy and that of the Quantum Booster. In the first case, the degree to which reported phenomena that (...) question established theory should be doubted arises; in the second case, the status of pleomorphism as a scientifically plausible doctrine is discussed. The application of the criterion of being scientific to these cases reveals something of the nature and density of the entanglement. (shrink)

Research has consistently demonstrated that viewing one's body in a mirror after an amputation or other perceived or visible body disfigurements can be a traumatic experience. Mirror viewing or mirroring is a taboo subject, which may be the reason this trauma has not been previously detected or acknowledged. Traumatic mirror viewing may lead to mirror discomfort, mirror avoidance, and a host of psychosocial concerns, including post‐traumatic stress. As mirroring is complex, four qualitative mirror viewing studies, embodiment concepts, polyvagal theory, and (...) memory theories were used to develop a model. In this article, foundational knowledge that led to the development of the model is shared. A neurocognitive model of mirror viewing is offered together with implications for nursing research, practice, and education. (shrink)

Cognitive therapies are often biased in their assessment of clinical problems by their emphasis on the role of verbally-mediated thought in shaping our emotions, and in stressing the influence of thought upon feeling. Alternatively, a more phenomenological appraisal of psychological dysfunction suggests that emotion and thinking are complementary processes which influence each other. Cognitive psychology developed out of information-processing models, whereas phenomenological psychology is rooted in a philosophical perspective which avoids the assumptions of positivist methodology. But, despite their (...) different origins, the two disciplines overlap and complement each other. This book, originally published in 1995, illustrates how feeling states are a crucial component of mental health problems and, if adequately differentiated, can result in a greater understanding of mental health. (shrink)

Complementary and alternative therapiesThere has long been debate about the degree to which conventional health professionals should work closely with complementary and alternative medicine practitioners, if patients choose treatment from both. Some doctors are trained in conventional and alternative therapies but often, liaison depends on the type of therapy, whether it is regulated by law and whether it supplements conventional methods of diagnosis and treatment or claims to provide an alternative to them. Among the therapies often (...) used by patients to supplement conventional medicine, but which do not claim to have a diagnostic purpose, are aromatherapy, massage, stress therapy, reflexology and hypnotherapy. Chinese medicine and homoeopathy are among those which are not statutorily regulated but claim to provide diagnosis and treatment. Practitioners of conventional medicine are often wary of unregulated treatments that supplant evidence-based therapy—even though not all conventional medicine has been proven by randomised controlled trials.The role of complementary and alternative therapies came under scrutiny in England in February 2010 when the Parliamentary Science and Technology Committee published a critical report on NHS funding for homoeopathy. 1 Focusing on whether government policy on homoeopathy was evidence-based, the Committee found a mismatch between the evidence and policy. Its main conclusion was that the evidence indicates that homoeopathy is not efficacious and does not produce results beyond the placebo effect. The Committee said that explanations for why homoeopathy was thought to work were implausible and that further homoeopathic clinical trials could not be justified. The amount that the NHS actually spends on homoeopathic therapies was left unclear and was subject to varying claims from the Society of Homoeopaths and the Health Minister.2 The Parliamentary report recommended that there should be a clear policy on prescribing placebos, including homoeopathic medicines, but the government has been …. (shrink)

Cognitive therapies are often biased in their assessment of clinical problems by their emphasis on the role of verbally-mediated thought in shaping our emotions, and in stressing the influence of thought upon feeling. Alternatively, a more phenomenological appraisal of psychological dysfunction suggests that emotion and thinking are complementary processes which influence each other. Cognitive psychology developed out of information-processing models, whereas phenomenological psychology is rooted in a philosophical perspective which avoids the assumptions of positivist methodology. But, despite their (...) different origins, the two disciplines overlap and complement each other. This book, originally published in 1995, illustrates how feeling states are a crucial component of mental health problems and, if adequately differentiated, can result in a greater understanding of mental health. (shrink)

