Ethnographic interviews to elicit patients' reactions to an intelligent interactive telephone health behavior advisor system.
Information technology is being used to collect data directly from patients and to provide educational information to them. Concern over patient reactions to this use of information technology is especially important in light of the debate over whether computers dehumanize patients. This study reports reactions that patient users expressed in ethnographic interviews about using a computer-based telecommunications system. The interviews were conducted as part of a larger evaluation of Telephone-Linked Care (TLC)-HealthCall, an intelligent interactive telephone advisor, that advised individuals about how to improve their health through changes in diet or exercise. Interview findings suggest that people formed personal relationships with the TLC system. These relationships ranged from feeling guilty about their diet or exercise behavior to feeling love for the voice. The findings raise system design and user interface issues as well as research and ethical questions. (+info)
Child sexual abuse, poor parental care and adult depression: evidence for different mechanisms.
BACKGROUND: Child sexual abuse (CSA) and poor parental care (neglect and institutional care) are associated with depression in adult life. Little is known about possible mechanisms underlying these associations. AIMS: To examine the role of adult intimate-love relationships as differential mediators or moderators of the associations between CSA, poor parental care and adult depression. METHOD: Sampling was carried out in two phases. In the first, questionnaires were sent to women aged 25-36 years in five primary care practices. Second-phase subjects for interview (n=198) were drawn from three strata defined on the basis of childhood adversities. Recalled childhood experiences and recent adult relationships and depression were assessed and rated independently. Frequencies of predictor and response variables, effect estimates and their confidence intervals were weighted back to the general population questionnaire sample. RESULTS: The risk for depression associated with CSA was unaffected by quality of adult relationships, while the risk associated with poor parental care was substantially altered. CONCLUSIONS: There may be different pathways linking CSA and poor parental care to adult depression. (+info)
Reply to Ann Bradshaw.
My original paper suggested that an ethics of care which failed to specify how, and about what, to care would be devoid of normative and descriptive content. Bradshaw's approach provides such a specification and is, therefore, not devoid of such content. However, as all ethical approaches suggest something about the 'what' and 'how' of care, they are all 'ethics of care' in this broader sense. This reinforces rather than undermines my original conclusion. Furthermore, Bradshaw's 'ethics of care' has philosophical and historical problems which I outline. (+info)
Models of dyadic social interaction.
We discuss the logic of research designs for dyadic interaction and present statistical models with parameters that are tied to psychologically relevant constructs. Building on Karl Pearson's classic nineteenth-century statistical analysis of within-organism similarity, we describe several approaches to indexing dyadic interdependence and provide graphical methods for visualizing dyadic data. We also describe several statistical and conceptual solutions to the 'levels of analytic' problem in analysing dyadic data. These analytic strategies allow the researcher to examine and measure psychological questions of interdependence and social influence. We provide illustrative data from casually interacting and romantic dyads. (+info)
Holistic medicine IV: principles of existential holistic group therapy and the holistic process of healing in a group setting.
