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Psychoanalysis in Britain: points of cultural access, 1893-1918.

An attempt is made here to organise a body of facts available in the published literature concerning who, when and why Freud and his ideas were first noticed during the early years of psychoanalysis. Specific citations and references mentioning Freud reveal a surprisingly wide range of different kinds of cultural interest. In fact, we can identify seven different cultural locations which adopted some element of the ideas of Freud for specific reasons: (i) the interest in the theory of hysteria, from the Society for Psychical Research, commencing in 1893; (ii) the interest in the psychoanalytic theory of sexuality, from Havelock Ellis, from about 1895, in support of radical attitudes towards sexual freedom; (iii) as part of the reaction against the pessimistic attitude to treatment in British psychiatry, from around 1905 onwards; (iv) the endeavour of W. H. R. Rivers and others to create an empirical science of psychology embracing scientific psychoanalysis, around 1910-15; (v) the application of psychoanalysis to the psychological novel by writers and also to understanding the creative process, using Freud's theory of symbols, around 1913; (vi) the attraction of some progressive educationalists to Freud's outline of child development, from 1913; and (vii) the struggle of philosophers, including Bertrand Russell, to comprehend the implications of the psychoanalytic view of the unconscious. It is claimed that the multivalent quality of Freud's ideas contributed to the success of psychoanalysis over the suggestive therapies, and in the conflicts with dissenters within the psychoanalytic movement.

Attitude to Death↗

[Selected ethical problems of oncologic patients during the terminal period].

Patient suffering from terminal disease is depended on his environment more than any other one. He often suffers from nervous break down, anxiety and fear and he is usually unprotected from the environment. Fast development of medical science and its technicisation can lead towards dehumanization and lack of psychological and spiritual care, which should be based on clear ethical principles. Main lines of ethical principles of Health Service which are included in Deontological Code of Physicians and Collection of ethical principles for a qualified nurse are the main rules how to proceed as to fulfill the rule: "benefit of a patient is the superior law." According to its speciality Palliative Medicine introduces also four general ethical principles: 1. Patient will is a rule of treatment. 2. The principle of proportion--benefits from the treatment should be higher than losses and suffering from iatrogenic acting. 3. The principle of equality--stop taking a cure does not differ from not undertaking treatment. 4. The principle of relativity--life is not an absolute good, death is not an absolute evil. Holistic acts of Palliative Medicine determines also specific ethical attitudes, especially in the following: 1. Communication between a therapist and a patient and his family (interpersonal attitudes). 2. Procedures how to lessen suffering and its interpretation according to culture, tradition and religion ("nonsense and significance of suffering"). 3. Negation of euthanasia. 4. Spiritual, psychological and social care of patients.

Attitude to Death↗

Interhemispheric interaction and beliefs on our origin: degree of handedness predicts beliefs in creationism versus evolution.

It has been suggested that strongly handed individuals have attenuated systems for updating beliefs compared to mixed handers (Niebauer, Aselage, & Schutte, 2002). The current research extended this theory to individual differences in updating beliefs concerning our origins. Although the theory of evolution has gained overwhelming success in the sciences, a significant percentage of the population believes in biblical creationist accounts of human origins that are inconsistent with accepted, contemporary scientific views. If strongly handed individuals possess attenuated systems for updating beliefs, they might be more likely to believe in creationism. In two studies, strongly handed participants were more likely to believe in creationism while mixed-handed participants were more likely to believe in evolution. A model of how interhemispheric interaction functions in maintaining and updating beliefs is discussed. Specifically, mixed-handedness seems to be associated with a lower threshold for updating beliefs.

Adolescent↗

Stress and human spirituality 2000: at the cross roads of physics and metaphysics.

