@FP= Although rehabilitation is often considered a type of punishment for criminal offenders, its objectives are therapeutic rather than punitive. While some theories of punishment claim that criminals deserve to suffer for their crimes, the rehabilitative ideal views criminal behavior more like a disease that should be treated with scientific methods available to cure the offender. Many convicts suffer from mental and physical illness, drug addiction, and limited opportunities for economic success and these problems increase the likelihood that they (...) will engage in criminal activity. If we simply incarcerate the convict while she “pays her debt to society,” she will likely reenter it with all of the obstacles that drove her to crime still in place. She will also need to contend with additional difficulties: a criminal record will impact her employment opportunities, she will be older and still without marketable skills or education, her social relationships may have deteriorated while she was in jail, and she may have become further acclimated to criminal culture. Thus incarcerating offenders could actually make them more likely to commit offenses after they are released, and recidivism rates attest to this. A rehabilitative approach would attempt to treat the underlying cause of her transgressions so that she can return to society to become a full and productive citizen. In other words, instead of exacting revenge against criminals and making their lives worse, rehabilitation tries to help them. (shrink)

BackgroundMethamphetamine addicts can experience severe emotional processing disorders, with abnormal responses to emotional and drug-related stimuli. These aberrant behaviors are one of the key factors leading to relapse. Nevertheless, the characteristics of addicts’ responses to drug-related stimuli and their responses to emotional stimuli remain controversial.Methods52 methamphetamine addicts from China passively viewed three different categories of images: Drug-related; positive emotional; and negative emotional. In the first task, participants completed a 9-point Self-Assessment Manikin (SAM) scale, rating the valence of (...) each image. In the second, they performed a cued-action task while electroencephalography (EEG) data were recorded.ResultDrug-related images were rated negatively, with an average rating of 3.57. However, reaction times to drug-related stimuli were significantly faster than for negative stimuli (p = 0.030), and were indistinguishable from positive stimuli (p > 0.99). Similarly, EPN amplitudes evoked by drug-related images were significantly larger than those evoked by negative stimuli (p 0.99). LPP amplitudes evoked by drug-related stimuli were significantly smaller than those evoked by negative (p < 0.001) and positive stimuli (p = 0.004).ConclusionDespite negative self-assessments of drug-related imagery, MA-addicts reaction times were no slower than positive reactions. Similarly, drug-related and positive imagery EPN amplitudes were indistinguishable. Together, these results suggest increased attentional resources were allocated to the processing of drug-related stimuli and the pathways responsible partially overlap with the those recruited in processing positive emotional imagery in addicts. Moreover, in the late stage of visual processing, MA-addicts showed reduced brain activity in response to drug-related stimuli, suggesting reverse inhibition in response preparation and emotional appraisal. These findings may provide a reference for clinicians treating drug-taking behavior and for the development of new models of rehabilitation therapy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Confronting Addiction Across DisciplinesAllison Mitchell (bio)Keywords(Anglo-American) analytic philosophy, scientific method, hyper-rationality, autonomous agency, externality, AugustinePatricia Ross's detailed and thorough response to my paper exemplifies some of those strengths and weaknesses typically associated with contemporary Anglo-American analytic philosophy. The development of her position involves the following representative moves: In the first stage of her discussion, she highlights the possible presence of an implicit, untested, and potentially false proposition underlying my (...) general argument, namely, that proper theorizing about ourselves and the world may provoke changes in our beliefs and any behaviors based on them. In the second stage of her project, she expresses a paradigmatically analytic mode of skepticism; this doubt concerns a "chain of events" implicit in the development of my position, and it takes the form of a set of questions that bear a strong family resemblance. First, Ross questions the very possibility or intelligibility of using fictional discourse and philosophical theory to explore the ways in which addicts conceive of themselves and their circumstances. Next, Ross turns to a more psychological (and intellectually profitable) line of questioning: Do people struggling with drug abuse and addiction have similar self-conceptions that, moreover, are meaningfully distinct from those expressed by nonusers? How might such idiosyncratic and shared modes of self-understanding instruct us about the disease of addiction? Finally, in what sense (if any) might certain alterations in our conceptual schemas have practical rehabilitative value? Having voiced uncompromising doubt concerning my pragmatic appropriation of philosophy and literature, Ross proceeds to an unlikely third step in her argument: She insists that my project is entirely theoretical, in the sense that I focus exclusively on truth-evaluable claims (about addicts' conceptions of self and world) that are garnered from literary narratives. Relatedly, she takes issue with my strong Wittgenstenian intuition about the presence of some intimate connection between linguistic self-expression and an individual's conceptual framework, insisting that I neglect "the degree to which the narratives are [not] honest, veridical expressions of self-conceptions" (228). Ross urges me to recognize that the language employed in narratives of drug abuse and addiction "might be said to reflect the addict's observations concerning his or her self-hood, or, alternatively, what the addict cares to portray about this conception, however truthful" (228). From her analytic-philosophical perspective, these features of language, combined with sensible intuitions about the practical limitations of theorizing, motivate a critique of my overall project. [End Page 233]A standard analytic response to Ross' commentary would typically involve certain moves: One might question the truth value of her claims, challenge the soundness and validity of her arguments, or take issue with her particular use of philosophical terms and concepts. Instead, I clarify further my project and its intended results, in such a way that opens up space for her analytic voice within the context of an interdisciplinary discussion. Ross and I agree on two absolutely central concerns: First, her description of the proper significance of the language under study is perfectly apt, if ultimately irrelevant as a criticism of my work. Of course, I concede the obvious point that the narratives I consider are not perfectly veridical, reliable, or honest. Yet far from being a problem, these rhetorical features make the narratives appropriate and fruitful objects of study. Through the use of philosophical tools and literary-critical practice, I seek primarily to develop an understanding of the ways in which addicts portray their subjectively informed, culturally conditioned, and selectively edited self-observations. Second, I would like to underline Ross' helpful reminder about the contingency of the hypothetical claims I develop through close reading and philosophical references. Our agreement about these fundamental points may reflect my own failure to describe clearly my procedure and desired results. The overarching aim of my project is simply to highlight the possibility that addicts conceive of themselves in distinctive ways that are describable in philosophical terms. Moreover, I would like to initiate an ongoing interdisciplinary discussion in which the truth, aptness, and practical relevance of my method and its results may be evaluated. Ross's remarks highlight the need for further clarification on three points: First, I do... (shrink)

