Thursday, July 26, 2012

PSYCHIATRY AT A GLANCE

As one of the contributing authors of Chapter 44 of the book, I am very pleased to be associated with the release of the 5th edition of the text Psychiatry at a Glance.

The book is an easy-to-use, accessible introductory and study text for all students of psychiatry---as well as mental health workers generally---presenting 'need to know' information on the basic science, treatment, and management of the major disorders.

The 5th edition features, among other things, new chapters on mental health capacity and coverage of the Australian and New Zealand mental health care legislation (Chapter 44).

Psychiatry at a Glance is the ideal companion for anyone about to start a psychiatric attachment or module and will appeal to medical students, junior doctors and psychiatry trainees as well as nursing students and other health care professionals.


Resource:
ISBN: 978-0-470-65891-8  Paperback  128 pages  July 2012  Wiley-Blackwell
AUD $47.95 / NZD $52.99


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Friday, July 20, 2012

HEALTH BENEFITS OF MINDFULNESS-BASED PRACTICES

Specific types of ‘mindfulness practices’ including Zen meditation have demonstrated benefits for patients with certain physical and mental health problems, according to a report in the July 2012 Journal of Psychiatric Practice.

‘An extensive review of therapies that include meditation as a key component -- referred to as mindfulness-based practices -- shows convincing evidence that such interventions are effective in the treatment of psychiatric symptoms and pain, when used in combination with more conventional therapies,’ according to Dr William R Marchand (pictured left) of the George E Wahlen Veterans Affairs Medical Center and the University of Utah in Salt Lake City.

Dr Marchand reviewed published studies evaluating the health benefits of mindfulness-based practices. The review focused on the following three techniques:

Zen meditation, a Buddhist spiritual practice that involves the practice of developing mindfulness by meditation, typically focusing on awareness of breathing patterns.

Mindfulness-based stress reduction (MBSR), a secular method of using Buddhist mindfulness, combining meditation with elements of yoga and education about stress and coping strategies.

Mindfulness-based cognitive therapy (MBCT), which combines MBSR with principles of cognitive therapy (for example, recognizing and disengaging from negative thoughts) to prevent relapse of depression.

Dr Marchand found evidence that MBSR and MBCT have ‘broad-spectrum’ effects against depression and anxiety and can also decrease general psychological distress. Based on the evidence, MBCT can be ‘strongly recommended’ as an addition to conventional treatments (adjunctive treatment) for unipolar depression. Both MBSR and MBCT were effective adjunctive treatments for anxiety.

Research data also supported the effectiveness of MBSR to help reduce stress and promote general psychological health in patients with various medical and/or psychiatric illnesses. On its own, MBSR was helpful in managing stress and promoting general psychological health in healthy people. There was also evidence that Zen meditation and MBSR were useful adjunctive treatments for pain management.

How do these practices work to affect mental and physical health? Dr Marchand discusses recent research showing the impact of mindfulness practices on brain function and structure, which may in part account for their psychological benefits. ‘These mindfulness practices show considerable promise and the available evidence indicates their use is currently warranted in a variety of clinical situations,’ Marchand concludes.

The article includes some proposed evidence-based guidelines for incorporating mindfulness-based practices into health care. So far there's little evidence on which patients are most likely to benefit, but Dr Marchand suggests that patient preferences and enthusiasm are a good guide. He comments, ‘The most important considerations may be desire to try a mindfulness-based practice and willingness to engage in the regular practice of seated meditation.’

This post sets out a simple form of mindfulness sitting meditation.



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Tuesday, July 17, 2012

WHY CAN’T PEOPLE BE REAL?

Yes, why can’t they?

What, you may ask, do I mean by ‘real.’ Well, here’s a Bible verse which encapsulates much of what is meant by being real. It’s as follows: ‘Simply let your “Yes” be “Yes,” and your “No,” “No”; anything beyond this comes from the evil one’ (Mt 5:37) [NIV]. So many people I know---especially young people---when invited to some event and asked to RSVP say, ‘I hope to come, but I may have something else on. I’ll let you know.’ What that means is they are waiting to see if they get a better offer. It almost invariably means they won’t be coming to your event. Why can’t they just say ‘yes’ or ‘no,’ and be done with it?