In 2019, the IEEE launched the P7000 standards projects intended to address ethical issues in the design of autonomous and intelligent systems. This move came amidst a growing public concern over the unintended consequences of artificial intelligence (AI), compounded by the lack of an anticipatory process for attending to ethical impact within professional practice. However, the difficulty in moving from principles to practice presents a significant challenge to the implementation of ethical guidelines. Herein, we describe two complementary frameworks for (...) integrating ethical analysis into engineering practice to help address this challenge. We then provide the outcomes of an ethical analysis informed by these frameworks, conducted within the specific context of internetdelivered therapy in digital mental health. We hope both the frameworks and analysis can provide tools and insights, not only for the context of digital healthcare, but for data-enabled and intelligent technology development more broadly. (shrink)

Compared with mainstream medicine and complementary and alternative therapies, the practice of psychotherapy has enjoyed a relative pass when it comes to ethical evaluation. Therefore, contributions to the, although slowly growing, body of literature on psychotherapy ethics are to be welcomed. In his paper ‘Psychotherapy, placebos, and informed consent’, Garson Leder takes issue with what he calls the ‘go open’ project in psychotherapy ethics—the idea that the so-called ‘common factors’ in therapy should be disclosed to prospective patients. Although (...) Leder does not give a detailed list, the common factors include therapist characteristics, patient characteristics, and the working alliance. He argues that the project advocating disclosure of these factors is flawed on two grounds: that information about common factors is not necessary for informed consent; and clarity about specific mechanisms of change in therapy is consistent with ‘many theory-specific forms of psychotherapy’. There are multiple serious problems with Leder’s critique of the recent literature, including how he represents the contours of the debate, which I list, and address in this response. (shrink)

Biosynthesis means "integration of life". It is a holistic form of body psychotherapy, which was founded over forty-five years ago. The concept of life-streams is one of its major foundations, which has since been supported by research in neurobiology. How can we integrate the three most important domains of being human: our bodily existence, our psychological experience and our spiritual essence? Biosynthesis Therapy has developed a broad spectrum of reliable methods to make this possible and to free our life energy. (...) It is resource-oriented and is practised worldwide. David Boadella brings his many years of experience to provide in this book a trend-setting model for the understanding both of the origin of illness and of therapy. First published in 1987, this book has appeared in ten languages. It provides numerous case examples and is fascinating and enriching for the normal reader as well as for therapists from many different schools. In this book, the word "bioenergetic" is used to refer to the study of life energy, which is a major foundation of the therapy method "Biosynthesis". This is not to be confused with the term "Bioenergetic Analysis", an other and different form of body psychotherapy. Since 1985, together with David Boadella, Biosynthesis has been developed further by Dr. Silvia Specht Boadella, particularly in its philosophical and transpersonal aspects. In 1990, Biosynthesis was the first form of body psychotherapy to be scientifically accredited by the European Association of Psychotherapy. Biosynthesis therapists can therefore receive the European Certificate of Psychotherapy ECP. In 2001, the International Foundation of Biosynthesis IFB was formed, to coordinate trainings and research in twenty countries in Europe, Asia, North and South America. The newest information about Biosynthesis, including our actual course programme, you will find on our website. David Boadella International Institute for Biosynthesis IIBS, Benzenrüti 6, CH-9410 Heiden, Switzerland E-mail: [email protected]_ _www.biosynthesis.org_ _The Author_ David Boadella, born 1931 in London, pioneer of body psychotherapy and founder of Biosynthesis. He studied education, psychology and literature and wrote numerous articles and several books. Since 1985, he is the Director of the International Institute for Biosynthesis in Switzerland. In 1989, he was elected as the first President of the European Association for Body Psychotherapy EABP. In 1995, he was awarded an honorary doctorate from the "Open International University of Complementary Medicine". Author of "Wilhelm Reich: The evolution of his work". _Disclaimer_ Basically this book contains neither exercises or advices. Nevertheless, if statements from the book should be used for self-treatment or for treatment of others, every form of liability of the author or the publisher for personal, material, or financial damage is excluded. (shrink)

