Book review ii. General Psychotherapy: Principles and Common Theoretical Aspects - Rediscovering Humanity

General Psychotherapy

Chapter 1 confirmed many points for me regarding psychotherapy, especially given the general treatment here. Hartmann-Kottek asks questions of psychotherapy as a science. Hence, the demarcation of science is also raised. The history of psychotherapy spans the 19th century to current day, with references to prehistory. Wundt is a reminder of my introduction to psychology (aged 14-15). 

Physics also features, with quantum theory noted on p.5. and throughout the book. Significant for me, reference to energy, took me back to nursing theory and the work of Prof. Martha Rogers. I've struggled with this in the past. Not just personally, Unitary Beings, is this a 1960s - 1970s thing(?), but what it meant to other students and qualified nurses, in the UK at least? Another factor as I tried to find 'space' - validation for Hodges' model (despite an assumed BEST BEFORE date) there was the perception of those outside nurse academia who questioned the very notion of nursing theory (Raskin, 2001). Pardon the digression, but in the text the scales and potential significance at which the quantum is 'present' are surprising and helpfully amplify the need for an open-mind.

The author highlights recognition in recent decades of quantum phenomena - descriptions in neurophysiological at the molecular - cellular level, meditation, energy, resonance, states of consciousness and unconscious. You will find E=mc² here too.

The question of the disparate disciplines, schools and their often warring, fractured state is not dodged. The reality of, and accounting for the the multiplicity of approaches to therapy is debated and celebrated. I like the thought of how as a student / learner the first psychotherapy we are exposed to as a clinician (usually?) is imprinted. This experience influences (understandably) how we respond to subsequent psychotherapeutic modalities. I've followed discussion on 'X' regards efforts in academia to work towards a way to integrate psychotherapy, at least improving co-habiting, but as cited by Wampold et al. (2018) p.336:

"In the thousands of (RCT) studies conducted, we are still yet to find a specific treatment for a particular disorder, which was, on average, clinically and systematically superior to any other psychotherapy." p.7.

The aim in this paper was to "find a suitable coordination system that incorporates variety." p.7.

From this and my focus on Hodges' model my motivation to read this book may be obvious:

• A mapping exercise of core communication concepts to Hodges' model
     (the common framework?)
• psychology 
• psychotherapy
• interprofessional?

Hartmann-Kottek writes:

"Even if the school of psychotherapy were to succeed in establishing a common framework, a certain amount of variation with regard to approach would nevertheless be required. I am referring to the entire field of play between body-therapeutic interventions, scenic realisations, artistic expressions and more restrained verbal interactions. This is the result of the diversity of our human state." p.33.

The politics of psychotherapy recur with exploration of interdisciplinary common factors. A book that takes a neutral stance is highlighted in one of several 'tips'. Interspersed within the text, readers will find other related asides 'important', 'note', and 'cave'. Each chapter (bar conclusion) has a bibliography. For me the references are comprehensive. There are figures too, not many (a listing would help) but they reflect the book's goals. As already suggested there is philosophical and ethical debate. How is science defined in this context and using current tools. Objectivity - Subjectivity are a constant too; while Buber et al. took me back to RN mental health (RMN) and lecture days (CPN Cert.). This is not just a reverie but vital at a time when several lecturers in mental health nursing, are concerned that the mental health nursing curriculum is being genericised.

I like reference to interspaces and constellations - again throughout. While not a psychotherapy, the brief section 1.8.3 Abandoned Aspects of Therapy, made me recall Token Economies, conceived as a therapy.

Chapter 2 discusses good and bad therapists (invariably, wherever people go the apple barrel follows), looking in depth at the therapeutic relationship, and as a common factor. Given the attention devoted to self-care at present^, it is fitting that given that people attracted to train as psychotherapists have experienced stress themselves (2.2.1); should be aware of their own self-care and mental hygiene (2.2.4). Behavioural and client-centered therapies provide focus, with gestalt therapy working towards sections on the 'special therapeutic relationship' and agape. To what extent do you need to be open to holistic orientation, in order to negotiate holistically embedded confrontation (2.4.5)?

More to follow.

Many thanks again to Prof. Hartmann-Kottek and Springer for the review copy.

