Replies to Timmerman and Gorman

In my reply to the thoughtful comments of Timmerman and Gorman, I take up, and further explore, some main questions, including: Can a horribly immoral person (a moral monster) lead a meaningful life? Similarly, can a significantly deluded person lead a meaningful life? What role do judgments of meaningfulness play in our normative framework? How can we understand the debate between those who would embrace the possibility of immortality and those who would reject it? What is the role of narrativity in evaluating meaning in human lives, and how would this concept apply to immortal lives? If death can be a bad thing for the deceased, should we fear death (the status of being dead)?

     

AIDS counselling in the context of the terrence higgins trust

The Terrence Higgins Trust provides counselling and support services for people who are affected by HIV. Counselling involves enabling people to unlock feelings and find ways in which to deal with them. Counsellors need to be able to listen non-judgetnentally. To listen and really hear what the client is saying, and also to what is not being said.

‘Being there’ involves dealing with one's own feelings about disability, death, dying, sex, sexuality, anger and so on. Counsellors also have a responsibility to look after their own needs. This means getting regular supervision to discuss the work they are doing and their feelings about this.

Counselling people living with, or affected by HIV brings up feelings of helplessness, anger, fear, grief and despair, but with this comes joy, amazement and wonder at the power and magic in all human beings.     

In defence of the concept of ‘spiritual education’: a reply to Roger Marples

In a paper published in Volume 11, no. 2, of this journal, Roger Marples argued that the term ‘spiritual education’ is at most superfluous and at worst entirely meaningless. He suggested that the use of the term is unhelpful and will continue to be so unless and until we can identify some body of spiritual knowledge and understanding, linked to experience, which is distinct from, and in some sense ‘beyond’, those of moral, aesthetic and other forms of experience.

This paper critique's Marples's thesis. It examines his ploy of admitting only certain forms of knowledge and understanding, and of privileging certain languages, when determining the rules of engagement with the concept of ‘the spiritual’. It is further argued that to require some empirical evidence in the form of personal experience before the words ‘spiritual’ and ‘spiritual education’ can be meaningful is fundamentally misguided. In conclusion, it is suggested that a willingness to embrace the spiritual as concept, experience and awareness is essential to the education of the child as a whole person.     

Augustine and education in critical thinking

Augustine's concept of the deep self provides a basis for a complex and many‐faceted account of critical thinking. He uncovers the moral sources of thinking in the inner depths of the self and shows that critical thinking presupposes radical self‐reflection ready to face the truth about oneself. Self‐knowledge assumes transparency, consciousness of the corrupt desires and prejudices that distort one's thinking. Unresolved guilt endangers transparency and thereby makes it difficult to become aware of the vices distorting one's perspective on reality. That is why human beings need divine grace that gives them the courage to face their corruption.

For Augustine, the problem of critical thinking is part of a larger problem about how the human self and identity are formed, which factors influence the process, and how a person comes to know herself. Augustine writes an open account of his life in order to clarify this problem. His intention is to make sense of the nature of his self by thinking carefully who he is and how he became who he is.

Augustine seeks to find an answer to this question both philosophically and autobiographically, by analysing the factors that influenced the formation of his own identity and the development of his self‐knowledge and by reflecting philosophically on the nature of these influences. Reason is one essential part of the human soul. Since God has given reason to human beings, it must have a purpose. Augustine seeks to clarify this purpose by reflecting on fundamental epistemological questions: What is knowledge and where does it come from? What is the relationship of human reason to knowledge? How can one reach ultimate knowledge?

According to Augustine, human reason and perception have been formed to acquire knowledge about reality. If God had not made human reason and perception fitting for their task, knowledge would be completely unattainable. Since God has made human reason capable of acquiring reliable knowledge, reason has an important task in the spiritual development of human beings. It is especially useful when trying to make clear conceptual distinctions.

Reason does not, however, function independently of the will and the emotions. For reason to acquire a reliable grasp on reality and to understand things properly, the human heart must love the truth, the good and the right sufficiently to face its own prejudices and to gain self‐knowledge.

Critical thinking has, therefore, certain crucial preconditions, according to Augustine. The aim of this article is to clarify the structure of these preconditions. (1) In order to think critically, one has to distinguish between how reality appears to one and how it is in fact. (2) There is a close connection between willing and thinking, between one's deepest desires and one's view on reality. (3) One cannot distinguish reality from appearances unless one realizes how corrupt desires and prejudices distort one's perspective on reality. (4) In order to be able to face one's evil desires and become conscious of their distorting influence, one needs the courage to face one's depravity. Such a courage presupposes God's grace and his promise of forgiveness, since without divine grace human beings try to cover up the truth about themselves and remain unconscious of the distorting influence of their evil desires. (5) One needs a source of light that enlightens the deep recesses of the self and shows it in the true light but is yet external to the human being and independent of him. (6) This source of inner light has to be of a personal nature to provide the learner with the possibility of inner dialogue. Augustine assumes that God is the inner teacher of every human being. A crucial factor in the development of critical thinking is that one becomes more dialogically engaged with the inner teacher.     

