Written Exposure Therapy for Suicide in a Psychiatric Inpatient Unit: A Case Series

Patients with posttraumatic stress disorder (PTSD) are at an elevated risk of suicide. For patients hospitalized for suicide risk, psychosocial treatment and stabilization are routinely offered; however, the availability of evidence-based, manualized therapeutic interventions for PTSD is sparse. Typically, the short duration of hospitalization makes it difficult to accommodate evidence-based, trauma-focused treatments. This article presents the clinical course of four active-duty service members with PTSD who were hospitalized in a psychiatric inpatient unit for acute suicide risk and treated with Written Exposure Therapy for Suicide (WET-S). WET-S is a brief, five-session therapy based upon Written Exposure Therapy and augmented with Crisis Response Planning for Suicide Prevention. Both posttraumatic stress symptoms and suicidal ideation were reduced from pre- to posttreatment for three of the four patients treated. WET-S shows promise as a manualized therapeutic intervention that can be delivered on an inpatient psychiatric unit.     

Is Disgust Prepared? A Preliminary Examination in Young Children

Children may be prepared to associate adult disgust reactions with adult disgust elicitors. To test this, three-year olds (and adults) were presented with two images and an emotive vocalization. The images and vocalizations included stimuli adults found disgusting, fear-provoking, and sad. On one set of trials, the main dependent variable (DV) was time spent looking at each image and on a second set of repeat trials the DV was knowledge of image-sound matches. Fear and disgust vocalizations were both more effective at orienting a child's attention to adult fear and disgust images, than sad vocalizations. Parental disgust sensitivity was associated with this effect, moderated by explicit matching knowledge. Matching knowledge was poor in children and good in adults. These data suggest that in children, fear and disgust vocalizations may both promote attention to stimuli that adults find disgusting and/or fear-provoking, suggesting that “preparedness” may not be wholly emotion-specific.     

Jung's understanding of schizophrenia: is it still relevant in the ‘era of the brain’?

Jung was highly committed to grasping the meaning of psychotic thinking, and left behind precious insights to treatment scattered through his works written between 1906 and 1958. The tendency of today's psychiatry is to attribute the psychotic process to alteration in the brain's anatomy, biochemistry and electrophysiology, thus exempting the subject, i.e. the afflicted person, from responsibility for attachment to reality and their sanity. Jung understood schizophrenia as an ‘abaissement du niveau mental’, a similar phenomenon to the one encountered in dreams, and caused by a peculiar ‘faiblesse de la volonté’. He contested that complexes in schizophrenia, in contrast with neurotic disorders, are disconnected and can either never reintegrate to the psychic totality or can only join together in remission ‘like a mirror broke into splinters’ (Jung 1939 , para. 507). Accordingly, a person who does not fight for the supremacy of ego consciousness and has let themself be swayed by the intrusion of alien contents arising from the unconscious (even to the point of becoming fascinated by regression) is exposed to the danger of schizophrenia. The contemporary relevance of these notions and their necessity in understanding the psychotic process in the light of modern scientific findings are discussed.     

ERNEST BECKER'S PSYCHOLOGY OF RELIGION FORTY YEARS ON: A VIEW FROM SOCIAL COGNITIVE PSYCHOLOGY

This article distinguishes between three projects in Ernest Becker's (1924–1974) later work: his psychology of “religion,” his psychology of religion, and his psychology of Religion (with a capital R). The first is an analysis of culture and civilization as immortality projects, means by which to deny death. The second, which overlaps with the first, is a characterization of religion‐as‐practiced (e.g., by adherents of the world religions) as a particularly effective immortality project vis‐à‐vis death anxiety. The third is less social scientific and more theological; Becker argues for a view of God that is in the tradition of Søren Kierkegaard and Paul Tillich (and, arguably, Pseudo‐Dionysius, Augustine, and Thomas Aquinas). Focusing on the second of these projects—as much has already been written on the first, and little can be said about the third—this article evaluates Becker's claims about religion‐as‐practiced in light of recent developments in social cognitive psychology.     

MORALITY AND NATURE: EVOLUTIONARY CHALLENGES TO CHRISTIAN ETHICS

Christian ethics accentuates in manifold ways the unique character of human nature. Personalists believe that the mind is never reducible to material and physical substance. The human person is presented as the supreme principle, based on arguments referring to free‐willed actions, the immateriality of both the divine spirit and the reflexive capacity, intersubjectivity and self‐consciousness. But since Darwin, evolutionary biology slowly instructs us that morality roots in dispositions that are programmed by evolution into our nature. Historically, Thomas Huxley, “Darwin's bulldog,” agreed with Darwin on almost everything, except for his gradualist position on moral behavior. Huxley's “saltationism” has recently been characterized by Frans de Waal as “a veneer theory of morality.” Does this mark the end of a period of presenting morality as only the fruit of socialization processes (nurture) and as having nothing in common with nature? Does it necessarily imply a corrosion of personalist views on the human being or do Christian ethics have to become familiar again with their ancient roots?     

