The clinical relation is the singular encounter between a patient who complains and a doctor who listens, in order to relieve and cure. But it is going through a period of crisis. One even announces his impending death! Strangely, technological advances are now coming to its rescue, prompting it to bounce back. Two hundred years after the stethoscope, the mediated vision by portable ultrasound becomes reality and enters the stage to probe the sick body “at his bedside”. (...) This virtual visible from the clinical examination becomes thus visible to the clinician, doctors and patients in general, because the images can be shared. That means for the clinician to take possession of space that was impermeable until there: the vision penetrates beyond old barriers, but it will only assert its full power if it is permeated by a clinical relation restored to its true beauty. (shrink)

To understand Lacan’s thinking process on vision, the entirety of his teaching must be taken into consideration. Until the 60s, the visual field is the imaginary, the constitutive principle of reality in its phenomenal giving to the experience of a subject. This register is the opposite of the field of the word with the L schema and, subsequently, as subordinated to the symbolic system according to the model of the optical schema of the inverted flower vase of Bouasse. It (...) is only with the 1964 seminar that Lacan makes a daring turnaround through which the visual becomes a sign of the emergence of a real that is irreducible to both reality and the mediation of the subject of knowledge. The split that separates reality and the real is reproduced in Lacan within the visual field, which is, on the one hand, the cardinal principle of the consistency of the experience of reality, and on the other, it is an element of irreducibility to reality. This produces a cascade of consequences: first of all, the modification of the presentation of the mirror stage. Unlike the voice, which through prosody, tone, and volume, finds some strips with which anchor itself imaginatively to reality, the gaze, invisible and elusive, escapes the imaginary grasp. Captured in myths, it reveals its power and ability to annihilate—as in the myth of Medusa’s gaze—or to make people fall in love but only with a narcissistic love that leads inexorably to death as in the myth of Narcissus. The gaze is elusive because the subject is dependent on it in the field of desire. Like the voice, it is about the desire on which the subject is supported; it is one of the objects on which the phantom depends. In our opinion, thanks to this characteristic, the gaze object can make remote psychoanalytic treatment possible through easily accessible videoconferencing tools and, at the same time, create new conditions within it that should be carefully evaluated to understand its implications in the session itself. (shrink)

Rarely do ethics consults focus on genuine moral puzzlement in which people collectively wonder what is the right thing to do. Far more often, consults are about conflict. Each side knows quite well what is “right.” The problem is that the other side is too blind or stubborn to recognize it. And so the ethics consultant is called, perhaps in the hope that s/he will throw the weight of ethics toward one side and end the controversy so everyone can get (...) on with other business. Perhaps the greater problem in these scenarios is that even if one side “wins” by gaining the power to dictate what happens next, the toxicity permeating the relationships often markedly worsens and other conflicts erupt, major and minor. (shrink)

Conflicts in the clinical setting can spiral downward with remarkable speed, as parties become ever more incensed and entrenched in their positions. Productive conversations seem unlikely at best. Nevertheless, such situations can sometimes be turned into collaborative problem solving with equally remarkable speed. For this to happen, those providing conflict-resolution services such as mediation need to bring, not just a set of skills, but also some key norms: the process must be voluntary for all; the mediator must abjure giving (...) advice or taking sides, and must honor the privacy of privately offered thoughts. This article describes a conflict that had reached the point of a hospital’s requesting judicial coercion. However, a conflict-resolution process was then initiated that, in the end, led to amicable resolution and mended relationships, obviating the need for court orders. This article describes that conflict and the resolution process in detail, along the way annotating specific strategies that are often highly effective. (shrink)

Clinical ethics mediation is invaluable for resolving intractable disputes in the hospital. But it is also a critical day-to-day skill for clinicians, especially those who serve a disproportionate number of vulnerable patients. While mediation is typically reserved for intractable cases, there are two important opportunities to expand its use. First is preventative mediation, in which clinicians incorporate clinical ethics mediation into their daily routine in order to address value-laden conflicts before they reach the point at which outside consultation (...) becomes necessary. Second is guided mediation, in which clinical teams resolve conflicts with patients or surrogates with guidance from an ethics consultant, who operates at some distance from the conflict and, rather than recommending a single action, counsels clinicians on the process they can use to resolve the conflict on their own. These approaches build the capacity of all clinicians to use clinical ethics mediation to improve the care of vulnerable patients. (shrink)

BackgroundCaregivers may play a fundamental role in the clinical pathway of cancer patients. They provide emotional, informational, and functional support as well as practical assistance, and they might help mediate the interaction and communication with the oncologists when care options are discussed, or decisions are made. Little is known about the impact of dyadic dynamics on patient-doctor communication, patient's satisfaction, or adherence to the therapies. This study protocol aims to evaluate the efficacy of a psychological support intervention on patients-caregivers (...) relationship and their alignment in the treatment decision-making process and estimate related improvement in patient' compliance/adherence to treatments.MethodsA total of 102 patients-caregivers' dyads will be involved, among breast and prostate cancer patients. The study entails a pre- post- evaluation through psychological questionnaires, with a randomization of participants in two conditions, the experimental one in which subjects participate in a psychological support consultation, and the control one, where dyads do not receive any intervention. A follow up after 6 months from the enrollment is planned.DiscussionA positive impact of the psychological support intervention on patients' anxiety, depression, distress, and perceived social support is expected. Such improvements can directly affect patients' satisfaction and adherence to treatments. Data gathered from this study may inform health care providers, policy makers, and public health managers about the importance of caregiver's involvement in the cancer care pathway, and the best way to manage it. A further impact is to develop a specific intervention protocol to support caregivers' involvement in cancer care pathway, improve patient's wellbeing, the interaction with physicians and the compliance with the cancer treatment. (shrink)

In this paper we focus on the modularity of visual functions in the human visual cortex, that is, the specific problems that the visual system must solve in order to achieve recognition of objects and visual space. The computational theory of early visual functions is briefly reviewed and is then used as a basis for suggesting computational constraints on the higher-level visual computations. The remainder of the paper presents neurological evidence for the existence of two visual systems in man, one (...) specialized for spatial vision and the other for object vision. We show further clinical evidence for the computational hypothesis that these two systems consist of several visual modules, some of which can be isolated on the basis of specific visual deficts which occur after lesions to selected areas in the visually responsive brain. We will provide examples of visual modules which solve information processing tasks that are mediated by specific anatomic areas. We will show that the clinical data from behavioral studies of monkeys (Ungerleider and Mishkin 1984) supports the distinction between two visual systems in monkeys, the 'what' system, involved in object vision, and the 'where' system, involved in spatial vision. (shrink)

This detailed 1990 book describes the light and dark adaptation of receptoral and post-receptoral mechanisms from a number of perspectives. The authors emphasise the importance of the study of achromatopsia, a rare congenital condition in which the visual mechanisms that mediate day vision are absent whilst those that mediate night vision remain intact.

