Saturday, September 18, 2010

All in the Mind - Schizophrenia: Personal confrontations and a philosophical investigation

I just finished listening to this podcast - it's rare to hear someone be so clear about their experience with schizophrenia at such a young age - he is one of the lucky few for whom the meds work very well. For many more, it's a constant battle with the voices and to find the right meds or combination of meds to make the person as functional as possible.

One of my classmates has a son with schizophrenia and it's heartbreaking sometimes to hear his pain (and anger) in having a son who, on most days, is nothing like the young man he had raised. As much as it sucks for the person with the disease, and I'm sure it REALLY sucks, it's also horrible for the family and friends who see the person they know and love walking around in the world, but as often as not, the consciousness/psyche/soul of that person is no longer there.

First up, the Friday blog post for this podcast, via Natasha Mitchell's All in the Mind blog:

The sea of daggers - A philosophical & personal interrogation of psychosis

Fearne-Photo-1bPaul Fearne has done a brave thing.

He's taken a diary he wrote years ago as an undergrad student in the thick of his first psychotic experience, and published it as Diary of a Schizophrenic (chipmunkapublishing, 2010).

Going public with something so intimate is brave enough, but publishing anything from those anxiety-tinged years of early adult life is perhaps braver still (nothing I wrote then will ever see the light of day, and that's a promise!).

But this was no average young guy, as you'll read in his diary:

"How can I continue with a life that is so dead in feelings? My emotional intensity was the well-spring from which my life drew its meaning, and now that it is gone I can do nothing but mourn its passing. There is such a large part of me which is gone that I sometimes feel that I will never recover.

There have been a number of defining moments in my life, but the day I lost my emotions is perhaps the day I will regret the most. How can this happen to one so young and so full of life? I thought such tragedy was only written about by the Greeks, not lived in this modern era. The ability to write poetry was one of the sweet joys of life that gave hope to a sometimes troubled existence. But it was those troubles which gave life its edge and vitality. To enjoy a sunset after the tumult of everyday living is a joy I guess I will rarely live again.


I remember once watching a documentary on one of the great musicians. It described how in the later parts of his life the creative fire began to die within his bosom. I remember it clearly because it was about the same time I was set upon by my troubles. It seems that those of us who burn the brightest are the same ones who die the coldest deaths. To know the exhilaration of heightened thought and then to watch it slowly slip away is something almost unbearable. I think I know how the supernova star feels".

Paul has decided to put himself out there with the diary of his much younger self because it might give an insight into the nature of the psychotic mind, or at least one experience of it. As you'll hear in the show, Paul experienced complex delusions in which he felt his mind was exposed to the world, the cat, the elements, light and sound. However, he didn't experience the auditory hallucinatations or voices in the head that many do. Everyone's experience of schizophrenia is their own - perhaps this is often forgotten in the quest to pin down a universal diagnosis.

The diary isn't always easy reading, partly because it describes a young man in a state of profound and painful confusion, but also because it's very repetitive - that's the nature of the delusional state, it gets well rehearsed. The same anxieties reveal themselves over and over again, about the fragmentation of his mind, and about all the things that we're all preoccupied with at that time of our lives...careers and identity, and as a student...essays, deadlines and academic performance.

What makes Paul Fearne's diary unique though is that, during his first psychosis, he was also reading many of the great classics of literature, which shaped his interpretations of what was going on inside his head at the time in interesting ways.

All this was before he was given a diagnosis and understood what it meant. With the right support and treatment he went on to complete his honours, a masters in the philosophy of aesthetics and beauty, get married, and have a child. He's been very fortunate. Talent combined with love and acceptance can take all of us a long way in the face of adversity.

His next brave move was to interrogate his illness for a PhD in Philosophy, which he finished this year, and we'll talk about that briefly too on this week's show.

Tune in on-air or over on the All in the Mind website.

And here, as promised is some extra audio of my interview with Dr Paul Fearne:

Why_go_public

Karl_Jaspers_and_creativity

Luce_irigaray

An_hypothesis_about_attachment

Opening_up

And here's a recording of the presentation he gave at his book launch at the Melbourne Writers' Festival this month. His is a story which he hopes will inspire others with schizophrenia about the possibilities for their own lives.

Paul_fearne_speech_part_1

Paul_fearne_speech_part_2

Thanks to Paul Penton for assisting with this recording.

Over to you.

And, now, this week's podcast from All in the Mind and Natasha Mitchell.

Schizophrenia: Personal confrontations and a philosophical investigation

Philosopher, poet and writer Dr Paul Fearne had his first psychotic episode as a young university student, and continues to take medication. 'To live is to take a leap into a sea of daggers, each one stabbing the fabric of your being,' he wrote in his diary at the time, now published. From Freud to Wittgenstein, his experience inspired a unique PhD investigation into the philosophical questions posed by schizophrenia.

Show Transcript

Guests

Dr Paul Fearne
Philosopher, poet
http://literaryleaves.blogspot.com/

Further Information

All in the Mind blog with Natasha Mitchell
You can comment on the program above (Add Your Comment), or over on Natasha's blog too.

2010 Melbourne Writers' Festival

Reclaiming imagination: art, psychosis and the creative mind
Broadcast on All in the Mind, ABC Radio National, 2006

Fragmented minds (Part 1 of 2), broadcast in 2006, ABC Radio National

Fragmented minds (Part 2 of 2) - broadcast ABC Radio National, 2006

Publications

Title: Diary of a Schizophrenic
Author: Paule Fearne
Publisher: Chipmunkapublishing: A Mental Health Publisher, 2010
URL: http://www.chipmunkapublishing.com/

Title: A Philosophical Response to the Questions Posed by Schizophrenia
Author: Paul Fearne
Publisher: PhD Thesis, LaTrobe University, 2010

Title: Neurosis and Psychosis
Author: Sigmund Freud (in The Standard Edition of the Complete Psychological Works of Sigmund Freud (trans James Strachey))
Publisher: The Hogarth Press, London, 1960

Title: Anti-Oedipus: Capitalism and Schizophrenia
Author: Gilles Deleuze & Felix Guattari (transl Robert Hurley, Mark Seem, Helen R Lane)
Publisher: Continuum, London, 1983

Title: Being and Time
Author: Martin Heidegger (trans. John Macquarie and Edward Robinson)
Publisher: Blackwell, Oxford, 1993

Title: General Psychopathology
Author: Karl Jaspers (trans. J. Hoenig and Marian W. Hamilton)
Publisher: The University of Chicago Press, Chicago, 1963

Title: Philosophical Investigations
Author: Ludwig Wittgenstein (trans. G.E.M Anscombe)
Publisher: Blackwell, Oxford, 1953

Title: To Speak is Never Neutral
Author: Luce Irigaray (trans. Gail Schwab)
Publisher: Continuum, London, 2002

Presenter

Natasha Mitchell


The Dalai Lama - Cultivate a spiritual practice under the guidance of a master

I'm not a big fan of the guru-student thing, but I know that many Buddhists are, so this is good advice if the guru thing is part of your path.


