_Disaster Psychiatry: Intervening When Nightmares Come True_ captures the state of disaster psychiatry in the aftermath of the terrorist attacks of September 11, 2001. This emergent psychiatric specialty, which is increasingly separated from trauma and grief psychiatry on one hand and military psychiatry on the other, provides psychotherapeutic assistance to victims during, and in the weeks and months following, major disasters. As such, disaster psychiatrists must operate in the widely varying locales in which natural and (...) man-made disasters occur, and they must establish their role among the chaotic array of organizations involved in direct disaster response. Editors Anand Pandya and Craig Katz have captured the challenge and promise of disaster psychiatry through first-person narratives. We hear from psychiatrists who have encountered disasters at various stages of their career and in widely varying social, political, and personal contexts. Accounts of psychiatric involvement with adults and children during and after 9/11 have understandable pride of place in this collection. But they are balanced by richly informative narratives about other domestic and international disasters. Fraught with the drama attendant to the events they describe, these essays delineate the dizzying array of challenges that confront the disaster psychiatrist. They range from the intense emotional responses that are part of the aftermath of any disaster, to the need to legitimize a psychiatric presence within diverse cultural and medical contexts, to the subtle task of providing therapeutic boundaries at a time when all rules seem to be suspended. Special attention is given to the daunting task of working with children whose parents' are disaster victims. What emerges from these testimonies is compelling documentation of skilled and compassionate psychiatrists at the outer limits of their specialty, pursuing their calling into uncharted realms of therapeutic engagement. (shrink)

Career transitions in psychiatry have rarely been discussed openly. Yet, in the light of health care reform and other forces affecting clinical practice, it is more important than ever that psychiatrists have information about the career options within their specialty. _Career Pathways in Psychiatry: Transition in Changing Times_ serves that purpose. It explores the professional development and career choices of prominent American psychiatrists, each of whom is identified with a particular career track and many of whom have themselves (...) experienced one or more career transitions. The autobiographical accounts of the contributors survey a wide range of career pathways in psychiatry, including clinical practice, HMO practice, research, administration, entrepreneurism, psychoanalysis, organized medicine, the pharmaceutical industry, public psychiatry, occupational psychiatry, forensic psychiatry, and military psychiatry. These accounts are as engaging as they are informative; their anecdotal nature and conversational tone make for pleasurable reading. References at the end of each chapter serve as recommended reading for those who wish to learn more about specific career options. Intended for psychiatric residents and psychiatrists early in their careers, _Career Pathways in Psychiatry_ will also appeal to their more experienced colleagues, including seasoned clinicians who have contemplated career changes. With a preface summarizing research on career transitions in medicine and numerous chapters shedding light on factors contributing to resistance to change, this book will also be of interest to social scientists, mental health administrators, and professional recruiters. (shrink)

Career transitions in psychiatry have rarely been discussed openly. Yet, in the light of health care reform and other forces affecting clinical practice, it is more important than ever that psychiatrists have information about the career options within their specialty. _Career Pathways in Psychiatry: Transition in Changing Times_ serves that purpose. It explores the professional development and career choices of prominent American psychiatrists, each of whom is identified with a particular career track and many of whom have themselves (...) experienced one or more career transitions. The autobiographical accounts of the contributors survey a wide range of career pathways in psychiatry, including clinical practice, HMO practice, research, administration, entrepreneurism, psychoanalysis, organized medicine, the pharmaceutical industry, public psychiatry, occupational psychiatry, forensic psychiatry, and military psychiatry. These accounts are as engaging as they are informative; their anecdotal nature and conversational tone make for pleasurable reading. References at the end of each chapter serve as recommended reading for those who wish to learn more about specific career options. Intended for psychiatric residents and psychiatrists early in their careers, _Career Pathways in Psychiatry_ will also appeal to their more experienced colleagues, including seasoned clinicians who have contemplated career changes. With a preface summarizing research on career transitions in medicine and numerous chapters shedding light on factors contributing to resistance to change, this book will also be of interest to social scientists, mental health administrators, and professional recruiters. (shrink)