Although stress is defined as a perceived threat, the implications of stress go well beyond physical well-being. In the words of Carl Jung, "Every crisis is a spiritual crisis." Western science, so strongly influenced by the Cartesian Principle of Reductionism, has ignored the essence and significance of human spirituality in the health and healing process. Holistic healing honors the integration, balance, and harmony of mind, body, spirit, and emotions, where the whole is greater than the sum of the parts. Stress (unresolved issues of anger and fear) chokes the human spirit, the life force of human energy, which ultimately affects the physical body. From the perspectives of both physics and metaphysics, stress is a disruption in the state of coherence between the layers of consciousness in the human energy field. The emerging paradigm of health reunites mind, body, and spirit, and considers health as a function of coherence among the energy levels of these components.

Humans↗

Science, nature, and tradition: the mass-marketing of natural medicine in urban Ecuador.

In the past 15 years, "natural" medicine has become increasingly popular in the southern Ecuadoran city of Cuenca. Natural medicine products, which are distinct from traditional herbal remedies, are commercially packaged and processed and sold in a number of retail outlets in the central shopping district. This article discusses the results of field research to determine the client base of natural medicine and the reasons for its growing popularity among the poorer classes in Ecuador. Using an interpretative framework that posits that medical products carry symbolic messages, I discuss the ways in which important themes of modern life in Ecuador are played out in the packaging and marketing of these products. This research supports the growing body of literature that argues against a medical-systems approach to analyzing medical plurality by highlighting the multiple ideologies found in Ecuadoran beliefs about commercial natural medicine.

Commerce↗

The contemporary failure of nerve and the crisis in psychoanalysis.

The American Academy of Psychoanalysis is undergoing an identity crisis at this time, which is at least to a large extent a function of the whole current identity crisis in the field of psychoanalysis itself. In order to better understand this crisis, in this article I have first reviewed a similar situation which occurred in the history of classical Greece. Plato's famous Academy underwent a progressive deterioration and disintegration and fragmentation, until it ended up merely the handmaiden of another discipline, Christian theology, for a thousand years. I then propose that the identity crisis in psychoanalysis today has to do with our failure of nerve in the teeth of the abusive behavior of insurance companies regarding the payment for psychoanalysis and the current cultural ambience demanding "fast-fast-fast" relief. I call in this article for a return to Freud's basic principles as a focus for our identity. Of course we cannot ignore new discoveries in neurobiology if they are well established, or what we learn from the study of enactments in the here-and-how of the analytic procedure. Certainly the findings of Freud that are contradicted by firmly accepted empirical findings in neurobiology and other disciplines call for revision of some of his ideas, as do his mistaken views on the psychology of women and on certain other topics such as art, religion, and evolutionary biology. But this should not be permitted to blur our continuing focus on the fundamental principles of the clinical practice of psychoanalysis as Freud developed them over his lifetime. In this article I briefly reviewed those basic principles and proposed that we employ them as the basis for our identity as psychoanalysts and psychoanalytic psychiatrists. It represents a failure of nerve to drift this way and that with current fads and with the continuously deteriorating ambiance of our culture as the world slides into rampant global capitalism. Franz Alexander said years ago that psychoanalytic psychotherapy is one of the last remnants of the humanistic ideal, focussing on the individual unique person and his or her transcendent possibilities as well as maladaptive pathology. This article represents a clarion call for a debate on the identity of the American Academy of Psychoanalysis and what it stands for, which can only be clarified if we have a sharp focus on what we basically mean by "psychoanalysis." As Saul Bellow puts it (Atlas, 2000) in discussing the disappointing current situation for the arts and the humanistic disciplines, the intelligent public is waiting to hear from these disciplines what it cannot hear from pure science: Out of the struggle at the center has come an immense, painful longing for a broader, more flexible, fuller, more coherent, more comprehensive account of what we human beings are, who we are, and what this life is for...the individual struggles with dehumanization for the possession of his soul, (p.462). Below points out, in talking about writers, and in a discussion equally applicable to psychoanalysts, that if we do not "come again into the center it will not be because the center is preempted. It is not. [We] are free to enter if [we] so wish" (p.462).

