Does the philosophy of medicine exist? A commentary on Caplan

Caplan has argued that the philosophy of medicine does not exist. Although I will not deny the points he makes, I will argue that the philosophy of medicine has characteristics of a developing field with the potential to meet all of Caplan's criteria. The argument is based on Dewey's established views on logical development for a field of inquiry, as well as pointing out how other criteria Caplan imposes can be fulfilled.The U.S. Government right to retain a non-exclusive, royalty free licence in and to any copyright is acknowledged.     

What's disclosed in self‐disclosures? Gender,sexuality, and the analyst's subjectivity commentary on paper by Samuel Gerson

It seems it would be helpful for all impasses to be “recollected in tranquility.” In the thick of impasses, however, when we are experiencing pressure, defensiveness, vulnerability, and the responsibility to come up with a quick solution, it can be nearly impossible to think clearly.

Time may take us to a place of greater calm and fresh awareness. But it may also provide an illusory calm, leaving us stuck circling in old familiar grooves, grooves rimmed by our own unconscious vulnerabilities and limitations. At such times, we may operate in a perceived state of calm, but with a set of powerful, yet ineffective, unseen or outgrown, concretized beliefs and perceptions, creating a perception of calmness. Some of these may even silence or damage the cooperative or struggling patient, who remains or dares to return (out of a longing to connect or make things “right”).

I wondered whether what Dr. Pizer's patient said at the end of Rebecca's second therapy with him was true (that she no longer needed a hug from him, finding it more mature to proceed without one), or if this was merely what she felt she should say in order to leave a key relationship she valued—also in peace and tranquillity.     

The essential invisibility of trauma and the need for repetition commentary on Shabad's “resentment,indignation, entitlement”;

This paper assesses the implications of Grünbaum's critique of Freud's “science”; for a discussion of the relation between theory and practice in psychoanalytically oriented psychotherapy. Guided by the work of the French sociologist, Bourdieu, it places Grünbaum's argument within a logic of intellectualism—a framework that tends to instrumentalize reason and romanticize practice, delineating the well‐known territories of objectivism and subjectivism. Grünbaum's arguments within this logic are taken to be rhetorical maneuvers—such as valorizing the tally argument and then debunking it—aimed at rejuvenating an objectivistic approach to theory and practice. Grünbaum is successful insofar as much of the debate generated by his views accepts the terms of his intellectualist bias. It is suggested, however, that these are terms that have long been suspect; that, indeed, it was Freud who helped bring them into question; and that there is a broader framework of discourse that relativizes intellectualism within a dialectical opposition to “participationism.”; A form of rationality founded in a nonconceptual knowledge of practice has begun to emerge within this more inclusive discourse under such rubrics as “social constructivist”; and “relational”; approaches to psychotherapy. It is argued that within the therapy situation a kind of “practical reason”; can mitigate the controlling, instrumental authority of intellectualism as well as the collusive, sentimental servility of participationism.

[T]he theoretician's claim to an absolute viewpoint, the “perspec‐tiveless view of all perspectives”; as Leibnitz would have put it, contains the claim to a power, founded in reason, over particular individuals, who are condemned to error by the partisan partiality of their individual viewpoints [Bourdieu, 1990, pp. 28–29]1 ^lThe work of sociologist Pierre Bourdieu (1977, 1990; Bourdieu and Wacquant, 1992) focuses on a scientific study of human interaction that is cognizant of the pitfalls of the conflicting poles within intellectualism of “objectivism”; and “subjectivism"—both of which are rejected. and redefined relative to the recognition of a distinct “logic of practice.”; I hope that the perceived significance of this work to the understanding of psychoanalytic practice will justify my extensive use of quotations.      

Hyperactivity from fluorescent lighting — Fact or fancy: A commentary on the report by O'Leary,Rosenbaum, and Hughes

The following commentary is designed to explain the experimental differences between the foregoing negative article by O'Leary, Rosenbaum, and Hughes and the original articles in this field, whose results were positive. These differences fall under the general categories of subjects, lights, measurements, and design.     

Working through the question of the phallus to the other side commentary on Bracha Lichtenberg‐Ettinger's paper

The work of Bracha Lichtenberg‐Ettinger implicates psychoanalysis as a political, clinical, and aesthetic project and draws theoretically from each of these domains. As part of her challenge to psychoanalysis, Lichtenberg‐Ettinger questions the Lacanian and Freudian preoccupation with the phallus. She queries the degree to which the psychical amplification of the phallus remains blindly tied to the penis and a masculine incarnation. She supplements this phallogocentric positioning with the concept of a matrixial subjectivity grounded in the intrauterine coexistence of mother and child. The womb and its possibilities indicate another relationship between the I and the non‐I based on forms of relating that do not revolve around the dichotomy of exclusion and merger. As part of her critique of phallogocentrism, the author repudiates the absoluteness of a phallic presence versus castrated absence and the binaries in conceptualization to which this configuration leads.

The following commentary is deeply in sympathy with this project and appreciates the great reach of Lichtenberg‐Ettinger project. Her project requires great care, however, as it tries to redefine formations of subjectivity through the Real of bodily difference. Further, it is not fully clear how matrixial subjectivity is situated with respect to certain questions raised by the phallus. More specifically, if the phallus represents a moment that structures one's relationship to speaking and to repression, a clearer articulation of the place of these moments in a matrixial subjectivity might create a more productive dialogue with the most innovative aspects of Lacanian psychoanalysis.     