Normative Embodiment. The Role of the Body in Foucault's Genealogy. A Phenomenological Re-Reading

In Foucault's later works, experience and embodiment become important for explaining the normative constitution of the subject: for norms to be effective, discourses are insufficient – they must be experienced and embodied. Practices of “discipline” inscribe power constellations and discourses into subjective experience and bodies. In his lectures on the Hermeneutics of the Subject, he turns this “violent” form of normative embodiment into an ethical perspective by referring to the Stoic tradition. Even though Foucault never developed a notion of experience and embodiment himself, his ideas can be re-read and complemented from a phenomenological perspective.

The article tries to investigate the role of bodily experience and practice in Foucault's Genealogy and to bring it into dialogue with Husserl and Merleau-Ponty's conceptions of the lived body. It will attempt to show that concepts like sedimentation and habituality can help to explain how cultural norms not only influence the way we think about, but also how we perceive and are affected by the world. This operation of norms happens already at the lowest stages of experience, where embodied experience leaves its traces, in sedimentation and habitualization. These passive layers of experience are permeable to historical discourses, so that norms are literally inscribed in the body. These are the foundations for what I seek to define as normative embodiment.     

The non-symbolic level of psychical reality

Freud introduced the concept of psychical reality as a consequence of abandoning the theory of seduction, and although this meant a turning point in his theoretical thinking he never defined the concept concisely and systematically. Thus it is possible to delineate at least two meanings of psychical reality that run through Freud´s writings as well as the writings of contemporary analysts. On the one hand psychical reality encompasses the whole field of subjective experiences. On the other, it is understood more narrowly as a transformation of experiences in the unconscious.

Substituting the idea of different meanings ascribed to Freud´s concept this article proposes to differentiate between levels in the psyche with the main focus on the unconscious level of the dream and of phantasy and the real unconscious. Starting from the most superficial level of subjective reality the text moves to that of fantasy formation illustrated by primarily Freud´s text on `A child is being beaten´. Adding Laplanche´s translational model the article ends up at the deepest level represented by the late Lacan and his concept of the real Unconscious.

The paper concludes that the term real points to something exceeding symbolization and the imaginary—thus escaping comprehension—and yet is absolutely indispensable to the organization of unconscious processes.     

More than Information: A Christian Critique of a New Dualism

In light of quantum theory and advances in computer science, scientists have posited that it is information, rather than matter, that forms the bedrock of the universe. Thus it follows that the essence of our selves as human beings is simply the information housed in the neural connections of our brain. If this is so, then the self could be reproduced digitally. Such a cybernetic immortality introduces a new Cartesian dualism that separates mind from body, locating the self wholly in the mind.

This view contrasts with the traditionally Christian view, that humans are created and best understood as being in the image of God—an image found in our rational intellect, our embodied agency, and our relationships. Our sense of self is incomplete without all three. We are neither just a mind nor just a body, but a mind that is both part and product of our human body, embedded within the larger environment of the physical world and human culture. Our knowledge, functioning, and self-understanding is shaped and acquired by and through our bodies. Without a body, we also cannot feel emotion, and thus have neither human-like intelligence nor compassion. The dreams of cybernetic immortality fail to capture the full nature of what it means to be human and are illusory hopes for a form of immortality not requiring the action of a supernatural being. Any hope for immortality is best found, as Niebuhr noted, beyond the scope of history. Further, this new dualism leads us to grandiose delusions—Niebuhr's sin of pride—regarding what we can accomplish in the here and now, delusions that are harmful to both our sense of self and to our capacity to love one another.     

Death Education in the Primary School [1]

Death Education, a common component of Religious Education (RE) and Personal and Social Education (PSE) at secondary level, is an issue beginning to raise its head within the field of primary education. Is there justification for death, a topic normally a taboo, to be taught about in the primary school? Is death education beneficial for children and are children aged 9‐11years capable of discussing such an abstract concept as the afterlife?

This article attempts to justify the teaching of death education at primary level. It examines research that proposes death education is of relevance to children and suggests, from examining children's conception of the afterlife, that children at the upper end of the primary school are capable of discussing the afterlife and thus of thinking abstractly.     