According to a number of influential views in penal theory, 1 one of the primary goals of the criminal justice system is to rehabilitate offenders. Rehabilitativemeasures are commonly included as a part of a criminal sentence. For example, in some jurisdictions judges may order violent offenders to attend anger management classes or to undergo cognitive behavioural therapy as a part of their sentences. In a limited number of cases, neurointerventions — interventions that exert a direct biological effect on the brain (...) — have been used as aids to rehabilitation, typically being imposed as part of criminal sentences, separate treatment orders, or conditions of parole. Examples of such interventions include medications intended to attenuate addictive desires in substance-abusing offenders and agents intended to suppress libido in sex offenders.This chapter reviews some of the ethical issues raised by the use of neurointerventions as aids to rehabilitation. (shrink)

High Culture is a collection of essays containing reflections on addiction. Some of the essays are original and some are reprints. The volume is divided into two sections: the first dealing with literature, philosophy, and the arts and the second with sociology, psychology, and the media. The editors promise something different from the usual “insistent drive to medicalize, discipline, rehabilitate, and contain the subject of drugs within frameworks that disguise deeply rooted moral and religious fears, values and beliefs or prejudices” (...) and that addiction will emerge as something “not reducible to substance abuse or compulsiveness per se” .The editors also lay claim to demonstrating the “complexity, creative value and diversity” of addiction in place of what they describe as the limited …. (shrink)

The common conception is that philosophy is an armchair endeavour. For many (Žižek 2023), the task of philosophy is just to provide the right kinds of questions to the sciences upon which they can develop further tools etc. The research will aim to show that it is not just the right kind of questions that philosophy can provide, instead, it can provide practical solutions as well. The research paper will primarily aim to showcase a methodology for addiction recovery based on (...) the philosophy of Advaita Vedanta, which can be broadly applied to most kinds of addiction. The biggest problem with most kinds of addiction treatment programmes is relapse. So, can we devise a methodology which not only cures the problem of addiction but also provides aid in refraining from subsequent relapse? (shrink)

