What is whole medicine?

Overview

Whole medicine is a treatment that is an alternative to allopathic (conventional)
medicine. Whole medicine is a type of complementary and alternative medicine
(CAM). Complementary medicine is a combination of allopathic and alternative
techniques, and alternative medicine is a substitute for allopathic medicine. Both
disciplines evaluate symptoms before making a diagnosis; however, whole medicine
searches for the underlying cause or causes of illness. In addition, whole
medicine embraces preventive health care to optimize a person’s health.

Whole medicine considers the body’s systems (circulatory, respiratory, and
gastrointestinal) as interdependent components of a person’s whole being. One’s
natural state is considered one of health; illness is deemed to be an imbalance in
the body’s systems. The whole-medicine approach emphasizes proper nutrition and
avoidance of substances that are harmful to one’s health. Whole medicine also
favors noninvasive techniques and the avoidance of pharmaceuticals.

In general, whole-medicine procedures and treatments are less expensive than those
of conventional medicine. Thus, some persons opt for this approach because of
financial considerations. Also, many health insurers cover CAM therapies and
treatments, especially chiropractic care.

Mechanism of Action

Whole-medicine practitioners employ the same basic principles of allopathic medicine, which encompass physical health, and they also incorporate mental, emotional, and spiritual well-being. A healthy diet is emphasized by whole-medicine practitioners, and they discourage the use of refined or preserved foods. In addition to having additives, these foods are often high in sugar, fat, and cholesterol. Many practitioners promote a vegetarian diet or, at minimum, a reduction in meat consumption, particularly in the consumption of red meat.

The goal of whole medicine is to bring all aspects of one’s life into harmony. This concept includes bringing all the energy flowing within the body into accord. Although noninvasive and pharmaceutical-free treatments are stressed, many whole-medicine practitioners are not averse to the inclusion of allopathic medicine and medications; these practitioners feel that the two disciplines are complementary. For example, most practitioners would agree that an inflamed appendix needs excision, a cancerous tumor needs to be surgically removed, and a diabetic requires insulin. For cases in which allopathic medicine predominates, most whole-medicine practitioners believe that their principles can help the ill person through the situation. They also believe that once the crisis of an acute illness has passed, whole-medicine techniques, which search for underlying causes, can reduce the chance of a negative recurrence.

Uses and Applications

Many applications of general medicine exist, and some incorporate whole medicine to varying degrees. Many wellness practitioners incorporate a combination of the following applications in their practice:

Chiropractic. Chiropractic focuses on manipulation of
the spinal column under the hypothesis that disorders of the spinal column affect
one’s health by means of the nervous system. In addition to manipulation of the
spine, chiropractic treatment entails manipulation of other joints and soft
tissues. Chiropractors often recommend specific exercises to treat a condition and
also provide lifestyle counseling.

Herbal medicine. The boundary between pharmaceuticals and herbs
is blurred. Many pharmaceuticals are herbal products or are derived from plants.
Digitalis, which is used for the treatment of heart
conditions, is derived from the foxglove shrub (Digitalis
lanata). Quinine, which has a number of medicinal uses (such as
antimalarial and analgesic), is derived from the bark of the cinchona tree
(Cinchona species). Herbal products have been used by Asian
peoples for medicinal purposes since antiquity. Because herbal products are
natural products, they do not fall under the jurisdiction of government regulatory
agencies such as the U.S. Food and Drug Administration
(FDA). The FDA requires a rigorous testing process before a drug
can be made available to the general public. Some herbal products have proven
benefits, while others have no proven benefit.

Homeopathy. Homeopathy involves the use of very
small amounts of a substance to stimulate the body’s immune system to fight a
disease. Homeopathic practitioners use substances such as herbs and metals as a
treatment regimen. Some of these substances are toxic if given in higher doses.
Homeopathic practitioners embrace the concept of whole medicine in that they treat
the whole person rather than focusing on the disease itself. Before prescribing a
treatment, they take a detailed history of the patient’s likes, dislikes, and
habits. Many illnesses are not suitable for homeopathic treatment alone, but in
others, homeopathic treatments have been shown to complement traditional medical
treatment.

Meditation. Meditation involves entering a state of
extreme relaxation and concentration; during meditation, the body is in a restful
state, and the mind is freed of surface thoughts. Several major religions (such as
Buddhism and Daoism) embrace meditation; however, practicing meditation does not
necessarily require a religious or spiritual component. Persons who meditate
regularly report that doing so improves their concentration and their ability to
deal with the stresses in their lives. People meditate for a variety of reasons,
including relaxation, personal insight, and communication with their god.

Naturopathic medicine. Naturopathic medicine embraces the concept
of whole medicine. The basic concept of naturopathy is that the body has an innate
ability to heal and maintain itself. The American Cancer Society (ACS) describes
naturopathy as “A complete alternative care system that uses
a wide range of approaches such as nutrition, herbs, manipulation of the body,
exercise, stress reduction, and acupuncture.” The ACS accepts that portions of
naturopathic medicine can sometimes be used with conventional medicine as
complementary therapy. Naturopaths include medical doctors with training in
naturopathy, naturopathic doctors who have college-level training in naturopathy,
and others with lower levels of training.

Nutritional therapies. A wide range of nutritional therapies are available in all developed nations. Most embrace the concept that a healthy diet is essential to attain and maintain good health. Nutritional therapy is often a component of both conventional and allopathic medicine.

Psychotherapy. Psychotherapy embraces the concept of
improving one’s sense of well-being by talking about problems with a
psychotherapist. Psychotherapists include medical doctors with specialized
training in psychiatry, clinical psychologists, mental health counselors, and
social workers.

Stress reduction. All whole-medicine therapies embrace the
concept of stress
reduction.

Therapeutic massage. Therapeutic massage
involves holding, manipulating, and applying pressure to the body’s soft tissues.
The manipulations have the goal of promoting health and wellness by reducing pain,
muscle spasm, and stress. Adjunctive therapies such as aromatherapy or soothing
music often accompany therapeutic massage. Types of massage therapy include
Swedish massage, which is a gentle, relaxing massage; pressure point therapy,
which focuses on a certain portion of the body; and sports massage, which focuses
on specific muscle groups. Massage therapy has been reported to improve
circulation (both blood and lymphatic), reduce muscular pain, reduce joint pain,
increase range of motion, relieve stress, relieve tension headaches, enhance
postoperative recovery, and promote rehabilitation after an injury.

Traditional Chinese medicine. Traditional Chinese Medicine
(TCM) is a form of CAM that is commonly practiced in Asia.
TCM also has advocates in the Western world and is increasing in popularity. TCM
is a holistic approach to health that attempts to bring the body, mind, and spirit
into harmony. It primarily consists of herbal medicine; however, it also embraces
acupuncture, nutritional therapy, and massage.

Yoga. Yoga is a physical and mental
discipline that originated in India. It reflects the belief that for one to be in
harmony with oneself and the environment, one must integrate the body, the mind,
and the spirit. For these three entities to be integrated, emotion, action, and
intelligence must be in balance. This balance is accomplished through exercise,
breathing, and meditation.

Other practices. Other whole-medicine practices are
Ayurvedic
medicine and Native American, or indigenous, medicine.
Ayurvedic medicine, the traditional medicine of India, emphasizes the
reestablishment of balance in the body through a healthy lifestyle and through
diet, exercise, and body cleansing. Ayurveda encompasses the body, mind, and
spirit. Native American medicine is based on natural remedies derived from the
earth. It combines herbs, spirituality, and magic and is overseen by a medicine
man or woman.

Scientific Evidence

Much of the literature regarding whole medicine lacks a high level of scientific
evidence. Valid studies randomly assign persons to a treatment group or to a
control group, which is given a placebo (a substance with no pharmacological
activity). The largest number of valid studies in whole medicine have been
conducted on herbal products. Placebo-controlled studies are easier to conduct on
herbal products than on other whole-medicine procedures such as massage and
acupuncture. Also, many whole-medicine studies comprise anecdotal reports, in
which a participant claims some benefit from the therapy (resulting in a
placebo
effect).

Aside from limited whole-medicine studies with a high level of evidence, it is well established that good nutrition, stress reduction, and other healthy lifestyle practices embraced by whole medicine are conducive to health. Furthermore, the medical literature contains innumerable well-conducted studies documenting the harmful effects of an unhealthy lifestyle. For example, obesity increases the risk of type 2 diabetes, cardiovascular disease, and many other diseases; smoking tobacco (or marijuana) increases the risk of many types of cancer.

Choosing a Practitioner

The training of practitioners of whole-medicine ranges from postgraduate work to
no formal training. Persons seeking whole-medicine care should examine the
credentials of practitioners, regardless of professional degree. It is appropriate
to ask what professional degree or degrees the practitioner holds, where his or
her training occurred, and to what professional organizations he or she belongs.
An informative resource for locating a whole-medicine practitioner is the American
Holistic Medical Association, which maintains a comprehensive list of
practitioners in many types of therapies throughout the United States. However,
the organization stresses that it is the responsibility of the person seeking care
to check a practitioner’s credentials before treatment. The American Naturopathic
Medical Certification Board (ANMCB) administers certification
for whole-medicine practitioners. Practitioners certified by ANMCB must meet
certain standards based on their level of certification.

