心理疗法在针灸治疗中的应用

随着疾病谱和死亡谱的改变,生物医学模式逐渐地不能满足医学发展的需要,取而代之的是生物心理社会医学模式。现代医学模式全方位探求影响人类健康与疾病的因果关系,认为生物学、心理学及社会学因素是人类致病共同的重要因素。针灸是中国传统医学同时也是西方辅助与替代医学的重要内容。针灸医护人员应大力宣传针灸知识,应用生物心理社会医学模式去对待每一位患者。本文试述心理疗法如支持性心理治疗、认知行为疗法、放松疗法在针灸临床的应用,展现针灸心身同治的诊疗特点。     

Health and Healing: Spiritual, Pharmaceutical, and Mechanical Medicine

Modern medical practice is identified as a relatively recent way of approaching human ill health in the wide scope of how people have addressed sickness throughout history and across a wide range of cultures. The ideological biases of medical or “allopathic” (disease as “other” or “outsider”) practice are identified and grafted onto other perspectives on how people not engaged in modern medicine have achieved healing and health. Alternative forms of healing and health open a consideration of ethnomedicine, many forms of which are unknown and, hence, untested by modern medical research. Ethnomedicine the world over and throughout human history has displayed unique spiritual (vitalism), pharmaceutical (herbs/drugs), and mechanical (manipulation/surgery) approaches to treating illness. The argument is that modern allopathic medicine would do well to consider such “world medicine” as having valuable alternative and complementary therapies, the use of which could enhance contemporary medical advice and practice.     

流行病学病因推断的辩证思维

随着疾病谱和死亡谱的改变,生物医学模式逐渐地不能满足医学发展的需要,取而代之的是生物-心理-社会医学模式.生物医学模式向生物-心理-社会医学模式的转变,是医学思维方式从单纯的还原论走向整体综合辩证思维的必然结果.因此,疾病病因的内涵及病因推断方法也相应地发生变化.     

Is Colour incompatibility analytic?

It is widely believed that some a priori necessary truths are not analytic in the sense of transformable by substitution of synonyms into logical truths. One much-cited example comes from the supposed incompatibility between colour predicates. The idea is that sentences like “Nothing is both blue all over (or uniformly or at a point) and also red” are not transformable into a logical truth in the same way as “Nothing is both a bachelor and married” because the requisite conceptual link between “bachelor” and “not married” is absent between “blue” and “not red”. This paper examines whether colour exclusion may be more like the bachelor case than it initially appears. It transpires that the most promising line of thought is not, however, as has been argued at length in the literature, that “blue” in some more or less convoluted way manages to mean “not red”. Instead it is suggested that the requisite conceptual link may reside in the oft-ignored qualifications (“all over”, “uniformly”, etc.), without which there is no incompatibility in the first place.     

Re‐framing systemic paradigms for the art of learning

Thoughtful people are increasingly concerned that the current paradigms for social, corporate, and educational activities are in disgraceful disarray. The “problem‐solving” or analytical model, the competitive or game model, the commercial or consumer model, the bureaucratic or institutional model, and the disease or illness model which prevail in public discourse are proving to be especially unwholesome. We cannot, however, educate ourselves without paradigms. A credible educational paradigm must be generally accessible without being simplistic, informative without being monothematic, and accommodating as well as discriminating. Given our disquiet with the current cognitive situation, a renewing paradigm must be somehow novel; given the character of human nature, a sustaining paradigm must be somehow familiar.

For a very long time now, professional Sciences have committed themselves to paradigms about “reality out there,” while professional Arts have devoted themselves to expressing “imagination from within here.” The more these two worldviews polarize in opposition to one another, the more room there is—and the more human heed there becomes—for mediation by an applied philosophy which accommodates the “real” as well as the “imaginary” in a complementary way. Such a philosophy would address not only “what do you know?” and “how do you do?” but also “how do you know?” and “why do you do?” In earlier times, people would have been considered neither educated nor wise unless they appreciated the Sciences and the Arts whole. In our time, we may not survive unless we can re‐integrate our fractured perceptions. How might we proceed to do so? There may be a systemological way.     

