What Do Dreams Do?

2020 ◽  
Author(s):  
Sue Llewellyn
Keyword(s):  
Decision Making ◽  
Mental Illness ◽  
Emotional Stability ◽  
Evolutionary Time ◽  
Brain Functions ◽  
Human Animal ◽  
Hidden Patterns ◽  
Access To Food ◽  
The Way

What is a dream? It’s a complex, non-obvious pattern derived from your experience. But you haven’t actually experienced it. Strange. Revealing complex, hidden patterns makes dreams odd. Dreams associate elements of different experiences to make something new: a pattern you didn’t know was there until you dreamt it. Patterns are discernible forms in the way something happens or is done. Some patterns are easy to spot, being certain and obvious: night follows day. Patterns in human/animal experiences are less obvious because, first, the patterned elements appear at different times or places and, second, the pattern exhibits tendencies not certainties. Spotting such patterns depends on non-obvious associations. If prompted with ‘sea’, while awake, your logical brain makes obvious associations, ‘beach’ or ‘boat’, with a seaside pattern i.e. beach-boat-seaside. But after awakening from dreaming, when your brain is still tuned to non-obvious associations, ‘sick’ may come to mind. A less obvious element of sea experiences. You tend to seasickness when it’s rough. But you also get sick if you eat shellfish, have a migraine, or travel in cars—but only if you read. Sea–rough–car–read–shellfish–migraine. Visualizing these non-obvious associations between elements of different experiences becomes dream-like. Dreaming brains evolved to identify non-obvious associations. Across evolutionary time, you didn’t want to get sick. Survival depended on being well enough to anticipate the non-obvious patterns of predators and human competitors, while securing access to food and water. Making associations drives many, if not all, brain functions. Dream associations support memory, emotional stability, creativity, unconscious decision-making, and prediction, while also contributing to mental illness. This book explains how.

Clinical Judgment Revisited

1999 ◽  
Vol 38 (04/05) ◽  
pp. 279-286 ◽  
Author(s):  
L. L. Weed
Keyword(s):  
Decision Making ◽  
Medical Practice ◽  
Clinical Judgment ◽  
Medical Information ◽  
Patient Records ◽  
Practice Of Medicine ◽  
The Way

AbstractIt is widely recognised that accessing and processing medical information in libraries and patient records is a burden beyond the capacities of the physician’s unaided mind in the conditions of medical practice. Physicians are quite capable of tremendous intellectual feats but cannot possibly do it all. The way ahead requires the development of a framework in which the brilliant pieces of understanding are routinely assembled into a working unit of social machinery that is coherent and as error free as possible – a challenge in which we ourselves are among the working parts to be organized and brought under control.Such a framework of intellectual rigor and discipline in the practice of medicine can only be achieved if knowledge is embedded in tools; the system requiring the routine use of those tools in all decision making by both providers and patients.

Patients’ practices for taking the initiative in decision-making in outpatient psychiatric consultations

2017 ◽  
Vol 13 (2) ◽  
pp. 169-184 ◽  
Author(s):  
Shuya Kushida ◽  
Takeshi Hiramoto ◽  
Yuriko Yamakawa
Keyword(s):  
Decision Making ◽  
Conversation Analysis ◽  
Treatment Decision ◽  
Close Inspection ◽  
Important Resource ◽  
Treatment Decision Making ◽  
The Way

In spite of increasing advocacy for patients’ participation in psychiatric decision-making, there has been little research on how patients actually participate in decision-making in psychiatric consultations. This study explores how patients take the initiative in decision-making over treatment in outpatient psychiatric consultations in Japan. Using the methodology of conversation analysis, we analyze 85 video-recorded ongoing consultations and find that patients select between two practices for taking the initiative in decision-making: making explicit requests for a treatment and displaying interest in a treatment without explicitly requesting it. A close inspection of transcribed interaction reveals that patients make explicit requests under the circumstances where they believe the candidate treatment is appropriate for their condition, whereas they merely display interest in a treatment when they are not certain about its appropriateness. By fitting practices to take the initiative in decision-making with the way they describe their current condition, patients are optimally managing their desire for particular treatments and the validity of their initiative actions. In conclusion, we argue that the orderly use of the two practices is one important resource for patients’ participation in treatment decision-making.

