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The actor-director and patient-therapist relationships: a process comparison.

The relationship between the actor and director, like that between the patient and psychotherapist, relies on intense emotional involvement. Both demand sensitivity, reciprocity, and a deep understanding of human behavior. Because dramatic action is created through continuous conflict between characters, actors must explore not only their actions, but also the reactions of those with whom they are in relationship. The process of therapy is equally interdependent. Through the relationship, therapists provide a context in which their patients can work through their conflicts. As in the rehearsal process, actions are explored in a supportive environment. This paper has presented a process comparison of the actor-director and patient-therapist relationships by proposing that both are art forms that rely on the skill of a trusted facilitator. Some of the techniques explored include: empathic attunement, emotional recall, transference, overcoming performance obstacles, improvisation, risk-taking, the pleasure principle, and creating a sense of family through new object relations. Like therapists, directors never forget that their work cannot be performed alone; it depends on interaction with the most delicate of phenomena: the human soul.

Communication↗

The silence of Socrates.

This paper emphasizes the humanistic and phenomenologic approach to the mind (soul, self) and contrasts it to the "era of the brain" that is so idealized by psychiatry today. It describes the debate between those who expect science to explain everything sooner or later and those who believe there are certain essential aspects of the world, such as the qualia of consciousness, that cannot be reduced to material factors. Plato's dialogue Timaeus is taken as the historically first example of this debate. The connection between it and what has been labeled "neuroism" in contemporary psychiatry is established and the relevance of this debate to the practice of psychoanalysis and dynamic psychiatry is discussed. Finally the wider consequences of the scientific or materialistic approach to the world as forecast already by Nietzsche are indicated.

Humans↗

Healing through differentiation: a pastoral care and counseling perspective.

Focuses on the function of healing as central to the cure-of-souls tradition of pastoral care and counseling and describes two prominent but contrary styles of healing in ministry. Proposes an interactional model of pastoral care which integrates the two healing styles of compassion and competence through the principle of differentiation, drawing from the perspective of constructivism as practiced in narrative therapy and the theory of natural systems as applied to the role of the pastor.

Career Choice↗

Effects of a physical activity intervention for women.

Physical activity is associated with health and reduced mortality risk, yet only 15% of U.S. adults achieve adequate activity. This study is an experimental repeated measures nested design randomizing two similar rural communities to investigate the effectiveness of the Heart and Soul Physical Activity Program (HSPAP) (Peterson, 2002) in promoting physical activity in midlife women (n=42) aged 35 to 65 years. The HSPAP, an innovative church-based health promotion intervention, is conceptualized in social support and designed to increase physical activity, energy expenditure (EE), and cardiorespiratory fitness (VO2 max), measured over time. A significant interaction (p<.001) was found for EE in one HSPAP group increasing their EE by 1,010 kcals/week. HSPAP participants increased their VO2 max level by 75% (p<.001) and 10%; comparison groups stayed the same or declined 16%. Study results provide preliminary support for the HSPAP intervention as an effective treatment to improve physical activity levels in sedentary, rural, midlife women.

Adult↗

The father of sports medicine (Galen).

Although there were many physicians who treated athletes before Galen, I believe that he was the first to devote a major portion of his time to this field of endeavor. Furthermore, his systematic observations, his aggressive pursuit of newer and better ways of treatment, his teaching, and his publishing of his observations make him a kindred soul to the team physician and practitioners of sports medicine of today. It is for these reasons that I believe that he can justly be called the "Father of Sports Medicine."

History, Ancient↗

Caring as being in nursing: unique or ubiquitous.

The purpose of this column is to explore ambiguities concerning the concept of caring as being in nursing and to consider if caring is unique to nursing or ubiquitous, present not only within other health disciplines, but as a potential choice for each person. Clarification is sought through an exploration of four pathways for thinking about caring as being--artistic endeavors, moving beyond self in caring relationships and spirituality, creating caring environments through caring-healing consciousness, and soulful caring consciousness. It is proposed that caring as being is an essential, but not necessarily unique, knowledge source within nursing.

Altruism↗

Caring for older adults: practice guided by Watson's caring-healing model.

Caring for older people and listening attentively to what they say about themselves and their varied health situations, especially in relation to quality of life and peace of mind, body, and soul, are important matters to nurses aligned with Watson's caring-healing theory. Assumptions and key concepts of Watson's framework are described with examples that illustrate how a nursing framework has shaped the author's advanced nursing practice. Some of the key concepts discussed include intersubjectivity, transpersonal caring, spirituality, and caring moments. Watson's framework of caring-healing is shown to inform practice, education, and research.

Aged↗

The philosophical core of King's conceptual system.

Aristotelian understanding of being human is presented as the philosophical core of King's conceptual system. A summary of King's thought is organized according to contemporary influences. The article then turns to what Aristotle teaches about the composition of the world and what it means to be a human being. Wallace's life-powers model of the soul brings these insights into contemporary thought. Aristotelian philosophy completes King's account of the personal system by providing insight into what it is to be human. Parallels in the reasoning of transaction and Aristotelian deliberation are further evidence of classical influences within King's work.