Here’s something that really gets me upset. I am a lawyer, and over the years I have acted for several government instrumentalities. I still do. Now, I want to speak about one of those organizations and its CEO. This CEO would often push things beyond the four corners or boundaries of the law. He would never let the law stand in the way of doing what he wanted to do. On several occasions, whilst acting as in-house lawyer, I wrote to him advising that what the organization was doing was wrong---indeed, unlawful. You see, statutory notices and orders affecting persons’ rights and interests were being issued by staff of the organization, and those notices and orders were invalid. That was exceedingly unfair to the persons affected by these notices and orders. In addition, the organization itself was being exposed to actionable liability.

Now, part of the role of a lawyer---especially an in-house lawyer---is to protect the organization against all risks, including itself. So, I dutifully drew the attention of the CEO---on several different occasions---to the various illegalities and irregularities (which, by the way, related to matters other than just notices and orders), and I politely requested that the CEO issue a direction to staff that all draft notices and orders be submitted to me for checking and review before they issued. Despite several emails to the CEO about this matter, I never received any reply---not even an acknowledgment of one of my communications. Some years later the Ombudsman investigated the organization and wrote a scathing report on the many illegalities and irregularities. It was one of the most damning reports of the type in question I have ever read in my 35 years in the law. Only some time thereafter did the CEO issue that direction to staff. Better late than never. No, not really.

I never did find out why the CEO ignored all of my emails, but it’s clear to me that he didn’t care whether the notices and orders were invalid. Not only did he fail to show respect to me, he exposed his organization to great risk. He was not real. You see, part of being real---a huge part of it---is showing respect to others. Now, this man---this CEO---would say to staff, ‘Respect must be earned.’ Rubbish! If that were the case, we would only show respect to those who are like us, and who give us what we want. Anyone who disagreed with us, or stood in our way, would not be the recipient of our respect. No, respect must be given to all people, regardless of who they are and what they do. That doesn’t mean we have to like them nor does it mean that we must always approve of their actions. Respect is, however, due to all persons because they are---human beings … persons among persons! Mind you, respect must also be given to all manifestations and forms of life, and that includes plants, animals and the environment. I digress.

The point is this---being real means being authentic. Such a person always acts and speaks from a position of integrity. Interestingly, the word ‘integrity’ stems from the Latin adjective integer, meaning ‘whole’ or ‘complete.’ Integrity is all about telling yourself the truth, whereas honesty is all about telling others the truth. Now, there can be no integrity without honesty. The word ‘honesty’---from the Latin noun honestās, means ‘oneness’---that is, oneness with the truth, the facts. Facts are occurrences in space and time---in other words ... what is … reality! Thus, anything that is not a fact, or not in accordance with the facts, is ... dishonest! Truth is nothing more than a factually correct statement or description of what is. A real person embodies and resonates the truth in all their dealings.

Being real is being whole, complete and at-one with what is. Nothing---absolutely nothing----is superior to that.

Try being entirely real for a day. Then do it again, the next day, and thereafter. In time, you may even get to like it. Before you know it, you will find that 'life ceases to be a fraction and becomes an integer,’ as Dr Harry Emerson Fosdick pointed out in his helpful book On Being a Real Person. I kid you not.





Friday, July 6, 2012

JOHN ANDERSON, PHILOSOPHER AND CONTROVERSIALIST EXTRAORDINAIRE


'There are only facts, i.e., occurrences in space and time.' - John Anderson, 'Empiricism', Australasian Journal of Psychology and Philosophy,
December 1927, p 14.


‘Let us now praise famous men … .’

Today---July 6, 2012---marks the 50th anniversary of the death of the Scottish-born philosopher and controversialist John Anderson (pictured left, as well as below), who was Challis Professor of Philosophy at the University of Sydney from 1927 to 1958 (and thereafter Emeritus Professor of Philosophy until his death in Sydney’s Royal North Shore Hospital in 1962). Anderson, regarded by many as the ‘patron saint’ of the Sydney Push, founded the school or branch of empirical philosophy known as ‘Sydney realism’ (and also known as ‘Andersonian realism’ as well as 'situational realism').

John Anderson was an intellectual giant of a man the likes of which we may never see again. On 3 July I was very pleased to be able to attend a symposium held in Sydney in Anderson’s honour and memory. Speakers at the mini-conference---convened by the ‘Sydney Realists’ group---included the esteemed philosopher Emeritus Professor David Armstrong (unarguably Australia's greatest living philosopher---perhaps our greatest all-time), the talented and dedicated Dr Mark Weblin (former John Anderson Research Fellow at the University of Sydney), and the equally gifted and scholarly 'Andersonian' psychologist Dr Terry McMullen.

