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PubMed2002

Twin death and mourning worldwide: a review of the literature.

Cultural beliefs about the nature of multiples appear in the mourning practices of many civilizations. Ethnographic literature suggests common themes that echo modern concepts. Many societies viewed twins as fragile, likely to die without preferential or meticulously equal treatment. A shared soul between twins is a common tenet, and the death of one is often felt to herald the other's prompt demise. The close relationship between multiples influences funerary rites. Honor, fear and mysticism are often evident in rituals. Twin infanticide was widely practiced, yet mourning customs were still observed. Many peoples recognize the special status of multiples and their families after one, two or more die.

Attitude to Death↗
PubMedDate not supplied

Pediatric endocrine diseases in pre-Hispanic Aztecs.

Aztec medical and religious knowledge derived from Olmecs (800 BC), Teotihuacans (100 BC) and Toltecs (1100-1521 AC); however, there is no unique source that accurately presents Aztec medicine. Sahagfin combines naturalism and religion but not magic ("First Memorials", "Matritense Codex", "Florentine Codex" and "General History of New Spain"); Hernández gives a naturalistic image but is full of mistakes ("Natural History of the New Spain"); Badiano tries to match Aztecs with contemporary Europeans and with the first century medicine of the Romans ("Badiano Codex"), and Ruiz de Alarcón contains plenty of magical concepts ("Book of Superstition"). For the Aztecs, surveillance of growth was very important and represented a balance between body and soul. They described the different steps of pubertal development. They had specific treatments for thyroid disease in children, mainly hypothyroidism and goiter. There are no references to rickets, nor to type 1 or 2 diabetes mellitus.

Child↗
PubMed1996

The inner world in the outer world: the phenomenology of posttraumatic stress disorder from a psychoanalytic perspective.

The intrapsychic processes underlying the phenomenology of PTSD symptoms appear to derive their fate from the states of consciousness at the time of traumatic experiences. The operative mechanisms of consciousness-condensation, avoidance of censorship, representability, and secondary revision-are the elements of trauma work as they are of dream work. These mechanisms establish an ever-present dynamic mental state of space consciousness, which is defined as an essential component of mental activities. This state of space consciousness exists beyond any experience of the self and beyond any processes regulated by the pleasure principle. When the sensory impressions derive from perceptions of and interactions with the mother, the matrix consists of the relationship between infant and mother. When the sensory impressions relate to traumatic circumstances the matrix reverts from the epigenetic context to the genetic one. The genetic matrix is manifest through disturbances in the activities of the higher mental functions. Under the impact of trauma, the epigenetic experiences are akin to a population floating without direction on a boat at the mercy of the elements-the raging higher mental functions. The factors operating on the higher mental functions create an inner world under traumatic circumstances, leading to an interpretation of the outer space according to the mental activities of the inner space. The concept of a dynamic process producing numerous modifications in mental scenes, thought, feelings, and reactions provides no surprise to psychoanalysts. The higher mental functions are seen as operating at the juncture of the physical and the mental. This juncture is the place where spatial consciousness and memories begin their common journey. Goodman wrote, "The conventional dichotomy between physical (organic) and mental (functional) is linguistic/conceptual rather than inherent in nature, and all events and processes involved in the etiology, pathogenesis, symptomatic manifestation, and treatment of psychiatric disorders are simultaneously biological and psychological" (Goodman, 1991, p. 553). The subjective experience of the dynamic unconscious activities of the higher mental functions form the inner nucleus selecting the relevant sensory impressions from the outer world. The juncture between the physical and the mental could be a crossroad for the psychic events occupying space and the psychic events determined by time factors. The psychic events that begin at this juncture find their composition evolving in time, in sequence, and in simultaneity. They follow a course determined by the four mechanisms responsible for the creation of dreams, of memories, of behaviors, and of narratives. The descriptive criteria of PTSD have in common the quality of persistence. The associated features show more variability and their appearance coincide with the appropriate circumstances that stimulate their arousal. Internal genetic factors remain persistent factors in the arousal of the reexperiencing phenomenon, of the avoidant behaviors and of the physiological reactivity. They furnish the impetus for the construction of the inner world, which is an indispensable tool in the management of ourselves, our bodies, and our environment. To paraphrase Freud's quotation used at the beginning of this article, there is a process in the inner world, stimulated by unconscious factors, that give rise to our view of the world and of our soul. The contents of this article-the ideas, the concepts, and the discourse itself-are a product of a continuing, evolving psychoanalytic way of thinking. The total of the analytic considerations gathered under the theory of trauma psychology could not be presented without the contributions of Freud, Hartmann, Rapaport, Erikson, Holt, Klein, Schafer, and others. We believe trauma psychology to be in its infancy, at a stage comparable to the stage of the libido theory at the time of the writing of The Interpretation