Modern health care is inextricably bound up with technologically mediated knowledge and practice. It is vital to investigate its use and role in different clinical contexts characterized, on one hand, by face to face practitioner and patient encounters (where technology may be conceptualised as hindering therapeutic relations) and, on the other hand, by practitioners’ encounter with bodily parts in laboratories (where conceiving of patients may be thought of as confounding objectivity). To contribute to the latter, I offer an (...) ethnographic analysis of cytology laboratory practitioners’ work and microscopic assessment of normal and abnormal cells. First, I discuss the biomedical literature on cytology and the quest for a non-variational bodiless vision. Second, I discuss the concept of multistability, first developed by philosopher of technology Don Ihde, here used to analyse technologically mediated perception and how practitioners interact with technology. Combined with long term ethnographic fieldwork it enables access to, and analysis and articulation of the implicit multifaceted practitioner–technology–cell interface embedded in clinical practice and diagnostic processes. I will also address some implications of my analysis for clinical cytology. (shrink)

This article contains an analysis of Warren Neidich’s early photographic work of 1997 until 2002. These works are linked to the extensive theoretical production of the artists who connect them to the concepts of the dispositif and apparatus respectively. The article provides a close description of the parameters of four pivotal work groups of Neidich’s early practice, Brain Wash (1997), Double Vision (1997—2000), Shot Reverse Shot (2001) and Law of Loci (1998—9). These works were realized with the aid of (...) low-tech devices stemming from neuro-ophthalmology, marking the interface between current neuro-philosophical discourses such as the plasticity of the brain, the apparati of visual, i.e. analog and digital, culture and the philosophy of memory. It is suggested that Neidich, even though he intervenes and contributes importantly to these intermingling discourses in a broad manner, is particularly interested in the degraded and infirm implementations of human vision in order to explore new sensations and habits of perception. (shrink)

Mediators utilize a wide range of skills in the process of facilitating dialogue and resolving conflicts. Among the most useful techniques for clinical ethics consultants (CECs)—and surely the least discussed—are those employed in acrimonious, hostile conversations between stakeholders. In the context of clinical ethics disputes or other bedside conflicts, good mediation skills can reverse the negative interactions that have prevented the creation of workable treatment plans or ethical consensus. This essay lays out the central framework mediators use in (...) distinguishing positions from interests and describes a set of strategies for managing contentious ethics consultations or working with “difficult” patients, families, or patient-careprovider interactions. (shrink)

The article examines the patient-doctor relationship, relying on Michel Foucault’s concept of the clinical gaze. We argue that during the last decades, a profound transformation of the social nature of medicine took place, one that Foucault’s understanding of the clinical gaze cannot adequately account for. First, the article offers an elaboration of the three-node network of clinical gaze, the clinic, and nosology to explain the positioning of the doctor and the patient within the specific (...) social ontology generated by the rise of medicine. We then discuss intensive but irresolute developments brought by technological advancements, especially the X-ray tube. Finally, we argue that in the contemporary clinic, equipped with a plethora of sophisticated devices, the position of the doctor endured the most radical transformation in comparison with Foucault’s proponent of the clinical gaze at the dawn of modern medicine. (shrink)

In conjunction with the growing feminist literature on pregnancy and visualization, this paper uses Foucault’s The Birth of the Clinic to demonstrate how the effort to make the interior of the pregnant body visible in medical discourse was a crucial part of the development of the modern medical gaze. In doing so I develop two concurrent arguments. First, I argue that the pathological corpse of the Clinic can conceptually serve as a double for the pregnant body as it emerged (...) in modern medicine in the 20th century. At the same time I use the insights of the Clinic to illustrate changes in pregnancy from early modernity to the 20th century. In early modernity, the pregnant body was understood in terms of generation, as a tree that bears fruit; by the 19th century, the pregnant body was a machine that reproduced the species. This transition can be seen in the overlap of pathology and pregnancy in early modernity, an overlap that continued throughout the 19 century and is inadvertently reinforced through the practice of ultrasound. (shrink)

In this volume Samuel Parkison explores the significance of the doctrine of the beatific vision for the life of the church. Engaging in close readings of biblical texts and ancient, medieval, early modern, and modern theologians, Parkison shows that the beatific vision - that ultimate hope of seeing and being in the presence of God - is a central Christian conviction shared across the history of the church. Parkison not only invites readers into the wide-ranging developments of the (...) doctrine, but shows us the implications of the Beatific Vision for how the church envisions itself today. (shrink)

In this paper, I leverage the pragmatist tradition in philosophy, the collective wisdom of scholarship in clinical ethics consultation, and earlier attempts to apply pragmatism in clinical ethics to develop a new vision of clinical ethics practice called New Clinical Pragmatism. It argues that clinical ethics methodology, from the New Clinical Pragmatist’s perspective, amounts to the recommendation that consultants should customize a methodological approach, drawing on the various available methods, depending on the demands (...) of the specific case, and should avoid attempts to identify a ‘true’ methodology but to the incoherence and inevitable failure of those attempts. I argue that pragmatism’s emphasis on practical wisdom and experimentation allow the New Clinical Pragmatist to do this while avoiding irrationality in choosing methods. I discuss how the New Clinical Pragmatist gives a unique, constructive perspective on key aspects of clinical ethics consultation such as the choice of common morality vs. internal morality of medicine approaches, process standards, bioethics mediation, and narrative ethics, and suggest how New Clinical Pragmatism’s relaxed approach to choice of methodology encourages consultants to balance attention to the particulars of the case with knowledge of what the many insightful scholars of clinical ethics methodology have found useful in the past. I also argue that New Clinical Pragmatism is consistent with efforts to professionalize clinical ethics consultation. (shrink)

