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PubMed2001

Descartes' embodied psychology: Descartes' or Damasio's error?

Damasio (1994) claims that Descartes imagined thinking as an activity separate from the body, and that the effort to understand the mind in general biological terms was retarded as a consequence of Descartes' dualism. These claims do not hold; they are "Damasio's error". Descartes never considered what we today call thinking or cognition without taking the body into account. His new dualism required an embodied understanding of cognition. The article gives an historical overview of the development of Descartes' radically new psychology from his account of algebraic reasoning in the early Regulae (1628) to his "neurobiology of rationality" in the late Passions of the soul (1649). The author argues that Descartes' dualism opens the way for mechanistic and mathematical explanations of all kinds of physiological and psychological phenomena, including the kind of phenomena Damasio discusses in Descartes' error. The models of understanding Damasio puts forward can be seen as advanced version of models which Descartes introduced in the 1640s. A far better title for his book would have been Descartes' vision.

Cognition↗

PubMed2003

Gulliver meets Descartes: early modern concepts of age-related memory loss.

Age-related memory loss was a marginal issue in medical discussions during early modern times and until well into the second half of the 17th century. There are many possible explanations: the lack of similar traditions in antiquity and in the Middle Ages, insufficient physiological and morphological knowledge of the brain, and the underlying conflict between idealistic and materialistic perspectives on the functions of the soul and the conditions of these in old age. After these boundaries had been pushed back by the influence of Cartesianism and Iatromechanism, the problem of age-related memory loss was increasingly regarded as a physical illness and began to receive more attention. This trend first occurred in medicine, before spreading to the literary world, where the novel "Gulliver's Travels" is one clear and famous example.

Aging↗

PubMed1984

Vocal abnormalities. What listening can tell you.

"The human voice is the organ of the soul," said Longfellow. It can also serve as a mirror of the physical and mental problems that affect not only the vocal mechanism but the rest of the body. We should strive to become more aware of this--and that our ears can be, at times, as important a diagnostic tool as our eyes. Mastery of the art of listening to vocal abnormalities will enable the clinician to determine which patients he or she can treat at the outset and which require immediate referral to a laryngologist or other specialist. An experienced listener often is able to diagnose vocal problems prior to a laryngeal examination.

Aphonia↗

PubMed2001

AMEE Medical Education Guide No. 23 (Part 1): Curriculum, environment, climate, quality and change in medical education-a unifying perspective.

This paper looks at five focal terms in education - curriculum, environment, climate, quality and change - and the interrelationships and dynamics between and among them. It emphasizes the power and utility of the concept of climate as an operationalization or manifestation of the curriculum and the other three concepts. Ideas pertaining to the theory of climate and its measurement can provide a greater understanding of the medical curriculum. The learning environment is an important determinant of behaviour. Environment is perceived by students and it is perceptions of environment that are related to behaviour. The environment, as perceived, may be designated as climate. It is argued that the climate is the soul and spirit of the medical school environment and curriculum. Students' experiences of the climate of their medical education environment are related to their achievements, satisfaction and success. Measures of educational climate are reviewed and climate measures for medical education are discussed. These should take account of current trends in medical education and curricula. Measures of the climate may subdivide it into different components giving, for example, a separate assessment of so-called Faculty Press, Student Press, Administration Press and Physical or Material Environmental Press. Climate measures can be used in different modes with the same stakeholders. For example, students may be asked to report, first, their perceptions of the actual environment they have experienced and, second, to report on their ideal or preferred environment. The same climate index can be used with different stakeholders giving, for example, staff and student comparisons. In addition to the educational climate of the environment that students inhabit, it is important to consider the organizational climate of the work environment that staff inhabit. This organizational climate is very significant, not only for staff, but for their students, too. The medical school is a learning organization evolving and changing in the illuminative evaluation it makes of its environment and its curriculum through the action research studies of its climate. Considerations of climate in the medical school, along the lines of continuous quality improvement and innovation, are likely to further the medical school as a learning organization with the attendant benefits. Unless medical schools become such learning organizations, their quality of health and their longevity may be threatened.

Journal Article↗

PubMed2001

AMEE Medical Education Guide No. 23 (Part 2): Curriculum, environment, climate, quality and change in medical education - a unifying perspective.