Hartmann-Kottek, L. (2022). General Psychotherapy, Principles and Common Theoretical Aspects - Rediscovering Humanity. Springer. https://doi.org/10.1007/978-3-030-87466-7

Raskin, Jef. "Humbug: Nursing Theory". Archived from the original on July 10, 2001. Retrieved December 14, 2015. (Wikipedia).

^Not a complaint, welcome in terms of the vertical axis of Hodges' model.

Book review i. General Psychotherapy: Principles and Common Theoretical Aspects - Rediscovering Humanity

   General Psychotherapy

Predictably, the title of this book caught my attention.

I did do some homework before requesting a review copy, but it was still a surprise that this book by Prof. Dr. med., Dipl. Psych. Lotte Hartmann-Kottek is not edited. It is a comprehensive tome at 491 pages. As a mental health nurse with experience of cognitive, behavioural and family therapy, I am not an expert, but Prof. Hartmann-Kottek's experience in psychotherapy, the history, theoretical development, clinical application, theoretical underpinnings (including physics) and political machinations are well demonstrated.

A disappointment for me is the lack of an index. This seems a major omission, and yet a comprehensive index here, might itself be difficult to navigate. There are some errors in word-use, repetition but they do not detract from the book and reading experience overall. The book is apparently translated from German. The book is expensive, but students may have access through their institutions and special schemes(?).

The book's subtitle: Principles and Common Theoretical Aspects - Rediscovering Humanity is delivered. The title General Psychotherapy - attracted me for several reasons:

'General' - the (seeming) opposition of generalist-specialist is relevant to the theory and application of Hodges' model.

'Psychotherapy' - I was interested to see how Prof. Hartmann-Kottek dealt with the disparate schools of psychotherapy, given some awareness of the politics and efforts to integrate and reconcile therapeutic approaches, philosophies, and legacies. 

Consequently, the chapters address multiplicity, systems, efficacy, commonalities and interspaces. If a book should benefit its reader, rewarding time/cost then this text has contributed to my continuing professional development. Discussion of systems, individual, whole, humanistic, interdisciplinarity, integration, the therapeutic relationship, transcripts and therapy scenarios provides ongoing stimulus for my efforts with Hodges' model.

"The increasing joint adoption of methods and methodological aspects through the partitioned barriers of the otherwise politic(al)ly competing schools in recent decades has, of course, been met with mixed reception, especially when the adoption was coupled with contemporary political and social repression.

However, it may be precisely this difficult topic of the mutually uncoordinated, intellectual adoption and incorporation of vicinity aspects on a macro scale that may indicate that the time has come for an integrative reconciliation or fusion of the essence of psychotherapeutic approaches. As perhaps needs no mention, this path will require an extensive field of play." p.viii. Preface.

'I' - 'Individual' 'SELF' 'Patient' 'Client'

|

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

dyad / couple  family  GROUP community population

psychological systems MIND psycho- identity psycho-therapy / therapies subjectivism cognitive  access	physical systems -somatic BODY identity? evidence objectivism physical access
social systems culture history community of practice social access	political systems power professionalism health systems/services funding political access

Many thanks to Prof. Hartmann-Kottek and Springer for the review copy.

More to follow.

Hartmann-Kottek, L. (2022). General Psychotherapy, Principles and Common Theoretical Aspects - Rediscovering Humanity. Springer. https://doi.org/10.1007/978-3-030-87466-7

Book review iv. General Psychotherapy: Principles and Common Theoretical Aspects - Rediscovering Humanity

   General Psychotherapy

My late teens - early twenties coincided with the emergence of chaos, fractals and yes - emergent phenomena. Consequently, I had to refer back to Chapter 3, as Hartmann-Kottek writes:

"If we imagine a fractal that encompasses all categories similarly to a quantum in this regard, all cells, organs, particularly the human brain, the entire person, groups of people, races, nature and the earth would also be in field and structure at the same time. This does not appear to be an abnormal notion. Several experiences with field phenomena of the relationship level would consequently gain their natural allocation.

Indeed, we are familiar with notions that cross categories with regard to states of matter: Water as ice, snowflakes, liquid, vapour, mist and clouds are normal aspects of daily life."p.215.