Adolescence is a period of several changes and a time when young people are confronted with some difficult tasks of dealing with a diversity of emotions and building their own identity. Therefore, it is a period of higher vulnerability for the development of internalizing problems. The present paper aims to study some constructs considered relevant to adolescents’ adjustment and/or internalizing disorders, emphasizing the role of well-being, emotional regulation and family environment. Therefore, this research aims to test the mediating role of (...) well-being in the relationship between emotional regulation difficulties, the family environment, and internalizing problems, and understand the differences between adolescents with a higher and lower risk of presenting internalizing problems. In the study, 723 adolescents of both sexes from middle to high school completed self-report questionnaires. The results indicated that the mediating role of well-being was partially established between emotional regulation difficulties and internalizing problems, explaining 31% of the variance in these problems. Well-being was also considered a partial mediator between family environment and internalizing problems, explaining 19 and 26% of the variance, respectively. Furthermore, the group with a higher risk of developing internalizing problems revealed higher levels of emotional regulation difficulties and family conflict. In contrast, this group reported less family cohesion and support and lower levels of well-being. The main results of the present study provide relevant data in the context of clinical practice. Important implications are also discussed for the design of psychopathology prevention programs and the promotion of global well-being with adolescents. Considering the limitations of the present study, such as the nonrandom sampling process and the reduced number of participants included in the clinical group, these results need to be deepened in future research in this area. (shrink)

This paper focuses on the importance of digital communication between medical teams and patients and their families when mediated by technological tools. Medicine is changing following the fourth industrial (the digital) revolution: from CAT scans, to X-rays, to UV radiation, to electronic records, to treatment tracking apps, to telemedicine, and the use of AI in doctors' decision-making processes. The COVID-19 pandemic highlighted both the fruitful and problematic sides of this medical evolution. Digital tools such as tablets, smartphones, and video (...) calling apps proved to be essential. Accordingly, I analyze three cases that reveal the helpfulness and the limitations of new communication technologies: on physicians and non-hospitalized patients, on families and patients, and on healthcare professionals and patients' families. Since the medical relationship is not only clinical but also relational and human, one must pay attention to the communicative dimensions of it to remain at least partly _human-e_. (shrink)

In this article, we explore alternative conflict resolution strategies to assist families and clinicians in cases of intractable dissent in paediatric health care decision-making. We focus on the ethical and legal landscape using cases from the Australian jurisdiction in New South Wales, while referencing some global sentinel cases. We highlight a range of alternative means of addressing conflict, including clinical ethics support, and contrast and contextualise facilitative or interest-based mediation, concluding that legal intervention via the courts can be protracted (...) and distressing and should be a ‘last resort’. We acknowledge many might view this as the current status quo, but we go further to recommend strategies optimal for all parties to recognise early signs of conflict and prevent its harmful escalation. While more empirical research is needed, we contend that interest-based mediation may be a valuable adjunctive method of conflict resolution. If judiciously distinguished from and utilised with clinical ethical support, it can be an effective tool to address dissent and its negative sequelae in paediatric healthcare decision-making. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:...

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 27.2 (2003) 480-484 [Access article in PDF] The Raymond Tallis Reader, edited by Michael Grant; xxx & 382 pp. Houndmills: Palgrave Macmillan, 2000, $79.95. For some people, the name Raymond Tallis evokes theoretical controversy, oversimplified arguments, biting rhetoric, and bruised egos. For others, like the editor of The Raymond Tallis Reader, Michael Grant, he is a twenty-first-century man of Enlightenment who has the vision and (...) the courage to reveal the foibles of poststructuralist literary and cultural theory. It should come as no surprise that an overview of his work so far shows that both of these views are justified, though incomplete.This selection of Tallis's writings draws on most of his published works, aside from his clinical writings. Texts range from philosophical investigations into the nature of consciousness to close methodological critiques of poststructuralist (or what Tallis also calls post-Saussurean) theory. He has consistently argued that that such theories are fundamentally flawed by relativism, obscurantism [End Page 480] and anti-humanist concepts (such as the language-bound subject), and many of his views are shared by scholars such as Wendell V. Harris (Beyond Poststructuralism and Literary Meaning) and Paisley Livingston (Literary Knowledge). "It is poststructuralism," Tallis writes, "that has brought to a climax the anti-rationalist, anti-individualist and, indeed, anti-humanist strains of the Counter-Enlightenment thought" (p. 152). Tallis has done a valuable service in expressing the most common objections to such theorizing with clarity and vigor, and The Raymond Tallis Reader is useful in collecting his arguments in a single volume, with Grant's prefaces to each reading providing a clear view of the main points. The collection does, however, also bring into focus some of the problems involved in Tallis's critiques. He is an admirable synthesizer of thought, but does occasionally fall into the trap of unsupported generalizations he spends so much effort in trying to eradicate in the writings of others.The first of section of the book focuses on Tallis's conception of "the explicit animal," on rescuing the idea of consciousness and rational will from scientistic neurological theories. Such views may come as a surprise to those readers who have come to know Tallis as the champion of Enlightenment thinking. He argues, however, that even though neurology has been in many ways invaluable, it has not been able to explain the synchronic and diachronic unity of the self, which collects the various impulses experienced by a human being and which preserves a connection between them over time.The second section brings together writings concerning the nature of language. Again, the central concept is explicitness: Tallis emphasizes the way human language differs from animal signaling systems or natural signs by virtue of being composed of explicit signs—signs in the Saussurean sense of combining a signifier with a signified in an arbitrary fashion. What he absolutely denies, however, is that such a system of signs would be completely cut off from reality: "Because words do not mirror the world, it does not follow that discourse is cut off from the world" (p. 134). Those theorists who have taken the step from defining the relationship between the signifier and the signified as arbitrary to declaring the relationship between reality and the sign as a whole to be equally arbitrary, have moved from Saussurean theories to what Tallis calls post-Saussurean thinking. His main objection lies in the way such theories deny the existence and efficacy of individual, explicit and conscious human selves: "Our contemporary anti-Enlightenment figures see society, or one of its proxies such as history, socially mediated instincts or language, as being anterior to, and transcending, the individuals that make it up.... The post-Saussureans... saw selves vanish completely into nodes in sign systems or soluble fish in a boundless sea of discourse" (pp. 148-49). Tallis particularly opposes the Lacanian view of the language-bound psyche. When discussing Lacan's mirror stage he attacks not only Lacan's obscurantist style and undefined terminology, but also the self-contradictory and empirically unsupported theory of the child's entry into the Symbolic... (shrink)