This article critically engages with the influential theory of ‘‘molecularized biopower’’ and ‘‘politics of life’’ developed by Paul Rabinow and Nikolas Rose. Molecularization is assumed to signal the end of population-centred biopolitics and the disciplining of subjects as described by Foucault, and the rise of new forms of biosociality and biological citizenship. Drawing on empirical work in Science and Technology Studies, we argue that this account is limited by a focus on novelty and assumptions about the transformative power of the (...) genetic life sciences. We suggest that biopower consists of a more complex cluster of relationships between the molecular and the population. The biological existence of different human beings is politicized through different complementary and competing discourses around medical therapies, choices at the beginning and end of life, public health, environment, migration and border controls, implying a multiple rather than a singular politics of life. (shrink)

The Belmont Report’s distinction between research and the practice of accepted therapy has led various authors to suggest that these purportedly distinct activities should be governed by different ethical principles. We consider some of the ethical consequences of attempts to separate the two and conclude that separation fails along ontological, ethical, and epistemological dimensions. Clinical practice and clinical research, as with yin and yang, can be thought of as complementary forces interacting to form a dynamic system in which the (...) whole exceeds the sum of its parts. Just as effective clinical practice cannot exist without clinical research, meaningful clinical research requires the context of clinical practice. We defend this thesis by triangulation, that is, by outlining how multiple investigators have reached this conclusion on the basis of varied theoretical and applied approaches. More confidence can be placed in a result if different methods/viewpoints have led to that result. (shrink)

The use of placebo in clinical practice has been the topic of extensive debate in the bioethics literature, with much scholarship focusing on concerns regarding deception. While considerations of placebo without deception have largely centred on open-label placebo, this paper considers a different kind of ethical quandary regarding placebo without an intent to deceive—one where the provider believes a treatment is effective due to a direct physiological mechanism, even though that belief may not be supported by rigorous scientific evidence. This (...) is often the case with complementary and alternative medicine (CAM) techniques and also with some mainstream therapies that have not proven to be better than sham. Using one such CAM technique as a case study—electroencephalography (EEG) neurofeedback for attention-deficit/hyperactivity disorder (ADHD)—this paper explores the ethics of providing therapies that may have some beneficial effect, although one that is likely due to placebo effect. First, we provide background on EEG neurofeedback for ADHD and its evidence base, showing how it has proven to be equivalent to—but not better than—sham neurofeedback. Subsequently, we explore whether offering therapies that are claimed to work via specific physical pathways, but may actually work due to the placebo effect, constitute deception. We suggest that this practice may constitute unintentional deception regarding mechanism of action. Ultimately, we argue that providers have increased information provision obligations when offering treatments that diverge from standard of care and we make recommendations for mitigating unintentional deception. (shrink)

Hereditary breast and ovarian cancers are frequently attributed to germline mutations in the tumor suppressor genes BRCA1 and BRCA2. BRCA1/2 act to repair double‐strand breaks (DSBs) and suppress the demise of unstable replication forks. Our work elucidated a dynamic interplay between BRCA2 and the WRN DNA helicase/exonuclease defective in the premature aging disorder Werner syndrome. WRN and BRCA2 participate in complementary pathways to stabilize replication forks in cancer cells, allowing them to proliferate. Whether the functional overlap of WRN and (...) BRCA2 is relevant to replication at gaps between newly synthesized DNA fragments, protection of telomeres, and/or metabolism of secondary DNA structures remain to be determined. Advances in understanding the mechanisms elicited during replication stress have prompted the community to reconsider avenues for cancer therapy. Insights from studies of PARP or topoisomerase inhibitors provide working models for the investigation of WRN's mechanism of action. We discuss these topics, focusing on the implications of the WRN‐BRCA2 genetic interaction under conditions of replication stress. (shrink)