Safety Issues

Many medical experts are concerned that some persons with serious medical conditions, such as a malignancy, will seek alternative medical care or purchase worthless herbal products rather than seek conventional medical care. In contrast to possible health risks from a whole-medicine regimen, the basic principles of healthy diet and stress reduction, for example, which are embraced by whole medicine, are not only safe but also beneficial to one’s health.

Bibliography

American Holistic Medical Association. http://www.holisticmedicine.org.

Ditcheck, Stuart, et al. Healthy Child, Whole Child: Integrating the Best of Conventional and Alternative Medicine to Keep Your Kids Healthy. New York: Harper, 2009. A thorough guide for parents who are interested in complementary methods of prevention and healing and who are looking for a reliable text for pediatricians unfamiliar with alternative treatments.

Lu, Henry C. Traditional Chinese Medicine: How to Maintain Your Health and Treat Illness. Laguna Beach, Calif.: Basic Health, 2006. Describes the thirteen syndromes identified in Chinese medicine. Also incorporates more familiar Western medical terminology, resulting in a handbook that straddles both traditions.

Murcott, Tony. The Whole Story: Alternative Medicine on Trial? New York: Palgrave Macmillan, 2006. Collects updated evidence on the placebo effect, the randomized-controlled trial, acupuncture, homeopathy, osteopathy, and more.

What does A Separate Peace say about moral rules, and how does this contribute to the story as a whole?

When someone mentions the words "morality" or "moral rules," one might think of following a code of chastity, but that isn't really the topic at hand in John Knowles's book. As far as "moral rules" are concerned in A Separate Peace, it's all about what is perceived as right vs. wrong when it comes to following the rules at school and rules for life. And life at that time was the war. For example, the boys must follow specific rules if they want to continue attending Devon. Next, the pressure is on all of these boys to conform to society by doing one's duty for the war effort. For them, it means enlisting right after graduation, or within one year's time. Finally, there's pressure if a boy doesn't measure up to the rules.

First, the rules of conformity at Devon school couldn't be stricter, unless your name is Phineas and it is the summer session. For some reason, probably because of his charm, Phineas gets away with bending the rules at school, and this is part of what causes Gene to envy him. The following explains how Phineas is permitted to bend the rules:

"The Devon faculty had never before experienced a student who combined a calm ignorance of the rules with a winning urge to be good, who seemed to love the school truly and deeply, and never more than when he was breaking the regulations, a model boy who was most comfortable in the truant's corner. The faculty threw up its hands over Phineas, and so loosened its grip on all of us" (23).

Since it is summer session, and the faculty probably wish they were at the beach, they let Phineas get away with bending a few rules. Some rules aren't worth fighting over. However, when someone questions a man's pride or courage, look out! These boys have pressure to fulfill their duty in the war and that is not a moral code to break. The following is the type of pressure the boys face at the end of their senior year, when parents such as Mr. Hadley expect conformity to social duty:

"I can't imagine any man in my time settling for duty on a sewing machine. . . But then times change, and wars change. But men don't change, do they? You boys are the image of me and my gang in the old days. It does me good to see you. What are you enlisting in, son. . . the Marines, the Paratroops? There are doggone many exciting things to enlist in these days. . . I'd give something to be a kid again with all that to choose from" (198-199).

If a boy answered Mr. Hadley with, "I'd like to work on the sewing machines," he would give that boy a dirty look and probably call him a pansy. No boy wants to be emasculated, so the pressure to prove their manhood is only acquired by enlisting in the military. 

Finally, there's Leper, who does fail after enlisting in the army because he goes AWOL (absent without leave) and loses his mind in the process. Soldiers who go crazy, and can't fulfill their duties, are given a Section Eight discharge, which is not considered honorable. Leper explains his concerns about his failure as follows:

"A Section Eight discharge is for the nuts of the service, the psychos, the Funny Farm candidates. . . You can't get a job after that. Everybody wants to see your discharge, and when they see a Section Eight they look at you kind of funny" (144).

Therefore, the moral rules in A Separate Peace center around succeeding in school and succeeding in the war. It's the right thing to do! It's the patriotic thing to do! Much of the plot centers around following the right code of ethics in order to come of age and become a man. Without these moral codes to follow, there wouldn't be the pressure or tension in the plot that moves it forward in an interesting way.

In Hemingway's, "Soldier's Home", there is dialogue between Harold and Helen Krebs about Harold being her beau. Are they in a relationship?

Ernest Hemingway's short story "Soldier's Home" is about returning World War I veteran Harold Krebs. Krebs has returned to his small Oklahoma town but is obviously ill at ease over his experiences in the war.

At one point he's talking to his sister Helen. She is younger than him and they were probably very close before he went off to war. She jokes with him that he is her "beau" or boyfriend. It is certainly a conversation that many older brothers and younger sisters have had. They are obviously not in a romantic relationship and, in fact, Harold has been avoiding going out with any of the girls in the town despite the urgings of his mother. For Harold, Helen is safe to talk to while "it was not worth it" to talk to girls his own age. He wants things to go "smoothly" in his life and his little sister is not a threat to his emotional stability. In the last lines he says he will go and watch her play "indoor baseball." 

What are the uses of a mercury barometer?

Mercury barometers are primarily used for measuring atmospheric pressure. It is a device that consists of an upside-down tube filled with mercury that is in a vessel full of mercury. The atmosphere (or the air) pushes down on the mercury in the vessel, which in turn, pushes the mercury in the tube up. And the height of mercury in this tube (also known as the height of mercury column) is used as a measure of atmospheric pressure. For instance, 1 atmospheric pressure causes a height of 760 mm of mercury in the tube and hence, 1 atmospheric pressure is also equivalent to 760 mm or 76 cm of mercury head. 

Since atmospheric pressure varies with altitude, the mercury barometer can also be used to measure the altitude of a place. Primarily, though, it is used for measurement of atmospheric pressure.

Hope this helps. 

How would you demonstrate the various ways in which the title of Things Fall Apart reflects events in Achebe's novel?

The title of Chinua Achebe’s debut novel Things Fall Apart perfectly encapsulates the tragic events that surround Okonkwo’s abbreviated life. The title, taken from W.B. Yeats’ “The Second Coming,” embodies how Okonkwo feels about his life. His traditional values are steadily undermined by the pervasive and intrusive Western influence that settles on Umuofia. Throughout the course of the novel, Okonkwo goes from one of the great men of the tribe to a tragic suicide whose body is taboo to his fellow clansmen. It all begins when Okonkwo and his family are forced into exile after he inadvertently kills a young tribesman during a ceremony:

“The only course open to Okonkwo was to flee from the clan. It was a crime against the earth goddess to kill a clansman, and a man who committed it must flee from the land. The crime was of two kinds, male and female. Okonkwo had committed the female, because it had been inadvertent. He could return to the clan after seven years” (124).

With this action, he jeopardizes everything that he has built up to this point in his life. In his time in exile, his beloved Umuofia changes forever. He anticipates his return, but it is ultimately a disappointment:

“Okonkwo's return to his native land was not as memorable as he had wished.... Umuofia did not appear to have taken any special notice of the warrior's return. The clan had undergone such profound change during his exile that it was barely recognizable.... And it was the wrong year too. If Okonkwo had immediately initiated his two sons into the ozu society as he had planned he would have caused a stir. But the initiation rite was performed once in three years in Umuofia, and he had to wait for nearly two years for the next round of ceremonies” (182-3).

This passage reflects many of the events in Okonkwo’s life. Nothing happens at the right time. He is always in the wrong place at the wrong time. Everything that he has built is taken away from him, his values lose their relevance in an altered Umuofia, and his oldest son runs away into the Christian faith. These are all points that illustrate how the aspects of Okonkwo’s life do in fact fall apart. This is why the title is so potent and fitting.

Describe the relationship of the old man and the boy. Is it a father and son relationship? (From "The Old Man and the Sea")

Santiago and Manolin share a mentor/mentee relationship.

Mandolin is Santiago's former apprentice, not his son. He used to work under Santiago, but Manolin's father made him stop and go work for someone else who was more successful because Santiago was having such a long streak without catching anything. Manolin continues to visit Santiago, however. He brings him food and even bait. It is obvious that Manolin cares for Santiago much like a father or even grandfather, and is doing his best to help the old man get by during his dry spell. 

Many of the lessons that Santiago imparts to Manolin are the types of lessons a father would share. They also share activities like a father and son, such as fishing and talking about baseball. Although we do not know Manolin's father, one cannot help but wonder if Manolin isn't closer to Santiago than his own father.

How did the persona of "A Poison Tree" deal with his anger while his enemy was alive? Give two things he did.

In "The Poison Tree," the persona deals with his anger while his enemy is still alive by nurturing it. He does this in two ways. First, as Blake puts it, he "water'd it in fears / night and morning with my tears." This means that when the persona wakes up in the morning and when he goes to bed at night he remembers over and over how he has been hurt by his enemy. He dwells on his "fears": how his enemy could hurt him again, and he thinks about his enemy with "tears" over the original injury.

The persona also pretends that nothing is wrong. Blake states it this way: "I sunn'd it [his anger] with smiles / And with soft deceitful wiles." Rather than confront his enemy or talk it through, the persona stuffs his anger down and pretends everything is fine. He smiles at his enemy. He is kind on the surface to his enemy. Meanwhile, the unresolved anger grows and grows.