Rangda and the Goddess Durga in Bali

2017 ◽  
Vol 12 (1) ◽  
pp. 50-77
Author(s):  
Sarah Weiss
Keyword(s):  
Decision Making ◽  
Binary Opposition ◽  
Dynamic Relationship ◽  
The Witch ◽  
Purity And Impurity ◽  
Good And Evil ◽  
Negative Attributes ◽  
The Way

This article examines Rangda and her role as a chthonic and mythological figure in Bali, particularly the way in which Rangda’s identity has intertwined with that of the Hindu goddess Durga— slayer of buffalo demons and other creatures that cannot be bested by Shiva or other male Hindu gods. Images and stories about Durga in Bali are significantly different from those found in Hindu contexts in India. Although she retains the strong-willed independence and decision-making capabilities prominently associated with Durga in India, in Bali the goddess Durga is primarily associated with violent and negative attributes as well as looks and behaviours that are more usually associated with Kali in India. The reconstruction of Durga in Bali, in particular the integration of Durga with the figure of the witch Rangda, reflects the local importance of the dynamic relationship between good and bad, positive and negative forces in Bali. I suggest that Balinese representations of Rangda and Durga reveal a flux and transformation between good and evil, not simply one side of a balanced binary opposition. Transformation—here defined as the persistent movement between ritual purity and impurity—is a key element in the localization of the goddess Durga in Bali.

What Patients With Severe Mental Illness Transitioning From Hospital to Community Have to Say About Care and Shared Decision-Making

2016 ◽  
Vol 37 (6) ◽  
pp. 400-405 ◽  
Author(s):  
Dawn I. Velligan ◽  
David L. Roberts ◽  
Cynthia Sierra ◽  
Megan M. Fredrick ◽  
Mary Jo Roach
Keyword(s):  
Decision Making ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Shared Decision Making ◽  
Shared Decision

The moral and political economy of suicide prevention

2021 ◽  
pp. 144078332110011
Author(s):  
Scott J Fitzpatrick
Keyword(s):  
Decision Making ◽  
Political Economy ◽  
Suicide Prevention ◽  
Social Practices ◽  
Economic Systems ◽  
Moral Norms ◽  
Policy Practice ◽  
Political Relations ◽  
Norms And Values ◽  
The Way

Suicide prevention occurs within a web of social, moral, and political relations that are acknowledged, yet rarely made explicit. In this work, I analyse these interrelations using concepts of moral and political economy to demonstrate how moral norms and values interconnect with political and economic systems to inform the way suicide prevention is structured, legitimated, and enacted. Suicide prevention is replete with ideologies of individualism, risk, and economic rationalism that translate into a specific set of social practices. These bring a number of ethical, procedural, and distributive considerations to the fore. Closer attention to these issues is needed to reflect the moral and political contexts in which decision-making about suicide prevention occurs, and the implications of these decisions for policy, practice, and for those whose lives they impact.

The capacity to designate a surrogate is distinct from decisional capacity: normative and empirical considerations

2021 ◽  
pp. medethics-2020-107078
Author(s):  
Mark Navin ◽  
Jason Adam Wasserman ◽  
Devan Stahl ◽  
Tom Tomlinson
Keyword(s):  
Decision Making ◽  
Mental Illness ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Decisional Capacity ◽  
Risks And Benefits ◽  
Relative Risks ◽  
Decision Making Capacity ◽  
Cognitive Diseases ◽  
Surrogate Selection

The capacity to designate a surrogate (CDS) is not simply another kind of medical decision-making capacity (DMC). A patient with DMC can express a preference, understand information relevant to that choice, appreciate the significance of that information for their clinical condition, and reason about their choice in light of their goals and values. In contrast, a patient can possess the CDS even if they cannot appreciate their condition or reason about the relative risks and benefits of their options. Patients who lack DMC for many or most kinds of medical choices may nonetheless possess the CDS, particularly since the complex means-ends reasoning required by DMC is one of the first capacities to be lost in progressive cognitive diseases (eg, Alzheimer’s disease). That is, patients with significant cognitive decline or mental illness may still understand what a surrogate does, express a preference about a potential surrogate, and be able to provide some kind of justification for that selection. Moreover, there are many legitimate and relevant rationales for surrogate selection that are inconsistent with the reasoning criterion of DMC. Unfortunately, many patients are prevented from designating a surrogate if they are judged to lack DMC. When such patients possess the CDS, this practice is ethically wrong, legally dubious and imposes avoidable burdens on healthcare institutions.

Problems of selection and phytogeny, terms and methods of behaviorism

1984 ◽  
Vol 7 (4) ◽  
pp. 713-717 ◽  
Author(s):  
A. Charles Catania
Keyword(s):  
Nonverbal Behavior ◽  
Evolutionary Time ◽  
Grand Tour ◽  
The Way

We have had a grand tour of operant behaviorism ranging over evolutionary time and the breadth of human cultures. It has included both verbal and nonverbal behavior, and it has visited both their public and their private domains. To test my understanding of some of the issues discussed and to offer what I hope will be constructive contributions to the treatments, I here address to Professor Skinner several questions and comments on some of the topics stopped at along the way (I will treat his responses as my souvenirs of the trip).

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