Although it seems scientifically implausible, holistically oriented forms of alternative and complementary medicine have become popular over the past few years. Homeopathy is considered to be one of the most widespread, heterogeneous, and controversial of these therapies. Science works as a generator of professional identity in such groups of medical outsiders. This article is based on extensive research on homeopathic communities conducted over several years. It will outline social conditions of homeopathic knowledge and treatment as opposed to scientific (...) standards and will shed some light on homeopathyas affected by science onthree levels: homeopathicresearch, education, and everyday work. Since the area of medical science and research affects homeopathic practice but not vice versa, this article will also highlight the challenge of “doing science” in a still marginalized field. (shrink)

The use of complementary and alternative medicine is increasing in the Western world. However, there is no clear evidence of effect of alternative therapies. Moreover, there is no consensus between practitioners and researchers as to the right way of assessing the efficacy of alternative therapies. To investigate practitioners’ perspective on evidence and ways of assessing efficacy twelve in-depth interviews were conducted in Denmark with acupuncturists, including physicians practising acupuncture, acupuncturists with a health-related background, and acupuncturists without a (...) health-related background. Two themes predominated the study, first, the interviewees’ general reflections on how it is possible to establish knowledge about an effect of acupuncture; and second the interviewees’ reflections on the use of randomized controlled trials in acupuncture, including obstacles and alternatives to conducting randomized controlled trials. Further, two conceptions of what constitutes evidence were identified: a biomedical conception and an experience-based conception. Most interviewees were sceptical about the use of randomized controlled trials in acupuncture. Two reasons, especially, were given for this scepticism. First, practical and instrumental reasons concerning the specific elements of the randomized controlled trial or relating to limited resources; and second, value-based reasons are concerning the nature of acupuncture. However, the interviewees were really opposed only to a certain kind of randomized controlled trial, the so-called explanatory trial. They would actually welcome a pragmatic trial. The study gives valuable insight into an under explored field and provide a platform for further investigation, and a better informed discussion of the subject. (shrink)

Psychotherapy helps one enact ideas about a good life, and therapists practice orientations rooted in their chosen approach. A 'good life' can therefore mean different things depending on the therapy. Building on the philosophy of Charles Taylor, Smith examines the link between therapy, ethics and the root of therapeutic views in comparison to modern, Western ideas about 'living well'. This is one of two complementary volumes. This volume builds on the last to explore what it means to engage the (...) different ethics of different therapies by offering a deeper explication of therapeutic ethics. Utilizing Taylor's work on practical reasoning, Smith explores topics like the nature of the ethical argument, the role of ethical intuitions and the value of framing ethical debate as ongoing dialogue. He applies this to therapeutics ethics to show how vital it is to consider the ethical proposals that are present in current theories and practices in order to understand the psychotherapies. A key text for upper level undergraduate, postgraduate students and professionals in the field of psychotherapy, psychoanalysis, theoretical psychology and philosophy of the mind. (shrink)

Psychotherapy helps one enact ideas about a good life, and therapists practice orientations rooted in their chosen approach. A 'good life' can therefore mean different things depending on the therapy. Building on the philosophy of Charles Taylor, Smith examines the link between therapy, ethics and the root of therapeutic views in comparison to modern, Western ideas about 'living well'. This is one of two complementary volumes. This volume explores the links between therapeutic aims and conceptions of wellbeing. It examines (...) three schools of psychoanalysis to show how similar therapies can be distinguished by their ethics. Smith argues that research shows little distinction ethical visions of psychotherapies and challenges the conception of therapy as a technical intervention for the treatment of circumscribed disorders. A key text for upper level undergraduate, postgraduate students and professionals in the field of psychotherapy, psychoanalysis, theoretical psychology and philosophy of the mind. (shrink)

In caring for pediatric patients, a multifaceted approach in decision-making is utilized. The role of the medical team in complementary and alternative medicine is controversial. In cases of conventional treatment refusal by parents in pursuit of complementary and alternative medicine, there must be balanced decision-making, autonomy, and the best interest of the child. This report highlights two illustrative cases of patients with brain tumor, whereby parents refused postoperative conventional therapy involving chemoradiotherapy, in pursuit of complementary and alternative (...) medicine alone. Parental decision-making in complementary and alternative medicine, in lieu of medical recommendations, poses an ethical and legal dilemma that may impede care of the pediatric patient and compromise outcome of oncological care. (shrink)

