Many questions Begs the Question (but questions do not Beg the Question)

The fallacy of many questions or the complex question, popularized by the sophism ‘Have you stopped beating your spouse?’ (when a yes-or-no answer is required), is similar to the fallacy of begging the question orpetitio principii. Douglas N. Walton inBegging the Question has recently argued that the two forms are alike in trying unfairly to elicit an admission from a dialectical opponent without meeting burden of proof, but distinct because of the circularity of question-begging argument and noncircularity of many questions. I offer a reconstruction of the many questions fallacy according to which it is just as circular as begging the question, concluding that many questions begs the question. The same analysis contradicts Walton's claim that questions can beg the question, drawing a distinction between questions as the instruments of question-begging, and as vehicles for categorical noninterrogative presuppositions that beg the question.     

The interviewing computer: A technology for gathering comprehensive treatment information

The interviewing computer is a practical device for gathering comprehensive information on mental health patients. The complex decisions of a treatment science will require a large body of patient facts and an automated interviewing system to elicit such facts, covering the patient’s intake assessment, therapeutic progress, and follow-up stages of treatment. Evidence suggests that the computer interview may equal or excel the interview accomplishments of some clinicians who are unknowledgeable about asking certain clinical questions, forget to ask these questions, or fail to record crucial patient facts. The documentation of each patient’s treatment episode is essential for a treatment science, and the computer interview may represent a technology for achieving this information goal.     

The questions and curiosity of the psychoanalyst

Questions the analyst asks of the patient are a powerful but neglected aspect of the theory of psychoanalytic technique. Their importance resides in their dynamic impact on the psychic equilibrium of the patient because of their ability to destabilize existing compromise formations. A clinical vignette illustrates the view that the linguistic shift from other modes of discourse to the spoken question heralds a less visible parallel shift in the psychic equilibrium of either the psychoanalyst or patient. There is no more and no less complexity to questions than to any other communication by either analyst or patient. For that reason there can be no systematic classification of questions in the clinical psychoanalytic situation, just as there can be no definitive taxonomy of psychoanalytic discourse. It makes no sense to reduce the enormous diversity and range of all the questions the analyst asks to the simple dichotomy of good or bad for the analysis. Questions are the emblem of the analyst's mode of inquiry; they can further the development of self-observation, which is such an important concomitant, cause, and consequence of structural change.     

The pursuit of the minor premise a commentary on normality

In this paper are explored the ethical implications of the answers to three questions: Whether or not a diseased state is discrete; the criteria by which that question is answered; and how the diseased state is to be identified. Examples are given showing that some states appear to be clearly discrete, and others equally clearly not discrete. The nature of the pertinent evidence will be affected accordingly. It is shown that a slavish and inappropriate concern with categories leads to anomalous ethics. Finally, it is suggested that many of these problems may be avoided by centering the ethics of medicine on optimizing the welfare of the patient rather than by thinking in terms of categorical disease.     

One last response to the Rorschach test: a second chance to reveal oneself

This paper explores a technical procedure, that of asking for one more response after the patient has given response(s) to Card X of the Rorschach. This "one last response" in the context of "ending" is discussed. Endings have many meanings but the ending of the Rorschach can be more than just a relief to the weary patient and/or tester who may have been experiencing the disquieting inner workings of the patient's unconscious. The ending of the Rorschach with the additional "one last response" can be the source of valuable clinical questions and inferences applicable to treatment.     

Special perspective: An immodest proposal: should treating mental health professionals be barred from testifying about their patients?

Notwithstanding ethical rules that address therapeutic and forensic role conflicts for psychologists and psychiatrists, overzealous patient advocacy by therapists, tightened reimbursement for therapy, and a growth market for forensic psychology and psychiatry, have led many therapists to appear willingly as forensic experts on behalf of their patients. Existing ethical rules, as well as other proposed approaches to address this problem, assume that it can be resolved by modest changes in existing practice that permit therapists to testify as long as their testimony avoids psycholegal opinions. This essay questions whether these modest changes can adequately address this problem and advances consideration of a more radical proposal to address this problem, prohibiting therapists from testifying about their patients. © 1998 John Wiley & Sons, Ltd.     