This paper looks at five focal terms in education - curriculum, environment, climate, quality and change - and the interrelationships and dynamics bemeen and among them. It emphasizes the power and utility of the concept of climate as an operationalization or manifetation of the curriculum and the other three concepts. Ideas pertaining w the theory of climate and its measurement can provide a greater understanding of the medical cumadurn. The environment is an impoltant detemzinant of behaviour. Environment is perceived by students and it is perceptions of environment that are related w behaviour. The environment, as perceived, may be designated as climate. It is argued that the climate is the soul and spirit of the medical school environment and curriculum. Students' experiences of the climate of their medical education environment are related w their achievements, sangaction and success. Measures of educational climate are reviewed and the possibilities of new climate measures for medical education are discussed. These should take account of current trends in medical education and curricula. Measures of the climate may subdivide it inw dzfferent components giving, for example, separate assessment of so-called Faculty Press, Student Press, Administration Press and Physical or Material Environmental Press. Climate measures can be used in different modes with the same stakeholders. For example, students may be asked to report, first, their perceptions of the actual environment they have experienced and, second, w report on their ideal or preferred environment. The same climate index can be used with different stakeholders giving, for example, staff and student comparisons. The climate is important for staff as well as for students. The organizational climate that teaching staff experience in the work environment that they inhabit is important for their well-being, and that of their students. The medical school is a learning organization evolving and changing in the illuminative evaluation it makes of its environment and its curriculum through the action research studies of its climate. Consderations of climate in the medical school along the lines of continuous quality improvement and innovation are likely to further the medical school as a learning organization with the attendant benefits. Unless medical schools become such learning organizations their quality of health and their longevity may be threatened.

Journal Article↗

PubMedDate not supplied

Perceptions of the concept of health among patients in mental health nursing.

Health has been a central concept in nursing science since the 18th century but the holistic concept of health that includes both the body and the soul, still has to be clarified. The concept of health is often unclear and represents an unreachable ideal state that can be hard to use as a realistic goal in nursing care. The aim of this study was to describe how the patient perceives the concept of health in mental health nursing. Twelve patients with experience of mental health nursing were interviewed and the data were analyzed with a phenomenographic approach. The patients described nine different perceptions that were divided into three descriptive categories: autonomy, meaningfulness, and community. All of these are important to achieve health. There is ambiguity about the possibility to influence the concept of health. Health is described, on the one, hand as a prerequisite to experiencing freedom and finding meaning in life and, on the other hand, it is believed that the search for meaning and the courage to fight and try in spite of the disease is what leads to health. The patients' descriptions are mostly about things that they need in the present time to achieve health, but health as a process with growth and potential for development does not appear that clearly. One conclusion is that mental health nursing must deliver a more process-focused nursing care where the concept of health is visibly used as a goal for all nursing interventions.

Adult↗

PubMed2000

Music and the brain: the impact of music on an oboist's fight for recovery.

A 20-year-old female, alias Sara, was an aspiring professional oboist who studied music performance at college level. While wading across a river she lost her balance, was swept down river, and suffered profound injuries including severe hypothermia, cardiac arrest, and hypoxic brain injury. While recovering, her family and friends surrounded Sara with music. Her oboe teacher placed Sara's oboe in her hand and played tapes of Sara's past performances. Her mother played recordings of her favourite music in hopes that the music would remind her of her life's passion and, thus, stimulate her mind and soul while she recovered. Two years post-injury, Sara continues to strive to improve her quality of life. In this case study, Sara's musical and medical recovery is detailed using quantitative and qualitative data. This data gathered allows one to provide an analysis of the powerful role of music in Sara's fight to recover.

Activities of Daily Living↗

PubMedDate not supplied

Psychoactive plants and ethnopsychiatric medicines of the Matsigenka.