Adaptation, Psychological↗
PubMed2001

Dante's Divine Comedy revisited: what can modern psychoanalysts learn from a medieval "psychoanalysis"?

I realize after having gone over this material that I have done a sort of deconstruction of Dante's Divine Comedy which putatively attempts to raise the human vision to transcendent heights and to focus love on the love of God, but which along the way indulges in the very human aspects of pity, compassion, music, poetry, and the other arts, as well as reason and puzzlement. In this sense the poem is also an exposition of the value of the higher human faculties, which contrasts at times rather vividly with the apparently harsh autocratic fates that are assigned to some characters--who do not seem quite deserving of what is inflicted upon them. Here we have a collision between absolute faith in the judgment of God and human reason and compassion which sometimes seems to be unable to justify these judgments. In spite of the fact that Dante is trying to adhere to orthodox theology throughout, it is clear that his poetic soul has great difficulty in avoiding the depiction of characters for whom he has a secret sympathy. The central point of this study of The Divine Comedy is to emphasize how Dante, almost in spite of himself, expressed empathy and understanding for a variety of unfortunates either in the Inferno or in the Purgatorio. Virgil even scolds him for his compassion, arguing that God's justice is always correct and if God is angry at someone and punishes him or her, Dante should also be angry and not compassionate. Dante tries, but he cannot quite manage to do it. Translated into modern terminology, we can learn from this report of a medieval "psychoanalysis" an important lesson in our clinical work. Rigid adherence to rules such as those Freud himself proclaimed (although he never followed them), for instance in his famous demand that one be always opaque to the patient, and/or rigid adherence to one or another psychoanalytic theory, must be understood as a form of countertransference, a character flaw in the analyst. Each case demands its own approach and its own form or forms or channels of understanding, just as Dante offers us in The Divine Comedy. It is because he offers such a perspective almost in spite of himself that his poem transcends the medieval mind and becomes relevant to all ages and cultures. As a rule of thumb, when one finds one's instinctual convictions about how to proceed in conflict with one's theories and set of rules, something is wrong. It is with the greatest trepidation that a well-analysed psychoanalyst should force him- or herself to ignore an instinctual or intuitive feeling of how to respond to a patient because it conflicts with some theoretical principles or official rules of procedure. Such a conflict is a call for further self-analysis, consultation with colleagues, and creative solutions.

Humans↗
PubMed2001

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↗
PubMed2002

Daniel Deronda and Gwendolen Harleth: a therapeutic relationship?

In Daniel Deronda, George Eliot presents Gwendolen as having been rescued by Daniel, and most commentators have agreed, with many comparing the relationship to that of patient and therapist. These commentators have allowed themselves to be unduly influenced by George Eliot's interpretations and judgments and have ignored the concrete depiction of her characters. While we are being told that Gwendolen is undergoing a conversion in which she develops a new consciousness, a new soul, we are being shown a character who is full of rage, self-hatred, and despair. Instead of leading her in the direction of psychological health, Deronda offers her his own defenses and fosters her dependency on him. Despite the upbeat tone of the ending, her prospects after he leaves England seem very bleak.

Adult↗
PubMed2001

Nocturnal hallucinations in ultra-orthodox Jewish Israeli men.