Alice-in-Wonderland terminological usage in,and communicational concerns about,that peculiarly American flight of technological fancy

Alice-in-Wonderland (AW) terminological usage employs basic terms in a systematically misleading and taxonomically anarchic way. The so-called “control” question “test” (CQT) polygraph procedure, which enjoys a controversial but nevertheless scientific status in North America, involves such AW terminological usage. The basic concepts of “test,” “control,” and “quantification” are loosely employed. There is loose talk about the “detection ofdeception,” which generates the paradox that in the CQT it is in the innocent that deception should be detected. Moreover, deception is not really assessed either in the CQT or in the more scientifically-based Guilty Knowledge Test (GKT). Finally, there is loose practice in evaluating the CQT, which should not be primarily assessed in terms of its overall accuracy, but in terms of its specific effects in improving accuracy through the provision of physiological information to the examiner. Such an assessment has not been carried out even in laboratory analogues of polygraphy. The treatment of the CQT exemplifies most psychophysiologists’ reluctance to treat basic definitional issues seriously, and also means that opponents of the CQT are unable to communicate clearly about it with non-psychophysiologist professionals and with the lay community.     

Prognosis in medicine: An analysis of its meaning and rôles

The medical concept of prognosis is analysed into its basic constituents: patient data, medical intervention, outcome, utilities and probabilities; and sources of utility and probability values are discussed. Prognosis cannot be divorced from contemplated medical action, nor from action to be taken by the patient in response to prognostication. Regrettably, the usual decision-theoretic approach ignores this latter aspect. Elicitation of utilities, decision contemplation and prognostic counselling interweave, diagnostics playing a subsidiary role in decision-oriented clinical practice. At times the doctor has grounds for withholding information. As this is known to the patient, prognostic counselling becomes a conflict-prone and rationality-thwarting activity. The meaning of standard phrases such as “prognosis of a disease”, “the prognosis of this patient”, “the prognosis is unknown”, is examined.     

Science and the Art of Healing: A Contribution to the History of Life Science

In conventional medicine, healing is effected mainly by treating the symptoms of the physical body disease, while in mind–body medicine the cure is performed by the mind itself (thoughts and emotions). In fact, the holographic mind theory claims that the mind could be either the healer or the slayer. Thus, this article is a contribution toward a more in-depth study of this theme of conventional medicine versus mind–body medicine, particularly to understand the gifts of quantum physics to life science and the art of healing, so that we might find an integrative medicine model (a holistic approach to health) that could explain some “incurable” diseases.     

Bourdieu and Derrida on Gift: Beyond “Double Truth” and Paradox

Bourdieu and Derrida share a focus on the ambiguity of the practice of gift relationships already pointed out by Mauss. From Bourdieu’s perspective, the question of gratuity is epistemically futile, as it veils the objective truth of gift-giving, yet ethically and politically relevant, as it refers to a hypocrisy which can be instrumental to enhancing civic virtue and solidarity. Bourdieu’s “scientific humanism,” however, implausibly reduces this ambiguity to interest maximization, and aims to build a solidaristic democracy by means of the generalization of the hypocrisy of gratuity. In turn, by interpreting gratuity as “unconditionality,” Derrida aims not at dissolving, but at dramatizing the ambiguity of gift relationships by turning it into “madness” and an “impossible possibility”. Whereas I agree with Derrida’s insistence on the salience of the requirement of gratuity, his approach can lead to counterintuitive and hubristic consequences. Instead, I suggest some elements of an alternative way of understanding gratuitous gifts as communicative acts irreducible to an economic calculation or circle. From this standpoint, a gratuitous gift can be constituted by certain forms of recognition, emotions, or convictions without for that becoming an “impossibility”.     

正念是什么——从正念内涵研究发展角度的思考

"正念是什么"是正念研究中的基本问题,也是长期困扰研究者的难题,造成此困境的重要原因是正念跨越了佛学与心理学两种语境。在正念内涵研究历程中,研究者们先后试图以"去神秘化"、"去语境化"及"整合化"来解决跨语境所造成的问题。本研究认为:正念为多维概念,其内涵的复杂性决定了研究者对正念的认识并非静态的判断,而是逐步成熟的过程;应深入整合佛学与心理学语境,以发展的视角看待正念。     

Personal Construct Theory and Cognitive Science

Abstract

Warren (1990) claims to have formulated an argument “that personal construct psychology is not a cognitive psychology” (p. 379). Nonetheless, he presents very little in the way of logical demonstration or empirical evidence to support this conclusion. Moreover, the theoretical significance of the question posed in the title of his essay (“Is Personal Construct Psychology a Cognitive Psychology?”) is far from obvious. He asserts that “what is at dispute here is the proper characterization of a position” however, his listing several textbooks that refer to Kelly's theory as a “cognitive” approach to the study of personality does nothing at all to either clarify the specific implications of this question or explain its importance. Interestingly, in a recent introductory personality text by one of Kelly's former students (Phares, 1988), this theory is designated as a “phenomenological approach,” which is consistent with Warren's own notion that “he [Kelly] was more phenomenological than he himself believed” Kelly vigorously resisted all such attempts to classify his model in terms of the usual textbook categories (cf. Adams-Webber & Mancuso, 1983).     