Stem cells have the capacity both to self‐renew and to give rise to differentiated progeny, and are vital to the organization of multicellular organisms. Stem cells raise a number of fundamental questions regarding lineage restriction and cellular differentiation, and they hold enormous promise for cell‐based therapies. Here I propose a theoretical framework for stem cell biology based on the concepts of autopoiesis (self‐production) and complementarity. I argue that stem cells are pivotal in the self‐production of the organism and that (...) we need complementary approaches to understand their probabilistic behavior. I discuss how this framework generates testable hypotheses regarding stem‐cell functions. BioEssays 26:1013‐1016, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

This article is aimed to compare the efficacy and acceptability of exercise intervention with other nonpharmacological therapies in improving attention in ADHD patients and then rank those therapies. Methods. Relevant RCT studies from the Cochrane Library, Web of Science, Psycinfo, and PubMed were systematically searched from January 2011 to January 2020. The literature was screened, and the researchers extracted and used Stata16 and WinBugs1.4 independently to analyze the data. Results. The improvement of “attention deficit” in ADHD patients was (...) measured in 83 independent studies with 4,998 participants and 14 nonpharmacological therapies. Therapies were ranked as follows, according to the efficacy and acceptability of the cumulative probability area under the curve : meditation and cognitive; sport intervention therapy; vitamin and mineral; cognitive behavioral therapy; computer training; psychological education; working memory training; neurofeedback therapy; polyunsaturated fatty acids; mineral supplements; meditation; vitamin; biofeedback therapy; and school-based training. However, because the effect size of meditation and cognitive therapy was at a marginally significant level ), the robustness of the results was far lower than that of sport intervention therapy. Therefore, careful interpretation is needed in practice. Conclusion. Considering the efficacy and acceptability of various nonpharmacological therapies, sport intervention has a more stable effect on the improvement of attention deficit. Secondly, meditation and cognitive therapy, cognitive behavioral therapy, and computer training can also be effective complementary tools. (shrink)

SummaryStarting with an analysis of the respiratory function and of the way it automatically connects the living organism with the physical milieu without any conscious or voluntary effort, Dr De Greeff then asserts that, on the Psychological level, similar basic mechanisms connect the individual with the social environment, and more generally with the Cosmos.Typical disorders of these mechanisms are to be seen in melancholic depressions and in the feelings of strangeness and loneliness they bring about. These mechanisms have à neural (...) basis in the diencephalic region and may be influenced by shock therapies. On the other hand, cerebral surgery shows that the frontal lobe intervenes to adjust these connecting mechanisms to the external world in its concrete structure, present and future.The author then criticizes the freudian conception, as he understands it, and proposes to substitute to the Instinct‐Reality dichotomy the antagonism of two internal attitudes, which are basic, automatic, and nearly organic, in the sense defined above: the sympathy‐attitude, which results in valorisation of and subordination to the object, and the defence‐attitude, which manifests itself in aggression and aims at annihilating the object. These attitudes are complementary and any awakening of one of them supposes the inhibition of the other one. But such an inhibition never reaches the stage of an absolute suppression.So much for the instinctive, unconscious and diencephalic basis of action. What kind of new developments do the cerebral cortex and the higher mental functions bring about? They make the individual aware of his basic attitudes, or, more exactly, of the way the object is affected by them so as to appear pleasant or unpleasant, lovable or threatening. They give him the possibility of accepting or refusing the first movements of instinct, and of stabilizing, delaying or inhibiting the corresponding reactions. They are the basis of temporal dimension and integration, of choice, liberty and morality. (shrink)