THE PATH TO ENLIGHTENMENT
by H.H. the Dalai Lama,
edited and translated by Glenn H. Mullin
more...

Dalai Lama Quote of the Week

The reason why the qualities of a teacher are described at such length in the scriptures is because we should know what to look for when seeking a guru capable of opening up the Buddhist paths within us. To take up training under an unqualified teacher can be disastrous. It is said in the tantric scriptures that one is not unwise to examine a guru for twelve years before accepting that person as one's teacher. The choice of teachers is an important one and must be made carefully.

Not only does the guru perform the work of the Buddhas and thus equal them in activity, in terms of kindness the guru surpasses them. Of all Buddhas of the past who have manifested as universal teachers, it is said that Buddha Shakyamuni is kindest to us; for it is with his teachings that we have come into contact...even though Buddha Shakyamuni is most kind of the past Buddhas, still we are unable to receive teachings from him or witness his inspiring presence.

Were all the Buddhas and lineage masters of the past to manifest before us at this very moment, we would not be able to recognize them as enlightened beings. Due to our not having a sufficiently strong karmic connection with them, they would be unable to affect us. The guru performs the great kindness of coming to us in an ordinary form which we can perceive and to which we can relate, and carries out the work of the Buddhas in our lives. The fact that a donkey like us is brought into the family of spiritual beings is purely due to the kindness of the guru. The Buddhas can only come to us through him or her. Thus if we do not respect the guru and heed his or her teachings, what hope do we have? We should meditate upon the guru's unexcelled kindness and give birth to profound appreciation.

The reason why we have been wandering unceasingly in cyclic existence since time immemorial is because we have not met a spiritual master before; or even if we have met one we did not cultivate an effective relationship with him or her. We should determine to take the opportunities afforded by our present human situation and cultivate a spiritual practice under the guidance of a master.

--from The Path to Enlightenment by H.H. the Dalai Lama, edited and translated by Glenn H. Mullin, published by Snow Lion Publications

The Path to Enlightenment • 5O% off • for this week only
(Good through September 24th).


Emory University in Atlanta Georgia is hosting the first
International Conference on Tibetan Buddhism
October 18-20, 2010

Participants include: H.H. the Dalai Lama, Ganden Tri Rizong Rinpoche, Sogyal Rinpoche, Gehlek Rinpoche, Thupten Jinpa, Matthieu Ricard, and 34 other notable participants.
For more information and registration please visit
www.dalailama.emory.edu.
Article on the Conference



NPR - Why Are These Crows So Good With Tools? (Video Pick of the Week)

Another piece on the intelligence of corvids - this time the tool-using New Caledonian crows, via NPR's Talk of the Nation: Science Friday, with Ira Flatow, who is interviewing Flora Lichtman.

Let's start with the video they make reference to in the discussion:

Video Pick: Crows Use Tools Too

New Caledonian crows are among only a handful of species on the planet that have been shown to use tools. They use twigs to fish out beetle larvae from dead trees. Reporting in Science, Christian Rutz and colleagues explore why the birds evolved to have this rare trait. (Credits: ) See More Videos

People use tools. Other primates use tools. But... crows? Flora takes a look at tool use in our feathered friends.

So there is the whole story.

New Caledonian crows are among only a handful of species that have been shown to use tools. They use twigs to fish out beetle larvae from dead trees. Reporting in Science, Christian Rutz and colleagues explore why the birds evolved this rare trait.

IRA FLATOW, host:

I'm Ira Flatow. This is SCIENCE FRIDAY, from NPR.

Joining me now is Flora Lichtman. Hi. Flora's here with our Video Pick of the Week.

FLORA LICHTMAN: Hi, Ira. Happy SCIENCE FRIDAY.

FLATOW: Happy SCIENCE FRIDAY today, thank you. Now, you've got a very - another nice video. I don't want to give it away. Tell us what you have in our Video Pick of the Week today.

LICHTMAN: It's a good animal tale.

FLATOW: Mm-hmm.

LICHTMAN: Let me the scene for you.

FLATOW: Set the scene.

LICHTMAN: Imagine you are a New Caledonian crow, which looks a lot like a regular crow, but you happen to live on the island of New Caledonia, which is pretty good. It's in the south Pacific.

FLATOW: Mm-hmm.

LICHTMAN: Life is pretty good, and you're a little bit hungry. And your bird friends are confined to eating nuts and fruit that they have to find on the ground. But you, because you are this special crow, have a very unusual trait, an unusual ability: You can use tools to get your food. Well, not you.

FLATOW: Well...

LICHTMAN: A New Caledonian crow can. You probably can, too, Ira.

(Soundbite of laughter)

FLATOW: That's right.

LICHTMAN: But the story is how these crows use sticks to pull out these juicy, long-horned beetle larvae.

FLATOW: They're like this super food for them...

LICHTMAN: Yeah. So...

FLATOW: ...like the gourmet food for a crow.

LICHTMAN: I mean, I think it's more like the Power Bar, the Snickers for a crow. They're really high in fat, and they've got a lot of protein, too. And that's what this new study was about this week in the journal Science. Christian Rutz and his colleagues wanted to understand why these crows have this ability that almost no other species in the, you know, in the animal kingdom...

FLATOW: Right. Right.

LICHTMAN: ...have. Like, why do these crows...

FLATOW: They're not primates, not like apes and us, who can use little sticks. But they can.

LICHTMAN: But they can. And so the question was: What's so good about these larvae? You know, maybe the crows that can get the larvae out of the trees have some advantage.

FLATOW: Mm-hmm.

LICHTMAN: And so they looked at the dietary impact of the larvae and found that, in fact, maybe two or three of these larvae a day covers all of the crow's energy needs.

FLATOW: So that's their motivation, then?

LICHTMAN: Right.