This resonates at present with reading on categories, seeking theory and to what extent can mathematics and logic be applied to Hodges' model and more importantly, to the humanities? There is some toing-and-froing in the book, but for me having read the book - it works. If a student asked me what is a good subject to study at high school. It would be Social and Economic History, especially if you are thinking of pursuing mental health nursing, psychiatry, or psychology. General nursing too, I would add, acknowledging the need for holistic and integrated theory, practice and management. 

Chapter 7: is a regular rollercoaster in terms of history and cultures:

The Spirit of the Times and Cultural Epochs as Reference Systems Along with Their Transformation of the Ideal Level of Human Development – A Historical Journey Into the Past to Learn for the Future

In healthcare we need to constantly ask (it's called mandatory training) about the protected characteristics, the various literacies, including emotional, spiritual, cultural; and all the determinants of health. And we need to be cognizant of all of them: individual, environmental, commercial, educational, social, and educational (hence why 'categories' are salient).

The discussion of non-European cultures are particularly rewarding - Africa, Australia, Polynesia, Ancient far East, Native Americas, Egypt, Yoruba and others. Page 437 brings Martial arts, where synergy between mind, body and spirit is central. Reflecting culture and the association between health, well-being, the human condition and pastoral care chapter 7 covers the main religions and relationships between several. The influence of aesthetics in certain cultures is also introduced. The book is a springboard for further reading. Section 7.1.2 on an Integrative, Holistic Stance as a Countermovement provides the names and dates of  more than fifteen personalities: Alexius Meinong (1853-1920) ... Wilhelm Witte (1915-1985). Through the history described, it is interesting to reflect on the significance of the holding of knowledge and power imbued through its use. The end of chapter is an effort to take stock of social development - a non-trivial task given the dynamic world we try to exist within. 

 I found I was rolling together chapters 6,7 and 8 even as they hold-their-own in content and placement. As a community mental health nurse I still reflect upon:

• There is no overarching theory of health communication.
• Gatekeeping is alive and well.
• The current often vociferous 'debate' between psychiatrists, psychologists, patients/clients, carers and nurses too.

Chapter 8 returns to the integration of psychotherapy with the politics of research, or how the exercise of power within psychotherapy research has resulted in crises. I wished I'd paid more attention, but I do recall at some events, conferences instances of animosity between different therapeutic camps. Hartmann-Kottek does not labour the final chapter. There are positive messages here too. A page and a half overview informs us that globally there is research attending to the knowledge and not the interests of particular therapeutic organisations and associations. Statistics, evidence, fake science are discussed, the history in psychotherapy and how this frames the future. When I started reading the book behavioural science was in the news for the wrong reasons. 

Chapter 8 reminds me of the proverb 'Reap what you sow'. Now across health and social care how many gates and gate-keepers are there? Outside of 'emergency' triage: how many are legitimate, needed? How as the original role - processes changed? In England there is ongoing debate about IAPT - Improving Access to Psychological Therapies. Fascinating and troubling the apparent increase in diagnosis of autism and attention deficit hyperactivity disorder (ADHD). Still many questions to be asked, especially on access to therapy within  the auspices of universal health coverage.

Here on the blog and in my application of Hodges' model, it may seem that the POLITICAL domain is the constant elephant. The thing to be climbed over, circumvented, accepted for all its ills (no pun intended). Politics, the political is a tool. It is, in Hodges' model, an essential domain in terms of care delivery and knowledge. The idea of that "Competitive constellations happen." (p.465) is of course a reality. In championing and studying Hodges' model this is well recognised. Chapter 8 is a mélange of socio-political concepts which briefly reveal what must be better resolved not just in psychotherapy, but health and social care: all the determinants.

Hodges' model = a natural home for contextual research?

 "At long last, 'contextual research' (Wampold et al.) has put an end to the belief solely in standardised and manualised treatment programmes." p.345.

While the above gives me great encouragement - a note in book: "Generalising partial perspectives only ever lead to impasse." (p.458) reminds me to take nothing for granted.

Chapter 8 places an emphasis on balance.