Working as a peacekeeper is associated with the exposure to acute and/or catastrophic events and chronic stressors. Hence, the meager literature about peacekeepers’ wellbeing has mainly analyzed Post-Traumatic Stress Disorder (PTSD). This study aims to deep the analysis of the wellbeing of peacekeepers military. Based on the few studies on this population, we hypothesized that Italian peacekeeper military officers and enlisted men (n = 167; 103 males, 6 females, 58 missing) exhibit lower levels of internalizing symptoms (i.e., PTSD, (...) depression, general anxiety, obsessions, and somatization) as compared to a control group (n = 60; 32 males, 28 females). Moreover, we hypothesized that peacekeepers have higher levels of psychological resources (i.e., self-efficacy, self-esteem, social support) and quality of life (i.e., higher life satisfaction and lower general stress). We compared the groups by means of MANOVAs on the subscales of the Psychological Treatment Inventory (PTI; Gori et al., 2015). We found that Italian peacekeepers have lower internalizing symptoms and higher levels of self-efficacy and self-esteem than the control group; however, no statistically significant differences were observed on perceived social support. Finally, peacekeepers have a higher quality of life: scores reflect higher life satisfaction and lower distress than the control group. This study is in line with previous literature supporting the claim that Italian peacekeeper military officers have sufficient psychological resources for coping with the stressful situations implied in peacekeeping missions. Future studies should deepen the analysis of the military’s psychological characteristics by comparing war veterans and peacekeeper military. (shrink)

Summary In his series of lectures, Le pouvoir psychiatrique, Michel Foucault employs concepts from the military field of knowledge in order to analyse the founding scenes of psychiatry. I focus on three issues connected to Foucault's use of these military terms. Firstly, I examine why Foucault was reluctant to use concepts from sociology and psychology in Le pouvoir psychiatrique and how this affects the notions that he had formulated in his earlier work, Histoire de la folie. Secondly, (...) I show how he challenges traditional understandings of the founding scenes of psychiatry by using concepts from a different field of knowledge. In doing this, he creates metaphors, and this is something that he himself had previously been critical of doing. Thirdly, I reflect upon the fact that Foucault's creative use of concepts from different disciplines and examples from different historical times can be related to episodes in his own life; I argue why it is important to supplement a structural analysis with linguistic, phenomenological and hermeneutical ones. (shrink)

Extended Reality (XR) systems, such as Virtual Reality (VR) and Augmented Reality (AR), provide a digital simulation either of a complete environment, or of particular objects within the real world. Today, XR is used in a wide variety of settings, including gaming, design, engineering, and the military. In addition, XR has been introduced into psychology, cognitive sciences and biomedicine for both basic research as well as diagnosing or treating neurological and psychiatric disorders. In the context of XR, the simulated (...) ‘reality’ can be controlled and people may safely learn to cope with their feelings and behavior. XR also enables to simulate environments that cannot easily be accessed or created otherwise. Therefore, Extended Reality systems are thought to be a promising tool in the resocialization of criminal offenders, more specifically for purposes of risk assessment and treatment of forensic patients. Employing XR in forensic settings raises ethical and legal intricacies which are not raised in case of most other healthcare applications. Whereas a variety of normative issues of XR have been discussed in the context of medicine and consumer usage, the debate on XR in forensic settings is, as yet, straggling. By discussing two general arguments in favor of employing XR in criminal justice, and two arguments calling for caution in this regard, the present paper aims to broaden the current ethical and legal debate on XR applications to their use in the resocialization of criminal offenders, mainly focusing on forensic patients. (shrink)