This collection of thirty yoga and mindfulness tools will help support those in recovery from addiction of all kinds. Thirty accessible, pointed teachings offer inspiration, comfort, and solidarity in the moment, helping us cultivate a powerful and purposeful life in recovery, and to create a new design for living. Each chapter focuses on a quality-such as vigilance, acceptance, accountability, among others-and delves into how to manifest it in your recovery journey. Brian Hyman, a yoga teacher and recovery activist, understands deeply (...) what people need to maintain sobriety and strengthen recovery-and knows that those who struggle with addiction also often need support with other mental health challenges, like obsession, anxiety, depression. He uses yogic philosophy, mindfulness teachings, personal anecdotes, and secular wisdom to illuminate each quality and the role it plays in helping us create the life we want. The practices--which include inquiry questions, meditations, awareness exercises, breathing practices, yoga nidra, among others--will quiet the mind in difficult moments, support us as we establish meaningful relationships, and reinforce the power that recovery offers us. Hyman offers resources and additional reading suggestions in the back matter. Based on Hyman's popular online course, this book is essential reading for people of all ages in recovery-along with their family members and friends, and anyone in a health care profession who works with those struggling with addiction of any kind. Hyman includes a list of recovery organizations and a reading list in the back matter. (shrink)

Considering the abysmal track record of orthodox drug rehabilitation programs, whereby a ten percent abstinence rate after one year of treatment is regarded as successful, a responsible introduction to viable alternative methodologies brings hope and promise along with new insight and information. Medical anthropologist H. K. Heggenhougen reviews the growing body of literature that describes and assesses traditional interventions rooted in other cultures , as well as therapies advanced through alternative achievements like acupuncture, biofeedback, and meditation. Besides exploring their (...) salient features and evaluating their efficacy, Dr. Heggenhougen comments authoritatively on their transferability to conventional American and European addiction programs, and supplies an annotated bibliography for use as an independent resource by theoreticians and practitioners in the fields of detoxification and rehabilitation. Exposure to the cross-cultural perspective, replete with potential for creative adaptation, enriches our understanding as it expands exponentially our repertoire of treatment options. (shrink)

Studies have reported high rates of childhood maltreatment among individuals with drug addiction problems; however, investigation about the potentially protective factors to mitigate the effects of maltreatment experiences on motivation to engage in addiction treatment has received less attention. This study aims at exploring the mediating effects of forgiveness and self-efficacy on the association between childhood maltreatment and treatment motivation among drug addicts. A total of 360 male drug addicts were recruited from three mandatory inpatient rehabilitation centers (...) in Malaysia. Participants completed a package of self-report questionnaires including measures of childhood maltreatment experiences, forgiveness, self-efficacy, and motivation for treatment. The analysis conducted using the structural equation model revealed that childhood maltreatment significantly predicted lower treatment motivation, while forgiveness and self-efficacy played a fully mediating role regarding the effect of childhood maltreatment on treatment motivation. In conclusion, these findings suggest that combining the element of forgiveness and self-efficacy in treatment programs appears to benefit the drug addicts with childhood maltreatment history. (shrink)

In this paper, I argue that the thought and behavior involved in drug dependence is associated with a certain pre-theoretic conception of the self that finds philosophical expression as a grossly simplified form of materialism. Addicts tend not to take mentality seriously: They do not understand themselves as minded beings capable of self-awareness and development through intentional action. Recognizing the practical implications of accepting this philosophically unconvincing view, I argue, encourages a modification of self-conception that is instrumental to the (...) process of recovery from addiction. Using a combination of philosophical analysis and close reading of a trio of narratives that describe drug dependence and recovery, I pursue the possibility that rehabilitation may involve the clarification and alteration of self-conception in such a way that emphasizes autonomous agency and certain values that have not yet been embraced by twelve-step programs, namely, integration, apprehension, moderation, and self-discipline. The rich and substantial history of analytic–philosophical thought about the self is of immense practical value to people impacted by drug dependence and/or engaged in recovery from it; philosophy offers us a set of investigative tools, terms, and concepts that may help to map the different cognitive routes to successful self-rehabilitation. A philosophical consideration of the use of self-related words and ideas within the context of narratives of addiction and recovery may bear directly and significantly on the improvement of the lives of those persons who struggle to overcome drug dependence. (shrink)

