Psychotherapy holds out the promise of help for people who are hurting and in need. It can save lives and change lives. In therapy, clients can find their strengths and sense of hope. They can change course toward a more meaningful and healthy life. They can confront loss, tragedy, hopelessness, and the end of life in ways that do not leave them numb or paralyzed. They can discover what brings them joy and what sustains them through hard times. They can (...) begin to trust, or to trust more wisely. They can learn new behaviors in therapy and how to teach themselves new behaviors after therapy ends. They can question what they always believed was a given. They can find out what matters most to them, and how to stop wasting time. They can become happier, or at least less miserable. They can become better able, as Freud noted, to love and to work. They can learn how to accept and love themselves just as they are and accept others who are different from them. Our ethics acknowledge and affirm our profession's responsibilities. This book was written to help strengthen, deepen, and inform ethical awareness and the sense of personal ethical responsibility. Its job is to help you hold onto the ideals-including ethical ideals-that called you into the profession to begin with, to help you develop and fulfill those ideals. There will be so much-trust us on this-that tends to dull ethical awareness, to make ethics drift out of focus, to create barriers between you and your ideals, to replace ethics with pseudo-ethics and ethics placebos. Fatigue, endless paperwork, unrealistic expectations, illness, family crises, not being able to make ends meet, burn out, threats of job loss, insurance coverage that doesn't come close to meeting the needs of our clients, biases that have not been addressed, and so many other forces can pressure us into cutting ethical corners. This book is intended to help you develop a strong and healthy resistance to such forces, to help you weather them without losing your ethical awareness and ideals. (shrink)

R. A. Duff has revived the tradition of “answerability” for crime. In this philosophical and jurisprudential tradition, a person is answerable to the criminal law of a state and the process of that state’s courts only if there is some appropriate relationship between the state and the person. Duff’s great contribution has been to develop the idea of accountability of persons to a state or other polity as a philosophical notion which, he argues, underlies all just implementations of criminal law. (...) Duff has centered his views around the relationship between the citizen and the polity (in today’s world, the state) to which the citizen belongs. His focus has been on insiders, rather than outsiders.This article argues that, in the current world, the relationship among cocitizens, outsiders, and the state is based in part on the moral idea that the state exists to protect citizens from evil acts, specifically those that we call public and criminal wrongs, wherever the acts originate. Outsiders understand this, and understand that states other than their own use criminal law to protect their citizens.Duff’s writings contain an idea which turns out to be very useful in cases of outside acts, even though he does not apply it directly to them. Some states or other entities may have only an incomplete relationship with an accused person (compared with the relationship of citizen and state), but nonetheless may have the moral and political authority to try her for crime. This paper extends this notion to show that such incomplete relationships exist in a great many common cases of outsiders (noncitizens who act outside the territory of a state) who commit crime. These relationships support criminal prosecution of outsiders, so long as we admit that protection of persons from crime is a legitimate goal of the criminal law. (shrink)

This multidisciplinary collection explores three key concepts underpinning psychiatry -- explanation, phenomenology, and nosology -- and their continuing relevance in an age of neuroimaging and genetic analysis. An introduction by Kenneth S. Kendler lays out the philosophical grounding of psychiatric practice. The first section addresses the concept of explanation, from the difficulties in describing complex behavior to the categorization of psychological and biological causality. In the second section, contributors discuss experience, including the complex and vexing issue of how self-agency (...) and free will affect mental health. The third and final section examines the organizational difficulties in psychiatric nosology and the instability of the existing diagnostic system. Each chapter has both an introduction by the editors and a concluding comment by another of the book's contributors. Contributors: John Campbell, Ph.D.; Thomas Fuchs, M.D., Ph.D.; Shaun Gallagher, Ph.D.; Kenneth S. Kendler, M.D.; Sandra D. Mitchell, Ph.D.; Dominic P. Murphy, Ph.D.; Josef Parnas, M.D., Dr.Med.Sci.; Louis A. Sass, Ph.D.; Kenneth F. Schaffner, M.D., Ph.D.; James F. Woodward, Ph.D.; Peter Zachar, Ph.D. (shrink)

Twelve-step programs such as Alcoholics Anonymous and Narcotics Anonymous invite members to trust that what is said in meetings remains confidential. However, the New York Times, a prominent and influential newspaper, has breached that confidentiality, offering both a precedent and a rationale to other media including newspapers, cable news programs, internet news blogs, and so on. This prominent breach may influence not only other news media but also the trust that 12-step members have in their programs.