Hartmann-Kottek uses the term '(r)evolutionary' in chapter 8. This is fitting as the chapter begins with history - with or without the Dodo. Perhaps quantum descriptions can be found by (necessarily) and paradoxically increasing the theory-practice gap. Taking 'theory' even further away from the noise, complexity of practice. We often consider theory, as an opportunity to be idealist. How often (in the past?) have nurses found the nursing theory - model they are trying to apply ungainly as the day-to-night pressures of care delivery make themselves known? Perhaps ironically by venturing further into theory new vistas will appear, with timely and much needed perspectives given the demands of health in the 21st Century.

 'I' - 'Individual' 'SELF' 'Patient' 'Client'

  |

    INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

dyad / couple  family  GROUP community population

PSYCHO - PSYCHO - ... experience-related,  mind and	- TECHNICS^ - MECHANICS^ confrontational connections in the physiological patterns ... (p.480).
foundational collective context i dyad, triad, couples, families, small and large groups	foundational collective context ii gates, gate-keepers, gate-keeping access, accessibility

Many thanks to Prof. Hartmann-Kottek and Springer for the review copy. I will add the related posts below soon.

An enjoyable, informative read and a great contribution to my CPD. There are many more points to highlight and I may do so in the future.

Hartmann-Kottek, L. (2022). General Psychotherapy, Principles and Common Theoretical Aspects - Rediscovering Humanity. Springer. https://doi.org/10.1007/978-3-030-87466-7.

^Used in the text.

Book review iii. General Psychotherapy: Principles and Common Theoretical Aspects - Rediscovering Humanity

   General Psychotherapy

In chapter 3 neurophysiological development is explored and epigenetic influences (3.2). For a decade or so I've highlighted to students the need for them to be aware of 'omics' which will clearly impact their future careers and subsequent learning. This is detailed also outlining limbic development, through to cognitive-linguistic functioning; and not just learning but forgetting. It is easy to take the self for granted, but here is a description of a self in formation, the neocortex, imagination and role of the pineal gland. Biological radiation of living beings (there is a error in the heading I believe*) is fascinating for reasons already acknowledged. Then it is as if time begins and psychological development can begin (life chances permitting). From the author's practice two cycles are illustrated - growth and transformation drawing on Gestalt thought and all referenced. 

Ever since reading on Goethe's part-whole thought I've been aware of mereology. Chapter 3 also examines intrapsychic and social space in respect of part-whole relationships. I'm continuing this journey so it helpful to find the distinction here also.

"According to the resonance principle, identification with key partial aspects can very quickly lead to an unresolved, formative core conflict. In an individual setting, empty chairs or symbolic locations may serve as backdrops for projection. Distance, posture and line of vision are highly relevant in this regard. In a group setting, forms of constellation work with representatives may be more helpful." p.155.

The book's philosophical content is well realised, fused with history and the development of psychology and neurosciences. Plato's cave is explained and related to tabula rasa: the blank slate (3.6.3). I feel I'm in Plato's cave in trying to look at Hodges' model as a mathematical object. There is encouragement too in Hartmann-Kottek identifying the role of blank slate. Hodges' model is also about forgetting, unconditional positive regard hence a blank slate. Chapter 3 concentrates on approaches to explain our development and personality, quantum-theoretic, Far-Eastern traditions, and Western working towards how we achieve coherence as an integral individual, building and relying on inner and external social and interpersonal resources (Fig. 3.4: Tower of consciousness. p.212.). Energy a key in this part of the book, is summarised in a further figure on background dimensions - combining two-axes of Whole-Parts and Space-time - Spaces of possibilities (p.222).

Chapter 4 is a welcome discussion of systems, interspaces, self, communication again through a cultural lens. Chapter 5 would benefit all healthcare students - an understanding of health and illness. While not tackled here - how we integrate and simultaneously address both requirements in service delivery is the challenge of 21st Century health provision? This is higher level from the outset: Attempts at Classification (5.1). While a  traditional book, reading had an immersive feel for me (with many posts on W2tQ): Diagnostic tools, 2-sided understanding of health and illness, the diagnostic, therapeutic (always kept in sight) reversal of symptoms, fields of tension and resources at various stages of development.

For readers looking for actual therapies, chapter 6 is the practical center of the text. The current state of psychotherapy is likened to the blind people trying to find an elephant in the dark. 'Many paths' in a subtitle is welcome, almost suggesting there is scope for all approaches and perhaps they can meet 'somewhere'? Motivations and politicisation aside, the variety of psychotherapeutic are indeed a treasure. They are listed, comprehensively as far as I can see, including many new to me. They are further sub-divided and considered: clusters through time, behavioural, then considered as per depth and effect levels, verbal - non-verbal, emotions, breathing and meditation, variations in consciousness. 

