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Manage series 3397097
A tartalmat a August Baker biztosítja. Az összes podcast-tartalmat, beleértve az epizódokat, grafikákat és podcast-leírásokat, közvetlenül a August Baker vagy a podcast platform partnere tölti fel és biztosítja. Ha úgy gondolja, hogy valaki az Ön engedélye nélkül használja fel a szerzői joggal védett művét, kövesse az itt leírt folyamatot https://hu.player.fm/legal.
Interviewing leading philosophers about their recent work
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64 epizódok
Mind megjelölése nem lejátszottként
Manage series 3397097
A tartalmat a August Baker biztosítja. Az összes podcast-tartalmat, beleértve az epizódokat, grafikákat és podcast-leírásokat, közvetlenül a August Baker vagy a podcast platform partnere tölti fel és biztosítja. Ha úgy gondolja, hogy valaki az Ön engedélye nélkül használja fel a szerzői joggal védett művét, kövesse az itt leírt folyamatot https://hu.player.fm/legal.
Interviewing leading philosophers about their recent work
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64 epizódok
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×Owen Flanagan [Duke University] James B. Duke University Professor Emeritus of Philosophy & Professor of Neurobiology Emeritus What Is It Like to Be an Addict?: Understanding Substance Abuse "A brilliant and unparalleled synthesis of the science, philosophy, and first-person phenomenology of addiction. Owen Flanagan is a distinguished philosopher who ... is also an ex-addict. This book is beyond excellent. It is wise. Everyone who wants to understand addiction must read it." -- Hanna Pickard, Bloomberg Distinguished Professor of Philosophy and Bioethics, Johns Hopkins University "This elegant and clear book ... deserves to be a landmark in the study of addiction." -- Carl Erik Fisher, M.D., Assistant Professor of Clinical Psychiatry, Columbia University, author of The Urge: Our History of Addiction Owen Flanagan is an internationally acclaimed philosopher of mind, consciousness, ethics, and comparative philosophy and author of 12 books translated into many languages. A powerful and important exploration of how addiction functions on social, psychological and biological levels, integrated with the experience of being an addict, from an acclaimed philosopher and former addict. What is addiction? Theories about what kind of thing addiction is are sharply divided between those who see it purely as a brain disorder, and those who conceive of it in psychological and social terms. Owen Flanagan, an acclaimed philosopher of mind and ethics, offers a state-of-the-art assessment of addiction science and proposes a new ecumenical model for understanding and explaining substance addiction. Flanagan has first-hand knowledge of what it is like to be an addict. That experience, along with his wide-ranging knowledge of the philosophy of mind, psychology, neuroscience, and the ethics and politics of addiction, informs this important and novel work. He pairs the sciences that study addiction with a sophisticated view of the consciousness-brain/body relation to make his core argument: that substance addictions comprise a heterogeneous set of "psychobiosocial" behavioral disorders. He explains that substance addictions do not have one set of causes, such as self-medication or social dislocation, and they do not have one neural profile, such as a dysfunction in dopamine system. Some addictions are fun and experimentation gone awry. Flanagan reveals addiction to be a heterogeneous set of disorders, which are picked out by multifarious cultural, social, psychological, and neural features. Flanagan explores the ways addicts sensibly insist on their own responsibility to undo addiction, as well as ways in which shame for addiction can be leveraged into healing. He insists on the collective shame we all bear for our indifference to many of the psychological and social causes of addiction and explores the implications of this new integrated paradigm for practices of harm reduction and treatment. Flanagan's powerful new book upends longstanding conventional thinking and points the way to new ways of understanding and treating addiction.…
Agnes Callard Open Socrates This is the the most impressive book I have ever read. What a mind! I was more nervous than usual, and I think I kept pronouncing her name wrong, but I feel honored, really, to have been able to talk with Agnes about this stunning work.
Two updates since I posted this audi. Specifically, I sent two emails to Corrigan or DMH staff. In the first, I asked for the plan again--this time I asked two other people in addition to LW. I also expanded the request to include prior years. In the second, I decided to go ahead and make an official Human Rights Complaint. You are supposed to make a complaint to the Person in Charge. I sent it to three people who, if they aren't that person, would certainly know who was. Needless to say, I don't expect any of them to even confirm receipt of the email!!! Here are the two emails: substantive part of first email--asking for plan Dear Ms. H, Mr. W, and Mr. G, I hereby request both the current version and all available prior versions of the written plan specified and required under 104 CMR §27.13(6)(f)5 for the inpatient unit at Corrigan Mental Health Center. I hereby also request any and all documents and records pertaining to the DMH determination of reasonable justification referenced referenced in 104 CMR §27.13(6)(f)(5)(c)(ii). substantive part of second email--human rights complaint Dear Mr. W, Dr. M, and Dr. A, I intend this email to constitute a complaint under 104 CMR, § 32. My complaint relates to a longstanding condition at the Acute Inpatient Unit (IPU) at Corrigan Mental Health Center ("Corrigan"). I believe this condition is either dangerous, illegal, or inhumane. The condition relates to all Corrigan IPU patients other than those who are young, physically fit, and relatively social (the "Youthful" patients). For example, it relates to those patients who are catatonic, obese, elderly, or who suffer from a physical handicap or a mental disorder such as social anxiety or claustrophobia (the "Compromised" patients). Corrigan staff represent that the patients have four times that they get to go outside. But there seems to be little or no concern or recognition that only the Youthful patients take part in these breaks. The Compromised Patients can spend days, weeks, and even years without ever accessing the outdoors. [Consider, e.g.,] patient D, who was an elderly man with significant social anxiety. In speaking with him, his favorite moments were the times he would take walks with his sister and look at flowers. Yet as a resident at Corrigan IPU, he was too socially anxious to go to lunch, much less to go with the group for outdoors. [Yet if someone dedicated themself to taking him outside, he greatly enjoyed and benefited from it.] [But for a staff member's taking it on themselves to encourage him to access the outdoors] however, he would never have gone outside. For practical purposes, for this patient to go outside, it is not sufficient to simply post outdoors times. Given