Although fertility is fundamental to spiritual health, it is often taken for granted. When a desired pregnancy fails to occur, stress and grief frequently follow. Visual expression of feelings through “art therapy” has proved a powerful healing tool for women brave enough to give it a try at the McMaster University Fertility Clinic. The objective and subjective findings of this ongoing project suggest that through simple visual self-expression, stress, anxiety and hopelessness may be reduced. This form of art therapy (...) also provides a joyful social experience of sharing with other women, who are dealing with these issues. (shrink)

Conversational agents (CA) are thought to be promising for psychotherapy because they give the impression of being able to engage in conversations with human users. However, given the high risk for therapy patients who are already in a vulnerable situation, there is a need to investigate the extent to which CA are able to contribute to therapy goals and to discuss CA’s limitations, especially in complex cases. In this paper, we understand psychotherapy as a way of dealing with existential situations (...) and position CAs in the context of the therapeutic experience of patients. This experience is determined by the patient’s unique personal context and specific therapy goals. We suggest that psychotherapy is a fundamentally dialogical activity, because it crucially involves work on the self and one’s self-narrative. This brings us to our central question: is it possible for CAs to engage in a productive therapeutic dialogue, given their limitations as epistemic agents? We will discuss several of those limitations, show how these undermine the possibility of engaging in a therapeutic dialogue, and illustrate those limitations through discussions of the cases of grief and abuse. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Rhetoric, Grief, and the Imagination in Early Modern EnglandStephen PenderIn 1633, the Northampton physician James Hart warned that excessive grief "will to some procure irrecoverable Consumptions," dry the brain and bone marrow, hinder digestion, interrupt rest, and "by consequent prove a cause of many dangerous diseases." The risk was grave: "Galen himself maketh answer that one may dye of these passions, and to this doe all Physicians (...) assent; and experience maketh it so appeare" (1633, 393–95).1 In the sixteenth and seventeenth centuries, physicians routinely treated grief and its effects, since it was commonly held that the passions were realized in matter.2 They applied an ensemble of remedies—bleeding, emetics, laxatives—predicated on sympathetic connection between bodies and souls, for disturbance "in the emotional climate of the body alters its inner temperature and causes in turn dangerous mutations in the balance and composition of the humours" (MacDonald 1981, 182).3 The spirits, too, were enlisted: for "the spirit being either withdrawne from the outwarde parts by vehement passio[n] of griefe," the "outward partes not only faile in their sense and motion, but even nourishment & growth thereby are hindered" (Bright 1586, 60; see also 47, 51–52). But grief also "besieged" the mind, weakened reason, hampered discourse, and impugned the will (Reynolds 1640, 229–30). By affecting mental faculties, passions subvented affliction, and thus physicians offered various prophylactics against fulminant emotion in the sick, most [End Page 54] of which focused on the imagination as potentially harmful faculty that prolonged or intensified suffering. A sufferer, Hart writes, "by reason of his sicknesse, hath sorrow enough, especially, if the party be of a feeble, fearfull and pusillanimous spirit, the phansie still framing unto it selfe new fears of some bad and sinistrous event." As wards against excessive passion, Hart recommends vigilance and circumspection, accommodation and distraction. First, physicians must guard against visitors who "prove the causes of infinite evills to the sicke" by occasioning overweening feeling. Drawing on Paul's distinction between worldly and "godly" sorrow in his second letter to the Corinthians, Hart recognizes that sufferers have just cause for fear, and physicians should not interrupt or retard "true sorrow for sinne," which offers comfort to a "drouping and sorrowfull soule." But the effects of any lenitive passion are endangered by "indiscreetly" compounding fear and grief "at an unseasonable time" (1633, 400). To avoid odium, a counselor's efforts must conform to "time, place, and person" (Wilson 1994, 120). Second, a physician should "accommodate himselfe to the severall dispositions of his patients, and to many particular circumstances concerning them," adjusting therapies and practices to individual sufferers. Finally, if not too fragile, the sick should be distracted with mirth (1633, 400).Those expressing "true sorrow for sinne" should read. Hart recommends one of the "many volumes written by our learned Divines, concerning this subject," Robert Bolton's 1631 Instructions for a Right Comforting Afflicted Consciences with Speciall Antidotes Against Some Grievous Temptations. Bolton, who was rector of Broughton, Northamptonshire, and a popular conformist preacher, insists that divines sometimes held even "godly sorrow" unseasonable, "when it unfitteth the body or minde to good duties" (1641, 587). Excessive grief is particularly foul: of "all other passions of the Soule," he writes, "sadnesse, and grief grates most upon the vitall spirits; dries up soonest the freshest marrow in the bones; and most sensibly suckes out the purest, and refinedst bloud in the heart" (1641, 21). Bolton's remedies are to avoid idleness and solitude, for both render the soul susceptible to disquiet (1641, 582), and to read: the sorrowful and the melancholy find succor in scripture. Although both forms of suffering may be treated medically, one remedy for an afflicted conscience is "Gods blessed Booke" (1641, 211–15). One early seventeenth-century Sussex physician turned to Burton's Anatomy of Melancholy (1621) for assistance.4Like most physicians in the period, both Hart and Bolton differentiate grief occasioned by humoral imbalance from sorrow born of a repentant conscience, and both confirm that the "phantasie" is central to physical and [End Page 55] moral therapy.5 For Bolton, grief, melancholy, and "terror of conscience" dwell chiefly in the imagination (1641, 212... (shrink)