Sadly, I never met Professor John Anderson. I knew his son Alexander (Sandy), but only slightly. Sandy was also a philosopher---Andersonian, of course. He and his late father lived in my street in Turramurra. Anyway, for most of my ‘thinking’ life I have been an Andersonian. Although in recent times I have moved away from a number of different aspects of his systematic philosophy I still adhere to the central thrust of that philosophy, and when I teach law and other disciplines at tertiary institutions I use his ideas on the nature of reality---and the importance of critical thinking---to explain to students the nature of ‘facts’ ... for, as Anderson taught, nothing, absolutely nothing, is superior to facts!

The central thrust of Professor Anderson’s otherwise complex realist philosophy is quite simple ... there is only one way of being, and one order or level of reality, that of occurrence ... that is, ordinary things occurring in space and time (or ‘spacetime’, as some would say today) ... that is, facts. Having said that, Anderson nevertheless saw all things as being 'irreducibly complex,' that is, he asserted that there is no a priori limit to the number of true things that one might---and can---say about any given state of affairs, and the relationships between that state of affairs and any one or more other states of affairs. Be that as it may, any notion of there being different---for example, so-called ‘higher’ and ‘lower’---orders or levels of reality or truth was, Anderson pointed out, ‘contrary to the very nature and possibility of discourse.’ Such thinking (if that be the right word for it) was, according to Anderson, ‘unspeakable’---indeed, meaningless. Anderson referred to this as the ‘problem of commensurability.’ If, for example, there were different orders or levels of reality, how could there ever be ‘connections’ between them, or any way---let alone a single or uniform way---of speaking about them?

You see, according to Anderson things themselves are ‘propositional,’ that is, it is only in propositions that we know---indeed can know---things at all. Things are not prior to propositions. The proposition---so central to traditional Aristotelian logic---is the way in which things actually occur. All objects of experience---indeed, all things---take the propositional form. In other words, there is, says Anderson, a direct, logical, coterminous relationship between the proposition and the way things actually are.

One way of being. One order or level of reality. When, many years ago, I grasped the significance of that truth all notions of and belief in the possibility of ‘supernaturalism’ as well as traditional theism totally vanished for me. A damn good thing, too. My whole life changed for the better. I do not miss my former belief in the so-called ‘supernatural’ and ‘miraculous.’ Indeed, I am much happier for being able to rejoice in the extraordinary in the ordinary. Reality just is. (And, as Krishnamurti used to say, ‘
In the acknowledgement of what is, there is the cessation of all conflict.’ There, you have all you need to know.)

Anderson taught that a single logic applies to all things and how they are related, and that there are three – yes, three – separate ‘entities’ to any relation such as seeing, having, knowing, etc---namely, the -er, the -ed, and the -ing. First, there is the person who sees, has or knows. Secondly, there is the thing seen, had or known. Thirdly, and most importantly, there is the act of seeing, having or knowing. Anderson taught that none of these three things---each of which is a fact---is constituted by its relations to any of the others nor dependent on any of the others. So, things do in fact exist independently of their being perceived, held or known. One more thing---all relations (even so-called ‘internal’ ones) are external to the objects or parts whose relations they are. That’s hard to understand, but I think Anderson is right about that.

Anderson had much to say about ‘facts.’ So, what is a fact? A fact is an occurrence in space and time---a ‘thing-in-itself’. There are only facts ... facts! And facts are knowable. Anderson pointed out that logic is not so much a body of rules, principles and methods for evaluating and constructing arguments as a description of how things---note that, 'things'---are related to each other. In other words, logic is about things, not thought. (I wish I could get that point across to others---including many logicians and philosophers who generally regard Anderson's view of logic as being somewhat quaint and even eccentric.)

Thus, logical thinking means relating (that is, putting together or distinguishing) different pieces of information about facts or alleged facts. In that sense, logic is a description of reality. Logic helps us to find facts and see the connections between one set of facts and another. It teaches us that, in order for there to be any theory, a fact can be explained only as following logically from other facts occurring on the same level of observability. Hence, Anderson denied that any proposition is ‘transparently’ (or ‘necessarily’) true. That means that a statement that something is the case can be justified only by a statement that something else is the case. So, every proposition---note that, every proposition---is contingently true or false. Having said that, there are no degrees, kinds or levels of truth. Every question---other than reality itself (which is neither true nor false, but just is)---is an issue of truth or falsity, although I must point out that Anderson rejected, among other things, any so-called 'totalistic' view of truth (which would see truth in the fullest sense of the word as being nothing less than the truth of the Whole, that is, 'the Whole Truth').