Does it work? This question lies at the very heart of the kinds of controversies that have surrounded complementary and alternative medicines (such as herbal medicine) in recent decades. In this article, I argue that medical anthropology has played a pivotal and largely overlooked role in taking the sham out of the placebo effect with important implications for what it means to say a therapy or drug `works'. If pharmacologists and clinicians have corporeally located the concept of efficacy in (...) terms of bio-availability, pharmacodynamics and pharmacokinetics, and herbalists in terms of a herbal revitalizing of the body's own vis medicatrix naturae, from the early 20th century onwards medical anthropologists (especially those who became interested in the `savage mind') have built up an equally rigorous theory of symbolic efficacy in terms of narratives, symbols and a kind of cognitive homeostasis. It was precisely as a mediating link between the somatic and the symbolic that I suggest a decriminalized placebo effect (as opposed to suggestion) could emerge in the middle of the 20th century. Taking the example of St John's Wort, I go on to show how notions of symbolic efficacy, spillover placebo efficacy and bio-efficacy co-circulate in recent attempts by herbalists, clinicians and pharmacologists to address the question of whether or not this herbal remedy `works' in the treatment of depression. (shrink)

Modern scientific medicine is increasingly challenged by complementary and alternative therapies. Reviewing policy options for contemporary healthcare development, the World Health Organization's first global strategy on traditional and alternative medicine, released in May 2002, advocates integration. However, experience in East Asia, the only part of the world where state of the art modern scientific facilities are commonly found alongside thriving traditional practices, reveals that medical integration can take several forms. To clarify the available policy options, this article categorizes (...) those forms, identifying three types of integration (unification, equalization and subjugation), plus one type of non-integration (marginalization). It marks out a zone of balanced healthcare development that cuts across two of the integrationist types, and comprises non-discriminatory state treatment of separate but linked sectors of traditional and modern medicine. The article closes by exploring arguments for and against locating state policy in this zone, and holds that policy should be situated here for medical practices that can meet broadly acceptable professional standards, demonstrate an existing social demand, and generate an adequate supply of medical practitioners, possibly through some state subsidy. (shrink)