Hallucinations that occur predominantly at night are reported in 122 out of a sample of 302 ultra-orthodox Jewish Israeli men referred for psychiatric evaluation. Demographic data and the content of a semistructured interview in 302 ultra-orthodox Jewish young men seen over a 10-year period in Jerusalem were evaluated retrospectively by two researchers. Of the 302 subjects, 122 reported hallucinations predominantly at night, 23 reported hallucinations with no diurnal variation, and 157 did not report hallucinations. Most of those with nocturnal hallucinations were in their late teens, were seen only once or twice, were brought in order to receive an evaluation letter for the Army, and had a reported history of serious learning difficulties. The nocturnal hallucinatory experiences were predominantly visual, and the images were frightening figures from daily life or from folklore. Many of the subjects were withdrawn, monosyllabic, reluctant interviewees. Ultra-orthodox Jewish beliefs include a belief in demons, particularly of dead souls, who visit at night. This cultural group's value on study at Yeshivas away from home places significant pressure on teenage boys with mild or definite subnormality, possibly precipitating the phenomenon at this age in this sex. Although malingering had to be considered as a possible explanation in many cases owing to the circumstances of the evaluation, short-term and long-term follow-up on a limited sample allowed this explanation to be dismissed in a significant number of cases. We suggest therefore that nocturnal hallucinations are a culture-specific phenomenon.

Adolescent↗
PubMed1996

The body that knows: from Cashinahua epistemology to a medical anthropology of lowland South America.

This article develops an anthropology of the body in its material and social environment among the Cashinahua (Huni Kuin) from Brazilian and Peruvian Amazonia. The Cashinahua body, it shows, is thought of as produced by others, not as growing naturally. Growth can be defined as the corporeal accumulation of knowledge in the form of "soul." The article describes the verbal, medical, and other techniques used to transform it into "a body that knows." In the Cashinahua understanding, a healthy body is one that constantly learns through the senses and expresses the accumulated knowledge in social action and speech. An ill body is one that no longer knows. Curing, therefore, acts to restore a person's capacity to know. The whole article defends the proposition, then, that a prior condition for any medical anthropology in the Cashinahua case is a thorough examination of Cashinahua epistemology. Finally, through comparative discussion of other peoples in lowland South America, it seeks to show that this is also the case more widely in the ethnographic region. Ultimately, it suggests that ethnography in lowland South America undermines the possibility of a "medical anthropology" per se.

Adult↗
PubMed1998

Objectified selves: an analysis of medicines in Andean sacrificial healing.

This analysis of medicines used in a Quechua soul-calling ritual in the southern Peruvian Andes demonstrates that the items in sacrificial bundles (despachos) embody the identity of patients. The manipulation of these medicinal objects gives insight into the meaning of the concept of embodiment in the Andean cultural context and expands Western conceptions of embodiment. An examination of the material representation of the body, the sacrificial object, illuminates the components of embodied identity in this particular cultural context. Analysis of the manipulation of medicines further illuminates the potency and efficacy of symbolic healing to transform the phenomenological world of the patient.

Disease↗
PubMed1995

"A battle not man's but God's": origins of the American temperance crusade in the struggle for religious authority.

Major theories of the origins of American temperance have emphasized materialist explanations without taking seriously enough the independent role of ideas--and, in particular, religious ideas--in stimulating the reform. This article develops a new interpretation, focusing on the religious origins of temperance in a "crisis of contested authority" that befell the Protestant denominations descended from Puritanism during the early years of the 19th century. One outgrowth of the crisis over the authority of traditional religious ideas was a new theology focused on religious salvation through the suppression of vice. This new religious ideology provided a core of beliefs and powerful justification for organizing a public crusade to "exterminate" vice, and one that for ideological reasons ultimately narrowed its focus to the specific vice of intemperance. The crusade against vice in the early republic offered clergymen a "solution" to their problems of contested authority by providing new strategies and an organizational base of voluntary societies for carrying out what they perceived to be their sacred duties: winning souls to God, guarding collective salvation and leveraging government to promote obedience to religious prohibitions on vice. At least initially, temperance was part of a new kind of effort to assert the authority of religious ideas in the public sphere, and to regroup religious forces under auspices outside the church.