We don't know how the enemy injured the persona, but the poem leads us to believe that whatever it was, the persona blows it (or grows it) all out of proportion both by dwelling on it silently and by pretending publicly that he is happy.

What is classical Adlerian psychotherapy?

Introduction

Alfred Adler’s individual psychology, his approach to psychotherapy, starts with the assumption that all people suffer from a feeling of inferiority. Though most people outgrow this complex by developing healthy compensations through their career, family, and friends, many individuals turn inward and attempt to compensate with a private logic. This is a personal and unconscious “fictional” way of understanding self and reality to assuage feelings of inferiority. Reliance on private logic, however, impairs the individual’s ability to cope.

The concept of private logic underlies Adler’s understanding of psychopathology. Each disorder represents a different manifestation of private logic. For example, schizophrenics cope with the inferiority complex by believing their own private logic so thoroughly that they separate from external reality and live in a delusional world in which they are intensely talented and important. The schizophrenic’s neologisms (invented words) can be seen as evidence of creativity. On the other hand, the critical auditory hallucinations often experienced by schizophrenics can be understood as their inability to master their internal worlds.

An obsessive-compulsive patient has focused attention exclusively on some private issue of no real objective importance; in the person’s private logic, however, the issue has great importance, which may confer on the person him- or herself some special status. A paranoid person’s private logic allows the person to believe that he or she is the most important person in the world—why else would the Mafia, CIA, or Martians, for example, persecute the person?

Adler was a general practitioner before he became a psychiatrist. As a result, he saw all sorts of patients, most of whom did not define their various diseases and problems as mental. Psychosomatic, hypochondriacal, and somatoform patients illustrate what Adler called organ dialect, in which their bodies’ problems reflect their dysfunctional approaches to life. Such physical disorders (real or imagined) mitigate feelings of inferiority by serving as an excuse for failure or a plea for sympathy.

Depressed patients suffer from low self-esteem, which may include feelings of hopelessness, helplessness, and guilt. The private logic of such a patient may be inadequate to lift the patient out of the inferiority complex. Some depressed patients even seem to rely on their own suffering as a sham sense of merit: “I suffer, therefore I am worthy.” Personality disorders, delinquency, and crime may spring from the attempt to overcome feelings of inferiority through defiance and a facade of toughness rather than by making meaningful contributions to society. Prostitutes and chemically dependent individuals have unresolved inferiority complexes coupled with ambivalent attitudes toward dependency.

What unifies people with different kinds of mental disorders, according to Adler, is that their private logic gives them a mistaken understanding of themselves and the world. They persist in their dysfunctional behaviors and attitudes to preserve their sham sense of self-esteem, but at the price of effective coping. When Adler set out to diagnose a patient, he was less interested in labeling that patient with a specific disorder than he was in reaching a deeper understanding of who the patient was: It is not so important what disease the person has, but what kind of person has the disease. Therefore, Adler’s approach to diagnosis was more qualitative than quantitative, more tailored to the individual situation than systematic and structured. However, Adler had an arsenal of a half dozen techniques that he employed regularly.

Diagnostic Techniques

Adler’s first diagnostic technique was to observe the patient’s body language. This included not only the organ dialect of the presenting (physical) problem but also all sorts of nonverbal behavior: how the patient walked into the room, how he or she wiggled or slouched in the seat, the kind of handshake, the degree of eye contact, and so on. Adler once said that one can learn more from patients in a minute of watching them as if they were mimes (and ignoring anything they say) than one can in an hour of listening to them.

A second approach was the use of direct and specific questions, not only about the manifest symptoms but also about the patient’s background. Because Adler was convinced that the formative stage of personality development is the first six years of life, he was most interested in asking about early childhood (relations with parents, siblings, teachers, and others), as well as the patient’s lifetime history of medical problems. Adler believed that people are purposive creatures and that mental disorders (and possibly physical disorders as well) are means to the end of assuaging feelings of inferiority; he would sometimes directly ask his patients: “If you were cured of this disorder, what would happen to you?” The answer could reveal what the patient most feared—sometimes that he or she would have higher expectations of his or her own performance in the areas of interpersonal relations and career.

During his ten-year association with Sigmund Freud, Adler learned to use dreams as a way of exploring a patient’s unconscious. He believed that dreams were ways in which the patient rehearsed coping for waking life. The behavior of the dreamer reflected his or her real-life coping patterns and private logic.

One diagnostic technique that originated with Adler was the use of early recollections. Asking a patient to recall early experiences is a projective technique facilitated by the question “What is the farthest back that your memory can go?” Adler realized that such recollections would be hazy on the facts, but they would provide excellent vehicles for expressing the patient’s private logic. Such recollections, like the patient’s dreams or works of art, could be made the instruments of projective techniques, because they were rich with the markings of the patient’s personality. Additionally, the patient’s current mood would color the mood of the recollection, and conflicts currently on the patient’s mind would be projected into the story. As the patient improved over the course of his or her psychotherapy, the early recollections would become more positive in tone, reflecting more effective coping strategies.

Adler’s own character is evident from the earliest recollection of his childhood. Young Alfred was lying in bed, very ill, and overheard the doctor out in the hall telling his father that Alfred would not make it through the night. Adler recalls that he resolved to live and prove the doctor wrong, and eventually to become a doctor himself and fight death. The memory shows Adler’s tremendous willpower as well as a desire to overcome suffering.

Therapy Techniques

The first step in Adlerian psychotherapy was to use diagnostic techniques to comprehend the patient’s underlying private logic. The next step was to use empathy to develop the patient’s trust. (This was not to be allowed to evolve into a transference, or the transferring of emotions that a patient feels about other people onto the therapist treating the patient. Adler regarded transference as a childish dependency that would lengthen therapy and delay progress.) Then, patients would be led to identify their own guiding private logic and to realize that it was dysfunctional. This might be accomplished through various techniques, including direct confrontation of the patient’s misfocusing, abstractness, closed-mindedness, or excessive self-expectations. The last stage of therapy was the cultivation of the patient’s social interest. It involved encouraging the patient to venture forth into interpersonal relations and the world of work, emerging from the protective shell of the private logic and into the normal world’s challenges.

Unlike Freudian psychoanalysis, Adler’s approach to psychotherapy was directive. In addition to direct confrontation, Adler sometimes attempted to shake up the patient’s guarded structure of private logic by answering with the unexpected. When one patient called him at home at three o’clock in the morning to report some trivial symptom, she ended by apologizing for awakening him; Adler responded that he had been sitting by his telephone awaiting her call. She thus gained the insight that she was behaving like a pampered child. Another patient was obsessed with the idea that he had contracted syphilis. He had compulsively sought the attention of many physicians around Vienna, all of whom had reported no evidence of the disease. Adler immediately agreed with the patient that he did, indeed, have the dreaded disease, thus pushing the patient to accept the validity of the previous diagnoses.

A variant of this technique was developed by one of Adler’s protégés, Rudolf Dreikurs, who became one of the foremost apostles of individual psychology in the United States. Dreikurs used antisuggestion, urging patients who complained of an uncontrollable urge to give in to it and even practice it.

Unlike practitioners of classical psychoanalysis, Adler believed that therapy should be brief. Progress should be apparent in weeks, and termination should be possible in less than a year. Even after their sessions have ended, patients often continue to progress on their own. Unlike the humanistic and emotional therapies of the 1960s, Adlerian psychotherapy tries not to provoke abreaction (the expression of repressed emotions or thoughts) but to build the patient’s capacity for self-control.

Case Studies

Case studies of diagnosis and counseling with three very different patients can illustrate Adlerian techniques.

Jay

Jay, age forty, had a psychophysiologic disorder (an ulcer) and was mildly depressed. He attributed his problems to organizational changes at the small firm where he had worked for a dozen years. An outstanding engineer with an earned doctorate, an MBA., and numerous patents, Jay was convinced that his own efforts had helped the company grow and survive. As vice president for research and development, Jay advocated several new projects to get the firm’s sales moving again; however, the other major figures in the company largely ignored Jay’s plans and lurched from one budget-cutting scheme to another. Jay reported, “I am working eighty-hour weeks and worrying about the company all the time, but I just can’t get things moving.”

Jay’s body language included averting his gaze and slouching, which he attributed to Vietnam War wounds. On direct questioning, he said that he was an only child: His father, fifty-five when Jay was born, wanted no children and resented the “accident” of Jay’s conception, while his mother wanted more children and had to be satisfied with one son. Jay found that his mother was extremely encouraging and loving, perhaps spoiling Jay somewhat, while his father tended to ignore him except when some major accomplishment got his father’s attention. Jay’s guiding private logic was “I must work hard and accomplish something great; then I will get attention.” This drove Jay to earn his degrees, invent new products, and work hard at the company. His frustration came from the fact that the old formula was not working in his changing corporate culture.

Jay was most angry at his company’s chief executive officer (CEO) and board of directors, whom he regarded as intellectually inferior to him. The CEO was an incredibly charming (and handsome) MBA from the sales division who rejected most of Jay’s suggestions for new products but had few ideas of his own. Jay admitted feeling envious of the CEO’s sustained popularity, “especially considering that he has been running the company into the ground for seven years.”

