Connecting adverse childhood experiences and community health to promote health equity

Adverse childhood experiences (ACEs) can have negative effects on health outcomes across the lifespan. Furthermore, the effects of ACEs are often compounded by social determinants of health and historical and contemporary trauma that can affect entire communities. The socio‐ecological model is a valuable framework for understanding the complex systems in which efforts to promote health equity are situated. Using a trauma‐informed lens, community health becomes a powerful focal point for viable prevention and treatment options to address ACEs and promote health equity. Self‐healing on a community level involves collective engagement; people most affected by ACEs and trauma come together around activities that have the potential to lift up the entire community and foster individual and community resilience. The use of community health research and evaluation methods that are consistent with trauma‐informed, empowerment approaches can contribute to community healing. This paper is intended to establish a common language for how community healing can address ACEs and foster health equity.     

“Strong objectivity”: A response to the new objectivity question

Where the old “objectivity question” asked, “Objectivity or relativism: which side are you on?”, the new one refuses this choice, seeking instead to bypass widely recognized problems with the conceptual framework that restricts the choices to these two. It asks, “How can the notion of objectivity be updated and made useful for contemporary knowledge-seeking projects?” One response to this question is the “strong objectivity” program that draws on feminist standpoint epistemology to provide a kind of logic of discovery for maximizing our ability to block “might makes right” in the sciences. It does so by delinking the neutrality ideal from standards for maximizing objectivity, since neutrality is now widely recognized as not only not necessary, not only not helpful, but, worst of all, an obstacle to maximizing objectivity when knowledge-distorting interests and values have constituted a research project. Strong objectivity provides a method for correcting this kind of situation. However, standpoint approaches have their own limitations which are quite different from the misreadings of them upon which most critics have tended to focus. Unfortunately, historically limited epistemologies and philosophies of science are all we get to choose from at this moment in history.     

The capacity to be an analyst: A contribution from attachment research to the study of candidate selection

In this paper the author discusses how the study of candidate selection, once a topic of vibrant research, has unfortunately languished. Certain qualities were thought to characterize the successful candidate. However, they were never successfully operationalized nor empirically tested. Possibly because of this lack of empirical data, selectors today have difficulty articulating their criteria and are relying on intuition. In order to provide a more rational basis for contemporary selection, the author looks to the attachment literature. This makes sense because attachment theory shares some basic assumptions of contemporary psychoanalysis. The Adult Attachment Interview (AAI) is a research tool that predicts the ability of a parent to convey attachment security. It is scored by attending to how a person speaks about his early attachment experiences. The AAI appears to tap into similar qualities to those selection researchers have sought in their candidates. Further, the scoring method of the AAI appears to be similar to the last attempt by selection researchers to operationalize them. Given these similarities, the author recommends an empirical study using the AAI to operationalize these qualities in analytic candidates. The study would test their importance for success in the training program, thus offering selectors some empirical grounding for their choices.     

Subjectivity and objectivity in analytic listening.

Analysts use the concepts of subjectivity and intersubjectivity to support many different technical recommendations; this represents a misuse of theory. The dichotomy between subjectivity and objectivity is a false one. Arguing against the notion of objectivity, analysts conflate it with the idealized notion of pure objectivity and then eliminate various technical devices in its name. One cannot have a concept of subjectivity without a concept of objectivity, or an intersubjective perspective that does not include some agreed-upon concept of objectivity. The simplest definition of objectivity is a directional one. Objectivity is the perception or experience of the external; subjectivity is the perception or experience of the internal. Subjectivity and objectivity are both necessary pathways to knowledge and are dependent on each other. Any form of looking or listening does to some extent preclude another, but to speak solely from a subjective or an objective perspective represents a regression in thinking to a form of naive objectivism or naive subjectivism. Clinical examples illustrate how the forming and testing of hypotheses require the cooperation of both subjective and objective listening.     

On subjectivity and objectivity in psychoanalysis.

Epistemological subjectivism has found its way into psychoanalysis along several theoretical and clinical paths. It has developed out of the clinical interest in transference and countertransference and, in particular, from the broadly generalized definition of countertransference now popular. The clinically necessary attention to analyst-analysand interaction has been turned into interactionism or intersubjectivism and a denial of epistemological subject-object differentiation. These perspectives transform a clinical focus on the here and now of the analytic relation into the determination of the past by the present and a teleological reversal of causality. Once this reversal is made, narrative in the analytic situation becomes the co-creation of the analysand's past by the present analyst-analysand relation. Psychoanalysis, on this view, can at best substitute a coherent, novelistic account for the life history of a person. Some of the problems of subjectivism are examined here with a view to restoring to psychoanalysis the epistemology of science and common sense.     

On objectivity and subjectivity in statistical inference: A response to Mayo

In this paper we respond to the article An Objective Theory of Statistical Testing by D. G. Mayo (1983). We argue that the theory of testing developed by Mayo, NPT*, is neither novel nor objective. We also respond to the claims made by Mayo against Bayesian theory.     

Introduction: striving for objectivity in space

Phenomenology and the Cognitive Sciences - In this special issue, we put together papers that explore the theme “objectivity, space, and mind” from various angles. In the introduction...     

Contextual variation and objectivity in olfactory perception

Synthese - According to Smell Objectivism, the smells we perceive in olfactory experience are objective and independent of perceivers, their experiences, and their perceptual systems. Variations in...     

Probability and objectivity in deterministic and indeterministic situations

This paper pursues the question, “To what extent does the propensity approach to probability contribute to plausible solutions to various anomalies which occur in quantum mechanics?” The position I shall defend is that of the three interpretations — the frequency, the subjective, and the propensity — only the third accommodates the possibility, in principle, of providing a realistic interpretation of ontic indeterminism. If these considerations are correct, then they lend support to Popper's contention that the propensity construction tends to remove (at least some of) the mystery from quantum phenomena.     

Transforming three-way arrays to maximal simplicity

Transforming the core array in Tucker three-way component analysis to simplicity is an intriguing way of revealing structures in between standard Tucker three-way PCA, where the core array is unconstrained, and CANDECOMP/PARAFAC, where the core array has a generalized diagonal form. For certain classes of arrays, transformations to simplicity, that is, transformations that produce a large number of zeros, can be obtained explicitly by solving sets of linear equations. The present paper extends these results. First, a method is offered to simplifyJ ×J × 2 arrays. Next, it is shown that the transformation that simplifies anI ×J ×K array can be used to also simplify the (complementary) arrays of order (JK −I) ×J ×K, of orderI × (IK −J) ×K and of orderI ×J × (IJ −K). Finally, the question of what constitutes the maximal simplicity for arrays (the maximal number of zero elements) will be considered. It is shown that cases of extreme simplicity, considered in the past, are, in fact, cases of maximal simplicity.     

Clinical strategies to promote compliance

Abstract

This article focuses on the need for effective client management throughout the therapeutic process. The appropriate and astute use of clinical strategies can promote client compliance with treatment and counteract the possibility of client dissatisfactions and ethical/legal complaints. This article offers a systemic explanation of compliance, identifies five major clinical strategies to foster treatment adherence, and discusses the need for clinical judgments that fulfill ethical/legal obligations while promoting quality care.