Originally published in 1970 this title commemorates the men and ideas that started, inspired and established a pioneer institution in British psychiatry. Based on the impetus of Freudian and related innovations after the First World War, the Tavistock Clinic offered treatment, training and research facilities in the field of neurosis, child guidance and later on group relations. Dr Dicks, who had been associated for nearly forty years with the work and personalities that helped to develop the Tavistock venture, describes (...) the struggles and capacity for survival of the clinic. He shows how, belonging neither to the older classical psychiatry nor to orthodox psychoanalysis, and suspect to both, the Clinic nevertheless became increasingly used by the rest of the profession as a psychotherapeutic resource. Dr Dicks describes the influence of the Tavistock on the medical, psychological and social work scene both before and after the Second World War, and assesses its achievements as a centre of psycho- and socio-dynamic thinking. The Tavistock is shown as a pioneer _sui generis_, launching psychosomatic research and initiating the exciting ventures in social psychiatry associated with the Army in the Second World War. As the Tavistock was the outcome of work with shell-shock victims in the first war, so its offspring, the Institute of Human Relations, was the natural continuation of the military effort in man-management, morale and group dynamic studies. The book includes an account of the inter-relationship between the Clinic, now part of the National Health Service, and the Institute, a private corporation. Still going strong as part of the Tavistock and Portman NHS Foundation Trust today this is an opportunity to revisit its early history. (shrink)

Originally published in 1970 this title commemorates the men and ideas that started, inspired and established a pioneer institution in British psychiatry. Based on the impetus of Freudian and related innovations after the First World War, the Tavistock Clinic offered treatment, training and research facilities in the field of neurosis, child guidance and later on group relations. Dr Dicks, who had been associated for nearly forty years with the work and personalities that helped to develop the Tavistock venture, describes (...) the struggles and capacity for survival of the clinic. He shows how, belonging neither to the older classical psychiatry nor to orthodox psychoanalysis, and suspect to both, the Clinic nevertheless became increasingly used by the rest of the profession as a psychotherapeutic resource. Dr Dicks describes the influence of the Tavistock on the medical, psychological and social work scene both before and after the Second World War, and assesses its achievements as a centre of psycho- and socio-dynamic thinking. The Tavistock is shown as a pioneer _sui generis_, launching psychosomatic research and initiating the exciting ventures in social psychiatry associated with the Army in the Second World War. As the Tavistock was the outcome of work with shell-shock victims in the first war, so its offspring, the Institute of Human Relations, was the natural continuation of the military effort in man-management, morale and group dynamic studies. The book includes an account of the inter-relationship between the Clinic, now part of the National Health Service, and the Institute, a private corporation. Still going strong as part of the Tavistock and Portman NHS Foundation Trust today this is an opportunity to revisit its early history. (shrink)

Psychoanalysis was introduced to Greece in 1915 by the progressive educator Manolis Triantafyllidis and was further elaborated by Marie Bonaparte, Freud’s friend and member of the Greek royal family, and her psychoanalytic group in the aftermath of the Second World War. However, the accumulated traumas of the Nazi occupation, the Greek Civil War, the post-Civil-War tension between the Left and the Right, the military junta and the social and political conditions of post-war Greece led this project and all attempts (...) to establish psychoanalysis in Greece, to failure and dissolution. The restoration of democracy in 1974 and the rapid social changes it brought was a turning point in the history of Greek psychoanalysis: numerous psychoanalysts, who had trained abroad and returned after the fall of the dictatorship, were hired in the newly established Greek National Health Service, and contributed to the reform of Greek psychiatry by offering the option of psychoanalytic psychotherapy to the non-privileged. This article draws on a range of unexplored primary sources and oral history interview material, in order to provide the first systematic historical account in the English language of the complex relationship between psychoanalysis and Greek society, and the contribution of psychoanalytic psychotherapy to the creation of the Greek welfare state. In so doing, it not only attempts to fill a lacuna in the history of contemporary Greece, but also contributes to the broader historiography of psychotherapy and of Europe. (shrink)