White Habits,Anti-Racism,and Philosophy as a Way of Life

This paper examines Pierre Hadot’s philosophy as a way of life in the context of race. I argue that a “way of life” approach to philosophy renders intelligible how antiracist confrontation of racist ideas and institutionalized white complicity is a properly philosophical way of life requiring regulated reflection on habits—particularly, habits of whiteness. I first rehearse some of Hadot’s analysis of the “way of life” orientation in philosophy, in which philosophical wisdom is understood as cultivated by actions which result in the creation of wise habits. I analyze a phenomenological claim about the nature of habit implied by the “way of life” approach, namely, that habits can be both the cause and the effect of action. This point is central to the “way of life” philosophy, I claim, in that it makes possible the intelligent redirection of habits, in which wise habits are more the effect than simply the cause of action. Lastly, I illustrate the “way of life” approach in the context of anti-racism by turning to Linda Martín Alcoff's whiteness antieliminativism, which outlines a morally defensible transformation of the habits of whiteness. I argue that anti-racism provides an intelligible context for modern day forms of what Hadot calls “spiritual exercises” insofar as the “way of life” philosophy is embodied in the practice of whites seeing themselves seeing as white and seeing themselves being seen as white.     

Defining disease beyond conceptual analysis: an analysis of conceptual analysis in philosophy of medicine

Conceptual analysis of health and disease is portrayed as consisting in the confrontation of a set of criteria—a “definition”—with a set of cases, called instances of either “health” or “disease.” Apart from logical counter-arguments, there is no other way to refute an opponent’s definition than by providing counter-cases. As resorting to intensional stipulation (stipulation of meaning) is not forbidden, several contenders can therefore be deemed to have succeeded. This implies that conceptual analysis alone is not likely to decide between naturalism and normativism. An alternative to this approach would be to examine whether the concept of disease can be naturalized.     

The Evolving Nature of Psychoanalytic Supervision: From Pedagogical to Andragogical Perspective

In what primary ways has psychoanalytic supervision evolved over the course of its 100-year plus history? In this paper, I address that question by: (1) sketching out some of the historical differences that have been identified as characterizing the patient-centered, supervisee-centered, and relational-centered supervision perspectives; (2) placing those three perspectives within an adult education framework; and (3) considering their pedagogical (youth-focused) versus andragogical (adult-focused) nature. Based on this examination, I propose the following. Due to the infusion of interpersonal/intersubjective views into the body psychoanalytic, (1) the “maturing” of vision in psychoanalytic supervision (i.e., the movement from a youth-focused to an adult-focused approach to supervision) was made possible; (2) a shift from a supervisory “one-person model times two” to a triadic conceptualization was actuated; (3) traditional perspective on power and authority in supervision was upended; and (4) a more egalitarian, empowering, co-participative approach to supervision emerged and now endures. Attending to the six core principles of adult learning is presented as one primary way in which that “maturing” of vision is most evident in the contemporary practice of psychoanalytic supervision.     

Psychotherapy,complementary and alternative medicine and social dysfunction

This article investigates a bio-psycho-social approach to psychotherapy which works, where possible, with interdisciplinary complementary and alternative medicine teams. The model, called anthroposophic psychotherapy, sees body, soul and spirit as interconnected and the study discusses the bio-psycho-social aspects of the model by linking cardiovascular disease, psychological stress, asocial behaviour and social dysfunction utilizing single case study methodology. The limitations of this method are acknowledged and discussed, but it is also argued that the study has a valuable part to play in a research programme which may also later include efficacy and effectiveness research. The methodology incorporates the principle of data synthesis, as well as data analysis, in accordance with the holistic nature of the clinical model, since it takes the view that all of the elements in the research field are connected. The anxieties presented by the client were linked to arteriosclerotic symptoms and social problems. All of these elements had their roots in childhood and needed to be treated with a number of interventions, including anthroposophic psychotherapy and medicine, which incorporates the homeopathic principle of ‘like cures like’.     