The earliest childhood recollection that Jay produced was that he was watching his mother use the toilet, sitting down on the bowl with the seat up, and that Jay was telling her that it was dangerous to do it that way. When the therapist encouraged Jay to ask his parents what had really happened, Jay found out that he was toilet trained early, and because he would urinate on the floor (through the crack between the seat and the bowl), his mother encouraged him to sit down on the bowl. His mother recalled that Jay then developed a fear of falling backward into the toilet. The interesting thing about Jay’s recollection is that he inverted his role with his mother’s: He was the one warning her of the danger. Although a Freudian would say something about the Oedipus complex or anal fixation here, Adlerians are more concerned with the power quality of the interpersonal relations. Jay saw himself as the one who pointed out the danger; he was also very frustrated when the parental figures (the CEO and members of the board of directors) failed to heed his warnings.

Jay’s ulcer was a badge of merit, like his earned degrees or patents (“Look at how much I have suffered for this company!”). Sacrifice and success had been Jay’s strategy for winning the attention of his “parents,” but now that strategy was not working, so he had become depressed.

An intelligent man, Jay rapidly gained insight into his private logic. After four sessions, he had the following dream: “I am going through one of my rental houses, and I discover a room that I did not remember before—a living room that looked so comfortable, I just wanted to sit and read for pleasure.” Jay enjoyed the dream and agreed that it reflected his ongoing resolution of his problem. The dream represented new possibilities in Jay’s life: a more mellow lifestyle in which he saw less need to push himself on the fast track to maintain his self-esteem.

Jay terminated after eight sessions, having made plans to seek a position with another firm. After two years in the new position, Jay reported that he made almost as much money, had slightly less status, worked half as many hours, but had twice as much enjoyment. His ulcer and depression had not recurred.

Dan

Dan was also a forty-year-old engineer when he began counseling. He met most, though not all, of the criteria for narcissistic personality disorder (which is characterized by a grandiose sense of self, lack of empathy, and other criteria). Although a brilliant computer programmer, Dan had never obtained a college degree. He had never remained with one company for more than a year, and most of his work history had been with “job shops” or as an independent consultant. The presenting problem for Dan was that he had gotten his girlfriend pregnant, and he was ambivalent about getting married and becoming a father.

Direct questioning revealed that Dan was the third of four children. His grandfather had been a famous politician, his father was an attorney, and an older brother was an accomplished (and very wealthy) surgeon. Dan directly denied feeling inferior to these male family members, for he was convinced that he was smarter than any of them and had a broader range of knowledge. Dan’s private logic worked something like this: “Everyone else needs to get a degree and work in one career line for twenty years to be a success; I don’t have to, because I am more brilliant than anyone else. Finishing my education or sticking with one company would be an admission that I am not more brilliant.”

During the first few sessions, Dan used big words and attempted to impress the therapist with his knowledge of psychology. Although Dan claimed an inability to come up with an early recollection, he was able to remember a dream: “I am at a new restaurant, and I am given a table next to the kitchen; although the waiters go back and forth, they ignore me. Finally, I am given the check and realize that I do not have enough money.” After much resistance and intellectualization, Dan agreed that the dream exposed his dissatisfaction with his life: the fear that the honors and accomplishments of the other men in his family would pass him by and that he would be unable to achieve as much.

The cultivation of Dan’s social interest took eight months, but it did progress. He accepted a position (which he initially thought to be beneath his talents) offering stable employment and advancement. He married his pregnant girlfriend and reported himself to be satisfied with his role of father, although he found his wife to be a little too “naggy.” He did not try so hard to impress people with his intelligence.

Alicia

Alicia, a sixty-four-year-old widow of fifteen years, went into therapy complaining of depression and suicidal thoughts. Her feeling of inferiority was expressed primarily as helplessness and ruminations of guilt. Direct questioning and discussion engendered by dreams indicated that she still blamed herself for her husband’s fatal heart attack (“I cooked food that was too rich”), for her son’s accidental death (“I encouraged him to follow his heart and become a pilot”), and for her daughter’s upcoming marriage to a former priest (“I did not instill enough religion in her”). The function of her depressive illness was that her daughter was talking about delaying her marriage until her mother got better.

Her earliest recollection was that her parents would punish her for wetting the bed by making her sit in a tub of cold water; once, when her parents were out of the house, she wet the bed. When her parents returned they found her sitting in a tub of cold water, telling herself “You sit there.” This consolidated the identification of her private logic: “I am responsible for things that go wrong, and I must punish myself when things go wrong.”

Alicia developed the insight that her private logic was dysfunctional and her own depression was a manipulative, though effective, way of reacting to her daughter’s forthcoming marriage. The facilitation of social interest in this case focused on getting Alicia out of the enmeshed relationship with her daughter and more involved with activities outside the home, such as religion and charity work.

Unique Contributions

Most of Sigmund Freud’s patients were “hysterical” women (with what would now be called somatoform or dissociative reactions) from the middle and upper classes of Viennese society. Most of Adler’s patients were from the poor and working classes; they were not as articulate as were Freud’s patients, so Adler had to assume a more directive stance. Adler remained in general medical practice, treating all kinds of physical illnesses and injuries as well as mental problems. Although he probably saw more patients in any given month than Freud saw in his professional lifetime, the brevity of Adler’s counseling may have given the impression that he had only a superficial understanding of their problems.

Adler, like Josef Breuer, Carl Jung, and Otto Rank, broke with Freud and came up with an alternative to psychoanalysis. He redefined Freud’s use of dreams and interpretation of patient resistance as a reaction against the threat to the private logic that assuages inferiority feeling. Adler rejected transference as an artificial by-product of therapy and as a license for the patient to continue infantile behavior. He redefined the unconscious not as a repository of sexual energy, but as the limitations of consciousness to understand one’s own private logic.

Adler’s emphasis on empathy and appreciating the uniqueness of each individual patient can be seen as a precursor to the humanistic approaches (such as that of Carl R. Rogers) that surfaced in the 1950s and 1960s. Adler’s focus on the patient’s private logic and coping strategies was echoed in the growth during the 1970s and 1980s of the cognitive approach (exemplified by Aaron T. Beck and Albert Ellis).

Some of Adler’s ideas have been challenged by modern research. The correlation between birth order and personality, for example, is lower than Adler believed. Adler’s notion that healthy people have no need to dream has been challenged by evidence from sleep laboratories that all people dream several times a night, though they might not remember their dreams. Nevertheless, Adler’s specific techniques of diagnosis and therapy are useful tools that eclectic therapists often add to their collection.

Bibliography

Adler, Alfred. The Individual Psychology of Alfred Adler. Ed. Heinz L. Ansbacher and Rowena R. Ansbacher. New York: Harper, 1977. Print.

Adler, Alfred. Superiority and Social Interest. Ed. Heinz L. Ansbacher and Rowena R. Ansbacher. Evanston, IL: Northwestern UP, 1964. Print.

Carlson, Jon, and Michael P. Maniacci. Alfred Adler Revisited. Hoboken, NJ: Taylor, 2011. Print.

Dinkmeyer, Don C., and W. L. Pew. Adlerian Counseling and Psychotherapy. 2d ed. Columbus, OH: Merrill, 1987. Print.

Dreikurs, Rudolf. Fundamentals of Adlerian Psychology. 1950. Reprint. Chicago: Adler Institute, 1989. Print.

Grey, Loren. Alfred Adler: The Forgotten Prophet. Westport, CT: Praeger, 1998. Print.

Mozak, Harold H., and Michael Maniacci. A Primer of Adlerian Psychology: The Analytic-Behavioral-Cognitive Psychology of Alfred Adler. Chicago: Brunner, 1999. Print.

Oberst, Ursula E. Adlerian Psychotherapy: An Advanced Approach to Individual Psychology. New York: Routledge, 2014. Digital file.

Sommers-Flanagan, John, and Rita Sommers-Flanagan. Counseling and Psychotherapy Theories in Context and Practice: Skills, Strategies, and Techniques. Hoboken, NJ: Wiley, 2012. Digital file.

Watts, Richard E., ed. Adlerian, Cognitive, and Constructivist Therapies: An Integrative Dialogue. New York: Springer, 2003. Print.

Why did Harper Lee use the allusion of the Garden of Gethsemane in the quote, "At each seat was a cardboard fan bearing a garish Garden of...

In Chapter 12, Calpurnia takes the children to First Purchase African M.E. for Sunday service. Scout is describing the church and mentions that each seat had a cheap cardboard fan with a garish image of the Garden of Gethsemane on it. Located in the New Testament, is the account of when Jesus and his disciples prayed and slept in the Garden of Gethsemane the night before his crucifixion. Harper Lee's Biblical allusion reflects Atticus' impending task to defend Tom Robinson in front of a prejudiced community. Atticus' personal sacrifice to defend Tom Robinson and suffer immense scrutiny from his community correlates to Jesus' personal sacrifice to die on the cross for the sins of humanity. In the Biblical account of the Garden of Gethsemane, Jesus is overwhelmed with sorrow and prays that he would not be required to die on the cross. Similar to the anguish Jesus felt, Atticus knows that Tom's case is unwinnable, and he will be viewed with contempt throughout Maycomb. Despite the negative response from his community and the difficult task ahead of him, Atticus chooses to defend Tom Robinson because he is a morally upright individual.