Alcoholism↗
PubMed2000

[The cultural meaning of cerebral aneurysm and its treatment for the patient and his family: an ethnographic study].

This is a descriptive ethnographic study with 13 patients with cerebral aneurysm and their relatives aiming at understanding the meaning of the illness and the treatment. The data were collected by interviews and observations during the hospitalization and, after the discharge, in the outpatient clinic and at home. The central theme obtained from the study was "It had to be for me! God knows what He does". This theme reveals a religious interpretation for the illness and a magic basis for its cure. Thus, cerebral aneurysm is interpreted as a material illness (body) and a spiritual illness (soul).

Adult↗
PubMed2005

The kidneys in the Bible: what happened?

The kidneys, always used in the plural (kelayot), are mentioned more than 30 times in the Bible. In the Pentateuch, the kidneys are cited 11 times in the detailed instructions given for the sacrificial offering of animals at the altar. Whereas those instructions were for purification ceremonies at the Temple, sacrificial offerings were made subsequently in seeking divine intervention for the relief of medical problems. In the books of the Bible that follow the Pentateuch, mostly in Jeremiah and Psalms, the human kidneys are cited figuratively as the site of temperament, emotions, prudence, vigor, and wisdom. In five instances, they are mentioned as the organs examined by God to judge an individual. They are cited either before or after but always in conjunction with the heart as mirrors of the psyche of the person examined. There is also reference to the kidneys as the site of divine punishment for misdemeanors, committed or perceived, particularly in the book of Job, whose suffering and ailments are legendary. In the first vernacular versions of the Bible in English, the translators elected to use the term "reins" instead of kidneys in differentiating the metaphoric uses of human kidneys from that of their mention as anatomic organs of sacrificial animals burned at the altar. This initial effort at linguistic purity or gentility has progressed further in recent versions of the Bible, in which the reins are now replaced by the soul or the mind. The erosion may have begun in the centuries that followed the writing of the Bible, when recognition of the kidneys as excretory organs deprived them of the ancient aura of mysterious organs hidden deep in the body but accessible to the look of God. At approximately the same time, Greek analytical philosophy argued that the brain, which is never mentioned in the Bible, was the most divine and sacred part of the body. This argument gained ground in the past century, when the functions of the brain were elucidated, and ultimately established in the 1960s, when salvaging the kidneys for transplantation necessitated a change in the definition of death as irreversible brain function. It is ironic that advances in understanding kidney function and in nephrology that made kidney transplantation feasible may have contributed, albeit indirectly, to the gradual elimination of the metaphoric mention of human kidneys in the Bible.

Animals↗
PubMed2002

Reconceptualizing native women's health: an "indigenist" stress-coping model.

This commentary presents an "indigenist" model of Native women's health, a stress-coping paradigm that situates Native women's health within the larger context of their status as a colonized people. The model is grounded in empirical evidence that traumas such as the "soul wound" of historical and contemporary discrimination among Native women influence health and mental health outcomes. The preliminary model also incorporates cultural resilience, including as moderators identity, enculturation, spiritual coping, and traditional healing practices. Current epidemiological data on Native women's general health and mental health are reconsidered within the framework of this model.

Acculturation↗
PubMed2002

Childrearing practices and child health among the Hmong in Australia: implications for health services.

This study of cultural beliefs and practices related to childrearing and child health among the Hmong in Melbourne, Australia, used in-depth interviews and participant observation of 27 Hmong mothers and some Hmong traditional healers between 1993 and 1998. Traditional Hmong beliefs and practices include: taking notice of the birth date and time, placing a silver necklace on the newborn, not praising the newborn, not taking the infant out during the first 30 days, breastfeeding, the infant's sharing a bed with the parents, and a soul-calling ceremony on the third day after birth. All Hmong mothers follow cultural beliefs and practices to prevent the ill-health or death of their newborn infants, but some aspects of these practices have had to be modified to suit the new living environment in Australia. Health care professionals need to acknowledge the different ways of caring for a young child among the Hmong so as to avoid misunderstandings and to provide sensitive care. Hmong beliefs and practices also have implications for health promotion campaigns and can be a valuable source of ideas in the efforts to promote infant health and reduce infant deaths in Australia and elsewhere.