EDMUND D. PELLEGRINO's PHILOSOPHY OF FAMILY PRACTICE

Family medicine has grown as a specialty from its early days of general practice. It was established as a Board Certified specialty in 1969. This growth and maturation can be traced in the philosophy of family medicine as articulated by Edmund D. Pellegrino, M.D. Long before it was popular to do so, Pellegrino supported the development of family medicine. In this essay I examine the development of Pellegrino's philosophical thought about family practice, and contrast it to other thinkers like Ian McWhinney, Kerr White, Walter Spitzer, Donald Ransom, and Hebert Vandervoort. The arguments focus on whether the goals of family medicine and family practice (possibly two distinct entities) can be articulated, especially considering the definitional problems of “family” and “community.” I conclude by echoing Pellegrino's hope that family medicine can contribute a fresh alternative to isolated, individualistic and technological thinking in medicine.     

Reinflating the semantic approach

The semantic, or model‐theoretic, approach to theories has recently come under criticism on two fronts: (i) it is claimed that it cannot account for the wide diversity of models employed in scientific practice—a claim which has led some to propose a “deflationary” account of models; (ii) it is further contended that the sense of “model” used by the approach differs from that given in model theory. Our aim in the present work is to articulate a possible response to these claims, drawing on recent developments within the semantic approach itself. Thus, the first is answered by utilizing the notion of a “partial structure”, first introduced in this context by da Costa and French in 1990. The second claim is undermined by consideration of van Fraassen's understanding of “model” which corresponds well with that evinced by modem mathematicians. This latter discussion, in particular, has an impact on the continuing debate regarding the relative merits of the semantic and syntactic views and the developments presented here can be taken to provide further support to the former.     

现代医学模式形成与疾病治疗

现代生物心理社会医学模式已经成为卫生界领导及广大医务人员的共识 ,并以此指导临床医疗实践。临床诊断正在增添新的内容 ,疾病治疗这个概念也拓宽了她的外延 ,人文科学在医学中越来越显示出她独特的不可替代的地位和作用 ,生物治疗、心理治疗、哲学治疗是未来的三大块治疗模式     

WHY BIOETHICS NEEDS THE PHILOSOPHY OF MEDICINE: SOME IMPLICATIONS OF REFLECTION ON CONCEPTS OF HEALTH AND DISEASE

Germund Hesslow has argued that concepts of health and disease serve no important scientific, clinical, or ethical function. However, this conclusion depends upon the particular concept of disease he espouses; namely, on Boorse's functional notion. The fact/value split embodied in the functional notion of disease leads to a sharp split between the “science” of medicine and bioethics, making the philosophy of medicine irrelevant for both. By placing this disease concept in the broader context of medical history, I shall show that it does capture an essential part of modern medical ideology. However, it is also a self-contradictory notion. By making explicit the value desiderata of medical nosologies, a reconfiguration of the relation between medicine, bioethics, and the philosophy of medicine is initiated. This, in turn, will involve a recovery of the caring dimensions of medicine, and thus a more humane practice.     

Scientific styles,plain truth,and truthfulness

Ian Hacking loosely defines a “style of scientific thinking” as a “way to find things out about the world” characterised by five hallmark features of a number of scientific template styles. Most prominently, these are autonomy and “self-authentication”: a scientific style of thinking, according to Hacking, is not good because it helps us find out the truth in some domain, it itself defines the criteria for truth-telling in its domain. I argue that Renaissance medicine, Mediaeval “demonology”, and magical thinking pass muster as scientific according to Hacking’s criteria. However, application of these thought styles to the entities they introduce generates statements that logically imply a set of “ordinary” statements – or what Bernard Williams calls “plain truths” – which, contra the claims of autonomy and self-authentication, allows styles to be assessed from a style-independent perspective. Using Williams’ notion of plain truth, I show that Renaissance medicine, demonology, and magical thinking, in reality issue in many plain falsehoods. This confronts us with what I call Hacking’s dilemma: either define stricter necessary conditions on being a style of scientific thinking, or concede that some styles albeit scientific are not as good at finding things out about the world as others. I make three suggestions to deal with the dilemma.