Blindsight is the term commonly used to describe visually guided behaviour elicited by a stimulus falling within the scotoma (blind area) caused by a lesion of the striate cortex. Such is normally held to be unconscious and to be mediated by subcortical pathways involving the superior colliculus. Blindsight is of considerable theoretical importance since it suggests that destriate man is more like destriate monkey than had been previously believed and also because it supports the classical notion of two visual (...) systems. It is also of potential clinical importance, since it has been claimed recently that systematic practice in blindsight can lead to the recovery of normal visual function in patients with cortical lesions. From a review of the literature it is concluded that all of the phenomena of blindsight can be attributed either to light scatter into unimpaired parts of the visual field or to residual vision resulting from spared striate cortex. The possible contribution f other factors is also considered. It is concluded that blindsight studies have generally failed to control for such nonblindsight interpretations partly because of poor methodology and partly because of difficulties in defining the term. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Clinic as Testing Ground for Moral Theory: A European ViewHans-Martin Sass (bio)A Philosopher’s View of Theory in the Clinical SettingThe clinic is a testing ground for theories. I am not clinician; I am a philosopher who has been in the clinic only as a patient or as an ethicist who never has had the final word nor was ever intended to have the final word. I have (...) learned that in the clinical setting general norms and conceptualizations in the Kantian sense must be tailored to real-life situations. From the philosophical schools of analytical reasoning, I learned the skills needed to analyze words and meanings and to dissect problems and so-called “solutions.” But even more impressive are the methodological skills of differential diagnosis, looking at medical problems from different angles and using different methods and instruments. The detail- and patient-oriented work of the clinician provides an excellent model of methodological clarity and professional devotion for a philosopher who assists those working for the “good of the patient.” That model has led to the development of what I call a theory and methodology of differential ethics. [End Page 351]Differential ethics is normative ethics, as it does not give up norms in favor of situational utility. Differential ethics does not venture out empty-handed in order to explore and find principles pre-existing in a given situation; rather it brings basic values and principles along with it and tries to discover the shape they must take and the priority they must be given in the situation at hand. Differential ethics differentiates between general norms and mid-level principles, virtues, and visions that must be introduced and protected effectively and specifically according to different scenarios (Sass 1993). From this European point of view, I shall briefly explain my position and comment on (1) the controversy between principlism and virtue theory, (2) differentiating and balancing, and (3) the importance of trust, both as a principle and as a virtue in the clinical setting.Principlism Versus Virtue Theory: A Mistaken ControversyFrom a European perspective, I find that the debate between the schools of virtue-theory and principlism in the United States is a mistaken controversy. The real conflict between the schools of thought is not methodology, but content. Tom Beauchamp (1995) gives examples of how one language or method can be translated into the other, and Edmund Pellegrino and David Thomasma (1988, p. 206) have formulated a rule for the virtuous physician that, in the language of principlism, reads “respect for autonomy,” but in the language of virtue theory reads “To assist my patients to make choices that coincide with their own values or beliefs, without coercion, deception, or duplicity.”In different situations, however, some systems of reference are more authoritative and effective than others. Appealing to professional virtues would be the most efficacious way to address an audience coherent in attitudes and concerned about personal character. Reaffirmation of personal and professional obligations in secular fraternities or religious communities works best when it includes an appeal to virtues in the language of the humanist tradition, moral theology, or professional ethics.But there are other situations in which authoritative attitudes and expectations are absent and society in general is searching for common, often dormant, principles that will hold it together whatever specific disagreements arise. Such a situation was present in 1978 when the Belmont Report (National Commission 1978) presented principles—respect for autonomy, nonmaleficence, beneficence, justice—and not virtues to guide moral and political reflections on and reactions to the ethical, legal, and social implications of modern biomedicine in a multi-faceted and multi-cultural society.The formal difference between the systems of principlism, virtue theory, and value theory becomes even less important when clinical-ethical questionnaires are used to understand specific scenarios or cases and to assess different options for proceeding. Thus, my first thesis is: Case discussion, scenario assessment, [End Page 352] and open questionnaires, rather than definite guidelines, bridge the difference between virtue theory and principlism, since such processes can employ any one language or a combination of all three.Differentiating and BalancingMy second thesis is: Whatever system of reference is used... (shrink)

Individual bacterial cells can communicate via quorum sensing, cooperate to harvest nutrients from their environment, form multicellular biofilms, compete over resources and even kill one another. When the environment that bacteria inhabit is an animal host, these social behaviours mediate virulence. Over the last decade, much attention has focussed on the ecology, evolution and pathology of bacterial cooperation, and the possibility that it could be exploited or destabilised to treat infections. But how far can we really extrapolate from theoretical predictions (...) and laboratory experiments to make inferences about ‘cooperative’ behaviours in hosts and reservoirs? To determine the likely importance and evolution of cooperation ‘in the wild’, several questions must be addressed. A recent paper that reports the dynamics of bacterial cooperation and virulence in a field experiment provides an excellent nucleus for bringing together key empirical and theoretical results which help us to frame – if not completely to answer – these questions. (shrink)

This essay argues that Berger and Mohr’s A Fortunate Man (1967) – comprising social observation and photographs of the rural practitioner, Dr. Sassall and his patients – enacts an embodied, intersubjective empathy called “pain-work.” The book enacts “pain-work” through two strategies. Firstly, by conflating three ways of seeing – Berger’s observation, Mohr’s photography, and Sassall’s medical gaze – it shows that the clinical encounter embodies objective vision through intersubjective pain. Secondly, it employs the concepts of recognition and (...) witnessing to show how the subjectivity of the physician is distributed in his community. Thus, Berger and Mohr witness Sassall’s witnessing of his patients; even as Sassall and his patients are constituted intersubjectively, so too are Berger, Mohr, and Sassall. (shrink)