I've considered blind-spots before and highlight Hodges' model as having a role in situational awareness - hence safety and care assurance. Hartmann-Kottek remains grounded in how blind-spots can affect therapists and patients - individually and in alliances. The therapeutic relationship, transference and countertransference are emphasised once again. Compassion too - as part of a credible relationship - with selective authenticity. Technical points are raised too, the use of counterpart in Gestalt therapy. Some 40 pages of chapter 6 are very practical, with exercises and examples of conversations between patient and therapist to illustrate specific approaches and situations. This is far from a specific therapy manual but there is this quality to the content.

 

 'I' - 'Individual' 'SELF' 'Patient' 'Client'

  |

    INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

dyad / couple  family  GROUP community population

psycho- symbolic personal meaning emotion lived experience emotional distance	-somatic

*Living near Manchester in NW England, the city's symbol is a bee (industry..). It appears in the text that 'Being' has become 'Beeing' in some instances - so an extra homely feel here.

Many thanks to Prof. Hartmann-Kottek and Springer for the review copy.

One more post to follow.

Hartmann-Kottek, L. (2022). General Psychotherapy, Principles and Common Theoretical Aspects - Rediscovering Humanity. Springer. https://doi.org/10.1007/978-3-030-87466-7

Empty chair image:
https://www.mentalhelp.net/blogs/gestalt-therapy-the-empty-chair-technique/

Empathy - Relating, Knowing, Objects, Patterns ...

INDIVIDUAL

|

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

"Logos is our capacity to separate ourselves from the surrounding world, making it into objects in order to recognize it objectively, reflect about it. Any fully developed human relationship needs both principles, the relating and the knowing. Knowing in this sense means the possibility of discriminating between the common ground and the difference of I and Thou. Without knowing, there is fusion or identity but not relationship between a separate I and a separate Thou." p.64.

"Recently a woman training to be an analyst came for supervision and brought with her for the first time a tape of an analytic session she had had with a woman patient of hers. To our amazement, in listening to this tape, we both had at certain times quite some difficulty in distinguishing her own voice from the voice of the patient. This happened mostly when the patient was talking very softly and obviously fighting to overcome feelings of shame. The candidate felt rather shocked at first and asked me whether she might have identified with the patient in an unhealthy way. I heard her interventions on the tape as being genuinely in tune to the atmosphere and situation of the patient at those moments, so I told her that to my mind she was responding in an empathetic way to her patient. It was apparent that the patient needed this kind of response, for later in the tape one could hear that the patient became more confident in exploring her feelings. I think the candidate reacted to the needs of her patient with a concordant countertransference reaction." p.38.

Jacoby, M. (1984) The Analytic Encounter: Transference and Human Relationship. Toronto: INNER CITY BOOKS.

In this text and other reading I can see a possible means as to how the concept of identity can be used between the Individual - Group (other).

To follow soon:

Book review iii. General Psychotherapy: Principles and Common Theoretical Aspects - Rediscovering Humanity

Book for review: iii "Philosophy of Care - New Approaches to Vulnerability, Otherness and Therapy"

Before moving beyond Pierron's 1st chapter (the whole book is very worth reading), there is much that reminds me of institutional care:

https://winwickremembered.org.uk/

Recognition of the sub-standard cockroach 'co-habiting' environment away from the entrance corridor, quality of life, task oriented, de-personalising, stagnant, passive, pervasive sense of hopelessness and helplessness. There was a chink of light. 

As registered mental health student's we were on a crusade. Carrying a torch, lit outside in the community to help open the doors to community care.

 On trips outside, gradually the institutional skin sloughed off, to reveal the person - the individual came alive (even through medication). 

'Bill' had a sense of humour, a lovely smile. He'd had the prospect of another life. So many people there for so long: too long. Potential unrealised?

"To be in contact with the other in care is not to exercise a hold over them." p.16. 

