Thursday, June 21, 2012

Mike Nova | Psychiatric Hermeneutics: The Interpretational Model Of Clinical Understanding

Last Update: 7:51 PM 6/21/2012

Mike Nova

Psychiatric Hermeneutics: The Interpretational Model Of Clinical Understanding


Clinical (medical, diagnostic) Logic involves a chain of certain distinct and identifiable hermeneutic (interrelated and interpretational) stages-steps, forming the conceptual "diagnosis-treatment circle":

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The Clinical Hermeneutic Round


 > Observations

Evaluation, Assessments, etc.

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> Interpretation

Diagnosis: a clinical concept of illness and its treatment with hypothetical references to its origins; continuously refined; and recognised on the basis of recollection of the previously familiar clinical diagnostic pattern, or, in other words, based on "experience".

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>  Intervention

Treatments, in their various forms and modalities; which represent the clinical "experimental", stimulus induced mode of conceptual diagnostic understanding; akin to "experiments" in natural sciences.

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> Reassessment

Clinical reconceptualisation on the basis of continuously renewed and reassessed data and information; the key, switch-step, concluding one round of the circle. Cognitively, this step might be especially difficult for clinicians, especially in psychiatry, since human thought in general and clinical thinking in particular tends to gravitate to some "safe and respectable middle ground", or "conservative stability". Inadequate resolution of this key clinical concept formation step, which can be described as a "microparadigmatic microrevolution", is probably one of the most common sources of diagnostic and treatment errors.

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> Observations

again, as a first step of the new clinical conceptual round.

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 >  ...

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Mental health and psychopathology on individual, group and social levels, along and within their biopsychosocial continuums, can be viewed and assessed with hermeneutic method of continuous analysis and interpretation by going from the whole picture to its particulars and back to the whole picture in the attempt to understand their connections, relationships and meanings.

This approach, viewing mental health-illness as a unitary homeostatic conceptual system is better suited for clinical mental health-illness assessment than traditional, medical, categorical  diagnostic approach (vs. dimensional, widely used in psychology). The human being as an object of psychiatric hermeneutic inquiry, in his/her medical, interpersonal and social contexts, is always more than the sum of these parts and certainly more than his/her presumed "psychiatric diagnosis".
The best "psychiatric diagnosis" for John Doe is "John Doe at a given moment", with his unique biological and genetic background and life history.
Psychiatric Diagnosis as a Clinical Concept is too complex and too multifaceted to be comprehended and communicated on the basis of the traditional medical one-directional model only.


The goal of any mental health-illness assessment is three-prong: to identify target symptoms, syndromes, disorders and problems for psychopharmacological, psychotherapeutic and psychosocial interventions.
Thus, psychiatric diagnosis per se becomes the process and conceptual outcome of identification of  syndromologically based psychopharmacological targets, which can be transcribed into any of existing categorical diagnostic systems (ICD-10, DSM-4, 5; etc.).
The static linguistic "diagnostic" labels for the overwhelming majority of psychiatric conditions, whose nature, origins, medical underpinnings and true nosology remain undetermined, simply do not matter that much and should remain a concern for billing and medical records departments, not for researchers and clinicians. Thus, the cloud and stigma of psychiatric diagnosis as an almost meaningless and abusive labeling system will be removed and replaced by the dynamic, based on psychometric monitoring of major Core Syndromes, continuously changing and reflecting patients' current mental state, hermeneutic, interpretational diagnostic system.
The task then becomes to conceptualise, organise, classify and systematise the historically formed and recognised general psychopathological syndromes (e.g. psychosis, affective states, etc.) as psychopharmacological dimensional targets, regardless of their presumed, hypothetical or known nosology, which corresponds with existing customs of psychopharmacological practice.

Psychiatric patient as "a clinical  hermeneutic text"

Psychiatric patient as an object of clinical hermeneutic inquiry shares unique characteristics with the objects of general and traditional hermeneutics (which is the study of understanding and interpretations of "sacred texts"), such as oddity and special, public or private meaning in content and presentations, the qualities of intuitive drives, puzzle and prophesy, etc. ("madness" and "sacred texts", in their various, including "real life" forms were often interconnected, throughout history), which might indicate the elements of common nature in these phenomena and confirm the suitability of hermeneutics as a theory, (heuristic) philosophy, method and approach in their studies.
Psychiatric Hermeneutics, based on broad clinical, evidence based, behavioral and scientific data, have a potential of developing into the new fields of philosophical, sociological (bio-psycho-sociological) and psychiatric inquiries. Philosophy and psychiatry had always been close, and it looks like this romance might reignite lively and productively.

Psychiatric Diagnosis as a Clinical Interpretational "Hermeneutic Circle" of Understanding and Continuous Analysis and Synthesis

of its particular symptomatological, syndromological; intrapsychic and psychosocial parts on their biopsychosocial continuum and the whole, continuously changing, redefining and refining Dynamic Psychiatric Diagnostic Formulation (although not necessarily and not always in a psychodynamic sense). - (1)

Psychiatric diagnosis per se, or medical part of this diagnostic system is a systematic combination of Core (prevailing) Psychopathological Syndromes (with their subjective symptoms and objectively observed signs), psychometrically measured; and well established medical nosologies (if and when they can be recognised and identified).

This system also corresponds with existing clinical practice of "provisional diagnoses". Any psychiatric diagnosis is, to a significant degree, "provisional"; just like any good medical diagnostic impression.

Psychiatric Hermeneutics and Cartesian "mind-body" false dichotomy


Philosophy of Psychiatric Diagnosis "is what Gadamer himself terms ‘practical philosophy’": it exists not only and not as abstract thinking about abstract knowledge but as a practical, clinical, and today - as an acute social necessity.
(Hans-Georg Gadamer - Stanford Encyclopedia of Philosophy)

Hermeneutics address both natural and social sciences, the principles of correct interpretation are the same. This allows conceptual integration of the body of knowledge obtained in various relevant scientific and clinical fields in their observational, interpretational and experimental modes. Psychopharmacological ("trial"), psychotherapeutic ("interpretation - working through - change") and psychosocial interventions are clinical experimental modes of general (as scientific knowledge), specific (as their respective fields of knowledge) and clinical diagnostic knowledge in each individual case; and are parts of the "hermeneutic circle of clinical diagnostic understanding". These external clinical stimuli disturb the homeostatic balance in a mental health-illness system (both as patient's current mental state and our clinical conceptual perception of it) and provide the additional conceptual feedback dimension: information on RESPONSE TO TREATMENT, which becomes an important, clinically valuable and sometimes defining part of the "hermeneutic clinical diagnostic circle of understanding". Clinical psychopathological syndromes as common and overlapping pathways for various conditions of various etiologies and pathogeneses can and should be redefined and refined further by their response to current psychopharmacological treatment.

Psychiatric diagnosis is ever changing, evolving, complex, multifaceted and multidimensional (and not just multiaxial DSM style - wise), dynamic, experimental hermeneutic circle of clinical conceptual interpretations and understandings.

Dialectical dichotomy-continuum of "mind-body": "physical" (psychopharmacological) and "non-physical" (intrapsychic, psychotherapeutic and psychosocial), in both their observational (including self-observational) and experimental (treatment) modes of psychiatric diagnosis is resolved by hermeneutic interpretation based on the same principles of philosophical and clinical inquiries:

"Coming from a very different tradition, Giambattisto Vico, the author of the Scienza nuova (1725), is another central figure in the development of early modern hermeneutics. Speaking out against the Cartesianism of his time, Vico argues that thinking is always rooted in a given cultural context. This context is historically developed, and, moreover, intrinsically related to ordinary language, evolving from the stage of myth and poetry to the later phases of theoretical abstraction and technical vocabularies. To understand oneself is thus to understand the genealogy of one's own intellectual horizon."
"Another philosopher who came to influence the early stages of modern hermeneutics is Benedict de Spinoza. In the seventh chapter of theTractatus theologico-politicus (1670), Spinoza proposes that in order to understand the most dense and difficult sections of the Holy Scriptures, one must keep in mind the historical horizon in which these texts were written, as well as the mind by which they were produced. There is an analogy, Spinoza claims, between our understanding of nature and our understanding of the Scriptures. In both cases, our understanding of the parts hinges on our understanding of a larger whole, which, again, can only be understood on the basis of the parts. Seen in a larger perspective, this hermeneutic circle, the movement back and forth between the parts and the whole of the text [or the patient as a clinical hermeneutic text - M.N.], is an important hermeneutical theme. What does not lend itself to immediate understanding can be interpreted by means of philological work [or psychiatric diagnostic work - M.N.]. The study of history [and, we add, in clinical psychiatry - study of individual patient's life and illness history - M.N.] becomes an indispensable tool in the process of unlocking hermetic meaning and language-use."

...

"Appreciating hermeneutics as a living tradition is not, in the end, a matter of identifying a theory or a family of theories. It is fundamentally a matter of perceiving a moving horizon, engaging a strand of dialogue that is an on-going re-articulation of the dynamically historical nature of all human thought."  

Hermeneutics (Stanford Encyclopedia of Philosophy)

plato.stanford.edu/entries/hermeneutics/Similar
http://plato.stanford.edu/entries/hermeneutics/

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"Issues such as a multi-axial approach, the particular axes of DSM-III and DSM-IV, a categorical versus a dimensional approach, the use of operational definitions and diagnostic criteria, the privileging of reliability over validity, and of objective signs and isolated symptoms over subjective unities of experience--all are decided in a manner that is inevitably arbitrary and value laden. All must be the subject matter of ongoing discussion, for there is nothing inherently right about the position taken by the DSMs regarding any of these issues."
James Phillips - Key Concepts: Hermeneutics - Philosophy, Psychiatry, & Psychology 3:1

Philosophy, Psychiatry, & Psychology 3.1 (1996) 61-69

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SYNDROMES: medical-biological and psychiatric - biopsychosocial

If syndromes in general medicine are always biological, in psychiatry (and mental health-illness field) they are always biopsychosocial, manifested by "aberrant, abnormal" behavior. In their prominent and extreme forms this "aberrant and abnormal" behaviors come into direct and obvious conflict with societal norms and laws. These types and patterns of abnormal and criminal behaviors constitute by themselves, for all practical intents and purposes, the distinct and recognisable (forensic psychiatric) behavioral syndromes, although they are not classified as such in general psychiatry. However, these forensic psychiatric behavioral syndromes (various forms of murders, aggression and self-aggression, sexual crimes, etc), are based on the same principle of primacy and central role of behavioral manifestations and have the same clinical (and social and "scientific") legitimacy as general psychiatric syndromes. Furthermore, their study from multidisciplinary and interdisciplinary perspectives (including contributions from criminalistics and behavioral forensic sciences) might yield a deeper and more comprehensive understanding of these and other related psychiatric phenomena, which might lead to the development of multi-prong psychosocial (including judicial) interventions, directed to prevention, easing or treatment of these ills.

For example, juvenile homosexual murders are not recognised and studied as a separate behavioral syndrome in general psychiatry, but this subject is viewed and studied as such (as a distinct behavioral syndrome) in behavioral forensic sciences:

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Juvenile homosexual homicide.

Juvenile homosexual homicide.
Behav Sci Law. 2012 Mar;30(2):90-102
Authors: Myers WC, Chan HC
Abstract
Limited information exists on juvenile homosexual homicide (JHH), that is, youths who perpetrate sexual homicides against same-sex victims. Only a handful of cases from the United States and internationally have been described in the literature. This study, the first of its kind, examines the epidemiology, victimology, victim-offender relationship, and weapon-use patterns in JHH offenders using a large U.S. database on homicide spanning three decades. The data for this study were derived from the Federal Bureau of Investigation's Supplementary Homicide Reports (SHRs) for the years 1976 through 2005. A total of 93 cases of JHH were identified. On average, three of these crimes occurred annually in the U.S., and there was a marked decline in its incidence over the study period. Ninety-five percent were male offender-male victim cases and 5% were female offender-female victim cases. JHH offenders were over-represented amongst all juvenile sexual murderers, similar to their adult counterparts. The majority of these boys were aged 16 or 17 and killed adult victims. They were significantly more likely to kill adult victims than other age groups, to be friends or acquaintances of the victims, and to use contact/edged weapons or firearms. Most offenders killed same-race victims, although Black offenders were significantly more likely than White offenders to kill interracially. A case report is provided to illustrate JHH. Further research is needed to promote our understanding of the pathogenesis, etiology, and associated risk factors for this aberrant form of murder by children. Copyright © 2012 John Wiley & Sons, Ltd.
PMID: 22447462 [PubMed - in process]

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This leads us to the discussion of the pragmatic and utilitarian aspects of diagnostic (psychiatric) classification, which corresponds with the nature of psychiatry not only as a (combined natural and social) science but as a medical discipline and medical practice. Any (psychiatric) diagnostic classification has to be an open conceptual system, allowing free, unimpeded formation and investigation of new clinical diagnostic concepts. Closed, prematurely ossified and codified diagnostic system, based on the past and current insufficient level of knowledge and diagnostic criteria designed to artificially enhance interrater reliability of questionable, not well studied and scientifically non-valid clinical diagnostic concepts, leads to scientific stagnation and infertility, which are evident to both the professionals and the public with an unarmed eye. Furthermore, recognition and studies of these new, "research" psychiatric syndromes will lead to better identification and "diagnosis" of these conditions and their better treatment and prevention.