Background: COVID-19 has taken many lives worldwide and due to this, millions of persons are in grief. When the grief process lasts longer than 6 months, the person is in risk of developing Complicated Grief Disorder. The CGD is related to serious health consequences. To reduce the probability of developing CGD a preventive intervention could be applied. In developing countries like Mexico, the psychological services are scarce, self-applied interventions could provide support to solve this problem and reduce (...) the health impact even after the pandemic has already finished.Aims: To design and implement a self-applied intervention composed of 12 modules focused on the decrease of the risk of developing CGD, and increasing the life quality, and as a secondary objective to reduce the symptomatology of anxiety, depression, and increase of sleep quality. The Intervention Duelo COVID follows the principles of User Experience and is designed according to the needs and desires of a sample of the objective participants, to increase the adherence to the self-applied intervention, considered one of the main weaknesses of online interventions.Methods: A Randomized Controlled Trial will be conducted from the 22nd of December of 2020 to the first of June 2021. The participants will be assigned to an intervention with elements of Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Mindfulness and Positive Psychology. The control group will be a wait-list condition, that will receive the intervention 1.5–2 months after the pre-measurement were taken. The Power Size Calculation conducted through G*Power indicated the need for a total of 42 participants, which will be divided by 21 participants in each group. The platform will be delivered through responsive design assuring with this that the intervention will adapt to the screen size of cellphones, tablets, and computers.Ethics and Dissemination: The study counts with the approval of the Research Ethics Committee of the Autonomous University of Ciudad Juárez, México, and it is registered in Clinical Trials. The article is sent and registered in clinical trials before the recruitment started. The results will be reported in future conferences, scientific publications, and media. (shrink)

This book, now in its fifth edition, provides a comprehensive introduction to Buddhist psychology and counselling, exploring key concepts in psychology and practical applications in mindfulness-based counselling techniques. This integrated study uses Buddhist philosophy of mind, psychology, ethics and contemplative methods to focus on the 'emotional rhythm of our lives', opening up new avenues for mental health.De Silva presents a range of management techniques for mental health issues including stress, anger, depression, addictions and grief. He moves beyond the restriction (...) of mental health issues to 'damage control', instead encouraging personal growth and positive emotions of compassion, forgiveness, generosity, equanimity and, ultimately, emotional balance.This book blends Western psychology and philosophy and ancient wisdom and contemporary thought to provide a key contribution to cognitive sciences, emotion studies, moral psychology and psychotherapy counselling. This new edition contains nine new chapters and an additional second part which focuses on counselling and mindfulness-based techniques in therapy. (shrink)

Deepfakes are hyper-realistic but fabricated videos created with the use of artificial intelligence. In the context of psychotherapy, the first studies on using deepfake technology are emerging, with potential applications including grief counselling and treatment for sexual violence-related trauma. This paper explores these applications from the perspective of medical ethics and health law. First, we question whether deepfake therapy can truly constitute good care. Important risks are dangerous situations or ‘triggers’ to the patient during data collection for the creation (...) of a deepfake, and when deepfake therapy is started, there are risks of overattachment and blurring of reality, which can complicate the grieving process or alter perceptions of perpetrators. Therapists must mitigate these risks, but more research is needed to evaluate deepfake therapy’s efficacy before it can be used at all. Second, we address the implications for the person depicted in the deepfake. We describe how privacy and portrait law apply and argue that the legitimate interests of those receiving therapy should outweigh the interests of the depicted, as long as the therapy is an effective and ‘last resort’ treatment option, overseen by a therapist and the deepfakes are handled carefully. We suggest specific preventative measures that can be taken to protect the depicted person’s privacy. Finally, we call for qualitative research with patients and therapists to explore dependencies and other unintended consequences. In conclusion, while deepfake therapy holds promise, the competing interests and ethicolegal complexities demand careful consideration and further investigation alongside the development and implementation of this technology. (shrink)