Medical interventions such as methadone treatment for drug addicts or “chemical castration” for sex offenders have been used in several jurisdictions alongside or as an alternative to traditional punishments, such as incarceration. As our understanding of the biological basis for human behaviour develops, our criminal justice system may make increasing use of such medical techniques and may become less reliant on incarceration. Academic debate on this topic has largely focused on whether offenders can validly consent to medical interventions, given (...) the coercive environment of the criminal justice system. Both sides in this debate share the assumption that administering medical interventions to offenders without their valid consent would be unethical. Recently, Thomas Douglas has mounted a formidable challenge to this “consent requirement”. Essentially, his argument rests on a comparison between prison and medical interventions. Douglas asks: if the state is entitled to impose a prison sentence on a criminal without the criminal’s consent, why is consent required for the imposition of a medical intervention? The most obvious way of defending the consent requirement against Douglas’s challenge appeals to the fact that incarceration merely interferes with the right to free movement, but medical interventions interfere with the right to bodily integrity. This argument rests on what Douglas calls the “robustness claim”—the claim that the right to bodily integrity is more robust than the right to freedom of movement. In other words, the right to freedom of movement loses its protective force in a wider range of circumstances than the right to bodily integrity. Douglas’s article seeks to undermine the robustness claim, by arguing that neither case-based intuitions, nor theoretical considerations support this claim. In this article, I will attempt to raise some doubts about Douglas’s challenge to the consent requirement and the robustness claim. (shrink)

Background Regionalised models of health care delivery have important implications for people with disabilities and chronic illnesses yet the ethical issues surrounding disability and regionalisation have not yet been explored. Although there is ethics-related research into disability and chronic illness, studies of regionalisation experiences, and research directed at improving health systems for these patient populations, to our knowledge these streams of research have not been brought together. Using the Canadian province of Ontario as a case study, we address this gap (...) by examining the ethics of regionalisation and the implications for people with disabilities and chronic illnesses. The critical success factors we provide have broad applicability for guiding and/or evaluating new and existing regionalised health care strategies. Discussion Ontario is in the process of implementing fourteen Local Health Integration Networks (LHINs). The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i) rehabilitation and services for people with disabilities; (ii) chronic illness and cancer care; (iii) senior's health; (iv) community support services; (v) children's health; (vi) health promotion; and (vii) mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs – equitable access based on patient need, preserving patient choice, responsiveness to local population health needs, shared accountability and patient-centred care – and describe how they apply. We then offer critical success factors to guide the LHINs in upholding these principles in response to the needs of people with disabilities and chronic illnesses. Summary This paper aims to bridge an important gap in the literature by examining the ethics of a new regionalisation strategy with a focus on the implications for people with disabilities and chronic illnesses across multiple sites of care. While Ontario is used as a case study to contextualize our discussion, the issues we identify, the ethical principles we apply, and the critical success factors we provide have broader applicability for guiding and evaluating the development of – or revisions to – a regionalised health care strategy. (shrink)

Biomedical interventions, such as pharmacological and neurological interventions, are increasingly being offered or considered for offer to offenders in the criminal justice system as a means of reducing recidivism and achieving offender rehabilitation through treatment. An offender’s consent to treatment may affect decisions about diversion from the criminal justice system, sentence or parole, and so hope for a preferable treatment in the criminal justice system may influence the offender’s consent. This thematic analysis of three focus group interviews conducted in (...) Canada with members of the public investigates how the public views the use of biomedical treatments within the criminal justice system, and the practice of encouraging offender consent to biomedical treatment through the hope of a reduced criminal sentence. The public focus group discussions followed a semi-structured interview guide, and were based on two hypothetical case examples involving individuals choosing whether to consent to a range of cocaine addiction or anti-libidinal treatments respectively in the hope of receiving a more lenient sentence. The discussions covered a wide range of themes, and here we present the participants’ evaluations of this type of biomedical treatment offer in light of three key theoretical sentencing objectives: the promotion of public safety, the infliction of retributive punishment, and the rehabilitation of offenders. We conclude that public safety was the predominant concern of the participants when evaluating biomedical treatment offered at the time of sentencing to offenders who had committed serious crimes. Another important observation was that the public tended to reframe and evaluate biomedical interventions in terms of retribution and punishment, rather than rehabilitation and reform. (shrink)