Now, listen to this. Even opinions and ideas can be said to be true or false when attention is directed, not to the opinion or idea itself, but to the thing that the opinion or idea or value is of. The test of a true opinion or idea is to see whether or not something is the case. No, it is simply not the case that one person or culture’s ideas are as good as those of any other. It may be politically correct to say or believe that, but it is not the case.

Here’s something else that I came to understand from a study of Anderson’s systematic philosophy. There is no such thing as the ‘universe.’ That’s right! The ‘universe’ is simply a word referring to the sum 'total' of all there is, with the totality of all things being what is known as a 'closed system.' Each 'thing' is a cause of at least one other 'thing' as well as being the effect of some other 'thing,' so everything is explainable by reference to everything else. End of story. Hence, all theological talk of the supposed need for some 'first cause' is ... well, nonsense and humbug! As Professor Anderson pointed out, 'there can be no contrivance of a "universe" or totality of things, because the contriver would have to be included in the totality of things.' In any event, the entire notion of a supposed 'Being'---the 'contriver'---whose essential attributes (eg omnipresence, omnipotence and omniscience) are non-empirical is unintelligible. Further, why would a supposedly supernatural 'contriver' bother to 'create' a natural universe---assuming for the moment it was created? (I have no problems whatsoever with the idea that the so-called universe was either self-created or uncreated.) In any event, empirical observation can find nothing ‘metaphysical’, ‘occult’ or ‘beyond experience’.

Further, both science and philosophy afford us no evidence or support for the idea that there are any entities beyond space and time which yet work out their supposed purposes within space and time. Both science and logic compel us to refuse to affirm that which is unobservable. Indeed, we are compelled to reject the unobservable (divine or otherwise) as the cause or explanation of the observable. Anderson relied solely on the observable. It should thus come as no surprise to hear that John Anderson was a militant atheist who was totally opposed to the teaching of religion in schools---except as mythology. (For Anderson, even the ethical teachings of Jesus were, for the most part, ‘trite,’ ‘trivial’ and ‘superficial.’ In short, he rejected all forms of moralism and meliorism.)

Anderson made it unambiguously clear that the task of the philosopher---indeed, the task of any true academic---is to inquire … freely. Established facts, not dogma, is the field of inquiry. Academicism is forfeited if one takes anything to be superior to facts (eg beliefs, dogmas). Nothing---absolutely nothing---can be accepted on faith or on the basis of supposed ‘revelation,’ whatever that is. Everything must forever be open to challenge and disproof.

Anderson wrote of the 'facts of complexity and interaction,' and the 'influence of the other things with which [things] come in contact.' Buddhists see that as evidence of the interconnectedness of all things---Thich Nhat Hanh calls it 'InterBeing'---and they assert a doctrine of 'dependent origination' (or 'dependent arising'). Anderson would reject such monism, but at least the Buddhist teaching makes more sense than certain alternative (especially Christian) worldviews. I think so, anyway.

Anderson also wrote that there is no such thing as ‘consciousness.’ That’s right! There is no ‘consciousness’ whose nature it is to know, just as there are no ‘ideas’ whose nature it is to be known---and also no so-called ‘ultimates.’ I repeat---nothing, absolutely nothing, is constituted by, nor can it be defined or explained by reference to, the relations it has to other things. One can be ‘conscious’ (or aware) of something, and one may speak of the ‘act of being conscious’ (or aware) of something, but there is no such thing as ‘consciousness’ per se. Yes, ‘relativism’ must be eliminated if one is to acknowledge the all-important distinction between qualities and relations. (Interestingly, Anderson himself doesn’t entirely avoid the pitfall of relativism. For example, he speaks of intellectual pursuits as being ‘operations of the love of truth (the inquiring spirit)’ [emphasis added]---just one of a number of instances where Anderson purports to define or explain something by reference to its object (despite his repeated injunction to eschew such relativist practices).