The issue, the problem and the questions are: what should be the principles of these behavioral (or any) syndromes identification: recognition, composition, architecture, etc., in other words, what should be its hermeneutic structure? What is the whole (the syndrome itself) and what are the parts, the particulars of this hermeneutic circle, and why and how are they interrelated?



The psychiatric diagnosis, to paraphrase a bit what Allan Frances said, quite directly and bravely, is too important, in the light of its social stigma and other factors, to be left in the hands or on the mind of the APA only, as a professional association, whose main concern is the professional interests of psychiatrists as physicians. The whole society has the stakes in this issue, and these stakes are quite high.

It is in the best interests of the APA, it seems to me, to share this huge responsibility and huge burden with the rest of the society and with the rest of the closely related scientific community. Psychiatry as a science might benefit from this closer association with it, and might come out of this crisis renewed and reinvigorated, with new, broader horizons and new, open scientific outlook.

Break Up the Psychiatric Monopoly - Friday, May 11, 2012 - By ALLEN FRANCES
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Psychiatric Hermeneutics and Psychoanalysis



From our perspectives, psychoanalysis (W) is, first of all and most of all, a hermeneutic conceptual enterprise and exercise (a "theory", whatever it means), then a popular ("vulgar") philosophy, and then - a branch of psychiatry and a treatment method. Psychoanalysis and Philosophy share a principle of free, associative thinking process (philosophers are great self-and-world analysands), expressed in a free (and sometimes quite idiosyncratic) language.


Psychodynamic interpretation and formulation as clinical hermeneutic devices


Interpretation is a surgeon's scalpel and a philosopher's aphorism, blent together into a mysterious, powerful and (hopefully) efficient tool in the arsenal of psychodynamic psychotherapeutic arts. It recapitulates and illuminates, in one swell masterful swoop, in one movement of interpretational hermeneutic circle, the object ("client") as Dasein (W), its existence (W) as "thrownness into the world (G)", and a stimulus for therapeutic change (G). This is how the experimental psychotherapeutic modality of psychiatric hermeneutic diagnosis - treatment circle starts.


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Psychiatric Hermeneutics Topics

for future elaboration


It seems to me that the following topics deserve some attention and future elaboration:

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Psychiatric, Behavioral and Medical Hermeneutics

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Psychiatric Hermeneutics and the Philosophy of General and Psychiatric Diagnosis

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Psychiatric Hermeneutics and Theory and practice of Psychodynamic Psychotherapies

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Psychiatric Hermeneutics, Forensic and Prison Psychiatry and Law

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Psychiatric Hermeneutics and World Mental Health Movements

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Psychiatric Hermeneutics and Religions

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Psychiatric Hermeneutics and Biosocial Sciences

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Psychiatric Hermeneutics and EthologyW     GS )

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Psychiatric Hermeneutics, Communications and Languages

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Psychiatric Hermeneutics, General Systems Theory and Biosociology

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Psychiatric Hermeneutics and Political Sciences

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Psychiatric Hermeneutics and Behavioral Economics

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Psychiatric Hermeneutics and Studies of Market Behaviors and mental health-illness issues in markets traders ("markets and traders psychology")

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... To be continued


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References and Links


(1) Michael Novakhov - The Hermeneutic Round Of Understanding In General Psychopathology - unpublished manuscript - 1983 - will be scanned and posted

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Philosophy of Psychiatric Diagnosis - GS

Philosophy of Psychiatric Diagnosis - PubMed

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Psychoanalysis - Wikipedia

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contemporarypsychotherapy.org/vol-4-no-1.../hermeneutic-inquiry/Cached
Hermeneutic inquiry uncovers “meanings and intentions that are, in a sense, ... is its openly dialogical nature: the returning to the object of inquiry again and .... the way various authors were interpreting key concepts (ie clinical reasoning, ...
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[PDF]
www.ajol.info/index.php/ipjp/article/view/65448/53139
File Format: PDF/Adobe Acrobat - Quick View
by AEMM Holroyd - 2011 - Cited by 15 - Related articles
different from an objectified method of knowledge attainment. ... of this particular hermeneutic inquiry are the .... openness, places our mental and intellectual processes at stake, and ..... “relationships between patients and medical staff …
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1.
Rosenman SJ, Nasti J.
Aust N Z J Psychiatry. 2012 Apr 23. [Epub ahead of print]
PMID:
22528975
[PubMed - as supplied by publisher]
Free Article
2.
Tsou JY.
Stud Hist Philos Biol Biomed Sci. 2012 Jun;43(2):542-51. Epub 2012 Feb 9.
PMID:
22520203
[PubMed - in process]
3.
Stoyanov D, Machamer PK, Schaffner KF, Rivera-Hernández R.
J Eval Clin Pract. 2012 Jun;18(3):704-709. doi: 10.1111/j.1365-2753.2012.01844.x. Epub 2012 Apr 19. No abstract available.
PMID:
22515313
[PubMed - as supplied by publisher]


Philosophy of Psychiatric Diagnosis - PubMed - RSS

Psychiatric diagnoses are not mental process: Wittgenstein on conceptual confusion.

Rosenman SJ, Nasti JGo to full article
Psychiatric diagnoses are not mental process: Wittgenstein on conceptual confusion.
Aust N Z J Psychiatry. 2012 Apr 23;
Authors: Rosenman SJ, Nasti J
Abstract
Background: Empirical explanation and treatment repeatedly fail for psychiatric diagnoses. Diagnosis is mired in conceptual confusion that is illuminated by Ludwig Wittgenstein's later critique of philosophy (Philosophical Investigations). This paper examines conceptual confusions in the foundation of psychiatric diagnosis from some of Wittgenstein's important critical viewpoints.Argument: Diagnostic terms are words whose meanings are given by usages not definitions. Diagnoses, by Wittgenstein's analogy with 'games', have various and evolving usages that are connected by family relationships, and no essence or core phenomenon connects them. Their usages will change according to the demands and contexts in which they are employed. Diagnoses, like many psychological terms, such as 'reading' or 'understanding', are concepts that refer not to fixed behavioural or mental states but to complex apprehensions of the relationship of a variety of behavioural phenomena with the world. A diagnosis is a sort of concept that cannot be located in or explained by a mental process.Conclusion: A diagnosis is an exercise in language and its usage changes according to the context and the needs it addresses. Diagnoses have important uses but they are irreducibly heterogeneous and cannot be identified with or connected to particular mental processes or even with a unity of phenomena that can be addressed empirically. This makes understandable not only the repeated failure of empirical science to replicate or illuminate genetic, neurophysiologic, psychic or social processes underlying diagnoses but also the emptiness of a succession of explanatory theories and treatment effects that cannot be repeated or stubbornly regress to the mean.Attempts to fix the meanings of diagnoses to allow empirical explanation will and should fail as there is no foundation on which a fixed meaning can be built and it can only be done at the cost of the relevance and usefulness of diagnosis.
PMID: 22528975 [PubMed - as supplied by publisher]
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Intervention, causal reasoning, and the neurobiology of mental disorders: Pharmacological drugs as experimental instruments.

Tsou JYGo to full article
Intervention, causal reasoning, and the neurobiology of mental disorders: Pharmacological drugs as experimental instruments.
Stud Hist Philos Biol Biomed Sci. 2012 Jun;43(2):542-51
Authors: Tsou JY
Abstract
In psychiatry, pharmacological drugs play an important experimental role in attempts to identify the neurobiological causes of mental disorders. Besides being developed in applied contexts as potential treatments for patients with mental disorders, pharmacological drugs play a crucial role in research contexts as experimental instruments that facilitate the formulation and revision of neurobiological theories of psychopathology. This paper examines the various epistemic functions that pharmacological drugs serve in the discovery, refinement, testing, and elaboration of neurobiological theories of mental disorders. I articulate this thesis with reference to the history of antipsychotic drugs and the evolution of the dopamine hypothesis of schizophrenia in the second half of the twentieth century. I argue that interventions with psychiatric patients through the medium of antipsychotic drugs provide researchers with information and evidence about the neurobiological causes of schizophrenia. This analysis highlights the importance of pharmacological drugs as research tools in the generation of psychiatric knowledge and the dynamic relationship between practical and theoretical contexts in psychiatry.
PMID: 22520203 [PubMed - in process]

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Philosophy of mental health - GS

  1. Philosophy and Mental Health - Tim Thornton

  2. sites.google.com/site/drtimthornton/philosophy-and-mental-health
  3. Because of its very nature, mental health care raises as many conceptual questions as empirical ones. The philosophy of mental health - also called the 'new ...
  4. You visited this page on 5/15/12.
  5. Mental Illness (Stanford Encyclopedia of Philosophy)

    plato.stanford.edu/entries/mental-illness/Similar
    22 Feb 2010 – The central philosophical debate over mental illness is not about its .... While we have not identified the causes of most mental disorders, it is ...
  6. Philosophy and Mental Health MA/PGDip/PGCert Postgraduate ...

    www.uclan.ac.uk › Study@UCLanCoursesCached - Similar
    13 Apr 2012 – Because of its very nature, mental health care raises as many conceptual questions as empirical ones.
philosophy of mental illness - GS


Scholarly articles for philosophy of mental illness

The myth of mental illness. - Szasz - Cited by 3016
Psychiatry in the scientific image - Murphy - Cited by 80
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Hermeneutics - W

From Wikipedia, the free encyclopedia
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In religious studies and social philosophy, hermeneutics (English pronunciation: /hɜrməˈn(j)uːtɨks/) is the study of the theory and practice of interpretation.
Traditional hermeneutics is the study of the interpretation of written texts, especially texts in the areas of literature, religion and law. A type of traditional hermeneutic is Biblical hermeneutics which concerns the study of the interpretation of The Bible. Modern hermeneutics encompasses everything in the interpretative process including verbal and nonverbal forms of communication as well as prior aspects that affect communication, such as presuppositions, preunderstandings, the meaning and philosophy of language, and semiotics.[1]
The terms exegesis and hermeneutics have been used interchangeably. However, hermeneutics is a more widely defined discipline of interpretation theory as it includes the entire framework of the interpretive process which encompass all forms of communication: written, verbal, and nonverbal. Exegesis on the other hand, focuses primarily on the written text.
Philosophical hermeneutics refers primarily to the theory of knowledge initiated by Martin Heidegger and developed by Hans-Georg Gadamer in Truth and Method, and sometimes to the theories of Paul Ricoeur.[2]


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Hermeneutics - Wikipedia

Sociology
In sociology, hermeneutics means the interpretation and understanding of social events by analysing their meanings to the human participants and their culture. It enjoyed prominence during the sixties and seventies, and differs from other interpretative schools of sociology in that it emphasizes the importance of the context[28] as well as the form of any given social behaviour. The central principle of hermeneutics is that it is only possible to grasp the meaning of an action or statement within the context of the discourse or world-view from which it originates. For instance, putting a piece of paper in a box might be considered a meaningless action unless put in the context of democratic elections, and the action of putting a ballot paper in a box. One can frequently find reference to the 'hermeneutic circle': that is, relating the whole to the part and the part to the whole. Hermeneutics in sociology was most heavily influenced by German philosopher Hans-Georg Gadamer.[29]

Hermeneutic circle

From Wikipedia, the free encyclopedia
The hermeneutic circle describes the process of understanding a text hermeneutically. It refers to the idea that one's understanding of the text as a whole is established by reference to the individual parts and one's understanding of each individual part by reference to the whole. Neither the whole text nor any individual part can be understood without reference to one another, and hence, it is a circle. However, this circular character of interpretation does not make it impossible to interpret a text; rather, it stresses that the meaning of a text must be found within its cultural, historical, and literary context.
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Retrieved: 6:05 PM 5/11/2012

  1. Hermeneutic circle - Wikipedia, the free encyclopedia
  2. en.wikipedia.org/wiki/Hermeneutic_circle



    The hermeneutic circle describes the process of understanding a text hermeneutically. It refers to the idea that one's understanding of the text as a whole is ...