Genes dance. They dance with culture. Theydance with environment. Genes act on the world through the brain, mind and behavior. Historically, psychologists, therapists,educators and most lay people have understoodgenes in the context of Gregor Mendel'sexperiments, which were only partiallyexplained to us. While many studies show thatbrain structures and behaviors have quiterobust influences from inheritance, mostbehavior is not influenced in the classic waywe were taught in our introduction to genetics– which has been revolutionized by molecularstudies and understandings that most of theimportant (...) genes of everyday life arequantitative, or polygenic.Popular culture and naïve theory has a verysimplistic view of genes. They are bad,impolite and vaguely anti-democratic if notsinister. A very simple truth exists, however.Were it not for the genes of our grandparents,no one would be reading this article.This article introduces the reader to an ideathat emerges from evolutionary psychology andbehavior genetics, which may turn our thinkinginside out. For the most part, genes are giftsof nature to solve problems, and to hedge a beton the future. Most true genetic diseases,regulated by the classic processes that Mendelobserved, are extremely rare – typically belowone in several hundred. Most of the behaviorsthat cause us grief or joy in our homes,schools and communities and with some form ofgenetic contribution happen far more often –3%, 5%, 10% or more of the time in thepopulation. If such behaviors were ``defects''harming our reproductive success, Mother Naturewould have quickly made short work of thosegenes in a handful of generations. The factthat many of the genes related to thesebehaviors and subtle changes in the brain seemto have been recent changes (pejorativelycalled by some ``mutations'') in the past fewthousand years implies that these changes are insome sense Nature's Gifts.Gifts are to be treasured, saved and perhapspassed on. Sometimes a gift may be burdensome. This paper is about reframing and explainingadvances in science in the past 10 years or so,parallel to the brain imaging studies. Themolecular studies, explored in the context ofevolutionary psychology and behavioral geneticsprovide a new model for human development,enhancing our understanding of more traditionalviews of human phylogeny and ontogeny. Thesame molecular studies, when framed in thecontext of twin, adoption and longitudinalstudies, provide new insights for parenting,schools, community and therapy. (shrink)

Sadness is generally seen as a negative emotion, a response to distressing and adverse situations. In an aesthetic context, however, sadness is often associated with some degree of pleasure, as suggested by the ubiquity and popularity, throughout history, of music, plays, films and paintings with a sad content. Here, we focus on the fact that music regarded as sad is often experienced as pleasurable. Compared to other art forms, music has an exceptional ability to evoke a wide-range of feelings and (...) is especially beguiling when it deals with grief and sorrow. Why is it, then, that while human survival depends on preventing painful experiences, mental pain often turns out to be explicitly sought through music? In this article we consider why and how sad music can become pleasurable. We offer a framework to account for how listening to sad music can lead to positive feelings, contending that this effect hinges on correcting an ongoing homeostatic imbalance. Sadness evoked by music is found pleasurable (1) when it is perceived as non-threatening; (2) when it is aesthetically pleasing; and (3) when it produces psychological benefits such as mood regulation, and empathic feelings, caused, for example, by recollection of and reflection on past events. We also review neuroimaging studies related to music and emotion and focus on those that deal with sadness. Further exploration of the neural mechanisms through which stimuli that usually produce sadness can induce a positive affective state could help the development of effective therapies for disorders such as depression, in which the ability to experience pleasure is attenuated. (shrink)

