Towards authentic conversations. Authenticity in the patient-professional relationship

The purpose of this paper is to evaluate the significance of the existential notion of authenticity for medical ethics. This is done by analyzing authenticity and examining its implications for the patient-professional relationship and for ethical decision-making in medical situations. It is argued that while authenticity implies important demand for individual responsibility, which has therapeutic significance, it perpetuates ideas which are antithetical both to authentic interaction between patients and professionals and to fruitful deliberation of moral dilemmas. In order to counteract these consequences, an alternative idea of authenticity is introduced. According to this idea, authenticity is not regarded primarily as individual sovereignty, but as an ability to participate in a dialogue in which the subjectivity of both partners is respected. Such practice, based on mutual trust and responsibility, would enhance common decision-making and overcome the alienation between patients and professionals.     

Sensorimotor synchronization: Motor responses to pseudoregular auditory patterns

Musically trained and untrained subjects (N=30) were asked to synchronize their finger tapping with stimuli in auditory patterns. Each pattern comprised six successive tonal stimuli of the same duration, the first of which was accented by a different frequency. The duration of interstimulus onset intervals (ISIs) gradually increased or decreased in constant steps toward the end of the patterns. Four values of such steps were used in different trials: 20, 30, 45, and 60 msec. Various time-control mechanisms are hypothesized as being simultaneously responsible for subjects’ incorrect reproduction of the internal temporal ratios of the stimulus patterns. The mechanism of assimilation (of a central tendency) led subjects to enforce a regular (isochronous) structure on the patterns. The influence of other time-control mechanisms (distinction, subjective expression of an accent, sequential transfer) was expressed mainly in differences between intertap onset intervals (ITIs) and the corresponding ISIs at the beginning of the patterns. The duration of the first two ITIs was in the majority of the trials in an inverse ratio to the ratio of the respective ISIs. The distortions resulting from the timing mechanisms concerned were more pronounced in the performance of nonmusicians than in that of musicians.     

The calibration and resolution of confidence in perceptual judgments

Carleton University, Ottawa, Ontariot Canada Confidence rating based calibration and resolution indices were obtained in two experiments requiring perceptual comparisons and in a third with visual gap detection. Four important results were obtained. First, as in the general knowledge domain, subjects were underconfident when judgments were easy and overconfident when they were difficult. Second, paralleling the clear dependence of calibration on decisional difficulty, resolution decreased with increases in decision difficulty arising either from decreases in discriminability or from increasing demands for speed at the expense of accuracy. Third, providing trial-by-trial response feedback on difficult tasks improved resolution but had no effect on calibration. Fourth, subjects can accurately reportsubjective errors (i.e., trials in which they have indicated that they made an error) with their confidence ratings. It is also shown that the properties of decision time, conditionalized on confidence category, impose a rigorous set of constraints on theories of confidence calibration.     

Beyond belief bias: Reasoning from conceptual structures by mental models manipulation

Mental models constitute an alternative to the rule-based systems in the explanation of human reasoning (Johnson-Laird, 1983). In this paper, we claim that the concept of believability generally used to categorize content and context effects is of little use within a semantic theory. Thus, we propose the use of categories that are directly extracted from subjective relations among concepts within the reasoning problem. We demonstrate that manipulations based on this kind of categorization produce predictable patterns of responses in reasoning problems. We present two experiments to test our predictions, using conditional and syllogistic reasoning problems, and in both cases, we demonstrate the influence of conceptual knowledge not only in natural contexts, but also in experimentally created artificial contexts.     

When More is Better than Less; Three Theories of Psychosis—Projection, Double Bind, and Possession

Three psychological theories of psychosis are described, each of which has standing in psychiatry. Defined by the terms projection, double bind, and possession, they initially appear to have little or nothing in common to explain psychosis, but converge at four points: (1) A high degree of anxiety precipitated by a dilemma or conflict perceived to be unsolvable by the person; (2) the anxiety triggers a shift from one thought or motive in the direction of its opposite, because the original was believed too antagonistic to the wishes of significant others; (3) the opposite, in order to remain opposite, requires that the original thought or motive be forgotten, (4) a singular means to produce and reinforce forgetting is the interposition of psychiatric symptoms. In psychiatry today treatment would fit more consistently with the three theories taken as a whole rather than any one, and a rationale for this viewpoint is elaborated.     

Interviewer evaluations of interviewee nonverbal behavior

Personnel representatives (N = 52) were shown one of four videotaped job interviews in which the verbal content of the 16-min interview was identical, but the interviewee's nonverbal behavior was manipulated. A “low nonverbal” interviewee was defined by minimal eye contact, low energy level, lack of affect and voice modulation, and a lack of speech fluency. The “high nonverbal” interviewee demonstrated the opposite behavior on each of these components. The subjects were asked to rate the videotaped candidates on dimensions previously identified as critical in influencing a job interviewer's decisions. Nonverbal behavior was found to have a significant effect on almost every rating made by subjects in this study. After reviewing the entire 16-min interview, 23 of the 26 subjects who saw the “high nonverbal” candidate would have invited him/her for a second interview. All 26 of the subjects who saw the “low nonverbal” candidate would not have recommended a second interview.     

Effects of a pairing contingency on behavior in a three-person programmed environment

Four groups of three subjects resided for 10 days within a continuously programmed environment. Subjects followed a behavioral program of contingently scheduled activities that determined individual and social behaviors. A triadic condition was in effect when all three subjects were required to select simultaneous access to a group area before it became available for a social episode. A dyadic condition was in effect when access to a group area was permitted to any combination of two, and only two, subjects. The effects of these two conditions on individual and social behaviors were studied in reversal designs with several successive days devoted to each condition. Results showed that durations of social activities and synchronization of individual activities were greater during triadic conditions than during dyadic conditions. Under both conditions, wake-sleep cycles departed from a typical day-night rhythm for most subjects. Instances when subjects did not respond to each others' attempts to initiate conversations using the intercom were generally more frequent during dyadic than triadic conditions. Physical distance during triadic social episodes was found to be related to sociability levels during dyadic conditions.     

Arterial blood gases in Pranayama practice.

Pranayama is a Yogic breathing practice which is known experientially to produce a profound calming effect on the mind. In an experiment designed to determine whether the mental effects of this practice were accompanied by changes in the arterial blood gases, arterial blood was drawn from 10 trained individuals prior to and immediately after Pranayama practice. No significance changes in arterial blood gases were noted after Pranayama. A neural mechanism for the mental effects of this practice is proposed.