The problem is - within institutions this can be forgotten and lost:

"To suspect a substituting mode of solicitude (cf. Heidegger) of being a highhanded charitable hold over someone invites one to consider the ethical and political fecundity of a solicitude which looks ahead. To think through this alternative would amount to unmasking the mechanisms of domination, whether voluntary and involuntary - naturalisation of roles, masculine domination, organisational violence, etc, - at work in care. Doing so politicizes care, enabling it to overcome that democratic optimism which doesn't want to recognize that violence is part of human history (Merleau-Ponty 1996: 124-125), that violence insinuates^ itself into care relations, and, as such, comes under the sway of what Merleau-Ponty called the 'maleficence of living among many' (maléfice de la vie à plusieurs)." p.16. 

^The need to be aware of subtle abuse? 

My notes for chapter 2 'From an Anthropology of Vulnerability to the Ethics of Care' by João Maria André, reflects a lot on relationality, and maps which I've drawn: "(identity is always dialogical identity)" and "how we map ourselves". Again this helps my (other) current reading and draft work. There's time here, plus "there is no such thing as abstract vulnerability - vulnerability is necessarily concrete". p.25. I don't think André mentions future generations but I've added a note; 'I-we' too. There's a triple axis, and more encouragement as Tronto and Gilligan feature. Heidegger's reference to Hyginus' Fable 220 (in which Care moulds man out of clay, Jove grants it spirit, and Earth gives him body, with Care being assigned the task of keeping him alive." (Gaia?) p.26.

As in chapter 1, and previously reviewed text 'General Psychotherapy', the term 'constellation' appears. In chapter 2 it is expanded (with reference to Corine Pelluchon); leading us to "appreciation of the world, and self-care as care for the world" p.29. So, planetary health too. With Hodges' model purposed (1/4) to help bridge the theory - practice gap; this perennial problem exhibits existential relevance here (p.27). We by-passed biopolitics on page 17, but  the interrelation of psychosocial and other examples informs the text (philosophy). As I scribbled, Hodges' model is simultaneously a space for resonance and unconditional positive regard (pp.30-31). Authors inevitably find themselves deliberating upon dualisms, Descartes of course, plus Spinoza and others. Entralgo is nails the duality: "the aim of caring is to lead the I from being 'a body that says I' to a learning how to progressively become, and define itself as, 'a body that says we'". p.35.

Braga, J. & Santiago de Carvalho, M. (Eds.), Philosophy of care: New approaches to vulnerability, otherness therapy. Springer. 

Many thanks again to Springer for my copy.

Individual

|

      INTERPERSONAL    :     SCIENCES                   

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

relational 'I' - mind  individual vulnerability intention affection - as movement	climate change 'I' - body maps - cartography Planetary Health action - movement
We context equity - equality social vulnerability	We policy bio-POLITICS accountability of government(s)

See also:
body & soul - Book: Philosophy of care: New approaches to vulnerability, otherness therapy

Book for review: ii "Philosophy of Care - New Approaches to Vulnerability, Otherness and Therapy"

Primary Care and the GP crisis: Individual - Group [Consultations]

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

Mental health (use of groups) One-to-One Interpersonal skills Psychological therapies PURPOSE Psychotherapy	Time, Place Efficiency Cost-effectiveness Evidence-based same conditions PROCESS
Group Consultations Group Therapy - an established therapeutic modality Group CBT for Older Adults PRACTICE	POLICY Treatment Therapy Education Doctor or Nurse led other disciplines too...

It’s great to hear #RCGP lead acknowledging the value of group consultations. Many of these pilots have been formulated & run by #nurses in general practice. It’s a shame their work wasn’t acknowledged on .@BBCr4today @weGPNS @theRCN https://t.co/zh4H7swoUv

— RCN GPN Forum (@RCNGPNForum) October 6, 2018

My source:
The Telegraph, GPs to see patients in groups of 15

@weGPNS - text corrected from original.

The naïve approach ii - Seeking / Avoiding a Catastrophe

In addition to Dodson's book I borrowed:

Zeeman, E.C. (1977) Catastrophe Theory-Selected Papers 1972–1977, Reading, MA: Addison-Wesley.

From the mid-1970s I remember catastrophe theory rather bursting on to the science scene. Articles in New Scientist (in a box somewhere?), Scientific American plus a BBC TV episode of Horizon (seeking details - originally aired July 28, 1975, 60 minutes 'Happy Catastrophe')*, that highlighted potential for new insights into the behaviour inside prisons. and other applications in the social sciences.