Levels of Analysis in Psychopathology draws research from psychiatry, philosophy, and psychology to explore the variety of explanatory approaches for understanding the nature of psychiatric disorders both in practice and research. The fields of psychiatry and clinical psychology incorporates many useful explanatory approaches and this book integrates this range of perspectives and makes suggestions about how to advance etiologic theories, classification, and treatment. The editors have brought together leading thinkers who have been widely published and are well-respected in their area (...) of expertise, including several developers of the Diagnostic and Statistical Manual of Mental Disorders and authors of the US National Institute of Mental Health's Research Domain Criteria Project (RDoC). Each main chapter has a commentary provided by one of the other authors and an introduction written by one of the editors to create an accessible, interdisciplinary dialog. (shrink)

The general consensus is that reform of medical malpractice law should be part of the health care system's overhaul. Medical malpractice litigation results in the expenditure of tens of billions annually, largely paid out of health care insurance funds and mostly paid to defendants' and plaintiffs' lawyers. By all accounts, this tort law regime ill serves the basic deterrence and compensation goals of civil liability. The causes and magnitude of these failings are disputed, and many typical reform proposals sidestep the (...) basic problems and may do more harm than good. In contrast, we advance a straightforward way to improve both deterrence and compensation. Essentially, the proposal is to remove current legal limitations on the scope of insurance subrogation that bar private and public health care insurers from “buying” the whole of their insureds' potential medical malpractice claims in exchange for lower premiums and taxes and expanded insurance coverage. Our proposal’s benefits accrue regardless of the cause and magnitude of the failings of malpractice law or the further reforms that might be adopted. (shrink)

The revisions of both DSM-IV and ICD-10 have again focused the interest of the field of psychiatry and clinical psychology on the questions of nosology. This book reviews issues within psychiatric nosology from clinical, historical and particularly philosophical perspectives. It brings together an interdisciplinary group of distinguished authors.

Der lebende Organismus stellt einen bestimmten, individuellen Teil des Universums dar, indem er seine Selbständigkeit abgetrennt von dem übrigen Universum erhält, durch den Teilungseffekt, welcher durch die Anordnung seiner Teile bestimmt wird. Es ist anerkannt, dass die Teilung nicht vollständig ist, jedoch eine beschränkte gegenseitige Beziehung zulässt. Es ist auch anerkannt, dass der Grad der Organisation in einer verwandten Reihe sich ändert von den tiefen Verwickelungen der einfachen Zelle zu den mannigfachen Abwandlungen wie sie beim Menschen auftreten. Die Auffassung von (...) effektiver Teilung ist ausserdem auch fest und substantiell auf der Tatsache begründet, die durch das Vorhandensein der Plasmamembran und Grenzflächen kolloidaler Aggregaten gegeben ist. Betont ist die dynamische Natur der charakteristischen Gleichgewichtszustände und es wird aufmerksam gemacht auf die kontinuierliche Bildung von effektiven Teilungen bei verschiedenen Gleichgewichtszuständen. Weitere Untersuchung der Bedeutung dieser Teilungen ergibt viele interessante Folgerungen. Schwierigkeiten finden sich, wenn man eine derartige Beschreibung auf geistige Phänomena ausdehnt. Zwar bestehen grundlegende Übereinstimmungen, aber es ist schwer sie genau zu definieren. Es ist klar, dass eine Synthese dieser Art notwendigerweise unvollständig ist, aber es schien wertvoll den Versuch zu machen, L'organisme vivant est présenté ici comme une partie définie et individualisée de l'univers maintenant son individualité propre au moyen de „l'effet de partition” déterminé par l'arrangement de ses parties. Il est entendu que la partition n'est pas complète mais permet encore des relations réciproques mais limitées. Il est reconnu aussi que le degré d'organisation varie dans le cours d'une série, des complexités profondes de la cellule aux innombrables modifications exhibées par l'organisme humain. Le concept de la partition effective est basé solidement sur l'évidence présentée par la membrane plasmatique et les limites de phases dans les aggrégations colloidales. De plus il est important de noter spécialement la nature dynamique des équilibres caractéristiques et l'on ne saurait manquer d'attirer l'attention sur la formation continue de partitions effectives aux différents niveaux d'équilibre. L'étude ultérieure de la signification de ces partitions présente un grand nombre d'implications intéressantes. Il est à noter que des difficultés sont rencontrées quand on essaie d'inclure en une description de ce genre les phénomènes mentaux et psychiques. Des stabilités fondamentales existent, mais elles sont difficiles à définir avec précision. Il est évident du reste au lecteur qu'une synthèse telle que celle-ci est nécessairement incomplète mais néanmoins intéressante à faire. (shrink)