Adult↗
PubMed2005

Narratives of social justice: learning in innovative clinical settings.

The nursing profession has renewed its commitment to social and political mandates, resulting in increasing attention to issues pertaining to diversity, vulnerable populations, social determinants of health, advocacy and activism, and social justice in nursing curricula. Narratives from a qualitative study examining undergraduate nursing student learning in five innovative clinical settings (corrections, international, parish, rural, and aboriginal) resonate with these curricular emphases. Data were derived from focus groups and interviews with 65 undergraduate nursing students, clinical instructors, and RN mentors. Findings of this study reveal how students in innovative clinical placements bear witness to poverty, inequities, and marginalization (critical awareness), often resulting in dissonance and soul-searching (critical engagement), and a renewed commitment to social transformation (social change). These findings suggest the potential for transformative learning in these settings.

Curriculum↗
PubMedDate not supplied

[St. Luke and his cult as holy healer of the Serbs].

Most school doctors, who lived in the period of Early Christianity from 1st to 4th century A.D. and who were canonized saints, have been known, up to these days, among people and in scientific and medical circles as Holy Healers. It is understood that only exclusively educated medical experts, trained to heal professionally and prepare medicines are considered Holy Healers. Out of all Holy Healers, St. Kosma and Damian, St. Panteleimon, St. Luke, etc., are highly respected by our people. St. Luke (1st century A.D.) is specially honored by Serbian nation. His relics were taken to Smederevo in 1453 and then the town became "the place of many cures and new healing spot". Out of these relics, only the foot of St. Luke was preserved in a very good condition and it remained in the possession of the Serbian Orthodox Church. In old documents written in old Greek and clerical-slavic language, St. Luke is glorified as "reliable doctor both for soul and body..." St. Luke is respected as a protector of medicine and pharmacy, doctors and pharmacists, and patients, as well as many families (family patron of the Serbs), even of the whole regions. Many chemist's shops and hospitals are named by this Saint, what is the confirmation that his cult and recognition of his personality and his work are still present in our milieu.

Eastern Orthodoxy↗
PubMed1993

Management of death and grief in obituary and in memoriam pages of Nigerian newspapers.

This analysis of obituaries and in memoriam advertisements in Nigerian newspapers provides the identification of dimensions of content used to manage death and grief. Ten dimensions of content were abstracted: pictorial representation is a widespread practice, immediacy of announcement following death is an appropriate etiquette in the management of death, funeral arrangements are included as open invitation to a community of mourners, advertisements indicate direct contact and communication with the deceased, contents suggest the belief in personal immortality of the soul, religion is a pervasive and dominating force in advertisements, there are similarities in choice of words used in death advertisements, there is recognition of the temporal nature of life, mourning seems to be an ongoing process, and often the deceased is perceived as resting in peace. Never do obituaries and in memoriam statements include the flaws of the deceased. Clearly, the dimensions of content in the obituaries and in memoriam advertisements of Nigerian newspapers are a specific cultural behavior of people who exhibit similarity in the management of death and grief. These advertisements serve as an unbroken link between the deceased and the bereaved. This study also suggests that openness to death is the appropriate etiquette in the management of death and grief in Nigeria.

Advertising↗
PubMed2005

Use of a religious hymn in remission of symptoms of social phobia (social anxiety disorder): a case study.

This case report described a veteran with social anxiety disorder who reported fears of negative evaluation by others, social avoidance, and accompanying physiological symptoms of heart palpitations, gastrointestinal discomfort, muscle tension and mental confusion. The symptoms of social anxiety disorder subsided with the use of a Christian hymn "Be Still My Soul" and its accompanying musical poem, in Finlandia. The veteran attributed the symptom remission to the feeling of stillness and surrender to God conveyed by the words and music of the hymn. Although previous studies have shown that both music and religious beliefs can affect mental health, the findings in this case cannot be generalized without conducting further prospective empirical studies.

Culture↗