Adult↗

[Compassion--a forgotten tradition in nursing care?].

This scientific study is based on the assumption that the Jewish-Christian motive of the compassionate God is the original model of the nurse. Accordingly it investigates the Wirkungs- and Rezeptionsgeschichte (the history of the tradition) of this motive in nursing from the perspectives of Nursing Science and Jewish Studies. To this purpose it was necessary to apply a transdisciplinary and methodologically pluralistic research approach. It involved various applications of hermeneutics such as applied by theology, historiography and philosophy. The research material comprised primary sources from Jewish and Christian scriptures and commentaries as well as nursing literature from the 19th and 20th century. A comparative analysis of the phenomenology of the research object during these periods was carried out: The results support the initial assumption and show that the motive of the compassionate God was actualised over the last 2000 years. What originally appeared as a religious motive presents itself as nursing concept under the name compassion or caring in modern and post-modern nursing theory.

Christianity↗

Schism and heresy in the development of orthodox medicine: the threat to medical hegemony.

Medical and scientific knowledge is not intrinsically different from other kinds of knowledge and has gone through the same processes in terms of its development. As a profession, medicine achieved its dominance in the 19th century and has subsequently consolidated its power base. A socio-historical perspective shows us that medicine has no more and no less fraud, heresy, schism, and relative knowledge than any other equivalent forms of knowledge. Orthodox medicine emerged from a number of healing systems in the 19th century by claiming the superiority and consequent authority of the biomedical model and its special relationship to laboratory science. This process has been seen by some to resemble the growth of religious orthodoxy and the emergence of alternative beliefs with the dissenting medical systems, based on different paradigms, becoming analogous to religious sects. An increasing body of opinion rejects the notion of "objective" knowledge and sees medical knowledge and practice as "socially constructed". An examination of HIV/AIDS measurement and 19th century craniology and contagion and anti-contagion theories indicates processes which are "contextual" rather than "objective". Heresy and schism are natural concomitants of socially constructed knowledge, functioning as providers of impetus and change and, as such, are to be welcomed as non-orthodox challenges.

Acquired Immunodeficiency Syndrome↗

Medicine and spirituality: a simple path to restore compassion in medicine.

Medical science has achieved impressive accomplishments in the diagnosis and treatment of human disease. However, the emphasis on science and technology has created a generation of physicians who find it difficult to relate to their patients about their suffering. Time constraints and economic pressures also add to the challenge of giving meaningful time to patients. Patients want to talk to their physician about their concerns, but surveys indicate that this is not being accomplished. Medical educators are developing curricula to teach how care can be given compassionately. This article reviews the importance of addressing spiritual care in medicine. Spirituality is defined and the spiritual history is explained. Research on the role of spirituality in health care is also reviewed. The role of the physician as a healer, attending to mind, body and spirit is encouraged.

Adaptation, Psychological↗

'New age' healing in the U.S.

This paper provides a conceptual overview of the 'New Age' phenomenon and of 'New age healing,' concepts which have gone virtually unaddressed in social science research, health-related or otherwise. First, drawing upon diverse sources, the authors attempt to define 'New age,' after which they discuss those medical, spiritual, and sociocultural developments which help account for the rise of new age healing in the U.S. Next, a comprehensive review of over a dozen schemata of healing, healers, and medical systems fails to provide a satisfactory classification of new age healing. Finally, by analyzing data derived from primary and secondary source materials on 81 healing systems or techniques identifying themselves with the new age, a typology of new age healing itself is inductively generated. Three general modes are found: mental or physical self-betterment, esoteric teachings, and contemplative practice. These types of new age healing place primary emphasis, respectively, on body, mind and soul.

Complementary Therapies↗

Signs and senses: diagnosis and prognosis in early medieval pulse and urine texts.