  3. Hermeneutics (Stanford Encyclopedia of Philosophy) 
http://plato.stanford.edu/entries/hermeneutics/


9 Nov 2005 – Seen in a larger perspective, this hermeneutic circle, the movement back and forth between the parts and the whole of the text, is an important ...

Hermeneutics

    First published Wed Nov 9, 2005
    The term hermeneutics covers both the first order art and the second order theory of understanding and interpretation of linguistic and non-linguistic expressions. As a theory of interpretation, the hermeneutic tradition stretches all the way back to ancient Greek philosophy. In the course of the Middle Ages and the Renaissance, hermeneutics emerges as a crucial branch of Biblical studies. Later on, it comes to include the study of ancient and classic cultures.
    ...

    Coming from a very different tradition, Giambattisto Vico, the author of the Scienza nuova (1725), is another central figure in the development of early modern hermeneutics. Speaking out against the Cartesianism of his time, Vico argues that thinking is always rooted in a given cultural context. This context is historically developed, and, moreover, intrinsically related to ordinary language, evolving from the stage of myth and poetry to the later phases of theoretical abstraction and technical vocabularies. To understand oneself is thus to understand the genealogy of one's own intellectual horizon.

    Another philosopher who came to influence the early stages of modern hermeneutics is Benedict de Spinoza. In the seventh chapter of theTractatus theologico-politicus (1670), Spinoza proposes that in order to understand the most dense and difficult sections of the Holy Scriptures, one must keep in mind the historical horizon in which these texts were written, as well as the mind by which they were produced. There is an analogy, Spinoza claims, between our understanding of nature and our understanding of the Scriptures. In both cases, our understanding of the parts hinges on our understanding of a larger whole, which, again, can only be understood on the basis of the parts. Seen in a larger perspective, this hermeneutic circle, the movement back and forth between the parts and the whole of the text, is an important hermeneutical theme. What does not lend itself to immediate understanding can be interpreted by means of philological work. The study of history becomes an indispensable tool in the process of unlocking hermetic meaning and language-use.

    So, too, is the philosophical background provided by Kant and Hegel. Yet it is Friedrich Schleiermacher who first manages to pull together the intellectual currents of the time so as to articulate a coherent conception of a universal hermeneutics, a hermeneutics that does not relate to one particular kind of textual material (such as the Bible or ancient texts), but to linguistic meaning in general.

    It is precisely the idea of a critical turn in hermeneutics combined with the focus on the individuality of language-use that made Schleiermacher such an important figure for the next generation of hermeneuticians, concerned as they were with the methodology of the human sciences, or, as they understood it, with the critique, in the Kantian meaning of the term, of historical reason.

    With Dilthey, the search for a philosophical legitimation of the human sciences is brought a significant step further. The author of a vast monograph on Schleiermacher and his time, Dilthey responds to the questions raised by Droysen and Ranke by retrieving the resources of romantic hermeneutics. Scientific explanation of nature, Dilthey argues, must be completed with a theory of how the world is given to us through symbolically mediated practices. To provide such a theory is the aim of the humanities, or rather the aim of the philosophy of the humanities, the area to which Dilthey dedicated his entire academic career.

    Turning to the level of historical research, the hermeneutically oriented scientist must respond to this situation by combining a more intuitive hypothesis-formation (aiming at the lived experience at stake) and a comparative method that would revise and secure the objectivity of this process. This is Dilthey's critical adaptation of Schleiermacher's romantic hermeneutics: a theory that replaces the romantic vocabulary of divination, congeniality, and comparison with one of an initial inductive hypothesis-formation leading up to a process of critical, empirical investigation and historical comparison aiming at revision or improvement of the initial hypothesis. Dilthey's most important contribution to hermeneutics might be said to rest in the fact that he is the first to ground hermeneutics in a general theory of human life and existence. In this sense, Dilthey's philosophy paves the way for what we have later come to recognize as the turn to ontology.

4. The Ontological Turn

    Informed by his reading of Schleiermacher, Droysen, and Dilthey, Martin Heidegger's Sein und Zeit (1927) completely transformed the discipline of hermeneutics. In Heidegger's view, hermeneutics is not a matter of understanding linguistic communication. Nor is it about providing a methodological basis for the human sciences. As far as Heidegger is concerned, hermeneutics is ontology; it is about the most fundamental conditions of man's being in the world. Yet Heidegger's turn to ontology is not completely separated from earlier hermeneutic philosophies. Just as Vico had started out with a critique of the Cartesian notion of certainty, so Heidegger sets out to overthrow what he takes to be the Cartesian trajectory of modern philosophical reason.
    This reflects back on Heidegger's definition of terms such as understanding, interpretation, and assertion. Understanding, in Heidegger's account, is neither a method of reading nor the outcome of a willed and carefully conducted procedure of critical reflection. It is not something we consciously do or fail to do, but something we are. Understanding is a mode of being, and as such it is characteristic of human being, of Dasein. The pre-reflective way in which Dasein inhabits the world is itself of a hermeneutic nature. Our understanding of the world presupposes a kind of pragmatic know-how that is revealed through the way in which we, without theoretical considerations, orient ourselves in the world. We open the door without objectifying or conceptually determining the nature of the door-handle or the doorframe. The world is familiar to us in a basic, intuitive way. Most originally, Heidegger argues, we do not understand the world by gathering a collection of neutral facts by which we may reach a set of universal propositions, laws, or judgments that, to a greater or lesser extent, corresponds to the world as it is. The world is tacitly intelligible to us.

    This Heideggerian reformulation of the problem of truth gives rise to a new conception of the hermeneutic circle. In Spinoza, Ast, and Schleiermacher, the hermeneutic circle was conceived in terms of the mutual relationship between the text as a whole and its individual parts, or in terms of the relation between text and tradition. With Heidegger, however, the hermeneutic circle refers to something completely different: the interplay between our self-understanding and our understanding the world. The hermeneutic circle is no longer perceived as a helpful philological tool, but entails an existential task with which each of us is confronted.

5. Hermeneutic Humanism

    After the publication of Being and Time, Heidegger stops engaging with explicit hermeneutic issues (as well as the terminology of understanding, interpretation, and the hermeneutic circle). This aspect of his thinking, however, is taken up by his student, Hans-Georg Gadamer.

    Gadamer works within the Heideggerian paradigm to the extent that he fully accepts the ontological turn in hermeneutics. Yet he wants to explore the consequences of such a turn for our understanding of the human sciences. This, Gadamer thinks, can only be done if we leave behind the framework of romantic hermeneutics, both in its Schleiermacherian and in its Diltheyan versions. Going back to Vico and the neo-Aristotelian strands of early modern humanism, Gadamer wants to combine the Heideggerian notion of the world-disclosive synthesis of understanding with the idea of Bildung, of education in culture. This, by and large, is the project ofWahrheit und Methode (1960), a work that Gadamer spent more than 30 years completing.
    Human being, Gadamer argues, is a being in language. It is through language that the world is opened up for us. We learn to know the world by learning to master a language. Hence we cannot really understand ourselves unless we understand ourselves as situated in a linguistically mediated, historical culture. Language is our second nature.

    This co-determination of text and reader is Gadamer's version of the hermeneutic circle. As important as the interplay between the parts and the whole of a text is the way in which our reading contributes to its effective history, adding to the complexity and depth of its meaning. The meaning of the text is not something we can grasp once and for all. It is something that exists in the complex dialogical interplay between past and present. Just as we can never master the texts of the past, so do we fail—necessarily and constitutively—to obtain conclusive self-knowledge. Gaining knowledge of tradition and knowing ourselves are both interminable processes; they are tasks without determinate end-points. This is the philosophical gist of Gadamer's humanistic ontology: that our being, historically conditioned as it is, is always more being (Sein) than conscious being (Bewusstsein).

6. Objectivity and Relativism

    The force with which Truth and Method came to shape the conjunctures of contemporary hermeneutics can only be envisaged by taking into account how, over the past 40 years, the discussion of philosophical hermeneutics has, by and large, been a discussion of Gadamer's work.

    One example is Emilio Betti. Publishing his Teoria della interpretatione in 1964, Betti approaches hermeneutics from a non-ontological point of view, explicitly connecting himself to the legacy of Schleiermacher and Dilthey. Hermeneutics, for Betti, should confine itself to the epistemological problems of interpretation, and not try to engage with the deepest conditions of human existence. Speech and texts, Betti argues, are objectified representations of human intentions. To interpret their meaning is to breathe life into these symbolically mediated intentions. This is possible because although the interpreter's individuality and the individuality expressed in the text are constitutively different, the interpreter may overcome her own point of view in order to get a grasp on the meaning of the text. At issue is an attempt to re-create the original process of creation: not in order to reach the psychological state or content of the author, but to get at the true and only meaning of the text.

    Similar aspirations lie behind the criticism launched by Eric D. Hirsch in the second half of the 1960s. Hirsch's major work,Validity in Interpretation (1967), attempts to refute the central Gadamerian notion of the fusion of horizons. Like Betti, Hirsch takes this idea to invoke a problematic epistemic relativism. Without a concept of validation, he argues, no interpretation would be more plausible than any other. Knowledge and objectivity would be impossible in the domain of hermeneutics. But knowledge and objectivity, Hirsch thinks, is precisely what defines the human sciences, even though these sciences are based upon interpretation rather than explanation.

10. Conclusion

    In the hands of Rorty, McDowell and an increasing number of other contemporary thinkers, the resources of philosophical hermeneutics are deployed in an effort to break out of the epistemic, dualistic paradigms of modern philosophy, and to open new philosophical ground no longer haunted by the specters of relativism and scepticism, nor by the dream of foundational justification. Now, it may seem paradoxical that a mode of thought that emphasizes exactly our beholdenness to tradition should be instrumental in what is often presented as a deliberate break with tradition. However, this impression of paradox ought to be fleeting. One of the lessons of philosophical hermeneutics is exactly that intellectual innovation of this sort depends on—indeed, is a manifestation of—the self-renewing power of tradition, of its dynamism, and its interpretability and reinterpretability. The current appropriation of hermeneutics for revisionist philosophical purposes illustrates the hermeneutic notion of effective history. While transcending anything the early interpretation-theorists could ever have imagined, the deployment of Gadamerian thought to break with subjectivism would not have been possible without them. This effective-history, moreover, is dialectical—our reading of the early hermeneuticians, our understanding of the potential inherent in their thought, is shaped essentially by this very effective-history, which both separates us from them and makes them understandable to us. Appreciating hermeneutics as a living tradition is not, in the end, a matter of identifying a theory or a family of theories. It is fundamentally a matter of perceiving a moving horizon, engaging a strand of dialogue that is an on-going re-articulation of the dynamically historical nature of all human thought.

Bibliography

____________________________________

Hans-Georg Gadamer

First published Mon Mar 3, 2003; substantive revision Mon Jun 8, 2009
Hans-Georg Gadamer is the decisive figure in the development of twentieth century hermeneutics—almost certainly eclipsing, in terms of influence and reputation, the other leading figures, including Paul Ricoeur, and also Gianni Vattimo (Vattimo was himself one of Gadamer's students). Trained in neo-Kantian scholarship, as well as in classical philology, and profoundly affected by the philosophy of Martin Heidegger, Gadamer developed a distinctive and thoroughly dialogical approach, grounded in Platonic-Aristotelian as well as Heideggerian thinking, that rejects subjectivism and relativism, abjures any simple notion of interpretive method, and grounds understanding in the linguistically mediated happening of tradition. Employing a more orthodox and modest, but also more accessible style than Heidegger himself, Gadamer's work can be seen as concentrated in four main areas: the first, and clearly the most influential, is the development and elaboration of a philosophical hermeneutics; the second is the dialogue within philosophy, and within the history of philosophy, with respect to Plato and Aristotle in particular, but also with Hegel and Heidegger; the third is the engagement with literature, particularly poetry, and with art; and the fourth is what Gadamer himself terms ‘practical philosophy’ (see Gadamer, 2001, 78-85) encompassing contemporary political and ethical issues. The ‘dialogical’ character of Gadamer's approach is evident, not merely in the central theoretical role he gives to the concept of dialogue in his thinking, but also in the discursive and dialogic, even‘conversational’, character of his writing, as well as in his own personal commitment to intellectual engagement and exchange. Indeed, he is one of the few philosophers for whom the‘interview’ has become a significant category of philosophical output (see Hahn, 1997, 588-599; also Gadamer, 2001, 2003). Although he identified connections between his own work and English-speaking ‘analytic’ thought (mainly via the later Wittgenstein, but also Donald Davidson), and has sometimes seen his ideas taken up by thinkers such as Ronald Dworkin, John McDowell, and especially Richard Rorty, Gadamer is perhaps less well known, and certainly less well-appreciated, in philosophical circles outside Europe than are some of his near-contemporaries. He is undoubtedly, however, one of the most important thinkers of the twentieth century, having had an enormous impact on a range of areas from aesthetics to jurisprudence, and having acquired a respect and reputation in Germany, and elsewhere in Europe, that went far beyond the usual confines of academia.
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http://forpn.blogspot.com/2012/05/james-phillips-key-concepts.html