East of Ego: The Intersection of Narcissistic Personality and Buddhist Practice

This article explores the intersection of clinical narcissism and Buddhist meditation practice. Through the lens of Otto Kernberg and Heinz Kohut’s theories of narcissism, the article investigates the many facets of Eastern spiritual practice when undertaken by a narcissistic practitioner. In particular, questions are raised regarding the potential psychological dangers of pursuing meditation practice when suffering from clinical narcissism. Potential applications for a cross-pollination of psychoanalytic support and Buddhist practice are also considered for the narcissistic patient and/or spiritual practitioner.     

Computerized encounter registers in primary care research: Is there a gold standard?

Computer technology as well as the need to conduct research in primary care settings, has stimulated the creation in the U.S. of information networks linking private physicians' offices and other primary care practice sights. These networks give rise to several problems which have philosophic interest. One is a “numerator problem” created by the difficulty in primary care of using the more complicated or invasive diagnostic technologies commonly employed in tertiary care research. Another is a “denominator problem” arising from the difficulties in determining which and how many patients constitute the population from which a practice is drawn. Finally, this mode of research raises questions about the social construction of medical reality and how “objective” medical truth is actually based on carefully selected patient experience. All these questions combine to challenge the “gold standard” view on medical research: the idea that some sorts of medical knowledge are epistemologically privileged and can serve as a bench-mark to determine whether new data are valid.     

School Effectiveness Findings 1979–2002

The London studies of school effectiveness in the 1970s provided evidence that the qualities of schools made a significant difference to pupil progress, after taking account of the characteristics and backgrounds of the pupils at the time of school entry. The purpose of this article is to review the further evidence that has accumulated since then in order to assess how far the findings have been confirmed or refuted, what new questions have arisen and what key challenges remain. The continuing areas of research and debate include school effects on behavioral outcomes, the effects of class size, the importance of parental involvement, the impact of intake mix, peer influences, and level of resources. There has been greater agreement on the many features fostering school effectiveness. However, questions remain on how to bring about desired changes. The paper concludes by drawing attention to 10 largely unanswered questions that matter for policy and practice.     

Terms of the debate on the format and structure of visual memory

Our ability to actively maintain information in visual memory is strikingly limited. There is considerable debate about why this is so. As with many questions in psychology, the debate is framed dichotomously: Is visual working memory limited because it is supported by only a small handful of discrete “slots” into which visual representations are placed, or is it because there is an insufficient supply of a “resource” that is flexibly shared among visual representations? Here, we argue that this dichotomous framing obscures a set of at least eight underlying questions. Separately considering each question reveals a rich hypothesis space that will be useful for building a comprehensive model of visual working memory. The questions regard (1) an upper limit on the number of represented items, (2) the quantization of the memory commodity, (3) the relationship between how many items are stored and how well they are stored, (4) whether the number of stored items completely determines the fidelity of a representation (vs. fidelity being stochastic or variable), (5) the flexibility with which the memory commodity can be assigned or reassigned to items, (6) the format of the memory representation, (7) how working memories are formed, and (8) how memory representations are used to make responses in behavioral tasks. We reframe the debate in terms of these eight underlying questions, placing slot and resource models as poles in a more expansive theoretical space.     

A computerized slot machine simulation to investigate the variables involved in gambling behavior

The present paper describes a computerized slot machine simulation designed to examine many of the potential variables involved in gambling behavior. This program was created in Visual Basic Version 6.0 and is designed to run on any Windows 95 or higher equipped computer. The program allows for experimenter manipulation of probabilities of payoffs, visual display of potential winning symbols, exact sequences of wins and losses, as well as pose run time questions to the subject on prespecified trials. The program records data on a trial-bytrial basis to a text file for easy importation into many data analysis and statistical programs. Conceptual and experimental questions that may be addressed with the described program are also discussed.     