his complex condition, and given the physical plant at Corrigan, for practical purposes, he would not have gone outside at all during his time there but for a person encouraging him and following through. Patient P has been a resident for perhaps two years. [Again, a special effort is required to take P outdoors, and staff is highly resentful and obstructinist when someone takes the effort. Staff would rather use the outdoors break as their own outdoors break, without having Compromised patients interfering. Once, it was impossible to take P down, and staff purposively blocked her participation. Yet there were three staff outside, and only two (Youthful) patients . Nevertheless, the explanation was that P could not access the outdoors due to ... "we don't have the staff"]. Essentially, there is a great deal of resistance to taking [Compromised] patients outside. [Social worker D.K. is in a position of authority but is highly resentful of any efforts to change practices. She seems to believe that because of her managerial position, she is beholden to defend the status quo. She does not have the experience or magnanimity for her job and appears to have been promoted too early.] Patient L, who was catatonic, probably never accessed the outdoors [although when asked, SW D.K. blithely asserted that he gets outside often. Just because you are management does not mean you have to lie or dissemble for the sake of the official version.] Accessing the outdoors is a human right for all detainees. Under Massachusetts law, access to the outdoors has to be either individual or group access. I do not believe that Corrigan offers individual access. Other psychiatric hospitals, such as Southcoast Behavioral, are built so that it is easy to access the outdoors. With Corrigan, it has to be done in a group and down two dark, steep staircases. It is a forbidding prospect [for Compromised patients]. I understand that that is a physical plant issue, but if outdoor access is not provided, it is necessary that Corrigan have a plan for why this is not possible, and that plan has to be approved by DMH. In October, I asked Mr. W. for a copy of this plan. I offered to help him revisit it. I never heard back from him, and DK provided no support for my initiative. [She is reckless and causes significant harm to actual people in apparently supporting what she believes are "rules" but often appear to be simply what-we've-always-done. As we know from Hannah Arendt, evil is not flashy; in practice in the world, evil is banal. And in America, served with a complacent smile.] I hope that this Complaint will serve to alert staff to the problem of outdoors access. Not being able to access the outdoors is considered a form of torture. There are important efforts to ensure that penitentiaries provide outdoor time to their inmates. The law--and common humanity--requires the same opportunity be provided to residents of psychiatric IPUs. Original post: The first time I encountered the de facto policy that DMH employees don't respond to emails, was on Halloween 2024. I wrote an email to the "Human Rights Officer" [LW] at Corrigan asking whether I could help by bringing a fresh eye to the facility's outdoors policy. I received zero reply. I have reprinted my email below. It refers to the CMR (Mass. code of regulations). So let's first get oriented to that. That Halloween email is quoted below. In that email, I quote some from the Massachusetts Code of Regulations (CMR). So let's consider the CMR first. The first five sections of the CMR are: 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES 102 CMR - OFFICE OF CHILD CARE SERVICES 103 CMR - DEPARTMENT OF CORRECTION 104 CMR - DEPARTMENT OF MENTAL HEALTH 105 CMR - DEPARTMENT OF PUBLIC HEALTH We are interested in 104. Within 104, the first five sections are: 104 CMR 25.00 - Authority, Mission, And Definitions (§ 25.01 to 25.04) 104 CMR 26.00 - Organizational Structure and Citizen Participation (§ 26.01 to 26.03) 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES (Subpart A to D) 104 CMR 28.00 - Licensing and Operational Standards for Community Services (§ 28.01) 104 CMR 29.00 - Application for DMH services, referral, service planning and appeals (§ 29.01 to 29.16) We are interested in 27. Within 27, there are four subparts: SUBPART A: SCOPE AND DEFINITIONS SUBPART B: LICENSING SUBPART C: OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES SUBPART D: OPERATIONAL STANDARDS FOR SUBSTANCE USE DISORDER TREATMENT FACILITIES We are interested in Subpart C, which has 13 subsections, including: § 27.11 - Periodic Review § 27.13 - Human Rights § 27.14 - Human Rights Officer; Human Rights Committee § 27.15 - Absence without Authorization We'll be looking here at 27.13 and specifically sub-section (6)(f) which states: "A patient of a facility ... shall have reasonable daily access to the outdoors."" There are six subsections to § 27.13(6)(f) which elaborate on this reasonable daily access. Three are relevant here (sub sections 1, 2, and 5). Sub section 1 says what is meant by "reasonable daily access." We are told it means "supervised or unsupervised daily access to the outdoors, individually or in groups." The word "individually" piqued my interest because Corrigan does not provide individual access. In addition, this section says that facilities can establish designated times for access, "as long as each patient has a reasonable opportunity to access the outdoors on a daily basis ... during one or more of" those schedule times. Subsection 2 is about how to construe "outdoors." Specifically, "outdoors" means "a space or area outside of a building, which may include a porch, courtyard, roof deck or open space surrounded by a building." Subsection 5 is about how the facility needs to have a plan. My Halloween email to LW was pretty tame. I simply noted that it doesn't seem like the Corrigan IPU patients have access to the outdoors. And I asked to see the plan. I assumed that would answer all my questions. Here is the email: ---Beginning of Halloween 2024 email to Human Rights Officer LW regarding outside air and outside light.