James Phillips - Key Concepts: Hermeneutics - Philosophy, Psychiatry, & Psychology 3:1



James Phillips - Key Concepts: Hermeneutics - Philosophy, Psychiatry, & Psychology 3:1

Philosophy, Psychiatry, & Psychology 3.1 (1996) 61-69



Key Concepts: Hermeneutics


James Phillips




Keywords: psychoanalysis, philosophy of science, nosology, classification
Hermeneutics is a concept whose breadth and significance have continued to grow in contemporary thought--and in psychiatry. Since its scope can be best appreciated through an historical overview of its development, I will begin there and then proceed to a discussion of its place in psychiatry. Derived from the Greek verb hermeneuein, which means "to interpret," and the noun hermemeia, "interpretation" (and both associated with the god Hermes), the word was first used in the seventeenth century to mean biblical exegesis (Palmer 1969). The Protestant Reformation created a need to interpret the scriptures without the aid of church authority, and with the plurality of possible interpretations for any biblical text, a need arose to establish the principles of correct interpretation. Hermeneutics was the study of such principles.
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Dualism - Wikipedia, the free encyclopedia

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    Drew Leder     Clinical interpretation: The hermeneutics of medicine

    "I argue that clinical medicine can best be understood not as a purified science but as a hermeneutical enterprise: that is, as involved with the interpretation of texts." - Theoretical Medicine and Bioethics, Volume 11, Number 1 - SpringerLink



    Theoretical Medicine and Bioethics, Volume 11, Number 1 - SpringerLink

    Humanities, Social Sciences and Law

    Abstract


    I argue that clinical medicine can best be understood not as a purified science but as a hermeneutical enterprise: that is, as involved with the interpretation of texts. The literary critic reading a novel, the judge asked to apply a law, must arrive at a coherent reading of their respective texts. Similarly, the physician interprets the lsquotextrsquo of the ill person: clinical signs and symptoms are read to ferret out their meaning, the underlying disease. However, I suggest that the hermeneutics of medicine is rendered uniquely complex by its wide variety of textual forms. I discuss four in turn: the ldquoexperiential textrdquo of illness as lived out by the patient; the ldquonarrative textrdquo constituted during history-taking; the ldquophysical textrdquo of the patient's body as objectively examined; the ldquoinstrumental textrdquo constructed by diagnostic technologies. I further suggest that certain flaws in modern medicine arise from its refusal of a hermeneutic self-understanding. In seeking to escape all interpretive subjectivity, medicine has threatened to expunge its primary subject — the living, experiencing patient.
    Key words clinical interpretation - embodiment - hermeneutics - history of medicine

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    Philosophy and psychiatry - Google Search

    Scholarly articles for philosophy and psychiatry

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    1. Philosophy of Psychiatry (Stanford Encyclopedia of Philosophy)

      plato.stanford.edu/entries/psychiatry/Similar
      28 Jul 2010 – Philosophical discussions of mental illness fall into three families. First, there are topics that arise when we treat psychiatry as a special science ...

    Philosophy of Psychiatry

    First published Wed Jul 28, 2010
    Philosophical discussions of mental illness fall into three families. First, there are topics that arise when we treat psychiatry as a special science and deal with it using the methods and concepts of philosophy of science. This includes discussion of such issues as explanation, reduction and classification. Second, there are conceptual issues that arise when we try to understand the very idea of mental illness and its ethical and experiential dimensions. Third, there are interactions between psychopathology and the philosophy of mind; philosophers have used clinical phenomena to illuminate issues in the philosophy of mind, and philosophical findings to try to understand mental illness. This entry will discuss issues in the philosophy of science and philosophy of mind that pertain to psychiatry.

    1. Introduction

    Scholars and textbooks alike agree (though they might not like it) that psychiatry now adheres to the “medical model”, which advocates “the consistent application, in psychiatry, of modern medical thinking and methods” (Black 2005, 3) because psychopathology “represents the manifestations of disturbed function within a part of the body” (Guze 1992, 44) to wit, the brain. But what does it mean to adopt this view of psychiatry, and what difference does it make?
    One might think that the medical model merely commits us to a brain-based view of mental illness with few implications for science, and it is true that clinical or scientific differences across practitioners seldom seem to have much to do with divergent interpretations of the medical model. However, many theorists have argued that our current diagnostic categories, as compiled into DSM-IV-T-R (American Psychiatric Association 2000), are faulty because they are derived from observable variables rather than underlying physical pathologies. These theorists are sceptical about many existing psychiatric diagnoses, and not just on empirical grounds; they see DSM diagnoses as collections of symptoms rather seeing them as medicine understands diseases—in terms of destructive processes realized in bodily tissues. Genuine mental illnesses, on this view, are not just sets of co-occurring symptoms but destructive processes taking place in biological systems. Following Murphy (2009), this may be termed the strong interpretation of the medical model. In contrast, a minimal interpretation of the medical model thinks of mental disorders as collections of symptoms that occur together and unfold in characteristic ways, but it makes no commitments about the underlying causes of mental illness.
    These two interpretations correspond to different ways of cashing out the medical model. They are set out in section 2. Explanation is discussed in section 3. The strong interpretation naturally suggests that psychiatry should embrace the practices of medical explanation. If disease is a pathological process in bodily systems, then there must be a way of understanding how such processes occur in the brain, and how they explain the clinically observable facts about mental illness. But it seems that the logic of the medical model does not force us to privilege any one level of explanation—notably, it does not commit us to explanations restricted to the resources of molecular biology. Psychiatry, then, is a multi-level science. But we often know very little about the mental illnesses that psychiatrists study, and much explanation in psychiatry involves case studies or narrative accounts that cite the characteristics of a disorder, rather than underlying systems. Theorists disagree over whether these should be seen as different kinds of explanation, or as rudimentary forms of a full causal explanation. Section 4 discusses some recent treatments of specific mental illnesses that have been held to teach philosophical lessons.

    2. The Medical Model and its Implications

    The idea that psychiatry is a branch of medicine is not universal, but even if we stick to professed believers in the medical model with the same broad view of the subject, we find disagreements about how its core commitments should be understood. It may be helpful to distinguishminimal and strong interpretations. A minimal interpretation makes no commitments about the underlying physical structure that causes mental illness. The stronginterpretation of the medical model, in contrast, dissents on just this issue. It says that the proper medical understanding of disease is in terms of morbid anatomy. It is committed to specific causal hypotheses in terms of abnormalities in underlying neurobiological systems. Minimalists treat diagnostic labels as useful heuristics rather than natural kind terms, whereas a strong interpretation commits psychiatry to a view of mental illness as a medical disease in the strongest sense, that of a pathogenic process unfolding in bodily systems.
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    1. Association for the Advancement of Philosophy and Psychiatry

      www3.utsouthwestern.edu/aapp/Cached - Similar
      Information on its conferences, journal and other activities.
    2. Philosophy of Psychiatry Bibliography

      www.uky.edu/~cperring/PhiPsybib.htmlCached - Similar
      A list of books on philosophical, ethical, social and historical issues in psychiatry. Includes sections on genetics, classification, psychology, mind, law, ...
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    Clinical psychiatric hermeneutics - Google Search

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    Karl Jaspers - New World Encyclopedia

    23 Dec 2007
    Jaspers applied Husserlian phenomenology and Dilthey's Hermeneutics into clinical psychiatry and published Allgemeine Psychopathologie (General Psychopathology) in 1913. Jaspers turned his focus to philosophy and published a ...

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    hermeneutic method - Google Search

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    Hermeneutics - Wikipedia

    Sociology
    In sociology, hermeneutics means the interpretation and understanding of social events by analysing their meanings to the human participants and their culture. It enjoyed prominence during the sixties and seventies, and differs from other interpretative schools of sociology in that it emphasizes the importance of the context[28] as well as the form of any given social behaviour. The central principle of hermeneutics is that it is only possible to grasp the meaning of an action or statement within the context of the discourse or world-view from which it originates. For instance, putting a piece of paper in a box might be considered a meaningless action unless put in the context of democratic elections, and the action of putting a ballot paper in a box. One can frequently find reference to the 'hermeneutic circle': that is, relating the whole to the part and the part to the whole. Hermeneutics in sociology was most heavily influenced by German philosopher Hans-Georg Gadamer.[29]

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    Psychosis - From Wikipedia, the free encyclopedia

    __________________________________

    Clinical Psychiatric Hermeneutics



    "Clinical Psychiatric Hermeneutics" bundle created by Mike Nova 

    _____________________________________

    Update on 1:09 PM 5/12/2012 

    Clinical Psychiatric Hermeneutics


    Continuous Topic Review


    "Clinical Psychiatric Hermeneutics" bundle created by Mike Nova

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    Comprehensive interdisciplinary collection of links to news and journal articles on General, Forensic and Prison Psychiatry and Psychology and the issues of Behavior and Law with occasional notes and comments by Michael Novakhov, M.D. ( Mike Nova). ..... Clinical Psychiatric Hermeneutics. Loading.

    Source. Hodgins, and Blackwood), Clinical Neuroscience (Dr ffytche), Neuroimaging (Drs Simmons and Howard), and Psychology (Dr Kumari), Institute of Psychiatry, King's College London, and The North London Forensic Service (Dr Blackwood), London, England; and Département de Psychiatrie, Université de Montréal, Montréal, Canada (Dr Hodgins). .... Mike Nova: The Hermeneutic (Interpretational) Mode... "I argue that clinical medicine can best be unders.

    Comprehensive interdisciplinary collection of links to news and journal articles on General, Forensic and Prison Psychiatry and Psychology and the issues of Behavior and Law with occasional notes and comments by Michael Novakhov, M.D. ( Mike Nova). .... Clinical Psychiatric Hermeneutics. Loading.

    Comprehensive interdisciplinary collection of links to news and journal articles on General, Forensic and Prison Psychiatry and Psychology and the issues of Behavior and Law with occasional notes and comments by Michael Novakhov, M.D. ( Mike Nova). .... Clinical Psychiatric Hermeneutics. Loading.

    Comprehensive interdisciplinary collection of links to news and journal articles on General, Forensic and Prison Psychiatry and Psychology and the issues of Behavior and Law with occasional notes and comments by Michael Novakhov, M.D. ( Mike Nova). .... Clinical Psychiatric Hermeneutics. Loading.

    via pubmed: psychodynamic interp... by Luyten P, Blatt SJ, Corveleyn J on 5/11/12
    Minding the gap between positivism and hermeneutics in psychoanalytic research.
    J Am Psychoanal Assoc. 2006;54(2):571-610
    Authors: Luyten P, Blatt SJ, Corveleyn J
    Abstract
    Two quite different cultures are to be found within psychoanalysis, one more clinical in orientation, more focused on meaning and interpretation, and relying primarily on the traditional case study method, the other more research-oriented, focused on cause-and-effect relationships, and relying primarily on methods borrowed from the natural and social sciences. The history of this divide is reviewed and arguments, pro and con, about the potential contributions of specific types of empirical investigation are discussed. Increasingly, it seems, criticisms concerning the scientific status of psychoanalysis are being responded to by empirical research. This has contributed to a growing recognition within the scientific community of the credibility of aspects of psychoanalytic theories and of the effectiveness of psychodynamic treatment. However, some segments of the psychoanalytic community are concerned that this increase in the quantity and quality of empirical research on psychoanalytic concepts risks creating an empirical one-sidedness, while other segments are concerned that not engaging in systematic empirical research can lead to intellectual isolation, fragmentation, stagnation, and orthodoxy. To counter this polarizing tendency, a recommendation is made for methodological pluralism. Adopting this stance could contribute to an enriched understanding of the clinical process and to the development of new research methodologies to investigate complex psychodynamic hypotheses, thus bridging the gap between the two psychoanalytic cultures, as well as the gap between research and clinical practice.
    PMID: 16773823 [PubMed - indexed for MEDLINE]

    He started with data, and INDUCTIVELY DEVELOPED THE THEORY, rather than beginning with theoretical formulations and deducing the observational data which should appear if the theory were correct. […] ... Compare (a) and (c): If valid interpretations cannot be distinguished from invalid interpretations, then the accumulated clinical evidence cannot be positive and decisive. Compare (b) and (c): ...... Basic Techniques of Psychodynamic Psychotherapy. Northvale ...

