Mental Health and Mental Disorder: A Sociological Approach,edited by Arnold M. Rose

This paper presents a model of group analysis based on Aristotle's causal notions. Aristotle's concept of man as a social animal provides a philosophical rationale for an interpersonal treatment forum. His causal theory supplies an encompassing atheoretical model for examining, understanding, and changing “things which have in themselves the source of their changing or staying unchanged.”

Attention to the four causal foci is suggested as the basis for a full-ranging group analysis. Material cause examines: “what” makes a thing what it is. Efficient cause investigates “how” various behaviors and emotions are set in motion. Final cause searches out “where” behavior is aimed. Formal cause traces “why” behaviors take particular forms.

It is suggested that a “cause for pause,” in the ongoing group process, is the emergence of a powerful and specifiable trend, whether a transference, poignant interaction, or groupwide conflict. The “pause to cause” is examined in detail, as each causal foci is elaborated. A sequential analysis moving from “what > how > where > why” is suggested at three levels of possible intervention: individual, interpersonal, and group as a whole. In conclusion, the timing, advantages, and restrictions of such a causal approach are considered.     

The experiences of transgender and non-binary children and young people and their parents in healthcare settings in England,UK: Interviews with members of a family support group

Abstract

Background: Transgender and non-binary children and young people and their parents in England, UK are poorly served across a range of healthcare settings. Whilst UK equalities legislation and international guidance on transgender healthcare pathways protects this group from discrimination and mandates an affirmative approach, services in England are not keeping pace.

Aims: This study aims to draw on the experiences of transgender and non-binary children, young people and their parents in a support group in England in order to investigate their experiences of healthcare provision, and to develop some ideas for improvement.

Method: Data was collected with participants in a family support group which offers a parent helpline service, social groups for children and parents, and training for schools and other organizations. 65 parents and children from 27 families from the family support group attended participatory workshops where they were given a range of briefs: “health,” “family,” “friends,” and “education.” Their participation involved being asked to define their own interview questions and collect data by interviewing each other. Their interview notes constituted the raw data. Data was coded inductively by the author with respondent checking as a second stage.

Results: Results constitute the views of a small group of people, so cannot be generalized. However, they do illustrate some of the issues which may arise. Participants’ experiences elicited five key themes: professionals’ perceived lack of clinical and therapeutic knowledge; mental distress caused by excessive waiting lists; professionals’ stereotyped gender assumptions; direct discrimination within healthcare settings; and a lack of attention to parent and child voice, especially in terms of school-based experiences and where a patient had a diagnosis of autism.     

Asymmetries of expressive facial movements during experimentally induced positive vs. negative mood states: A video-analytical study

Abstract

When reviewing the literature, it appears that the striking disparity among findings concerning facial expression asymmetry may be due to inconsistent experimental settings. In our study we applied a set of standard mood induction procedures within a semi-standardised face-to-face interview. We predicted a greater right-sided lifting of the corners of the mouth during positive mood states and a greater left-sided lowering during negative mood states. The results were in line with our expectations. Our interpretation attempts to reconcile the “right hemisphere hypothesis” and the “valence hypothesis” of emotional processing.     

Psychiatry in the labyrinth: Deconstructing deviancy

Abstract

Deviancy is a key concept in psychiatry and other therapeutic disciplines, because it dramatizes the way in which they depend on the establishment of norms, in order to justify their theory and practice. The writings of Derrida as well as Goethe provide a different view: that “deviation” from a “norm” can be fundamentally important to the well‐being of the norm. Thus deviancy can be viewed not as something to be “corrected” but rather as a creative possibility to be encouraged and shaped in productive ways. As a case of “deviancy” we have selected the writings of John Perceval, whose Narrative provides a critique of the mental‐health establishment of his day, particularly the asylum, and offers an alternative to 19th‐century views of “lunacy.” We see his “schizophrenic” commentary on his “psychosis” and its treatment as analogous to the deconstructive, “schizophrenic” discourse of postmodernity which is similarly critical of the reigning, modernist psychiatric order.     

All my toys are dead: Chantal Akerman’s No Home Movie (2015)

Abstract

Making films can be a lifeline, an aid to going on living when (we feel) the world around us has disappeared. Looking, showing that there’s a “there there,” recording the present moment and thereby preserving it, can, for a time, make us not feel the nothingness within us. But the rescue that comes from making a film is always provisional. Why? Because every film has an end. Because if there are no more films to make, if there is nothing that deserves to be looked at (the worst case scenario), going on living will have exhausted itself, and taking one’s own life (if indeed there was a life to take) may seem the only option. Chantal Akerman’s No Home Movie – a film recording the slow death of her mother in her Brussels apartment – is this worst case scenario. A moving record of the psychic devastation that comes about when we, slowly but surely, lose the one object worth looking at. Panic, depression, hopelessness, and a fierce determination to go where the disappeared object went. To this last home where nothing no longer moves.     