---------------- "I am writing to ask if I could help assist you / your office in conducting a fresh-eyed review of Corrigan Inpatient's compliance under 104 CMR, §27.13(6)(f) (reasonable daily access to the outdoors). Although Corrigan Inpatient does schedule Recreation breaks (at 8am, 1pm, 4pm, and 8pm), it is my understanding and belief that some patients, especially elderly patients or largely bedridden patients, do not in fact take advantage of these breaks. ... On three occasions, I prompted elderly patients to go to on one of these outside breaks. On two of those occasions, my efforts were successful, and I believe the patients greatly benefited. [Yet to my understanding, this trip outside was rare for these individuals,] causing me to wonder whether some patients would *like* to take advantage of the outside but are intimidated by the current structures of these breaks. For example, note that under 104 CMR, §27.13(6)(f)(1), "reasonable daily access ... mean[s] daily access to the outdoors, individually or in groups" [my emphasis]. I do not believe that Corrigan Inpatient offers individual access. Yet, for many IPU patients [e.g., those with paranoia, social anxiety, obesity, or catatonia], the only way they could reasonably be expected to access the outdoors would be via individual access]. Admittedly, it may not be possible or feasible to offer individual access, but my aim is to help assist you and Corrigan Inpatient in taking a fresh look at this issue. ... To start, could you please provide to me (or point me towards) the written plan described in 104 CMR 27.13(6)(f)5? That may answer all my questions. I look forward to working with you on this important issue. The Association for the Prevention of Torture, for example, recommends a minimum of one hour outdoor exercise for any detainee [https://www.apt.ch/knowledge-hub/dfd/outdoor-exercise]. The benefits of exercise and sunlight for mental health are very well established. I would be happy to discuss these issues in person at at any point. -------End of Halloween email No response. Zip. Not even acknoweldgment of receipt. I did, however, re-send this email to LW yesterday (February 7, 2025). Note that despite being significantly over-staffed, the answer to the question, "Why don't you provide individual access?" will probably be: "we don't have the staff for that." It will also be pointed out that the building is old, and it is not feasible to provide secure access: partly due to the unreliable elevators and partly due to the fact that to access the outdoors from the unit, it is necessary to walk down a long and narrow stairway. That is certainly understandable. Nevertheless, the CMR specifies that if the facility cannot provide access, they simply need to document it in the plan. Here is the code regarding that plan. Section c is the part saying that if staffing or the physical plant preclude satisfying the requirements, then you simply add that to the plan. --------BEGIN EXCERPT FROM CODE REGARDING THE PLAN THE FACILITY MUST KEEP----------- a. The plan shall include the following: i. procedures, including staffing and other safety requirements, to allow for access to nonsecure outdoor space for patients who have been assessed as clinically appropriate and safe to exercise this option; and ii. procedures, including staffing and other safety requirements, to allow for access to secure outdoor space, if available, for patients who have been assessed as clinically appropriate and safe to exercise this option. b. Reasonable efforts to safely provide access to outdoor space may include, but shall not be limited to: i. reasonable capital expenditures to develop, construct or otherwise acquire outdoor space; ii. reasonable modifications of staffing patterns to permit staff escorts; or iii. reasonable modificationsto building access policies to permit patient access to common areas of the facility or proximate to the facility not normally dedicated as patient areas. c. If the facility determines that it cannot safely provide secure outdoor access due to staffing or physical plant limitations, it shall: i. identify and document such limitations in the plan; and ii. identify what actions the facility will take to address these limitations and the time frame for the actions. If the facility determines that the limitations cannot be reasonably remedied, the facility shall identify the reasons for such determination. Such reasons shall be documented with sufficient detail to enable the Department to determine whether they constitute reasonable justification. d. Upon request of the Department, but no less frequently than in its application for licensure or license renewal, the facility shall demonstrate to the Department’s satisfaction that its plan is current and that it has identified, considered and implemented all reasonable actions to safely provide access to outdoor space. --------END EXCERPT FROM CODE REGARDING THE PLAN THE FACILITY MUST KEEP ------------ That was 27.13. The next section is also relevant. It's about how the Human Rights (including the right of access to the outdoors) is (supposedly) enforced. It doesn't look promising, but here it is: 27.14: Human Rights Officer; Human Rights Committee (1) Human Rights Officer. Each facility shall have a person or person employed by or affiliated with the facility appointed to serve as the human rights officer and to undertake the following responsibilities: (a) To participate in training programs for human rights officers offered by the Department; (b) To inform, train and assist patients in the exercise of their rights; (c) To assist patients in obtaining legal information, advice and representation through appropriate means, including referral to attorneys or legal advocates when appropriate; and (d) In the case of Department facilities, to serve as staff to the facility’s human rights committee. The human rights officer must have no day-to-day duties that are in conflict with his or her responsibilities as a human rights officer, including carrying out fact-finding activities under 104 CMR 32.00: Investigation and Reporting Responsibilities. 2) Human Rights Committee. For each facility operated by, or under contract to the Department, the Commissioner or designee shall establish, impanel and empower a human rights committee in accordance with the provisions of 104 CMR 27.14. Such a human rights committee may be established jointly with other programs in an Area; provided however, that the number, geographical separateness or programmatic diversity of the programs is not so great as to limit the effectiveness of the committee in meeting the requirements of 104 CMR 27.14. (3) The majority of members of each human rights committee shall be current or former consumers of mental health services, family members of consumers, or advocates; provided however, that a member who has any direct or indirect financial or administrative interest in the facility or the Department shall notify the facility director or Commissioner, as applicable, in writing. (4) The general responsibility of each such human rights committee shall be to monitor the activities of the facility with regard to the human rights of the patients in the facility. The specific duties of the committee shall include: (a) Reviewing and making inquiry into complaints and allegations of patient mistreatment, harm or violation of patient’s rights and referral of such complaints for investigation in accordance with the requirements of 104 CMR 32.00: Investigation and Reporting Responsibilities; (b) Reviewing and monitoring the use of restraint, seclusion and other physical limitations on movement; (c) Reviewing and monitoring the methods utilized by the facility to inform patients and staff of the patient’s rights, to train patients served by the program in the exercise of their rights, and to provide patients with opportunities to exercise their rights to the fullest extent of their capabilities and interests; (d) Making recommendations to the facility to improve the degree to which the human rights of patients served by the facility are understood and enforced; and (e) Visiting the facility with prior notice or without prior notice provided good cause exists. (5) Each such human rights committee shall meet as often as necessary upon call of the chairpersons, or upon request of any two members, but no less often than quarterly. Minutes of all committee meetings shall be kept and shall be available for inspection by the Department upon request. The committee shall develop operating rules and procedures, as necessary.…