In existential holistic group therapy, the whole person heals in accordance with the holistic process theory and the life mission theory. Existential group psychotherapy addresses the emotional aspect of the human mind related to death, freedom, isolation, and meaninglessness, while existential holistic group therapy addresses the state of the person"s wholeness. This includes the body, the person's philosophy of life, and often also love, purpose of life, and the spiritual dimension, to the same extent as it addresses the emotional psyche and sexuality, and it is thus much broader than traditional psychotherapy. Where existential psychotherapy is rather depressing concerning the fundamental human condition, existential holistic therapy conceives life to be basically good. The fundamentals in existential holistic therapy are that everybody has the potential for healing themselves to become loving, joyful, sexually attractive, strong, and gifted, which is a message that most patients welcome. While the patient is suffering and fighting to get through life, the most important job for the holistic therapist is to keep a positive perspective of life. In accordance with these fundamentals, many participants in holistic group therapy will have positive emotional experiences, often of an unknown intensity, and these experiences appear to transform their lives within only a few days or weeks of therapy. An important idea of the course is Bohm's concept of "holo-movement" in the group, resulting from intense coherence between the group members. When the group comes together, the individual will be linked to the totality and the great movement forward towards love, consciousness, and happiness will happen collectively--if it happens at all. This gives the individual the feeling that everything that happens is right, important, and valuable for all the participants at the same time. Native Americans and other premodern people refer to this experience as "the spiritual design". This design is actually an underlying regulation that appears when people, through their feelings and engagement for each other, tie the group together and engage their complex emotional intelligence. Practically, this means that all participants are sunk in the same information matrix, so that everybody learns from each other. Everything that happens in the perception of each trainee has immediate and developing relevance for him. Spontaneous healing happens far more effectively in a group setting, where all the participants stand together and support each other, than it does in the clinic, where the therapist is alone with the patient. A 5-day course in personal development can be compatible to a half year of holistic individual therapy. (+info)
Importance of object relations theories for development of capacity for mature love.
We discuss Klein's, Winnicott's, and Mahler's object relational theories relevant for creating and maintaining the mature love relationship. The concept of love refers to the basic human relationship. The capacity for adult love involves the attainment of the relation towards the object as whole, satisfying the emotional needs of the self, including simultaneous tolerance of the specific needs of the object. It also involves the optimum resolution of anxiety related to schizo-paranoid and depressive positions and phases of separation and individuation. Primitive defense mechanisms, such as splitting, are replaced by more mature defense mechanisms, and primitive idealization is replaced by more mature idealization. The fusion with the object is reversible and helps in creating the experience of closeness with the partner, while the possibility of separation provides the possibility of recognizing and respecting the differences. Obstacles in the development of object relationships from pre-object to object phase, from symbiotic to separation and individuation phase can impair the capacity to love. (+info)
Consciousness-based medicine is our term for a form of medical treatment that works by direct appeal to the consciousness of the patient, in contrast to modern biomedical treatment where drugs are used to affect body chemistry. With this concept, maybe we are (in a sense) turning back to the "old medicine", where the family physician was the all-concerned "old country doctor" who knew the child, the siblings, the parents, the family, and the village. In a series of papers on clinical holistic medicine, we would like to present the classic art of healing, where the physician works mostly with his hands, then show how the modern biomedical physician performs with biochemistry, and finally introduce consciousness-based medicine. Some of our questions will be: If you improve your quality of life, will you also improve your health? Will learning more about yourself bring more purpose in your life? Will finding someone to live with in a loving and mutually respectful relationship improve your health? Scientists and thinkers like Antonovsky, Frankl, Maslow, and Jung have pointed to love as a unique way to coherence in life, and thus to biological order and a better health. Several scientific studies have also suggested that patients who focus on improving their quality of life usually will not follow the general statistics for survival, since somehow other factors are at play, which sometimes you will find referred to as "exceptional". (+info)
Clinical holistic medicine: classic art of healing or the therapeutic touch.
Touching is often a forgotten part of medicine. The manual medicine or therapeutic touch (TT) is much more powerful than many modern, biomedically oriented physicians think. Pain and discomfort can be alleviated just by touching the sick area and in this way help the patient to be in better contact with the tissue and organs of their body. Lack of presence in the body seems to be connected with many symptoms that can be readily reversed simply by sensitive touch. When touch is combined with therapeutic work on mind and feelings, holistic healing seems to be facilitated and many problems can be solved in a direct and easy way in the clinic without drugs. This paper gives examples of the strength of manual medicine or therapeutic touch in its most simple form, and points to the power of physical contact between physician and his patient in the context of the theory and practice of holistic healing. Intimacy seems highly beneficial for the process of healing and it is very important to distinguish clearly between intimacy and sexuality for the physician and his patent to be able to give and receive touch without fear and without holding back emotionally. (+info)