A number of textbooks in the field of psychoanalysis go so far as to suggest that Freud would have been astonished by the implications of the French psychoanalytic movement in the “1968 moment”. The position today dominant in the psychoanalytic mainstream is that in the aftermath of those years when the movement had drifted astray, psychiatry and psychoanalysis eventually attained their “age of reason”. In parallel, this doxa foregrounds what is a rather singular historiography concerning the relations between analysts (...) and the military institution in the interwar years. Didn’t Freud, after all, discover the death-bearing repetition complex through the problem of war trauma? And if this is the case, then what is termed the « Freudian indifferentiation » could be coupled with what is qualified as the « Freudian pessimism », object of an interminable and predictable commentary in contemporary psychoanalysis. The consequences are the relegation and marginalization of a number of other crucial facts, which together sketch the contours of an entirely different history. The issue of such a popular history of psychoanalysis, and of the factors leading to its being forgotten by the doxa of the 1980s, is addressed in the present article. (shrink)

Many strands are woven into the ideas and work of Jeffrey Gray. From a background of classical languages and a spell in military intelligence spent honing skills in languages and typing, he took two BA degrees (in modern languages and psychology) at Oxford University. He then trained as a clinical psychologist at the Institute of Psychiatry (IOP), London, capping this with a PhD on the sources of emotional behaviour.

This article traces the career arc of Dutch psychoanalyst Joost A. M. Meerloo by examining his biography and his psychology of interrogation and confession. His life story, particularly his experiences during the German occupation of the Netherlands and his escape to England during World War II, shaped his views on these issues, as well as his rise to prominence as an expert on these topics in the United States. His psychoanalytic perspectives on interrogation and confession, including false confession, reflected the (...) zeitgeist of the First Wave of Cold War interrogation tactics and related scholarship. His career as a scholar of interrogation faded with the study of distinct interrogation tactics used by communists during the Korean War, the emergence of experimental social psychology, and a growing cohort of scholars who rejected his psychoanalytic views in favor of more contemporary approaches. For these reasons, his work remains undervalued, increasing the risks that today’s scholars will fail to recognize his larger contributions and his warnings about vulnerability and psychologists’ roles in military interrogations. The article reviews the rise and fall of the career of Joost A. M. Meerloo as a scholar of Cold War interrogation, including his contributions and his unheeded warnings about vulnerability and psychologists’ roles in military interrogations. (shrink)

Is it ethical to treat a death row inmate only to stabilize him or her for eventual execution? What happens when a military provider receives highly sensitive intelligence from a client?

