Theory as metaphor: clinical knowledge and its communication

Abstract :  This paper investigates the relationship between clinical knowledge and psychological theory and considers the implications for clinical writing. I argue that clinical knowledge is a way of understanding rather than a body of facts and compare clinical material to 'texts' that generate multiple and indeterminate meanings. Analytic theories, which represent the crystallization of ways of understanding clinical phenomena, have an inherently metaphorical 'as if' quality since they are derived from and adapted to the clinical process of making meaning by representing psychic states in symbolic form. Thus good clinical writing demonstrates an integration of theory and clinical material into a unified network of symbolic meanings. Redfearn's paper, 'The captive, the treasure, the hero and the "anal" stage of development' (1979), is discussed as an exemplar of such integration. It is suggested that clinical knowledge is equivalent to the skill of making effective interpretations.     

Clinical ethics as medical hermeneutics

There are several branches of ethics. Clinical ethics, the one closest to medical decisionmaking, can be seen as a branch of medicine itself. In this view, clinical ethics is a unitary hermeneutics. Its rule is a guideline for unifying other theories of ethics in conjunction with the clinical context. Put another way, clinical ethics interprets the clinical situation in light of a balance of other values that, while guiding the decisionmaking process, also contributes to the very weighting of those values. The case itself originates ideas, not only about which value ought to predominate in its resolution, but also provides the origin of clinical rules that can be used in other cases. These are interpretive rules. Some examples of these rules are presented as well.     

Transference, the transcendent function, and transcendence

People in analysis come into direct contact with the transcendent – that which surpasses not only our ego consciousness but the whole psyche – through the transcendent function working in the transference–countertransference field. Reductive and synthetic methods of interpretation of transference, in both objective and subjective levels of meaning, inaugurate moving the ego out of center stage into the process of relating to the Self. The transcendent function is the means of enlarging psychic space in the transference field to make room for coinciding opposites and a 'creative solution' that arises from their conversation. That solution, or set of symbols, addresses us with such compelling authority that Jung likens it to 'the voice of God', A clinical case illustrates the connection of transference, the transcendent function, and the experience of the transcendent which, I believe, we must identify as such in order to go on relating to it.     

Cognitive, Affective and Behavioral Correlates of Internalization of Regulations for Religious Activities

The main goal of this study was to examine the relationship between different types of extrinsic motivation for religious behaviors as conceptualised within self-determination theory (Ryan & Deci, 2000) and Wulff's (1991) framework of literal versus symbolic approaches of religious contents. Results from a Belgian sample of active believers (N=186) show that the internalization of one's reasons for performing religious behaviors was positively associated with an open, symbolic interpretation of religious belief contents and a stronger adherence to Christian beliefs. Moreover, internalization was also positively related to general well-being and frequency of prayer but unrelated to church attendance. It is concluded that individuals who engage in religious behaviors because of its perceived personal significance will show more cognitive flexibility and open-mindedness towards Christian belief contents, a stronger adherence to this message, higher well-being and more frequent engagement in specific religious behaviors.

Giving Science a Bad Name: Politically and Commercially Motivated Fallacies in BSE Inquiry

It is a feature of scientific inquiry that it proceeds alongside a multitude of non-scientific interests. This statement is as true of the scientific inquiries of previous centuries, many of which brought scientists into conflict with institutionalised religious thinking, as it is true of the scientific inquiries of today, which are conducted increasingly within commercial and political contexts. However, while the fact of the coexistence of scientific and non-scientific interests has changed little over time, what has changed with time is the effect of this coexistence on scientific inquiry itself. While scientists may no longer construct their theories with various religious dictates in mind, growing commercial and political interests in science have served to distort the interpretation of science. Using the U.K.’s recent crisis with bovine spongiform encephalopathy (BSE) as my context, I examine two ways in which this distortion has occurred – the interpretation of the science of BSE by politicians and by commercial parties for the purposes of justifying policy decisions and informing the public of risk, respectively. Fallacious reasoning, I contend, is the manifestation of this distortion in these contexts. In demonstration of this claim, I examine how politicians and commercial parties alike have employed two fallacies in their assessments of the science of BSE. These fallacies extend in novel ways the set of so-called traditional informal fallacies. The interpretation of science, I conclude, is a rich context in which to conduct a study of fallacious reasoning; moreover, such a study can contribute in significant ways, I argue, to the public understanding of science.     