In Chapter Two of Percy Jackson and the Olympians: The Lighting Thief, whose conversation does Percy overhear? What are they discussing?

In Chapter Two, Percy decides to ask his teacher, Mr. Brunner, for help with his homework. Outside the teacher’s office, he overhears Mr. Brunner and Percy’s best friend, Grover, discussing Percy himself.

Specifically, Mr. Brunner and Grover are discussing Mrs. Dodds' fight with Percy. Grover refers to the woman as one of the Kindly Ones and seems to be very worried that she appeared in the school. He also seems to be worried about a deadline of some kind.

Mr. Brunner talks about the need to let Percy mature and “enjoy his ignorance” while he can. He goes on to say that the Mist will cause both Percy and the other students to forget what they saw.

Furthermore, Grover sees the attack as a failure on his part, but Mr. Brunner tries to assure him that if there is any blame, it is Mr. Brunner’s.

How do London's descriptions of the dog reveal its purpose and function in "To Build a Fire"?

The dog, who is perfectly suited to its environment, reflects the role of heredity, instinct, and natural selection in the ability to survive. It functions as the creature who has adapted to nature, in contrast to the man, and whose instinct makes it the winner in the "survival of the fittest."

On his trek to another camp, the man "plunges" in and out of the large spruce trees, following a faint trail on a day which the old timer at the previous camp has warned him not to travel, and certainly not to travel alone. But the dog, a big, native husky,  

...knew that it was no time for traveling. Its instinct told a truer tale than was told to the man by the man's judgment.

Since the man has previously been out in two cold snaps, he mistakenly believes that he is always capable of dealing with the cold. Unlike the dog, he ignores the signs that the cold in which he treks this time is much more severe than it has been on his other trips. While the man has learned to be wary of springs that run underneath the snow lest he wet his feet in the frigid temperatures and suffer severe frostbite, he underestimates the danger of the severe cold, which allows no margin for error in building a fire. Instead, he merely notices this cold:

Once and a while the thought reiterated itself that it was very cold and that he had never experienced such cold.

When he removes his mitten as he pulls out his lunch, the man is amazed at how quickly he feels the cold. He "chuckled at his foolishness" of not first building a fire, but he does note the numbness in his fingers. He notices that his toes are beginning to numb as well, yet his arrogance still prevents him from comprehending the danger he faces.

Later on, when he hurriedly tries to start a fire, he unwisely does so beneath snow-covered branches. With the ensuing heat, the snow melts and puts out the fire. The man's nemesis, the brutal cold, causes his fingers to freeze so much that he is unable to gather twigs fast enough and strike a match before frostbite sets in.

Thus, the man is defeated by nature because of his delusion of self-sufficiency. On the other hand, the dog possesses no such delusions, as its instincts signal to it what is dangerous. So, while the man lacks the means to survive by himself, the wolf-dog and its centuries of natural adaptation equip it for survival. Seeing the dog angers the man as he realizes how much better equipped this animal is than he in the brutal cold.

Furthermore, the dog quickly senses danger and leaps away from the man, who would kill it to use his body to warm himself. After the man freezes to death, the dog catches the scent of death and moves away. In a brief time, it turns and trots up the trail to the camp it knows has other fire providers, acting only out of self-preservation.

With the aid of a diagram, explain the process of urine formation.

There are three main steps to urine formation.  In order, the tree steps of urine formation are glomerular filtration, tubular reabsorption, and tubular secretion. Each step is briefly explained below. Links to diagrams of urine formation are also included.

Glomerular filtration

During glomerular filtration, salts, nutrient molecules, and wastes move from the glomerulus to the inside of the glomerular capsule. These small molecules are called filtrate.

Tubular reabsorption

During tubular reabsorption, the nutrient molecules and salt molecular filtrated are reabsorbed from the convoluted tubules into the particular capillary network and water follows passively.

Tubular secretion

During tubular secretion, certain molecules are actively secreted from the particular capillary network into the convoluted tubules.

Urine excretion

Water is then reabsorbed and urine is passed via the renal tubule.

What is the link between Sergeant Major Morris and the White family in "The Monkey's Paw"?

The text of the story does not explicitly say how Sergeant Major Morris knows the White family; but, the connection is implied by the way Mr. White acts when he sees his old friend coming up the path.

"The old man rose with hospitable haste, and, opening the door was heard condoling with the new arrival."

If this had been a friend of Mrs. White or the son, either of these two would have gone to the door first to greet the visitor. As it is, Mr. White makes a great excited effort to be the first one to meet Morris and get him out of the inclement weather. Then, it is Mr. White who introduces Morris to his wife and son, suggesting that he and Morris are friends and the other two have not met him before. Mr. White also seems very proud to introduce this man to his family.

The only other clue the reader gets to how Mr. White knows Morris is when he says, "When he went away he was a slip of a youth in the warehouse. Now look at him." The reader can infer by this quote that Mr. White and Sergeant Morris probably knew each other from working in a warehouse when they were young.

What is the summary of "The Story of an Hour" by Kate Chopin?

When the story begins, the narrator informs the reader that it is known that Louise Mallard has a heart condition. Her sister, Josephine, is therefore careful in breaking the news that Louise's husband has been killed in a train accident. Louise immediately cries and retreats to her room. Emotionally and physically exhausted from that outburst of grief, she sinks into a chair and then stares out the window. Her sobbing subsides and she starts to have quite different feelings. As the reality of her husband's death sinks in, she suddenly realizes that she has a new kind of freedom. She would no longer have to live for her husband. She would no longer have to be dependent upon him. She would also no longer have to bend her will to his, as this was the custom in traditional marriage roles: 

There would be no one to live for her during those coming years; she would live for herself. There would be no powerful will bending hers in that blind persistence with which men and women believe they have a right to impose a private will upon a fellow-creature. A kind intention or a cruel intention made the act seem no less a crime as she looked upon it in that brief moment of illumination. 

Reveling in this new independence, she exits her room and discovers her husband at the door. She dies "of a joy that kills." In other words, she dies because of the shock and heartbreak she experiences with having lost that new freedom. 

What is pericarditis?

Definition

Pericarditis is the irritation and swelling of the pericardium, the two-layered
sac that envelops the heart. Pain is caused when the inflamed layers rub together
or against the heart. The inflammation may in turn cause fluids to build up within
the sac. Complications include cardiac tamponade (excessive fluid buildup that squeezes the heart)
and constrictive pericarditis (scarring and stiffening of the pericardial sac).

Causes

Most often, pericarditis is caused by a viral
infection such as influenza, meningitis,
mumps, infectious mononucleosis, intestinal tract
disorder, or complications from acquired immunodeficiency syndrome.
Bacterial pneumonia, meningitis, or influenza; other bacterial
infections such as empyema, tuberculosis,
or skin and wound diseases; and fungal infections can also spread to
the pericardium and cause inflammation. Pericarditis may also be related to
cancer, chest trauma (including surgery), kidney failure, autoimmune disease, and
radiation therapy. Often the cause is unknown.

Risk Factors

Anyone can develop pericarditis; however, the condition is most common in men age twenty to fifty years. Children younger than four years of age are more apt to develop bacterial pericarditis. After an acute episode, 15 to 30 percent of people will have a recurrence; some will develop chronic pericarditis.

Symptoms

Pericarditis caused by a virus typically comes on suddenly and is short-lived, whereas bacterial pericarditis may develop gradually. Sharp chest pain is the most common symptom, although some people report dull pain or pressure; chronic episodes can be painless. The neck, left shoulder, back, and abdomen may also be affected, and pain may worsen with deep breathing and coughing or when lying flat; the pain may ease when sitting upright or bending forward. Shortness of breath is also common, as is a dry cough, fatigue, an increased heart rate, and a fever. In cases of constrictive pericarditis, the legs and ankles may swell; with cardiac tamponade, blood pressure levels may drop.

Screening and Diagnosis

The affected person’s symptoms, especially from any recent flulike infections, are important in the diagnosis. During the physical examination, the clinician will use a stethoscope to listen for the scratchy sound of the pericardium rubbing against the heart and for other signs of fluid buildup. A chest radiograph, echocardiogram, and computed tomography scan can confirm fluid buildup or other signs of pericardial damage. Cultures of the blood and pericardial fluid can detect bacterial or fungal infections.

Treatment and Therapy

Treatment generally depends on the underlying cause. Pericarditis caused by a
virus usually resolves within three weeks; affected persons are advised to rest
and are given medications to relieve pain and reduce inflammation. Persons who do
not respond to this regimen may be given corticosteroids or colchicine. Antibiotics
or antifungal medications are also prescribed for bacterial pericarditis. Those
with fluid buildup or other complications are typically hospitalized for
observation and further testing. Fluids may be drained from the pericardial sac,
which requires local anesthetic. For persons with chronic or constrictive
pericarditis, part or all of the pericardium may be surgically removed.

Prevention and Outcomes

Untreated bacterial pericarditis can be life-threatening. Prompt medical treatment and follow-up can help to prevent complications or a second attack.

Bibliography

Berger, John. “Pericarditis, Bacterial.” Available at http://emedicine.medscape.com/article/891369-overview.

Spodick, David H. The Pericardium: A Comprehensive Textbook. New York: Marcel Dekker, 1997.