Is it ethical to treat a death row inmate only to stabilize him or her for eventual execution? What happens when a military provider receives highly sensitive intelligence from a client? How can clinicians refuse costly gifts from clients without damaging the therapeutic relationship? Should a therapist disclose a client's suicidal intent to the authorities? In Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice, these and other real-life scenarios constitute a comprehensive and definitive ethics casebook for mental health (...) professionals. Inspired by the many difficult situations they themselves have faced, an eminent group of accomplished mental health clinicians provide first-hand accounts of ethical problems that defy boilerplate solutions. Each chapter begins with a compelling and ethically complex case followed by an illustrative yet succinct analysis of the key ethical issues present and a personal reflection on the case itself, along with the process of ethical reasoning used to arrive at a final decision. Every case concludes with key recommendations for promoting ethical practice within an often challenging work setting. Highlighting the human aspect of ethics in mental health practice through the use of mesmerizing narratives while also provoking the reader to reflect upon what is the "right" thing to do, Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice offers trainees and seasoned professionals alike invaluable informative models for dealing with ethical dilemmas, as well as the inspiration to confront seemingly insurmountable clinical problems. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Explication or Explanation?Giovanni Stanghellini (bio) and Mario Rossi Monti (bio)Keywordsexplanation, explication, interpretation, phenomenology, psychopathologyMike Martin's paper raises questions about the process and the effectiveness of psychotherapy in the case of an Iraq war veteran, Colin, described by Dr. Bailey in his essay “A Painful Lack of Wounds”: does psychotherapy succeed? If so, why does it succeed? How far is and should psychotherapy be value free? The clinical phenomenon discussed (...) in this paper is defined as a serious but not severe depression occurring upon returning from the Iraq war. The impression, from the vantage point of a psychotherapist, is that too many details are lacking from the account that is provided and that the case is hurriedly explained away invoking a naturalistic evolutionary model.The psychotherapeutic, as well as the clinical (Stanghellini 2007) and the research (Stanghellini and Ballerini 2008) interview is a quest for meaning. Its first concern is an accurate unfolding of subjective experiences and the organization of these experiences according to a pattern of sense that is immanent to the experiences themselves; the interpretation or the explanation of these experiences according to a model that is not immanent in the clinical material itself may come as a later step.The first step may be called the explication of case material. It consists in bringing out the raw feelings of the patient's experiences and the personal meanings that the patient attributes to his experiences. Here is a list a questions that a clinician would (tactfully) address to Dr. Bailey's patient to enrich the clinical explication of this case (a great deal of questions, of course, can be found also in Martin's [2009] commentary): What are the phenomenal features of Colin's “depression”? Which thoughts and emotions are involved? Anxiety? Anguish? Fear? Frustration? Anger? Irritability? Sadness? Apathy? Guilt? Shame? Which other experiences are involved, for example, physical pains or somatic symptoms? What is it like for Colin not to have proven his “manhood” in Iraq? What does it mean for him to be a “man”? Why does he want to be a man? How does it look like his “ideal” man? How does he exactly feel and what does he mean by “being a wimp”?We also need to illuminate the internal relations of dependence between these experiences: are these phenomena each one independent form the others, or can we find a meaning organizer among them (Rossi Monti and Stanghellini 1996), for instance a core emotion that let us understand the manifold of symptoms as a unitary structure? Does Colin feel angry for not being assigned to a combat duty? Or guilty because he did not object to this? Or does he feel ashamed because he was judged not suitable for a combat duty? Apparently, there is a “basic” wound here, maybe a narcissistic one—the epicenter of a story that reminds us of Ajax's “madness” when the Greek generals did not offer [End Page 237] him Achilles’ weapons. Looking for this wound with Colin and through Colin's words is much different from endorsing an armchair theory of his “depression.” The latter reminds us of someone who feels full after reading the restaurant menu.We need to look for the relations between these clinical phenomena and the situation (event) in which they take place: what do we know about the pathogenetic situation? We