The CONTENTS reads:

GENERAL INTRODUCTORY PAPERS 

1. Catastrophe theory : Draft for a Scientific American article 1

2. Levels of structure in catastrophe theory 65

 BIOLOGICAL SCIENCES 80

3. Differential equations for the heartbeat and nerve impulse 81 

4. Primary and secondary waves in developmental biology 141 

5. A clock and wavefront model for the control of repeated structures during animal morphogenesis (with J.Cooke) 235

6. Gastrulation and formation of somites in amphibia and birds (Addendum by R. Bellairs.) 257 

7. Dialogue between a Biologist and a Mathematician 267 

8. Brain modelling 287 

9. Duffing's equation in brain modelling 293

 SOCIAL SCIENCES 302

10. Some models in the social sciences (with C.A.Isnard) 303 

11. On the unstable behaviour of stock exchanges 361 

12. Conflicting judgements caused by stress 373 

13. A model for institutional disturbances (with C.S.Hall, P.J.Harrison, G.H.Marriage, P.H.Shapland) 387

14. Prison disturbances 403 

PHYSICAL SCIENCES 408 

15. A catastrophe machine 409

16. Euler buckling 417 

17. Stability of ships 441

MATHEMATICS 496

18. The classification of elementary catastrophes of codimension <= 5 (with D.J.A.Trotman) 497

19. The umbilic bracelet and the double-cusp catastrophe 563 

DISCUSSION 604

20. Research ancient and modern 605 

21. Catastrophe theory : its present state and future perspectives (with R.Thom) 615

22. Afterthought 651 

As an area of contention the subject of catastrophe theory (CT) possibly presents(?) a dual-cusp of contention. Firstly, CT brought with it controversy within academia and mathematics. The book was reviewed by T. W. Barrett, Department of Physiology and Biophysics, University of Tennessee Center for the Health Sciences, Memphis, TN 38163: 

'Catastrophe theory (CT), as a new field in mathematics with many possible ramifications for both the physical and biological sciences, has recently been the subject of much controversy (see [1]-[5]). This controversy, in this reviewer's opinion, has served a valuable purpose insofar as it has stimulated the theory's proponents to refine and delineate their concepts more clearly. Catastrophe theory was developed by the Field prize winner, Rene Thom; but much work has been accomplished by E. C. Zeeman and his group, especially with respect to applications.' pp.609-610. IEEE TRANSACTIONS ON SYSTEMS, MAN, AND CYBERNETICS, VOL. SMC-9, NO. 9, SEPTEMBER 1979. https://ieeexplore.ieee.org/stamp/stamp.jsp?arnumber=4310286 

Stephen Smale also reviewed Zeeman's book; BULLETIN OF THE AMERICAN MATHEMATICAL SOCIETY Volume 84, Number 6, November 1978. 1360-1368. 

https://www.ams.org/journals/bull/1978-84-06/S0002-9904-1978-14580-7/S0002-9904-1978-14580-7.pdf

'To write a review in this environment has a very personal side for me. On one hand my own work on dynamical systems is closely connected to the origins of CT. I have had a long and close personal and professional relationship with both Thorn and Zeeman. More than 20 years ago I was discussing singularities of maps, transversality, and immersions with René Thom. Thom tried to interest me in an early draft of chapters of his book Structural stability and morphogenesis in 1966.

On the other hand I have remained skeptical and aloof from CT, perhaps due to my conservatism in science. While my colleagues and students were showing enthusiasm for CT, I gave critical lectures, one at the University of Chicago in 1974, one at the Aspen Institute of Physics in 1975. More recently I have been quoted negatively in the "Science" and New York Times references above. This is the first time I have written on the subject, and I should warn the reader of this negative bias, far from shared by many of my fellow mathematicians.' p.1360.

Some defenders of CT may accuse me of discussing very special examples not characteristic of the literature of the subject. I feel that the problem of lack of justification discussed above, is also found in Zeeman's other models. Furthermore Thorn's models are even less specific and less developed. On the other hand, Thorn's work in CT covers many subjects; in this connection Zeeman writes in his Scientific American article, April 1976, p. 65: "The method has the potential for describing the evolution of form in all aspects of nature, and hence it embodies a theory of great generality."' p.1366.