Introduction to Group-Analytic Psychotherapy by S. H. Foulkes

This article will explore special leader issues that emerge in psychodynamically oriented therapy groups with adult children of alcoholics. Particular focus will be on countertransference feelings that get stirred up in group leaders and techniques for dealing with some of these special dilemmas. Specific issues include (a) assumption of sameness between the therapist and the patient (the therapist assuming that he or she “understands” because of having also grown up in an alcoholic family); (b) the “will to restore,” which may be destructive when the therapist, whose own self-esteem is dependent on the patient's progress in therapy, forces a “rush to recovery” on the patient; (c) other personal issues in the life of the therapist that may also resonate with experiences of the patient; (d) “countertransference goodness and availability” as it affects therapists' abilities to set reasonable limits on their patients, as well as reasonable expectations for themselves; and (e) special issues regarding therapist transparency and self-disclosure.     

Machenschaft and Seynsgeschichte in the Black Notebooks: Heidegger on Nietzsche’s “Rediscovery” of the Greeks

ABSTRACT

One of the outcomes of the publication of the Black Notebooks has been to invite scholars to rethink their understanding of Heidegger’s thinking, including his “world-historical anti-Semitism,” his relation to war and politics, via Schmitt and Jünger, as well as machination/calculation but not less his Seynsgeschichte. Other questions include education and academic life in addition to Heidegger’s anxieties regarding the reception of Being and Time in the framework of his history of Beyng/Seyn. Refusing Nietzsche on the Greeks, especially Anaximander, Heidegger “plays out” typically bellicose interpretations of Will to Power, consummating the “abandonment of beings by being, the abandonment that gained sovereignty in the history of metaphysics.” If Heidegger’s Nietzsche thus suspiciously resembles the Nazi Nietzsche, reading the proliferation of editions bears out Heidegger’s claims for the backwards-working force of the Nachlaß.     

What setting limits may mean: a feminist critique of Daniel Callahan's Setting Limits

In Setting Limits, Daniel Callahan advances the provocative thesis that age be a limiting factor in decisions to allocate certain kinds of health services to the elderly. However, when one looks at available data, one discovers that there are many more elderly women than there are elderly men, and these older women are poorer, more apt to live alone, and less likely to have informal social and personal supports than their male counterparts. Older women, therefore, will make the heaviest demand on health care resources. If age were to become a limiting factor, as Dr. Callahan sug-gests it should, the limits that will be set are limits that will affect women more dras” tically than they affect men. This review essay examines the implications of Callahan's thesis for elderly women.     

Knowing When to Say Goodbye: Final Exit and Suicide in the Elderly

The publication of Derek Humphry's Final Exit in 1991 caused a large uproar. Although designed as a suicide manual for terminally ill persons, there has been considerable fear that the book's methods might be used by others, such as nonterminal elderly individuals who have made a “rational” decision to end their lives. This piece, a short story about an elderly couple that commits double suicide, explores rational suicide by using fiction, as opposed to a standard bioethical approach. Fiction does not provide answers, but rather highlights the ambiguities surrounding elder suicide, and reminds us to evaluate this issue in the context of individual life experiences.     

Queer Muslim love: a time for ijtihad

ABSTRACT

Across the globe, Muslim communities have developed, and are continuing to develop, a theology of compassion, non-judgmental attitudes, and support toward queer Muslims. This discourse uses ijtihadic analysis to support acceptance of queer Muslim love, because religion is a strong and deep social construct that acts as a moral compass where Muslim queers learn to feel “unacceptable”, “bad”, and “worthless” and under the mercy of the horrified gaze of mainstream, heteropatriarchy, which uses religious arguments to contest the rights enshrined in the South African constitution. It provides a case study as a pedagogical reflection to share intentions, process, and outcomes of sexual diversity workshops to support queer Muslim love to broadly raise critical consciousness about alternative sexual orientations and identities.     

1966 and All That: James Gibson and Bottom-Down Theory

ABSTRACT

The “later” James Gibson is widely misrepresented as an extreme stimulus–response theorist. In fact, Gibson's 1966 book presents a radical alternative to stimulus–response theory. “Perceptual systems” are not passive and receptive but “organs of active attention” (1966/1968, p. 58). Perceivers “reach out” into the world. This commentary examines some of the implications of Gibson's systems-cum-functionalist-cum-ecological approach, including the relations between the senses; the concept of “sensationless” perception; and most fundamentally, the nature of perceptual systems as extending beyond the body. I conclude that an adequate understanding of perception cannot be limited to the already severely limited domain of psychology. If Gibson is right, “ecological psychology” is a contradiction in terms.     