know that the same person in different situations can behave and be valued in opposite ways. As Kretschmer pointed out, persons that in times of peace psychiatrists would label as psychopathic personalities in troubled times become celebrated heroes. In the same manner, a boy with an antisocial personality disorder can become a hero if he put his “qualities” to the service of military special forces. In particular, what did Colin expect from enrolling in the army? His expectations were his own or someone else's hopes? What happened exactly in Iraq? What does “Iraq” mean for the patient? What did he do and what did he not do to become a “man” or a hero there? Is Iraq the only place where someone can demonstrate to be a man? Is being a hero the only valuable way... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Inappropriate RegretClaire Pouncey (bio)Keywordsanxiety, inappropriate guilt, moral sentiments, supererogation, regretThis delightful and provocative vignette has many interesting clinical facets, and I thank Dr. Bailey for his candid introspection. For me, this essay calls attention to an asymmetry in our culture, in which women tend to feel more comfortable than men in expressing anxieties about our unpredictable and often dangerous world. Women's fears, however, often are dismissed or minimized, revealing (...) an overall social discomfort with expressed anxiety, and a sense that anxiety itself is, somehow, feminine. When I read Dr. Bailey's essay, I am struck that two self-aware men need the metaphors of war and heroism to address their own anxieties.The vignette builds around a soldier, Colin, who presents with guilt about having been deployed to Iraq, but not engaging in combat. Guilt is a moral sentiment, a feeling that one ought to have acted otherwise in a given situation. It is a self-imposed sanction for a moral failure. In mental health care, we use the term ‘inappropriate guilt’ to describe a clinical symptom commonly associated with depression. Clinicians understand inappropriate guilt as a manifestation of the self-criticism and low self-esteem often associated with depressive disorders. In Colin's case, it did fit with a constellation of symptoms that suggested depression. Dr. Bailey's essay explores the psychodynamics of Colin's guilt, and possible responses to it.As I understand the situation, Colin sees himself as having a moral obligation to exceed his contractual obligation to the military. In the terminology of ethics, he imposes upon himself a duty to be supererogatory, that is, a duty to go beyond the call of duty, which some moral philosophers have considered oxymoronic. For Colin to feel guilty about not engaging in combat, he must have understood a moral obligation to participate in combat that goes beyond his obligation to follow orders. It seems to me that soldiers have a nonmoral, contractual obligation to train, deploy, follow orders, and if circumstances so dictate, fight. But if the circumstances do not lead to combat (Nagel might call this good moral luck), it does not seem to me that a soldier has failed either a contractual or a moral obligation by not being sent into battle. Supererogation aside, to my mind, Colin's guilt is inappropriate: he is holding himself to an unreasonable moral standard, according to which he is required not only to do what the military demands, but also to sacrifice or suffer from the experience in some meaningful way.Although the notion of inappropriate guilt fits with the description of Colin's depression, it occurs to me that the word ‘guilt’ may be too strong here. Perhaps what Dr. Bailey is seeing is better characterized as ‘inappropriate regret’ that Colin missed “his last, best chance to be a hero.” ‘Regret’ is the sentiment that one could have (rather than should have) acted otherwise, perhaps to a better eventual end. Dr. Bailey agrees that Colin's guilt is inappropriate, that no one is ever required [End Page 233] to be a hero. But he seems to share, and even encourage, what I am calling Colin's ‘inappropriate regret,’ which suggests that if Colin had engaged in combat, he would not experience feelings of helplessness or insecurity in our uncertain world. What fascinates me is that Dr. Bailey accepts this premise, and even reflects on his own fears about self-protection in his own urban setting.Rather than challenging it, Dr. Bailey clearly shares Colin's concern that he may not be able to respond adequately should a real threat arise. Both therapist and patient seem to want reassurance that they can keep themselves and their families safe when danger strikes. But this is not a matter of achieving or going beyond the call of duty. Rather, it is an expression of familiar and diffuse anxiety that is unrelated to wartime. In the essay, heroism seems to serve as a metaphor, a filter that makes the expression of anxiety more palatable to both the patient and the therapist. I am fascinated that these two sensitive and introspective interlocutors need to filter their anxieties through... (shrink)

