Alex Fornito and Edward T. Bullmore
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780195393804
- eISBN:
- 9780199863495
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195393804.003.0004
- Subject:
- Neuroscience, Disorders of the Nervous System
Functional magnetic resonance imaging (fMRI) has rapidly emerged as an important tool for understanding the neural correlates of myriad cognitive and emotional processes. By offering a direct window ...
More
Functional magnetic resonance imaging (fMRI) has rapidly emerged as an important tool for understanding the neural correlates of myriad cognitive and emotional processes. By offering a direct window into brain activity, fMRI promised to usher in a new era of psychiatry, in which clinical decisions would be based on objective neurobiological measures rather than often-contentious symptom classifications. However, research conducted over the past two decades has failed to realise this goal, and fMRI remains an unutilized tool in the psychiatric clinic. In this chapter, we consider reasons why fMRI has failed to fulfill its promise as a clinically useful tool for psychiatrists and consider recent progress towards this goal in three key clinical domains: diagnosis, prediction and treatment monitoring. In particular, we focus on moving away from using traditional case-control comparisons of mean differences in brain activation to more sophisticated statistical techniques using brain activity patterns to classify individual participants to key clinical outcome variables, such as diagnosis or treatment response.Less
Functional magnetic resonance imaging (fMRI) has rapidly emerged as an important tool for understanding the neural correlates of myriad cognitive and emotional processes. By offering a direct window into brain activity, fMRI promised to usher in a new era of psychiatry, in which clinical decisions would be based on objective neurobiological measures rather than often-contentious symptom classifications. However, research conducted over the past two decades has failed to realise this goal, and fMRI remains an unutilized tool in the psychiatric clinic. In this chapter, we consider reasons why fMRI has failed to fulfill its promise as a clinically useful tool for psychiatrists and consider recent progress towards this goal in three key clinical domains: diagnosis, prediction and treatment monitoring. In particular, we focus on moving away from using traditional case-control comparisons of mean differences in brain activation to more sophisticated statistical techniques using brain activity patterns to classify individual participants to key clinical outcome variables, such as diagnosis or treatment response.
Rocco J. Gennaro (ed.)
- Published in print:
- 2015
- Published Online:
- May 2016
- ISBN:
- 9780262029346
- eISBN:
- 9780262330213
- Item type:
- book
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262029346.001.0001
- Subject:
- Philosophy, Moral Philosophy
In Disturbed Consciousness, philosophers and other scholars examine various psychopathologies in light of specific philosophical theories of consciousness. The contributing authors—some of them ...
More
In Disturbed Consciousness, philosophers and other scholars examine various psychopathologies in light of specific philosophical theories of consciousness. The contributing authors—some of them discussing or defending their own theoretical work—consider not only how a theory of consciousness can account for a specific psychopathological condition but also how the characteristics of a psychopathology might challenge such a theory. Thus one essay defends the higher-order thought (HOT) theory of consciousness against the charge that it cannot account for somatoparaphrenia (a delusion in which one denies ownership of a limb). Another essay argues that various attempts to explain away such anomalies within subjective theories of consciousness fail. Other essays consider such topics as the application of a model of unified consciousness to cases of brain bisection and dissociative identity disorder; prefrontal and parietal underconnectivity in autism and other psychopathologies; self-deception and the self-model theory of subjectivity; schizophrenia and the vehicle theory of consciousness; and a shift in emphasis away from an internal (or brainbound) approach to psychopathology to an interactive one. Each essay offers a distinctive perspective from the intersection of philosophy, consciousness research, and psychiatry.Less
In Disturbed Consciousness, philosophers and other scholars examine various psychopathologies in light of specific philosophical theories of consciousness. The contributing authors—some of them discussing or defending their own theoretical work—consider not only how a theory of consciousness can account for a specific psychopathological condition but also how the characteristics of a psychopathology might challenge such a theory. Thus one essay defends the higher-order thought (HOT) theory of consciousness against the charge that it cannot account for somatoparaphrenia (a delusion in which one denies ownership of a limb). Another essay argues that various attempts to explain away such anomalies within subjective theories of consciousness fail. Other essays consider such topics as the application of a model of unified consciousness to cases of brain bisection and dissociative identity disorder; prefrontal and parietal underconnectivity in autism and other psychopathologies; self-deception and the self-model theory of subjectivity; schizophrenia and the vehicle theory of consciousness; and a shift in emphasis away from an internal (or brainbound) approach to psychopathology to an interactive one. Each essay offers a distinctive perspective from the intersection of philosophy, consciousness research, and psychiatry.