Public and private responsibility for mental health services

Relative to public services, private sector corporate mental health care has significantly increased since the late 1960s. The many tensions encountered in assigning public and private responsibility for mental health service give rise to significant value-laden questions for psychologists. These questions go to the heart of community mental health, deinstitutionalization, mental health policy development and evaluation, and many other areas in which psychologists are playing major roles. The public-private issue should be understood historically, from the twin vantage points of developments in general medicine and in mental health. Among the many public interest and public policy matters psychologists and others concerned with mental health should address are the emergence of corporate chains; the nature, cost, and quality of private sector services; the compatibility of profit motivation and the motivation to provide care; and patient selection issues (e.g., cream-skimming). Public and private cooperation and planning are certainly in order if the public interest is to be served in addressing the nation's mental health problems.     

The body of the analyst and the analytic setting: Reflections on the embodied setting and the symbiotic transference

In this paper the author questions whether the body of the analyst may be helpfully conceptualized as an embodied feature of the setting and suggests that this may be especially helpful for understanding patients who develop a symbiotic transference and for whom any variance in the analyst's body is felt to be profoundly destabilizing. In such cases the patient needs to relate to the body of the analyst concretely and exclusively as a setting ‘constant’ and its meaning for the patient may thus remain inaccessible to analysis for a long time. When the separateness of the body of the analyst reaches the patient's awareness because of changes in the analyst's appearance or bodily state, it then mobilizes primitive anxieties in the patient. It is only when the body of the analyst can become a dynamic variable between them (i.e. part of the process) that it can be used by the patient to further the exploration of their own mind.     

Conditioning and post-hospital generalization of nondelusional responses in a chronic psychotic patient

An operant conditioning approach was successful in getting a chronic psychotic patient to give factual answers to direct questions that had previously elicited only delusional responses. Multiple baseline and reversal controls established that the changes were due to the experimental procedure. The subject was a female patient classified as paranoid schizophrenic who had persisted in giving bizarre responses to direct questions regarding her identity, age, and personal history during 26 yr of hospitalization. She was discharged after factual answers to these questions had been obtained, but operant conditioning trials were continued in the community to promote generalization. Two follow-up interviews were conducted 36 and 52 days after discharge to evaluate generalization. No generalization was found in the first interview, but the second gave evidence of some generalization.     

What is A Philosophical Question?

There are many ways of understanding the nature of philosophical questions. One may consider their morphology, semantics, relevance, or scope. This article introduces a different approach, based on the kind of informational resources required to answer them. The result is a definition of philosophical questions as questions whose answers are in principle open to informed, rational, and honest disagreement, ultimate but not absolute, closed under further questioning, possibly constrained by empirical and logico‐mathematical resources, but requiring noetic resources to be answered. The article concludes with a discussion of some of the consequences of this definition for a conception of philosophy as the study (or “science”) of open questions, which uses conceptual design to analyse and answer them.     

Ethical issues in pediatric life-threatening illness: dilemmas of consent, assent, and communication

The treatment of life-threatening illnesses in childhood is replete with ethical issues and with clinical issues that have ethical implications. The central issues are those involved with a child's participation in the decision-making process and with communication of information about the illness and treatments to children. This article examines the questions of patient autonomy and of parental responsibility and prerogative in the context of pediatric oncology. Included in this examination of the ethical dimensions of pediatric life-threatening illness is a discussion of the many related aspects involved, including medical, cultural, psychosocial, legal, and developmental. A multidimensional approach that considers the ways in which these multiple aspects interact with one another, and which focuses on establishing a strong working alliance between the health care team and the pediatric patient's family, can help to avoid or resolve potential ethical and clinical conflicts.     

