Bradley Lewis

What is psychiatric truth? How do psychiatrists understand it? How do they use and abuse it? ese questions preoccupy this chapter, and I will give my perspective from the start. I see psychiatry as a philosophical and narrative hermeneutic practice (Lewis, 2011). is means that "psychiatric truth" always involve questions of interpretation and meaning-making. In keeping with some of the central principles of philosophical hermeneutics, I see humans as meaning-making creatures, or, as Charles Taylor so memorably put it, "self-interpreting animals"-constituted by the way we interpret ourselves and our worlds (Taylor, 1985, p. 96). I appreciate Hans-George Gadamer's foundational insight that interpretation is not "an isolated activity of human beings but a basic structure of our experience of life. We are always taking something as something. at is the givenness of our world orientation, and we cannot reduce it to anything simpler or more immediate" (Gadamer, 1970, p. 87). Or, as John Caputo puts it, philosophical hermeneutics means that interpretation is unsurpassable and that, when we encounter the world, both inner and outer, it's interpretation "all the way down" (Caputo, 2018, p. 4). Narrative hermeneutics adds to philosophical hermeneutics by layering in narrative meaning-making as part of the larger process of human meaning-making (Brockmeier & Meretoja, 2014; Freeman, 2017; Ricoeur, 1991, 1992). is narrative addition is particularly relevant for interpreting ideas of self, identity, and di erence and how we tell the stories of our lives (Lewis, 2011, 2017). From this perspective, psychiatric practice is a subset of philosophical and narrative hermeneutics. Psychiatry, in other words, is a dialogic practice of working with people to make meaningful interpretations of their selves, their worlds, their su ering, their joys, and their psychic di erences (the ways that mental states vary and "normal" mental states only scratch the surface of psychic possibility).

Despite a growing prevalence of mental illness diagnoses and treatments, there remains remarkable interpretive diversity regarding the meaning of these diagnoses and their implication for mental healthcare. Humanities scholarship devoted to language, power and ethical cares of the self provides invaluable tools for navigating interpretive diversity in this domain. This scholarship suggests that ethical questions of informed consent regarding mental difference and disability go much deeper than the usual standards. Ethical questions of informed consent go back to the very language choices people use to narrate and navigate the mental difference or disability. Making these ethical choices between different ways of understanding psychic difference is fundamentally about making narrative and lifestyle choices. This article considers these issues in the context of the many interpretations of Vincent van Gogh's life and their ongoing relevance for contemporary approaches to mental difference and disability.

The contemporary brain disorders debate echoes a century-long conflict between two different approaches to mental suffering: one that relies on natural sciences and another drawing from the arts and humanities. We review contemporary neuroimaging studies and find that neither side has won. The study of mental differences needs both the sciences and the arts and humanities. To help develop an approach mindful of both, we turn to physicianwriter Anton Chekhov's story "A Nervous Breakdown." We review the value of the arts and humanities as a coequal partner with natural sciences in the creation of a robust mental health humanities.

Mindfulness based interventions (MBIs) are rapidly emerging in health care settings for their role in reducing stress and improving physical and mental health. In such settings, the religious roots and affiliations of MBIs are downplayed, and the possibilities for developing spiritual, even mystical, states of consciousness are minimized. This article helps rebalance this trend by using the tools of medical humanities and narrative medicine to explore MBI as a bridge between medical and spiritual approaches to health related suffering. My narrative medicine method draws insights from the arts and humanities that are rarely used in standard clinical research but are increasingly common among medical humanities and narrative medicine scholars. The specific path I take will be to work through historical, linguistic, and philosophic dimensions of mindfulness and mysticism as relevant to illness, suffering, death, and dying. I close with two case examples in which mindfulness is used as an intentionally spiritual practice for health concerns.