Will Jackson
- Published in print:
- 2013
- Published Online:
- May 2013
- ISBN:
- 9780719088896
- eISBN:
- 9781781705827
- Item type:
- book
- Publisher:
- Manchester University Press
- DOI:
- 10.7228/manchester/9780719088896.001.0001
- Subject:
- History, Imperialism and Colonialism
Kenya Colony, for the British at least, has customarily been imagined as a place of wealthy settler-farmers, sun-lit panoramas and the adventure of safari. Yet for the majority of Europeans who went ...
More
Kenya Colony, for the British at least, has customarily been imagined as a place of wealthy settler-farmers, sun-lit panoramas and the adventure of safari. Yet for the majority of Europeans who went there life was very different. This book offers an unprecedented new account of what was - supposedly - the most picturesque of Britain's colonies overseas. While Kenya's romantic reputation has served to perpetuate the notion that Europeans enjoyed untroubled command, what the lives of Kenya's white insane powerfully describe are stories of conflict, immiseration, estrangement and despair. Crucially, Europeans who became impoverished in Kenya or who transgressed the boundary lines separating colonizer from colonized subverted the myth that Europeans enjoyed a natural right to rule. Because a deviation from the settler ideal was politically problematic, therefore, Europeans who failed to conform to the collective self-image were customarily absented, from the colony itself in the first instance and latterly from both popular and scholarly historical accounts. Bringing into view the lives of Kenya's white insane makes for an imaginative and intellectual engagement with realms of human history that, so colonial ideologies would have us believe, simply were not there. Tracing the pathways that led an individual to the hospital gates, meanwhile, shows up the complex interplay between madness and marginality in a society for which deviance was never intended to be managed but comprehensively denied.Less
Kenya Colony, for the British at least, has customarily been imagined as a place of wealthy settler-farmers, sun-lit panoramas and the adventure of safari. Yet for the majority of Europeans who went there life was very different. This book offers an unprecedented new account of what was - supposedly - the most picturesque of Britain's colonies overseas. While Kenya's romantic reputation has served to perpetuate the notion that Europeans enjoyed untroubled command, what the lives of Kenya's white insane powerfully describe are stories of conflict, immiseration, estrangement and despair. Crucially, Europeans who became impoverished in Kenya or who transgressed the boundary lines separating colonizer from colonized subverted the myth that Europeans enjoyed a natural right to rule. Because a deviation from the settler ideal was politically problematic, therefore, Europeans who failed to conform to the collective self-image were customarily absented, from the colony itself in the first instance and latterly from both popular and scholarly historical accounts. Bringing into view the lives of Kenya's white insane makes for an imaginative and intellectual engagement with realms of human history that, so colonial ideologies would have us believe, simply were not there. Tracing the pathways that led an individual to the hospital gates, meanwhile, shows up the complex interplay between madness and marginality in a society for which deviance was never intended to be managed but comprehensively denied.
Rocco J. Gennaro
- Published in print:
- 2015
- Published Online:
- May 2016
- ISBN:
- 9780262029346
- eISBN:
- 9780262330213
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262029346.003.0001
- Subject:
- Philosophy, Moral Philosophy
This is the first and introductory chapter to the volume entitled Disturbed Consciousness: New Essays on Psychopathology and Theories of Consciousness. Rocco J. Gennaro presents an overview of ...
More
This is the first and introductory chapter to the volume entitled Disturbed Consciousness: New Essays on Psychopathology and Theories of Consciousness. Rocco J. Gennaro presents an overview of philosophical psychopathology, specific disorders of consciousness, and philosophical theories of consciousness. Some background on key terminology and a summary of the essays to follow is also included. Some of the theories of consciousness described are the higher-order thought theory, self-representationalism, and the global workspace theory. A fairly lengthy list of disorders, along with their definitions, is also provided.Less
This is the first and introductory chapter to the volume entitled Disturbed Consciousness: New Essays on Psychopathology and Theories of Consciousness. Rocco J. Gennaro presents an overview of philosophical psychopathology, specific disorders of consciousness, and philosophical theories of consciousness. Some background on key terminology and a summary of the essays to follow is also included. Some of the theories of consciousness described are the higher-order thought theory, self-representationalism, and the global workspace theory. A fairly lengthy list of disorders, along with their definitions, is also provided.
Jennifer L. Lambe
- Published in print:
- 2017
- Published Online:
- September 2017
- ISBN:
- 9781469631028
- eISBN:
- 9781469631042
- Item type:
- book
- Publisher:
- University of North Carolina Press
- DOI:
- 10.5149/northcarolina/9781469631028.001.0001
- Subject:
- History, Latin American History
On the outskirts of Havana lies Mazorra, an asylum known to—and at times feared by—ordinary Cubans for over a century. Since its founding in 1857, the island’s first psychiatric hospital has been an ...
