The anthropological tradition in the philosophy of medicine

The tradition of anthropological medicine in philosophy of medicine is analyzed in relation to the earlier interest in epistemological issues in medicine around the turn of the century as well as to the current interest in medical ethics. It is argued that there is a continuity between epistemological, anthropological and ethical approaches in philosophy of medicine. Three basic ideas of anthropologically-oriented medicine are discussed: the rejection of Cartesian dualism, the notion of medicine as science of the human person, and the necessity of a comprehensive understanding of disease. Next, it is discussed why the anthropological movement has been superseded by the increasing interest in medical ethics. It is concluded that the present-day moral issues cannot be interpreted and resolved without clarification of the underlying anthropological images.     

Defensive patterns in reflective group supervisions at Child Health Centres

Reflective group supervision with infant healthcare workers has been described in several publications. It aims to enhance their ability to help distressed families, and to comprehend and relieve themselves of the distress that they encounter in such work. The ultimate aim has been formulated as an effort at increasing the professional's reflective function. The present article adds to the literature by applying an ego-psychological perspective on the group process and investigating defensive patterns in such supervisions. This approach includes a critical discussion of the place of the reflective function concept in psychoanalytic metapsychology. The article also suggests a Bionian perspective to account for skewed communicative patterns in groups, so-called basic assumptions. Some technical recommendations are provided on the frame in group supervision. They aim to disarm such defenses and facilitate the group participants’ possibilities of understanding and thus helping their colleague's problematic relationship with the family. To illustrate the discussion, and to help readers form an image of the supervision process, brief detailed accounts of such work are submitted.     

IS REFLECTIVE SUPERVISION ENOUGH? AN EXPLORATION OF WORKFORCE PERSPECTIVES

Infant mental health practice requires the performance of intense emotional labor. Professionals comprising the infant mental health (IMH) field are largely women at seminal points in adult life‐span development. The purpose of this article is to explore the day‐to‐day challenges faced by clinical infant mental health professionals and their perspectives on the supports available for effective job performance. We review reflective supervision as a long‐cherished professional support in the IMH field designed to hold the practitioner's fears, worries, and ambivalence, so that she may return to the work fortified to remain in therapeutic alliance with families despite unsolvable problems and an unknowable future (Weatherston, D., 2009). Yet, we propose that reflective supervision alone may not be an adequate protective measure for a workforce performing intensive emotional labor for extended periods and therefore at potentially increased risk for burnout and high turnover (Hochschild, A.R. 1983 ; C. Maslach, 1982 , C.M. Brotheridge & A.A. Grandey, 2009; A.S. Wharton, 2009 ). We suggest that structural factors concerning organizational culture, flexibility in scheduling, and professional growth and versatility bear deeper examination for their merits in supporting the IMH workforce. Finally, we contend that the overrepresentation of women in practitioner positions in IMH leaves an empirical gap where little is known about the experience of male IMH practitioners and the ramifications of their performance of emotional labor.     

I through thou,and we through I: Dietrich von Hildebrand and Karol Wojtyla on the personal foundation of community

This article is an attempt to scrutinize the phenomenological social ontology of Dietrich von Hildebrand and Karol Wojtyla by drawing on the particular role and nature of interpersonal relatedness and second-person engagement in the constitution of first-person-plural perspective. Both Hildebrand and Wojtyla endorse the unique value of the person and personality as the foundational principle for different dimensions of community, including the face-to-face “I-thou” way of being together and more complex, even anonymous, we communities. Both philosophers deny the constitutive primacy of first-person plural over first-person singular, the only exception being the mystical body of Christ when “I” is conditioned and formed by “we.” Moreover, what they have in common is the critical reappraisal of one stream in the phenomenological movement, first and foremost associated with Max Scheler's conception of the possibility of a “collective person.” Drawing on Hildebrand's and Wojtyla's accounts, the article endorses the view regarding the relational character of “I,” “thou,” and “we,” claiming that “we” hinges on an experiential dimension of “I.”     

Margarita Von Lüttichau: Intermediary between Jung and Bill Wilson

This paper details Von Lüttichau’s relationship with Carl Jung and Bill Wilson, co-founder of Alcoholics Anonymous (AA), and her role as intermediary in the relationship between the two men. Her contribution within this mediator role has not been previously recognized but is an important factor in explaining how Jung became introduced to the AA 12-step format and validated the effectiveness of group work. After the Second World War, Von Lüttichau travelled between America and Switzerland and introduced the writings and ideas of Wilson and Jung to each other and acted as an intermediary between both titans. Jung gave Von Lüttichau extraordinarily detailed instructions on how the 12-step programme of AA could be applied to ‘general neurotics’. Von Lüttichau’s private papers provide a bridge between Jung and Wilson’s correspondence and help to piece together gaps in both Jungian and AA history.     

Opening the closed heart: affect-focused clinical work with the victims of early trauma

This paper begins with the understanding that early trauma leads to powerful dissociative defenses which injure the capacity to feel. It further explores ways to restore this capacity through body-centred attention to affect-in-the-moment in the psychoanalytic situation. Using the author’s personal experience while in analysis as well as a case of severe early trauma, he demonstrates the consciousness-killing effect of primitive defenses and shows how body-sensitive techniques hold the promise of restoring the patient’s sense of aliveness and hence, opening the unconscious to those affect-images that are the building blocks of the human imagination. A final section focuses on the neglect of feeling in Jungian psychology and suggests that the “creation of consciousness” which Jung described as his personal myth, is quintessentially a process of emotional transformation – of bringing unconscious suffering into consciousness – as feelings.     

Neurofibromatosis Type 1 in Genetic Counseling Practice: Recommendations of the National Society of Genetic Counselors

The objective of this document is to provide recommendations for the genetic counseling of patients and families undergoing evaluation for neurofibromatosis type 1 (NF1) or who have received a diagnosis of NF1. These recommendations are the opinions of a multi-center working group of genetic counselors with expertise in the care of individuals with NF1. These recommendations are based on the committee’s clinical experiences, a review of pertinent English language medical articles, and reports of expert committees. These recommendations are not intended to dictate an exclusive course of management, nor does the use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider’s professional judgment based on the clinical circumstances of an individual patient. Both Heather B. Radtke and Courtney D. Sebold contributed equally to this document.     

Hunger and love: Schiller and the origin of drive dualism in Freud's work1

The interpretation of dreams was the fi rst text in which Freud referred to the system of two drives (drive of self‐preservation and the sexual drive). In order to understand how this question was at work in Freud's mind, one has to go back to 1898, when Freud began to write the third chapter of The interpretation of dreams. One can then see, in contrast with Sulloway's assertions, how Freud was inspired by Schiller, whose shadow haunted his dreams between April and December 1898. The analysis of these dreams emphasizes how the references to Schiller's works and to the drive of self‐preservation cover sexual impulses, in particular, those connected with the relationship to the father. The food drive or drive of self‐preservation also enabled Freud to construct a heroic romance. He was thereby able to bury an internal criticism which was at odds with his persistence in describing the father as a seducer, and to conceal scenes in which he was defeated and sexually subdued by another boy.