People in the ancient world thought of vision as both an ethical tool and a tactile sense, akin to touch. Gazing upon someone—or oneself—was treated as a path to philosophical self-knowledge, but the question of tactility introduced an erotic element as well. In _The Mirror of the Self_, Shadi Bartsch asserts that these links among vision, sexuality, and self-knowledge are key to the classical understanding of the self. Weaving together literary theory, philosophy, and social history, Bartsch traces this (...) complex notion of self from Plato’s Greece to Seneca’s Rome. She starts by showing how ancient authors envisioned the mirror as both a tool for ethical self-improvement and, paradoxically, a sign of erotic self-indulgence. Her reading of the _Phaedrus_, for example, demonstrates that the mirroring gaze in Plato, because of its sexual possibilities, could not be adopted by Roman philosophers and their students. Bartsch goes on to examine the Roman treatment of the ethical and sexual gaze, and she traces how self-knowledge, the philosopher’s body, and the performance of virtue all played a role in shaping the Roman understanding of the nature of selfhood. Culminating in a profoundly original reading of _Medea_, _The Mirror of the Self_ illustrates how Seneca, in his Stoic quest for self-knowledge, embodies the Roman view, marking a new point in human thought about self-perception. Bartsch leads readers on a journey that unveils divided selves, moral hypocrisy, and lustful Stoics—and offers fresh insights about seminal works. At once sexy and philosophical, _The Mirror of the Self_ will be required reading for classicists, philosophers, and anthropologists alike. (shrink)

Vision and the gaze are key issues in the analysis of racism, sexism and ethnocentrism. In recent radical theory, generally, and French theory in particular, vision has been seen as a means of control. But this view is often unnuanced. It bypasses questions such as: Why is it that contemporary theories have been so critical of vision, and generous towards listening (in psychoanalysis) and language (in philosophy)? This collection of original essays brings together historical studies and (...) contemporary theoretical perspectives on vision. The historical papers focus in turn on Ancient Greece, medieval theology, the Renaissance, the Enlightenment and the nineteenth century. These historical studies are themselves thoroughly informed by poststructuralist theory. They provide a rigorous background for several new, exciting articles on vision and its bearings for feminism, race, sexual orientation, film and art. This collection is the first of its kind in juxtaposing historical and contemporary. (shrink)

During the Corona pandemic, it became clear that people are vulnerable to potentially harmful nonhuman agents, as well as that our own biological existence potentially poses a threat to others, and vice versa. This suggests a certain reciprocity in our relations with both humans and nonhumans. In his The Visible and the Invisible, Merleau-Ponty introduces the notion of the flesh to capture this reciprocity. Building on this idea, he proposes to understand our relationships with other humans, as well as those (...) with nonhuman beings as having a chiasmic structure: to sense, or perceive another entity in a particular way simultaneously implies to be sensed or perceived in a particular way by this other entity. In this paper, we show how a postphenomenological perspective expands on Merleau-Ponty: first, it more radically interprets Merleau-Ponty’s notion of flesh by not only considering it to be a medium that is the condition of possibility for vision but as pointing to the constitution of an intercorporeal field in which entities—both human and nonhuman—mutually sense one another. Second, it augments Merleau-Ponty’s thought by drawing attention to how technologies mediate chiasmic relations. This is clarified through the example of the facemask, which reveals the chiasmic structure of our relation with nonhuman entities, and shows that technologies co-constitute interpersonal relationships by making humans present to one another in a particular way. We suggest that these aspects are not unique to the facemask, but point to a general technologically mediated chiasmic structure of human-world relations. (shrink)

Studies in the psychology of visual expertise have tended to focus on a limited set of expert domains, such as radiology and athletics. Conclusions drawn from these data indicate that experts use parafoveal vision to process images holistically. In this study, we examined a novel, as-of-yet-unstudied class of visual experts—architects—expecting similar results. However, the results indicate that architects, though visual experts, may not employ the holistic processing strategy observed in their previously studied counterparts. Participants (n = 48, 24 architects, (...) 24 naïve) were asked to find targets in chest radiographs and perspective images. All images were presented in both gaze-contingent and normal viewing conditions. Consistent with a holistic processing model, we expected two results: (1) architects would display a greater difference in saccadic amplitude between the gaze- contingent and normal conditions, and (2) architects would spend less time per search than an undergraduate control group. We found that the architects were more accurate in the perspectival task, but they took more time and displayed a lower difference in saccadic amplitude than the controls. Our research indicates a disjunctive conclusion. Either architects are simply different kinds of visual experts than those previously studied, or we have generated a task that employs visual expertise without holistic processing. Our data suggest a healthy skepticism for across-the-board inferences collected from a single domain of expertise to the nature of visual expertise generally. More work is needed to determine whether holism is a feature of all visual expertise. (shrink)

In this commentary on a clinical ethics case pertaining to a same-sex couple that does not have explicit surrogate decision-making or hospital-visitation rights (in the face of objections from the family-of-origin of one of the queer partners), the authors invoke contemporary legal and policy standards on LGBTQ health care in the United States and abroad. Given this historical moment in which some clinical rights are guaranteed for LGBTQ families whilst others are in transition, the authors advocate for the (...) implementation of clinical ethics mediation as the soundest and most humane form of resolution in matters where there is a dispute between family members about an incapacitated loved one. They argue that clinical ethics mediation is an ideal alternative solution because it works toward consensus about outcome, even where consensus about values is not achievable. (shrink)

David Michael Levin's ongoing exploration of the moral character and enlightenment-potential of vision takes a new direction in _The Philosopher's Gaze_. Levin examines texts by Descartes, Husserl, Wittgenstein, Nietzsche, Heidegger, Benjamin, Merleau-Ponty, and Lévinas, using our culturally dominant mode of perception and the philosophical discourse it has generated as the site for his critical reflections on the moral culture in which we are living. In Levin's view, all these philosophers attempted to understand, one way or another, the distinctive pathologies (...) of the modern age. But every one also attempted to envision—if only through the faintest of traces, traces of mutual recognition, traces of another way of looking and seeing—the prospects for a radically different lifeworld. The world, after all, inevitably reflects back to us the character, the reach and range, of our vision. In these provocative essays, the author draws on the language of hermeneutical phenomenology and at the same time refines phenomenology itself as a method of working with our experience and thinking critically about the culture in which we live. (shrink)

According to policy makers, telemedicine offers “huge opportunities to improve the quality and accessibility of health services.” It is defined as diagnosis, treatment, and monitoring, with doctors and patients separated by space but mediated through information and communication technologies. This mediation is explored through an ethnography of a U.K. teledermatology clinic. Diagnostic image transfer enables medicine at a distance, as patients are removed from knowledge generation by concentrating their identities into images. Yet that form of identity allows images and (...) the expert gaze to be brought into potentially lifesaving proximity. Following Latour’s thread, images must be captured and then mobilized to the knowledge base, where they must be stabilized into standard diagnoses, then combined with different images, waiting lists, skin lesions, dermatologists, paper records, and beds, so that ultimately, outcomes are produced. This huge task requires new knowledges and a widening of agency that, if unacknowledged, may see telemedicine projects continue to founder. (shrink)