The Rational Reconstruction of Argumentation Referring to Consequences and Purposes in the Application of Legal Rules: A Pragma-Dialectical Perspective

In this paper, the author develops an instrument for the rational reconstruction of argumentation in which a judicial decision is justified by referring to the consequences in relation to the purpose of the rule. The instrument is developed by integrating insights from legal theory and legal philosophy about the function and use of arguments from consequences in relation to the purpose of a rule into a pragma-dialectical framework. Then, by applying the instrument to the analysis of examples from legal practice, it is demonstrated that the instrument can offer a heuristic and critical tool for the analysis and evaluation of legal argumentation that can ‘bridge’ the gap between more abstract discussions of forms of legal argumentation on the one hand, and legal arguments as they occur in actual legal practice on the other hand.     

Applied Political Philosophy at the Rubicon: Will Kymlica's Multicultural Citizenship

Will Kymlicka's Multicultural Citizenship represents an extraordinary attempt to put applied political philosophy to work in the empirical context of contemporary political debates about immigration and ethnic minorities in western society. This paper explores the methodological and interpretative difficulties of combining normative and empirical goals, in a critical discussion of the examples Kymlicka makes of multicultural issues in France, Britain and the US. It goes on to argue that these weaknesses lie in the Rawlsian influence in Kymlicka's work, and that political philosophers may have to rethink their methodological approach if they wish to pursue further the kind of applied work which Kymlicka is aiming for.     

Hermeneutics and Experiences of the Body. The Case of Low Back Pain

The purpose of this paper is to elaborate on the notion of clinical medicine as a hermeneutical enterprise and to bridge the gap between the general perspectives of hermeneutics and the particularities of medical practice. The case of a patient with low back pain is analyzed. The discussion centers around the metaphor of the patient as a text and a model of five social discourses about low back pain. The problems addressed are: (1) the nature of a moral experience, (2) the variety of available texts, (3) the difference between the doctor's and patient's narratives, and (4) the patient's and doctor's responsibility regarding the existential, biographical meaning of an illness. Although many problems are left unsolved, it is argued that from a philosophical point of view the notion of medicine as a hermeneutical enterprise opens up the possibility of gaining insight in the foundations of the clinical encounter.     

QUANTUM PHYSICS, PHILOSOPHY, AND THE IMAGE OF GOD: INSIGHTS FROM WOLFGANG PAULI

Abstract. Nobel Laureate in physics Wolfgang Pauli studied philosophy and the history of ideas intensively, especially in his later years, to form an accurate ontology vis-à-vis quantum theory. Pauli's close contacts with the Swiss psychiatrist C.G. Jung gave him special qualifications for also understanding the basic problems of empirical knowledge. After Pauli's sudden death in 1958, this work was maintained mainly in his posthumously published correspondence, which so far extends only to 1939. Because Pauli's view differs essentially from the direction physics research took after the deaths of the founding fathers of quantum theory, this article attempts to describe the main features in Pauli's revolutionary thought, which is based on nature's "epistemological lesson" as revealed by Pauli's atomic research. Pauli's conclusions have important implications for various issues in Western culture, not least with the limits of science and the relation of science to religion.     

Rhetoric,reasonableness and ethics: An essay on Perelman

The article deals with an interpretation of the work of Ch. Perelman. The author tries to determine the meaning of reasonableness in a hermeneutical and anthropological perspective. He then places the work of Perelman in the light of the theory of symbolic interactionism of G.H. Mead.