The American Bar Association , the U.N. Standard Minimum Rules for the Treatment of Prisoners (Nelson Mandela Rules), and the Association for the Prevention of Torture all recommend a minimum of one hour outdoors daily, weather permitting, as part of minimum humane standards for detention and incarceration. ------------------------------------- This is a 2nd podcast about the IPU (inpatient unit) at Corrigan Mental Health Center. There are many other things going on at Corrigan MHC besides the IPU. For example, there is a great program for helping families in which there is a young person who may be experiences the early stages of psychosis. The people there are excellent. This podcast is only about the IPU. In brief, the IPU itself is a valuable entity for the community. If you did not consider the taxpayer perspective, there would be little to find fault with. Once, however, you do consider the taxpayer perspective, you start to see Corrigan IPU in a very different light. On the surface, it looks like a place to treat people who are a danger to themselves or others, albeit one that is substantially overstaffed. From the taxpayer perspective, however, we look at the underlying reality: where is the cash going? Who is receiving the cash? And the answer is that from this perspective, Corrigan IPU is a benefit program where labor-market subsidies are suppled to a group of white, middle-class professionals. For a population of at most 15 or 16 patients at a time, we have a staff of 30? 40? middle-class white professionals working for whom Corrigan IPU provides employment safe from labor market presures. The IPU may also effectively provide a private IPU for the patients of providers working there. I wanted to get some data or records to confirm or deny my understanding. I wanted to know how did we end up with such a small unit with so many professionals working there? So I first tried to make a public records request. The folklore was that it was a patient suicide which caused the dramatic downsizing (but not the elimination) of the unit. I wanted to find out when that suicide had occurred. The public records request put me in touch with a very nice young person who referred me then to the Director of Communications (DOC). They may have the data I need at their fingertips. I expanded my request and sent it to the DOC. That was mid January. By early February, I had received nothing back. Not even an acknowledgement of receipt of the email. So on Feb. 3, I left two voicemails and re-sent the original email. As of February 7, today, still I have received nothing. This was my experience also when I wrote the Human Rights Director originally to ask how Corrigan IPU justified its practically minimal provision of outside air and outside light to patients. (Effectively, on information and belief, only about 1/4 to 1/3 of the patients there receive daily outdoor air and light. None are provided with individual access to the outdoors). When I wrote the HRD, I received nothing, zip back. There are laws and then there is what happens. My guess would be that DMH employees face incentives which make it inadvisable for them to reply to non-fluff inquiries. It seems like it will only lead to frustration to keep communicating with the DOC. So all I do, below, is provide the email chain with DMH. 1. At first, I was simply interested in trying to verify the folklore, viz., that the unit's bed count was cut dramatically following a patient suicide. I wanted to know the date of that suicide, so I sent this request on January 11: I request all documents related to any patient suicides at Corrigan Mental Health Center in Fall River, from 1990 to the present. 2, They replied: Thank you for your email. Kindly let me know when you have a moment to speak about your request over the phone this week. Our office hours are M-F 9 am to 5 pm. 3, We spoke on the phone, and I was diverted via this email: Thank you for your conversation today, where we went over your request and concluded that you were looking for information and not records regarding capacity at CMHC. Given this, we agreed to withdraw your request and to connect you with our Director of Communications, [GH] to go over your inquiry about that information and how it is reported. I have copied her contact information below. [GH] 617-626-8150 4, I then called the Director of Communications (DOC), and I got the sense from the outgoing message that the phone number was more of a voice message collection device. (It was doubtful would ever be actually answered). The outgoing message also indicated people should email the DOC. I expanded my request and sent the following email to the DOC on Friday January 17th: Hi. I am planning to do a series of podcasts about the Acute Inpatient Unit Corrigan Mental Health Center in Fall River ("Corrigan IPU). (If you are interested, the first of these podcasts is here: https://philosophypodcasts.org/pork , but you don't of course need to listen to that. I merely provide it in case you are interested. ) I wrote a records request (below), but Mr. [G] steered me instead towards you, suggesting you may be in the best position to answer my questions. The major puzzle I have is the following: It seems that the Corrigan IPU has only 16 beds. Despite the fact that these are non-violent, non-medically compromised patients, there are more professional staff than patients. On information and belief, the Corrigan IPU once served a much larger caseload. (Specifically, at one time, it held 40 patients). Questions 1) Is it correct that the the Corrigan IPU only has 16 beds 2) Is it correct that the Corrigan IPU employs many more than 16 professionals (specifically, is it correct that Corrigan IPU employs over 10 nurses (including two in administrative positions--i.e., who do not interact with patients, but merely serve as administrators of the staff), 1 nurse practitioner, 1 MD, 3 full-time social workers, 2 full-time occupational therapists, a dietician and a peer-support specialist? 3) Is it correct that all of these professionals are white (i.e., caucasian) 4) Is it also correct that the Corrigan IPU also employs at least 12 mental-health workers? 5) Is it correct that all of the higher-level (level 3 or 4) mental health workers are white? 6) Is it correct that Corrigan IPU also employs a doctor-on-call around the clock? 7) Including all staff, what are the annual labor costs for operating the Corrigan IPU? 8) Is it also correct that Corrigan IPU does not track whether its patients access the outdoors? 9) Is it correct that patients do not have the opportunity to access the outdoors individually? 10) Is it correct that the patients can only access the outdoors in groups, and only by traversing staircases that are daunting for older patients? 11 Is it correct that the Corrigan staff does not require or even encourage patients to access the outdoors? 12) Does the Massachusetts DMH agree that not being able to access the outdoors is a form of torture? 5. After a couple of weeks of not hearing anything, I decided to attempt contact again. On February 3rd, I left a voicemail message with the DOC asking if she had received my email and asking if she could call me or email me at least to confirm receipt. I also sent them an email forwarding the Feb. 17 email. Dear [DOC], I hope you are well. Could you please confirm that you received this message? I just want to make sure it didn't slip through the cracks! Thank you so much. As of Feb. 7 2025, I have received neither a phone call nor an email in reply.…