How might approaching loss philosophically help us grieve? What does it mean to approach something philosophically? Why might such an approach be advantageous to studies of grief? In my paper, I discuss the abovementioned queries and offer an example of how philosophy has helped me navigate the wakes of loss faced with respect to the passing of my father. In the process, I discuss the field of philosophical counseling, a specific brand of practice advanced by Dr. Elliot D. Cohen, (...) and offer a brief account of the basic tenets and steps of its leading modality, Logic-Based Therapy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BreakClarice DouilleBreakWe have low expectations for M3s this early in their clerkships. I'm disappointed in you; I had higher expectations for you.""Be yourself. But …""I can see where ____ was coming from. You lack emotional intelligence.""I expected you to have constant questions because of what's going on with your mom.""Don't insert yourself into conversations.""You are a med student; you don't have a reputation yet … you can't change medicine. (...) Nobody will listen to you.""Everyone is going through something. If you knew half the stuff I'm dealing with, you'd cry. So I know what you're going through with your mom right now is tough, but you need to compartmentalize and be fully present with patients.""We know each other …"I can't get this "feedback" out of my head.________I can't quite escape my mom's breast cancer diagnosis since it is shoved in my face every day. This is exposure therapy like no other. Immediately after seeing my mom for the first time since her diagnosis—seeing her distressed and supporting her after losing 75% of her hair during the four days I was home for a visit—I was thrust into assisting with three mastectomies on my first day of the breast cancer surgery service.My third year of medical school has been more than a struggle. I've accepted going through the motions as the best I can do, for I barely have enough energy to make it through each day. Every time I start feeling relief—like I can come up for air—I'm pushed back down and feel myself drowning. I'm constantly waiting for the next shoe to drop. While I can forget about my grief momentarily, as soon as I slow down, the pain returns in unrelenting multiples, pushing me into a dark hole of self-isolation.All I've been doing is grieving. Grieving my mom's diagnosis and fearing the unknown. Grieving the idea that I'm a subpar daughter. Grieving that I'm a subpar friend. Grieving the idea of medicine I had believed in. I grieve for the medical student I was in the past, who wanted to excel in this setting. I grieve that I cannot be this student because I am frozen in fear. I'm grieving the life I thought I'd have, and the life my mom thought she'd have. I'm grieving the life we lost. Time is standing still and simultaneously going by in a blur. I want to be able to control something in my life. My heart and head are heavy with thoughts of disappointment, overwhelm, anger, guilt, and confusion. This is grief.I need a break, but I fear a break might make things worse. In medical school, we are given no time to be human, to live a life full of joy, pain, achievement, and disappointment. I feel myself cracking. I'm being pulled in a thousand different directions. I might break. I tell myself I should be able to get past this. Everyone has something going on. Why can't I be like everyone else—able to tough it out and do medicine? [End Page E1]During clerkships, we are constantly thrown into vulnerable situations where we show up every day and put our best foot forward to impress our team and attendings. We can't miss a beat. It feels like we must be Superman. Every day, we feel inadequate and have to "fake it till we make it." It's soul-crushing. It's exhausting. Every day is terrifying. We worry about getting "pimped"—if we'll be able to answer any question correctly—if we'll present the patient adequately—hopefully not too long, or not too short—so our attending doesn't become annoyed. We don't know when we're allowed to go home, and it feels like we can't even go to the bathroom or eat without asking permission. It feels like we're back in Kindergarten, except with so much more at stake.I think attendings forget that we're more than... (shrink)

Ritual scholars note that rituals have powerful psychological, social and even biological effects, but these findings have not yet been integrated into the practice of psychotherapy and psychiatry. In _Healing Symbols in Psychotherapy _Erik D. Goodwyn attempts to rectify this by reviewing the most pertinent work done in the area of ritual study and applying it to the practice of psychotherapy and psychiatry, providing a new framework with which to approach therapy. The book combines ritual study with depth psychology, placebo (...) study, biogenetic structuralism and cognitive anthropology to create a model of interdisciplinary psychology. Goodwyn uses examples of rituals from history, folklore and cross-cultural study and uncovers the universal themes embedded within them as well as their psychological functions. As ritual scholars show time and again how Western culture and medicine is ‘ritually impoverished’ the application of ritual themes to therapy yields many new avenues for healing. The interdisciplinary model used here suggests new ways to approach problems with basic identity, complicated grief, anxiety, depression meaninglessness and a host of other problems encountered in clinical work. The interdisciplinary approach of this accessibly-written book will appeal to psychotherapists, psychiatrists and Jungian analysts as well as those in training and readers with an interest in the science behind ritual. (shrink)

The COVID-19 pandemic represents the most significant global challenge in a generation. Based on extant data from previous pandemics, demographic, occupational, and psychological factors have been linked to distress and for some vulnerable members of society. COVID-19 has added to the layers of grief and distress of existing trauma. Evidence-based frameworks exist to guide our individual and collective response to reduce the trauma associated with the experience of a pandemic. Pandemic and post-pandemic measures to ameliorate impacts require a multi-disciplined (...) approach, central to which is community connectedness, resilience, and access to support. We advocate for the acceptance and broader application of Dadirri, a healing practice held by the Ngan'gikurunggurr and Ngen'giwumirri Aboriginal people of the Daly River region in the Northern Territory, Australia. This modality engages therapeutic phases that are comparable with other practiced trauma therapies. The demonstrated therapeutic outcomes from Dadirri can be attained through an individualistic or in a relational engagement context. This practice is accessible to all ages, is non-specific to gender and is suitable for people constrained in their mobility or limited by resources, pertinent in pandemic affected settings. (shrink)