The book's introductory papers are somewhat confusing in content, as drawn to 'SOCIAL SCIENCES' it is the introductory section (and Part Two) that includes  'Anorexia nervosa', Example 9 pp.33-52. 

This is the second 'cusp' as the assessment, diagnosis, intervention, outcomes, skilled staff, access to specialised mental health services remains contentious to this day. As a charge nurse on a female acute admission mental health ward in the early 1980s, eating disorders have always presented a 'clinical' challenge. Often within a staff group and for individual staff members too.

Twitter/X is hardly an objective record but it appears today, that people and families affected by eating disorder continue to advocate for appropriate service provision, treatment and recognition. Recognition that can also develop evidence-based interventions. As discussed by Dr. Agnes Ayton, consultant psychiatrist and others in the video below:

A related paper:

Ibrahim, A., Ryan, S., Viljoen, D. et al. Integrated enhanced cognitive behavioural (I-CBTE) therapy significantly improves effectiveness of inpatient treatment of anorexia nervosa in real life settings. J Eat Disord 10, 98 (2022). https://doi.org/10.1186/s40337-022-00620-y [ My source: @AgnesAyton ]

The Zeeman chapter on anorexia nervosa is interesting graphically and conceptually ...

Page 42. Figure 20. The effect of the butterfly factor, d>0.
(Sorry for the image quality)

- but is of course 'from another time' and is clearly not person-centred. Eating disorders affect many people in the UK and are a cause of trauma, distress, disrupted life-chances and mortality. Referring to Hodges' model, such graphics, reinforce the idea that 'solutions' are to be found in the mechanistic and quantitative domains of the sciences and politics (choice, power, services, safety..). Here, maths and theories (seemingly) provide an explanation for people who are ill, and need treatment. As a teenager for most of the 1970s, Hodges' model was not yet a reality. As I have found since 1987-8 looking at the POLITICAL care/knowledge domain, the model's relevance has increased since the start of my nursing career in 1977. Consider for example, the politics of:

• the global phenomena of famine
• - whether or not associated with economic crisis, drought, other natural disaster, or conflict, political crisis
• ultra-processed foods
• obesity pandemic
• weight loss drugs
• appetite stimulants
• appetite suppressants
• eating disorder (anorexia and bulimia) across care sectors - primary, secondary, specialist
• community / in-patient care
• person-centred care
• user involvement in service design
• the availability of treatment modalities - psychotherapy (as in the video)
• the impact on family relationships and peer group (estranged - loss of friends)
• diagnostic blurring - psychosis, borderline personality disorder - the rise of 'anti-psychiatry'

Here then is the purpose of this post, what potential is there to look at nutrition from a situated individual and collective (global) perspective? This could be focussed on nutrition, or eating disorder; or alternately take a collective stance to encompass the global food supply and the industry. Discovering the diffeomorphism, I wonder if there are others, and their respective properties and character? 

INDIVIDUAL

|

INTERPERSONAL : SCIENCES              

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL   

|

GROUP

COGNITIVE THERAPY EMPATHY&RAPPORT LISTENING - MUTUAL ENGAGEMENT MENTAL HEALTH DIAGNOSIS TRAINED / SKILLED STAFF EVIDENCE-BASED INTERVENTIONS* MOTIVATION MOOD MULTIMORBIDITY	RESEARCH EATING DIET NUTRITION NUTRITIONAL VALUE WEIGHT BMI IN-PATIENT UNIT place of safety
PUBLIC HEALTH SOCIETY FAMILY CARERS	Developed nations are collectively and increasingly 'eating disordered' and exporting this 'lifestyle'.

Before I return the book, I will revisit the discussion section.

See also:

Jones P, Wirnitzer K. Hodges’ model: the Sustainable Development Goals and public health – universal health coverage demands a universal framework. BMJ Nutrition, Prevention & Health 2022;5:doi: 10.1136/bmjnph-2021-000254

*I could not find on BBC website. I have contacted the Open University. I did find - 'In this Horizon episode, Rene Thom's mathematical discovery of the catastrophe theory is investigated.' at  https://thetvdb.com/series/horizon/episodes/1385431