Tag: mental illness

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VR and PTSD: Healing from trauma by confronting fears in virtual reality environments

By Katie Givens Kime
Image courtesy of Flikr

What are the ethical implications of therapeutically re-exposing patients to trauma via virtual reality technologies? Of the 2.7 million American veterans of the Iraq and Afghanistan wars, at least 20% suffer from depression and/or post-traumatic stress disorder (PTSD), and other studies peg that percentage even higher. As a chronic, debilitating mental illness, one PTSD symptom is hyperarousal, in which a person repeatedly re-experiences a trauma in the form of nightmares, panic attacks, and flashbacks.  One of the most long-trusted therapeutic approaches to PTSD is exposure therapy; now, virtual reality technology is increasingly being used to simulate exposure to traumatic events and to environments related to the traumatic event.


Image courtesy of Flikr

Last month’s Neuroethics and Neuroscience in the News event featured the recent research and observations of Barbara O. Rothbaum, who is the Paul A. Janssen Chair in Neuropsychopharmacology at the Emory University School of Medicine and Director of the Emory Veterans Program & Trauma and Anxiety Recovery Program. Rothbaum outlined the way in which exposure therapy (with or without the aid of virtual reality technology) is based on principles of learning and also discussed reliable findings with animals and phobic disorders (Foa & Kozak, 1986). The underlying premise of such therapy is that repeated and prolonged exposure to feared but realistically safe stimuli leads to habituation, and eventually to extinction.

The virtual reality exposure therapy (VRE) combat environments for “Virtual Vietnam” (developed by Georgia Tech and Emory Universities) includes a virtual Huey helicopter, a “fly” over the jungles of Vietnam, a “walk” in clearings near jungles and swamps, and other imaginal immersions in Vietnam-related stimuli.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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2nd International Conference on End-of-Life Law, Ethics, Policy, and Practice (Halifax, Nova Scotia)

Join me this September in Halifax, Nova Scotia for the 2nd International Conference on End-of-Life Law, Ethics, Policy, and Practice.


Here are some highlights from the schedule:


Wednesday, September 13, 2017


The Story of Law Reform in Canada
Joe Arvay, Jim Cowan, Mona Gupta


Thursday, September 14, 2017


Empirical Studies: What do we know about end of life decisions making around the world?
Luc Deliens, Linda Ganzini, Bregje Onwuteaka-Philipsen, Lindy Wilmott


Palliative Care and its Relationship with Medical Aid in Dying
Kenneth Chambaere, James Downar, Eric Wasylenko


Stopping/Not Starting Potentially Life-Sustaining Treatment:
The Issue of Unilateral Decision Making 
Jennifer Gibson, Hilary Young


Palliative Sedation
Jocelyn Downie, Agnes van der Heide


Friday, September 15, 2017


Legal Status of Assisted Dying
Joan M. Gilmour, Maria M. Gomez, Emily Jackson, Ben White


Pressure Points for Eligibility for Medical Assistance in Dying (mature minors, mental illness as sole underlying condition, advance requests)
Christine Chambers, Justine Dembo, Jocelyn Downie, Jennifer Gibson, Joan M. Gilmour, Ken Rockwood

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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In the Journals–March 2017, Part I by Julia Kowalski

Here is Part I of our March article round-up.

American Anthropologist

A Dog’s Life: Suffering Humanitarianism in Port-au-Prince, Haiti

Greg Beckett

In the Bel Air neighborhood of Port-au-Prince, Haiti, most residents are dependent on humanitarian and foreign assistance for food, services, aid, and jobs. Yet, some residents feel that the conditions under which such aid is provided actively blocks their ability to live a life they find meaningful. In this article, I explore how some Haitians theorize this humanitarian condition through the figure of the dog, an animal that exemplifies, for Haitians, the deep history of violence, dehumanization, and degradation associated with foreign rule. I then contrast this with how foreign aid workers invoke the figure of the dog to illustrate their compassionate care for suffering others. Drawing on research among Bel Air residents and foreign aid workers in the years after a devastating earthquake destroyed much of Port-au-Prince, I show how the figure of the dog is central both to Haitian critiques of humanitarian aid and to the international humanitarian imaginary that responds to forms of suffering it deems cruel.