BackgroundReiki is an energy healing technique or biofield therapy in which an attuned therapist places their hands on or near the client’s body and sends energy to the client to activate the body’s ability to heal itself and restore balance. It was developed in Japan at the end of the 19th century by Mikao Usui of Kyoto. Given the enormous international socioeconomic burden of mental health, inexpensive, safe, and evidenced-based treatments would be welcomed. Reiki is safe, inexpensive, and preliminary research (...) suggests it may assist in treating a wide variety of illnesses. Given that Reiki is a biofield therapy, growing in use, and not yet accepted by the dominant biomedical paradigm, it is important to establish its effectiveness over placebo. This study aimed to examine Reiki’s effectiveness over placebo in treating symptoms of mental health and to explore parameters for its effectiveness.MethodA systematic review of randomized placebo-controlled trials examining Reiki’s effectiveness in treating symptoms of mental health in adults was conducted through a systematic search of PubMed, PsycINFO, MEDLINE, CINAHL, Web of Science, Scopus, Embase, and ProQuest. Fourteen studies met the inclusion criteria, and risk of bias was assessed using Cochrane’s Revised ROB 2 assessment tool. This was followed by a grading of recommendations, assessment, development and evaluations assessment.ResultsThe evidence to date suggests that Reiki consistently demonstrates a greater therapeutic effect over placebo for some symptoms of mental health. The GRADE level of evidence is high for clinically relevant levels of stress and depression, moderate to high for clinically relevant levels of anxiety, low to moderate for normal levels of stress, and low to moderate for burnout, and low for normal levels of depression and anxiety.ConclusionThe results suggest that, Reiki may be more effective in treating some areas of mental health, than placebo, particularly if symptoms are clinically relevant. To date, there are a small number of studies in each area, therefore findings are inconclusive and, more RCTs controlling for placebo in Reiki research are needed. Most included studies were also assessed as having a risk of bias of some concern. Incorporating Reiki as a complementary treatment to mainstream psychotherapy for depression, stress, and anxiety may be appropriate.Systematic Review Registration[https://www.crd.york.ac.uk/], identifier [CRD42020194311]. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.3 (2003) 267-271 [Access article in PDF] Likening Strikes Twice:Psychiatry, Osteopathy, and the Likeness Argument Stephen Tyreman PRIMA FACIE PSYCHIATRY and osteopathy do not appear to share much common ground; however, in at least one important respect they pursue similar goals. By seeking to consolidate their independent identities, each is challenging the dominance of the medical model. This involves justifying what they do and why (...) they should exist as independent professions. With osteopathy the situations are different in the United Kingdom and the United States, but in both countries the same challenge exists (Howell 1999; Tyreman 1998). Broadly, it boils down to how osteopathy is positioned in relation to conventional (orthodox or allopathic) medicine and, particularly, to how its practice and theory is validated by scientific methodology. Howell, an allopathic practitioner, sums up the situation as he sees it in the United States by concluding in his New England Journal of Medicine editorial, "many people—even osteopaths—question what it is that osteopathy has to offer that is distinctive.... The paradox is this: if osteopathy has become the functional equivalent of allopathy, what is the justification for its continued existence? And if there is value in therapy that is uniquely osteopathic—that is, based on osteopathic manipulation or other techniques—why should its use be limited to osteopaths?" (1999, 1468). In the United Kingdom, with the passing of the Osteopaths Act in 1993 and the establishment of statutory self-regulation, the profession has been trying to define itself by identifying its raison d'être and the extent to which it aligns itself with medical assumptions.Fueling this dilemma, which in different ways affects psychiatry and osteopathy (and other professions supplementary to, allied with, or complementary to medicine), is the same question: does the paradigm of physical illness, explained and validated by the biological sciences, provide the basic model for understanding and treating all forms of illness—physical, mental, and functional? How are the concepts of illness and disease to be defined and how do such definitions relate to the justification for treatment and other health interventions?Neil Pickering has produced an interesting contribution to the mental illness side of this debate by analyzing the likeness argument, wherein mental illness is said to be a real illness and therefore a legitimate reason for providing treatment, because, in significant respects, it has the same features as other forms of illness acknowledged as being real illnesses. In criticizing the argument he identifies two key assumptions: "that there are features of human conditions... that decide what category or kind, these conditions are a member of" and "that, with respect to the [End Page 267] presence or absence of these features, a condition... is describable independent of the category it is assigned to" (2003, p. 245). He rightly points out that these assumptions do not stand up to analysis and therefore, if indeed they are fundamental assumptions for the argument, the likeness argument must fail. His reason for requiring the argument to fail is that it is not possible to describe (illness) features independently of the category to which they are assigned, which undermines both key assumptions. Therefore all such attempts must fail. He is not clear about what replaces it other than implying that it entails value judgments and human selection.My comments are not so much criticisms of Pickering's conclusion, which I think is correct, but of his reasons for coming to that conclusion, which I think are based on false assumptions; with a different emphasis his argument could be made much stronger.Pickering's argument appears to rest on (at least) three assumptions: he explicitly states that (for the purposes of his argument) illness and disease can be used interchangeably; second, that physical illness is a natural kind; third, that for conventional/allopathic medicine, illness is best understood and explained in physical terms. In addition, and partly as a consequence of the above, there is an implicit assumption that physical illness is the standard against which all other claims to be illnesses should be tested; that is, that... (shrink)