For the Matsigenka of the Peruvian Amazon, health and well-being in daily life depend upon harmonious relationships within the social group and with the spirit world. Psychoactive plants play a crucial role in curing disrupted social relationships while giving humans access to the otherwise remote, parallel world of spirits. Different species and cultivars of psychoactive plants, as well as varying admixtures and doses, are used to obtain different intensities and qualities of psychoactive experience, depending upon the individual's goals. Strongly psychoactive plants are used by shamans to travel to the realm of spirits. A number of mild to strongly psychoactive plants are used by male hunters to purify their souls and improve their aim. Mildly psychoactive plants are used to improve women's concentration for spinning and weaving cotton, to control negative emotions such as grief and anger, to manipulate the content of dreams, and to pacify sick or frightened children. A majority of such remedies come from the botanical families of Rubiaceae, Solanaceae and Cyperaceae, known sources of psychoactive compounds. Interdisciplinary research into the culture, botany and pharmacology of psychoactive plants in indigenous medical systems contributes to a better understanding of the role of psychological states in human health and well-being.

Ethnobotany↗

PubMed2005

Aquinas's account of human embryogenesis and recent interpretations.

In addressing bioethical issues at the beginning of human life, such as abortion, in vitro fertilization, and embryonic stem cell research, one primary concern regards establishing when a developing human embryo or fetus can be considered a person. Thomas Aquinas argues that an embryo or fetus is not a human person until its body is informed by a rational soul. Aquinas's explicit account of human embryogenesis has been generally rejected by contemporary scholars due to its dependence upon medieval biological data, which has been far surpassed by current scientific research. A number of scholars, however, have attempted to combine Aquinas's basic metaphysical account of human nature with current embryological data to develop a contemporary Thomistic account of a human person's beginning. In this article, I discuss two recent interpretations in which it is argued that a human person does not begin to exist until a fetus has developed a functioning cerebral cortex.

Beginning of Human Life↗

PubMed2004

The illness of Vincent van Gogh.

Vincent van Gogh (1853-1890) was a wonderfully accomplished artist whose work is now widely appreciated. He created a great number of masterpiece paintings and drawings in just one decade devoted to art. His productivity is even more remarkable when considered in the context of his debilitating illness. He suffered from medical crises that were devastating, but in the intervening periods he was both lucid and creative. He left a profound, soul-searching description of his jagged life in his correspondence, which provides the basis for the present analysis. An inherited metabolic disease, acute intermittent porphyria, accounts for all of the signs and symptoms of van Gogh's underlying illness. On this 150th anniversary of the birth of Vincent van Gogh it is appropriate to revisit the subject and to analyze the lack of organized skepticism in the popular media about other diagnoses.

Famous Persons↗

PubMed2004

Black bile and psychomotor retardation: shades of melancholia in Dante's Inferno.

The history of melancholy depression is rich with images of movement retardation and mental dysfunction. The recent restoration of psychomotor symptoms to the diagnostic terminology of affective disorder is not novel to the students of medieval melancholia. The move back to the biology of this psychomotor dysfunction with the technical advances in brain imaging in recent years only echoes centuries-old writings on the centrality of movement changes in the depressive condition. The Inferno, the first cantica of Dante Alighieri's Commedia, has a wonderful abundance of allusions to the importance of psychomotor symptoms in describing the depressed individual. Slowed steps, garbled speech, frozen tears, these and many other images keep the physical manifestations of psychomotor suffering in the forefront of the reader's mind. Considering Medieval and Renaissance writings on melancholy suffering, it is fitting that Dante shows a bodily illness reflected in the hellish torments visited on the damned. From the souls of the sullen to those of the violent, the panorama of psychomotor symptoms plays a prominent role in the poem as well as in the medical and literary prose of succeeding centuries.

Depressive Disorder↗

PubMedDate not supplied

The advanced practice of psychotherapy.

The advanced practice of psychotherapy involves deconstructing and transcending separate schools in the search for universal healing processes. Knowledge from major psychotherapeutic schools over the last 100 years, as well as ancient teachings over the last 5000 years, is distilled in the training and formation of the psychotherapist. Five major elements of training (theory, technique, the patient, the therapist, and the patient/therapist relationship), as well as one element in the therapist's formation (the person), are presented. To be a true healer, the clinician must cultivate his or her soul and spirit. Only then can the therapist guide the patient to reach his or her authentic self.

Humans↗

PubMedDate not supplied

An introduction to spiritual psychology: overview of the literature, east and west.