FLATOW: And you have it on our website at sciencefriday.com, our Video Pick of the Week is you can watch these crows put some sticks in their mouths - in their beaks...

LICHTMAN: In their beaks.

FLATOW: ...thank you, in their beaks, and poke in to pull out these larvae out of a tree.

LICHTMAN: And the most amazing part of the footage that the researchers provided was not just watching the crows pull them out, but watching the larvae point of view. So they put a larva in a glass cylinder...

FLATOW: Mm-hmm.

LICHTMAN: ...and filmed the crow poking in. And you watch the larva open its mandibles, because the way this works - it's not exactly fishing. They don't skewer them...

FLATOW: Right.

LICHTMAN: ...like a kebab. They actually just irritate them to the point where the larvae open their mandibles and grab onto the stick because they're so annoyed, and then get yanked out.

FLATOW: It's a great video, our Video Pick of the Week...

LICHTMAN: Very dramatic.

FLATOW: ...at sciencefriday.com. You know, you feel like you're Jane Goodall all over, watching these crows.

LICHTMAN: Yeah, it's true. I mean, I think one of the neat things about the footage...

FLATOW: Yeah.

LICHTMAN: ...is that you have access to the crows in a way you didn't before. So another piece of footage where these crow cams, where they actually attached cameras to the tails of crows, which are kind of funny because you've got a through-the-legs shot, which is a little bit awkward, I think...

FLATOW: Right.

LICHTMAN: ...but you see them in flight and you see them sort of going about their daily business.

FLATOW: And it just - it's so shocking that - you know, I've seen crows pick things up off the ground and - a watch or a golf ball or something like that, but I never realized that they could actually put a tool in their mouth and use it all the time without being taught how to do that.

LICHTMAN: Right. I mean, even the crows in the lab that have never - you know, who've been raised in the lab, will use tools and bend tools and make them. I mean, it really makes you think about what it means to be a tool user. Christian Rutz said...

FLATOW: Right.

LICHTMAN: ...that a lot of people were like, wow, these crows must be really super smart. And he said, you know, actually, maybe it's just - lots of animals can do amazing things, thanks to evolution.

FLATOW: Mm-hmm. So if you thought that crows didn't know how to use tools, nevermore think that way. I had to work that...

LICHTMAN: Work it in.

FLATOW: ...Edgar Allan Poe line in.

LICHTMAN: Hey, you just stole the literary reference thunder.

(Soundbite of laughter)

FLATOW: Shucks. I'm sorry about that. And so there's our Video Pick of the Week up there on our website. Flora Lichtman, our digital media editor. Thank you.

LICHTMAN: Thanks, Ira.

FLATOW: See that up there. It'll be up there all week at sciencefriday.com.


Friday, September 17, 2010

My Review: Robert Augustus Masters - Spiritual Bypassing: When Spirituality Disconnects Us from What Really Matters

[Note: I bought this book - I did not receive a review copy.]


I have been reading and enjoying Robert Augustus Masters' newest book, Spiritual Bypassing: When Spirituality Disconnects Us from What Really Matters. I'm reading a Kindle version on my iTouch, so I find myself highlighting whole pages that I want to share.

I can't post the whole book here. Yet I cannot recommend this book strongly enough - if you want to be fully integrated as a human being, get the most from your spiritual practice, and/or go deeper in your psychotherapy, you MUST get this book and read it, slowly and let it sink in.

Of all the people who talk about an integral spirituality and psychology, Masters is the only one I really see walking the talk. His books are not filled with abstract theory, they are practical guides to becoming more authentic, more integrated, and more whole.

Masters gives us an overview of the many varied ways we engage in spiritual bypassing in the first 7 chapters. When we get to chapter 8, "What Generates Spiritual Bypassing?", the answer he gives is perfectly obvious - pain - and yet all the ways we seek to escape the pain generally just make it worse. We seldom look into our pain and seek to heal it - we often try to bypass it and spirituality is often a great way - in our minds - to do it.

This is an excerpt from Spiritual Bypassing. In my opinion, this book will become as important as Chogyam Trungpa's Cutting Through Spiritual Materialism, which they publisher mentions as well.

Here is a blurb from the Amazon site:
Spiritual bypassing—the use of spiritual beliefs to avoid dealing with painful feelings, unresolved wounds, and developmental needs—is so pervasive that it goes largely unnoticed. The spiritual ideals of any tradition, whether Christian commandments or Buddhist precepts, can provide easy justification for practitioners to duck uncomfortable feelings in favor of more seemingly enlightened activity. When split off from fundamental psychological needs, such actions often do much more harm than good.

While other authors have touched on the subject, this is the first book fully devoted to spiritual bypassing. In the lineage of Chögyam Trungpa’s landmark Cutting Through Spiritual Materialism, Spiritual Bypassing provides an in-depth look at the unresolved or ignored psychological issues often masked as spirituality, including self-judgment, excessive niceness, and emotional dissociation. A longtime psychotherapist with an engaging writing style, Masters furthers the body of psychological insight into how we use (and abuse) religion in often unconscious ways. This book will hold particular appeal for those who grew up with an unstructured new-age spirituality now looking for a more mature spiritual practice, and for anyone seeking increased self-awareness and a more robust relationship with themselves and others.

Robert Augustus Masters, PhD, is the author of eleven books, including Transformation Through Intimacy and Darkness Shining Wild. He holds a doctorate in psychology and is a master integral psychotherapist, trainer of psychotherapists, and group leader. He lives in White Rock, British Columbia.
This excerpt is on boundaries:
SPIRITUAL BYPASSING: WHEN SPIRITUALITY DISCONNECTS US FROM WHAT REALLY MATTERS

Here is part of the chapter on boundaries:

...If we are inclined to be overboundaried—overbudgeting for defense—we wall ourselves in, confusing security with freedom. On the other hand, if we tend to be underboundaried—leaving the gates too open—we float on the periphery of embodied life, confusing fusion with intimacy, limitlessness with freedom, and excessive tolerance with compassion. Boundaries make containment possible, but does such containment protect or overprotect us, entrap or serve us, ground or cement us, house or jail us?