More
On the outskirts of Havana lies Mazorra, an asylum known to—and at times feared by—ordinary Cubans for over a century. Since its founding in 1857, the island’s first psychiatric hospital has been an object of persistent political attention. Drawing on hospital documents and government records, as well as the popular press, photographs, and oral histories, Jennifer L. Lambe charts the connections between the inner workings of this notorious institution and the highest echelons of Cuban politics. Across the sweep of modern Cuban history, she finds, Mazorra has served as both laboratory and microcosm of the Cuban state: the asylum is an icon of its ignominious colonial and neocolonial past and a crucible of its republican and revolutionary futures.
From its birth, Cuban psychiatry was politically inflected, drawing partisan contention while sparking debates over race, religion, gender, and sexuality. Psychiatric notions were even invested with revolutionary significance after 1959, as the new government undertook ambitious schemes for social reeducation. But Mazorra was not the exclusive province of government officials and professionalizing psychiatrists. U.S. occupiers, Soviet visitors, and, above all, ordinary Cubans infused the institution, both literal and metaphorical, with their own fears, dreams, and alternative meanings. Together, their voices comprise the madhouse that, as Lambe argues, haunts the revolutionary trajectory of Cuban history.Less
On the outskirts of Havana lies Mazorra, an asylum known to—and at times feared by—ordinary Cubans for over a century. Since its founding in 1857, the island’s first psychiatric hospital has been an object of persistent political attention. Drawing on hospital documents and government records, as well as the popular press, photographs, and oral histories, Jennifer L. Lambe charts the connections between the inner workings of this notorious institution and the highest echelons of Cuban politics. Across the sweep of modern Cuban history, she finds, Mazorra has served as both laboratory and microcosm of the Cuban state: the asylum is an icon of its ignominious colonial and neocolonial past and a crucible of its republican and revolutionary futures.
From its birth, Cuban psychiatry was politically inflected, drawing partisan contention while sparking debates over race, religion, gender, and sexuality. Psychiatric notions were even invested with revolutionary significance after 1959, as the new government undertook ambitious schemes for social reeducation. But Mazorra was not the exclusive province of government officials and professionalizing psychiatrists. U.S. occupiers, Soviet visitors, and, above all, ordinary Cubans infused the institution, both literal and metaphorical, with their own fears, dreams, and alternative meanings. Together, their voices comprise the madhouse that, as Lambe argues, haunts the revolutionary trajectory of Cuban history.
Ernst Waltraud (ed.)
- Published in print:
- 2016
- Published Online:
- May 2016
- ISBN:
- 9780719097690
- eISBN:
- 9781526104465
- Item type:
- book
- Publisher:
- Manchester University Press
- DOI:
- 10.7228/manchester/9780719097690.001.0001
- Subject:
- History, History of Science, Technology, and Medicine
This edited book offers a systematic critical appraisal of the uses of work and work therapy in psychiatric institutions across the globe, from the late eighteenth to the end of the twentieth ...
More
This edited book offers a systematic critical appraisal of the uses of work and work therapy in psychiatric institutions across the globe, from the late eighteenth to the end of the twentieth century. Contributors explore the daily routine in psychiatric institutions within the context of the wider socio-political and economic conditions. They examine whether work was therapy, part of a regime of punishment, or a means of exploiting free labour. By focusing on mental patients’ day-to-day life in closed institutions, the authors fill a gap in the history of psychiatric regimes. The geographic scope is wide, ranging from Northern America to Japan, India and Western as well as Eastern Europe, and authors engage with broader historical questions, such as the impact of colonialism and communism, the effect of the World Wars, and issues of political governance and care in the community schemes.Less
This edited book offers a systematic critical appraisal of the uses of work and work therapy in psychiatric institutions across the globe, from the late eighteenth to the end of the twentieth century. Contributors explore the daily routine in psychiatric institutions within the context of the wider socio-political and economic conditions. They examine whether work was therapy, part of a regime of punishment, or a means of exploiting free labour. By focusing on mental patients’ day-to-day life in closed institutions, the authors fill a gap in the history of psychiatric regimes. The geographic scope is wide, ranging from Northern America to Japan, India and Western as well as Eastern Europe, and authors engage with broader historical questions, such as the impact of colonialism and communism, the effect of the World Wars, and issues of political governance and care in the community schemes.
Ben Harris
- Published in print:
- 2016
- Published Online:
- May 2016
- ISBN:
- 9780719097690
- eISBN:
- 9781526104465
- Item type:
- chapter
- Publisher:
- Manchester University Press
- DOI:
- 10.7228/manchester/9780719097690.003.0002
- Subject:
- History, History of Science, Technology, and Medicine
This chapter shows the key role played by patient labour in the birth, development, and decline of the hospital treatment of the mentally ill in the United States. Patient labour was present at the ...