Biosocieties

“Let’s pull these technologies out of the ivory tower”: The politics, ethos, and ironies of participant-driven genomic research

Michelle L. McGowan, Suparna Choudhury, Eric T. Juengst, Marcie Lambrix, Richard A. Settersten Jr., Jennifer R. Fishman

This paper investigates how groups of ‘citizen scientists’ in non-traditional settings and primarily online networks claim to be challenging conventional genomic research processes and norms. Although these groups are highly diverse, they all distinguish their efforts from traditional university- or industry-based genomic research as being ‘participant-driven’ in one way or another.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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Janis H. Jenkins’ “Extraordinary Conditions: Culture and Experience in Mental Illness” by Katie Barron

Extraordinary Conditions: Culture and Experience in Mental Illness

Janis H. Jenkins

University of California Press, 2015, 343 pages

It has been a privilege, through reading Extraordinary Conditions, to come into contact with a writer and practitioner of extraordinary compassion. The book bears witness to a process of open-ended interviewing that contributed to presenting the lives and experiences of Jenkins’ interlocutors with a deep concern for their dignity and self-esteem.

Part One of Extraordinary Conditions focuses on experiences of schizophrenia among different ethnic groups within the US, while Part Two focuses on trauma among Salvadoran refugees also living in the US. In all the interviews, Jenkins has been especially struck with the “centrality of struggle” which entail the wide variety of difficulties, including, losing jobs and relationships, weight gain as a result of medication, cognitive and logical incoherencies in experience, family criticism, and so forth. To describe the traditionally-named “patient” as an agent struggling to define and attain positive outcomes has political implications, implied in the text though not stated at length, viz. that the psychiatrist and the struggler are placed on an equal footing, as co-workers, along with helpers from other disciplines, working to accomplish negotiated goals.

The contention of the book is that psychiatry and anthropology have much to teach each other. For the anthropologist, studying mental illness within a given group sheds light on the whole group. The “extraordinary” illuminates the “ordinary”. In fact, Jenkins believes that those suffering diagnosed mental illness can be viewed not as different and separate from their community but as typical examples: “those with mental illness are just like everyone else – only more so.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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Psychiatric Genetics in a Risk Society

by Nicole Martinez-Martin

Kong and colleagues raise substantive areas of ethical concern regarding the translation of psychiatric genetic research into clinical and public health contexts. They recognize that psychiatric genomic research itself does not support essentialist claims, but point out that, nonetheless, the translation of genetic research to these new contexts may reinforce essentialist views of mental illness. Underlying Kong and colleagues’ analysis is recognition of the ways in which certain epistemological orientations, embedded within culture and institutional practices, may shape the translation of genetic research.…

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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A New Hope for Mental Illness

Both Carrie Fisher and George Michael – just like far too many celebrities and average folk — struggled with addiction. Moreover, it wasn’t just alcoholism that Carrie Fisher struggled with. She was also an outspoken advocate for other mental illnesses, courageously sharing her own experience with bipolar disorder. Carrie herself believed that her years-long battle with addiction was a result of her undiagnosed bipolar disorder. Along with other well-deserved epithets, 2016 will be remembered as the year that the mental health community lost a remarkable advocate. Despite Ms. Fisher’s untimely passing, however, there is still “a new hope”.

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The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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De-stigmatization of the disgraceful mark of stigma in the opioid crisis

After attending Albany Government Law Review’s symposium, Script to Street: Opioids and the Law in the Capital District this past Thursday, there was several issues addressed but the one overarching concern was about the role of stigma in this opioid crisis. Many different types of stigma were identified and the different ways our negative judgments have impacted society. As one speaker during the first panel discussion stated, addiction is not a new problem. He described one historic painting that showed different reactions of society to addiction: disgust, numbness, shock, or simply ignoring the problem. All of these reactions illustrate stigma and shows how despite all our social advancements, we still have not eliminated (or destigmatized) stigma of the addiction problem. 