Those who are underboundaried tend to mistake collapsed boundaries for expanded ones; especially in the realm of spiritual bypassing, a collapsing (or outright dissolution) of boundaries is seen as letting go or even transcending them. A similar mistake is made in our idealized view of romance, where the overwhelming urge to merge is seen as the ultimate state of love rather than as a temporary fantastical state that inevitably unravels over time. We may rationalize or glamorize this abandonment of boundaries as a kind of liberation, a casting-off of shackles in the service of transcendence and spiritual realization. As much as we might conceive of such radical expansion as a wonderful thing, confusing our flight from boundedness with true openness, we don’t realize that the actual practice of spiritual bypassing does not expand boundaries, but rather neglects and disrespects them. For example, someone we are close to speaks very disrespectfully to us, clearly crossing a line, and instead of asserting ourselves with them, taking a needed stand, we leave their behavior unaddressed and unchallenged, thinking we are being compassionate with them, thereby disrespecting the very boundary of ours that was inappropriately crossed.

Abandoning our boundaries is not indicative of a higher or more noble state—however much we might spiritually rationalize this—but is just escapism and aversion, an avoidance of facing, entering, and moving through our pain. Dissociation in spiritual robes is still dissociation! We may make a virtue out of moving beyond the personal, perhaps thinking that we are transcending it, when in fact we are slipping into the domain of depersonalization (a well-known psychiatric disorder featuring disconnection from one’s sense of self). But depersonalization is not the same as the self-transcending or “no-self ” realizations of advanced spiritual practice! It is just another form of dissociation (or unhealthy separation).

And what is arguably the opposite of dissociation? Intimacy. And intimacy requires healthy boundaries. Healthy boundaries protect but do not overprotect; they stand guard but do not jail. If we keep ourselves overprotected, we don’t thrive but stagnate. And if we keep ourselves underprotected, we also don’t thrive but open ourselves undiscerningly, left in a state in which overabsorption is inevitable. The spiritual bypasser in us might protest: shouldn’t we be receptive? Yes, but overabsorption and receptivity are not necessarily the same thing! Consider the example of a man who is exaggeratedly nice and almost always smiling, even when he is treated badly. He may appear very receptive and unusually open, but in fact he is taking in much more than is healthy for him, perhaps because this strategy—never saying a clear “no”—helped him survive difficulties in his early years.

Having healthy boundaries doesn’t mean a lack of receptivity; instead, it is a discerning receptivity, an openness that can just as easily say a full-blooded “no” as a “yes”. The undiscriminating openness and too easy “yes” (and possible show of equanimity) of those who are underboundaried is especially difficult to cut through when it’s taken to be a sign of spiritual attainment. When we cannot voice and embody an unequivocal “no,” allowing ourselves to be closed at times, our only way of protecting ourselves is to dissociate, to get away from what’s difficult rather than face and pass through it. Where being overboundaried appears to promise freedom through security, being underboundaried seems to promise freedom through limitlessness. But both cut us off from living fully. This fact is usually obvious when we overprotect ourselves but not necessarily when we underprotect ourselves, especially when we legitimize our actions spiritually, making an unquestioned virtue out of our undiscriminating openness...
I could offer lots of other quotes, especially from the chapters on shadow work (hint: 1-2-3 shadow work ain't real shadow work), blind compassion, false transcendence, magical thinking, sex, shame, and so much more.

This book is so clear and so true that one wonders how no one else has ever written this.
Instead of trying to get beyond our personal history, we need to learn to relate to it with as much clarity and compassion as possible, so that it serves rather than obstructs our healing and awakening. This also means relating in similar fashion to our tendency to spiritually bypass, casting a lucid, caring eye upon the part of us who buys into us. (Location 225)

* * *

When we remain outside or removed from our fear, we are trapped by it, but when we actually do get inside, cultivating intimacy with it, we are no longer trapped by it, discovering--and not just intellectually--that it is but darkly contracted energy, a knotted-up vitality that can be freed when we become intimate with it. (Location 337)

* * *

Real shadow work does not leave us intact; it is not some neat and tidy process but rather an inherently messy one, as vital and unpredictably alive as birth. The ass it kicks is the one upon which you are sitting; the pain it brings up is the pain we've been fleeing most of our life; the psychoemotional breakdowns it catalyzes are the precursors to hugely relevant breakthroughs; the doors it opens are doors that have shown up year after year in our dreams, awaiting our entry. Real shadow work not only breaks us down but also breaks us open, turning frozen yesterday into fluid now. (Location 635)
Those are from the first few chapters - there are wise quotes like these on nearly every page.


Fred Dallmayr - Integral Pluralism: Beyond Culture Wars

Michael McLean at Zero Integral has already commented on how strange it is to see this book from Fred Dallmayr - Integral Pluralism: Beyond Culture Wars, University of Kentucky Press - that seems to make no mention of Ken Wilber (I checked the index to be sure). As Michael points out, it seems strange that he could have written this book without stumbling over Wilber's 'Integral Methodological Pluralism' someplace along the way.

On the other hand, I have yet to meet a "serious" philosopher who takes Wilber seriously. he is still seen primary as a New Age guru. Hanging out with and endorsing people like Andrew Cohen, Marc Gafni, and so many other less than academic "teachers" (using that word loosely) certainly does nothing to change that perception.

Anyway, Dallmayr mentions Jurgen Habermas and William James, as well as John Dewey, Charles Taylor, and others, all deserving of discussion (especially James, whose A Pluralistic Universe may have been the first real look at pluralism, and Taylor, who Dallmayr seems to dismiss (along with Maurice Merleau-Ponty and other embodied intersubjectivists) as "solely ... allies against "hegemony, exploitation, and oppression" (122)." I think this is wrong - and I saw no mention of Ken Gergen in this review, who must be included.

The review from University of Notre Dame Press is good and comprehensive.

Fred Dallmayr: Integral Pluralism: Beyond Culture Wars

Fred Dallmayr, Integral Pluralism: Beyond Culture Wars, University of Kentucky Press, 2010, 231pp., $40.00 (hbk), ISBN 9780813125718.

Reviewed by Kenneth W. Stikkers, Southern Illinois University, Carbondale


In his most recent volume, Integral Pluralism: Beyond Culture Wars, Fred Dallmayr again demonstrates, as he has throughout his distinguished career, his passionate commitment to making ours a more just and peaceful world. His central concern in this work is that, with postmodernism's steady move toward pluralism and emphatic rejection of totalizing monisms of every sort, there is a danger of cosmic incoherence whereby "individual lives likewise become incoherent and unintelligible" (1) and rendered incapable of effective engagement in the world. Dallmayr warns us:

Pluralism harbors a danger that curiously approximates it again to the monistic temptation. Carried to the extreme of radical fragmentation or dispersal, pluralism -- despite its protestations -- shades over into an assembly of fixed and self-enclosed monadic units exhibiting the same monadic units exhibiting the same static quality as its counterpart (8-9).