Wouter Kusters A Philosophy of Madness: The Experience of Psychotic Thinking MIT Press: https://mitpress.mit.edu/9780262044288/a-philosophy-of-madness/
The IPU at Corrigan Mental Health Center. This is a psychiatric IPU in Fall River, MA. It's a DMH facility. Best parts: 1) there are some excellent staff members (excellent both for patients and for co-workers), (e.g., OT Kyle, providers Max and Allison, nurses Christian and Jill, tech Sean, Social Worker Nicole). 2) As a public-sector, unionized shop, the staff can be their authentic selves. For those who don't like their jobs, they can express that openly. They are not pressured to dissimulate. 3) for patients, if you are looking for a place to stay a while, (i.e., if you are okay with being detained longer than the usual 72 hours), and if you are young and hence able to access the outdoors space, it may be a good place. If you are a patient of one of the Corrigan doctors (like Mayer, then an advantage of having Mayer as a doctor is that he is able to use this unit as an IPU for his regular outpatient clients. He can keep them there in an emergency and thus provide a respite for the patient and their family, a chance to return to stabilization) Worst parts: (a) Approximately half of the patients do not have actual access to the outside. The staff will tell you they provide four outdoor opportunities per day. But for practical purposes, many of the patients cannot--orwould not be reasonably expected to--access the outdoors as provided by Corrigan. (To go outside requires negotiating a steep set of stairs [it can be possible to take elevators but the elevators are difficult to operate, the techs don't make them readily available, and even when the techs are asked to take someone down in the elevator, they may choose not to. ). In addition, accessing the outside can only be done in a large group. Many of the patients are anxious in groups and would love to access the outside if they were able to do so individually, but prefer not to go down in the crowded group, long-stair, way with chains and locks, and authentically depressed staff). (b) Taxpayers lose big time. This is an extremely cost inefficient IPU. It is staffed 24/7/365, (including always an on-call provider apparently), and the staffing levels are such that, during the day shift alone, there are more staff than patients!!! At one time, Corrigan IPU had 40 patients. The folklore is that a patient there hung themself and, as a result, the beds were dropped all the way to 16. But there are more than 16 staff working the day shift alone (not even counting the evening shift or nighttime shift). During the daytime, there are 5 nurses (a charge nurse, another unit nurse, a med nurse, and two nurses in an administrative role (not on unit). 2 occupational therapists 2 providers 4 techs and 3 social workers That is for 16 beds, and often a bed or two is empty, so let's say 15 patients on average. In addition, there are other staff who are not full time (or who work full time, but divide their time across the IPU and other operations): a pharmacist, a nutritionist (she may be full time), a peer advocate, a human rights officer, and more layers of admin. In addition, Corrigan tends to keep people longer than other inpatient units--- much longer (e.g., instead of 72 hours, one stays for months or even, for two patients, 2 years and counting). Because of this, there are more court proceedings compared to units which churn more on a 72 hour cycle. Few if any patients bring their own counsel. So whenever there is a hearing, the taxpayers are paying for the DMH attorney, the Corrigan Staff, the patient's attorney, and the judge or magistrate. (c) Danielle Keogh, LICSW is a reckless individual. You would think that social workers would be people who will talk directly to anyone they have issues with. SW Keogh was incapable of doing this and, instead, recklessly tries to railroad subordinates by going behind their back and trying to squeeze them. You would think that she, as a social worker, would be patient-centered. In fact, she claims the patients at Corrigan are not well enough for a patient-centered approach. Her priority appears to be her career and her title / her status. (How, one might ask did she get promoted to her current position after only a few years on the job? Pretty privilege? Who was making the hiring decision? Why do they like working with her?) Her focus is entirely on appearances and, in particular, looking good to bureaucrats. Her direction to her subordinates is to lie on MIS because her main priority is to do well in audits. That is, she wants to do well when she is evaluated from above. Her going behind subordinates' back and trying to clamp them down is the sign of someone who thinks that social work is about being a tool in a hierarchy. You would think that she, as a social worker, might view social work as a place to create change and fight social injustice. But in reality, she deals with personnel matters unprofessionally--as a matter for gossip. Her view of what social work is about is doing whatever has no effect. For example, it is essential that social workers spend hours and hours--not actually talking with patients-- but arranging post-discharge PCP appointments which, if you know anything about the patients, you know they will never attend. She acts friendly to your face while going behind your back, and she lies to your face about it. She is unprofessional and insecure. She is reckless because she is dysregulated. It seems she holds anger inside, unwilling to talk with the person she is angry with. Instead, she takes it out by interfering with their lives. She is the sort of social worker who is essential a Karen. She thinks her role is to interfere in the lives of everyone around her because of her insecure attachment to some bureacratic rules she got somewhere. Very little integrity. She is not to be trusted. She is really disappointing. Or it is disappointing that whoever hired her and has been reviewing her has made her think the way she is in professional situations is ok. Very disappointing to have met such a disingenuous, dishonest, insecure, unprofessional, disregulated person. Overall. somehow when Southcoast Behavioral was created, Corrigan was not folded in. A staff of 50 to oversee 15 non-violent patients who don't have medical issues. The unit doesn't even track which patients actually get outside for outdoor air and outdoor light. On information and belief, about half of the patients never get outside, yet no accommodations are made. (Frequently, the reason given for not being able to make changes is, of course, "we don't have the staff." It should not be surprising that not one member of the professional staff is African American, and Dr. Mayer's patients (who comprise 20% of the population) are disproportionately if not entirely middle-class. Be thankful you don't get the government you pay for.…
