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Saturday, April 18, 2015

Stigmatized Schizophrenia Gets a Rebrand

By Elizabeth Picciuto
The Daily Beast
Originally published March 26, 2015

Here are two excerpts:

The word “schizophrenia” was coined in the early 20th century, deriving from the Greek word for “split mind.” The term conveyed the idea that people with schizophrenia experienced a splitting of their personality—that they no longer had unified identities.

Considering all the words for mental illness, both those used by medical doctors and those that are cruel slurs used by the general public, it is striking how many of them have connotations of being broken or disorganized: deranged, crazy (which means cracked— itself a derogatory term), unglued, having a screw loose, unhinged, off the wall.

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“The first lesson from the Japanese experience is that a change is possible and that the change may be beneficial for mental health users and their careers, for professionals and researchers alike,” said Lasalvia. “An early effect of renaming schizophrenia, as proven by the Japanese findings, would increase the percentage of patients informed about their diagnosis, prognosis, and available interventions. A name change would facilitate help seeking and service uptake by patients, and would be most beneficial for the provision of psychosocial interventions, since better informed patients generally display a more positive attitude towards care and a more active involvement in their own care programs.”

The entire article is here.

Friday, April 17, 2015

We all feel disgust but why do some of us turn it on ourselves?

By Jane Simpson and Phillip Powell
The Conversation
Originally posted March 27, 2015

Here is an excerpt:

Self-disgust differs from other negative feelings that people have about themselves in a number of ways. While self-disgust is likely to happen alongside other self-directed issues such as shame, unique features include feelings of revulsion, for example when looking in the mirror, contamination and magical rather than reasoned thinking. These, taken with other characteristics, such as its particular cognitive-affective content, suggest an emotional experience that is different to shame (related to hierarchical submission and diminished social rank).

Disgust is not about just “not liking” aspects of yourself – the depth of the emotion can mean you can’t even look at yourself without being overwhelmed with revulsion. The feeling that you are disgusting also means that you are potentially toxic to others – so people can become isolated as they do not wish to “infect” and “contaminate” others with their own perceived “disgustingness”.

The entire post is here.

Editor's Note: This article pertains to psychotherapy with trauma, personality disorders, and eating disorders.

Instilling empathy among doctors pays off for patient care

By Sandra G. Boodman via Kaiser Health News
CNN website
Originally posted March 26, 2015

Here is an excerpt:

Clinical empathy was once dismissively known as "good bedside manner" and traditionally regarded as far less important than technical acumen. But a spate of studies in the past decade has found that it is no mere frill. Increasingly, empathy is considered essential to establishing trust, the foundation of a good doctor-patient relationship.

Studies have linked empathy to greater patient satisfaction, better outcomes, decreased physician burnout and a lower risk of malpractice suits and errors. Beginning this year, the Medical College Admission Test will contain questions involving human behavior and psychology, a recognition that being a good doctor "requires an understanding of people," not just science, according to the American Association of Medical Colleges. Patient satisfaction scores are now being used to calculate Medicare reimbursement under the Affordable Care Act. And more than 70 percent of hospitals and health networks are using patient satisfaction scores in physician compensation decisions.

The entire article is here.

Thursday, April 16, 2015

Thinking about how we think about morality

By Jennifer Cole Wright
OUPblog
Originally published March 22, 2015

Morality is a funny thing. On the one hand, it stands as a normative boundary – a barrier between us and the evils that threaten our lives and humanity. It protects us from the darkness, both outside and within ourselves. It structures and guides our conception of what it is to be good (decent, honorable, honest, compassionate) and to live well.

On the other hand, morality breeds intolerance. After all, if something is morally wrong to do, then we ought not to tolerate its being done. Living morally requires denying the darkness. It requires cultivating virtue and living in alignment with our moral values and principles. Anything that threatens this – divergent ideas, values, practices, or people – must therefore be ignored or challenged; or worse, sanctioned, punished, destroyed.

The entire blog post is here.

Stigma Around Physician-Assisted Dying Lingers

By Clyde Haberman
The New York Times
Originally posted on March 22, 2015

Here is an excerpt:

Arguments, pro and con, have not changed much over the years. Assisted dying was and is anathema to many religious leaders, notably in the Roman Catholic Church. For the American Medical Association, it remains “fundamentally incompatible with the physician’s role as healer.”

Some opponents express slippery-slope concerns: that certain patients might feel they owe it to their overburdened families to call it quits. That the poor and the uninsured, disproportionately, will have their lives cut short. That medication might be prescribed for the mentally incompetent. That doctors might move too readily to bring an end to those in the throes of depression. “We should address what would give them purpose, not give them a handful of pills,” Dr. Ezekiel Emanuel, a prominent oncologist and medical ethicist, told Retro Report.