    Some, especially depth psychologists, also consider the unconscious mind.a In addition or opposition to employing empirical and deductive methods, psychologists sometimes rely upon symbolic interpretation and other inductive techniques. ... which was increasing in popularity as physiology grew more sophisticated, could provide useful psychosocial understanding of a type that comparatively subjective inquiries, such as psychodynamic analysis as employed by ...

    Fields of Expertise : Research Methods in the Human Sciences Financial Statement Analysis Advanced Financial Accounting Accounting Theory and Practice Financial Reporting Issues Methodology and Method in Accounting Research ..... Fields of Expertise : 1991-Present: Studies in malingering in the forensic setting including validation of the M-Test as a screening device for malingered psychosis (at the North Florida Evaluation and Treatment Center, Gainesville, Florida) and ...

    In 1899 he published The Interpretation of Dreams, in which he analyzed the complex symbolic processes underlying dream formation: he proposed that dreams are the disguised expression of unconscious wishes. ...... On the basis of his early clinical work Freud postulated that unconscious memories of sexual molestation in early childhood were a necessary precondition for the psychoneuroses (hysteria and obsessional neurosis), a formulation now known as the seduction theory.

    via Psychodynamic interpretation and formulation as clinical hermeneutic devices - Google Blog Search by Robin L Carhart-Harris, Helen S Mayberg, Andrea L Malizia and David Nutt on 7/24/08
    This paper draws attention to consistencies between physiological processes identified by modern clinical research and psychological processes described by Freud, with a special emphasis on his famous paper on depression ... It must be stated that the evidence cited in this paper cannot logically validate psychoanalysis on the hermeneutic level and neither does it provide evidence for the efficacy of psychoanalysis as a treatment modality (see [11] for a review).

    Language, Eros, Being: Kabbalistic Hermeneutics and Poetic Imagination Elliot Wolfson 2005 Fordham University Press ISBN10:0823224198;ISBN13:9780823224197. The Mad Hatter Mystery (Dr. Gideon Fell Mystery) John .... Windows Mobile Game Development: Building Games for the Windows Phone and other Mobile Devices Adam Dawes 2010 ISBN10:1430229284;ISBN13:9781430229285. Behavioral Neurobiology of Schizophrenia and Its Treatment ...

    In addition, or in opposition, to employing empirical and deductive methods, some—especially clinical and counseling psychologists—at times rely upon symbolic interpretation and other inductive techniques. Psychology .... of the wider cognitive science. In its early years, this development had been seen as a "revolution", as it both responded to and reacted against strains of thought—including psychodynamics and behaviorism—that had developed in the meantime.

    When the child sees itself in the mirror, often propped up by another person or mechanical device and is able to associate the image with itself, it retroactively posits that before this autonomy that it now perceives, its body was in “bits and pieces.” The dependency upon .... I also know that because people don't read practical psychoanalytic texts often, they forget that many analytic observations are based on clinical experience, not speculation. Freud's scriptures on the ...

    in which the self is studied as an information-processing device, and the narrative metaphor, in which, ... J. M. Hermans, Department of Clinical Psychology and Personality, University ..... Arguments are formulated to convince someone of ..... explanation. Private Audience Drawing on the work of early symbolic interactionists and recent impression management theorists, Baldwin and Holmes (1987) started from the assumption that a sense of self is experienced ...

    For example, earlier Gestalt therapy practice often stressed the clinical use of frustration, a confusion of self-sufficiency with self-support, and an abrasive attitude if the patient was interpreted by the therapist as manipulative.

    Clinical psychiatric hermeneutics have a potential of developing into the new fields of both philosophical and psychiatric inquiries. Philosophy and psychiatry had always been close, and it looks like this romance might reignite ...

    Mike Nova: The Hermeneutic (Interpretational) Model Of Clinical Mental Health-Illness Assessment and other posts - Mike Nova's starred items · Google Reader - Mike Nova's starred items. Mike Nova's starred items ...

    As we turn from this historical review to the matter of hermeneutics in clinical theory and practice, it will prove useful to distinguish hermeneutics in psychoanalysis from hermeneutics in general psychiatry. The discussion ...

    "I argue that clinical medicine can best be understood not as a purified science but as a hermeneutical enterprise: that is, as involved with the interpretation of texts." - Theoretical .... Clinical Psychiatric Hermeneutics. Loading.
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    Update: 3:49 PM 5/9/2012

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    • Clinical psychiatric hermeneutics - pubmed
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    Hermeneutical Theory and Clinical Psychiatry ‹ The theory of interpretation and its corresponding implication for interpreting the patient. [What counts as Truth (Althethia or re-presentation)? Can an accurate assessment of a patient¹s concept ...

    via pubmed: clinical psychiatric... by Onocko-Campos RT, Campos GW, Ferrer AL, Corrêa CR, de Madureira PR, da Gama CA, Dantas DV, Nascimento R on 5/8/12
    Evaluation of innovative strategies in the organization of Primary Health Care.
    Rev Saude Publica. 2012 Feb;46(1):43-50
    Authors: Onocko-Campos RT, Campos GW, Ferrer AL, Corrêa CR, de Madureira PR, da Gama CA, Dantas DV, Nascimento R
    Abstract
    OBJECTIVE: To compare the performance of Primary Care Units according to the implementation of new arrangements and strategies in primary care and mental health.
    METHODOLOGICAL PROCEDURES: Evaluative research with triangulation of methods and theoretical framework of critical hermeneutics, carried out at six Primary Care Units of the two most populous health districts of the city of Campinas (Southeastern Brazil) in 2007. The Primary Care Units were analyzed according to clinical resolution, articulation between the primary care and mental health networks and implementation of health promotion strategies. Two groups were defined by cluster analysis: one with higher and another one with lower degree of implementation of the actions. The groups were compared based on the improvement in clinical follow-up, given by the occurrence of cerebral vascular accident; evaluation of dispensation of psychiatric medicines; focal groups with workers, users and community health agents; and interviews with users and relatives. Inclusive and participatory research strategies were employed.
    ANALYSIS OF RESULTS: There were no pure models, but a mosaic of organizational proposals. Positive advances were identified in the group with higher implementation of innovative strategies in relation to better integration of the community agents in the Units' teams; to the workers' and agents' perception of improvement in the assistance; and to the facility for referrals and assistance of mental health cases. The difficulties identified in both groups were: communication among the levels of care and within the teams, in the implementation of matrix support, and incipient health promotion actions.
    CONCLUSIONS: The development and implementation of mechanisms to fix professionals in Primary Care in large cities are necessary. The community health agents are fundamental to perform the territorial work proposed by the Family Health Strategy, using mechanisms to integrate the community health agents into the healthcare teams in order to counterbalance the tendency to isolation. The researched arrangements proved to be potent to produce this integration.
    PMID: 22252789 [PubMed - in process]

    via pubmed: clinical psychiatric... by Mun MS on 5/8/12
    An analysis of narratives to identify critical thinking contexts in psychiatric clinical practice.
    Int J Nurs Pract. 2010 Feb;16(1):75-80
    Authors: Mun MS
    Abstract
    The development of students' critical thinking abilities is one of the greatest challenges facing contemporary nursing educators. Nursing educators should know about what kind of contents or situations need critical thinking. The research was undertaken to identify the critical thinking contexts that nursing students confront in psychiatric clinical practices. Students were asked to document their everyday experience. The narratives were analysed and interpreted from the philosophical notion of hermeneutics. Four themes emerged as critical thinking contexts: anxiety, conflict, hyper-awareness, dilemmas. Writing narratives appear to provide opportunities for reflection in addition to facilitating critical thinking and communicative skills in students. Also, for the instructor, students' clinical narratives could provide insight to understand how students are thinking and to share student's personal difficulties.
    PMID: 20158552 [PubMed - indexed for MEDLINE]

    via pubmed: clinical psychiatric... by Resch F, Fegert JM on 5/8/12
    [Medical teaching in the area of conflict between "Evidence-based Medicine" and "Experience-based Medicine"].
    Z Kinder Jugendpsychiatr Psychother. 2009 Mar;37(2):97-103; quiz 104
    Authors: Resch F, Fegert JM
    Abstract
    As a medical discipline Child and Adolescent Psychiatry and Psychotherapy has gained increasing importance within society since given the epidemiological importance of behavioural problems in childhood and adolescence, it has verifiably improved the developmental chances of children at high risk. Child and Adolescent Psychiatry and Psychotherapy therefore should be systematically integrated into the German Medical Curriculum. The bio-psycho-social model provides us with a comprehensive paradigm of psychiatric disorders and has to face the problem of hermeneutics. An equilibrium between Evidence-based Medicine and the individual clinical experience with patients (Experience-based Medicine) must be established within medical teaching, rather than playing one against the other. Ethical dilemmas of medical therapy have to be taken into account.
    PMID: 19401995 [PubMed - indexed for MEDLINE]

    via pubmed: clinical psychiatric... by Vandenberghe J on 5/8/12
    [Does evidence-b(i)ased psychiatry have its limitations?].
    Tijdschr Psychiatr. 2008;50(6):377-85
    Authors: Vandenberghe J
    Abstract
    Evidence-based medicine (EBM) is an algorithm that integrates information technology and the results of outcome research into clinical work. EBM, if well understood, is a valuable and critical bottom-up method that promotes a dialectical process by which the practitioner is able to arrive at an informed treatment choice; the method starts from the individual patient and involves discussion with the patient and critical reading of the relevant literature. However, there is a risk that EBM will become an ideology unless we are aware of its assumptions and epistemology. It is not valuefree, but is driven by an implicit objectivist view of man. EBM attaches greater value to biomedical sciences that to the humanities, to empiricism than to hermeneutics and to quantitative research than to qualitative research. EBM focuses on internal validity, but is in danger of neglecting factors such as qualitative changes that are difficult to measure, ecological validity and effectiveness and may hinder the generalisation of research results to clinical practice. The limitations of EBM are even more poignant in psychiatry, because psychiatry is highly sensitive to context and values. EBM is a blessing if we use it critically and remain aware of its limitations and underlying philosophy and if we supplement it with strategies such as value-based medicine (VBM). EBM, however, does not teach us what is useful or valuable, whereas VBM helps us to explain and weigh up the values that are at stake.
    PMID: 18548416 [PubMed - indexed for MEDLINE]

    via pubmed: clinical psychiatric... by Limacher LH, Wright LM on 5/8/12
    Exploring the therapeutic family intervention of commendations: insights from research.
    J Fam Nurs. 2006 Aug;12(3):307-31
    Authors: Limacher LH, Wright LM
    Abstract
    Offered in this article are interpretations that emerged in a qualitative, interpretive study focused on the family intervention called a "commendation." The tradition of philosophical hermeneutics informs and shapes the analysis of the data. Research participants include a heterosexual couple and a nurse who engaged in therapeutic conversations focused on difficulties with Internet pornography. Data sources include videotapes of clinical sessions, documentation, and research interviews. Isolated segments of clinical videotape are shared with the couple to prompt their memory of commending practices that emerged in clinical sessions. Commendations are not experienced by this couple as gentle and warm but instead as extremely provocative, albeit constructive. This study illuminates the complex, contextual nature of commending practice and suggests that the noticing of strengths and resources contains much more than the spoken word.
    PMID: 16837697 [PubMed - indexed for MEDLINE]

    via pubmed: clinical psychiatric... by Luyten P, Blatt SJ, Corveleyn J on 5/8/12
    Minding the gap between positivism and hermeneutics in psychoanalytic research.
    J Am Psychoanal Assoc. 2006;54(2):571-610
    Authors: Luyten P, Blatt SJ, Corveleyn J
    Abstract
    Two quite different cultures are to be found within psychoanalysis, one more clinical in orientation, more focused on meaning and interpretation, and relying primarily on the traditional case study method, the other more research-oriented, focused on cause-and-effect relationships, and relying primarily on methods borrowed from the natural and social sciences. The history of this divide is reviewed and arguments, pro and con, about the potential contributions of specific types of empirical investigation are discussed. Increasingly, it seems, criticisms concerning the scientific status of psychoanalysis are being responded to by empirical research. This has contributed to a growing recognition within the scientific community of the credibility of aspects of psychoanalytic theories and of the effectiveness of psychodynamic treatment. However, some segments of the psychoanalytic community are concerned that this increase in the quantity and quality of empirical research on psychoanalytic concepts risks creating an empirical one-sidedness, while other segments are concerned that not engaging in systematic empirical research can lead to intellectual isolation, fragmentation, stagnation, and orthodoxy. To counter this polarizing tendency, a recommendation is made for methodological pluralism. Adopting this stance could contribute to an enriched understanding of the clinical process and to the development of new research methodologies to investigate complex psychodynamic hypotheses, thus bridging the gap between the two psychoanalytic cultures, as well as the gap between research and clinical practice.
    PMID: 16773823 [PubMed - indexed for MEDLINE]