In a recent article, Henri Wijsbek discusses the 1991 Chabot “psychiatric euthanasia” case in the Netherlands, and argues that Chabot was justified in helping his patient to die. Dutch legislation at the time permitted physician assisted suicide when the patient’s condition is severe, hopeless, and unbearable. The Dutch Supreme Court agreed with Chabot that the patient met these criteria because of her justified depression, even though she was somatically healthy. Wijsbek argues that in this case, the patient’s integrity had been (...) undermined by recent events, and that this is the basis for taking her request seriously; it was unreasonable to expect that she could start again. In this paper, I do not challenge the Dutch euthanasia criteria in the case of somatic illness, but I argue that both Chabot and Wijsbek are wrong because we can never be sufficiently confident in cases of severe exogenous depression to assist the patient in her irreversible act. This is partly because of the essential difference between somatic and mental illness, and because of the possibility of therapy and other help. In addition, I argue that Wijsbek’s concept of integrity cannot do the work that he expects of it. Finally, I consider a 2011 position paper from the Royal Dutch Medical Association on euthanasia, and the implications it might have for Chabot-style cases in the future. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Melancholy and the Therapeutic Language of Moral Philosophy in Seventeenth-Century ThoughtJeremy SchmidtThe concept of melancholy comprehended a wide range of characteristics and conditions in seventeenth-century European culture, from the brooding introspection of the genius and the scholar to a condition of delirious and delusory madness.1 Its central and most immediately identifiable characteristic, however, was the excessive and unreasonable nature of its symptomologically defining emotions of fear and sorrow. As (...) Robert Burton noted out in The Anatomy of Melancholy (1621), the melancholic condition was commonly taken to be "a kind of dotage without fever, having for his ordinary companions fear and sadness, without any apparent occasion."2 The presence of a pervasive and unreasonable sense of fear and sorrow invariably solicited the melancholic label. Indeed, melancholic emotions were the primary substance of melancholic dotage; the ravings of the melancholically mad and their frequent obsession with a single idea were often driven by an overwhelming feeling of fear and sorrow.3The concept of melancholy as a mental disorder involving these specific emotions had coalesced under the gaze of medical observation in ancient Greece, and the melancholic condition was thought by many medical theorists of classical [End Page 583] antiquity to be caused by a physiological surfeit of black bile, the Greek word for which was melancholia.4 Western medicine, profoundly influenced by the Greek medical tradition, continued to diagnose and treat melancholic disturbance as a physical distemper well into the nineteenth century. Yet the kind of mental anguish which early medical observers labeled melancholic bore a striking resemblance to forms of emotional disorder whose point of origin was thought to be the mind itself. Various traditions of classical moral philosophy sought to treat disorders of the mind that unchecked emotion could create primarily by directing, ordering, and correcting the thought of the sufferer. Where the melancholic condition displayed qualities of the emotions as these were represented and analyzed by moral philosophers it was viewed as susceptible to philosophical treatment and insight.5Early modern English writers, no less than classical writers, thought it appropriate to apply to cases of melancholy therapies derived from the philosophic endeavor to define and achieve peace of mind. Burton argued explicitly in The Anatomy of Melancholy for the rightful authority of the philosophical "physician of the soul" in the treatment of melancholy; and the conceptual similarity of melancholy to moral diseases of the soul which provided the basis for this authority is evidenced in the works of several seventeenth-century moralists, as well as in the writings of the influential seventeenth-century physician and natural philosopher Thomas Willis on melancholy and the passions. Willis noted that melancholic emotions were structured and caused by the judgments of the mind rather than by the force of physiological dysfunction alone. His recognition of the importance of the mental aspects of melancholy provided the basis for his prescription of moral therapies for the government of the mind in addition to therapies for the body. Moreover, his writing on the passion of grief displays the ability of moral philosophical language to represent melancholic-like states as problems of the moral life, to be engaged through rational meditation and control.The importance of moral philosophy in understanding and treating melancholy has been largely ignored in current scholarship in the history of psychiatry and madness, which has concentrated on early modern medical concepts of mental disorder that traced its origins to the body. The historian of psychiatry and "madness" Roy Porter has, for instance, referred to Willis's medical writings as evidence for the "thoroughgoing somatic grounding of disorders of thought, feeling and behavior" that he alleged to have dominated the era's medical [End Page 584] conceptualization and treatment of madness.6 While Michel Foucault insightfully noted that Willis's ostensibly chemical account of the nature of melancholy was in fact "a phenomenology of the melancholic experience," he dismissed out of hand the relevance of classical moral philosophical language to the early modern treatment of madness, asserting the complete absence of moral treatments of madness until the end of the eighteenth century.7 In analyzing Willis's writing he thus failed to note the broader moral philosophical... (shrink)