Such fragmentation, he further suggests, is a major source for today's "culture wars."

As an antidote to radical, atomizing pluralism, and as a middle position between it and tyrannizing monism, Dallmayr offers "integral pluralism," which he finds well exemplified already by classical pragmatists such as John Dewey, but especially by William James in A Pluralistic Universe. Integral pluralism entails "mutual embroilment, interpenetration, and contestation . . . differential entwinement without fusion or segregation" (9). The universe is taken as incomplete, but its pieces maintain real, although sometimes antagonistic, relations to one another. Other, non-Western thinkers whom Dallmayr offers as exemplars of integral pluralism are the philosopher of religion, Raimon Panikkar, whom Dallmayr discusses throughout this volume (and with whom this reviewer was privileged to study), Mahatma Gandhi, who receives a full chapter (Chapter 7), and two other, recently deceased Indian thinkers, little known in the West, Daya Krishna and Ramchandra Gandhi (a grandson of Mahatma Gandhi), who are the central subjects of the concluding chapter (Chapter 8). This reviewer is very appreciative of being made aware of these last two thinkers, and Dallmayr's interesting account of them has prompted him to read them first-hand.

Moreover, each of the above figures, including Dewey, is used to demonstrate the importance of religion for integrative pluralism. The Indian thinkers are especially exemplary because they articulate religious sensibilities that are integrated with the secular, in contrast to Western tendencies toward dualism, and thus steer between the dangers stemming from such dualism, namely, the politicizing of religion on the one hand (e.g., America's religious right and Islamic and Zionist extremisms), and the privatizing of religion and withdrawal into the solitude of religious consciousness, on the other.

Dallmayr offers brief references to Lyotard and Rorty to illustrate his concern about the danger of radical pluralisms, but they seem insufficient in persuasively demonstrating that his concern is a real rather than merely an imagined one or that he is attacking anything other than a strawman. Where do we actually see pluralism devolving into such atomism and causing the dire consequences he fears? "Pluralism" enjoys such a variety of meanings presently: a more nuanced discussion of its varieties at the start might have aided Dallmayr's analysis. In some contexts "pluralism" is merely descriptive of the fact that inquiry is concretely situated in the world, that we all think from somewhere, rather than from nowhere, that we are not placeless cogitos, that the starting points for inquiry are as numerous as thinkers, and that although we might usefully, but cautiously and provisionally, cluster such starting points, in terms such as race, gender, and class, there ultimately is no singular, privileged or God's-eye view from which inquiry begins. Pluralism understood descriptively in this way is thus the opponent of any sort of apriorism that imperialistically aims to secure a proper or "objective" perspective in advance of inquiry.

"Pluralism," however, also has normative meanings: normative pluralism, or what I have termed "cultivated pluralism,"[1] argues for the need to preserve plurality. Classical pragmatists, such as Peirce, James, and Dewey, are at least descriptive pluralists, but they also see the plurality of perspectives from which inquiry begins as a primary source of "irritation" (Peirce) and one of the factors that generates socially "problematic situations" (Dewey). The aim of inquiry, then, is to arrive at "truth" and thereby forge a common perspective as the alternative to violence. As Peirce describes, inquiry aims to "grind off" individuality and plurality. New perspectives, however, continuously emerge, and thus plurality remains an ineradicable feature of our world, despite even the most violent efforts toward uniformity. There are, however, at least for Dewey but especially for Alain Locke, good reasons to preserve and even cultivate plurality in the face of inquiry's tendency toward monism. For Dewey, the reasons are largely aesthetic: variety is the spice of life. For Locke, cultivated pluralism deepens the quality of inquiry by serving as a safeguard against a consensus that comes too quickly and easily. Locke's cosmopolitanism derives mainly from his study under Josiah Royce and his participation in the Baha'i faith, and I strongly recommend him as an important resource for Dallmayr and those interested in his project.

Dallmayr equivocates between descriptive and normative meanings of "pluralism," and it is not evident that he is a pluralist in the normative sense: he offers no clear arguments for the active preservation, cultivation, and celebration of plurality but only for its tolerance and against imperialistic monisms. "Integral pluralism" thus appears to be more a program for peaceful, democratic consensus-forming -- a noble goal, to be sure -- than it is one for the cultivation and celebration of difference. With James, Dallmayr holds that (descriptively) there is likely never to be an "all-form" to encase the whole of life, but it is not evident that such an ontological fact is a good thing for him. Indeed, like Carl Schmitt, whom he discusses extensively and critically (especially in Chapters 2 and 3), Dallmayr seems more impressed by society's need for decision-making than he is by the need for and goodness of plurality.
Read the whole review.


Upaya Dharma Podcasts - Cultivating Compassion and Fearlessness (7 parts)

http://www.odiyanacentre.org/images_gallery/pic02_Buddha_of_Compassion.jpg

Another great podcast series from Upaya Zen Center - this summer has been outstanding for the wonderful content they have provided. This series features Sharon Salzberg & Roshi Joan Halifax talking on compassion.

This is an excellent series of teachings - it's one thing to want to be more fearlessly compassionate, but it's a whole other thing to know how to go about changing ourselves to make that possible. We often need to work with our own projections and biases - changing our internal schemas and self-talk.

Another important issue they touch on is spiritual bypass - using unskilled spirituality to gloss over our emotional wounds and personality flaws - it's best exemplified in the New Age injunction to simply focus on the positive. Sounds promising, but it leaves us acting out our projections and wounds in very unhealthy ways because we have relegated them to shadow.

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Cultivating Compassion and Fearlessness Part 1 of 7

Speakers: Sharon Salzberg & Roshi Joan Halifax
Recorded: Saturday Aug 28, 2010

Roshi Joan kicks off the Cultivating Compassion and Fearlessness retreat by recalling 2 powerful issues that brought her to Buddhism … the civil rights movement and the war in Vietnam. She speaks about relationships and says that Buddhism is about relationships, with ourselves and with the world. She recommends using an experience of deep suffering to cultivate Bodhichitta, or the awakened heart. Sharon Salzberg talks about mindfulness and speaks of loving kindness.