Parent Grief 1–13 Months After Death in Neonatal and Pediatric Intensive Care Units

Objective. Describe changes in mothers’ and fathers’ grief from 1 to 13 months after infant or child neonatal or pediatric intensive care unit death and identify factors related to their grief.

Methods. Mothers (n = 130) and fathers (n = 52) of 140 children (newborn–18 years) completed the Hogan Grief Reaction Checklist at 1, 3, 6, and 13 months postdeath.

Results. Grief decreased from 3 to 13 months for mothers and from 3 to 6 months for fathers. Grief was more intense for mothers of deceased adolescents and mothers whose children were declared brain dead.

Conclusion. Mothers’ and fathers’ grief intensity may not coincide, resulting in different needs during the 13 months after infant or child death.     

Working psychodynamically and psychosocially with women who have been raped

In this paper, I analyse aspects of the experience of some female University students who have been raped drawing on a Kleinian psychoanalytic perspective and Layton’s concept of ‘normative unconscious processes’. I suggest that Klein’s writing provides a theoretical basis for thinking about the projective and introjective processes that may be at play between perpetrator and ‘victim’. Here, I focus upon Kleinian conceptualisations of castration anxiety, fragmentation, envy, greed and guilt. In terms of ‘normative unconscious processes’, I explore how castration anxiety (in a more symbolic sense of powerlessness), fragmentation, envy, greed and guilt may also operate within social discourses around sexual violence. Specifically, I draw upon Freyd’s concept of DARVO and Payne’s Rape Myth Acceptance Scale which both explain ‘victim blaming’ in terms of the social reversal of the positions of perpetrator and ‘victim’. I illustrate this social process with reference to representations of rape within the mainstream media. My hypothesis is that, although the ‘psychic’ and the ‘social’ are two contrasting positions theoretically, it is possible to draw on both of them to make sense of the experience of working with rape clinically.

The clinical context of this paper is my work as a psychodynamic counsellor at a modern London-based University. I draw on composite case studies of women who have been raped, drawing on both ‘psychic’ and ‘social’ perspectives. I seek to explore how the ‘psychic’ and the ‘social’ can be integrated in different ways depending upon the clinical situation. I suggest that they can be mutually enriching ways of working. Through approaching how the ‘psychic’ and the ‘social’ might interrelate from a clinical viewpoint, I conclude that the idea of ‘working psychosocially’ is of most use when approached as a flexible concept that different clinicians may draw on in different ways with different patients.     

Treatment Adherence Among War Veterans with Posttraumatic Stress Disorder: A Concept Analysis

Aim: This study was made to analyze the concept of treatment adherence among war veterans who suffer posttraumatic stress disorder.

Methods: This concept analysis was done using Walker and Avant’s concept analysis model. Online English and Persian databases were searched using keywords such as “posttraumatic stress disorder,” “mental disorder,” “compliance,” and “adherence.” Finally, 11 eligible documents were included in the analysis. The retrieved articles were perused word-by-word, line-by-line, and paragraph-by-paragraph in order to arrive at an in-depth understanding about their contents. Then, the obtained excerpts from the articles, which were relevant to the study subject matter, were coded. The codes were then grouped into the antecedents, consequences, and attributes of the concept.

Findings: In total, 122 primary codes, 19 subcategories, 8 main categories, and 4 main themes were extracted. The main antecedents of the treatment adherence concept are patients’ personal health background and the attributes of posttraumatic stress disorder and its treatments while its main outcome is the changes in the quality of life. Moreover, the main attribute of adherent veterans is that they take responsibility for their own health and subsequently attempt to plan for health promotion.

Conclusion: The concept of treatment adherence among war veterans who suffer from PTSD is a complex and relative concept which depends on patients’ personal health background as well as the attributes of the afflicting disorder and its treatments. The concept is manifested by patient’s attempts to plan for receiving or parting with treatments and can result in changes in health-related quality of life.     

A systematic review of the relationship between religion and attitudes toward transgender and gender-variant people

Background: Prejudice against transgender people is widespread, yet in spite of the prevalence of this negativity relatively little is known about the antecedents and predictors of these attitudes. One factor that is commonly related to prejudice is religion, and this is especially true for prejudice targets that are considered to be “value violating” (as is the case for transgender individuals).

Method: In this paper, we present the findings of our systematic search of the literature on this topic and present the synthesized evidence. Our search strategy was conducted across five databases and yielded 29 studies (across 28 articles).

Results: We found consistent evidence that self-identifying as with either being “religious” or as Christian (and to a lesser extent, being Muslim) was associated with increased transprejudice relative to being nonreligious (and to a lesser extent, being Jewish). Additionally, we found consistent evidence that certain forms of religiosity were also related to transprejudice – specifically religious fundamentalism, church attendance, and interpretations of the bible as literal (transprejudice was unrelated to religious education).