The comprehensive guide to ethics "An excellent blend of case law, research evidence, down-to-earth principles, and practical examples from two authors with outstanding expertise. Promotes valuable understanding through case illustrations, self-directed exercises, and thoughtful discussion of such issues as cultural diversity."--Dick Suinn, president-elect 1998, American Psychological Association "The scenarios and accompanying questions will prove especially helpful to those who offer courses and workshops concerned with ethics in psychology."--Charles D. Spielberger, former president, American Psychological Association; distinguished research professor of psychology, University (...) of South Florida The authors draw on their professional experience, empirical studies, and case examples to examine the ethical responsibilities that confront psychotherapists and counselors in their day-to-day practice. They offer insights into contending with the sometimes competing demands of clients' needs, formal ethical principles, personal values, and evolving legal standards in a range of areas--including fees, informed consent, sexual concerns, confidentiality, documentation, and supervision. (shrink)

In an era where autonomous technologies are progressively taking over more complex tasks and decision-making previously done by humans, the mastering of paradox-based skills and effectively reconciling paradoxical situations in everyday life will become increasingly important. This paper asserts that understanding and living with paradox is not only necessary for the future of work but also for human flourishing. While work is the primary means by which humans flourish in the traditional sense, there are deeper and more holistic understandings of (...) human flourishing which requires the acceptance and learning of paradoxical realities. Those who are steeped in the understanding and reality of paradox in everyday life can also be more open to these deeper and more holistic understandings of human flourishing. (shrink)

Psychiatry has long struggled with the nature of its diagnoses. This book brings together established experts in the wide range of disciplines that have an interest in psychiatric nosology. The contributors include philosophers, psychologists, psychiatrists, historians and representatives of the efforts of DSM-III, DSM-IV and DSM-V.

This essay selectively reviews, from an historical and philosophical perspective, the dopamine (DA) hypothesis of schizophrenia (DHS; Table 1 lists the abbreviations used in this essay). Our goal is not to adjudicate the validity of the theory—although we arrive at a generally skeptical conclusion—but to focus on the process whereby the DHS has evolved over time and been evaluated. Since its inception, the DHS has been the most prominent etiologic theory in psychiatry and is still referred to widely in current (...) textbooks (e.g., Buchanan and Carpenter, Jr. 2005, 1336; Cohen 2003, 225; Gazzaniga 2004, 1257;Kandel et al. 2000, 1200). Understanding its origins and evolution should help to clarify the nature of modern .. (shrink)