Alenka Zupančič Disavowal This book argues that the psychoanalytic concept of disavowal best renders the structure underlying our contemporary social response to traumatic and disturbing events, from climate change to unsettling tectonic shifts in our social tissue. Unlike denialism and negation, disavowal functions by fully acknowledging what we disavow. Zupancic contends that disavowal, which sustains some belief by means of ardently proclaiming the knowledge of the opposite, is becoming a predominant feature of our social and political life. She also shows how the libidinal economy of disavowal is a key element of capitalist economy. The concept of fetishistic disavowal already exposes the objectified side of the mechanism of the disavowal, which follows the general formula: I know well, but all the same, the object-fetish allows me to disregard this knowledge. Zupancic adds another twist by showing how, in the prevailing structure of disavowal today, the mere act of declaring that we know becomes itself an object-fetish by which we intercept the reality of that very knowledge. This perverse deployment of knowledge deprives it of any reality. This structure of disavowal can be found not only in the more extreme and dramatic cases of conspiracy theories and re-emerging magical thinking, but even more so in the supposedly sober continuation of business as usual, combined with the call to adapt to the new reality. To disrupt this social embedding of disavowal, it is not enough to change the way we think: things need to change, and hence the way they think for us…
Stijn Vanheule Why Psychosis Is Not So Crazy A Road Map to Hope and Recovery for Families and Caregivers An expert’s guide to humanizing psychosis through communication offers key insights for family and friends to support loved ones during mental health crises. Are we all a little crazy? Roughly 15 percent of the population will have a psychotic experience, in which they lose contact with reality. Yet we often struggle to understand and talk about psychosis. Interactions between people build on the stories they tell each other—stories about the past, about who they are or what they want. In psychosis we can no longer rely on these stories, this shared language. So how should we communicate with someone experiencing reality in a radically different way than we are? Drawing on his work in psychoanalysis, Stijn Vanheule seeks to answer this question, which carries significant implications for mental health as a whole. With a combination of theory from Freud to Lacan, present-day research, and compelling examples from his own patients and well-known figures such as director David Lynch and artist Yayoi Kusama, he explores psychosis in an engaging way that can benefit those suffering from it as well as the people who care for and interact with them.…
Peter Singer Consider the turkey Why this holiday season is a great time to rethink the traditional turkey feast.
Maria Balaska Anxiety and wonder On being human Description At times, we find ourselves unexpectedly immersed in a mood that lacks any clear object or identifiable cause. These uncanny moments tend to be hastily dismissed as inconsequential, left without explanation. Maria Balaska examines two such cases: wonder and anxiety – what it means to prepare for them, what life may look like after experiencing them, and what insights we can take from those experiences. For Kierkegaard anxiety is a door to freedom, for Heidegger wonder is a distress that opens us to the truth of Being, and for Wittgenstein wonder and anxiety are deeply connected to the ethical. Drawing on themes from these thinkers and bringing them into dialogue, Balaska argues that in our encounters with nothing we encounter the very potential of our existence. Most importantly, we confront what is most inconspicuous and fundamental about the human condition and what makes it possible to encounter anything at all: our distinct capacity for making sense of things. Table of Contents Preface Acknowledgments Abbreviations Introduction 1. What Makes Us Anxious? 2. Anxiety and the Origin of Human Existence 3. Wonder and the Origin of Philosophy 4. The Paradox of Anxiety and Wonder 5. After Anxiety and Wonder Notes Bibliography Editorial Reviews Review “In this astute analysis of anxiety and wonder, Maria Balaska argues that understanding ourselves requires more than natural causal explanations and resists psychopathological approaches to overpowering experiences. With Kierkegaard, Heidegger, Wittgenstein, and Lacan, she insightfully elucidates the deeply human desires to feel at home in the world and find meaning in it-and the possibility of their fulfilment.” ―Kate Kirkpatrick, Regent's Park College, University of Oxford, UK “Maria Balaska presents the best treatment to date of wonder and anxiety in Kierkegaard and Heidegger. Focused on the objectlessness of both experiences – what Kierkegaard calls the ambiguous power of spirit and Heidegger terms “the nothing” – the book draws as well on Freud, Lacan, Plato, and Wittgenstein to argue that living authentically means embracing the liberating power of one's mortal open-endedness. Capacious, insightful, and written in lucid prose, Prof. Balaska's text will enrich both lay and professional readers.'” ―Thomas Sheehan, Professor Emeritus of Religious Studies, German Studies and Philosophy, Stanford University, USA “Maria Balaska facilitates a conversation between Heidegger, Kierkegaard, Lacan and Wittgenstein that presents philosophy as embodying an anxious wonder at our capacity to make sense of things. She thereby deepens our understanding of all four thinkers, and illuminates not only the distinctive nature of philosophy, but its ineliminable role in the perennial human task of making sense of ourselves and our place in the universe.” ―Stephen Mulhall, Professor of Philosophy, University of Oxford, UK “This is an excellent book … A must-read for specialists interested in how continental philosophy can contribute to the thriving discourse on the experience and place of anxiety and wonder in our lives.” ―Philosophical Investigations About the Author Maria Balaska is a Research Fellow at Åbo Akademi University, Finland, and a Visiting Research Fellow at the University of Hertfordshire, UK. She is the author of Wittgenstein and Lacan at the Limit: Meaning, and Astonishment (2019) and editor of Cora Diamond on Ethics (2020). Publisher : Bloomsbury Academic (May 2, 2024) Language : English Paperback : 168 pages ISBN-10 : 1350302937 ISBN-13 : 978-1350302938…
Deirdre Nansen McCloskey Liberalism By revealed preference, Prof. McCloskey is our favorite scholar to talk with. This is our third conversation with her. Today, we discuss two working papers on liberalism.