Another thing. Anderson saw the uselessness and folly of beliefs---beliefs of all kinds, not just religious ones. He and other Andersonians would say, ‘The sky is blue. The sky does not become any bluer because you believe it to be blue. Further, the proposition---the sky is blue---does not become any truer because you believe it to be true.’ There is nothing to believe. And there is no need to belief anything. Just look … observe … understand … and know. You see, truth is not relative to persons. Truth is what is. Ignorance and mistaken beliefs do nothing to make truth relative. When any proposition is taken to its logical conclusion, a question of fact---truth or falsity---is always reached. One always can get back to the objective distinction between something being the case and not being the case. So, if I say, quite subjectively, 'The sky is for me blue', you may think quite differently. However, once I ask, 'Is the sky blue for you?', an objective issue is immediately raised. The question is whether it is true that the sky is blue for you, not whether it is true for you that the sky is blue for you. Forget it. I'm sorry I started on that one!

Anderson was an empiricist, not a rationalist. The great pitfall with rationalism is that it starts with the mind, whereas empiricism starts with our direct, immediate and non-representational experience with facts. Yes, we are in direct, unmediated contact with facts---not ‘sense data’ (the latter being the supposed ‘content’ of our experience). As Anderson saw it, rationalism was just another form of idealism---something to be shunned. Anderson was a realist---that is, one who holds with George Berkeley's Hylas that 'to exist is one thing, to be perceived another.'

John Anderson in the garden at Turramurra

Anderson was an intellectual. He stood for a non-utilitarian, traditional, classical, liberal arts (i.e. 'Scottish') education—as well as for academic freedom (which, sadly, is gone today). If Anderson were alive today, he would be totally appalled at today’s educational system. One of the greatest books ever written is Charles Sykes’ book, Dumbing Down Our Kids: Why American Children Feel Good About Themselves but Can’t Read, Write or Add. If you haven't read that book, please do so. As a university lecturer based in Sydney, Australia, I taught law---which is all about the power of the written and spoken word---at a major university in Sydney for almost 20 years, and I was simply appalled at how few of my law students over the years could write a simple, decent English sentence.

The problem got worse as the years progressed. It wasn't really the fault of the students. It was the fault of a number of silly people in high places in government and educational bureaucracy over the previous 2 or 3 decades who preached that literacy of the supposed 'old-fashioned kind' was unimportant. What was supposedly important was ensuring that every 'precious' (and supposedly equally ‘gifted’) student---whose opinion was said to be as good as that of any other student---had a 'healthy ego' and was not 'stigmatized' or ‘shamed’ in any way. ‘Let the children express themselves in any way they wish’---that sort of nonsense. So, the task of the teacher or lecturer was to 'jolly them [the students] along.' The result? Wholesale mediocrity, normopathic conformity (yes!) and narcissism of an almost clinical kind.

The freethinking John Anderson was a bit eccentric and idiosyncratic, but I am of the view that all truly clever people are eccentric and idiosyncratic. However, in today’s world---especially in academia---eccentricity and idiosyncrasy are increasingly labelled an ‘unacceptable pattern of behaviour,’ and are seen at best as signs of a personality disorder, to be punished in various ways. There is no place for John Andersons in today’s not-so-hallowed halls of learning. The cranky, caustic commentator---the gadfly who says ‘the Emperor has no clothes’---is relegated to the back pages of the tabloids … if they’re allowed to be heard at all.

Now, there are, as I and others see it, some not insignificant problems with many aspects of Anderson’s determinist, empiricist philosophical position (for example, his view of ‘mind as feeling,’ which fails to account for ‘feelings’ themselves, and his somewhat implausible objectivist view of ethics), but that’s for another day. Also, it seems to me that the often irascible and anti-clerical Anderson must have been just as much of a dogmatist when it came to his system of philosophy as the Sydney Anglicans (for whom he had utter contempt) were---and still are---with respect to their narrow, twisted, perverted version of Christianity. Be that as it may, Anderson was, as I have already said, an intellectual giant of a man.

Things are propositional; propositions are identical to the states of affairs described (subject, perhaps, to what are known as 'false propositions'). A single logic applies to all things. There is only one way of being, and one order or level of reality---a spacetime world full of interacting material things ('facts'). Nothing is superior to facts. There are only facts. There is no such thing as the ‘universe.’ We must always reject the unobservable as the cause or explanation of the observable. There is no God of the traditional kind---and absolutely no need for, or possibility of, one. Indeed, there are no ‘ultimates’ at all, which means, among other things, that there are no 'higher' truths that one can appeal to in order to explicate what are invariably complex matters of fact. Academic inquiry and endeavours must always be free and unencumbered. And so it is.

Aye, the distinctive ideas and teachings of John Anderson are needed now more than ever before.


NOTE. Those interested in the ideas and teachings of Professor John Anderson can visit the
John Anderson Archive.



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