Humanism↗

Ecospirituality. A pattern that connects.

Ecospirituality is a manifestation of the spiritual connection between human beings and the environment. Ecospirituality incorporates an intuitive and embodied awareness of all life and engages a relational view of person to planet, inner to outer landscape, and soul to soil. This study describes an appraisal of a pattern in the human-environmental, continuous mutual process and innovative change; a phenomenological study that used the focus group method. Randomly selected volunteer registrants (n = 36) of phase one of the American Holistic Nurses' Association Certificate Program in Holistic Nursing constituted the sample and participated in one of four focus groups. The findings of this study contribute to holistic nursing by examining the essence of the lived experience of an ecospiritual consciousness of select holistic nurses. The essences of an ecospiritual consciousness are uniquely inseparable entities embedded within the framework of an ecospiritual consciousness. The essences are tending, dwelling, reverence, connectedness, and sentence.

Adult↗

Libro de Melancholía by Andrés Velázquez (1585). Part 2. its context and importance.

The second part of this paper examines the views of the hitherto forgotten Spanish physician Andrés Velázquez on the subject of melancholy. The study was made possible by the reissue in 1996 of his books originally published in 1585 - one of the earliest European works to deal exclusively with the subject of melancholy. Velázquez attempted to analyse the illness known as melancholy and, in order to do this, he had to explain some of the functions and structures of the human brain. His explanations about the role that the brain played as the location of thought and the substrate of the soul were based mainly on the ideas of Galen; he was also influenced by the work of other physicians and writers, including Arab writers and some of his own contemporaries.

Books↗

Excerpt from Medicinische Psychologie oder Physiologie der Seele by Dr Rudolph Hermann Lotze.

Hermann Lotze (1817-81) is a neglected figure in the history of psychiatry although it has been claimed that his early views were influential, for example, on the young Griesinger. Trained as a physician, psychologist and philosopher he saw better than many the impending epistemological crisis that was to affect disciplines such as psychology and medical psychology as they were being taken over by the natural sciences. The problem he endeavoured to resolve was double-headed. On the one hand, Lotze believed that the mechanisms proposed by physiology and other relevant natural sciences were essential to the explanation of human behaviour provided that its meaning and context were respected; on the other, he wanted to do away with the mysterious (metaphysical) explanations such as 'vital force' which in his time were still popular in biology. The solutions he eventually offered can understandably be seen as a weak compromise and one which statisfied no one. Materialists à outrance such as Vogt, Büchner, Lange and Ribot though he was too 'metaphysical'; spiritualist philosophers believed that he had surrendered too much to biology. It is likely that Lotze remained, in fact, a metaphysician as can be ascertained by studying his concept of Seele (soul, mind) into which he packed enough furniture to make many believe that he was an idealist thinker. This paper discusses some of these issues and justifies the choice of classic text, namely, Lotze's illuminating Introduction to his book Medicinische Psychologie oder Physiologie der Seele.

Germany↗

Torture survivors: a challenge to nursing practice.

Why should all nurses and student nurses receive instruction in the subject of torture, its purpose, methods and sequelae on body and soul? One reason is because torture is an atrocity, the most perverted and digusting act that exists. Some nurses meet torture survivors and their families in their private lives and at work. Many countries have ratified codes and declarations in relation to torture, and are therefore obliged to educate some professional groups in the subject. This article describes how the subject 'Torture' is dealt with at the School of Nursing in Aalborg, Denmark. Aspects of how the course is planned, the placement of the subject, teaching objectives, content of the lessons, teaching methods and teaching materials are mentioned. This article also underlines why it is so important to educate student and qualified nurses about torture. The conclusion is that nurses can help to alleviate the effects of torture in a merciless and unfeeling world.

Curriculum↗

Being in the world of the suffering patient: a challenge to nursing ethics.

Ethics in caring is what we actually make explicit through our approach and how we invite the suffering patient into a caring relationship. This phenomenological study investigates suffering and health and how this presupposes a deeper reflection on ethics in caring. The aim was to try to discover, describe and understand how patients experience their life situation three years after undergoing surgery. The theoretical approach is based on central aspects of Eriksson's caritative theory (i.e. the view of the person as body, soul and spirit). The informants were four women and four men aged between 55 and 77 years. The empirical material revealed suffering that was connected with both illness and life. Suffering involves experiences of grief, loneliness and struggling. Health implies a yearning for something beyond the current life situation, a yearning to experience some meaning in life. This leads to an awareness of unplumbed possibilities. Understanding the experiences of individual patients demands of us, as both researchers and nurses, to act, seeking after the scientific truth (i.e. a deeper reflection of the ontological, epistemological and methodological questions). The idea of responsibility helps us to interpret and meet the innermost desires of suffering patients in their true presence. Caritative caring ethics means 'being there', confirming patients' absolute dignity; it is a manifestation of the love that 'just exists'. Compassion requires an inner disposition to go with others to the places where they are weak, vulnerable, lonely and broken. An ontology of caring provides both a starting point and a context for reflection about ethics and the ethical life.