More
This chapter shows the key role played by patient labour in the birth, development, and decline of the hospital treatment of the mentally ill in the United States. Patient labour was present at the birth of the asylum, as a key feature of both theory and practice. In the late nineteenth century, its change to non-therapeutic drudgery corresponded with the ascendance of custodial pessimism and the warehousing of the chronically ill poor. Its revival at the start of the twentieth century was engineered by an optimistic alliance of psychotherapists, clergy and physicians, reflecting the national mood of expansionism and financial promise. Soon, however, both Freudians and harried hospital bureaucrats put an end to the idea that work would help individuals overcome their symptoms and re-direct their inner resources. In public asylums it was succeeded by non-therapeutic labour that hospitals relied upon for economic survival. When the asylums were dismantled in the 1970s and 1980s, legal attacks on unpaid patient work played a key role.Less
This chapter shows the key role played by patient labour in the birth, development, and decline of the hospital treatment of the mentally ill in the United States. Patient labour was present at the birth of the asylum, as a key feature of both theory and practice. In the late nineteenth century, its change to non-therapeutic drudgery corresponded with the ascendance of custodial pessimism and the warehousing of the chronically ill poor. Its revival at the start of the twentieth century was engineered by an optimistic alliance of psychotherapists, clergy and physicians, reflecting the national mood of expansionism and financial promise. Soon, however, both Freudians and harried hospital bureaucrats put an end to the idea that work would help individuals overcome their symptoms and re-direct their inner resources. In public asylums it was succeeded by non-therapeutic labour that hospitals relied upon for economic survival. When the asylums were dismantled in the 1970s and 1980s, legal attacks on unpaid patient work played a key role.
James Moran
- Published in print:
- 2016
- Published Online:
- May 2016
- ISBN:
- 9780719097690
- eISBN:
- 9781526104465
- Item type:
- chapter
- Publisher:
- Manchester University Press
- DOI:
- 10.7228/manchester/9780719097690.003.0003
- Subject:
- History, History of Science, Technology, and Medicine
Focusing on the evidence provided by civil trials in lunacy in the American state of New Jersey, this chapter first examines how work was considered in its relationship to madness in everyday life ...
More
Focusing on the evidence provided by civil trials in lunacy in the American state of New Jersey, this chapter first examines how work was considered in its relationship to madness in everyday life outside of an institutional setting. There was a strong link made between work and madness in a society that considered success in work as essential to success in the social organization of the family and the community. Next, this chapter explores how New Jersey’s first lunatic asylum superintendent understood the value of patient labour within his institution. Although asylum work was closely connected to mental health and to varying states of madness the work/madness relationship operated very differently in the new psychiatric settingLess
Focusing on the evidence provided by civil trials in lunacy in the American state of New Jersey, this chapter first examines how work was considered in its relationship to madness in everyday life outside of an institutional setting. There was a strong link made between work and madness in a society that considered success in work as essential to success in the social organization of the family and the community. Next, this chapter explores how New Jersey’s first lunatic asylum superintendent understood the value of patient labour within his institution. Although asylum work was closely connected to mental health and to varying states of madness the work/madness relationship operated very differently in the new psychiatric setting
Dominic A. Sisti, Arthur L. Caplan, and Hila Rimon-Greenspan (eds)
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9780262019682
- eISBN:
- 9780262317245
- Item type:
- book
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262019682.001.0001
- Subject:
- Biology, Bioethics
This book discusses some of the most critical ethical issues in mental health care today, including the moral dimensions of addiction, patient autonomy and compulsory treatment, privacy and ...
More
This book discusses some of the most critical ethical issues in mental health care today, including the moral dimensions of addiction, patient autonomy and compulsory treatment, privacy and confidentiality, and the definition of mental illness itself. Although debates over these issues are ongoing, there are few comprehensive resources for addressing such dilemmas in the practice of psychology, psychiatry, social work, and other behavioral and mental health care professions. This book meets that need, providing foundational background for undergraduate, graduate, and professional courses. Topics include central questions such as evolving views of the morality and pathology of deviant behavior; patient competence and the decision to refuse treatment; recognizing and treating people who have suffered trauma; addiction as illness; the therapist’s responsibility to report dangerousness despite patient confidentiality; and boundaries for the therapist’s interaction with patients.Less
This book discusses some of the most critical ethical issues in mental health care today, including the moral dimensions of addiction, patient autonomy and compulsory treatment, privacy and confidentiality, and the definition of mental illness itself. Although debates over these issues are ongoing, there are few comprehensive resources for addressing such dilemmas in the practice of psychology, psychiatry, social work, and other behavioral and mental health care professions. This book meets that need, providing foundational background for undergraduate, graduate, and professional courses. Topics include central questions such as evolving views of the morality and pathology of deviant behavior; patient competence and the decision to refuse treatment; recognizing and treating people who have suffered trauma; addiction as illness; the therapist’s responsibility to report dangerousness despite patient confidentiality; and boundaries for the therapist’s interaction with patients.