    via pubmed: clinical psychiatric... by Chessick RD on 5/8/12
    Psychoanalytic peregrinations. II: Psychoanalysis as science and art.
    J Am Acad Psychoanal. 2002;30(2):259-76
    Authors: Chessick RD
    Abstract
    The foundations of psychoanalytic clinical practice involve the role of fantasy, creativity, and imagination as well as the natural science aspects of psychoanalysis. There is a common ground for psychoanalytic technique and we should not in a "politically correct" manner, as is so popular today, abandon the philosophical or Platonic foundationalism that lies at the basis of Freud's psychoanalytic practices. Although it is a "politically incorrect" view, a reasonable degree of objectivity and scientific validity is attainable by the relatively neutral psychoanalyst, using both natural science observations as well as introspection and hermeneutics. Furthermore, since psychoanalysis is fundamentally a creative activity, the roots of creativity require exploration and careful study. Subjective and first person methodologies such as Freud's psychoanalysis and phenomenology cannot be ignored in our search for the core of the self of each of our patients.
    PMID: 12197255 [PubMed - indexed for MEDLINE]

    via pubmed: clinical psychiatric... by Yegdich T on 5/8/12
    Clinical supervision, death, Heidegger and Freud come 'out of the sighs'.
    J Adv Nurs. 2000 Apr;31(4):953-61
    Authors: Yegdich T
    Abstract
    In his recent paper on clinical supervision, 'Out of the sighs' - an existential-phenomenological method of clinical supervision: the contribution to palliative care', in this journal, Jones weds psychoanalytical ideas with Heidegger's existential-phenomenological concepts to provide a theoretical framework for clinical supervision in palliative nursing. Although this is an interesting undertaking, theoretical diversity is not a simple matter of merely interchanging concepts. Rather, it is a complex process that must account for varying philosophical assumptions upon which any theory attempts to explain or understand reality. This paper examines the major themes identified by Jones. In particular, it focuses on the spirit of ontological hermeneutics and psychoanalysis, represented by their respective founders, Heidegger and Freud, and in general, refers to other thinkers and ideas mentioned by Jones - as for instance, Schön's reflective practice, Polanyi's personal commitment, Husserl's lived experience, Schutz's intersubjectivity and Yalom's existential disidentification. Here, discussion concerns the subject-object polarity. The paper argues that many of these philosophies are incompatible. In particular, psychoanalysis and existentialism imply inconsistent aims in that psychology does not equate with fundamental ontology - and Jones has not adequately distinguished between these in his supervision discourse. The implications of the accompanying conceptual problems for the practice of clinical supervision in palliative nursing are exemplified by Jones's case study of Lindsey, a dying patient.
    PMID: 10759992 [PubMed - indexed for MEDLINE]

    via pubmed: clinical psychiatric... by Kirshner LA on 5/8/12
    Toward a postmodern realism for psychoanalysis.
    J Am Psychoanal Assoc. 1999;47(2):445-63
    Authors: Kirshner LA
    Abstract
    The current status of psychoanalysis is explored in the light of the postmodern critique of forms of knowledge. Analysts have tended to respond by redefining psychoanalysis in the language of the exact sciences or by finding a language that includes both (Kuhn, Rorty), thereby falling either into a reductive "scientism" or the fallacies of the "strong program" in postmodern thought. However, psychoanalytic theories do not meet the probative requirements of science. Neither is the serious problem of competing theories and interpretations adequately addressed by hermeneutics. Philosophical realism (Putnam 1981, 1988) offers some helpful ways to look at this problem. Following Lacan, we define psychoanalysis as a clinical discipline which has as its unique object of study the human subject, an indeterminate and language dependent entity. Concepts and rules specific to our field make an internal realism of psychoanalytic inquiry possible. An extended case vignette accompanies this philosophical discussion.
    PMID: 10422049 [PubMed - indexed for MEDLINE]

    via pubmed: clinical psychiatric... by Walsh K on 5/8/12
    Shared humanity and the psychiatric nurse-patient encounter.
    Aust N Z J Ment Health Nurs. 1999 Mar;8(1):2-8
    Authors: Walsh K
    Abstract
    The paper is based on a phenomenological study of the nurse-patient encounter, the purpose of which was to uncover meaning and generate understandings of being a psychiatric nurse. The study was informed by the phenomenology of Martin Heidegger (1962) and the philosophical hermeneutics of Hans-Georg Gadamer (1975). Drawing upon this phenomenological study it is my intention to discuss three of the existential elements to emerge from an interpretative analysis of these encounters; 'Being-with' as understanding, 'Being-with' as possibility, and 'Being-with' as 'care-full' concern. The paper also discusses two modes of being-with patients; the modes of the 'they' nurse and the 'self' nurse. An underlying theme of shared humanity emerged from the study and had the effect of unifying the other concepts uncovered.
    PMID: 10382394 [PubMed - indexed for MEDLINE]

    via pubmed: clinical psychiatric... by Gedo JE on 5/8/12
    Reflections on metapsychology, theoretical coherence, hermeneutics, and biology.
    J Am Psychoanal Assoc. 1997;45(3):779-806
    Authors: Gedo JE
    Abstract
    Unable to correlate clinical findings with contemporary neurophysiology, Freud tried to anchor psychoanalysis within biology through a speculative metapsychology. Recently, epistemological objections have led to abandonment of his proposals qua scientific theory, although many still use them metaphorically. Others deny the need for any general theory of mental functions. Some theorists would espouse a hermeneutic basis for psychoanalysis, outside the boundaries of biology; they purport to confine their purview to mental contents but often use concepts based on metapsychological assumptions. Because the meanings of such contents are difficult to determine, their interpretation should be "constructed" in collaboration with analysands. By contrast, trained observers may reliably collect psychobiological data, accumulating knowledge of cognition, affectivity, communication, and the regulation of behavior--matters Freud encompassed via the economic and structural viewpoints. Hence analytic theory should be correlated with the findings of semiotics, cognitive psychology, and brain science. The hermeneutic focus on dynamics and genetics overlooks crucial data, such as the occurrence of trauma, leading to confusion about processes of pathogenesis, working through, and structural change. These and other biological phenomena (such as functional deficits and repetitive enactments) call for interventions beyond interpreting mental contents; improvement depends on learning better to process these contents. Change implies gradual establishment of alternative neural pathways; this does not automatically follow insight. Hence psychoanalysis must deal with intrapsychic phenomena beyond subjectivity. Intrapsychic conflicts represent efforts to ward off archaic mentality (primitive thought processing). Theories divorced from neurocognitive considerations encourage the theoretical fiction that analysands possess an "intact ego."
    PMID: 9353706 [PubMed - indexed for MEDLINE]

    via pubmed: clinical psychiatric... by Young-Eisendrath P on 5/8/12
    The self in analysis.
    J Anal Psychol. 1997 Jan;42(1):157-66
    Authors: Young-Eisendrath P
    Abstract
    This paper develops a theoretical and clinical approach to the self which is non-essentialist and post-modern. Briefly, it offers a framework for theorizing Self based on hermeneutics and psychological constructivism. It then develops a critique of the essentialist Jungian theory of Self in which the Self is frequently described as a human subject with views, intentions and desires of its own. With this as background, a post-modern Jungian framework for Self is advanced, with a brief clinical account of the self in analysis.
    PMID: 9062088 [PubMed - indexed for MEDLINE]

    via pubmed: clinical psychiatric... by Roiphe J on 5/8/12
    The conceptualisation and communication of clinical facts: a consideration of the 75th anniversary edition IJPA.
    Int J Psychoanal. 1995 Dec;76 ( Pt 6):1179-90
    Authors: Roiphe J
    Abstract
    The contributors to the Anniversary Edition of the IJPA attempt to respond to the Babel of ideas within contemporary psychoanalysis and to grapple with our methodology for discovering and validating our facts. Underlying this ambitious endeavour is the complex question of the status of psychoanalysis as a discipline--is it science, art, hermeneutics, or religion? Those who contribute to the volume have varying points of view on this question, reinforcing our ongoing confusion of tongues. The author argues that while we must tread very carefully to preserve the creativity and art of our discipline, we desperately need to address the basic science of psychoanalysis. Whether, and to what extent, we can succeed in doing so will perhaps best answer the question of what kind of discipline psychoanalysis is or can be. Many of us wish to view psychoanalysis as capable of scientific discourse and yet remain very ambivalent about embracing scientific methodology. What is unique to psychoanalysis must not be lost in turning to empirical research, nor in facile, 'reductive' translations to other models from other disciplines. However, if we are to make the claims of a scientific method, we must accept the burdens of it as well. In this regard, the author argues in favour of machines and brain, and against those who view such methods as 'radically' empiricist or reductionist. To truly test and reject our hypotheses, we must creatively and adaptively make use of empirical research methods that historically we have been very reluctant to embrace.
    PMID: 8789168 [PubMed - indexed for MEDLINE]

    via pubmed: clinical psychiatric... by Chessick RD on 5/8/12
    Hermeneutics for psychotherapists.
    Am J Psychother. 1990 Apr;44(2):256-73
    Authors: Chessick RD
    Abstract
    Hermeneutics as a method of approach has been used differently by many different authors, and in this paper I have reviewed the history and evolving employment of the hermeneutic approach. For the purposes of psychotherapists, the point of hermeneutics is that, in contrast to the natural sciences, it focusses away from the classical notion of the neutral independent observer (or subject or psychotherapist) as detached from the object of his or her study, the patient. All understanding in the human sciences is viewed by hermeneutics as arising out of a fusion of horizons between the investigator and the humans being investigated. The "knowledge" which arises from such an investigation is not some sort of immutable truth or essence, but is context dependent and a function of the "prejudices" which the investigator brings to the investigation. Diagnoses and formulations in the practice of psychotherapy, if the hermeneutic approach is employed, cannot be viewed as disease entities and natural science "facts," but rather as temporary formations that change with changing times, historical eras, cultures, and prevailing prejudices and practices. The problem of a hermeneutic psychiatry would be to steer between the Scylla of naive realism ignoring the major participation of the psychotherapist on the one hand, and the Charybdis of relativism, nihilism, and hopeless skepticism on the other. Much work remains to be done in order to clarify the role and limitations of hermeneutics, and to incorporate it into the clinical practice of psychotherapy, and this work must be done against the prevailing ideology of scientific materialism that characterizes our historical era. A hermeneutic psychiatry offers us the best hope of not losing sight of the methodological horizons that delimit our clinical work, and of widening these horizons so as to provide further understanding of our patients.
    PMID: 2195904 [PubMed - indexed for MEDLINE]

    via pubmed: clinical psychiatric... by Becker K on 5/8/12
    [Everyday psychiatry--a contribution to the hermeneutics of diagnostic and therapeutic clinical practice].
    Psychiatr Prax. 1987 Sep;14(5):151-6
    Authors: Becker K
    Abstract
    The relations between diagnostic and therapeutic practice and the events of everyday life are investigated in a two-fold regard. The first view is directed towards the signification of "psychiatry" and of the psychiatric view-points in the everyday life of society; the second view is the experience of everyday life inside psychiatric institutions. Under both aspects an interest in the development and the both aspects an interest in the development and the process of mental illness is pursued, which is also an interest in correct diagnostic insight and in promoting therapeutic consequence that positively influences the process.
    PMID: 3671588 [PubMed - indexed for MEDLINE]

    The previous lack of a proper diagnostic system had set psychiatry adrift – lurching toward hermeneutics and away from healing. DSM-III ... Now it was the center of every clinical, research, teaching, forensic conversation.

    Jaspers applied Husserlian phenomenology and Dilthey's Hermeneutics into clinical psychiatry and published Allgemeine Psychopathologie (General Psychopathology) in 1913. Jaspers turned his focus to philosophy and published a ...

    via Clinical psychiatric hermeneutics - Google Blog Search by acountrydoctorwrites on 2/26/12
    It is not only the patient with a psychological or psychiatric complaint who needs to tell the story that goes with the symptoms. Many patients cannot reduce their experience of any illness to clear-cut, easily catalogued clinical ...

    This hermeneutic, phenomenologic study explored the experiences and the meaning that psychiatric nurse clinicians make of self-disclosure, and inevitably, nondisclosure in their therapeutic relationships with clients. ^ Participants included ...