Cultivating Compassion and Fearlessness Part 2 of 7

Speakers: Sharon Salzberg & Roshi Joan Halifax
Recorded: Saturday Aug 28, 2010

Sharon guides a loving kindness meditation and Roshi and Sharon answer questions from the audience.


Cultivating Compassion and Fearlessness Part 3 of 7

Speakers: Sharon Salzberg & Roshi Joan Halifax
Recorded: Saturday Aug 28, 2010

Roshi speaks of spiritual bypass and explains the importance of bringing to surface what we are afraid of. The audience moves into groups to discuss fear and then shares 3 big fears in their lives. The group shares what came up for them about fear. Roshi explains “strong back, soft front” and talks about the 5 fears.

Cultivating Compassion and Fearlessness Part 4 of 7

Speakers: Sharon Salzberg & Roshi Joan Halifax
Recorded: Saturday Aug 28, 2010

Sharon says it’s not the thoughts that are the problem … It’s the “glue.” Our job is to sit and rest attention on the feeling and learn to let go. She then leads a guided meditation.

Cultivating Compassion and Fearlessness Part 5 of 7

Speakers: Sharon Salzberg & Roshi Joan Halifax
Recorded: Saturday Aug 28, 2010

Roshi asks how do we nourish our beginners mind, or not knowing. The audience breaks up into groups to discuss what has helped support or sustains them.

Cultivating Compassion and Fearlessness Part 6 of 7

Speakers: Sharon Salzberg & Roshi Joan Halifax
Recorded: Sunday Aug 29, 2010

Roshi speaks of balance, both emotional and physical. Part of opening up fearless compassion is to view our own limits with compassion, just as we view the suffering of others. Our own self talk is so important, grounding ourselves, learning how to slow down effects our self compassion. How do we take in the suffering of the world and allow it to crack our hearts open. Sharon and Roshi answer questions from the audience.

Cultivating Compassion and Fearlessness Part 7 of 7

Speakers: Sharon Salzberg & Roshi Joan Halifax
Recorded: Sunday Aug 29, 2010

Roshi guides a powerful meditation on breathing in the suffering of ourselves and the world and breathing out compassion.


NPR - Where Your Brain Figures Out What It Doesn't Know

Cool segment - BUT, as always, the map (brain) is not the territory (mind).
If you've ever watched Who Wants to Be a Millionaire?, you've watched people engaged in something called metacognition.

Brain scans
Science/AAAS

The highlighted spot in the gray matter of the brain is where you figure out what you you don't know.

Contestants not only need to answer questions. They need to assess how confident they are in the cognitive processes in their own brain that produced the answer.

"You might have the opportunity to ask the audience or phone a friend," says Steve Fleming, a neuroscientist at University College London. But, he adds, "You need to know how sure you are about your own answer before you opt to use those lifelines."

That sort of self-monitoring is something we do all the time. Am I sure that person's expression is friendly? Do I really know the route to the train station? Is the man who just stepped onto the elevator really named Bob?

Researchers have found that some people are better at this than others. And the reason seems connected to a bit of brain just behind the eyes that helps us assess how confident we are in our knowledge and decisions, Fleming says.

Fleming and a group of researchers discovered this after studying 32 volunteers who played a computer game that's a bit like Who Wants to be a Millionaire, but without the big money.

Participants had to identify a patch of screen that was just slightly brighter than the rest of the screen. And every time they did this they had to say how confident they felt about their choice.

Then the researchers scanned the brain of every participant. And they found something.

"We isolated a region of the prefrontal cortex, which is right at the front of the brain and is thought to be involved in high-level thought, conscious planning, monitoring of our ongoing brain activity," Fleming says.

In people who were good at assessing their own level of certainty, that region had more gray matter and more connections to other parts of the brain, according to the study Fleming and his colleagues published in the journal Science.

That's a really interesting finding, says Janet Metcalfe, a psychology professor at Columbia University who studies metacognition.

She says knowing which parts of the brain carry out this process could help people with problems like schizophrenia or Alzheimer's.

"There are elderly patients who are becoming demented and some of them know that this is happening and some of them don't," Metcalfe says. "So if we're going to help those people it's really important to know what the brain correlates are."

The study could also help scientists figure out why some people with healthy brains do such a bad job judging their own mental abilities.

She says people are especially bad at judging their own skill at reading another person's emotions.

"In fact, there was one study where people who are narcissistic would say they are really spectacularly good at this and they were actually worse than everyone else," Metcalfe says."

But there may be hope for people who aren't good at knowing what they know, Metcalfe says. There are hints that people can improve with lots of practice.


Thubten Chodron - Going Beyond Resentment


Working with Anger
by Thubten Chodron
more...

Dharma Quote of the Week

People harm others only when they are unhappy. No one wakes up in the morning and says, "I feel so great today! I think I'll go out and harm someone!" When we can allow ourselves to know the depth of the pain and confusion felt by those who have harmed us, compassion--the wish that they be free from such suffering--can easily arise. Thinking in this way does not mean whitewashing or denying harm that was done. Rather, we acknowledge it, but go beyond amassing resentment, because we know that grudges help neither ourselves nor others.

--from Working with Anger by Thubten Chodron, published by Snow Lion Publications

Working with Anger • Now at 5O% off
(Good until September 24th).


Bell & McBride - Affect Regulation and Prevention of Risky Behaviors

From last month, a good commentary in JAMA on affect regulation as it relates to public health. The NIH is actually seeking research designs on this topic, so it seems that people are starting to understand more than risky behaviors, including most unhealthy behaviors, are related to an inability to control impulses, to manage anxiety, and so on. For the health community this is a HUGE step in the direction of a more holistic approach to health.

Just in case you are not versed in psychology, here is a definition of affect regulation. This comes from an excellent article by Jaydip Sarkar and Gwen Adshead, "Personality disorders as disorganisation of attachment and affect regulation" (Advances in Psychiatric Treatment (2006) 12: 297-305)
Regulation in any homoeostatic system (including that of affect) means not only initiating a response to a stimulus, but also modulating it appropriately and turning it off when no longer required. Regulation also implies that the response itself is organised and effective. Phillips et al(2003) suggest that affective experience involves:

  1. identification of the emotional significance of a stimulus;
  2. production of an affective state in response;
  3. regulation of the affective state.

Identification of emotional significance
Two areas of the brain – the amygdala and the insula – are involved in the identification of the emotional significance of a stimulus. The amygdala is responsible for modulation of vigilance and attention to emotionally salient information. The insula conveys aversive sensory information to the amygdala, and the two areas act in concert to detect and respond to threatening and aversive stimuli. They can be conceptualised as a defence radar alerting the organism to the presence of threat in its environment and stimulating a fight or flight self-preservative response (see Phillips et al, 2003).