Mental disorder is an urgent and growing public health problem.1 Scientific investigation of this problem has the pragmatic goals of identifying the causes of mental disorders and developing strategies to effectively treat them. Philosophers of psychiatry have participated in the inquiry into the empirical examination of mental disorders, predominantly by debating whether psychopathology is a legitimate target of scientific inquiry and, if so, how mental disorders should be explained, predicted, and intervened on. However, as I show in this paper, (...) these philosophical discussions have mostly neglected the actual state of inquiry in psychiatry and relevant disciplines, as well as the first-person experiences... (shrink)

Various traditions in mental health care, such as phenomenological, and existential and cognitive-behavioral psychotherapy, implicitly or explicitly acknowledge that a disruption of the self, or the person, or the agent is among the common denominators of different mental disorders. They often emphasize the importance of understanding patients as reasonsresponsive, in their full mental health relevant complexity, if their mental disorder is to be treated successfully. The centrality of the concept of the self is not mirrored in the mainstream scientific approaches (...) in psychiatry however; the self has rarely been considered as the object of scientific research, the empirical investigation of which might yield successful explanations of and interventions in mental disorders. Thus, even though self-related phenomena are clinically relevant in so far as they give important information about a mental disorder to the clinician and help the development of effective interventions, they are not considered among the scientifically relevant properties of mental disorders. Leaving the self-related phenomena out of the scientific research on mental disorders can be attributed to the presupposition that the self is not empirically tractable and its use will hinder psychiatry’s goal to be scientific. In this paper, taking issue with this, I argue the self is empirically tractable, and its use as a target of research will not hinder psychiatry’s scientific commitments. (shrink)

While few soldiers may have read the works of Epictetus or Marcus Aurelius, it is undoubtedly true that the ancient philosophy known as Stoicism guides the actions of many in the military. Soldiers and seamen learn early in their training "to suck it up," to endure, to put aside their feelings and to get on with the mission. Stoic Warriors is the first book to delve deeply into the ancient legacy of this relationship, exploring what the Stoic philosophy actually (...) is, the role it plays in the character of the military (both ancient and modern), and its powerful value as a philosophy of life. Marshalling anecdotes from military history--ranging from ancient Greek wars to World War II, Vietnam, and Iraq--Nancy Sherman illuminates the military mind and uses it as a window on the virtues of the Stoic philosophy, which are far richer and more interesting than our popularized notions. Sherman--a respected philosopher who taught at the US Naval Academy--explores the deep, lasting value that Stoicism can yield, in issues of military leadership and character; in the Stoic conception of anger and its control (does a warrior need anger to go to battle?); and in Stoic thinking about fear and resilience, grief and mourning, and the value of camaraderie and brotherhood. Sherman concludes by recommending a moderate Stoicism, where the task for the individual, both civilian and military, youth and adult, is to temper control with forgiveness, and warrior drive and achievement with humility and humor. Here then is a perceptive investigation of what makes Stoicism so compelling not only as a guiding principle for the military, but as a philosophy for anyone facing the hardships of life. (shrink)

I explain the notion of contributory injustice, a kind of epistemic injustice, and argue that it occurs within psychiatric services, affecting those who hear voices. I argue that individual effort on the part of clinicians to avoid perpetrating this injustice is an insufficient response to the problem; mitigating the injustice will require open and meaningful dialogue between clinicians and service user organisations, as well as individuals. I suggest that clinicians must become familiar with and take seriously concepts and frameworks for (...) understanding mental distress developed in service user communities, such as Hearing Voices Network, and by individual service users. This is especially necessary when these concepts and frameworks explicitly conflict with medical or technical understandings of users’ experiences. I defend this proposal against three objections. (shrink)

This essay focuses on the meaning that the term “experimental” acquires within spiritualism during the second half of the nineteenth century. It builds upon Paul Janet’s notions of “experience” and “experimentation” in psychology, by stressing the role of physiology and pathology in his reflection. Regardless of the role the concept of “experimentalism” took on in Victor Cousin’s psychology, which arguably indicated more an “internal affection” than actual experimentation, in Janet’s spiritualism the term regains its original meaning of empirical verification. Janet (...) highlights the importance of madness to the development of a new psychological paradigm that could reconcile philosophy and medicine, reason and experience, by taking up pathology as a form of natural and indirect experimentation. (shrink)

Because psychiatry deals specifically with ‘mental’ suffering, its efforts are always centrally involved with the meaningful world of human reality. As such, it sits at the interface of a number of discourses: genetics and neuroscience, psychology and sociology, anthropology, philosophy, and the humanities. Each of these provides frameworks, concepts, and examples that seek to assist our attempts to understand mental distress and how it might be helped. However, these discourses work with different assumptions, methodologies, values, and priorities. Some are (...) in dispute with one another. At various times in the history of psychiatry, a particular form of understanding has become dominant and worked to marginalize .. (shrink)

Neuropsychiatrist Michael T. H. Wong argues that the notions of soul, mind, brain, self and consciousness are no longer adequate on their own to explain humanity. He formulates a “third discourse” that brings philosophy neuroscience theology and psychiatry together as an innovative multilayered narrative for the person in the twenty-first century.