Aged↗

Afterbirths in the afterlife: cultural meaning of placental disposal in a Hmong American community.

Interviews were conducted with 94 Hmong Americans in California's Central Valley to explore attitudes regarding placental disposition and the cultural values that affect those attitudes. Research indicated a persistence of the traditional belief that placentas should be buried at home. The placenta is perceived to be essential for travel by the soul of the deceased into the spirit world to rejoin ancestors. Older respondents (older than age 35) and those who self-identified as animists were most likely to believe in the importance of home placental burial. Comments by respondents indicated some reluctance on the part of Hmong patients to ask health care providers for permission to take placentas home. Incorporating non-Western patients' traditional health care practices into Western health care delivery may be facilitated by an awareness of the reluctance of some patients to verbalize their wishes.

Adult↗

The cultural context of suicide stigma in Taiwan.

In the ethnographic study on which this article is based, the authors investigate experiences after a suicide attempt from the perspective of patients and their family members in Taiwan. Thirty-four patients and 49 family members or colleagues participated in interviews from the point of patients' hospitalization to their return to the community. The postsuicide stigma suffered by patients and their families was based on such cultural themes as Suicide is bu-hsiao (non-filial piety), Suicide results in an inability to transmigrate the soul, and Suicide is inherited. Patients, family members, and colleagues cope with the stigma through explaining suicide as due to "bad luck" or "a kan-huo (hot energy) problem," or by insisting that it was "not a true suicide." These findings suggest that health professionals can move closer to patients and their families and suggest appropriate health care policy through understanding the patient's and the family's explanation of suicide experiences.

Attitude to Health↗

Jungian spirituality: a developmental context for late-life growth.

Ira Byock's "opportunities for growth" at the end of life have become defining features of the hospice and palliative care movement and create a strong moral imperative against futile and distracting treatment for the terminally ill. This article examines a larger developmental and cultural context that includes the work of Carl Jung and others who describe similar growth as characteristic of the midlife transition and the movement toward "gerotranscendence" in later life. The author suggests that in developmental terms, gerotranscendence forms a bridge between the work of Jung and that of Byock. She examines archetypal concepts and practices that facilitate psychospiritual growth and argues that these may be used with terminally ill patients to help them engage the process of "dying well." She notes that these modern findings lie within a long and cross-cultural humanistic tradition that anticipates the development of wisdom for those whose aging occurs within a spiritual framework that involves identifying with the soul rather than with the body.

Attitude to Death↗

Inuit interpretations of sleep paralysis.

Traditional and contemporary Inuit concepts of sleep paralysis were investigated through interviews with elders and young people in Iqaluit, Baffin Island. Sleep paralysis was readily recognized by most respondents and termed uqumangirniq (in the Baffin region) or aqtuqsinniq (Kivalliq region). Traditional interpretations of uqumangirniq referred to a shamanistic cosmology in which the individual's soul was vulnerable during sleep and dreaming. Sleep paralysis could result from attack by shamans or malevolent spirits. Understanding the experience as a manifestation of supernatural power, beyond one's control, served to reinforce the experiential reality and presence of the spirit world. For contemporary youth, sleep paralysis was interpreted in terms of multiple frameworks that incorporated personal, medical, mystical, traditional/shamanistic, and Christian views, reflecting the dynamic social changes taking place in this region.

Adult↗

The perceived benefits of singing: findings from preliminary surveys of a university college choral society.

Two exploratory studies are reported on the perceived benefits associated with active participation in choral singing. In the first study, 84 members of a university college choral society completed a brief questionnaire that asked whether they had benefited personally from their involvement in the choir and whether there were ways in which participation could benefit their health. A large majority of respondents agreed they had benefited socially (87%) and emotionally (75%), with 58% agreeing they had benefited in some physical way, and 49% spiritually. A content analysis of written comments served to elaborate the ways in which choir members felt they had benefited. Common themes expressed were: meeting new people, feeling more positive, increased control over breathing, feeling more alert and feeling spiritually uplifted. With respect to health benefits, 84% of participants gave answers, the main themes of which related to improved lung function and breathing, improved mood and stress reduction. In the second study, 91 members of the choir completed a structured questionnaire consisting of 32 statements about singing reflecting the ideas expressed in the first study. Over 40% of respondents strongly agreed that 'singing helps to make my mood more positive', 'singing is a moving experience for me sometimes', 'singing makes me feel a lot happier' and 'singing is good for my soul'. A principal components analysis followed by Oblimin rotation identified six dimensions of benefit associated with singing. These were labelled as: benefits for well-being and relaxation, benefits for breathing and posture, social benefits, spiritual benefits, emotional benefits, and benefits for heart and immune system. Cronbach alpha coefficients were satisfactory for all components except the third, social benefits, due primarily to the small number of items loading on this component. Women were significantly more likely to experience benefits for well-being and relaxation, younger people were more likely to report social benefits, and those professing religious beliefs were more likely to experience spiritual benefits. The present studies have a number of limitations, but they provide a useful foundation for future larger scale surveys, more sophisticated qualitative studies, and experimental investigations of the impact of singing on psycho-physiological functioning.

Adult↗