Kelso Cratsley
- Published in print:
- 2017
- Published Online:
- September 2017
- ISBN:
- 9780262035484
- eISBN:
- 9780262341752
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262035484.003.0008
- Subject:
- Psychology, Clinical Psychology
Despite widespread recognition that psychiatry would be better served by a classificatory system based on etiology rather than mere description, it goes without saying that much of the necessary work ...
More
Despite widespread recognition that psychiatry would be better served by a classificatory system based on etiology rather than mere description, it goes without saying that much of the necessary work is yet to be done. Most of it will be empirical, but there are also conceptual issues that need to be addressed. In this chapter I take up the increasingly important question of how mechanistic explanation fits into the larger effort to build a scientifically sound etiological and nosological framework for psychiatry. I sketch a rough picture of what mechanistic explanation should look like in the context of psychiatric research, with a focus on several potential challenges posed by the special features of many psychiatric conditions. These include the role of social and environmental factors, the relatively transient nature of symptoms, the presumably complex organization of underlying systems, and the likelihood that many disorders are the product of a nonstandard developmental course. I suggest that these explanatory challenges can be met with a sufficiently broad notion of mechanism, one that allows for something less than the flawless execution of internal operations, attends to organizational relations both within the mechanism itself and across the wider cognitive system, and appeals to the influence of contextual factors.Less
Despite widespread recognition that psychiatry would be better served by a classificatory system based on etiology rather than mere description, it goes without saying that much of the necessary work is yet to be done. Most of it will be empirical, but there are also conceptual issues that need to be addressed. In this chapter I take up the increasingly important question of how mechanistic explanation fits into the larger effort to build a scientifically sound etiological and nosological framework for psychiatry. I sketch a rough picture of what mechanistic explanation should look like in the context of psychiatric research, with a focus on several potential challenges posed by the special features of many psychiatric conditions. These include the role of social and environmental factors, the relatively transient nature of symptoms, the presumably complex organization of underlying systems, and the likelihood that many disorders are the product of a nonstandard developmental course. I suggest that these explanatory challenges can be met with a sufficiently broad notion of mechanism, one that allows for something less than the flawless execution of internal operations, attends to organizational relations both within the mechanism itself and across the wider cognitive system, and appeals to the influence of contextual factors.
J. L. Cassaniti
- Published in print:
- 2018
- Published Online:
- September 2018
- ISBN:
- 9781501707995
- eISBN:
- 9781501714177
- Item type:
- chapter
- Publisher:
- Cornell University Press
- DOI:
- 10.7591/cornell/9781501707995.003.0001
- Subject:
- Anthropology, Asian Cultural Anthropology
This chapter introduces the landscape of mindfulness practices in the regions of South and Southeast Asia, where people overwhelmingly follow the kind of Theravāda Buddhism from which the modern ...
More
This chapter introduces the landscape of mindfulness practices in the regions of South and Southeast Asia, where people overwhelmingly follow the kind of Theravāda Buddhism from which the modern mindfulness movement emerged. The chapter begins with a question: what kind of mindfulness-based therapeutic interventions are and could be used in a Thai psychiatric hospital, as part of a broader Buddhist cultural environment? It answers this question by introducing the methodological and theoretical project of Remembering the Present, including an overview of the interview and survey-based ethnographic research into sati with over 600 psychiatrists, monks, students, and villagers in Thailand, Burma, and Sri Lanka. It also previews some of the central findings of the book, in relation to what the author calls the TAPES of mindfulness: the ways that people frame mindfulness culturally around issues of Temporality, Affect, Power, Ethics, and Selfhood.Less
This chapter introduces the landscape of mindfulness practices in the regions of South and Southeast Asia, where people overwhelmingly follow the kind of Theravāda Buddhism from which the modern mindfulness movement emerged. The chapter begins with a question: what kind of mindfulness-based therapeutic interventions are and could be used in a Thai psychiatric hospital, as part of a broader Buddhist cultural environment? It answers this question by introducing the methodological and theoretical project of Remembering the Present, including an overview of the interview and survey-based ethnographic research into sati with over 600 psychiatrists, monks, students, and villagers in Thailand, Burma, and Sri Lanka. It also previews some of the central findings of the book, in relation to what the author calls the TAPES of mindfulness: the ways that people frame mindfulness culturally around issues of Temporality, Affect, Power, Ethics, and Selfhood.