Two important movements leading the way toward a new approach to healthcare are narrative medicine and contemplative care. Despite considerable common ground between these two movements, they have existed largely parallel to each other, with different literatures, different histories, different sub-communities, and different practitioners. This article works toward integration of narrative medicine and contempla-tive care through a philosophical exploration of key similarities and differences between them. I start with an overview of their similar diagnosis of healthcare's problems and then consider their related, but different, responses to these problems. Finally, I use the example of Margaret Edson's Pulitzer Prize winning drama W;t to highlight how these issues can play out at the end of life. Keywords Narrative medicine Á Contemplative care Á Healthcare reform Á Empathy Á Phenomenology Á Spirituality Á End of life Á Margaret Edson Á W;t Despite ongoing problems in healthcare financing and access, this is a time of growth and regeneration in healthcare. Practitioners and scholars are going beyond the obvious healthcare crisis problems to ask deeper questions: what kind of healthcare do we want, what kinds of clinicians do we most value, and what kinds of clinical encounters do we need in the face of suffering, disability, and death? These deeper questions take us to the heart of health and healing and to core issues of human empathy and wisdom in the face of morbidity and mortality. Healthcare reform devoted to these deeper questions aims at nothing less than combining the sophistication of scientific medicine with an equal sophistication in compassionate care.

Inspired by a passage from Kate Chopin's The Awakening, this article considers the possibility of a Bmedical sublime.^ It works through a history of the sublime in theory and in the arts, from ancient times to the present. It articulates therapeutic dimensions of the sublime and gives contemporary examples of its medical relevance. In addition, it develops the concept of sublime-based stress-reduction workshops and programs. These workshops bring the sublime out of the library and the museum into the lives of the healthcare community—patients, families, clinicians, staff, concerned others—in the service of better navigating human vulnerability and finitude. Opening the cannon of aesthetic theory and the arts as resources for the human condition is at the heart of health humanities. The sublime can be an invaluable tool in this task.

Working through the lens of Donna Haraway's cyborg theory and directed at the example of Prozac, I address the dramatic rise of new technoscience in medicine and psychiatry. Haraway's cyborg theory insists on a conceptualization and a politics of technoscience that does not rely on universal “Truths” or universal “Goods” and does not attempt to return to the “pure” or

The coronavirus pandemic has shattered our world with increased morbidity, mortality, and personal/social sufferings. At the time of this writing, we are in a biomedical race for protective equipment, viral testing, and vaccine creation in an effort to respond to COVID threats. But what is the role of health humanities in these viral times? This article works though interdisciplinary connections between health humanities, the planetary health movement, and environmental humanities to conceptualize the emergence of "planetary health humanities." The goal of this affinity linkage is to re-story health humanities toward promotion of planetary health and community well-being. Wellbeing is critical because the main driver of environmental destruction and decreasing planetary health is coming from non-sustainable definitions of wellbeing. We need the arts and humanities to help reimagine the possibility of a sustainable community wellbeing. For health humanities , a basic role and narrative identity starts to emerge-we should become a planetary health (and well-being) humanities. Emerging infectious diseases (EIDs) are a significant burden on global economies and public health. Their emergence is thought to be driven largely by socioeconomic , environmental and ecological factors… EID events are dominated by zoonoses (60.3% of EIDs): the majority of these (71.8%) originate in wildlife… and are increasing significantly over time. Jones et al. 2008 Journal of Medical Humanities

In this paper, we propose analogies between medical discourse and Edward Said's “Orientalism.” Medical discourse, like Orientalism, tends to favor institutional interests and can be similarly dehumanizing in its reductionism, textual representations, and construction of its subjects. To resist Orientalism, Said recommends that critics—“intellectuals”—adopt the perspective of exile. We apply Said's paradigm of intellectual-as-exile to better understand the work of key physician-authors who cross personal and professional boundaries, who engage with patients in mutually therapeutic relationships, and who take on the public responsibility of representation and advocacy. We call these physician-authors “medical intellectuals” and encourage others to follow in their path.

... by. Bradley Lewis (bio) Gallatin School of Individualized Study New York University. Lennard Davis. Obsession: A History. Chicago: University of Chicago Press, 2009. Cloth $27.50 . 296 pp. Paperback, $17.00 . e-Book, $5–$17.00 . Allan V. Horwitz and Jerome Wakefield. ...

Artistic Epiphanies and Arts for Health Epiphanies Experiencing Epiphanies in Literature and Cinema explores artistic epiphanies in the service of sustainable well-being. By spending time with artistic epiphanies, we not only get a chance to be with these extraordinary moments in art, we also cultivate the conditions through which we may bring epiphanies into our daily lives.