Contemporary and emerging chatbots can be fine-tuned to imitate the style, tenor, and knowledge of a corpus, including the corpus of a particular individual. This makes it possible to build chatbots that imitate people who are no longer alive — deathbots. Such deathbots can be used in many ways, but one prominent way is to facilitate the process of grieving. In this paper, we present a framework that helps make sense of this process. In particular, we argue that deathbots can (...) serve as affective scaffolds, modulating and shaping the emotions of the bereaved. We contextualize this affective scaffolding by comparing it to earlier technologies that have also been used to scaffold the process of grieving, arguing that deathbots offer some interesting novelties that may transform the continuing bonds of intimacy that the bereaved can have with the dead. We conclude with some ethical reflections on the promises and perils of this new technology. (shrink)

This paper argues that Sulmasy and Sugarman have not succeeded in showing a moral difference between withholding and withdrawing treatment. In particular, they have misunderstood historical entitlement theory, which does not automatically prefer a first occupant by just acquisition.

Undeniably, a strikingly higher number of people die with direct health care provider involvement in Canada’s euthanasia regime, euphemistically termed “Medical Assistance in Dying” [MAiD], than un...

Advances in medicine in the latter half of the twentieth century have dramatically altered human bodies, expanding choices around what we do with them and how they connect to other bodies. Nowhere is this more so than in the area of reproductive technologies. Reproductive medicine and the laws surrounding it in the UK have reconfigured traditional boundaries surrounding parenthood and the family. Yet culture and regulation surrounding RTs have combined to try to ensure that while traditional boundaries may be pushed, (...) they are reconstructed in similar ways. This paper looks at the most recent RT to be permitted in the UK, mitochondria replacement therapy. Despite controversial media headlines surrounding the technique, MRT is in fact an example of how science and regulation seek to expand models of traditional relatedness in a way that doesn’t challenge the existing order. Yet, like other RTs, while attempts are made to ensure it doesn’t push traditional boundaries too far, fissures and inconsistencies appear in law and culture, which give interesting insights into how genetics, parentage and identity are being mediated in new but familiar ways. (shrink)

The ambiguity regarding whether a given intervention is perceived as enhancement or as therapy might contribute to the angst that the public expresses with respect to endorsement of enhancement. We set out to develop empirical data that explored this. We used Amazon Mechanical Turk to recruit participants from Canada and the United States. Each individual was randomly assigned to read one vignette describing the use of a pill to enhance one of 12 cognitive, affective or social domains. The vignettes described (...) a situation in which an individual was using a pill to enhance the relevant domain under one of two possible enhancement conditions, one perceived as enhancing above the norm, what most people recognize as a clear case of enhancement, whereas the other perceived as enhancing towards the norm, with the individual using the enhancement having a modest, but subclinical deficit. Participants were asked how comfortable they were with the individual using the enhancement and about the impact the enhancement might have had in the individuals’ success in life. We found that irrespective of the domain to be enhanced, participants felt significantly more comfortable with ETN than with EAN, and they regarded the enhancement intervention as contributing to greater success in life with ETN rather than EAN. These data demonstrate that the therapy enhancement distinction is morally salient to the public, and that this distinction contributes to the angst that people feel when considering the propriety of CAS enhancement. (shrink)

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

Letheby’s naturalistic theory of psychedelic therapy argues that the therapeutic power of psychedelics lies in their ability to allow individuals “to discover the contingency, mutability and simulatory nature of their own sense of identity and habitual modes of attention.” The general shape of this project is persuasive; it is hard to see how the claim that successful therapy must involve changes to the self could be objected to, and Letheby sketches a consistent, if speculative, picture of psychedelic experience. But the (...) role of affect in psychedelic therapy is insufficiently explored by Letheby as a comparison to MDMA-assisted therapy indicates. This comparison further suggests that Letheby’s reliance on a particular conceptualization of ego dissolution experiences is in need of further explanation and justification. (shrink)