Based on a nuanced understanding of immersion and sense of presence as two key aesthetic effects that the application of virtual reality to cinema is believed to innovate, this paper develops the concept of synthetic vision as fundamental to understanding the visual experience of VR media, particularly VR documentaries. The concept contends that viewers’ experience in VR is based on two visions that seemingly contradict each other: first, a disembodied vision that transports them to a simulated world, and (...) second, an embodied vision guaranteed by the freedom to control kinesthetic movement and direction of gaze. This serves to advance the idea that immersion and SoP are not unified but rather multifaceted concepts premised on a nuanced understanding of the varying relationships between the technological system of VR, its media content, and its user. For the concept of synthetic vision points to the paradoxical coexistence of viewers’ presence in the virtual world and their structural absence from the world that lays the groundwork for their immersive experience. By classifying three generic categories of contemporary VR documentaries, and by examining the aesthetic and ethical underpinnings VR brings to each of them, I argue that it hinges upon what kind of cinematic conventions and genres are remediated to determine the effective synthesis of the two visions. The varying effects of synthetic vision in the three subgenres of VR documentary stress that immersion and SoP have different political and ethical consequences of media witnessing. In the conclusion, I recapitulate multiple implications that the concept of synthetic vision has in regards to both the studies on VR and the recently flourishing investigation into cinematic VR artifacts. (shrink)

Background Belonging to the clinical environment and the professional values of the performers play a role in forming a professional identity. Therefore, it is necessary to understand the degree of connection among these concepts. Aim This study aimed to examine the mediating effects of professional values on the relationship between nurses’ clinical environment belongingness and professional identity. Design In the present study, a descriptive cross-sectional multicenter design was used. Participants and research context A convenient sample of 635 nurses (...) recruited from three hospitals in Fars Province, Southern Iran, from September 2023 to January 2024. Nurses Professional Values Scale–Revised, Clinical Environment Belongingness Scale, and Professional Identity Scale were used to collect the data. The mediation model was analyzed using SPSS v27 and the Process Macro 4.0. Ethical considerations The protocol of this study was approved by the Research Ethics Committee of Fasa University of Medical Sciences, and informed consent was obtained from all nurses. The study conforms to the principles outlined in the Declaration of Helsinki. Results Based on the results of regression analysis, clinical environment belongingness had a positive and significant impact on professional identity (β = 0.366, p < 0.001) and professional value (β = 0.676, p < 0.001). Professional value significantly predicted professional identity (β = 0.170, p < 0.001). The indirect effect of clinical environment belongingness on professional identity via professional values was statistically significant (β = 0.115, SE = 0.024, 95% CI = [0.068, 0.162]), and this effect was directly (β = 0.336, SE = 0.034, 95% CI = [0.297, 0.434]) significant. Conclusions The new theoretical framework for nurses developed in this study can contribute to professional development. It is further recommended that the promotion of professional value and clinical environment belongingness may be effective in enhancing the professional identity of the nursing staff, as indicated by the results. (shrink)

Trait mindfulness confers emotional benefits and encourages skillful emotion regulation, in part because it helps people more deliberately attend to internal experiences and external surroundings. Such heightened attentional control might help skillfully deploy one’s attention towards certain kinds of stimuli, which may in turn help regulate emotions, but this remains unknown. Testing how trait mindful people deploy attention when regulating their emotions could help uncover the specific mechanisms of mindfulness that confer its emotional benefits. The present study aimed to determine (...) whether high trait mindfulness is associated with sustained attention biases to (i.e. longer gaze at) emotional scenes, when all participants are given the emotion regulation goal of staying in a positive mood. To measure this, we used eye tracking to assess selective attention to positive, neutral, and negative photographs. Higher trait mindfulness was associated with both a stronger attention bias for positive (vs. neutral and vs. negative) images, as well as greater success staying in a positive mood during viewing. Surprisingly, this attention bias towards the positive images did not mediate the relationship between mindfulness and maintenance of positive mood. Future work should compare visual attention to other emotion regulation strategies that may maximise positive affect for mindful people. (shrink)

Chaplains who serve in a clinical context often minister to patients representing a wide variety of faiths. In order to offer the best pastoral care possible, the chaplain should first possess a set of personal theological convictions as a foundation for ministry. Second, he or she needs to be sensitive to the beliefs and practices of the patients. Third, it is vital to develop a relationship of acceptance and trust not only with patients under their care, but also with (...) family members and caregivers as well. At times, situations will arise that are purely religious or theological. In a clinical setting, however, the questions and problems that arise more often are both theological and ethical. It is beneficial for the chaplain to be involved in an ethics committee, where the specifics of each case can be discussed, and staff can offer counsel to patients and their families. This study examines issues that chaplains face at the bedside, such as terminal care, life-prolonging treatments, dementia, persistent vegetative state, and euthanasia/assisted suicide. We will discover that those who are involved in clinical pastoral ministry will be called upon to be a comforter, mediator, educator, ethicist, and counselor. (shrink)

Aim: This study aimed to investigate the relationship between moral self, moral integrity, and moral sensitivity in decision-making among nurses. Background: nurses face moral dilemmas almost on a daily basis. Studies have demonstrated that nurses with high moral sensitivity make thoughtful decisions and exhibit professional responsibility. The current study seeks to examine personality variables that may be related to moral sensitivity among nurses. Design: A cross-sectional study. Ethical considerations: This study was approved by the IRB of the authors University’s ethics (...) committee (number: AU-HEA-LO-20220317). Written consent was obtained from all participants. Methods: A structured questionnaires were administered to a sample of 187 Israeli nurses. Results: The degree of nurses’ moral self, moral integrity and moral sensitivity was relatively high. “Patient-centered care” was found to be the most significant component of moral sensitivity. The next component is “Using knowledge bases,” followed by “Exercising professional judgment.” While the concept of patient-centered care was found to be related to the nurses’ moral self, the other components were found to be related to their moral integrity. The mediation model found that moral integrity mediates and even strengthens the moral self in its connection with moral sensitivity. Conclusions: Understanding the role of moral self and moral integrity in explaining moral sensitivity, can contribute to achieving a desirable combination of “the good and the right” in nursing practice, thereby enhancing nurses’ work. From a practical perspective, these findings are also relevant to nursing education. Nursing education plays a pivotal role in fostering moral and ethical decision-making in both clinical aspects and ethical moral sensitivity. Strengthening the moral self and moral integrity among nursing students can aid in making balanced and morally sensitive decisions while also building moral and ethical support systems to assist students in distressing and emergency situations. (shrink)