Some definitions of stigma include a mark of disgrace, society disapproval of something, or a negative set of beliefs society has about something.  All definitions include this perceived negativity and describe stigma as bad. Stigma is not something one like to face and usually, a judgment one tends to try avoiding. 

The issue with stigma our current opioid crisis is that it is not just one type of stigma, it is layers of stigma on top of one another. There is the stigma of being a drug user and the stereotypes of who is a drug user (the poor, African American, Hispanic). Drug-users are perceived to be “bad” people who only care about drugs.  This perception becomes a barrier to treatment as individuals do not want to seek treatment in fears they will be labeled as a drug user, even if these individuals are suffering from chronic pain.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Uncategorized

De-stigmatization of the disgraceful mark of stigma in the opioid crisis

After attending Albany Government Law Review’s symposium, Script to Street: Opioids and the Law in the Capital District this past Thursday, there was several issues addressed but the one overarching concern was about the role of stigma in this opioid crisis. Many different types of stigma were identified and the different ways our negative judgments have impacted society. As one speaker during the first panel discussion stated, addiction is not a new problem. He described one historic painting that showed different reactions of society to addiction: disgust, numbness, shock, or simply ignoring the problem. All of these reactions illustrate stigma and shows how despite all our social advancements, we still have not eliminated (or destigmatized) stigma of the addiction problem. 

Some definitions of stigma include a mark of disgrace, society disapproval of something, or a negative set of beliefs society has about something.  All definitions include this perceived negativity and describe stigma as bad. Stigma is not something one like to face and usually, a judgment one tends to try avoiding. 

The issue with stigma our current opioid crisis is that it is not just one type of stigma, it is layers of stigma on top of one another. There is the stigma of being a drug user and the stereotypes of who is a drug user (the poor, African American, Hispanic). Drug-users are perceived to be “bad” people who only care about drugs.  This perception becomes a barrier to treatment as individuals do not want to seek treatment in fears they will be labeled as a drug user, even if these individuals are suffering from chronic pain.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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The Balancing Act Between Mental Illness and Gun Rights

Editor’s Note: This is an update of the post “Second Amendment Rights and Mental Illness,” originally published on September 1, 2015.  By Mariam Ahmed, JD/MSPP In September 2015, we offered a glimpse of the current landscape of laws addressing mental … Continue reading

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

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In the Journals: February 2017 by Christine Sargent

American Ethnologist

Good ramps, bad ramps: Centralized design standards and disability access in urban Russian infrastructure

Cassandra Hartblay

Accessible design seeks to reconfigure the social by restructuring the material. As the idea moves globally, it becomes entwined in local logics of moral obligations between citizens and the state. Wheelchair users in the city of Petrozavodsk, in northwestern Russia, talk about inaccessible infrastructure as being embedded in moral relationships. In their stories, hierarchies of expertise diffuse responsibility for outcomes and devalue user knowledge. When accessible design elements are installed to meet minimum standards, they are “just for the check mark” and often do not “work.” Wheelchair ramps produce value for businesses or governments by representing an idea of access that circulates as a commodity. Failed accessible design draws attention to a moral field governing the responsibilities of actors to produce a “good” built environment, imbricated in teleologies of progress. [disability, design, infrastructure, access, ramps, postsocialism, Russia]

Self-governance, psychotherapy, and the subject of managed care: Internal Family Systems therapy and the multiple self in a US eating-disorders treatment center

Rebecca J. Lester

“The self” has seen a surprising resurgence in recent anthropological theorizing, revitalizing interest in whether and how it can be studied ethnographically. These issues are brought to the fore by a newly popular psychotherapy technique, Internal Family Systems therapy (IFS), as practiced in a US eating-disorders clinic. There, clinicians and clients negotiate tensions between this model’s understanding of a multiple, refracted self and managed-care companies’ insistence on personal responsibility. In considering the moral and pragmatic work of IFS in the clinic, a new critical anthropology of selfhood illuminates the vectors through which economic and political commitments become imbricated in the self.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.