A singularity of the famous Art of War《孫子兵法》 attributed to Sunzi is the way this work conceives of knowledge as a resource for the military strategist. The idea is new in Chinese tradition, and new in the worldwide context of thinking about strategy, where Sunzi’s ideas about the value of knowledge are far in advance of the thinking of Western theorists like Machiavelli or especially Clausewitz. In this paper I analyze the role of knowledge in the Sunzi theory of (...) strategy, and show the consistency of what this work says about knowledge with a philosophical idea of knowledge that emerges in Warring States texts of diverse genres. (shrink)

Psychiatry is a discipline on the border between the biomedical sciences on the one hand and the humanities and social sciences (most notably psychology and anthropology) on the other. This unique position undoubtedly contributes to the attractiveness of psychiatry as a medical specialism for many young doctors, but it also causes significant problems. Unlike other medical disciplines, in which the definitions of diseases are based on objective, measurable pathophysiological underpinnings, psychiatric diagnosis and classification has been based on descriptions (...) of inherently subjective mental and behavioral symptoms that are supposed to be deviant from "normal" psychology or behavior, as reflected in the current .. (shrink)

This study compared the effects of three education models, namely, the bag-of-virtues, values clarification, and virtue ethics models, through qualitative and quantitative approaches. In the quantitative study, a between-subjects design was adopted in sampling 120 freshman cadets from a Taiwanese military academy. For the qualitative study, focus group interviews were conducted with 10 freshman cadets. The results show that the VC model was the most effective among the three moral education models, followed by the VE and BV models.

The question “What is the relationship between the self and mental disorder?” is especially important for mental health professionals interested in understanding and treating patients, as most mental disorders are intimately tied to self‐related concerns, such as loss of self‐esteem and self‐control, or diminished agency and autonomy. Philosophy, along with the cognitive and behavioral sciences, offers a wealth of conceptual and empirical resources to answer this question, as the concepts of the self and psychopathology have occupied a central place in (...) these fields since their inception. Interestingly, and unfortunately, however, scientific psychiatry, in its approach to mental disorder as primarily a cluster of signs and symptoms has been slow in acknowledging the advances in conceptualizing and investigating mental disorders in relation to the self. The article addresses this problem and offers solutions for better cross‐fertilization between empirical and philosophical inquiry into the self and psychiatric research on mental disorders. The first part evaluates what empirically informed philosophical inquiry and philosophically informed empirical inquiry offer to the examination of the relationship between the self and mental disorders. The second part argues that scientific psychiatry has missed opportunities to find effective treatments for mental disorders because of its insularity from debates in naturalistic philosophy and cognitive and behavioral sciences. Psychiatry has much to gain from the conceptual, scientific, and clinical resourcefulness of philosophy's collaboration with the cognitive and behavioral sciences. (shrink)

Can there be scientific theories in psychology, medicine or psychiatry? I approach this question through an in-depth analysis of a typical experiment for clinical depression involving the monoamine hypothesis, drug action, and placebos. I begin my discussion with a reconstruction of Adolph Grünbaum's conceptual analysis of 'placebo,' and then use his notion of "intentional placebo" to discuss a typical experiment using the monoamine hypothesis, two drugs and a placebo. I focus on the theoretical aspects of the experiment, especially on (...) the notion of causal explanation. I then raise five conceptual and methodological problems for theory construction. These problems focus on questions of the causal efficacy of placebos and drugs; ad hoc versus ceteris paribus explanations in biomedicine and psychology; and the falsifiability of the monoamine hypothesis. I conclude by pointing out the need for further, rigorous philosophical analysis concerning the possibility of theory construction in psychology, medicine, or psychiatry. (shrink)