Studies of drug development have described the role of clinical trials in the selection of drug profiles. This article presents a case study of the development of hormonal drugs in the 1920s and 1930s to illustrate that clinical trials have a more extensive role than is assumed. Clinical trials are instrumental in mediating the relationships between the pharmaceutical industry, the laboratory, and the clinic, resulting in a network of actors collectively creating medical knowledge, drugs, and markets for (...) these drugs. (shrink)

Ethics consultation is a commonly applied mechanism to address clinical ethical dilemmas. However, there is little information on the viewpoints of health care providers towards the relevance of ethics committees and appropriate application of ethics consultation in clinical practice. We sought to use qualitative methodology to evaluate free-text responses to a case-based survey to identify thematically the views of health care professionals towards the role of ethics committees in resolving clinical ethical dilemmas. Using an iterative and reflexive (...) model we identified themes that health care providers support a role for ethics committees and hospitals in resolving clinical ethical dilemmas, that the role should be one of mediation, rather than prescription, but that ultimately legal exposure was dispositive compared to ethical theory. The identified theme of legal fears suggests that the mediation role of ethics committees is viewed by health care professionals primarily as a practical means to avoid more worrisome medico-legal conflict. (shrink)

ObjectivesHostile attribution bias is reportedly common from non-clinical population to those with serious mental illness, such as schizophrenia, and is known to be closely related to theory of mind. This study aimed to investigate whether ToM skills mediate the relationship among neurocognitive ability, personality traits, and attribution bias.MethodsA total of 198 non-clinical youths were recruited. To assess their neurocognitive ability and ToM skills, the participants were asked to complete Raven’s Standard Progressive Matrices and the Korean version of the (...) Reading the Mind in Eyes Test. To determine their personality traits, the Eysenck Personality Questionnaire and interpersonal reactivity index were used. To evaluate hostile attribution bias, the Ambiguous Intentions Hostility Questionnaire was administered. Path analysis and bias-corrected percentile bootstrap methods were used to estimate model fit and the parameters of the mediating effects.ResultsBased on model comparison, the best model characterized two direct pathways from psychoticism and the K-RMET to hostility attribution bias and three indirect pathways, wherein SPM, perspective taking, and psychoticism influenced hostile attribution bias through K-RMET. The final model fit indices were good [x2/df = 1.126; comparative fit index = 0.996; root mean square error of approximation = 0.026; standard root mean square residual = 0.026 and Akaike information criterion = 28.251] and the K-RMET fully mediated the association between SPM, perspective taking, psychoticism, and hostile attribution bias.ConclusionThe main findings suggested that ToM skills, such as the RMET, play an important role in explaining the relationship among neurocognitive ability, personality traits, and hostile attribution bias. ToM skills and a remediation strategy may need to be developed to balance the enhanced hostility bias that underlies the paranoia. (shrink)

In the context of a crisis of confidence in executive leadership in corporate America, this paper examines the role of integrity as a mediator within strategic leadership and its impact on credibility in reputational capital. A tension can occur within strategic leadership between the elements of strategic planning and leadership vision. This tension can destroy the credibility of reputational capital unless strategic leadership is managed effectively. Integrity can be used as the glue providing for credible leadership vision amid (...) a strategic perspective oriented to competitive pressures, thereby enabling strategic leadership to contribute to a sustainable competitive advantage. A strategic leadership audit is presented as a tool by which strategic leadership and reputational capital can be managed. (shrink)

This chapter discusses imaginary technologies that do not exist yet but are expected to be implemented in clinical work in the near future. Adopting a phenomenological view on the politics of organizational time, we illuminate how the rhetoric of futurity and protentional anticipation dominate managerial acts in healthcare organizations. This future-oriented management includes strategies of risk assessment, investments in emerging technologies, and other actions to reduce external uncertainty and move towards an enhanced capacity to cope with potential challenges. However, (...) we suggest that potentially harmful consequences of emerging technologies cannot be established reliably in advance by investigation, experiments, and risk assessments. The phenomenological notion of embodied information infrastructure allows us to consider how visions of complex technologies intertwine with clinical practices in healthcare professionals’ work. We use two examples of imaginary technologies—automated decision-making systems and care robotics—to concretize how the line between imaginary technologies and existing technologies becomes increasingly volatile in healthcare organizations. (shrink)

Technology is pervasive and overwhelming in the intensive care setting. It has the power to inform and direct the nursing care of critically ill patients. Technology changes the moral and social dynamics within nurse—patient encounters. Nurses use technology as the main reference point to interpret and evaluate clinical patient outcomes. This shapes nurses’ understanding and the kind of care provided. Technology inserts itself between patients and nurses, thus distancing nurses from patients. This situates nurses into positions of power, granting (...) them epistemic authority, which constrains them as moral agents. Technology serves to categorize and marginalize patients’ illness experience. In this article, moral agency is examined within the technologically-mediated context of the intensive care unit. Uncritical use of technology has a negative impact on patient care and nurses’ view of patients, thus limiting moral agency. Through examination of technology as it frames cardiac patients, it is demonstrated how technology changes the way nurses understand and conceptualize moral agency. This article offers a new perspective on the ethical discussion of technology and its impact on nurses’ moral agency. Employing reflective analysis using the technique of embodied reflection may help to ensure that patients remain at the centre of nurses’ moral practice. Embodied reflection invites nurses critically to examine how technology has reshaped conceptualization, understanding, and the underlying motivation governing nurses’ moral agency. (shrink)