Sharon Patricia Holland an other In an other, Sharon Patricia Holland offers a new theorization of the human animal/divide by shifting focus from distinction toward relation in ways that acknowledge that humans are also animals. Holland centers ethical commitments over ontological concerns to spotlight those moments when Black people ethically relate with animals. Drawing on writers and thinkers ranging from Hortense Spillers, Sara Ahmed, Toni Morrison, and C. E. Morgan to Jane Bennett, Jacques Derrida, and Donna Haraway, Holland decenters the human in Black feminist thought to interrogate blackness, insurgence, flesh, and femaleness. She examines MOVE’s incarnation as an animal liberation group; uses sovereignty in Morrison’s A Mercy to understand blackness, indigeneity, and the animal; analyzes Charles Burnett’s films as commentaries on the place of animals in Black life; and shows how equestrian novels address Black and animal life in ways that rehearse the practices of the slavocracy. By focusing on doing rather than being, Holland demonstrates that Black life is not solely likened to animal life; it is relational and world-forming with animal lives. “With her characteristic brilliance and speculative flair, Sharon Patricia Holland breaks new ground in an other, a book that will prove to be her most philosophical and speculative text yet. Holland pulls at the ways that blackness as ontology and epistemology undoes and ethically remakes the bio/zoopolitical distinction between animals and humans. She remakes the very ideas that underline life itself as a human project that both denies and relies on animality: love, death, knowing, being, and ultimately revolution as it happens on the scale of the ordinary and the everyday. An essential volume.” — Kyla Wazana Tompkins, author of Racial Indigestion: Eating Bodies in the Nineteenth Century “Sharon Patricia Holland’s an other is a beautiful, expansive, rich, and genius gift to a world that could not have anticipated it. Her work at the level of the animal and cohabitation and about relationality and comportment is assuredly a necessary and brilliant offering. Holland’s enormous intervention cannot be overstated. Black studies will not be the same after this book.” — Sarah Jane Cervenak, author of Black Gathering: Art, Ecology, Ungiven Life Sharon Patricia Holland is Townsend Ludington Distinguished Professor of American Studies at the University of North Carolina at Chapel Hill, and author of The Erotic Life of Racism and Raising the Dead: Readings of Death and (Black) Subjectivity, both also published by Duke University Press…
Stephanie Li Ugly White People: Writing Whiteness in Contemporary America White Americans are confronting their whiteness more than ever before, with political and social shifts ushering in a newfound racial awareness. And with white people increasingly seeing themselves as distinctly racialized (not simply as American or human), white writers are exposing a self-awareness of white racialized behavior—from staunch antiracism to virulent forms of xenophobic nationalism. Ugly White People explores representations of whiteness from twenty-first-century white American authors, revealing white recognition of the ugly forms whiteness can take. Stephanie Li argues that much of the twenty-first century has been defined by this rising consciousness of whiteness because of the imminent shift to a “majority minority” population and the growing diversification of America’s political, social, and cultural institutions. The result is literature that more directly grapples with whiteness as its own construct rather than a wrongly assumed norm. Li contextualizes a series of literary novels as collectively influenced by changes in racial and political attitudes. Turning to works by Dave Eggers, Sarah Smarsh, J. D. Vance, Claire Messud, Ben Lerner, and others, she traces the responses to white consciousness that breed shared manifestations of ugliness. The tension between acknowledging whiteness as an identity built on domination and the failure to remedy inequalities that have proliferated from this founding injustice is often the source of the ugly whiteness portrayed through these narratives. The questions posed in Ugly White People about the nature and future of whiteness are vital to understanding contemporary race relations in America. From the election of Trump and the rise of white nationalism to Karen memes and the war against critical race theory to the pervasive pattern of behavior among largely liberal-leaning whites, Li elucidates truths about whiteness that challenge any hope of national unity and, most devastatingly, the basic humanity of others. Ugly White People is not about the 'racists' but about the way whiteness shapes the subjectivity of all white people. Relying on an elegant and parsimonious textual analysis of the work of contemporary authors, Stephanie Li shows how whites manage to evade while they acknowledge their whiteness, how they consume people of color through racist love, and how they accept whiteness in a way that neglects addressing racism. I highly recommend this book to readers interested in understanding contemporary whiteness. — Eduardo Bonilla-Silva, Duke University The best writing critically studying whiteness today intensely engages imbrications of race with other identities, especially class, gender, nationality, and disability. No one does all of that better than Stephanie Li. Addressing literary moments with a sure grasp of history and an adventuresome readings of texts, Ugly White People speaks compellingly to the persisting strength of Trump and white nationalism and to the desire for social media celebrity as something authors both explore and share. — David Roediger, author of The Sinking Middle Class: A Political History of Debt, Misery, and the Drift to the Right Stephanie Li is Lynne Cooper Harvey Distinguished Professor of English at Washington University in St. Louis. She is author of Pan-African American Literature, Playing in the White, and Signifying without Specifying.…