IntroductionA symptom cluster is very common among oncological patients: cancer-related fatigue, emotional distress, sleep difficulties, pain, and cognitive difficulties. Clinical applications of interventions based on non-ordinary states of consciousness, mostly hypnosis and meditation, are starting to be investigated in oncology settings. They revealed encouraging results in terms of improvements of these symptoms. However, these studies often focused on breast cancer patients, with methodological limitations. Another non-ordinary state of consciousness may also have therapeutic applications in oncology: self-induced cognitive trance. It seems (...) to differ from hypnosis and meditation, as it involves the body more directly. Thus, investigating its clinical applications, along with hypnosis and meditation interventions, could improve available therapeutic options in oncology. This article details the study protocol of a preference-based longitudinal controlled superiority trial aiming to assess the effectiveness of 3 group interventions to improve oncological patients’ quality of life, and more specifically CRF, emotional distress, sleep, pain, and cognitive difficulties.Methods and analysisA power analysis required a total sample of 160 patients. Main inclusion criteria are: cancer diagnosis, active treatments completed for less than a year, no practice of hypnosis, meditation, or SICT, and presence of at least one of these four symptoms: fatigue, sleep difficulties, depression, or anxiety. Each participant will choose the intervention in which they want to participate. To test the effectiveness of the interventions, data will be collected by questionnaires and neurobiological measures and directly from the medical record at four time points: before inclusion in the study ; immediately after the intervention; and at 3- and 12-month follow-up. The longitudinal data in each group will then be measured.DiscussionIn addition to standard cancer therapies, there is a growing interest from patients in complementary approaches, such as hypnosis, meditation, and SICT. The results of this study will be useful to increase knowledge about short- and long-term effectiveness of 3 group interventions for CRF, emotional distress, sleep, pain, and cognitive difficulties in patients with different cancers.Clinical Trial RegistrationClinicalTrials.gov/. Retrospectively registered on the 29th of April 2021. url: https://clinicaltrials.gov/ct2/show/NCT04873661. (shrink)

Small tandem DNA duplications in the range of 15 to 300 base‐pairs play an important role in the aetiology of human disease and contribute to genome diversity. Here, we discuss different proposed mechanisms for their occurrence and argue that this type of structural variation mainly results from mutagenic repair of chromosomal breaks. This hypothesis is supported by both bioinformatical analysis of insertions occurring in the genome of different species and disease alleles, as well as by CRISPR/Cas9‐based experimental data from different (...) model systems. Recent work points to fill‐in synthesis at double‐stranded DNA breaks with complementary sequences, regulated by end‐joining mechanisms, to account for small tandem duplications. We will review the prevalence of small tandem duplications in the population, and we will speculate on the potential sources of DNA damage that could give rise to this mutational signature. With the development of novel algorithms to analyse sequencing data, small tandem duplications are now more frequently detected in the human genome and identified as oncogenic gain‐of‐function mutations. Understanding their origin could lead to optimized treatment regimens to prevent therapy‐induced activation of oncogenes and might expose novel vulnerabilities in cancer. (shrink)

Many symptoms of possession described by exorcists correspond to the symptoms of psychiatric disorders. Before helping a person who feels that they are possessed by an evil spirit, one should answer this question: when is therapy necessary, and when is an exorcism required? The article points out that psychiatrists have different attitudes to theological explanations of possession and exorcism. According to the author, it is best to adopt a complementary attitude, such as leaves room for the thought that there (...) exist two causes for the symptoms of possession - the natural and the supernatural one. This may then furnish a common approach for medicine, psychology and religion. The article presents the theological criteria for determining possession by an evil spirit, and the psychological criteria for diagnosing pathological possession, as given by the World Health Organisation and the American Psychiatric Association. The author discusses similarities and differences between the theological criteria for diagnosing demonic possession and the criteria involved in a medical diagnosis. On the basis of both psychological and theological criteria, it is possible to recognize psychopathological states and demonic possession in multidimensional terms. This allows the author to distinguish four situations: health, psychopathological possession, demonic possession of a mentally healthy person, and coexistence of demonic possession with psychiatric disorders. Practical experience shows that the largest number of patients seeking help in health centres belongs to the fourth group, which is why there is a need for close cooperation between exorcists and psychologists or psychiatrists. (shrink)

We describe our clinical experience in treating patients with Tourette syndrome and other tic disorders using infra-low frequency neurofeedback, often in conjunction with cognitive behavior therapy. Following a narrative description of our approach, we present outcome data for 100 successive cases. Many of the children and adolescents that we have treated since 2005 did not derive sufficient benefit from standard treatment for Tourette syndrome and other tic disorders. In our clinical experience, based on extensive before- and after- testing and symptom (...) tracking, this patient group derived significant additive benefit from complementary neurofeedback treatment. The majority of trainees attained a higher level of functioning and were able to live up to their potential in a way they were not able to prior to neurofeedback treatment. (shrink)