:Since the advent of recombinant DNA technology, expectations about the potential for altering genes and controlling our biology at the fundamental level have been sky high. These expectations have gone largely unfulfilled. But though the dream of being able to control our biology is still far off, gene editing research has made enormous strides toward potential clinical use. This paper argues that when it comes to determining permissible uses of gene editing in one important medical context—germline intervention in reproductive medicine—issues (...) about enhancement and eugenics are, for the foreseeable future, a red herring. Current translational goals for gene editing research involve a different kind of editing than would be required to achieve manipulation of complex traits such as intelligence, and there are more pressing questions that need attention if clinical use of gene editing in reproductive medicine ever becomes a possibility. (shrink)

The prescription of growth hormone therapy for children who are not growth hormone deficient is one of the controversies in contemporary paediatric endocrinology. Is it morally appropriate to enhance the growth, by means of medical treatment, of a child wish idiopathic short stature? The medical, moral, and philosophical questions in this area are many. Data on the effects of human growth hormone (hGH) treatment will not on their own provide us with answers, as these effects have to be evaluated from (...) a normative perspective. In this article we consider hGH treatment for children of idiopathic short stature from three normative perspectives: the goals of medicine, the good of the patient, and the public good. We argue that the prevention of psychological and social problems due to short stature (and not merely the enhancement of growth) should be the ultimate goal of medical treatment and research. (shrink)

In August 2024, The U.S. Food and Drug Administration rejected Lykos Therapeutics, Inc.'s new drug application for midomafetamine with psychological intervention (MDMA-AT) to treat post-traumatic stress disorder (PTSD). Among the many issues raised during review was concern about a highly publicized case of alleged sexual misconduct by an unlicensed therapist during a Phase 2 study of MDMA and the potential risk of future abuse. This incident of misconduct, along with several other publicized cases of misconduct by guides, facilitators, and shaman (...) offering psychedelic retreats, has raised the question of whether physical contact is ever appropriate during psychedelic-assisted therapy (PAT). Drawing on research about supportive touch in other clinical contexts and taking into consideration features of psychedelics that exacerbate the potential for harm associated with supportive touch, we advocate for a precautionary approach to harm-reduction while arguing that supportive touch ought not be thrown out whole-cloth. (shrink)

The Pyrrhonist’s argumentative practice is characterized by at least four features. First, he makes a therapeutic use of arguments: he employs arguments that differ in their persuasiveness in order to cure his dogmatic patients of the distinct degrees of conceit and rashness that afflict them. Secondly, his arguments are for the most part dialectical: when offering an argument to oppose it to another argument advanced by a given dogmatist, he accepts in propria persona neither the truth of its premises and (...) conclusion nor the validity of its logical form. Thirdly, he avails himself of arguments in his own open-minded inquiry into the truth about a wide range of topics. Fourthly, Pyrrhonian argumentation is oppositional inasmuch as it typically works by producing oppositions among arguments that appear to the Pyrrhonist to be equipollent. In this article, I focus on the first three features with the aim of both shedding some light on them and determining whether they are in tension or coherently relate to each other. (shrink)

In this paper it is argued that physicians’ restrictive attitudes in offering abortions during 1946–1965 in Sweden were due to their private values. The values, however, were rarely presented openly. Instead physicians’ values influenced their assessment of the facts presented—that is, the women's’ trustworthiness. In this manner the physicians were able to conceal their private values and impede the women from getting what they wanted and needed. The practice was concealed from both patients and physicians and never publicly discussed. It (...) is also argued that a similar tacit practice could currently be applied by palliative care physicians. Such practice might allow palliative care physicians to be restrictive when offering sedation therapy without appearing paternalistic or declaring conscientious objections. However, the practice runs counter to patients’ right to participate in making decisions. The women seeking abortion began to oppose the situation and eventually a new abortion law was introduced 1975. Patients at the end of life will never be able to protest against palliative care physicians’ restrictive attitudes. This is a vulnerable and weak group, unable to lodge complaints after the treatment. In order to respect patients’ autonomy, even suffering patients at the end of their lives, it is suggested that physicians should openly declare their values when it comes to providing treatments that might shorten life. Such transparency might facilitate more genuine shared decision-making and accordingly less suboptimal end-of-life care. (shrink)

Suicidality, a significant problem in New Zealand for the past decade or so, has invited a substantial body of research into causes and prevention. However, given the effort, the prevention results do not appear to be sufficiently convincing when coroners’ views are considered. This paper focuses on two mainstream therapeutic approaches towards persons with borderline personality disorder, in which suicidal behaviour is a prominent feature demanding understanding and active attention. It is argued that dialectical behaviour therapy and psychoanalytically informed therapies (...) are lacking on two accounts. Firstly, the philosophical and methodological underpinnings of both approaches perpetuate what Heidegger refers to as the compound misunderstanding of ourselves as human beings. Secondly, what this translates into is a practice which forgets the human order and misunderstands the experience of the singular human present in despair. As an alternative approach towards dealing with suicide in practice, the author presents concepts central to Heidegger’s phenomenology of human existence and discusses how these may inform and enhance the treatment of suicidal patients. Indo-Pacific Journal of Phenomenology , Volume 7, Edition 2 September 2007. (shrink)