The battle of Salamis can be dated with a high degree of certainty. Probably about the time of that battle, Cleombrotus was at the Isthmus, constructing the defences there. At some point while building the wall, he considered giving chase to the Persian army. When his sacrifice was answered by a solar eclipse, he took this as a bad omen and immediately returned to Lacedaemon. The eclipse visible to Cleombrotus could only have been that of 2 October 480. Now it (...) is generally supposed that Cleombrotus would not have thought to abandon the construction of the wall and pursue Xerxes unless the latter had just begun his retreat from Athens. Thus, as Herodotus says that a few days () after the battle of Salamis Xerxes withdrew from Attica, the battle of Salamis probably occurred before 2 October 480. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Rhetoric and AngerKenneth S. Zagacki and Patrick A. Boleyn-FitzgeraldSince most believe anger can be either good or bad, rhetors face a moral problem of determining when anger is appropriate and when it is not. They face a corresponding rhetorical problem in deciding when and how to express anger and determining the role that it might play in public discourse, with specific audiences and in particular rhetorical situations. Rhetorical scholars (...) have catalogued whole genres of angry rhetoric—apocalyptic genres, jeremiads, the demonizing rhetoric of religious and political leaders—wherein the rhetorical display of anger is explained in terms of situational conventions and cultural norms.1 Yet these scholars have not easily resolved the moral problems associated with angry rhetoric. Aristotle suggested the earliest and most obvious solutions to these problems. In the Nicomachean Ethics, he outlines a typology for discerning the moral limits of anger and, by implication, angry rhetoric. And in Book II of the Rhetoric he asserts that the orator needs to know the structure of emotions like anger and how to intensify and dissipate them. Or, in other words, the orator must know how to make it reasonable to be angry. Some contemporary philosophers have gone further, suggesting that a failure to feel and express anger in public betrays an insufficient concern for justice and self respect.In this essay, we follow Aristotle in arguing that anger is sometimes the emotion we expect people to feel or the rhetorical response we expect them to display and evoke in others. But we also challenge part of Aristotle's argument by asking: "Even when angry rhetoric would appear to be a reasonable, morally appropriate response, is there a way in which rhetors might manage anger in their public discourse in order to achieve ends which are both morally and pragmatically productive?" The answer, we propose, lies in what we call "non-angry" rhetoric, which involves transforming and reflecting upon anger in public discourse. Because such rhetoric often promotes noble ends such as reconciliation and forgiveness, it is at least morally permissible and more likely morally virtuous.2 In order to establish these claims, our analysis focuses on the case of Nelson Mandela and his "Address to the Interfaith Commissioning Service for the Truth and Reconciliation Commission."3 In this speech, Mandela, as our [End Page 290] analysis demonstrates, managed anger and turned it into an object of reflection, thereby illustrating what opportunities for reconciliation and democratic deliberation would look like during the difficult period attending the political transition in South Africa in general and the Truth and Reconciliation Commission (TRC) hearings in particular. His "Address" exemplified a unique moment when the rhetoric and the ethics of anger came together in a public performance. While acknowledging the understandable anger of blacks, Mandela (who may in fact have harbored considerable anger himself) simultaneously suggested that by engendering a less hostile social-political context, in which participants maintained their self-respect without necessarily sacrificing justice, a new democratic community could emerge. This would be a community where, as he described it, individuals began to reconcile with and no longer persecute one another. As Aristotle might explain, the purpose of Mandela's speech was to manage the anger of blacks, so that they would then be able to deliberate properly about the issues before the TRC and about the larger democratic transition. As the philosopher Eugene Garver says, the particular passions Aristotle chooses to explore in the Rhetoric serve a role necessary for the kind of public, political decision making he assigns to rhetoric. These emotions serve to integrate—or segregate, as the case may be—"distinct individuals into a deliberative or judging body, or demos" (1994, 131).What we are recommending, then, is that rhetoric encompasses both considerations of moral desert as well as broader moral concerns. While there are times when individuals seem to deserve our angry rhetoric, it may not be justified from a broader moral perspective, especially when the goal is the good of the state or the community—viz., if angry rhetoric leads to the violent dissolution of democratic community. Ultimately, we argue that the moral constitution of political, deliberative communities must be viewed in terms... (shrink)

Ethical theories grounded in utilitarianism suggest that social welfare is improved when agents seek to maximize others' welfare in addition to their own (i.e., are altruistic). However, I use a simple game-theoretic model to demonstrate two shortcomings of this argument. First, altruistic preferences can generate coordination problems where none exist for selfish agents. Second, when agents care somewhat about others' utility but weight their own more highly, total social welfare may be lower than with selfish agents even in the absence (...) of coordination problems. (Published Online April 18 2006) Correspondence:c1 105 St. George St., Toronto, Ontario M5S 3E6; kenneth[email protected]. Footnotes1 I thank Adam Brandenburger and Mara Lederman for helpful comments. (shrink)

E. T. Jaynes' resolution of Bertrand's paradox in terms of invariance principles is criticized. An experimental setup is considered which generates general solutions to Bertrand's problem by rotating a line around a point a distancer+d from a circle of radiusr. The general solution obtained is neither translationally nor scale invariant, but depends on the value ofr/d. Only in the limitr/d » 0, when the line is just translating across the circle, is the distribution translationally invariant and scale invariant. In this (...) limiting case the distribution found is just that obtained by Jaynes. (shrink)

