Coalition – creation – church*

Taking the recent UN Report about extreme poverty in the UK as a point of departure, this article analyses and assesses William Cavanaugh’s political ecclesiology. Drawing on the interpretation of Martin Luther’s concept of creation in Scandinavian Creation Theology, I argue that creation destabilises the distinction Cavanaugh draws between what he considers to be church and what he considers not to be church. I account for creation as a web of vulnerability in which all creatures are vulnerable to both creature and creator. In contrast to Cavanaugh’s strong and stable church, I advocate for what I call “coalitional church”: a church that can enter into coalitions with Christians and non-Christians in order to call for conditions under which vulnerable life is liveable. The public and political task of churches is not necessarily to fight the state, but to hold the state accountable to its citizens, whether they are Christian or non-Christian.     

Charakterpathologie – Persönlichkeitsorganisationen – Strukturniveaus

Following the recent development of special treatment for people with defective ego structures, the diagnosis of ego structures has become highly relevant. Four models, developed during the last 40 years for the differentiation of particular levels of the ego structure are presented: the classification of character pathology (Kernberg 1966), the personality organisations (Kernberg 1977 and 1996), the structure axis of the OPD (Operationalized Psychodynamic Diagnosis 1996) and the personality organisations of the STIPO (2006). Because the levels of character pathology, the personality organisations as well as the structural levels of the OPD are widely used and the last two often even in parallel, it is worthwhile comparing them concerning their strengths, weaknesses and compatibility. It turns out that especially the categories between the neurotic and the borderline personality organisation (Kernberg 1977) show significant differences. The fact that the OPD as well as the STIPO pay much more attention to these levels as the models of personality organisations also do, is to be considered because of its great clinical significance as an advantageous innovation. In addition, both instruments offer the possibility to assign different structural levels to particular dimensions and, due to their operationalization, assure comparability and allow change measurement.     

Leonid Stolovich,Filosofija – Estetika – Smekh

Studies in East European Thought -     

Verachtung – eine Gefühlsbestimmung – Teil 1

Es scheint beliebtere Gefühle zu geben, beispielsweise den Ekel – bemisst man Beliebtheit an der Publikationst?tigkeit zum Thema. Das Gefühl der Verachtung hingegen findet vergleichsweise wenig explizite Resonanz in der Fachliteratur und bietet auch physiologisch wenig Erkl?rungsans?tze. Dieser Text tr?gt in zwei Teilen Beschreibungen, Erkenntnisse und überlegungen zusammen, um kaleidoskopisch Aspekte dieses Themas auf-scheinen zu lassen.     

Zwangsbehandlung – eine Zwischenbilanz

Each medical treatment encroaches on patient rights; therefore, every patient has the right to freely decide whether to be treated or not and has the freedom to refuse treatment even if it is unreasonable from a medical perspective. The law acknowledges this freedom even if the patient is incapable of responsible self-determination as a result of (mental) illness. Treatment contrary to the patient’s declared intentions (“Zwangsbehandlung”—compulsory treatment) is allowed only under specific, strict circumstances. These requirements must be legally established in a clear and precise manner. On the basis of a number of cases concerning compulsory treatment with drugs of patients in a forensic psychiatric hospital, the Federal Constitutional Court therefore established specific guidelines. The Federal legislators and some state legislators have generally implemented these guidelines, even with reference to partly different settings, but considering the fact that these guidelines were related to a special treatment situation they also found differing solutions to some extent. Nevertheless, there are significant regulatory gaps remaining which in particular relate to the treatment of somatic diseases of psychiatric patients.     

Psychoedukation – zusammen weniger allein

Das Anbieten psychoedukativer Trainingsprogramme ist State-of-the-Art der medizinisch-therapeutischen Behandlung von Menschen mit psychischen St?rungen. Psychoedukation sollte gleich zu Beginn der psychischen Erkrankung erfolgen und auch den Angeh?rigen oder nahen Bezugspersonen erm?glicht werden. Erwiesenerma?en ist eine Kombination aus Medikamenten und den Gruppenangeboten Psychoedukation sowie Selbsthilfe am erfolgversprechendsten für den Krankheitsverlauf. Durch psychoedukative Trainingsprogramme wird nicht nur die Lebensqualit?t der Patienten gef?rdert, sondern auch das Wissen um die Erkrankung und ihre Früherkennung. Die Patienten lernen in der Psychoedukation wie sie bei einer drohenden Wiedererkrankung reagieren mussen, um diese rasch abzufangen. Die Wichtigkeit der verschiedenen psychoedukativen Trainingsprogramme für einen günstigen Krankheitsverlauf wurde in zahlreichen Studien untersucht und immer wieder best?tigt.     

