R．D．莱因对传统精神疾病诊疗观的变革

传统的精神疾病诊断以一种经验式的分类手册来诊断精神疾病,而莱因主张从存在主义——现象学的视角来理解精神疾病,认为家庭或社会才是精神疾病的真正来源。在精神疾病的治疗方面,莱因主张通过改变患者的生存环境来促使其进行自我恢复。莱因的思想推动了当代精神病学的变革与发展,具有重要的现实意义。     

R.D.莱因对传统精神疾病诊疗观的变革

传统的精神疾病诊断以一种经验式的分类手册来诊断精神疾病,而莱因主张从存在主义--现象学的视角来理解精神疾病,认为家庭或社会才是精神疾病的真正来源.在精神疾病的治疗方面,莱因主张通过改变患者的生存环境来促使其进行自我恢复.莱因的思想推动了当代精神病学的变革与发展,具有重要的现实意义.     

精神疾病诊断“有效性”的哲学探讨

精神病学与哲学有着密切的关联,精神病学哲学是对精神健康与精神疾病进行哲学探讨的一门学科。在精神病学哲学研究中,学者们对于目前通行的国际精神疾病诊断标准的有效性展开争论,而对于这一争论中所提出的一些问题,如精神疾病是否等于大脑障碍,是否可以对精神疾病诊断的有效性作出形而上学承诺,以及在伦理学意义上,精神"正常"与"不正常"区分意味着什么等问题进行哲学分析,不仅有助于推动精神病学理论和临床实践的发展,也可以为不同文化背景下精神病学哲学的建构提供契机。     

宗教心理-鬼神心理疾病—濒死体验的诊断与预后

濒死体验是科学现象而不是灵学现象,有初步问卷和最终量表可供筛查和诊断;是心理疾病而不是精神病。美国精神病学学会《精神疾病诊断与统计手册》标定为“宗教—鬼神问题”。除非获得适当的心理治疗与社会心理康复,患者预后不良。     

宗教心理—鬼神心理疾病——濒死体验的诊断与预后

濒死体验是科学现象而不是灵学现象,有初步问卷和最终量表可供筛查和诊断;是心理疾病而不是精神病.美国精神病学学会《精神疾病诊断与统计手册》标定为"宗教-鬼神问题".除非获得适当的心理治疗与社会心理康复,患者预后不良.     

罗洛·梅论焦虑

在美国心理学界,存在主义心理学家罗洛·梅(Rollo Mag 1909)以研究焦虑理论而著名。他吸收存在主义哲学家克尔凯哥尔和精神分析的创使人弗洛伊德的焦虑理论,结合自己的心理治疗临床实践,写出了《焦虑的意义)一书,阐发了自己的焦虑观。本文拟对这一理论作一概括性的介绍,并就这一理论的利弊得失作一客观的评价。     

罗洛—梅存在心理治疗的基本思想

罗洛·梅是美国推动人本主义心理学的健将、存在主义心理学家、临床心理治疗家。梅以丰富的临床心理治疗经验,站在存在主义哲学的角度,用现象学的研究方法,一生致力于研究“人究竟是什么”这个人本心理学的基本问题。     

权力、知识和精神病学主题——福柯的视角

精神病学领域有关权力因素的讨论日渐增多,法国哲学家福柯对权力和知识的含义及其关系进行了讨论,同时也对当代精神病学领域的相关的主题,如精神疾病、精神病院、诊断、治疗等,提出了批判性的思考,指出了其中隐含的权力因素及其历史性、文化性构成,有助于我们重新理解精神病的主题,更加关注人文因素的强大作用     

与我一道存在——谈R.D.莱因的存在心理治疗观

R.D.莱因受存在主义-现象学影响,把人看作独特的存在,反对传统的经验式分类手册进行精神病诊断的模式,主张人性地看待精神分裂症患者,从患者整个前后关系之中来理解其特殊经验;莱因注重治疗关系,反对生硬的技巧性治疗,认为治疗是陪伴患者进行一次特殊的心灵探险旅行.他在精神分裂症的诊断及治疗方面作出了重要贡献,对后来的心理治疗流派产生了较大影响.     