The entire article is here.

Wednesday, April 15, 2015

The disremembered

Dementia undermines all of our philosophical assumptions about the coherence of the self. But that might be a good thing

By Charles Leadbeater
Aeon
Originally published March 26, 2015

Here are two excerpts:

The memory-based account of identity is powerful, deeply rooted and dangerously partial. It will direct us to potential memory cures – a mixture of implants and drugs – that will almost certainly disappoint as much as they excite. Memory is not created in a little box in the brain, but by diffuse and dispersed circuits of neurons firing in concert. Someone with dementia would need more than an implant: they would need their brain refreshed and rewired. And still the nagging question would remain: are they the same person?

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The notion of an embedded identity takes us into much more fertile territory when it comes to considering meaningful care for dementia sufferers. It implies that the main challenge is to work imaginatively and empathetically to find common ground, creating conversational topics and cues that help make connections with people, despite their failing memory. As the British psychologist Oliver James explains in Contented Dementia (2008), this requires more skill and persistence than most conversations demand, precisely because its pre-suppositions cannot be taken for granted. My 85-year-old mother-in-law, for example, cannot always remember that she has a preserving pan, but that does not stop her enjoying making (and, even more, talking about making) marmalade.

The entire article is here.

Measuring the Return on Character

Harvard Business Review
April 2015

Here is an excerpt:

Character is a subjective trait that might seem to defy quantification. To measure it, KRW cofounder Fred Kiel and his colleagues began by sifting through the anthropologist Donald Brown’s classic inventory of about 500 behaviors and characteristics that are recognized and displayed in all human societies. Drawing on that list, they identified four moral principles—integrity, responsibility, forgiveness, and compassion—as universal. Then they sent anonymous surveys to employees at 84 U.S. companies and nonprofits, asking, among other things, how consistently their CEOs and management teams embodied the four principles. They also interviewed many of the executives and analyzed the organizations’ financial results. When financial data was unavailable, leaders’ results were excluded.

The entire article is here.

Tuesday, April 14, 2015

Hannah Arendt: thinking versus evil

By Jon Nixon
The Times of Higher Education
Originally posted February 26, 2015

Here are two excerpts:

That is why the notion of “thinking” played such an important part in Arendt’s analysis of totalitarianism, from her 1951 The Origins of Totalitarianism to her highly controversial coverage of the Adolf Eichmann trial, the latter culminating in her 1963 book Eichmann in Jerusalem. In this, she famously employed the phrase “the banality of evil” to describe what she saw as Eichmann’s unquestioning adherence to the norms of the Nazi regime. In concluding from the occasional lies and inconsistencies in his courtroom testimony that Eichmann was a liar, the prosecution had missed the moral and legal challenge of the case: “Their case rested on the assumption that the defendant, like all ‘normal persons’, must have been aware of the criminal nature of his acts” – but, she added, Eichmann was normal only in so far as he was “no exception within the Nazi regime”. The prosecution had, according to Arendt’s analysis, failed to grasp the moral and political significance of Eichmann’s “abnormality”: namely, his adherence to the norms of the regime he had served and therefore his lack of awareness of the criminal nature of his acts.

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In Arendt’s view, Eichmann’s “banality” left him no less culpable – and rendered the death sentence no less justifiable – but it shifted the basis of the argument against him: if he was a monster, then his monstrosity arose from an all too human propensity towards thoughtlessness. If Heidegger had represented the unworldliness of “pure thought”, then Eichmann represented the unworldliness of “thoughtlessness”. Neither connected with the plurality of the world as Arendt understood it. A world devoid of thinking, willing and judging would, she argued, be a world inhabited by automatons such as Eichmann who lacked freedom of will and any capacity for independent judgement.

The entire article is here.

The Ethics of Physicians’ Web Searches for Patients’ Information

Nicholas Genes and Jacob Appel
The Journal of Clinical Ethics
Volume 26, Number 1, Spring 2015

When physicians search the web for personal information about their patients, others have argued that this undermines  patients’ trust, and the physician-patient relationship in general. We add that this practice also places other relationships at risk, and could jeopardize a physician’s career.

Yet there are also reports of web searches that have unambiguously helped in the care of patients, suggesting circumstances in which a routine search of the web could be beneficial. We advance the notion that, just as nonverbal cues and unsolicited information can be useful in clinical decision making, so too can online information from patients. As electronic records grow more voluminous and span more types of data, searching these resources will become a clinical skill, to be used judiciously and with care—just as evaluating the literature is, today.

But to proscribe web searches of patients’ information altogether is as nonsensical as disregarding findings from physical exams—instead, what’s needed are guidelines for when to look and how to evaluate what’s uncovered, online.

The entire article is here.