Conclusion: Although this young, but important field of research is growing, more empirical exploration is needed to fully understand that nuances of the religion-transprejudice relationship.     

Dyadic coping mediates the relationship between parents’ grief and dyadic adjustment following the loss of a child

Background and Objectives: This study aimed to examine forms of dyadic coping (DC) as mediators of the association between parents’ grief response and dyadic adjustment and to determine whether these indirect effects were moderated by the child’s type of death, timing of death, and age.

Design: The study design was cross-sectional.

Method: The sample consisted of 197 bereaved parents. Participants completed the Prolonged Grief Disorder Scale, Revised Dyadic Adjustment Scale, and Dyadic Coping Inventory.

Results: Significant indirect effects of parents’ grief response on dyadic adjustment were found through stress communication by oneself and by the partner, positive and negative DC by the partner, and joint DC. The timing of death moderated the association between grief response and dyadic adjustment and between joint DC and dyadic adjustment. Grief response was negatively associated with dyadic adjustment only when the death occurred after birth. Grief response was negatively associated with joint DC, which, in turn, was positively associated with dyadic adjustment, when the death occurred both before and after birth. However, the association was stronger in the latter.

Conclusions: Specific forms of DC might be mechanisms through which grief response is associated with dyadic adjustment and should be promoted in clinical practice.     

Negotiating faith and identity in Muslim–Christian marriages in Britain

Marriage between Muslim men and Christian or Jewish women has been a recognized though controversial phenomenon through Islamic history. Qur'anic permission is given (Q 5:5) but the normative condition in Shari^ca is that Islam should predominate over another faith, particularly in the identification of children.

In Britain and other Western countries the prevailing cultural and legal context of autonomy in relationship formation and choice of marriage partner means that Muslim–Christian marriages may happen without conformity to religious rules or familial preference, for example in the case of Muslim women marrying non-Muslim men. Nevertheless, amongst those surveyed, Muslim identification remained strong even where marriages were deemed transgressive.

Amongst Christian partners, faith identification (of parents and children) was more likely to be treated as autonomous and personally negotiable in the context of marriage.

The experience of hybridity and liminality in these marriages may influence attitudes to faith itself and there was evidence of both ‘universalizing’ and ‘particularist’ faith responses amongst couples.     

Barriers and facilitators of physical activity and sport participation among young transgender adults who are medically transitioning

Background: Transgender people (those who feel incongruence between the gender they were assigned at birth and their gender identity) engage in lower levels of physical activity compared to cisgender (non-transgender) people. Several factors have been shown to affect physical activity engagement in the cisgender population; however, the physical activity experiences of young transgender adults have not been explored. It is therefore the aim of the current study to understand what factors are associated with physical activity and sport engagement in young transgender adults who are medically transitioning.

Method: Semi-structured interviews were conducted with 14 young transgender adults (18–36 years) who had initiated their medical transition at a transgender health service in the United Kingdom. The data were analyzed using thematic analysis.

Results: Two main themes were identified: (1) barriers and (2) facilitators to physical activity and sport. Overall, the young transgender adults were insufficiently active due to inadequate changing facilities, body dissatisfaction, fears surrounding “passing” and not being accepted by others. At the same time, participants were motivated to engage in physical activity to increase their body satisfaction and gender congruence. However, participants felt there was a lack of safe and comfortable spaces to engage in physical activity and sport.

Conclusion: Young transgender adults who are medically transitioning experience several barriers to physical activity and sport, despite being motivated to be physically active. Initiatives to facilitate young transgender adults' ability to put their motivations into practice (i.e. to be more physically active) are needed.     

Jivacide,Zombies and Jivanmuktas: the meaning of life in the Bhagavad Gitā

In discussing the meaning of life in the Bhagavad Gitā two obvious questions arise: first, what is the meaning of ‘the meaning of life'?, and second, how does that meaning apply to the Bhagavad Gitā? In Part I of this brief paper I will attempt to answer the first question by focusing on one of the common meanings of that phrase; in Part II, I will apply that very common meaning to the Bhagavad Gitā; and in the third and final part, I will point to a puzzle, the paradox of the jivanmukta, that would seem to follow from the discussion in the first two parts of this paper.

My own feeling is that the concept of ‘the meaning of life’ is a Western invention [1]. This being so, perhaps it would be wise to probe for that concept and its meaning among Western authors. We turn first, then, to one ancient writer, Aristotle of Stagira, and conclude Part I with a modern writer also concerned with the meaning of life, Albert Camus.     