Two nurses diagnosed with opioid addiction launched legal action after being found guilty of unprofessional conduct due to addiction‐related behaviors. When covered by the media, their cases sparked both public and legal controversies. We are curious about the broader discursive framings that led to these strong reactions, and analyze the underlying structures of knowledge and power that shape the issue of opioid addiction in the profession of nursing through a critical discourse analysis of popular media, legal blogs and hearing tribunals. (...) We argue that addiction in nursing is framed as personal choice, as a failure in the moral character of the nurses, as decontextualized from addiction as disease arguments, and as an individualized issue devoid of contextual factors leading to addiction. Our investigation offers a critical case study of a nursing regulatory body that upheld popular assumptions of addiction as an autonomous, rational choice replete with individual‐based consequences – a framing that is inconsistent with evidence‐based practice in health‐care. We put forth this critical interrogation to open up possibilities for counterdiscourses that may promote more nuanced and effective responses to the issue of addiction in nursing. (shrink)

This paper presents a reconceptualization of autonomy as the iterative realization of one’s capacity for “effective self-definition,” that is, possessing a sense of clarity and coherence in “who I am,” and exercising the decisional and volitional ownership over my life that this engenders. This process is “Relational,” wherein people’s interpersonal interactions have a deep and pervasive influence on their ability to recognize and exercise their autonomous capacities. This Relational understanding of autonomy is contextualized within the field of addiction rehabilitative practice. (...) Addiction is a pathology that progressively and insidiously undermines autonomy – producing a number of negative consequences that present themselves along a “continuum of pervasiveness.” In order to most fully foster rehabilitation, therapeutic alliances should to be attentive to facilitating autonomy’s dialogical antecedents. Here, interpersonal recognition can help clients to more fully recognize their own autonomous resources – enabling them to embark on their rehabilitative journey and achieve broader autonomous living. This paper concludes by proposing ways that practitioners can manifest their recognition of their clients’ autonomy within the therapeutic encounter. (shrink)

Research on psychedelic-assisted psychotherapy has shown that music affects therapeutic outcomes at a fundamental level. The development of such therapies calls for research on the use of music with consciousness-altering substances, especially in contexts informed by their traditional use. Informed by ethnographic reports, our project answers this call, investigating the phenomenology of listening to icaros (medicine songs) during ayahuasca ceremonies as reported by addiction rehabilitation patients at Perú’s Centro Takiwasi. We found that icaros were therapeutically significant. They elicited experiences (...) of healing by modulating patients’ emotions and the altered state induced by ayahuasca. They helped patients feel safe while guiding them through difficult memories and emotions, and facilitating experiences of healing and learning about their addictions. Thus, similar therapies must carefully consider how they incorporate music in their protocols. We suggest further research to better understand the synergistic, therapeutic effects of music and altered states of consciousness, especially in cross-cultural environments. (shrink)

Ethical clinical practice requires cultural competency. In the United States, Hispanics report stronger attitudinal barriers to drug abuse treatment than any other racial/ethnic group. Hispanics report feeling that drug abuse treatment providers do not understand their unique cultural needs and are unfamiliar with their experiences of discrimination and immigration. Using this case study to explore broader ethical and policy issues, this study investigates the extent to which US universities train counselors to address the culturally specific needs of Hispanic patients and (...) how this is reflected in practice in Los Angeles County. Based on a content analysis of the required courses, syllabi, and course descriptions at 30 universities related to culture/race/racism/ethnicity/diversity at the undergraduate and graduate levels on the addiction therapist track, and thematic analysis of eight in-depth interviews with counselors working in outpatient rehabilitation centers in Los Angeles, I argue that cultural competency education for drug abuse counselors is too surface level and infrequent to adequately prepare students for a career in addiction counseling for Hispanic clients. Significant changes must be made to how cultural diversity is valued and prioritized in the field of psychology to provide better care for Hispanic people with a substance use disorder and fulfill the moral obligation to eliminate this health disparity. Although this study focuses on counselors in Los Angeles, these findings are relevant for professionals and healthcare systems across the United States and beyond who seek to provide equitable and effective care for Hispanic patients. (shrink)