Sydell and Arnold Miller Family Heart and Vascular Institute. Pericarditis Guide. Cleveland, Ohio: Cleveland Clinic, 2009. Available at http://my.clevelandclinic.org/documents/heart/pericarditis_treatment_guide.pdf.

Zipes, Douglas P., et al., eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 7th ed. Philadelphia: Saunders/Elsevier, 2005.

What is speech perception?

Introduction

The perception of human speech signals involves a variety of phenomena that initially appear trivial but are actually exceedingly complex. The basic phenomena are the ability to perceive the same speech message correctly when it is presented by various speakers or by the same speaker performing under different conditions (the phenomenon of perceptual constancy); differences in the perceptual processing of speech and nonspeech sounds; the ability to discriminate among sounds from different speech-sound categories, but only poorly among sounds from within the same speech-sound category (categorical perception of speech); and the problems presented by the signal’s immediate speech sound (phonetic) context for the correct identification of the signal (the phenomenon of context-sensitive cues).

Each phenomenon is so complex primarily because of the nature of the speech signal. A spoken language is perceived by a native listener as a sequence of discrete units, commonly called words. The physical nature of the typical speech signal, however, is more accurately described as a continuous, complex acoustic wave. In this signal, not only the sounds associated with consecutive syllables but also the sounds of consecutive world often overlap considerably.

The ultimate goal of speech perception research is the development of a theory that explains the various phenomena associated with the perception of the human speech signal. To achieve this goal, researchers need two basic types of information: a detailed description of the speech signal, to test whether any acoustic cues exist that could be used by listeners; and accurate measurements of the acts of speech perception, to test hypotheses related to the different theories of speech perception.

Consonant and Vowel Distinctions

When describing the speech signal for a given language, researchers have noted that the signal is composed of a set of basic units called phonemes, which are considered to be the smallest units of speech. The phonemes can be thought of (though this analogy is imprecise) as corresponding somewhat to the letters in a written word. For example, American English is said to contain twenty-five consonant phonemes and seventeen vowel phonemes. The distinction between consonant and vowel speech sounds is based on the degree to which the vocal tract is closed. Consonants are generated with partial or complete closure of the vocal tract during some point of their production. Vowels are created with the vocal tract in a more open state.

Consonants are produced by closing or nearly closing the vocal tract, so they contain relatively little acoustic energy. Because of the dynamic changes occurring in the shape of the resonant cavities of the vocal tract during consonant production, the consonants are difficult to specify exactly in terms of acoustic patterns. Consonants commonly contain bursts of noise, rapid changes of frequencies, or even brief periods of silence, which all may take place within twenty-thousandths of a second.

Vowels have less complex acoustical characteristics, primarily because they are produced with the vocal tract open and do not change its shape so dramatically. They are of relatively long duration and tend to have more constant acoustical features than consonants. The most important features of vowel sounds are their formants, which are narrow ranges of sound frequencies that become enhanced during vowel production. The formants result from basic physical characteristics of the vocal tract, chief among these being its shape for a particular vowel, which cause most of the vocal frequencies to become suppressed, while only a few narrow bands of frequencies (the formants) are reinforced. Formants are numbered in increasing order from the lowest- to the highest-frequency band. The relative-frequency relationships among the formants of a vowel sound characterize that vowel.

Experiments show that the vowel sounds in English speech can be distinguished from one another by reference to the frequency values of formants one and two. For any given vowel sound, however, there is a range of frequencies that typically occurs for the formants, depending on the person speaking and the conditions under which the individual speaks. There is even some overlap between the ranges for some vowels.

Vowels and consonants can be further subdivided according to the articulatory features that characterize production of the sound. Articulatory features include the location of the greatest constriction in the vocal tract, the degree of rounding of the lips, the place of articulation (that is, where in the vocal tract the sound tends to be primarily produced, such as the lips or in the nasal cavity), and the manner of articulation (for example, voiced means the vocal folds vibrate, and voiceless means the vocal folds do not vibrate). These factors are important because of their possible use by a listener during the process of speech perception.

The nervous system can be viewed as consisting of two main subdivisions: transmission systems and integrative systems. For speech perception, the transmission systems both transmit and process the nervous signals that are produced by acoustic stimulation of the sensory structures for hearing. The integrative systems further process the incoming signals from the transmission systems by combining and comparing them with previously stored information. Both systems are actively involved in the processes of speech perception. Much research has been done concerning the exact mechanisms of signal processing in the nervous system and how they enable listeners to analyze complex acoustic speech signals to extract their meaning.

Theoretical Approaches

Theories of speech perception can be described in several ways. One way of categorizing the theories labels them as being either top down or bottom up. Top-down theories state that a listener perceives a speech signal based on a series of ongoing hypotheses. The hypotheses evolve at a rather high level of complexity (the top) and are formed as a result of such things as the listener’s knowledge of the situation or the predictability of the further occurrence of certain words in a partially completed sequence. Bottom-up theories take the position that perception is guided simply by reference to the incoming acoustic signal and its acoustic cues. The listener then combines phonemes to derive the words, and the words to produce sentences, thereby proceeding from the simplest elements (the bottom) up toward progressively more complex levels.

A contrasting description is that of active versus passive theories. Active theories state that the listener actively generates hypotheses about the meaning of the incoming speech signal based on various types of information available both in the signal and in its overall context (for example, what has already been said). The listener is said to be using more than simply acoustic cues to give meaning to what has been heard. Passive theories state that the listener automatically (passively) interprets the speech signal based on the acoustic cues that are discerned.

Perceptual Constancy and Processing

Often, major differences in acoustic waves are produced by different speakers (or the same speaker performing under different conditions) even when speaking the same speech message. Nevertheless, native listeners typically have little trouble understanding the message. This phenomenon, known as perceptual constancy, is probably the most complex problem in the field of speech perception.

Variations in the rate of speaking, the pitch of the voice, the accent of the speaker, the loudness of signal, the absence of particular frequency components (for example, when the signal is heard over a telephone), and other factors are handled with amazing speed and ability by the typical listener. Many variations result in drastic changes or even total elimination of many acoustic cues normally present in the signal.

There is experimental evidence to support the hypothesis that when speech occurs at a higher-than-normal rate, the listener uses both syllable and vowel durations as triggers to adjust the usual stored acoustic cues toward shorter and faster values. This automatic adjustment permits accurate speech perception even when the speaking rate approaches four hundred words per minute.

Another difficult task is to explain the ease with which a listener can understand speech produced by different persons. The largest variations in vocal tract size (especially length) and shape occur between children and adults. Even among adults, significant differences are found, the average woman’s vocal tract being nearly 15 percent shorter than that of the average man. These differences introduce quite drastic shifts in formant frequencies and other frequency-dependent acoustic cues. Nevertheless, experiments show that even very young children generally have no difficulty understanding the speech of complete strangers, which indicates that the nervous system is able to compensate automatically even before much speech perception experience has been garnered.

Studies of human perceptual processing using speech and nonspeech sounds as stimuli provide evidence for differences in the way people deal with these two categories of sounds. The implication is that specialized speech-processing mechanisms exist in the human nervous system. A major difference is a person’s ability to process speech signals at a higher rate than nonspeech signals. Experiments show that phonetic segment information can be perceived as speech at rates as high as thirty segments per second (normal conversation rates transmit about ten segments per second). The rate of perception for comparable nonspeech signals, however, is only about four sounds per second.

Categorical Perception of Speech

The phenomenon of categorical perception of speech refers to the fact that people discriminate quite well among sounds from different speech sound categories (for example, a /b/ as opposed to a /p/ sound, as might occur in the two words “big” and “pig”); however, people’s discrimination of different acoustic examples of sounds from within the same speech sound category (for example, variations of the /b/ sound) is not as good. One theory to explain categorical perception proposes that the auditory system is composed of nerve cells or groups of nerve cells that function as feature detectors that respond whenever a particular acoustic feature is present in a signal. In the example of the sounds /b/ and /p/ from the spoken words “big” and “pig,” according to this theory, there are feature detectors that respond specifically to one or the other of these two consonants, but not to both of them, because of the different acoustic features that they each possess. One problem for proponents of the theory is to describe the particular features to which the detectors respond. Another problem is the number of different feature detectors a person might have or need. For example, is one detector for the consonant /b/ sufficient, or are there multiple /b/ detectors that permit a person to perceive /b/ correctly regardless of the speaker or the context in which the /b/ is spoken (and the consequent variations in the acoustic patterns for the /b/ that are produced)?

Context-Sensitive Cues

Although variations in the immediate speech sound (phonetic) context often result in major changes in the acoustic signature of a phoneme (the phenomenon of context-sensitive cues), a person’s ability to identify the phoneme is remarkable. People can recognize phonemes even though the variations found in the acoustic signatures of a given phoneme when spoken by even a single speaker but in different contexts (for example, for /d/ in the syllables “di,” “de,” “da,” “do,” and “du”) make it difficult to specify any characteristic acoustic features of the phoneme.

Research shows that many acoustic cues (such as short periods of silence, formant changes, or noise bursts) interact with one another in determining a person’s perception of phonemes. Thus, there is no unique cue indicating the occurrence of a particular phoneme in a signal because the cues depend on the context of the phoneme. Even the same acoustic cue can indicate different phonemes, according to the context. A complete theory of speech perception would have to account for all these phenomena, as well as others not mentioned.