When the Topic is You: Genetic Counselor Responses to Prenatal Patients’ Requests for Self-Disclosure

A limited amount of research indicates patient requests play a major role in genetic counselors’ self-disclosure decisions and that disclosure and non-disclosure responses to patient requests may differentially affect genetic counseling processes. Studies further suggest patient requests may be more common in prenatal settings, particularly when counselors are pregnant. Empirical evidence is limited however, concerning the nature of patient requests. This study explored genetic counselors’ experiences of prenatal patients’ requests for self-disclosure. Four major research questions were: (1) What types of questions do prenatal patients ask that invite self-disclosure?; (2) Do pregnant genetic counselors have unique experiences with prenatal patient disclosure requests?; (3) How do genetic counselors typically respond to disclosure requests?; and (4) What strategies are effective and ineffective in responding to disclosure requests? One hundred seventy-six genetic counselors completed an online survey and 40 also participated in telephone interviews. Inductive analysis of 21 interviews revealed patient questions vary, although questions about counselor demographics are most common, and patients are more likely to ask pregnant counselors questions about their personal pregnancy decisions. Participants reported greater discomfort with self-disclosure requests during pregnancy, yet also disclosing more frequently during pregnancy. Counselor responses included personal self-disclosure, professional self-disclosure, redirection, and declining to disclose. Factors perceived as influencing disclosure included: topic, patient motivations, timing of request, quality of counseling relationship, patient characteristics, and ethical/legal responsibilities. Disclosure practices changed over time for most counselors. Additional findings, practice implications, and research recommendations are discussed.     

A model for the analysis of multiple strategies

In many decision problems the decision-maker must ask a series of questions or select cues relevant to but prior to the decision. There are many strategies which would prescribe an order for asking such questions or selecting such cues. It is the purpose of the paper to describe a manner in which the strategy or strategies of the decision-maker can be analyzed. From this model can be derived limits corresponding to thepossible use of a particular strategy, and theeffective or observed use of the strategy or strategies by the decision-maker.Preparation of this paper was supported in part by Fellowship 1-F1-MH-24, 324-01, from the National Institute of Mental Health. This paper comprises Publication Number 63 of the Institute of Behavioral Science, University of Colorado. The author would like to thank K. R. Hammond and D. W. Stilson for many helpful comments and suggestions.     

Reflections on the use of patient records: Privacy,ethics, and reparations in the history of psychiatry

One of the most common questions we get asked as historians of psychiatry is “do you have access to patient records?” Why are people so fascinated with the psychiatric patient record? Do people assume they are or should be available? Does access to the patient record actually tell us anything new about the history of psychiatry? And if we did have them, what can, or should we do with them? In the push to both decolonize and personalize the history of psychiatry, as well as make some kind of account or reparation for past mistakes, how can we proceed in an ethical manner that respects the privacy of people in the past who never imagined their intensely personal psychiatric encounter as subject for future historians? In this paper, we want to think through some of the issues that we deal with as white historians of psychiatry especially at the intersection of privacy, ethics, and racism. We present our thoughts as a conversation, structured around questions we have posed for ourselves, and building on discussions we have had together over the past few years. We hope that they act as a catalyst for further discussion in the field.     

Interventive Interviewing: Part I. Strategizing as a Fourth Guideline for the Therapist

A clinical interview affords far more opportunities to act therapeutically than most therapists realize. Because so many of these opportunities remain outside the therapist's conscious awareness, it is useful to elaborate guidelines that orient his or her general activity in directions that are liable to be therapeutic. The Milan associates defined three such basic guidelines: hypothesizing, circularity, and neutrality. Hypothesizing is clear and easy to accept. The notions of circularity and neutrality have aroused considerable interest but are not as readily understood. These guidelines may be clarified and operationalized when reformulated as conceptual postures. This process is enhanced by differentiating a fourth guideline, strategizing, which entails the therapist's decision making, including decisions about how to employ these postures. This paper, the first in a series of three, explores these four interviewing guidelines. The other papers will appear in a subsequent issue. Part II will focus on reflexive questioning, a mode of inquiry oriented toward mobilizing the family's own healing capacity. Part III will provide a scheme for analyzing and choosing among four major types of questions: linear questions, circular questions, reflexive questions, and strategic questions.