The character of early medieval medical manuscripts makes it difficult to generalize about the nature of medical knowledge in this period. In order to reconstitute one field of medical science, namely diagnosis and prognosis, while avoiding the pitfalls of unjustified generalization, this essay limits itself to reconstructing the understanding of pulse and urine inspection available in a particular place and time: the Italian monastery of Monte Cassino at the end of the first millennium. The available texts reveal little about the rationale behind these bedside techniques; indeed, pulse and urine seem to be signs without any semiotics, any underlying theory. The clue to this paradox is the fact that these texts see pulse and urine as primarily prognostic rather than diagnostic. Prognosis was understood to be analogous to forms of intuition, judgement, revelation, and prophecy that operated outside the logic of causality. Hence a fully rationalized semiotics was not regarded as necessary for effective medical practice.

Diagnosis↗

A Q-methodological study on nursing students' attitudes toward nursing ethics.

PURPOSE: Professional nursing ethics is a living, dynamic set of standards for nurses'professional moral behavior. Furthermore, in daily clinical nursing training, nursing students are constantly confronted with decision-making that is moral in nature. The aim of this study was to identify the perceived ethical attitudes in the clinical training process of senior nursing students using Q-methodology to offer basic strategies for nursing ethics education and thereby improve patients'care. METHODS: Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty-seven participants in a university rated 38 selected Q-statements on a scale of 1-9. The collected data were analyzed using pc-QUNAL software. RESULTS: Principal component analysis identified 3 types of ethical attitudes in nursing students in Korea. The categories were labeled Sacred-life, Science-realistic and Humane-life. Sacred-life individuals think that a life belongs to an absolute power (God), not a man, and a human life is a high and noble thing. Science-realistic individuals disagreed that allowing an induced abortion or embryo (human) duplication is unethical behavior that provokes a trend, which takes the value of a life lightly; most of them took a utilitarian position with respect to ethical decisions. Humane-life individuals exhibit a tendency toward human-centered thought with respect to ethical attitudes. CONCLUSION: This study will be of interest to educators of students of nursing and hospital nursing administrators. Also, the findings may provide the basis for the development of more appropriate strategies to improve nursing ethics education programs.

Adaptation, Psychological↗

Paracelsus, Paracelsianism, and the secularization of the worldview.

This paper examines Paracelsus and Paracelsianism in the light of the ideas of Max Weber concerning the social consequences of the Reformation, with special reference to his theories of Entzauberung and secularization. He linked these tendencies both to the rise of capitalism and the growth of experimental science. The detailed case study of Paracelsus' account of diseases linked with saints, in common with his interpretation of many other conditions, demonstrates that he self-consciously extended the boundaries of medicine and eroded the role of magic and witchcraft associated with the church. On the other hand, Paracelsus adopted the Neoplatonic worldview, was immersed in popular magic, and evolved a system of medicine that self-consciously revolved around magic. These factors seem to place a distinct limit on his role in the demystification of knowledge. However, the magic of Paracelsus entailed a decisive break with the entrenched elitist and esoteric tradition of the occultists and hermeticists. It is argued that this reconstructed magic re-establishes the credentials of Paracelsus as a significant contributor to the disenchantment and secularization of the worldview.

Europe↗

The parallels between Asclepian and Hippocratic medicine on the island of Kos.

At the end of the 20th century, Hippocratic medicine--which developed at the cross-roads between the occidental and oriental civilisations--acts as a link, a bridge and a symbol for the need to combine both the experience of traditional (Eastern) and the trends of modern (Western) medicine. Hippocratic medicine is one vital pathway to the proper study of the evolution of the medical art. Not only is it the beginning of the art and science of medicine, but modern medicine can still learn from the Hellenic medicine of ancient Greece. Hippocratic medicine is both an antidote to an overconcentration and overemphasis on medical technology and a stimulus to more humane technical achievements. Hippocratic bedside examination has not died, but is merely pushed aside temporarily by modern technology. The fact that ancient Hellenic medicine was based on the coexistence of both Asclepian (traditional) and Hippocratic (rational) medicine on the island of Kos reveals and symbolises the necessary coexistence and cooperation of both systems, a synthesis of their concepts being essential to solve the problems threatening the future of humankind. Hellenic medicine serves to highlight that the parallels between Asclepian and Hippocratic medicine are closer than medical historians usually realise, and that alternative medicine may function in a complementary way to conventional primary medical care.

