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We explore the problematic dynamics in the relationship between societal systems of care and the chronically excluded, with particular reference to severe personality disorder and the >difficult-to-reach< patient. The individual who >refuses< is often met with a violent response: yet his violence must be understood as related to an experience of being violently excluded. We reformulate personality disorder as a disturbance of >groupishness< and suggest, as a paradigm for the problem of refusal, the story of Diogenes the Cynic, who >holed himself up< in a barrel; and of his legendary encounter with Alexander the Great, who tried unsuccessfully to persuade him to >come in from the cold.< We suggest it may be as important to focus on Alexander's violence as on that of Diogenes, and we examine modes of violence deployed by society against the excluded outsider, with particular reference to the hostile attribution of intentionality to the personality disordered individual's acts of violence and self-harm. We conclude by considering both the merits of the democratic therapeutic community model as a response to severe personality disorder and the dangers, inherent in this model among others, in an unconscious identification with Diogenes in his barrel.
Erich Fromm’s biophilia, a theory of personality development incorporating an interaction between existential needs and the socio-economic environment, was a significant element of Fromm’s proposed Analytic Social Psychology. Despite an enduring influence, Fromm’s theory of biophilia has been largely untested in the literature. Fromm argued that biophilia was the optimum way to conceptualise malignant aggression, and that the introduction and reward of cooperation was the best way to increase levels of biophilia, and thereby reduce levels of destructive behaviour in a population. It was the aim of this thesis to investigate whether the introduction and reward of cooperation would increase biophilia, and decrease aggression, in a population. In Studies One to Six, a trait biophilia scale was developed and psychometric validity and reliability established. In Studies Seven to Nine, scale predictive validity in comparison to existing trait measures was investigated in theoretically appropriate areas including online behaviour, positive psychology and pro-environmental behaviour. In Study Ten, a game theory paradigm for introducing and rewarding cooperation was developed, and the relationships among biophilia, cooperation and aggression were investigated. Contrary to Fromm’s theory, a positive association between aggression and cooperation, and negative associations between those and biophilia, were found. In addition, the effects of introducing and rewarding cooperation were investigated, and again contrary to Fromm’s theory, introducing and rewarding cooperation produced an increase in aggression and a reduction in biophilia. These findings may reflect an inherent tension within Fromm’s theory between the use of existential needs, that were argued to be the product of competitive natural selection, and the use of cooperative interventions derived from Marxist theory. It is proposed that the relationships among biophilia, cooperation and aggression may be mediated by frustration. Implications for interventions and future research are discussed.
The aim of this paper is to clarify some important interpersonal dynamics that underpin forensic patients’ presentations within the clinical environment, in a way that is accessible to nurses. The world of forensic mental health nursing is often difficult to describe to those who have not experienced first hand prolonged clinical contact with patients at the therapeutic interface of secure services. Even then, the characteristic, intense emotional phenomena that tend to arise out of interpersonal relationships with patients and colleagues is not easy to articulate. Yet, for those of us who consider our professional identity to be one of >forensic mental health nurse,< it seems important to find a way to put words to what appears to occupy a large component of our working lives. More importantly, if we can develop a way to make sense of the way our work makes us feel and the way we can find ourselves relating to others within our professional roles, we will be in a better position to harness our energy and enthusiasm in the service of supporting forensic patients towards effective care and treatment pathways. Of course, forensic patients are supported through services with or without a framework for articulating emotional and interpersonal experiences. However, this frequently occurs in the context of significant struggle. For patients, this struggle is often characterized by difficulty communicating what their needs are, and for nurses this struggle is often characterized by feeling emotionally overwhelmed by their task of providing containing, therapeutic relationships for patients whose interpersonal needs are not clear to them. This article will use case examples to describe some of the complex interpersonal and emotional challenges faced by forensic nurses, and explain how a psychodynamic framework could support nursing practice in each of the case examples.
Far more long before the >interdisciplinarity< as a concept, become a prominent issue in scientific and philosophical developments, many thinkers and philosophers have investigated interdisciplinary. Erich Fromm is one of the distinguished contemporary intellectuals who have applied interdisciplinarity as the way of investigation. Here, we attempt to follow interdisciplinarity and border-crossing in his works. Studying social and political crisis of the modem society, Fromm realized that it is rooted in human's psycho-existential characteristics on the one hand, and the socio-political status of, the modern society on the other; which only >love< and >creative work< can treat. In Fromm's view, neither political nor psychological analysis can offer a comprehensive understanding of what is going on in the society; rather a combination of the two. Thus, he believes in the necessity of border-crossing. >Love< as the >psycho-political< is the core of Fromm's interdisciplinary study of the modem society.