This article uses the concept of a progressive jail assemblage to think about the focus on jails as both a target of social justice organizing and a tool for advancing social justice goals. Drawing on ethnographic research conducted among formerly incarcerated organizers and their allies in Western Massachusetts (New England), I explore how the sheriffs who operate jails in this region, along with their collaborators, have increasingly sought to redefine the figure of the criminal as not just a danger to (...) others but also a danger to themselves, someone in need of rehabilitative treatment and even care. In doing so, these sheriffs have attempted to reinvent their role, from the quintessentially American crime fighting figure, to one who is also a provider of care. Social justice activism has helped to expand the “caring” role of the jail, through increased addiction treatment, re-entry support, and community outreach – even to the extent of incarcerating individuals dealing with addiction who have not been charged with a crime. As progressive jails have been reconfigured as providers of care, abolitionists are confronted with the ongoing dilemma of how to remain a figure opposed to the use of prisons and jails without being seen as against care. (shrink)

In this chapter I use virtue theory to critique certain contemporary punishment practices. From the perspective of virtue theory, respect for rational agency indicates a respect for choice-making as the process by which we form dispositions which in turn give rise to further choices and action. To be a moral agent one must be able to act such that his or her actions deserve praise or blame; virtue theory thus demands that moral agents engage in rational choice-making as a means (...) to develop and exercise the character traits from which culpable action issues. With respect to criminal offenders, virtue theory indicates the state is obligated to recognize offenders’ right to form their own moral character via rational choice-making, even while under state supervision. I will argue below that punishment practices should limit choice-making only to the extent necessary to achieve the functions of punishment : whenever possible, punishment should preserve opportunities for the rational exercise of character and development of virtue. This means that even within a prison setting incarcerated offenders should be able to make some choices about their daily lives. Offenders should also be offered opportunities to develop virtuous traits through rehabilitative programming such as drug addiction treatment, educational programming, and job training. I will also argue that two contemporary punishment practices unjustly undermine an offender’s moral agency. The first is the overuse of isolation sanctions, which very severely limits offender choice-making. The second is chemical castration, which results in limiting an offender’s capacity to develop his character within a specific realm of choice-making. I conclude that these two punishments violate offenders’ moral agency, and that this violation cannot be justified by appeal to the aims of incapacitation, deterrence, retribution, and rehabilitation. (shrink)

Currently held conceptions of autonomy that inform biomedicine are inadequate and oppressive. Liberal notions of individualism are anti-humanist and constitute pernicious socialization, which leads to internalized oppression and dehumanization, especially among already oppressed groups. Women in recovery from addiction and other mental illnesses are especially affected by anti-humanist conceptions of autonomy. I argue that these women need to receive treatment that supports autonomy through supplementing psychiatric and rehabilitative therapy with humanistic education and group therapy. Treatment must encourage the construction of (...) healthy social interaction that augments a sense of supported autonomy. (shrink)

This article explores the relationship between organizationalproblem formulation and social responsibility. Thepurpose of the article is to illuminate how organizationalproblem formulations determine the manner in whichthe organization attempts to solve the problem and involve the ascription of significance to a group of stakeholdersseen as relevant for the organization. This has implicationsfor the degree to which they assume responsibilityfor those stakeholders. We discuss three dimensions ofresponsible decision making – rationality in goal attainment,reverence for ethical norms, and respect for stakeholders.Thereby, we arrive (...) at an understanding of how differentorganizations in the same sector conceive of, andattempt to solve fundamental problems in the sector, aswell as how their assumed responsibility is reflected therein.We present and discuss a case that discusses keysimilarities and differences between two organizations inthe drug sector – a pharmaceutical company that producesmedicine for the treatment of drug addiction and a foundationworking with drug rehabilitation. We illuminatehow the two organizations base their activities on divergentformulations of the drug problem and how this ismanifested in their approach to the problem. We argue that this ultimately translates into differences in the inclusion of various stakeholdersin their problem space, and thereby the degree to which they assumeresponsibility for key stakeholders. This contributes to the corporate socialresponsibility literature by providing an in depth account of how problem formulationsshape organizational activities and determine the practical inclusionof stakeholders’ interests in the decisions and activities of organizations. (shrink)

