The causal explanatory functions of medical diagnoses

Diagnoses in medicine are often taken to serve as explanations of patients’ symptoms and signs. This article examines how they do so. I begin by arguing that although some instances of diagnostic explanation can be formulated as covering law arguments, they are explanatory neither in virtue of their argumentative structures nor in virtue of general regularities between diagnoses and clinical presentations. I then consider the theory that medical diagnoses explain symptoms and signs by identifying their actual causes in particular cases. While I take this to be largely correct, I argue that for a diagnosis to function as a satisfactory causal explanation of a patient’s symptoms and signs, it also needs to be supplemented by understanding the mechanisms by which the identified cause produces the symptoms and signs. This mechanistic understanding comes not from the diagnosis itself, but rather from the theoretical framework within which the physician operates.     

Where’s the problem? Considering Laing and Esterson’s account of schizophrenia,social models of disability,and extended mental disorder

In this article, I compare and evaluate R. D. Laing and A. Esterson’s account of schizophrenia as developed in Sanity, Madness and the Family (1964), social models of disability, and accounts of extended mental disorder. These accounts claim that some putative disorders (schizophrenia, disability, certain mental disorders) should not be thought of as reflecting biological or psychological dysfunction within the afflicted individual, but instead as external problems (to be located in the family, or in the material and social environment). In this article, I consider the grounds on which such claims might be supported. I argue that problems should not be located within an individual putative patient in cases where there is some acceptable test environment in which there is no problem. A number of cases where such an argument can show that there is no internal disorder are discussed. I argue, however, that Laing and Esterson’s argument—that schizophrenia is not within diagnosed patients—does not work. The problem with their argument is that they fail to show that the diagnosed women in their study function adequately in any environment.     

The biographical approach in Karl Jaspers’ work: From philosophy of life to autobiography

This study considers the origins and characteristics of Karl Jaspers’ biographical approach. Specifically, we analyse how this approach manifests itself in Jaspers’ work, namely, in his understanding of psychology, his psychology of worldviews, his views on the history of philosophy and his philosophical method. The biographical approach was a central strategy in Jaspers’ work as an appeal to life and was closely linked with how Jaspers understood both philosophy and his thought. For Jaspers, biography could restore mental unity and reveal the existence behind creativity.     

Thinking love: Heidegger and Arendt

“Thinking Love: Heidegger and Arendt” explores the problematic nature of romantic love as it developed between Martin Heidegger and Hannah Arendt, whom Heidegger later called “the passion of his life.” I suggest that three different ways of understanding love can be found at work in Heidegger and Arendt’s relationship, namely, the perfectionist, the unconditional, and the ontological models of love. Explaining these different ways of thinking romantic love, this paper shows how the distinctive problems of the perfectionist and unconditional models played out in Heidegger and Arendt’s relationship and how that relationship eventually gave rise to the third, ontological understanding of love. This ontological vision of love combines some of the strengths of the perfectionist and unconditional views while avoiding their worst problems, and so emerges as perhaps the most important philosophical lesson about romantic love to be drawn from studying the lifelong love affair between two of the twentieth century’s greatest thinkers.     

The Failure of Clara Thompson’s Ferenczian (Proxy) Analysis of Harry Stack Sullivan*

After hearing Ferenczi’s talks on theory and practice in New York in 1926, psychiatrist Harry Stack Sullivan urged his friend and colleague Clara Thompson to get analyzed by Ferenczi so they could learn his technique. After saving for 2 years Thompson was a patient of Ferenczi for three summers and then moved to Budapest full-time for analysis until Ferenczi’s death. Two years after she returned to New York she attempted to analyze Sullivan. Analysis was broken off in anger by Sullivan after 14 months. Before the promised Ferenczian analysis began Thompson discovered Wilhelm Reich’s Character Analysis (1933) and she tried an aggressive attack on character with Sullivan rather than Ferenczian trauma-oriented “relaxation” and “neocathartic” therapy. Sullivan could not tolerate this. Because of their own unhealed trauma both individually and in relation to each other, neither Thompson nor Sullivan was able to advance Ferenczi’s views on trauma or its healing in America.     

Validation of the Functional Assessment of Chronic Illness Therapy—Spiritual Well-being (FACIT-Sp12) on French Old People

The study aimed to develop a French version of the Functional Assessment of Chronic Illness Therapy—Spiritual Well-being short version (FACIT-Sp12), in order to provide a self-reported measure for French people in the field of gerontology. The study involving 63 nursing home residents was conducted to evaluate the construct validity, reliability, and convergence validity of the FACIT-Sp12. A confirmatory factor analysis corroborated a three-factor model (Meaning, Peace and Faith) with modifications for two items, also valid among people with cognitive impairment. Subscales showed good internal consistency and are correlated with quality of life and depression. In conclusion, the validated French version is an suitable instrument to study the maintenance and promotion of quality of life in the elderly.