Vincenzo Di Nicola
- Published in print:
- 2018
- Published Online:
- January 2019
- ISBN:
- 9780823280261
- eISBN:
- 9780823281602
- Item type:
- chapter
- Publisher:
- Fordham University Press
- DOI:
- 10.5422/fordham/9780823280261.003.0002
- Subject:
- Religion, Philosophy of Religion
While the goal of both clinical work and cultural research generally is the transformation and transcendence of trauma, these communities struggle to characterize trauma as a unified discourse even ...
More
While the goal of both clinical work and cultural research generally is the transformation and transcendence of trauma, these communities struggle to characterize trauma as a unified discourse even within one discipline. This chapter makes three proposals that provide order for the concept of trauma through conceptual dichotomies that divide their discourses: first, the term has accrued a supplementarity or excess, which helps explain the variation between the clinical use of trauma and its cultural avatar; second, theorists must separate the ways the word trauma deployed within the trauma process; third, trauma must be separated radically from Event, which is the subtext of a cultural trauma theory. This philosophical archaeology offers keys of translation between these competing cultural and psychiatric trauma theories, calls to deactivate the desubjectivation associated with trauma, and opens new prospects for interdisciplinary research in these intersecting fields based on the possibilities of the Event.Less
While the goal of both clinical work and cultural research generally is the transformation and transcendence of trauma, these communities struggle to characterize trauma as a unified discourse even within one discipline. This chapter makes three proposals that provide order for the concept of trauma through conceptual dichotomies that divide their discourses: first, the term has accrued a supplementarity or excess, which helps explain the variation between the clinical use of trauma and its cultural avatar; second, theorists must separate the ways the word trauma deployed within the trauma process; third, trauma must be separated radically from Event, which is the subtext of a cultural trauma theory. This philosophical archaeology offers keys of translation between these competing cultural and psychiatric trauma theories, calls to deactivate the desubjectivation associated with trauma, and opens new prospects for interdisciplinary research in these intersecting fields based on the possibilities of the Event.
Frederick H. White
- Published in print:
- 2014
- Published Online:
- January 2015
- ISBN:
- 9780719091643
- eISBN:
- 9781781707449
- Item type:
- book
- Publisher:
- Manchester University Press
- DOI:
- 10.7228/manchester/9780719091643.001.0001
- Subject:
- Literature, World Literature
By the first decade of the twentieth century, Russia was experiencing a decadent period of cultural degeneration. Simultaneous with this artistic response, science was developing ways to identify ...
More
By the first decade of the twentieth century, Russia was experiencing a decadent period of cultural degeneration. Simultaneous with this artistic response, science was developing ways to identify medical conditions that supposedly reflected the health of the entire nation. Leonid Andreev (1871–1919), the leading literary figure of his time, stepped into the breech of this scientific discourse with literary works about degenerates. The spirited social debates on mental illness, morality and sexual deviance which resulted from these works became part of the ongoing battle over the definition and depiction of the irrational, complicated by Andreev’s own publicized bouts with neurasthenia. Specific to the study is the way in which Andreev readily accepted and incorporated scientific conjecture into his cultural production and how these works were in turn cited by medical authorities as confirmation of their theories, creating a circular argument. This book demonstrates the implications of scientific discourse on Russian concepts of mental illness and national health. It examines the concept of pathology in Russia, the influence of European medical discourse, the development of Russian psychiatry, and the role that it had on popular culture by investigating the life and works of Andreev. Although widely discussed in its European context, degeneration theory has not been afforded the same scholarly attention in Russian cultural studies. As a result, this study extends and challenges scholarship on the Russian fin de siècle, the emergence of psychiatry as a new medical science, and the role that art played in the development of this objective science.Less
By the first decade of the twentieth century, Russia was experiencing a decadent period of cultural degeneration. Simultaneous with this artistic response, science was developing ways to identify medical conditions that supposedly reflected the health of the entire nation. Leonid Andreev (1871–1919), the leading literary figure of his time, stepped into the breech of this scientific discourse with literary works about degenerates. The spirited social debates on mental illness, morality and sexual deviance which resulted from these works became part of the ongoing battle over the definition and depiction of the irrational, complicated by Andreev’s own publicized bouts with neurasthenia. Specific to the study is the way in which Andreev readily accepted and incorporated scientific conjecture into his cultural production and how these works were in turn cited by medical authorities as confirmation of their theories, creating a circular argument. This book demonstrates the implications of scientific discourse on Russian concepts of mental illness and national health. It examines the concept of pathology in Russia, the influence of European medical discourse, the development of Russian psychiatry, and the role that it had on popular culture by investigating the life and works of Andreev. Although widely discussed in its European context, degeneration theory has not been afforded the same scholarly attention in Russian cultural studies. As a result, this study extends and challenges scholarship on the Russian fin de siècle, the emergence of psychiatry as a new medical science, and the role that art played in the development of this objective science.