The diverse essays in this volume speak to the relevance of phenomenological and psychological questioning regarding perceptions of the human. This designation, human, can be used beyond the mere identification of a species to underwrite exclusion, denigration, dehumanization and demonization, and to set up a pervasive opposition in Othering all deemed inhuman, nonhuman, or posthuman. As alerted to by Merleau-Ponty, one crucial key for a deeper understanding of these issues is consideration of the nature and scope of perception. Perception defines (...) the world of the perceiver, and perceptual capacities are constituted in engagement with the world – there is co-determination. Moreover, the distinct phenomenology of perception in the spectatorial mode in contrast to the reciprocal mode, deepens the intersubjective and ethical dimensions of such investigations. -/- Questions motivating the essays include: Can objectification and an inhuman gaze serve positive ends? If so, under what constraints and conditions? How is an inhuman gaze achieved and at what cost? How might the emerging insights of the role of perception into our interdependencies and essential sociality from various domains challenge not only theoretical frameworks, but also the practices and institutions of science, medicine, psychiatry and justice? What can we learn from atypical social cognition, psychopathology and animal cognition? Could distortions within the gazer’s emotional responsiveness and habituated aspects of social interaction play a role in the emergence of an inhuman gaze? -/- Perception and the Inhuman Gaze will interest scholars and advanced students working in phenomenology, philosophy of mind, psychology, psychiatry, sociology and social cognition. -/- Table of Contents -/- Introduction -/- Part I. The Gaze in Classical Phenomenology: Perspectives on Objectification -/- 1. Defending the Objective Gaze as a Self-transcending Capacity of Human Subjects -/- Dermot Moran -/- 2. Two Orders of Bodily Objectification: The Look and the Touch -/- Sara Heinämaa -/- 3. On Eliminativism’s Transient Gaze -/- Timothy Mooney -/- 4. Not wholly human. Reading Maurice Merleau-Ponty with Jacques Lacan. -/- Dorothée Legrand -/- 5. Disclosure and the Gendered Gaze in Simone de Beauvoir's Ethics -/- Christinia Landry -/- Part II. Vision, Perception and Gazes -/- 6. Inside the gaze -/- Shaun Gallagher -/- 7. Perception and its Objects. -/- Maurita Harney -/- 8. Technological Gaze: Understanding How Technologies Transform Perception -/- Richard Lewis -/- 9. The Inhuman Gaze and Perceptual Gestalts: The Making and Unmaking of Others and Worlds -/- Anya Daly -/- Part III. Psychiatry, Psychopathology and Inhuman Gazes -/- 10. Values and Values-based Practice in Psychopathology: Combining Analytic and Phenomenological Approaches -/- G Stanghellini and K.W.M. (Bill) Fulford -/- 11. The Inhuman and Human Gaze in Psychiatry, Psychopathology and Schizophrenia. -/- Matthew Broome -/- 12. Overcoming the Gaze: Psychopathology, Affect, and Narrative. -/- Anna Bortolan -/- 13. From excess to exhaustion : The rise of burnout in a post-modern achievement society. -/- Philippe Wuyts -/- 14. Blackout Rages: The Inhibition of Episodic Memory in Extreme Berserker Episodes -/- John Protevi -/- Part IV. Beyond the Human: Divine, Posthuman and Animal Gazes -/- 15. Wondering at the Inhuman Gaze -/- Sean. D. Kelly -/- 16. What Counts as Human/ Inhuman Right Now? -/- Rosi Braidotti -/- 17. Beyond Human and Animal: Metamorphosis in Merleau-Ponty -/- Dylan Trigg -/- Part V. Sociality and Boundaries of the Human -/- 18. Voice and gaze considered together in ‘languaging’. -/- Fred Cummins -/- 19. Ethics Beyond the Human: Disability and The Inhuman -/- Jonathan Mitchell -/- 20. Social Invisibility and Emotional Blindness -/- James Jardine -/- 21. What are you looking at? Dissonance as a window on the autonomy of participatory sense-making frames. -/- Mark James. (shrink)

Background Caring behaviour is critical for nursing quality, and the clinical internship environment is a crucial setting for preparing nursing students for caring behaviours. Evidence about how to develop nursing students’ caring behaviour in the clinical environment is still emerging. However, the mechanism between the clinical internship environment and caring behaviour remains unclear, especially the mediating role of moral sensitivity and the moderating effect of self-efficacy. Research objective This study aimed to examine the mediating effect of moral (...) sensitivity and the moderating function of self-efficacy on the association between the clinical internship environment and caring behaviours. Research design A cross-sectional design used acceptable validity scales. The hypothesised moderated mediation model was tested in the SPSS PROCESS macro. Participants and research context This survey collected data from 504 nursing students in an internship at a teaching hospital in Changsha, China. Ethical considerations This study was pre-approved by the ethics committee of the medical school (No. E2022210). Informed consent was obtained from all students. Results The clinical internship environment ( B = 0.450, 95% CI = [0.371, 0.530]) and moral sensitivity ( B = 1.352, 95% CI = [1.090, 1.615]) had positive direct effects on nursing students' caring behaviours. Clinical internship environment also indirectly influenced students’ caring behaviours via moral sensitivity ( B = 0.161, 95% CI = [0.115, 0.206]). In addition, self-efficacy played a moderating role between the clinical internship environment and caring behaviours ( B = 0.019, 95% CI = [0.007, 0.031]), as well as the relationship between the clinical internship environment and moral sensitivity ( B = 0.006, 95% CI = [0.003, 0.010]). Conclusion Moral sensitivity mediates the effect of the clinical internship environment on caring behaviour, and self-efficacy strengthens both direct and indirect effects. This study emphasises the importance of self-efficacy in developing moral sensitivity and caring behaviours in nursing students. (shrink)

Individuals vary in perceptual accuracy when categorising facial expressions, yet it is unclear how these individual differences in non-clinical population are related to cognitive processing stages at facial information acquisition and interpretation. We tested 104 healthy adults in a facial expression categorisation task, and correlated their categorisation accuracy with face-viewing gaze allocation and personal traits assessed with Autism Quotient, anxiety inventory and Self-Monitoring Scale. The gaze allocation had limited but emotion-specific impact on categorising expressions. Specifically, longer (...) class='Hi'>gaze at the eyes and nose regions were coupled with more accurate categorisation of disgust and sad expressions, respectively. Regarding trait measurements, higher autistic score was coupled with better recognition of sad but worse recognition of anger expressions, and contributed to categorisation bias towards sad expressions; whereas higher anxiety level was associated with greater categorisation accuracy across all expressions and with increased tendency of gazing at the nose region. It seems that both anxiety and autistic-like traits were associated with individual variation in expression categorisation, but this association is not necessarily mediated by variation in gaze allocation at expression-specific local facial regions. The results suggest that both facial information acquisition and interpretation capabilities contribute to individual differences in expression categorisation within non-clinical populations. (shrink)