Research Questions

Speech sounds represent meanings in a language, and a listener extracts the meanings from a speech signal. What has remained unclear is how the nervous system performs this decoding. One hypothesis is that there are sensory mechanisms that are specialized to decode speech signals. This idea is suggested by the experimental results that indicate differences in the processing of speech and nonspeech signals. An alternative hypothesis is that special speech-processing mechanisms exist at a higher level, operating on the outputs of generalized auditory sensory mechanisms.

In the 1960s, the study of speech perception developed rapidly and three major theories were developed. These motivated a wealth of research projects, assisted by advances in electronic instrumentation, and have formed a basis for the development of later theories. All three theories specify an interaction between the sensory representation of the incoming speech signal and the neuromotor commands (that is, the pattern of signals that the nervous system would have to generate to activate the muscles for speaking) that would be involved in the production of that same signal. Two of the main theories are the motor theory and the auditory model of speech perception.

Motor Theory

The first and probably most influential of the theories is Alvin M. Liberman’s motor theory of speech perception. Briefly stated, the motor theory maintains that a listener decodes the incoming speech signal by reference to the neuromotor commands that would be required to produce it. The process of speech perception therefore involves a sort of reverse process to that of speech production, in which a speaker has a message to send and generates appropriate neuromotor commands to enable the articulatory muscles to produce the speech signal. According to the motor theory of speech perception, the listener has an internal neural pattern, generated by the incoming speech signal’s effects on the sensory apparatus. This pattern can be “followed back” to the neuromotor commands that would be necessary to produce an acoustic signal like the one that has just produced the internal (sensory) neural pattern. At this point, the listener recognizes the speech signal, and perception occurs by the listener’s associating the neuromotor commands with the meanings they would encode if the listener were to produce such commands when speaking.

Among the problems facing the motor theory, a major one has been to explain how infants are able to perceive surprisingly small differences in speech signals before they are able to produce these same signals, since it would seem that they do not possess the necessary neuromotor commands. Another problem has been the inability for the supporters of the theory to explain how the “following back” from the incoming signal’s generated neural activity patterns to the appropriate neuromotor commands.

Auditory Model

At the other end of the theoretical spectrum from the motor theory, Gunnar Fant’s auditory model of speech perception places greater emphasis on an auditory analysis of the speech signal. This theory proposes that the speech signal is first analyzed by the nervous system so that distinctive acoustic features get extracted or represented in the activity patterns of the nervous system. Then these features are combined into the phonemes and syllables that the listener can recognize. Much as in the motor theory, this recognition depends on the listener possessing basic knowledge about the articulatory processes involved in speech production—in particular, the distinctive phonetic features possible in the language being heard.

In contrast to the motor theory, Fant’s model supposes an ability of the listener’s auditory system to pick out distinctive acoustic features from the phonetic segments being heard. The auditory model, therefore, separates the auditory and articulatory functions more distinctly than the motor theory does.

One of the problems of the auditory model is that distinctive acoustic features of phonetic segments are difficult to specify unambiguously. Supporters of the model argue that the important features are more complex than the relatively simple ones normally proposed and represent characteristic relationships between various parts of the signal.

Bibliography

Bailly, G, et al. Audiovisual Speech Processing. Cambridge: Cambridge UP, 2012. Print.

Behrman, Alison. Speech and Voice Science. San Diego, Calif.: Plural, 2007. Print.

Jekosch, Ute. Voice and Speech Quality Perception: Assessment and Evaluation. New York: Springer, 2005. Print.

Mulak, K. E. "Development of Phonological Constancy: Nineteen-Month-Olds, but not Fifteen-Month Olds, Identify Words in a Non-Native Regional Accent." Child Development 84.6 (2013): 2064–78. Print.

Pisoni, David B., and Robert E. Remez, eds. The Handbook of Speech Perception. Malden, Mass.: Blackwell, 2005. Print.

Tatham, Mark, and Katherine Morton. Speech Production and Perception. New York: Palgrave Macmillan, 2006. Print.

Warren, Richard M. Auditory Perception: An Analysis and Synthesis. 3d ed. New York: Cambridge University Press, 2008. Print.

Wolfe, Jeremy M. Sensation & Perception. 3rd ed. Sunderland: Sinauer, 2012. Print.

What is hashish?

History of Use

According to some studies, people have been using cannabis for thousands of years. It now is the most commonly used illicit drug worldwide. Hashish, a potent substance derived from cannabis, has a long history of its own. The word hashish is of Arabic origin and refers to preparations made from strong resins, plant oils, and sometimes flowers, which are dried and shaped into various forms; these can then be smoked or, after being dissolved in a liquid, baked into foods.

Hashish originally was used for religious purposes in what is now Pakistan, but its use had spread throughout India and the Middle East by the Middle Ages. Marco Polo and other medieval writers thought that the drug was used to motivate a particularly fierce group of warriors in northern Syria. Somewhat later, hashish was experimented with in Europe, most famously by French writers and doctors in the mid-nineteenth century. Several of these persons believed the hallucinations associated with the drug could be of use in psychotherapy.

Effects and Potential Risks

Like other forms of cannabis, hashish contains dozens of substances called "cannabinoids," the general functions of which are not well understood. The most psychoactive substance is delta-9-tetrahydrocannabinol (THC), which binds to specific receptors in the human forebrain and cerebellar cortex. The flowering top and the resins and oils of cannabis are comparably richer in THC than are the other parts of the plant. Once bound to receptors, THC affects motor activity, reward and reinforcement, memory, and the sensation of nausea.

In practical terms, the person consuming small amounts of hashish may experience hallucinations and euphoria. Larger doses may produce increased anxiety and paranoia. With chronic and heavy use, users can experience disorganized or scattered thinking, cognitive deficits, decreased motivation, social withdrawal, and decreased range of affect.

Like other psychoactive substances, THC use can induce dependence. Dependent users tend to experience anxiety, insomnia, and loss of appetite without the drug.

Bibliography

Benjamin, Walter. On Hashish. Ed. Howard Eiland. Cambridge: Harvard UP, 2006. Print.

Breivogel, Chris, and Laura Sim-Selley. “Basic Neuroanatomy and Neuropharmacology of Cannabinoids.” International Review of Psychiatry 21.2 (2009): 113–21. Print.

"DrugFacts: Marijuana." National Institute on Drug Abuse. Natl. Insts. of Health, Sept. 2015. Web. 27 Oct. 2015.

"Effects of Hashish Use." Narconon. Narconon International, n.d. Web. 27 Oct. 2015.

Sewell, R. Andrew, Mohini Ranganathan, and Deepak Cyril D’Souza. “Cannabinoids and Psychosis.” International Review of Psychiatry 21.2 (2009): 152–62. Print.

Can the actions of one person change history?

There was once a theory, called “The Great Man” theory, that argued that a single dynamic person changed the path of history by himself – Hitler, Alexander, Stalin, Caesar, etc. But more modern theories maintain that the social and political milieu is what really makes the path of history, and that the “great man” is merely the instrument that history follows to give focus to the historical narrative. For example, Stalin moved Russian history in a certain direction because serfdom had collapsed (see Elias Canetti’s Crowds and Power), or slavery was abolished during Lincoln’s presidency but not because of Lincoln himself. So while it is true that history is in part the biography of great persons, one man’s effect on history’s path is exaggerated. It is true that random individuals (Lee Harvey Oswald, John Wilkes Booth) can interrupt the path of history. Another exception might be technological innovators, such as Henry Ford, Thomas Edison, or Galileo.

What is rule-governed behavior?

Introduction

Following the tradition of B. F. Skinner, the famous Harvard
University psychologist who pioneered the study of operant
conditioning, behavior analysts initially examined the
behavior of rats and pigeons because nonhuman subjects could be studied under
well-controlled conditions in the experimental laboratory. This made it possible
for operant psychologists to discover a number of important behavioral principles
and to demonstrate that much of the behavior of their experimental subjects was
shaped and maintained by contingencies of reinforcement. “Contingencies” can be thought of as
cause-effect relations between a context (in operant terms, a “discriminative
stimulus”), an action (“response”), and the consequence (“reinforcement”)
it produces. For example, if pressing a bar is followed by food only when a light
is on and never when it is off, a rat’s behavior is gradually shaped by these
contingencies until the rat presses the lever only when the light is on.

When operant researchers began to bring human subjects into the laboratory,
however, the analysis went beyond behavior directly shaped by contingencies to
include behavior under the control of instructions or rules. According to Skinner,
a rule is a “contingency-specifying stimulus.” It functions as a discriminative
stimulus (SD), but it differs from other SDs in that it is a
description of a behavior-outcome relation. Other SDs are
stimuli in the environment that acquire control over behavior only through
specific training; rules, in contrast, have an immediate effect on behavior
because they make use of an already existing language repertoire. For example,
through a history of careful shaping, a seeing-eye dog can be trained to stop at red lights and
cross the street only when the light is green. A verbal child, however, can be
taught the same discrimination simply by being told, “Go when the light is green;
don’t go when the light is red.”