The battle of Salamis can be dated with a high degree of certainty. Probably about the time of that battle, Cleombrotus was at the Isthmus, constructing the defences there . At some point while building the wall, he considered giving chase to the Persian army. When his sacrifice was answered by a solar eclipse, he took this as a bad omen and immediately returned to Lacedaemon . The eclipse visible to Cleombrotus could only have been that of 2 October 480. (...) Now it is generally supposed that Cleombrotus would not have thought to abandon the construction of the wall and pursue Xerxes unless the latter had just begun his retreat from Athens. Thus, as Herodotus says that a few days () after the battle of Salamis Xerxes withdrew from Attica , the battle of Salamis probably occurred before 2 October 480. (shrink)

A profession's values - including its ethical values - are reflected in the degree to which its structures are accessible to people with disabilities. The profession expresses its values through the decisions of its members to effectively address barriers to access or to maintain those barriers through action or inaction. What barriers can block access to the field for psychologists and psychology students with disabilities? What barriers can block access for people with disabilities to the services that psychologists provide? This (...) brief editorial notes three major kinds of such barriers. (shrink)

We compare astronomers' removal of Pluto from the listing of planets and psychiatrists' removal of homosexuality from the listing of mental disorders. Although the political maneuverings that emerged in both controversies are less than scientifically ideal, we argue that competition for "scientific authority" among competing groups is a normal part of scientific progress. In both cases, a complicated relationship between abstract constructs and evidence made the classification problem thorny.

Psychiatry has been subject to major changes in the last 150 years. This book explores the forces that have shaped these changes and how they have impacted on the psychiatric profession in this time. The result is a dynamic discussion about the nature of psychiatric disorders, and a book that is compelling reading.

Emotion plays an essential role in the perception of time such that time is perceived to “fly” when events are enjoyable, while unenjoyable moments are perceived to “drag.” Previous studies have reported a time-drag effect when participants are presented with emotional facial expressions, regardless of the emotion presented. This effect can hardly be explained by induced emotion given the heterogeneous nature of emotional expressions. We conducted two experiments ( n = 44 and n = 39) to examine the cognitive mechanism (...) underlying this effect by presenting dynamic sequences of emotional expressions to participants. Each sequence started with a particular expression, then morphed to another. The presentation of dynamic facial expressions allows a comparison between the time-drag effect of homogeneous pairs of emotional expressions sharing similar valence and arousal to heterogeneous pairs. Sequences of seven durations (400, 600, 800, 1000, 1200, 1400, 1600 ms) were presented to participants, who were asked to judge whether the sequences were closer to 400 or 1600 ms in a two-alternative forced choice task. The data were then collated according to conditions and fit into cumulative Gaussian curves to estimate the point of subjective equivalence indicating the perceived duration of 1000 ms. Consistent with previous reports, a feeling of “time dragging” is induced regardless of the sequence presented, such that 1000 ms is perceived to be longer than 1000 ms. In addition, dynamic facial expressions exert a greater effect on perceived time drag than static expressions. The effect is most prominent when the dynamics involve an angry face or a change in valence. The significance of this sensitivity is discussed in terms of emotion perception and its evolutionary significance for our attention mechanism. (shrink)

This essay discusses unlimited insurance subrogation (UIS) as a means of improving the deterrence and compensation results of medical malpractice law. Under UIS, health care insureds could assign their entire potential medical malpractice claims to their first-party commercial and government insurers. UIS should improve deterrence by establishing first-party insurers as plaintiffs to confront liability insurers on the defense side, leading to more effective prosecution of meritorious claims and reducing meritless and unnecessary litigation. UIS should improve compensation outcomes by converting litigation (...) cost- and risk- laden “tort insurance” into cheaper and enhanced first-party insurance. UIS also promises dynamic benefits through further reforms by contract between the first-party and liability insurers that would take charge of system. No UIS-related costs are apparent that would outweigh these benefits. (shrink)

Eunapius, pagan historian of the fourth century, wrote a history of the contemporary Roman Empire. Scholars have understood Eunapius'animosity toward Christianity as coloring his judgment and supplying him with a purpose for writing. Though his history did reflect contemporary religious tension, it is primarily shaped by traditional approaches to historiography. Eunapius attempts to analogize and explain human behavior in terms of the natural laws which pervade the history. His message is founded on classical values independent of current concerns; Eunapius inculpates (...) an apparently innocent pagan to prove one point. He was not only participant in the sectarian struggle which divided the Empire; he was also part of a thousand-year-old culture that served to unify it. (shrink)