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    Clinical psychiatric hermeneutics - Pubmed Search


    Clinical psychiatric hermeneutics - Pubmed Search - RSS

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    Gedo JE.
    J Am Psychoanal Assoc. 1997;45(3):779-806. Review.
    PMID:
    9353706
    [PubMed - indexed for MEDLINE]
    *
    Roiphe J.
    Int J Psychoanal. 1995 Dec;76 ( Pt 6):1179-90.
    PMID:
    8789168
    [PubMed - indexed for MEDLINE]
    *
    Chessick RD.
    Am J Psychother. 1990 Apr;44(2):256-73. Review.
    PMID:
    2195904
    [PubMed - indexed for MEDLINE]
    Mun MS.
    Int J Nurs Pract. 2010 Feb;16(1):75-80.
    PMID:
    20158552
    [PubMed - indexed for MEDLINE]
    *

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    Hermes - Google Search

    Hermes
    From Wikipedia, the free encyclopedia
    Jump to: navigation, search
    Hermes
    So-called “Logios Hermes” (Hermes,Orator). Marble, Roman copy from the late 1st century CE - early 2nd century CE after a Greek original of the 5th century BCE.
    So-called “Logios Hermes” (Hermes,Orator). Marble, Roman copy from the late 1st century CE - early 2nd century CE after a Greek original of the 5th century BCE.
    Messenger of the gods
    God of commerce, thieves, travelers, sports, athletes, and border crossings, fish, guide to the Underworld
    SymbolCaduceus, Talaria, Tortoise, Lyre, Rooster, Snake
    ConsortMerope, Aphrodite, Dryope, Peitho
    ParentsZeus and Maia
    ChildrenPan, Hermaphroditus, Tyche, Abderus, Autolycus, and Angelia
    Roman equivalentMercury
    Hermes (play /ˈhɜrmz/; Greek : Ἑρμῆ(ς),[1] -οῦ, -ὁ,[2][2][3]) An Olympian god in Greek religion and mythology, Hermes was the son of Zeus and the Pleiade, Maia, a daughter of the Titan, Atlas. The second youngest of the Olympian gods, he was born before Dionysus.
    His symbols include the rooster and the tortoise, his purse or pouch, winged sandals, winged cap, and held in his left hand, the herald's staff, the Greek kerykeion or Latin caduceus.[4]
    Hermes was the herald, or messenger, of the gods to humans, sharing this role with Iris. A patron of boundaries and the travelers who cross them, he was the protector of shepherds and cowherds, thieves,[5] orators and wit, literature and poets, athletics and sports, weights and measures, invention, and of commerce in general.[6]
    In the Roman adaptation of the Greek pantheon (see interpretatio romana), Hermes was identified with the Roman god Mercury, who, though inherited from the Etruscans, developed many similar characteristics, such as being the patron of commerce.[citation needed]

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    Mike Nova: Hermes

    Updated: 7:30 AM 5/13/2012

    http://east-and-west-org.blogspot.com/2011/11/blog-post_17.html 

    Гермес

    Дал имя Герменевтике лукавой
    Хитрец Гермес, Богов посланник верный,
    Душ проводник в последний мир подземный,
    Изобретатель языков и речи, а также — их толмач;
    А также лжец, а также вор и плут;
    And, according to the rumors - gay.
    Слова-пророчества или слова-ловушки?
    Гадайте сами, герменевтируйте в потёмках.
    А он лишь ухмыльнётся в ус свой тонкий

    http://www.russ.ru/pole/CHem-i-kak-zhivet-germenevtika
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    Explorations in Criminal Psychopathology: Clinical Syndromes With Forensic Implications, Second Edition - JAAPL

    Explorations in Criminal Psychopathology: Clinical Syndromes With Forensic Implications, Second Edition

    The book is divided into three sections of five chapters each: “Disorders of Behavior,” “Disorders of Thought,” and “Borderline and Psychotic Disorders.” In each section, the reader will find description and analysis of unusual or uncommonly discussed criminal forensic topics. The first section covers catathymic reactions, pathological gambling and its relationship to crime, idiosyncratic alcohol intoxication, organic brain dysfunction, and sadistic aggression. Section II reviews delusional misidentification syndromes, obsessional following (stalking), factitious disorder (including the by-proxy variant), morbid jealousy, and forensic aspects of pseudologia fantastica, or pathological lying. In Section III are discussions of Ganser's syndrome and other rare dissociative states, conduct disorder history in men with schizophrenia, dissociative identity disorder, post-traumatic stress disorder (PTSD), and malingering. As this listing indicates, only a few chapters, such as those on PTSD and on the assessment of malingering, cover ground that is likely to be familiar to many or most forensic practitioners.      
         

    J Am Acad Psychiatry Law 40:1:153-154 (January 2012)

    Explorations in Criminal Psychopathology: Clinical Syndromes With Forensic Implications, Second Edition

    Edited by Louis B. Schlesinger. Springfield, IL: Charles C Thomas Publisher, Ltd., 2007. 394 pp. $79.95 hardcover, $55.95 paperback, $55.95 ebook.
    1. Joseph R. Simpson, MD, PhD
    + Author Affiliations
    1. Long Beach, CA
    By design, Explorations in Criminal Psychopathology differs from most books in the fields of forensic psychiatry and forensic psychology. In the Introduction, the Editor, Dr. Louis B. Schlesinger, describes the book's intent: “Practitioners …need to have expertise in a wide range of clinical conditions—beyond those covered in the Diagnostic and Statistical Manual of Mental Disorders (DSM)—that relate to various forms of criminal conduct ” (p xiii). The Introduction's final paragraph states: “The need for forensic practitioners to understand…the psychodynamics of crime cannot be overemphasized” (p xiv). With these goals in mind, the volume is organized in terms of clinical and psychodynamic concepts, as opposed to specific diagnostic categories (such as psychosis or substance abuse) or medico-legal matters, such as competence to stand trial, diminished capacity, and legal insanity.
    The book is divided into three sections of five chapters each: “Disorders of Behavior,” “Disorders of Thought,” and “Borderline and Psychotic Disorders.” In each section, the reader will find description and analysis of unusual or uncommonly discussed criminal forensic topics. The first section covers catathymic reactions, pathological gambling and its relationship to crime, idiosyncratic alcohol intoxication, organic brain dysfunction, and sadistic aggression. Section II reviews delusional misidentification syndromes, obsessional following (stalking), factitious disorder (including the by-proxy variant), morbid jealousy, and forensic aspects of pseudologia fantastica, or pathological lying. In Section III are discussions of Ganser's syndrome and other rare dissociative states, conduct disorder history in men with schizophrenia, dissociative identity disorder, post-traumatic stress disorder (PTSD), and malingering. As this listing indicates, only a few chapters, such as those on PTSD and on the assessment of malingering, cover ground that is likely to be familiar to many or most forensic practitioners.
    Some might wonder why a book devoted to examining psychodynamic processes and forensic “zebras” is necessary or worthwhile. But anyone who has worked in forensic psychiatry for any length of time realizes that the complexities of human behavior cannot always be easily explained simply by the application of a diagnostic label. Knowledge of psychodynamics can be of great value in assisting the forensic expert to make sense of the unconscious motivations and other antecedents for what may on the surface appear to be a bizarre or senseless crime. In certain cases, familiarity with psychodynamic mechanisms allows the evaluator to provide a more complete picture of the defendant's psychological makeup, emotional reactions, and thought processes, as well as their relationship to the legal question(s) at hand, especially for criminal defendants who have personality disorders or clinically significant maladaptive personality traits, but whose perception of reality in the traditional sense is found to be intact.
    In the past few decades, many psychiatry residency programs have de-emphasized the teaching of psychodynamic formulation. In a one-year forensic psychiatry fellowship, there may be little time to explore psychodynamic subjects while learning the basics of the legal system, report writing, correctional mental health, and so forth. This book, which includes concepts with which early-career forensic psychiatrists are only vaguely familiar, should pique their curiosity and motivate them to learn more about how psychodynamic theories of behavior may influence forensic psychiatric practice. While the book does not attempt to provide a comprehensive review of psychodynamic theories, the chapters that discuss these concepts generally do so in a clear and accessible manner.
    Many chapters in the volume include illuminating discussions of the unconscious mental processes and motivations thought to drive certain types of criminal conduct. A few examples serve to illustrate this theme. Chapter 1 reviews catathymia, the process by which an unresolved conflict, often centered on feelings of sexual inadequacy, leads to violence toward a victim who is symbolically representative of the conflict and who therefore threatens the perpetrator's psychological integration. The author explains that the violent act resolves the emotional tension and reestablishes internal equilibrium.
    The authors use the chapter on delusional misidentification to explain the hypothesized psychological mechanisms underlying aggression in patients with Capgras syndrome, the belief that a person in one's environment has been replaced by an identical-appearing impostor. Symptoms originate when anger toward another person is first defended against by denial. When this is not effective, splitting takes place, such that positive attributes are assigned to the original identity and all negative attributes are assigned to the impostor. Thus the delusional patient is free to experience righteous anger toward the supposed impostor without emotional conflicts. Subsequently, through projection and projective identification, the patient attributes his own hostile impulses to the misidentified object and comes to fear that person's hostility and malevolent intent.
    In the chapter on obsessional following, we find a discussion of borderline personality organization in the stalker. The obsessional following typically has its origin in a pathological response to social isolation and social incompetence that challenges a narcissistic fantasy of specialness. Feelings of shame and humiliation are defended against with rage, which also prevents the experience of sadness. As with aggression in the context of a Capgras delusion, obsessional followers frequently employ borderline defense mechanisms such as denial, splitting, and projective identification, as well as idealization and, later, devaluation.
    Similar analyses are found in other chapters. In each chapter, practical applications of the psychological explanations are covered in discussions of matters such as epidemiology, risk assessment, treatment, and legal topics, such as insanity and sentencing mitigation. Ultimately, the reader will gain an appreciation of how identifying and understanding unconscious mental processes can translate into an explanation of aberrant behavior that is useful in a forensic context. As mentioned previously, this is likely to be of particular relevance in regard to individuals who do not have psychosis and who may appear relatively “normal” in the eyes of the legal system.
    One evident weakness of the book is the outdated nature of the research cited by several of the contributors. This is the second edition; the first was published in 1996. Four of the 15 chapters include no references more recent than that date, and thus it must be assumed that they were not updated for the second edition. One of these chapters describes three references from 1984 as “current opinion” (p 71). In another two chapters, the only post-1996 reference is to the 2000 text revision to the fourth edition of the DSM.
    A second weakness is Chapter 12, entitled “The Consequences of Conduct Disorder for Males Who Develop Schizophrenia: Associations With Criminality, Aggressive Behavior, Substance Use, and Psychiatric Services.” This chapter describes the results of a single study examining the prevalence of premorbid conduct disorder in a group of men with schizophrenia or schizoaffective disorder. Although it is interesting in its own right, it does not fit in particularly well with the topics covered elsewhere in the book. It does not discuss psychodynamic processes or provide much in the way of practical information for use in the legal arena.
    Despite these problems, Explorations in Criminal Psychopathology clearly would make an excellent addition to the library of any forensic practitioner who evaluates criminal defendants.

    11:50 AM 6/21/2012 - Prison Psychiatry News Review

    11:50 AM 6/21/2012 - Prison Psychiatry News Review


    "Prison Psychiatry News" bundle created by Mike Nova

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    ________________________________

    Last Update: 12:11 PM 6/21/2012

    Congressional Hearing on Solitary Confinement: finally!

    via Prison Watch Network by Prison Watch Network on 6/21/12
    On June 19th the first Congressional Hearing in the USA on Solitary Confinement took place. Many friends, family, activists and advocats for those held in these torturous conditions sent in their testimony. Solitarywatch has an archive with this testimony here:

    http://solitarywatch.com/resources/testimony/

    The actual hearing text can be read too in PDF form here:

    http://solitarywatch.files.wordpress.com/2012/06/transcript-of-the-hearing.pdf

    Here are some more articles about the Hearing:

    Mother Jones: Senators Finally Ponder the Question: Is Solitary Confinement Wrong?

    The Guardian: Congress unlocks America's hidden shame of solitary confinement.