Greece↗

Intensive care ethics in evolution.

The ethics of treating the seriously and critically ill have not been static throughout the ages. Twentieth century medicine has inherited from the nineteenth century a science which places an inappropriate weight on diagnosis over prognosis and management, combined with a seventeenth century duty to prolong life. However other earlier ethical traditions, both Hippocratic and Christian, respected both the limitations of medicine and emphasised the importance of prognosis. This paper outlines some of the historical precedents for the treatment of the critically ill, and also how the current paradigm limits clinical practice and causes ethical tensions. An understanding that other paradigms have been ethically acceptable in the past allows wider consideration and acceptance of alternatives for the future. However future alternatives will also have to address the role of technology, given its importance in this area of medicine.

Biomedical Technology↗

[Inspired by Apollo and Asclepio's sons in Homer and Virgil].

Important passages of the Homeric and Virgilian epic are regarding the art of divination and the medical science, and underline contextually the figures of the fortune teller and that of the physician. Two roles are associated to one matrix: heroic-aristocratic or royal-sacerdotal. In Homer's epic it is possible to single out surgical and phytotherapeutic knowledge together with remedies for diseases aroused by a solar god, like Apollo is, gods' physician. Pitiful divinities comfort those who have been struck by demoniac and mysterious forms. On the contrary, in Virgil's epic a symbiosis is carried out between the physician's figure and the priest's one, with the very vague outlines of the two arts and however, overloaded by factors which are typically Virgilian. Unusual form of incubation of the Greek rituals has been transplanted in the Latin matrix; and moreover there is a constant recall of words used in their most antique meaning.

Diagnosis↗

Educating nurses for their future role in bioethics.

The emerging new multidisciplinary and crosscultural field of bioethics will require sensitive, open-minded professionals to take the lead in hospital ethics, in genetic counselling, and in the teaching of bioethics to students in nursing, medicine and the basic sciences. Nurses with ward experience who return to university to gain an MA or PhD in bioethics are eminently suited for this leadership role, for they may be more likely than physicians to study for a liberal education to supplement their professional knowledge; their first-hand experience in nursing is an antidote to the pointless subtleties into which philosophical ethics so often degenerates. When teaching ethics to nurses one must remember that, while some will simply use this knowledge in their own clinical work, others will go on to be teachers and researchers in bioethics. Their training must therefore be broad and interdisciplinary, including real substantive philosophy (as opposed to philosophical ethics), as well as mystical bioethics, religious law, ethics of genetic counselling, clinical approaches to ethical pseudo problems, research skills, etc.

Cultural Diversity↗

Attitudes and reactions of Jordanian medical students to the dissecting room.

Emotional and psychological reactions of Jordanian medical students to the dissecting room (DR) were assessed. A questionnaire was distributed to 200 students in preclinical years in the academic year 2002-2003 in the faculty of medicine at Jordan University of Science and Technology; 145 students have responded. Varying degree of fear on first entering the DR was reported by 28.4%. The most frequent reactions were recurring visual images of cadavers 28.9% and palpitation 19.3%. Students' reactions were most commonly elicited by smell of the DR 58.5% and by fear of infection 50.3%. The most frequent method of coping with such fears was by rationalization 89.8%. Significant gender differences (P<0.05) were found in the most aspects of DR experiences. Female students showed higher level of fear, reported recurring visual images of cadavers more often than males, were more disturbed by certain stimuli in the DR and used religious books and praying as coping methods more frequently than their male peers. The need for appropriate psychological preparation of students before DR practical on human cadavers is discussed.

Adaptation, Psychological↗