Production of a responding affective state
Sites implicated in triggering the production of affective states in response to a stimulus include the amygdala, insula, parts of the anterior cingulate gyrus, striatum, and orbitofrontal and ventromedial prefrontal cortices.

The amygdala subserves fear-conditioning (Bechara et al, 1995) and autonomic reactions associated with feelings of fear (Gloor, 1992). The insula is implicated in induced sadness, and anticipatory, phobic and traumatic anxiety (Charney & Drevets, 2002). It is also activated during internally generated self-directed disgust, i.e. social emotions such as guilt and shame (Shin et al, 2000). Stimulation of the ventral (affective) division of the anterior cingulate gyrus evokes autonomic and visceromotor changes and spontaneous emotional vocalisations (Bancaud & Talaraich, 1992). The ventral striatum appears to be involved in craving (Breiter et al, 1997), anticipation of reward (Pagnoni et al, 2002) and romantic love (Bartels & Zeki, 2000). The orbitofrontal cortex is associated with autonomic changes accompanying affective states such as anger (Dougherty et al, 1999) and physical aggression (Pietrini et al, 2000). The ventromedial prefrontal cortex is involved in induction of sad mood (Pardo et al, 1993) and guilt and in responding to facial expressions of negative emotions (Sprengelmeyer et al, 1996).

Regulation of the affective state
Affect regulation is largely dependent on the functioning of two neural systems: a ventral and a dorsal system (Phillips et al, 2003).

The ventral system includes the amygdala, insula, ventral striatum and ventral (affective) regions of the anterior cingulate gyrus and prefrontal cortex. It is important for rapid appraisal of emotional material, and automatic affective regulation in response to social interactions, including the capacity for interpersonal empathy.

The dorsal system includes the hippocampus and dorsal (cognitive) regions of the anterior cingulate gyrus and prefrontal cortex. It supports selective and sustained attention, planning and effortful (rather than automatic) regulation of affective states, and autonomic responses to those states. Here affect regulation involves cognitive appraisals: using logic and rational evaluations, based on past experience and anticipated future outcomes.

These contributions of the two systems might be summarised as insight and foresight respectively (Freeman, 1999: p. 124).

Box 2 The neural systems that govern affect regulation

Insight is mediated by the ventral system:

  • amygdala
  • insula
  • ventral striatum
  • ventral (affective) regions of the anterior cingulate gyrus and prefrontal cortex

Foresight is mediated by the dorsal system:

  • hippocampus
  • dorsal (cognitive) regions of the anterior cingulate gyrus and prefrontal cortex
  • So with that definition, here is the JAMA article. They seem to be pointing to the neuroscience of affect dysregulation in terms of how the amygdala can generate feelings (often fear or anger) that cannot be tolerated, which then leads to an attempt to self-regulate or self-medicate through risky behaviors (addictions, over-eating sex, etc.).

    http://ecx.images-amazon.com/images/I/41GFEBG7MML._BO2,204,203,200_PIsitb-sticker-arrow-click,TopRight,35,-76_AA300_SH20_OU01_.jpg
    I highly recommend these two books by Allan Schore - he is the one of the best there is in this field. He's psychoanalytic, but he is an expert in attachment and affect regulation.
    Affect Regulation and Prevention of Risky Behaviors

    Carl C. Bell, MD; Dominica F. McBride, PhD

    JAMA. 2010;304(5):565-566. doi:10.1001/jama.2010.1058

    Affect is the behavioral expression of emotion and affect regulation is a set of processes individuals use to manage emotions and their expression to accomplish goals. However, structures involved in affect regulation are among the last to mature in the developing brain; therefore, many adolescents may not be adequately equipped to regulate their affect. Consequently, adolescents are at increased risk of adverse health outcomes associated with poor affect regulation.

    Embryologically, the central nervous system develops from bottom to top and from inside to out.1 The limbic system, which engages flight, fight, or freeze behaviors and is located deep within the cerebral hemispheres, is the first part of the brain to develop, whereas the prefrontal cortex, which is the seat of affect regulation, judgment, deductive reasoning, and discernment, does not fully develop until approximately 26 years.1 Therefore, youthful brains are underdeveloped with respect to affect regulation. Metaphorically, emotions and their expression are the "gasoline" that propels the lives of adolescents and adults, and judgment steers the vehicle on course and applies the brakes when necessary to maneuver through life. In other words, youth are neurodevelopmentally predisposed to being "all gasoline, no brakes, and no steering wheel."

    Most individuals have experienced emotional upset and engaged in behaviors that could have resulted in premature mortality or morbidity. Engaging in risky behaviors is often motivated by misdirected and mismanaged affect stemming from the limbic system, in essence being the gasoline fueling the behavior. As a car without brakes and steering will inevitably crash, the lack of affective "brakes and steering" often leads to adverse health outcomes, such as psychiatric disorders, addiction, unplanned pregnancies, violence, and sexually transmitted diseases. Throughout human history, adults have continuously struggled with how to provide "brakes and steering" for youth until they can appropriately apply affect regulation themselves.

    Affect regulation may be protective against adverse physical and mental health outcomes.1 One source of affect regulation for adolescents and young adults is the social support of families and communities, which can provide sufficient scaffolding to prevent their limbic systems from being overstimulated and overwhelmed. This social infrastructure protects many youth by providing them with formal and informal social controls that act as "brakes and steering." Social support is important for all adolescents and young adults, regardless of whether their affect regulation has been impaired by exposure to adverse childhood experiences, because all adolescents confront some degree of affect dysregulation.