BackgroundAt present, tic disorder has attracted the attention of medical researchers in many countries. More clinicians choose non-drug therapy, especially cognitive-behavioral therapy because of the cognitive side effects of drug therapy. However, few studies had assessed its efficacy. It is necessary to have a more comprehensive understanding of the literature quality of CBT and its intervention effect.MethodsIn this study, MEDLINE, Embase, and Cochrane were searched from the beginning to June 15, 2021 to study the efficacy of -CBT on tic disorder. (...) Only studies using the Yale Global Tic Severity Scale and the control group were included.ResultsA total of 12 randomized controlled trials, including 536 patients with tic disorders, were identified. The results showed that the effect of CBT was better than that of the control group. The pooled standardized mean difference was −0.34. The effect size of CBT differs from different intervention conditions. In seven studies, the subjects’ motor tic scores were counted. The sample size of the experimental group was 224 and that of the control group was 218. The pooled SMD was −0.43. Seven studies counted the vocal tic scores of subjects, 224 in the experimental group and 218 in the control group. The pooled SMD was −0.22. Seven studies counted the tic impairment scores of subjects, 220 in the experimental group and 214 in the control group. The pooled SMD was −0.48.ConclusionThe literature shows that different CBTs can significantly reduce the total score of tic disorder and the score of motor tic, but cannot significantly reduce the score of vocal tic. In the future, more new interventions were needed to improve the symptoms of different patients, especially vocal tic. (shrink)

Daya Krishna’s creative criticism of the prevalent traditionalist interpretation of classical Indian philosophy is analytically stated and evaluated. His objections to classifying Indian philosophies into orthodox and heterodox systems, applying to a group of differing philosophies the common labels of vedānta or vedāntic, making these terms multi-referential, inappropriately titling some books as Nyāyasūtra, Sānkhayarikārika, etc., though they discuss a miscellany of themes, etc., are also discussed and assessed. His calling of these terms and some others of their like, or the (...) practice of using them, mythical is examined. It is shown that they may not be accurate but their use has not become disutile. In their prevailing usage, seemingly misleading characters have become sterile and therefore they have ceased to be misleading and continue functioning as convenient classificatory terms. Enjoying his calling of the concept of puruṣārtha and the theory of puruṣārtha too mythical, it has been shown that the concept is not because it means any object of anyone’s and there are many such objects; the theory is not because it is historically an important component of classical Indian value theory. I have also shown that as presented by traditionalist writers, it is not a logical elegant theory, but a fairly workable one can be carved out of the classical theory by linking together some elements of it in newer ways with the logical cement obtainable from modern value theorizing. Something similar has been done with Daya Krishna ’s analysis of the traditionalist claim that Indian philosophy is spiritualist. DK links it with Indian culture through the concept of mokṣa. I have shown that it is the result of linking philosophy too tightly with religion, of course, through the doorway of the concept of mokṣa, by pointing out that mokṣa is a religious, and not an ethical, value. (shrink)

I would like to begin this essay by sharing an intuition. It is an intuition requiring much fuller development, but I see myself making a modest contribution to it here—and that is the prospect of integrating mimetic theory with Christian contemplative practice. Such integration would, I imagine, be the beginning of something very ancient and very new.I am aware of some promising developments in this direction,1 but my conviction is that its potential is barely tapped. It would probably be too (...) much to suggest that such integration could result in a distinctive "school" of spirituality, though that is not inconceivable. Perhaps a better analogy for what I envision can be found in the emerging field of Contemplative... (shrink)

This chapter examines two premises of cognitive-behavioral therapy (CBT) - that emotions are caused by beliefs and that those beliefs are represented in the mind as words or images. Being a philosophical examination, the chapter also seeks to demonstrate that these two premises essentially are philosophical premises. The chapter begins with a brief methodological suggestion of how to properly evaluate the theory of CBT. From there it works it way from examining the therapeutic practice of capturing the mental representations that (...) supposedly elicit emotional reactions to examining the assumption that emotions are caused by beliefs. The chapter ends by briefly pointing to some consequences of what has been said to the practice of CBT. (shrink)

Name der Zeitschrift: Nietzsche-Studien Jahrgang: 46 Heft: 1 Seiten: 82-104.