精神疾病时代心理治疗的哲学反思

在精神疾病时代,心理治疗家应增强心理治疗的文化敏感性,关注心理治疗对象的个体性,将目标和价值作为关注焦点的同时重视哲学引导在心理治疗中的作用.     

Where’s the problem? Considering Laing and Esterson’s account of schizophrenia,social models of disability,and extended mental disorder

In this article, I compare and evaluate R. D. Laing and A. Esterson’s account of schizophrenia as developed in Sanity, Madness and the Family (1964), social models of disability, and accounts of extended mental disorder. These accounts claim that some putative disorders (schizophrenia, disability, certain mental disorders) should not be thought of as reflecting biological or psychological dysfunction within the afflicted individual, but instead as external problems (to be located in the family, or in the material and social environment). In this article, I consider the grounds on which such claims might be supported. I argue that problems should not be located within an individual putative patient in cases where there is some acceptable test environment in which there is no problem. A number of cases where such an argument can show that there is no internal disorder are discussed. I argue, however, that Laing and Esterson’s argument—that schizophrenia is not within diagnosed patients—does not work. The problem with their argument is that they fail to show that the diagnosed women in their study function adequately in any environment.     

Entrevista con R. D. Laing

RESUMEN

Ronald D. Laing suele considerarse como uno de los fundadores del movimiento de reinterpretación de la “enfermedad mental” y liberación institucional al que se conoce por el nombre de “antipsiquiatría“. En esta entrevista, el Dr. Laing habla de sus preocupaciones actuales en el ámbito de su trabajo y de su vida. También reflexiona sobre los temas que siempre han ocupado toda su obra, y revisa la situación actual de la psiquiatría después de muchos años de la formulación de sus ideas, de lo que se ha llamado antipsiquiatría. Al final de esta entrevista el Dr. Laing comenta sus ideas sobre la locura y el tratamiento del “enfermo mental”     

The disease-subject as a subject of literature

Based on the distinction between living body and lived body, we describe the disease-subject as representing the impact of disease on the existential life-project of the subject. Traditionally, an individual's subjectivity experiences disorders of the body and describes ensuing pain, discomfort and unpleasantness. The idea of a disease-subject goes further, representing the lived body suffering existential disruption and the possible limitations that disease most probably will impose. In this limit situation, the disease-subject will have to elaborate a new life-story, a new character or way-of-being-in-the-world, it will become a different subject.     

Trauma,Treatment, and Religion

Abstract

When children and youth are traumatized, caretakers must attend to behavioral, cognitive, physiological, ecological and spiritual/existential aspects of their reactions. This article focuses on the latter facet of traumatization. The Hebrew Scriptures and the New Testament offer little about the traumatic symptoms of victims. Using many of the same sources, Fundamentalist Christians, Jews, mainline Christians and secularists may offer children different interpretations of the meaning of trauma events. Understanding these interpretations is crucial for children who develop symptoms which suggest a diagnosis of PTSD. Caretakers, other than mental health professionals, can understand and use various techniques explicated in the TREAT model for treatment of PTSD. Concepts discussed can be used, within a spiritual/existential framework, to support traumatized youngsters.     

Cultural variations in the understanding and treatment of psychiatric disorders: India and England

Although much has been made of the nation of cultural specificity of mental illness, this paper argues that mental illness is a universal human experience. However, the types of disorders, the incidence and the severity of disorders may vary markedly across cultures. To understand mental illness and identify it across cultures, it is necessary to examine the problem against the backdrop of the dominant value systems which prevail in any culture at a given point in time. There are salient value systems to which most cultures subscribe, which in turn influence our understanding, diagnosis and treatment of mental illness and consequently the allocation of resources and the provision of care within the community. The different valueorientations between Western and Eastern cultures have a strong bearing on the problems of diagnosis and on the treatment of mental disorders, which in many instances are the outgrowth of the available resources and the acceptance of traditional arrangements unique to each culture.     