Caregiving in multiple sclerosis and quality of life: A meta-synthesis of qualitative research

Objective: The lack of adequate conceptualisation and operationalisation of quality of life (QoL) limits the ability to have a consistent body of evidence to improve QoL research and practice in informal caregiving for people with multiple sclerosis (MS). Thus, we conducted a meta-synthesis of qualitative research to improve the conceptual understanding of the experiences of MS carers and to identify factors that affect carers’ QoL.

Design: Systematic searches of five electronic databases yielded 17 qualitative studies which were synthesised using the principles of meta-ethnography.

Results: The synthesis resulted in nine inter-linking themes: Changes and losses; challenges revolving around MS; caregiving demands; burden of care; future concerns; external stressors; experiences of support; strategies used in managing the caregiving role; and motivating factors. Our findings suggest that MS carers can have both positive and negative experiences which may bring challenges and rewards to the carers.

Conclusion: We present a proposed QoL model for MS caregiving which can be used to inform the development of interventions for MS carers to improve their QoL. However, further empirical research is needed to examine the utility of this model and to explore the concept of QoL in MS carers in more detail.     

How resilience is strengthened by exposure to stressors: the systematic self-reflection model of resilience strengthening

Background: Exposure to demands is normally considered to drain resources and threaten wellbeing. However, studies have indicated a resilience-strengthening role for stressors.

Objectives: This paper introduces a unifying model, including five testable hypotheses regarding how resilience can be strengthened progressively via exposure to life-stressors.

Methods: We review and synthesize relevant scholarship that underpins the Systematic Self-Reflection model of resilience-strengthening.

Results: The model highlights the importance of a specific meta-cognitive skill (self-reflection on one’s initial stressor response) as a mechanism for strengthening resilience. The Systematic Self-Reflection model uniquely proposes five self-reflective practices critical in the on-going adaptation of three resilient capacities: (1) coping resources, (2) usage of coping and emotional regulatory repertoire, and (3) resilient beliefs. The self-reflective process is proposed to strengthen a person’s resilience by developing insight into their already-present capacities, the limitations of these capacities, and by stimulating the search for person-driven alternative approaches.

Conclusion: This model extends the existing scholarship by proposing how the experience of stressors and adversity may have resilience-strengthening opportunities. The implication of this model is that engaging with stressors can have positive consequences for longer-term healthy emotional development if scaffolded in adaptive reflective practices.     

From Brahmanism to Buddhism

It is argued that early (canonical) Buddhism to a very considerable extent can and should be seen as reformed Brahmanism.

Speculations about cosmogony in Buddhist sÛtras can be traced back to Vedic sources, above all Rígveda 10.129 & 10.90—two hymns that play a similar fundamental role in the early Upanisads.

Like the immortal and unmanifest Brahman and the mortal and manifest Brahmā, the Buddha, as a mythological Bhagavat, also had two forms (or bodies). In his highest form he is “the profound” beyond being and non‐being, like Brahman. As a teacher, he is like Brahmâ. By suppressing mind and by getting rid of desire a Buddhist should “swim” back to the profound beyond the duality of life and death, which is also suffering. One becomes real and true by seeing the causal identity of tat and tvam, i.e. of macrocosm and microcosm. The spiritual ideals of early Buddhism are thus founded on natural philosophy.     

Autonomy deficits as vulnerability for anxiety: evidence from two laboratory-based studies

Background: Autonomous individuals are characterized by self-governance; awareness of and capacity to realize one’s wishes and needs, while being connected with and sensitive towards others. In line with earlier research showing consistent associations between autonomy-connectedness deficits and anxiety, we tested in two studies whether autonomy deficits predict anxious responses to acute stressors.

Methods: In Study 1, participants (N?=?177) viewed an anxiety-inducing film fragment and reported anxiety before and after viewing the clip. In experimental Study 2, participants (N?=?100) were randomly allocated to one of two conditions: giving a short presentation to an audience (impromptu speech task) or watching another person’s presentation (control condition). Anxiety was measured at baseline, after a preparation period and directly after the presentation.

Results: In Study 1, individuals’ anxiety in reaction to watching the movie was positively associated with the autonomy-connectedness component sensitivity to others. In Study 2, individuals’ anxiety in reaction to preparing the presentation was negatively associated with the autonomy-connectedness component self-awareness.

Conclusions: Specific autonomy components may be related to experiencing anxiety in differing situations (i.e., related to others’ distress or presenting one’s personal views). Collectively these results indicate that autonomy-connectedness deficits may form a vulnerability factor for experiencing anxiety.