    New York Times Editorial: The Abuse of Solitary Confinement
     
    _________________________________

    DiMasi faults prison for medical care delay - Boston Globe

    via prisons - Google News on 6/21/12

    Boston Globe


    DiMasi faults prison for medical care delay
    Boston Globe
    DiMasi, serving an eight-year sentence in a Kentucky prison on a public corruption conviction, said he discovered lumps in his neck in December, but he was not ...
    DiMasi faults prison for care delayBoston.com
    Lawer: Sal DiMasi denied cancer treatment by fedsBoston Herald
    Former Mass. House Speaker diagnosed with Stage 4 cancerNECN
    Worcester Telegram -GoErie.com
    all 27 news articles »

    via prisons - Google News on 6/21/12


    Prisoner of the day
    Iranian
    ICHRC: Upon completion of his three-year prison term, journalist Issa Saharkhiz has been sentenced to an additional 1.5 years in prison, despite a medical ...

    via prisons - Google News on 6/21/12


    Quinn decides to keep open 3 prison work-release centers
    The State Journal-Register
    PEORIA — The Peoria Adult Transition Center and two other prison work-release centers will remain open indefinitely, according to a memorandum released by Gov.
    Peoria Adult Transition Center to stay openPeoria Journal Star

    all 3 news articles »

    via prisons - Google Blog Search by Lynnanne Nguyen on 6/20/12
    Illinois Governor Pat Quinn announced today seven Illinois facilities are closing to save the state money. The facilities affected got a memo from the state yesterday letting them know employees and p.

    via prisons - Google Blog Search by Jake on 6/21/12
    Maybe one of the reasons we do so is because we've been privatizing our prisons. As we privatize, prison companies can only grow if we incarcerate more and more people. Are we creating a Prison Industry Complex?

    via prisons - Google Blog Search by unknown on 6/17/12
    Accra, June 17, GNA The Human Rights Advocacy Centre HRAC of Ghana at the weekend cited the Ghana Prisons Authority for gross violation of the rights of remand prisoners and called for immediate measures to address it ...

    via prison mental health - Google Blog Search by alecrosenberg on 6/19/12
    Haney, who toured several California prisons to assess overcrowding and staffing, testified that prison mental health workers are too overburdened to provide adequate care to inmates, which not only harms prisoners but also ...

    via prison mental health - Google Blog Search by sjennings29 on 5/30/08
    Short-changed – Spending on prison mental health care , 30th May 2008, Sainsbury Centre for Mental Health Click on the title above for the full-text of this report Summary Last year, £20.8 million was spent on mental health ...

    via prison mental health - Google Blog Search by Views and News staff on 6/21/12
    That's because any doubt in the matter of his mental health generally means the law should go in the defendant's favour, allowing him or her to avoid prison and instead be treated for their psychiatric ailment.

    By Don Thompson The Associated Press via The San Francisco Chronicle SALINAS VALLEY, Calif. — Six inmates were taken to hospitals after fighting broke out Tuesday among dozens of armed inmates at a maximum-security prison in Central California, corrections officials said. No employees were injured in the morning disturbance at Salinas Valley State Prison in Soledad, about 130 miles southeast of ...

    By Brett Hambright Intelligencer Journal/New Era Lancaster, Pa. — Despite urging from prosecutors that George Nichols Sr. is a danger to motorists across Lancaster County, he was allowed Tuesday to stay free on bail. But only under certain conditions. Nichols, charged this month with causing a New Year's Eve crash that killed two people, must wear a bracelet that monitors alcohol intake and ...

    via Prison News on 6/21/12
    The Supreme Court Justices pose for a picture in 2010. President Barack Obama, Vice President Joe Biden, and senior staff, react in the Roosevelt Room of the White House, as the House passes the health care reform bill, March 21, 2010.

    The Associated Press LOS ANGELES — The California Highway Patrol sought help from the public Wednesday as it investigated an online video that appears to show a man being beaten unconscious in a road-rage attack on an East Los Angeles freeway. The video, which has drawn more than 100,000 views on YouTube and other networks, apparently was taken at about 3:30 p.m. June 12 on a transition road to ...

    By Henry Bailey The Commercial Appeal DESOTO, Tenn. — A contract for jailhouse video-visitation operations that officials hope will slam the door on forbidden items has gotten the unanimous approval of the DeSoto Board of Supervisors. Best of all - it's at virtually no ongoing cost to taxpayers. "We're not paying anything - they're paying us," board attorney Tony Nowak said ...

    The state executed a former grocery store butcher for dismembering a man during a 1996 attack

    via prison psychiatry - Google Blog Search by alecrosenberg on 6/19/12
    Haney, who toured several California prisons to assess overcrowding and staffing, testified that prison mental health workers are too overburdened to provide adequate care to inmates, which not only harms prisoners but also ...


    IceNews


    75 percent want Breivik sent to jail
    Views and News from Norway
    That's because any doubt in the matter of his mental health generally means the law should go in the defendant's favour, allowing him or her to avoid prison and ...
    Send Breivik to jail, say most NorwegiansIndependent Online
    Breivik to stay in Oslo prison whatever trial outcomeIceNews
    Anders Behring Breivik trial nears end with closing argumentsTelegraph.co.uk
    Sky News -Wall Street Journal -BBC News
    all 479 news articles »


    TIME


    As Breivik's Trial Nears Its End, Psychiatry Takes a Beating
    TIME
    Psychiatry is being judged as well. With Mr ... If he is considered sane, the court's five judges will sentence him to 21 years in prison (though he can be detained ...


    ForUm


    Psychiatrist Vyacheslav Mishiyev: We don't force people into treatment
    ForUm
    In the post-Soviet space there are enough stereotypes, defining psychiatry .... Allegedly, certain doctors fake diagnoses "insane" to help criminals escape prison.

    via candidaabrahamson by rfinkel on 6/21/12
    “A mood diary is incredibly helpful, and I always encourage my patients to use them. . .The patients are, on a day-to-day basis, in tune with how they’re doing, and they can take care of themselves.” ~ Adele C. Viguera, MD, Adele C. Viguera, MD, psychiatrist and associate director of the perinatal and reproductive psychiatry program [...]


    ForUm


    Psychiatrist Vyacheslav Mishiyev: We don't force people into treatment
    ForUm
    In the post-Soviet space there are enough stereotypes, defining psychiatry .... Allegedly, certain doctors fake diagnoses "insane" to help criminals escape prison.


    Interview / 21 June 2012 | 14:34
    Psychiatrist Vyacheslav Mishiyev: We don't force people into treatment

    Psychiatrist Vyacheslav Mishiyev: We don't force people into treatment


    Mental illness is one of the favorite subjects of Hollywood scrip writers. Manias, visions, strait jackets, electroshock - all these attributes help to create dark, spooky, but exciting atmosphere, while doctors and nurses are usually depicted as monsters, who abuse the helplessness of the patients.

    In the post-Soviet space there are enough stereotypes, defining psychiatry as closed, corrupted and penal science. ForUm has had an interview with the chief psychiatrist of the Kyiv Pavlov's mental hospital Vyacheslav Mishiyev to clarify the situation and may be to bust some myths.

    - What can you say about mental health of the Ukrainian nation? Is it mentally healthy?

    - Ukrainians are neither sicker nor healthier than any other world nation. Mental disorders are predetermined by complicated and global factors, let's say something more that a fight with a girlfriend and low salary. There is a common biological pattern, which leads to mental instability. It is determined by the very course of man's life and affects 1-3% of Ukrainian population in particular and the world population in general. Besides, the Ukrainian nation was not born yesterday, but evolved from the common European family. We do not possess something the rest of Europe never had.



    - We've learned there is an infant care unit in your hospital. Why would you hospitalize small children of two, three or five years old? And what are the treatment methods exactly?

    - A part of little patients has been born with mental disorders, and they need a therapy. A part of children has born disposition and our task is to prevent the illness from development. There are also children affected by external factors, like stress, a family tragedy or fear experience. They all need professional help, otherwise they would not be here.

    We apply complex treatment, including medications, psychotherapy, and social rehabilitation therapy. If to speak about children with born mental deficiency, which is incurable, we use therapy to correct psychomotor agitation and behavior of a patient.

    - According to some data, 80% of Ukrainians with mental disorders are hospitalized, while in Western countries only 20% are in hospital stay, which is considered more humane. Is it true?

    - Don't believe everything you hear. In Kyiv, for example, there are 60 thousand registered patients, but only two thousand hospital beds. As you see, the majority of patients are treated at home.


    - In Ukraine compulsory psychiatric care is applied by court decision only. But in the street you may sometimes meet people, who look inadequate. Don't you think such people are like loaded firearms without safety lock?

    - I believe that authorities and mental clinics should act within the law and follow court decisions. The law "On psychiatric help" says we cannot force mentally ill person into treatment, unless he poses a threat to himself or to the public.

    There are people, who do not like migrants of Caucasia origin and who honestly believe they must be locked up, for example... These are all biased opinions. The only unbiased factor in this question is to determine whether a person poses a threat. You know, it's not amusing to tie somebody to a 16-kilo kettlebell, especially for those tied up.


    - Here or there we hear about infamous crimes, like the one on Oksana Makar case. Does it mean the Ukrainian society is becoming more aggressive and cruel, or those are some single cases?

    - I would not say there is a pattern or tendency. I believe these are single outbreaks of aggression, which exist in every society of all times. Norwegian Anders Breivik killed 77 people. Some years ago in Germany a schoolboy brought a gun and killed a dozen people in the school. Similar cases happen in the US. All this public reaction is conditioned not by the increase of violence, but by availability of information. 30 or 40 years ago the mass media was not so spread, and people learnt about infamous crimes belatedly or did not learn at all. But similar crimes did happen before. So I don't believe our society is becoming more aggressive and cruel.

    - Ukrainians are known for their weakness to self-treatment. They do all by themselves: diagnosis, prescription, treatment. How dangerous can it be?

    - If you compare the amount of drugs the Americans consume, our society will appear as an innocent baby. Americans take drugs in every case: fight with a wife, overweight, bad mood...Hence, I don't think we have such a bad situation with groundless medication. Besides, more or less serious drugs cannot be bought without a prescription, only harmless ones.

    - The state service on drug control wants to cancel criminal responsibility for possession of drugs for personal use. Do you thin in this case you'll have more patients?

    - Abuse of drugs is not common for our culture. Alcohol, on the other hand, is. But if we legalize drugs for personal use we will give birth to a separate group of people who will justify drug abuse following the law. Besides, possession for personal use is already legal for sick people.

    - There is a new therapy based on methadone being introduced in Ukraine to treat drug addiction. But methadone is also a drug. Don't you think we will repeat the sad story of the therapy treating opium addiction with cocaine, which was widely used in 19th century?

    - Back then they also used heroin to cure opium addiction. But yes, you right, we can easily let out a jinni. Methadone can be applied for heavy addicts, especially for those infected with AIDS, so they don't needle the veins. But the very fact of methadone introduction will foster a group of people, who will use this drug for fun and will eventually get addicted.


    - They say that due to the financial crisis in Ukraine the number of alcoholics has increased...

    - You know what. We did not start yesterday. It all began three hundred years ago. And if, let's say, our alcoholism had been increasing for all these years, we would have been doing this interview totally wasted. We drank under Peter the First reign, during the war, in 1960ies...Those who declare growth of alcohol addiction just want to promote themselves.

    - Have you ever had cases of gambling addiction?

    - Yes, I had several cases. In such cases patients need psychological treatment and medications to strengthen their will and reduce the craving to make a bet. We must make such patients to abandon their style of life. By the way, I do welcome the decision to forbid gambling at the legislative level.

    - How successful was the treatment?

    - Well, one patient recovered in full and never played again, while another one snapped once and came back for the repeated tour of therapy.

    - What about internet addiction? Is it wide-spread in Ukraine?

    - I believe that all those talks about internet addiction are just the latest thing in mass media world. There are, of course, some single cases, but it's not like mothers standing in line to treat their children.

    - In early 60ies there was an anti-psychiatry movement originated in Ukraine. The followers of this movement accuse traditional psychiatry of being penal medicine. What is your opinion on this?

    - Nobody forces anybody into treatment. We discussed this at the beginning. If a person does not want profession help, he does not get it. If a person hears voices, but goes to a voodoo-hoodoo doctors to be cured with moonlight or solar energy it is his business. Psychiatry is a medical science with long history. Ukrainian psychiatry is successful enough. Schizophrenia, for example, used to be a fatal disease, but now we can beat it. In 30-50% of mental disorder cases we achieve positive results.

    - You mean full recovery?

    - I mean positive results. We achieve a high level of remission. You know that gastric ulcer cannot be cured completely, but somehow nobody says that gastroenterology is unsuccessful or even penal medicine...

    - There is an opinion that not all psychiatrists are equally honest. Allegedly, certain doctors fake diagnoses "insane" to help criminals escape prison...

    - Oh, this is absurd. The institute of legal psychiatry has skilled doctors with many-year experience. If a person tries to fake mental illness he will be discovered very quickly. Speaking about some plots on fake diagnosis, believe me no decent doctor will not go for it. At least, I've never heard about such cases for the whole period of my practice.

    Alina Yeremeyeva, author's photos
    ForUm