Charles E. Rosenberg
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9780262019682
- eISBN:
- 9780262317245
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262019682.003.0001
- Subject:
- Biology, Bioethics
Since the 19th century, we have come to think of disease in terms of specific entities--entities defined and legitimated in terms of characteristic somatic mechanisms. Since the last third of that ...
More
Since the 19th century, we have come to think of disease in terms of specific entities--entities defined and legitimated in terms of characteristic somatic mechanisms. Since the last third of that century, we have expanded would-be disease categories to include an ever-broader variety of emotional pain, idiosyncrasy, and culturally unsettling behaviors. Psychiatry has been the residuary legatee of these developments, developments that have always been contested at the ever-shifting boundary between disease and deviance, feeling and symptom, the random and the determined, the stigmatized and the value-free. Even in our era of reductionist hopes, psychopharmaceutical practice, and corporate strategies, the legitimacy of many putative disease categories will remain contested. The use of the specific disease entity model will always be a reductionist means to achieve necessarily holistic ends, both in terms of cultural norms and the needs of suffering individuals. Bureaucratic rigidities and stakeholder conflicts structure and intensify such boundary conflicts, as do the interests and activism of an interested lay public.Less
Since the 19th century, we have come to think of disease in terms of specific entities--entities defined and legitimated in terms of characteristic somatic mechanisms. Since the last third of that century, we have expanded would-be disease categories to include an ever-broader variety of emotional pain, idiosyncrasy, and culturally unsettling behaviors. Psychiatry has been the residuary legatee of these developments, developments that have always been contested at the ever-shifting boundary between disease and deviance, feeling and symptom, the random and the determined, the stigmatized and the value-free. Even in our era of reductionist hopes, psychopharmaceutical practice, and corporate strategies, the legitimacy of many putative disease categories will remain contested. The use of the specific disease entity model will always be a reductionist means to achieve necessarily holistic ends, both in terms of cultural norms and the needs of suffering individuals. Bureaucratic rigidities and stakeholder conflicts structure and intensify such boundary conflicts, as do the interests and activism of an interested lay public.
Ralph B. Little and Edward A. Strecker
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9780262019682
- eISBN:
- 9780262317245
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262019682.003.0002
- Subject:
- Biology, Bioethics
This paper presents an early example of empirical applied ethics in which the authors survey psychiatrists about their views on an array of array of common ethical issues.
This paper presents an early example of empirical applied ethics in which the authors survey psychiatrists about their views on an array of array of common ethical issues.
Toksoz B. Karasu
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9780262019682
- eISBN:
- 9780262317245
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262019682.003.0003
- Subject:
- Biology, Bioethics
The author addresses the ethics of psychotherapy in terms of the interface between science and ethics, the goals of treatment, the therapeutic relationship, and special issues of confidentiality and ...
More
The author addresses the ethics of psychotherapy in terms of the interface between science and ethics, the goals of treatment, the therapeutic relationship, and special issues of confidentiality and therapist-patient sex. He considers the problems of multiple therapeutic modalities, dual allegiance of the therapist, the therapeutic use (and abuse) of power, and issues of dependency and suggests ways to maximize the clinician’s exercise of ethical choices. Ethical dilemmas in psychotherapy are not entirely soluble; ultimately, the therapist, guided by his or her profession as a group, still be able to find answers to the complex problems that inevitably arise.Less
The author addresses the ethics of psychotherapy in terms of the interface between science and ethics, the goals of treatment, the therapeutic relationship, and special issues of confidentiality and therapist-patient sex. He considers the problems of multiple therapeutic modalities, dual allegiance of the therapist, the therapeutic use (and abuse) of power, and issues of dependency and suggests ways to maximize the clinician’s exercise of ethical choices. Ethical dilemmas in psychotherapy are not entirely soluble; ultimately, the therapist, guided by his or her profession as a group, still be able to find answers to the complex problems that inevitably arise.
Jennifer Radden and John Z. Sadler
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9780262019682
- eISBN:
- 9780262317245
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262019682.003.0004
- Subject:
- Biology, Bioethics
In this discussion by a clinician and a philosopher, clinical scenarios using exchanges and inner monologue illustrate key aspects of virtues. Virtues are acquired through habituation; they are ...