The import of infancy for individual, family, and societal development: commentary on the special section: does infancy matter?

Across their life spans humans actualize a rich potential for cognitive and behavioral plasticity, a set of developmental changes that require regulation of organism-context relations on the part of both the individual and society. An individual’s action on the context must be started in infancy and maintained in subsequent periods of life for adaptive functioning to occur across ontogeny. The process of the individual acting as an agent of his or her own development is continuous, although the particular ways in which such control is manifested will change in developmentally appropriate ways. As demonstrated by the papers in this special issue, the significance of infancy for the rest of the life-span rests on an integration of this continuity and discontinuity within the person-context developmental system.     

Siblings’ appearance-related commentary,body dissatisfaction,and risky eating behaviors in young women

IntroductionNegative feedback on appearance is a risk factor for the development of problems related to one's body image.ObjectiveThe present research aimed to analyze the relationship among siblings’ positive and negative appearance-related feedback, dissatisfaction with one's body and risky eating behaviors among young women. The mediational role of body-related social comparison has been investigated.MethodTwo hundred and eight young women living in Italy, with a mean age of 23.15 years, filled in a questionnaire containing the Italian version of the Verbal Commentary on Physical Appearance Scale – Siblings, the Physical Appearance Comparison Scale, the Body Shape Questionnaire-14, and the Eating Disorder Examination-Questionnaire.ResultsDissatisfaction with one's body shows a significant link with risky eating behaviors. Weight and shape-related positive comments made by siblings were significantly and negatively related to social comparison, which in turn was associated with women's dissatisfaction with their body image. Negative comments were directly linked to body dissatisfaction; the mediation role of social comparison with respect to negative comments was not confirmed.ConclusionsThese findings underline the significant role of siblings in the development of females’ body image. Programs aimed to prevent or reduce body dissatisfaction and risky eating behavior could be implemented; these programs should be concerned with not only negative feedback on appearance but also positive comments because of their relevant role.     

Carson Strong's “positive killing and the irreversibly unconscious patient”: A commentary

There is general agreement that death of the entire brain results in death of the person, and that such a condition can exist in a body which is still technically “alive.”1,2 Dr. Strong additionally contends that in cases of irreversible coma, since cognitive abilities characteristic of the person are no longer manifest and cannot be expected to reappear, such an individual no longer has the “right to life” and somatic death can be initiated by “positive killing.” This, the author claims, can be considered a logical and morally acceptable extension of the conceptual framework now in force for dealing with cases of isolated brain death.     

A personal commentary on J.W. Perry,M.D., and introduction to ‘Reconstitutive process in the psychopathology of the Self’

John Weir Perry’s influence on the understanding of the psychotic process through his research in San Francisco between 1950 and 1981 was groundbreaking, because it both verified and expanded upon C.G. Jung’s research at the Burghölzli Hospital in Switzerland in the early 1900’s. The author explores both the brilliance of Perry’s contribution as a psychiatrist and Jungian analyst and also shows the flawed human, who, with his rare sensitivity to the psychotic process, devoted his life work to the schizophrenic population and their often ill-fated search for meaning. She tells how his creative engagement with the analytic processes of Self discovery eventually led to analytic boundary violations, which ultimately resulted in his indefinite suspension from membership in his local Jungian community. Further, this paper describes her reflections on the innovative work that influenced both the treatment of this population, as well as educating candidates in analytical training to be receptive to and cognizant of psychotic affects and imagery. The archetypal field of the psychotic process, its influence on the development of analytical psychology relative to the psychotic process, and one man’s impact on the analytic community are considered.     

Do the same social mechanisms explain bullying in different classrooms? A commentary on Madhavi & Smith and Atria,Strohmeier, & Spiel

This paper reviews two studies on between-classroom variation in bullying by Mahdavi and Smith and by Atria, Strohmeier, and Spiel in this issue. Both studies demonstrated large variability between classrooms in the prevalence of bullying and the distribution of participant roles. The authors of the original studies consider this variability at odds with the influential participant roles and scapegoating approaches to bullying. In contrast, this review proposes that the essence of these theoretical approaches is to explain variance, both within and between classrooms, and over time. More explicit theorizing concerning determinants of between-classroom variance and assessment of classroom-level variables implicated by this theorizing are called for.     

Conflicting interests and the creation of a “third space”; reply to commentary

This paper addresses how to be an available and responsive therapist to a controlling and narcissistically vulnerable young girl. It presents an overview of the treatment relationship and specific vignettes from sessions. The paper describes an impasse that posed a quandary: how to find a balance between staying in control of the treatment while being responsive to the kind of object the child needs the therapist to be—being empathic without being intrusive—and meeting her aggression without getting into a power struggle. The author discusses how asserting her subjectivity by playfully role-playing aspects of the patient, by spontaneously using humor, and by surviving her destructiveness allows the treatment to move forward. Trial and error, reflection on practice, and informed intuition contributed to the author's understanding of the child and of the transference. Various theoretical perspectives influenced the work.     

How to play the flute: A commentary on Dreyfus's “Intelligence without representation”

Phenomenology and the Cognitive Sciences -     

When does algorithmic decomposition help? commentary

Algorithmic decomposition is a way of extending thinking. It will help when thinking is otherwise poor, and it may hinder when thinking is otherwise adequate. It may help decision making more than it helps numerical estimation.