    However, many youth are exposed to adverse childhood experiences, which can predispose them to poor affect regulation and subsequent sequelae, including psychiatric disorders, substance abuse, and violence. Such childhood adversities stemming from "maladaptive family functioning clusters" (including parental mental illness, substance abuse disorder, and criminality; family violence; physical and sexual abuse; and neglect) may be associated with subsequent mental health disorders, explaining (in a predictive sense) 32.4% of all disorders, 41.2% of disruptive behavior disorders, 32.4% of anxiety disorders, 26.2% of mood disorders, and 21.0% of substance use disorders.2-3

    Strong evidence asserts there are effective prevention interventions to help young children,4 preadolescents,5 and adolescents6 develop necessary social and emotional skills for optimal affect regulation. The following programs are exemplars for providing scaffolding for affect regulation in youth. The Nurse-Family Partnership4 is an effective intervention that targets the mother-infant bond, which directly affects later affect regulation of the offspring. The study by Olds et al4 found that the Nurse-Family Partnership improved pregnancy outcomes, maternal caregiving, and the maternal life course, preventing antisocial behavior. A meta-analysis7 of 60 home visiting programs revealed benefits for children in 3 of 5 areas of children's cognitive and social-emotional functioning compared with controls. Another intervention, the Incredible Years program,5 which included parent, teacher, and social training components, demonstrated positive interactions and communications between parents and children, the value of praise and reward, and the use of time-out (an affect-regulating strategy). These components have been extensively evaluated and found effective in treating children with conduct disorders and preventing aggressive behaviors.5

    The Positive Parenting Program is a multilevel intervention with universal, selective, and indicated components. The intervention has significantly reduced disruptive behavior and emotional problems through targeting parent-child relations.8 The Aban Aya Youth Project6 was a randomized controlled trial designed to prevent risky behaviors of violence, provoking behavior, substance use, school delinquency, and early risky sexual activity. In an effort to decrease impulsivity, this intervention used a "Stop, Think, Act" technique specifically aimed at affect regulation. The program was found to be effective in reducing the rate of increase in negative behaviors between the fifth and eighth grades. In 2 experimental conditions of the study, there was a decrease in violence by 35% and 47%; provoking behavior by 41% and 59%; school delinquency by 31% and 66%; drug use by 32% and 34%; and recent sexual intercourse by 44% and 65%. This research informed the Chicago Public Schools Violence Prevention Initiative that substantially decreased such behaviors in the entire school system.9

    All these prevention interventions work by 2 basic mechanisms. First, they provide caregivers with social and emotional skills to support youth rather than traumatizing them. Second, they provide youth with an environment that cultivates the social and emotional skills necessary for healthy affect regulation. These examples are characteristic of the multitude of efficacious and effective programs described in the 2009 Institute of Medicine prevention report,1 which makes a strong case that intervention strategies can prevent mental and behavioral problems, and thus bolster health and longevity.

    Considering the evidence for the effectiveness of interventions to assist youth with affect regulation, the logical next step is to disseminate these interventions widely. Helping adolescents regulate their affect, and consequently their behavior, is a public health intervention analogous to adding iodine to table salt to prevent hypothyroidism or restricting the diets of individuals who are unable to metabolize phenylalanine. However, in contrast with biomedical technologies such as iodized salt intake and use of restriction diets, which are designed to prevent specific diseases, psychosocial technologies for affect regulation may prevent a wide range of adverse health outcomes, such as mental disorders, substance abuse, and problem behaviors in youth.1 Moreover, as strategies for affect regulation are disseminated, they can potentially break the intergenerational cycle of risky behaviors within families and neighborhoods.

    When it comes to applying public health prevention science to thwart disorders stemming from affect dysregulation, the United States has so far failed to take advantage of its psychosocial technologies. Richmond, who helped Head Start, the preschool readiness program, become a ubiquitous US reality, proposed that in order to institutionalize a program or process, several elements are needed: a strong evidence base that what is being put in place works; a mechanism to adapt, disseminate, and implement the intervention; and political will to do it.10 These elements are as applicable to a strategy for improving affect regulation among adolescents and young adults as they were to the institutionalization of Head Start for preschool children. Evidence for affect regulation programs is available1 and emerging systems for prevention under health care reform could provide the mechanism. What is lacking, thus far, is the political will to implement them.


    AUTHOR INFORMATION


    Corresponding Author: Carl C. Bell, MD, Community Mental Health Council Inc, 8704 S Constance, Chicago, IL 60617 (carlcbell@pol.net).

    Financial Disclosures: None reported.

    Author Affiliations: Community Mental Health Council Inc and Institute for Juvenile Research, Department of Psychiatry, University of Illinois (Dr Bell); and Holism, Empowerment, Leadership, and Personhood (HELP) Institute, Huntsville, Alabama (Dr McBride).


    REFERENCES


    1. National Research Council and Institute of Medicine. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. O’Connell ME, Boat T, Warner KE, eds. Washington, DC: National Academies Press; 2009.
    2. Green JG, McLaughlin KA, Berglund PA; et al. Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Arch Gen Psychiatry. 2010;67(2):113-123. FREE FULL TEXT
    3. McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky AM, Kessler RC. Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication II: associations with persistence of DSM-IV disorders. Arch Gen Psychiatry. 2010;67(2):124-132. FREE FULL TEXT
    4. Olds DL, Sadler L, Kitzman H. Programs for parents of infants and toddlers: recent evidence from randomized trials. J Child Psychol Psychiatry. 2007;48(3/4):355-391. FULL TEXT | WEB OF SCIENCE | PUBMED
    5. Webster-Stratton C, Reid MJ, Hammond M. Treating children with early onset conduct problems: intervention outcomes for parent, child, and teacher training. J Clin Child Adolesc Psychol. 2004;33(1):105-124. FULL TEXT | WEB OF SCIENCE | PUBMED
    6. Flay BR, Graumlich S, Segawa E, Burns JL, Holliday MY, Aban Aya Investigators. Effects of 2 prevention programs on high-risk behaviors among African American youth: a randomized trial. Arch Pediatr Adolesc Med. 2004;158(4):377-384. FREE FULL TEXT
    7. Sweet MA, Appelbaum ML. Is home visiting an effective strategy? a meta-analytic review of home visiting programs for families with young children. Child Dev. 2004;75(5):1435-1456. FULL TEXT | WEB OF SCIENCE | PUBMED
    8. Sanders MR, Ralph A, Sofronoff K; et al. Every family: a population approach to reducing behavioral and emotional problems in children making the transition to school. J Prim Prev. 2008;29(3):197-222. FULL TEXT | PUBMED
    9. Bell CC, Gamm S, Vallas P, Jackson P. Strategies for the prevention of youth violence in Chicago public schools. In: Shafii M, Shafii S, eds. School Violence: Contributing Factors, Management, and Prevention.Washington, DC: American Psychiatric Press; 2001:251-272.
    10. Richmond JR, Fein R. The Health Care Mess: How We Got Into It and What It Will Take to Get Out. Cambridge, MA: Harvard University Press; 2005.