More
In this discussion by a clinician and a philosopher, clinical scenarios using exchanges and inner monologue illustrate key aspects of virtues. Virtues are acquired through habituation; they are habits of mind as much as behavior; they are as a group heterogeneous, and individually composite; they involve affective responses; they are not impartial; they are compatible with the “role morality” required of professionals; they are responses to particular temptations and weaknesses; and they include, in the capacity for practical judgment known as phronesis, a way of resolving many of the conflicts and dilemmas that arise in practice. The virtue approach to ethics will likely be most useful in the educational setting where practitioners are learning clinical skills and socialized into the broad ethos of professional practice. Aspects of this educational effort are briefly reviewed, including whether it ought to be undertaken at all, whether the effort to teach virtues is possible, and, if so, how it can be achieved.Less
In this discussion by a clinician and a philosopher, clinical scenarios using exchanges and inner monologue illustrate key aspects of virtues. Virtues are acquired through habituation; they are habits of mind as much as behavior; they are as a group heterogeneous, and individually composite; they involve affective responses; they are not impartial; they are compatible with the “role morality” required of professionals; they are responses to particular temptations and weaknesses; and they include, in the capacity for practical judgment known as phronesis, a way of resolving many of the conflicts and dilemmas that arise in practice. The virtue approach to ethics will likely be most useful in the educational setting where practitioners are learning clinical skills and socialized into the broad ethos of professional practice. Aspects of this educational effort are briefly reviewed, including whether it ought to be undertaken at all, whether the effort to teach virtues is possible, and, if so, how it can be achieved.
Paul S. Appelbaum
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9780262019682
- eISBN:
- 9780262317245
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262019682.003.0005
- Subject:
- Biology, Bioethics
Advance directives have been one of the more promising innovations in recent years to give patients a greater voice in their psychiatric treatment. The author describes the clinical-legal ...
More
Advance directives have been one of the more promising innovations in recent years to give patients a greater voice in their psychiatric treatment. The author describes the clinical-legal implications of the Hargrave vs. Vermont. Hargrave represents a continuation of the battle over the right of psychiatric patients to refuse treatment that began in the 1970s.Less
Advance directives have been one of the more promising innovations in recent years to give patients a greater voice in their psychiatric treatment. The author describes the clinical-legal implications of the Hargrave vs. Vermont. Hargrave represents a continuation of the battle over the right of psychiatric patients to refuse treatment that began in the 1970s.
Arthur L. Caplan
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9780262019682
- eISBN:
- 9780262317245
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262019682.003.0006
- Subject:
- Biology, Bioethics
American bioethics affords extraordinary respect to the values of personal autonomy and patient self-determination. Many would argue that the most significant achievement deriving from bioethics in ...
More
American bioethics affords extraordinary respect to the values of personal autonomy and patient self-determination. Many would argue that the most significant achievement deriving from bioethics in the past 40 years has been to replace a paternalistic model of health provider–patient relationships with one that sees patient self-determination as the normative foundation for practice. This shift away from paternalism towards respect for self-determination has been on going in behavioral and mental health as well, especially as it is reflected in the ‘recovery movement’. As a result of the emphasis placed on patient autonomy, arguments in favor of mandatory treatment are rare and often half-hearted. Can a case be made which acknowledges the centrality and importance of autonomy but which would still deem ethical mandatory treatment for addicts? I think it can.Less
American bioethics affords extraordinary respect to the values of personal autonomy and patient self-determination. Many would argue that the most significant achievement deriving from bioethics in the past 40 years has been to replace a paternalistic model of health provider–patient relationships with one that sees patient self-determination as the normative foundation for practice. This shift away from paternalism towards respect for self-determination has been on going in behavioral and mental health as well, especially as it is reflected in the ‘recovery movement’. As a result of the emphasis placed on patient autonomy, arguments in favor of mandatory treatment are rare and often half-hearted. Can a case be made which acknowledges the centrality and importance of autonomy but which would still deem ethical mandatory treatment for addicts? I think it can.
Margery Gans and Willam B. Gunn Jr.
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9780262019682
- eISBN:
- 9780262317245
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262019682.003.0007
- Subject:
- Biology, Bioethics
In this paper, the authors introduce a case in which the central question was the competence of a woman in the end stages of anorexia nervosa to refuse treatment when she knew that death was a likely ...
More
In this paper, the authors introduce a case in which the central question was the competence of a woman in the end stages of anorexia nervosa to refuse treatment when she knew that death was a likely outcome. Then, the authors identify the major issues relevant in this situation: the nature of anorexia nervosa, the notion of competence, and the complications inherent in determining competence to refuse life-saving treatment in a patient diagnosed with anorexia nervosa. Finally, the authors identify the criteria we used to determine competence in this patient and describe the process we used to assess her competence.Less
In this paper, the authors introduce a case in which the central question was the competence of a woman in the end stages of anorexia nervosa to refuse treatment when she knew that death was a likely outcome. Then, the authors identify the major issues relevant in this situation: the nature of anorexia nervosa, the notion of competence, and the complications inherent in determining competence to refuse life-saving treatment in a patient diagnosed with anorexia nervosa. Finally, the authors identify the criteria we used to determine competence in this patient and describe the process we used to assess her competence.