Gilligan, Carol In a Human Voice Carol Gilligan's landmark book In a Different Voice – the "little book that started a revolution" – brought women's voices to the fore in work on the self and moral development, enabling women to be heard in their own right, and with their own integrity, for the first time. Forty years later, Gilligan returns to the subject matter of her classic book, re-examining its central arguments and concerns from the vantage point of the present. Thanks to the work that she and others have done in recent decades, it is now possible to clarify and articulate what couldn't quite be seen or said at the time of the original publication: that the "different voice" (of care ethics), although initially heard as a "feminine" voice, is in fact a human voice; that the voice it differs from is a patriarchal voice (bound to gender binaries and hierarchies); and that where patriarchy is in force or enforced, the human voice is a voice of resistance, and care ethics is an ethics of liberation. While gender is central to the story Gilligan tells, this is not a story about gender: it is a human story. With this clarification, it becomes evident why In a Different Voice continues to resonate strongly with people's experience and, perhaps more crucially, why the different voice is a voice for the 21st century. ----------------------------------------------------------------------- During the podcast, Mary Gaitskill's piece on Anna Karenina, from Fassler, Joe. Light the Dark: Writers on Creativity, Inspiration, and the Artistic Process (pp. 69-73). Penguin, excepted here: MARY GAITSKILL "I Don’t Know You Anymore" I READ ANNA KARENINA for the first time about two years ago. It’s something I’d always meant to read, but for some reason I didn’t expect to like it as much as I did. ... I found one section in particular so beautiful and intelligent that I actually stood up as I was reading. I had to put the book down, I was so surprised by it—and it took the novel to a whole other level for me. Anna’s told her husband, Karenin, that she’s in love with another man and has been sleeping with him. You’re set up to see Karenin as an overly dignified but somewhat pitiable figure: He’s a proud, stiff person. He’s older than Anna is, and he’s balding, and he has this embarrassing mannerism of a squeaky voice. He’s hardened himself against Anna. He’s utterly disgusted with her for having gotten pregnant by her lover, Vronsky. But you have the impression at first that his pride is hurt more than anything else—which makes him unsympathetic. Then he finds out Anna is dying, and he goes to visit her.] He hears her babbling, in the height of her fever. And her words are unexpected: She’s saying how kind he is. That, of course, she knows he will forgive her. When Anna finally sees him, she looks at him with a kind of love he’s never seen before. ... Throughout the book, he’s always hated the way he’s felt disturbed by other people’s tears or sadness. But as he struggles with this feeling while Anna’s talking, Karenin finally realizes that the compassion he feels for other people is not weakness: For the first time, he perceives this reaction as joyful, and becomes completely overwhelmed with love and forgiveness. He actually kneels down and begins to cry in her arms; Anna holds him and embraces his balding head. The quality he hated is completely who he is—and this realization gives him incredible peace. He even decides he wants to shelter the little girl that Anna’s had with Vronsky (who sits nearby, so completely shamed by what he’s witnessing that he covers his face with his hands). You believe this complete turnaround. You believe it’s who these people really are. I find it strange that the moment these characters seem most like themselves is the moment when they’re behaving in ways we’ve never before seen. I don’t fully understand how this could be, but it’s wonderful that it works. But then the moment passes. Anna never talks about the “other woman” inside of her again. At first, I was disappointed. But then I thought: No, that’s actually much more realistic. What Tolstoy does is actually much better, because it’s more truthful. We feel a greater sense of loss, knowing it will never happen again. I very much saw that as the core of the book. Everyone says Anna Karenina is about individual desire going against society, but I think the opposite perspective is stronger: the way social forces actively go against the soft feelings of the individual.…
Merav Roth A Psychoanalytic Perspective on Reading Literature Reading the Reader (Art, Creativity, and Psychoanalysis Book Series) 1st Edition What are the unconscious processes involved in reading literature? How does literature influence our psychological development and existential challenges? A Psychoanalytic Perspective on Reading Literature offers a unique glimpse into the unconscious psychic processes and development involved in reading. The author listens to the 'free associations' of various literary characters, in numerous scenarios where the characters are themselves reading literature, thus revealing the mysterious ways in which reading literature helps us and contributes to our development. The book offers an introduction both to classic literature (Poe, Proust, Sartre, Semprún, Pessoa, Agnon and more) and to the major psychoanalytic concepts that can be used in reading it – all described and widely explained before being used as tools for interpreting the literary illustrations. The book thus offers a rich lexical psychoanalytic source, alongside its main aim in analysing the reader’s psychological mechanisms and development. Psychoanalytic interpretation of those literary readers opens three main avenues to the reader’s experience: the transference relations toward the literary characters; the literary work as means to transcend beyond the reader’s self-identity and existential boundaries; and mobilization of internal dialectic tensions towards new integration and psychic equilibrium. An Epilogue concludes by emphasising the transformational power embedded in reading literature. The fascinating dialogue between literature and psychoanalysis illuminates hitherto concealed aspects of each discipline and contributes to new insights in both fields. A Psychoanalytic Perspective on Reading Literature will be of great interest not only to psychoanalytic-psychotherapists and literature scholars, but also to a wider readership beyond these areas of study.…
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