Guilherme Messas is a Brazilian psychiatrist, founding member of the Brazilian Society for Phenomeno-Structural Psychopathology and author of many peer-reviewed articles in the field of psychopathology. His book entitled 'The Existential Structure of Substance Misuse' is an important and comprehensive phenomenological analysis of psychoactive substance abuse behaviour, considering a field still partially explored by clinical and psychopathological research. The contents provided by the author in this work are not only of great theoretical relevance, but also of clinical utility in the (...) rehabilitation of these patients. It would be important to deepen the field of phenomenological research in addictions, exploring the contents proposed with the aim of providing tools and knowledge that would be of concrete help in the treatment pathway of substance abuse. (shrink)

Critical realism has a reputation for requiring substantial intellectual commitment and time to gain understanding, and being difficult to operationalize as an empirical research methodology. Our paper employs the theoretical framework of ‘threshold concepts’ to explore these issues. We illustrate the five qualities of ‘threshold concepts’ using existing literature by scholars describing their journey of engagement with critical realism. We then apply the framework from three viewpoints. First, we offer the perspective of a budding critical realist scholar who transforms their (...) understanding through reflexivity. Second, we consider the role of critical realist communities of practice, peer-to-peer and social learning. Finally, we look from the standpoint of a more experienced critical realist academic advisor or supervisor working with a student. The paper concludes by asking: what kind of learning and teaching frameworks of engagement can the critical realist community build to better support apprentice critical realists? (shrink)

Every day, millions of people use mobile phones, play video games and surf the Internet. It is thus important to determine how technologies like these change what people think and how they behave. This is a central issue in the study of persuasive technologies. ‘Persuasive technologies’—henceforth ‘PTs’—are digital technologies, such as mobile apps, video games and virtual reality systems, that are deployed for the explicit purpose of changing attitudes and/or behaviours, without using coercion, deception or extreme forms of psychological manipulation (...) (such as hypnosis or indoctrination), and without exerting a direct (not psychologically mediated) physical effect on the brain. Typically PTs employ strategies such as prompting, information provision and encouragement... (shrink)

In this article, the Heidegger and Derrida controversy about the nature of questioning is revisited in order to rehabilitate questioning as an essential characteristic of contemporary philosophy. After exploring Heidegger's characterization of philosophy as questioning and Derrida's criticism of the primacy of questioning, we will evaluate Derrida's criticism and articulate three characteristics of Heidegger's concept of questioning. After our exploration of Heidegger's concept of questioning, we critically evaluate Heidegger's later rejection of questioning. With this, we not only contribute to the (...) discussion about why Heidegger rejected questioning in his later thought and whether this rejection is legitimized, but also to the rehabilitation of questioning in contemporary philosophy. (shrink)

The logical positivists’ critical attitude towards metaphysics is sketched. Strawson’s conception of descriptive and revisionary metaphysics is described. Revisionary metaphysics is argued to be chimerical, and descriptive metaphysics is argued not to be a form of metaphysics at all. Strawson’s failure to account for the status of propositions of descriptive metaphysics is held to be remediable by reference to Wittgenstein’s conception of grammatical propositions that express norms of representation.