Panikattacken – mTGT ohne Pharmakotherapie

Only a limited number of medical studies referring to Animal Assisted Therapy have been published worldwide. The specific concept of medically oriented Animal Assisted Therapy (mAAT) was developed by the Austrian Institute for Animal Assisted Therapy & Research (AIAATR), based north of the city of Krems/Donau in Lower Austria, as a nonpharmacological treatment method for patients with mental or psychological overload. This particular case study describes a 30-year-old female academic who had been brought to the institute by her concerned neighbour because of repeated panic attacks. Despite extensive briefing, the patient vehemently refused any pharmacological intervention. Therefore, two-step management starting with an acute phase therapy of two therapeutic units (ThU), 90 min each over 5 days – during this period the patient stayed at the patient appartement of the institute – followed by a regular treatment cycle of 1 ThU/week over 12 weeks was selected. The HAMA-21 was used to evaluate treatment quality, therapy progress, and success. A total score of 30 at the beginning declined to 3 at the end of treatment.     

Truth as Translation – Part B

This is the second part of a paper dealing with truth and translation. In Part A a revised version of Tarski's Convention T has been presented, which explicitly refers to a translation mapping from the object language to the metalanguage; the vague notion of a translation has been replaced by a precise definition. At the end of Part A it has been shown that interpreted languages exist, which allow for vicious self-reference but which nevertheless contain their own truth predicate – this is possible if truth is based on a nonstandard translation mapping. However, this result has only been proved for languages without quantifiers. In Part B we now extend the result to first-order languages, and we show that this can be done in three different ways. In each case, the addition of a truth predicate to an interpreted language with a high degree of expressiveness leads to changes in the ontology of the language.     

Therapieresistente Depression – eine differenzialdiagnostische Herausforderung

Background

Diagnosis and treatment of major depression is part of daily routine in psychiatric practice. We therefore rely on the latest ICD-10 and the described symptoms. However, is this decision always obvious, and which differential diagnostic considerations should be made, especially for patients with treatment-resistant depression or in elderly patients?

Method

A clinical case report is described, taking into consideration the results of a literature search and national and international guidelines.

Results

Major depression is usually part of daily routine in the psychiatric hospital. It is one of the most common diagnoses; the estimated lifetime prevalence of unipolar major depression is 12?% and continues to increase. But what should be done, if symptoms continue to deteriorate, despite guideline-based treatment? The following case report shows that in this situation further diagnostic procedures are needed and necessary. An 80-year-old man is transferred to a psychiatric ward because of depressive symptoms. Despite adequate treatment, the psychiatric state deteriorates. Finally, the diagnosis of normal pressure hydrocephalus (NPH) is made with the direct consequence of further treatment options. Especially the possible overlap of symptoms for depression, dementia, and NPH are shown, thus, making the differential diagnosis challenging.

Conclusion

In 80?% of cases, NPH remains unrecognized and untreated. Similarities in the symptoms lead to the difficulty of distinguishing NPH from other neurodegenerative disorders and, as in this case report, also from major depression. In case of NPH, early diagnosis and treatment are important because if the disease is too advanced, clinical improvement is unlikely. Therefore, in cases of treatment-resistant major depression it is advisable to perform additional diagnostic tests and to consult with interdisciplinary neurology and neuroradiology teams.     

Mass Effect – 1st Place

Journal of Medical Humanities -     

Flat intentions – crazy dispositions?

Future-directed intentions, it is widely held, involve behavioral dispositions. But of what kind? Suppose you now intend to Φ at future time t. Are you thereby now disposed to Φ at t no matter what? If so, your intention disposes you to Φ even if around t you will come to believe that Φ-ing would be crazy. And would not that be a crazy intention to have? – Like considerations have led Luca Ferrero and others to believe that only intentions with strong internal conditions are capable of rationality. This paper explores in how far a broadly dispositional view of intention supports their claims. Its first point will come as a surprise: Intentions indeed involve dispositions toward follies in plenty. Natural objections against this bizarre-sounding claim are shown to fail, and standard counterfactual analyses of disposition locutions are shown to underpin it further. However, since the dispositions at issue are pro tanto dispositions, the consequences are not as odd as might be expected: When hedged by reasonable habits to reconsider one’s intentions, dispositions toward follies do not entail any actual crazy behavior. On balance, unconditional intention is therefore found rational after all. Dispositions toward crazy actions need not be crazy dispositions.