IMAGO DEI,DUALISM, AND EVOLUTION: A PHILOSOPHICAL DEFENSE OF THE STRUCTURAL IMAGE OF GOD

Most contemporary theologians have distanced themselves from views that identify the image of God with a capacity or a set of capacities that humans have. This article examines three arguments against the structural view and finds them wanting. The first argument is that the structural view entails mind/body dualism and dualism is no longer viable given neuroscience and contemporary philosophy. Against this, I argue that contemporary forms of dualism are able to circumvent such worries and are at least prima facie plausible. The second claim is that structural views end up disvaluing the human body and our relatedness. Here, I argue that neither the structural view nor dualism has such consequences. The third issue consists of various evolutionary worries that have to do with the lack of a clear‐cut boundary between human capacities and the capacities of nonhuman animals. As a response, the article argues that although there might not be a clear‐cut set of capacities that all humans share, we could still have a notion of human distinctiveness that is sufficient for the structural image of God.     

Natural Reflection,Phenomenological Reflection and Hyperreflexivity

This paper examines critically the notion of reflection as self-objectification and points out its insufficiency in accounting for the pathological phenomenon of hyperreflexivity. It proposes an understanding of reflection as situated and motivated from within a world and having a normative aspect that concerns the very life of the reflecting person. On this account, the paper argues, on the one hand, that both phenomenological reflection and hyperreflexivity can be viewed as forms of reflection characterized by loss of the world. On the other hand, by construing the phenomenological loss as imaginative vis-à-vis the real loss of hyperreflexivity, the paper emphasizes a difference between the two domains.     

The animacy advantage for free-recall performance is not attributable to greater mental arousal

People often demonstrate better memory for animate concepts (e.g., lion and sailor) than for inanimate concepts (e.g., hammer and mountain). Researchers have attributed this effect to an adaptive memory mechanism that favours information relevant for survival, including information about living things. In the present experiment, we examined the hypothesis that people demonstrate better free-recall performance for animate than inanimate words because animate words tend to be associated with greater mental arousal than inanimate words, a factor that was not controlled for in previous experiments on this topic. To this end, we matched animate and inanimate word lists on mental arousal (and several other factors), and compared participants’ free-recall performance for the two word types. We were able to replicate past findings that participants’ free-recall of animate words exceeds their free-recall of inanimate words, but we found no support for the possibility that the effect stems from differences in mental arousal between animate and inanimate concepts, as this effect maintained even when the word lists were matched on mental arousal. The present results therefore indicate that mental arousal cannot explain the effects of animacy on free-recall performance.     

MATRIX THINKING: AN ADAPTATION AT THE FOUNDATION OF HUMAN SCIENCE,RELIGION, AND ART

Intrigued by Robinson and Southgate's 2010 work on “entering a semiotic matrix,” we expand their model to include the juxtaposition of all signs, symbols, and mental categories, and to explore the underpinnings of creativity in science, religion, and art. We rely on an interdisciplinary review of human sentience in archaeology, evolutionary biology, the cognitive science of religion, and literature, and speculate on the development of sentience in response to strong selection pressure on the hominin evolutionary line, leaving us the “lone survivors” of complex, multiple lines of physical and cultural evolution. What we call Matrix Thinking—the creative driver of human sentience—has important cognitive and intellectual features, but also equally important characteristics traced to our intense sociability and use of emotionality in vetting rational models. Scientist, theologian, and artist create new cultural knowledge within a social context even if alone. They are rewarded by emotional validation from group members, and guided by the ever present question, “Does it feel right?”     

The triumph of American psychiatry: How it created the modern therapeutic state

Over the past 170 years, American psychiatry has progressively asserted its authority over a larger segment of the American population. From the mid-1800s to the end of World War II, psychiatry had authority over the asylum population, which markedly increased in the first half of the twentieth century due to the influence of eugenics, an ideology that argued the ‘mentally ill’ had to be segregated from society. After the war, American psychiatry adopted Freudian conceptions of mental disorders, which enabled it to begin treating people in the community who were ‘neurotic’ in some way, which dramatically expanded its influence in society. Then, in the 1970s, when many in American society were questioning psychiatry’s legitimacy as a branch of medicine, the American Psychiatric Association (APA) responded by adopting a disease model for diagnosing mental disorders, which it set forth in the third edition of its Diagnostic and Statistical Manual. There were no scientific discoveries that led to this new model, but soon the APA was informing the American public that mental disorders were diseases of the brain, and that psychiatric drugs helped fix those diseases, ‘like insulin for diabetes.’ The APA, in concert with pharmaceutical companies, has successfully exported this belief system to much of the developed world. In order to break free of this ‘therapeutic state,’ the public needs to understand the history of how it came to be, and see the social injury it has caused.