Proverbs, maxims, advice, instructions, commands, and so forth all function as
rules when they control behavior. In complete form, rules specify an antecedent
condition, an action, and its consequences, and often take the form of if-then
statements, as in “If you want to get to the other side safely, then cross the
street only when the light is green.” Most rules, however, are only partial
statements of contingencies, specifying exclusively the antecedent (such as a male
figure or the word “men” on a door), the behavior (a sign reading do not enter),
or the consequence (“Lose twenty-five pounds in one month!”), and it is left to
the individual to fill in the blanks.

Despite an abundance of rules in the human environment, many people are not
reliable rule-followers. Control by rules is often deficient because rules only
determine the topography, or form, of behavior, but they do not impart the
motivation to act. Stated differently, rules tell people
what to do, but whether people actually do it depends on other circumstances.

Role of Contingencies

For a rule to be followed, it must be part of an effective contingency: Either
the outcome specified in the rule must function as a reinforcer, or the rule giver must be able to
mediate aversive consequences (punishment) for noncompliance.
Psychologists Steven C. Hayes and Robert D. Zettle have drawn an important
distinction between contingency-shaped and rule-governed behavior. They assert that
contingency-shaped behavior is controlled by one set of contingencies, usually
consisting of a situation, an action, and a consequence (such as being offered a
beer, drinking, and feeling relaxed).

In contrast, rule-governed behavior involves two sets of contingencies. One of them is the behavior-outcome relation specified in the rule itself (“If you want to avoid addiction, just say no”). The second involves social consequences for rule following, such as praise or criticism from significant others or social pressure to comply with peer norms. As the following examples will show, at times both sets of contingencies support rule following, but sometimes they compete with each other. In one example, a man is lost and his wife insists that he ask for directions. He is told to “turn left at the light and then follow the signs to the interstate.” The man is likely to follow these directions, because both sets of contingencies surrounding rule following are congruent: The natural consequences of finding the highway are indeed reinforcing to him, and the social consequences are reinforcing because following the directions will satisfy his wife and spare him criticism. In another example, however, a child is given a box of candy. Her mother says, “You may have only one piece of candy before dinner, or else you will spoil your appetite.” The contingency specified in the rule may be ineffective, because eating only one piece of candy if there is more may never have been reinforcing to the child. Hence, if the child obeys, it is not for the contingency specified in the rule but for the parental consequences that would result from noncompliance.

Behavior under the control of a description of contingencies does not involve a
new process but is consistent with an operant framework postulating that the
probability of behavior is controlled by its outcome. Rule governance results from
an extensive history of reinforcement in which rule-following has directly led to
contact with the contingencies specified in the rule, to social consequences
associated with compliance and noncompliance, or both.

Role in Learning

Teaching people to follow rules is important for a number of reasons, which B.
F. Skinner outlined in his book About Behaviorism (1974). Most
important, many behaviors can be acquired much more quickly through rules than
through shaping by the contingencies described in the rules. For example, it is
easier to teach a boy the basics of a card game by explaining the rules to him
than by playing with him until he gradually (if at all) figures out the rules for
himself. Furthermore, there are cases when the contingencies are so complex or
vague that most people would never understand them without the help of rules.
Learning to type with ten fingers illustrates such a case. Without appropriate
instruction, the immediate success accruing from a hunt-and-peck method will
reinforce typing with two fingers, and the person will never learn to use ten
fingers, even though in the long run this would have been much more efficient.

According to Roger L. Poppen in a 1989 essay, initially people learn rules from
a multitude of external sources such as parents, peers, teachers, television, and
books, and eventually they learn to extract rules from interacting with and
observing environmental contingencies. Parents encourage the rehearsal and
internalization of rules so that these self-instructions then help children guide
their own behavior in similar circumstances.

Behavior-Analytic Theory

The effects of rules on behavior have been extensively studied within a
behavior-analytic methodology. A summary of this research can be found in a
chapter by Margaret Vaughan in the book Rule-Governed Behavior:
Cognitions, Contingencies, and Instructional Control, edited by Steven
C. Hayes (1989). Most of these human operant studies use a method in which
subjects press a button that, according to some schedule of reinforcement (an
arrangement that specifies which responses within an operant class will be
reinforced), occasionally produces points exchangeable for money. Depending on the
preparation, button pressing may be controlled by the contingency between pressing
and point delivery; in this case, the behavior would be contingency-shaped. Button
pressing may also be controlled by experimenter instructions, in which case the
behavior would be rule-governed.

A number of studies showed that experimenter-provided instructions quickly
bring the behavior under stimulus control (behavior occasioned by a stimulus because the
stimulus signals some consequence of responding) but also create insensitivity to
the scheduled contingencies. For example, telling subjects that “the best way to
earn points is to press the button fast” (a fixed-ratio contingency) immediately
allows them to respond correctly and earn points. When the contingencies are then
surreptitiously changed, however, subjects continue to follow the instructions for
long periods of time although they have become obsolete and no longer produce
rewards. In contrast, when subjects receive no instructions and their responses
are shaped, sensitivity to changing contingencies develops; that is, when the
schedule of reinforcement changes, subjects adjust their behavior to the new
schedule and continue to earn points. This observation has led operant researchers
to conclude that insensitivity to contingencies may be an inherent property of
instructional control.

Effect of Irrational Beliefs

The insensitivity effect of rules has intriguing implications: Instructing
people how to solve problems is immediately effective, but it may be
counterproductive in the long run, because individuals may come to act in
accordance with outdated rules. Their behavior may come to be guided by what
cognitive psychologists call irrational beliefs or unrealistic expectations, which
from an operant
perspective would be considered inaccurate statements about contingencies
resulting from broad overgeneralizations of old rules. The following example
illustrates how an irrational belief may come to control behavior. A mother might
tell her child, “Stop making noise! I don’t love you when you are bad.” This rule
may quiet the child immediately, and because it is effective, the parent may use
it in other situations. Over the course of her development, the child learns many
instances of what her parent considers “bad” (perhaps disobeying instructions,
perhaps asserting herself, showing anger, and so on). Gradually she internalizes a
generalized rule, “I am only lovable when others approve of me,” and evolves into
an adult who tries to please everybody and feels unworthy at any sign of
disapproval, however ineffective this behavior may be.

Humans live in a world in which rules abound, in the form of instructions,
advice, warnings, manuals, cookbooks, self-help books, laws, and social norms.
They are intended to provide guidelines for effective behavior. Even when no
external rules are available, most people can formulate their own plans of action.
The greatest advantage of rules is that they can be extremely helpful and can
establish effective behavior quickly. Their greatest disadvantages are that rules
do not produce behavior unless other contingencies support rule following and (as
Skinner has pointed out) that they may be troublesome rather than helpful when the
contingencies change but the rules do not.

Evolution of Study

Originally, behavioral researchers attempted to replicate findings from
experimental work with rats and pigeons to demonstrate the generality of the
principles of behavior discovered in the animal laboratory. It soon became
apparent that people often showed response patterns not comparable to those of
animal subjects on the same schedules of reinforcement. For example, a cumulative
record of responding on a fixed-interval schedule for animals typically shows
“scallops” (a pause after reinforcement, followed by a gradually accelerating
response rate until delivery of the next reinforcer). In contrast, human subjects
typically time the interval by counting; toward the end, they respond as few times
as necessary to obtain the reinforcer.

Behavior analysts suspected that the differences between human and animal
responding mainly stemmed from people’s prior conditioning history and from instructions,
both experimenter-provided and self-generated, with which they approached the
experimental tasks. These assumptions began to focus the attention of operant
researchers on the role of instructions. By the mid-1970s, instruction following
became synonymous with rule-governed behavior and began to evolve into a field of
study in its own right.

Importance of Approach

One importance of rule governance lies in the possibility of a rapprochement
between behaviorist and cognitivist positions. Behaviorists have often been
accused of disregarding or failing to acknowledge the importance of higher mental
processes. Although such accusations are polemic and extremely misleading, it is
true that it was not until the mid-1970s that operant psychologists began a
systematic empirical analysis of cognitive-verbal processes. The study of
rule-governed behavior marked the beginning of the experimental analysis of
phenomena that until then pertained to the domain of cognitive
psychology.

The analysis of rule-governed behavior is important for another reason. It
provides some insights into causal mechanisms that may underlie current cognitive
therapies. For example, in 1987 Poppen presented an excellent theoretical analysis
of a self-efficacy approach and of rational emotive therapy,
while in 1982, Zettle and Hayes presented a similar analysis of cognitive
restructuring and cognitive therapy for depression. The common denominator of
these diverse cognitive approaches is their assertion that people’s reactions to
their environment are mediated by covert verbal statements, which, when
dysfunctional, are given labels such as irrational beliefs, low self-efficacy, and
negative expectancies. From an operant perspective, such formal categorizations
are considered not very useful because formally distinct verbal statements may all
have the same function, while statements identical in form may have different
functions (one person might say “I can’t do it; I’m too dumb” to avoid an
unpleasant task, while another person may say the same thing to request
assistance).

Within a framework of rule-governed behavior, all these dysfunctional
cognitions are considered partial statements of contingencies, and the behavior
they produce is rule-governed. Hence, findings from basic experimental research on
rule-governed behavior could conceivably be brought to bear on clinical phenomena,
which eventually might lead to a better understanding of psychological
dysfunctions and to the development of more effective therapies.

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