Perfecting not Perfect: Christology and Pneumatology within an Imperfect Yet Purposeful Creation

Abstract

The issue of evolutionary theodicy remains an area of difficulty within the science–theology dialogue. The evolutionary understanding of life identifies a process where suffering and extinction are intrinsic; however, theology seeks to articulate God's loving goodness towards creation. Therefore the central question of evolutionary theodicy becomes: “How can a loving God act by such a process?” Within the view of theistic evolution, evolutionary theodicy has resulted in a deeper understanding of Christology and Pneumatology, as the whole of creation is understood to be moving towards its eschatological perfection in Christ.     

An Aesthetics of the Ordinary: Wittgenstein and John Cage

Comparisons of Ludwig Wittgenstein and John Cage typically focus on the “later Wittgenstein” of the Philosophical Investigations. However, in this article I focus on the deep intellectual sympathy between the “early Wittgenstein” of the Tractatus Logico‐Philosophicus—with its evocative and controversial invocation of silence at the end, the famous proposition 7: “Whereof we cannot speak, thereof we must be silent”—and Cage's equally evocative and controversial work on the same theme—his “silent piece,” 4′33″. This sympathy expresses itself not only in the common aim of the two works (a mystical appreciation for the ordinary, everyday world that surrounds us) but also in a shared methodology for bringing about this aim (tracing the limits of language from within in order to transcend those very limits). In this sense, I argue that Cage's work gives a concrete, performative reality to Wittgenstein's early conception of language as well as the mystical revelation that lies behind it.     

Biomatrix: The web of life

Abstract

The interrelationship between all things on earth has long been accepted. It is known that we are part of a great, complex network of processes, sections of which extend to the small building blocks of our bodies. But how are the parts of this network connected together? Is there perhaps a simple overall pattern? We believe that there exists such a pattern which incorporates all living as well as lifeless matter on earth. We refer to this network as the “biomatrix” and define it as the “living network of all things on earth.”

There are units or elements composing the matrix. We call these doublets, within and around which essentially two types of processes, viz., endodynamic and exodynamic processes, take place. Endodynamic processes are those which are directed in purpose toward the components of the doublet in question. Exodynamic processes, on the other hand, are those which have purposes directed toward the greater doublets of which the doublet in question forms a part. All things, lifeless as well as living and organizational entities, from atoms to societies and the total ecosystem, can be thought of as doublets of the biomatrix.

The matrix is not a simple net, such as the fisherman's, in which all knots are the same and are placed alongside one another. The web of life on earth is complex. The connecting strands are processes, endodynamic or exodynamic, and the knots are the doublets. Although many doublets occur alongside one another, they also occur within one another in a “Chinese‐box hierarchy” fashion, viz., those of greater complexity generally enclosing the simpler ones.

A general scheme pertaining to the biomatrix is discussed and it is shown that for an optimally functioning system there must be a balance between the endodynamic and exodynamic processes relating to all doublets within the system.

It is hoped that our efforts will contribute to the evolution of a generally accepted systems framework for life on earth. It is important that such a framework be applicable to practical problems which confront us in everyday affairs.     

A critical commentary on follow-up studies and “desistance” theories about transgender and gender-nonconforming children

ABSTRACT

Background: It has been widely suggested that over 80% of transgender children will come to identify as cisgender (i.e., desist) as they mature, with the assumption that for this 80%, the trans identity was a temporary “phase.” This statistic is used as the scientific rationale for discouraging social transition for pre-pubertal children. This article is a critical commentary on the limitations of this research and a caution against using these studies to develop care recommendations for gender-nonconforming children.

Methods: A critical review methodology is employed to systematically interpret four frequently-cited studies that sought to document identity outcomes for gender-nonconforming children (often referred to as “desistance” research).

Results: Methodological, theoretical, ethical, and interpretive concerns regarding four “desistance” studies are presented. The authors clarify the historical and clinical contexts within which these studies were conducted to deconstruct assumptions in interpretations of the results. The discussion makes distinctions between the specific evidence provided by these studies versus the assumptions that have shaped recommendations for care. The affirmative model is presented as a way to move away from the question of, “How should children's gender identities develop over time?” toward a more useful question: “How should children best be supported as their gender identity develops?”

Conclusion: The tethering of childhood gender diversity to the framework of “desistance” or “persistence” has stifled advancements in our understanding of children's gender in all its complexity. These follow-up studies fall short in helping us understand what children need. As work begins on the 8th version of the Standards of Care by the World Professional Association for Transgender Health, we call for a more inclusive conceptual framework that takes children's voices seriously. Listening to children's experiences will enable a more comprehensive understanding of the needs of gender-nonconforming children and provide guidance to scientific and lay communities.