Ethicists have for the past 20 years debated the possibility of using neurointerventions to improve intelligence and even moral capacities, and thereby create a safer society. Contributing to a recent debate concerning neurointerventions in criminal rehabilitation, Nicole Vincent and Elizabeth Shaw have separately discussed the possibility of responsibility enhancement. In their ethical analyses, enhancing a convict’s capacity responsibility may be permissible. Both Vincent and Shaw consider self-control to be one of the constituent mental capacities of capacity responsibility. In this (...) paper, we critically examine the promise of improving convicts’ capacity responsibility by neuroenhancements of self-control to see whether the special characteristics of the inmate population make a difference in the analyses. As improving self-control by means of neurointerventions seems plausible, we then ask whether it is or could be a justified measure in court rulings. We conclude that, even if there are cases in which neurointerventions were warranted in the context of the stated goals of the criminal court, i.e., decreasing recidivism and rehabilitating the offenders to the society, due to the range of individual variability in the constitution of self-control, the prescription of specific neurointerventions of self-control falls outside the scope of legitimate court rulings. (shrink)

The paper offers a historical survey of the emergence of logical formalization in twentieth-century analytically oriented philosophy of religion. This development is taken to have passed through three main ?stages?: a pioneering stage in the late nineteenth and early twentieth centuries (led by Frege and Russell), a stage of crisis in the 1920s and early 1930s (occasioned by Wittgenstein, logical positivists such as Carnap, and neo-Thomists such as Maritain), and a stage of rehabilitation in the 1930s, 1940s, and 1950s (...) (led by the Cracow Circle and Quine). (shrink)

Virtual reality allows the user to be immersed in environments in which they can experience situations and social interactions from different perspectives by means of virtual embodiment. In the context of rehabilitation of violent behaviors, a participant could experience a virtual violent confrontation from different perspectives, including that of the victim and bystanders. This approach and other virtual scenes can be used as a useful tool for the rehabilitation of intimate partner violence perpetrators, through improvement of their empathic (...) skills or for training in non-violent responses. In this perspective, we revise and discuss the use of this tool in a prison environment for the rehabilitation of IPV perpetrators with a particular focus on practical aspects based on our experience. (shrink)

Taking regular walks when living with Parkinson’s disease has beneficial effects on movement and quality of life. Yet, patients usually show reduced physical activity compared to healthy older adults. Using auditory stimulation such as music can facilitate walking but patients vary significantly in their response. An individualized approach adapting musical tempo to patients’ gait cadence, and capitalizing on these individual differences, is likely to provide a rewarding experience, increasing motivation for walk-in PD. We aim to evaluate the observance, safety, tolerance, (...) usability, and enjoyment of a new smartphone application. It was coupled with wearable sensors and delivered individualized musical stimulation for gait auto-rehabilitation at home. Forty-five patients with PD underwent a 1-month, outdoor, uncontrolled gait rehabilitation program, using the BeatWalk application. The music tempo was being aligned in real-time to patients’ gait cadence in a way that could foster an increase up to +10% of their spontaneous cadence. Open-label evaluation was based on BeatWalk use measures, questionnaires, and a six-minute walk test. Patients used the application 78.8% of the prescribed duration and enjoyed it throughout the program. The application was considered “easy to use” by 75% of the patients. Pain, fatigue, and falls did not increase. Fear of falling decreased and quality of life improved. After the program, patients improved their gait parameters in the six-minute walk test without musical stimulation. BeatWalk is an easy to use, safe, and enjoyable musical application for individualized gait rehabilitation in PD. It increases “walk for exercise” duration thanks to high observance.Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02647242. (shrink)

For much of the 20th century, scholars of American and European applied psychology and psychiatry have concerned themselves with the concepts of progress and power. In an effort to revisit the character of 19th-century psychiatry and to use the results as a means of evaluating 21st-century practice, this paper explores the relationship between power and progress in two popular but chronologically distinct approaches to caring for the mad: 19th-century moral treatment and late 20th-century psychiatric rehabilitation. Using the theoretical framework (...) of Foucault (1979), moral treatment (as developed by Thomas Story Kirkbride, for example, [1854] 1973) and psychiatric rehabilitation (as developed by William A. Anthony and colleagues, for example, Anthony, Cohen, and Farkas 1990) are compared for the degree to which each is structured by disciplinary interests and technologies. Based on this textual analysis, important differences emerge. Not only do these differences cast moral treatment in a new, and perhaps more positive light, but they also shed light on how disciplinary structures might affect a psychiatric approach's ability to carry out expressly humanitarian goals. To the extent that both propositions are accurate, the traditional view equating psychology and psychiatry's progress with a diminished reliance on power is brought into question. (shrink)