This article outlines the philosophical background to spiritual psychology and selectively reviews Western and Eastern literature on the subject. The world views of theism, atheism, and agnosticism are defined and critiqued, and the boundaries of scientific knowledge discussed. The views of James, Jung, and Freud are reviewed, and the contributions of humanistic psychology noted. Contemporary spiritual psychology is then summarized with reference to recent literature on theistic psychotherapy, Buddhist psychology, mind-body medicine, and transpersonal psychology. Sri Aurobindo's work is introduced as a modern Asian perspective on theistic psychology, and his model of the relationship between the "soul" and the unconscious described. Finally, a brief clinical vignette is given.

Humans↗

PubMed2005

On the Christian in Christian bioethics.

What is Christian about Christian bioethics? And is an authentically Christian bioethics a practical possibility in the world in which we find ourselves? In my essay I argue that personhood and the personal are so fundamental to the Christian understanding of our humanity that body, soul, and spirit are probably best understood as the components of a triune (as opposed to dual) aspect theory of personhood. To confess to a Christian bioethics is to admit that Christians cannot pretend fully to understand either cures or their meaning. However effective and "knowledge-based" contemporary medical interventions are, a Christian must humbly and honestly confess a lack of complete knowledge on both levels. At the same time, a Christian bioethicist must express a total personal commitment to Christian Faith.

Bioethics↗

PubMed2006

Why patients should give thanks for their disease: traditional Christianity on the joy of suffering.

Patristic teaching about sin and disease allows supplementing well-acknowledged conditions for a Christian medicine with further personal challenges, widely disregarded in Western Christianities. A proper appreciation of man's vocation toward (not just achieving forgiveness but) deification reveals the need to cooperate with the Holy Spirit's offer of grace toward restoring man's pre-fallen nature. Ascetical exercises designed at re-establishing the spirit's mastery over the soul distance persons from (even supposedly harmless) passion. They thus inspire the struggle towards emulating Christ's (self-crucifying) kenotic love, and to accept even secularly "undeserved" suffering as spiritually deserved in view of his (forever) lacking fervor in that struggle. Only in the spirit of that love can the evil Adam's sin brought into this world work its therapeutic impact, the eschatological purpose of which explains God's lovingly permitting that evil. This therapeutic impact is physically manifested already in this life through the transforming energies granted the saints of the church.

Attitude to Death↗

PubMed1989

Travel-related infections: prevention and treatment.

Some 15 million Americans travel abroad each year, half of them to developing countries. Not only are they venturing farther afield than ever before but they are more inclined to be adventurous. A high percentage of these hardy souls acquire some form of infection. Physicians should know the risks, their geographic distribution, and both prophylactic and therapeutic strategies.

Adult↗

PubMed2004

Prevalence, clinical and ultrasonographic characteristics of thyroid incidentalomas.

High-resolution ultrasonography (US) has made possible the detection of asymptomatic small thyroid nodules. Thyroid incidentalomas have created a clinical dilemma as to how to properly manage such incidental findings. We investigated the prevalence, the clinical and US characteristics, and optimal diagnostic approach to incidentally detected benign and malignant thyroid nodules < 1.5 cm. Retrospective review was done on 1475 patients who had visited Samsung Medical Center, Soul Korea from January 1999 to December 2000. The prevalence of thyroid incidentalomas was 13.4%. The malignancy rate within thyroid incidentalomas was 28.8%. There were no significant differences in age, nodule size and number, thyroid function test, and Tc99m thyroid scan between benign and malignant incidentalomas. US characteristics of solid echostructure, irregular margin, and calcification showed meaningful diagnostic value in detecting malignancy in thyroid incidentalomas (p < 0.05). Most malignant incidentalomas were low stage. In conclusion, occult thyroid cancers are a fairly common finding. There were no significant differences in clinical and laboratory parameters between benign and malignant thyroid nodules <1.5 cm; however, US findings can be used in the decision of optimal management strategies.

Female↗

PubMed2003

Weaving medicine back together: mind-body medicine in the twenty-first century.

In the past century, the medical profession has taken pride in the rapid and often effective advancement of diagnostic technology, surgical interventions, and pharmaceutical remedies. However, it has also witnessed the unraveling of the woven connection among mind, body, and the human soul. The history of the fall and rise of the concept of mind-body medicine is discussed, along with a review of the recent laboratory and clinical studies providing evidence of the direct connection between mind, body, and belief systems. Relevant components of a mind-body skills group program for clinical practices are addressed.

Attitude of Health Personnel↗