Arts-of-Living

The term 'art-of-living' refers to capabilities for leading a good life. Since there are different views on what a good life is, there could also be a difference in the capabilities called for. In this paper I distinguish two main views on the good life: the 'virtuous' life and the 'enjoyable' life and describe variants of each. I explore what competencies are required for living such lives and conclude that these differ indeed. So there are different arts-of-living. The set of capabilities required for leading a happy life can be identified by means of empirical research. This capability-profile comes close to the notion of 'positive mental health'. This revised version was published online in August 2006 with corrections to the Cover Date.     

心理异常中“一般心理问题“的判别标准与临床表现

心理异常是相对于心理健康而言的。心理异常不仅是指心理障碍、心理疾病以及心身障碍和心身疾病,而且也包括一般心理问题。人们通常认为的所谓“心理障碍”以及心理辅导和心理咨询中常见的心理异常,大量的还是指一般心理问题。本文就一般心理问题的判别标准以及各种主要一般心理问题的临床表现与鉴别诊断作了有益的探索,为心理辅导和心理咨询工作提供了心理学依据。     

Psychiatry and Psychology in the Writings of L. Ron Hubbard

Objectives: Celebrity followers of the Church of Scientology have recently used their public forum to attack the modern practice of mental health. The practice of Scientology is rooted in the religious writings of its founder, L. Ron Hubbard. This paper will review the religious writings of L Ron Hubbard to understand Scientology’s position on mental health. Method: This paper reviews four of the major religious books written by L Ron Hubbard, in addition to a comprehensive overview of Scientology compiled by Scientology staff. Results: Hubbard’s theory of mind borrowed heavily from the earlier writings of Freud, until Hubbard’s psychological theory extended to include a spiritual existence that goes beyond the material world. The goal of Hubbard’s psychology and religion were to optimize the freedom of the individual, and he viewed psychiatry and psychology as inherently anti-spiritual and opposed to personal freedom and self-realization. Ultimately Hubbard presents a world view of potential nuclear world cataclysm, fueled by the geopolitical climate and mental health theories that dominated the mid 20th century. Conclusions: Hubbard’s writings mirrored the times in which he lived. His views that mental health practices are inherently anti-religious, freedom-inhibiting, and brain damaging do not reflect the modern-day practices of mental health. Dr. McCall is presently Professor and Chairman of the Department of Psychiatry and Behavioral Medicine at the Wake Forest University School of Medicine. He completed his medical degree and post-graduate psychiatric training at Duke University. He completed a Masters degree in Epidemiology from Wake Forest University. He is board certified in general psychiatry, geriatric psychiatry, and sleep disorders medicine. His research interests include depression, electroconvulsive therapy, quality of life, and insomnia. His research has been continuously funded by the National Institute of Mental Health since 1995, and he is author of more than 100 peer-reviewed journal articles. He is Editor of the Journal of ECT, Immediate-Past President of the Association for Convulsive Therapy, and a prior Director of the Board of the American Academy of Sleep Medicine.     

False positives in psychiatric diagnosis: implications for human freedom

Current symptom-based DSM and ICD diagnostic criteria for mental disorders are prone to yielding false positives because they ignore the context of symptoms. This is often seen as a benign flaw because problems of living and emotional suffering, even if not true disorders, may benefit from support and treatment. However, diagnosis of a disorder in our society has many ramifications not only for treatment choice but for broader social reactions to the diagnosed individual. In particular, mental disorders impose a sick role on individuals and place a burden upon them to change; thus, disorders decrease the level of respect and acceptance generally accorded to those with even annoying normal variations in traits and features. Thus, minimizing false positives is important to a pluralistic society. The harmful dysfunction analysis of disorder is used to diagnose the sources of likely false positives, and propose potential remedies to the current weaknesses in the validity of diagnostic criteria.