The concepts of medicine and health are becoming conflated. This can be seen in the language of medicine and health: medicine is discussed in terms of health and health in terms of medicine. A review of literature by medicine and health scholars gives evidence of the conflation and of its effects. The collapse of two concepts into one constrains the development and utilization of medicine and the meaning and pursuit of health. The conflation also obscures the distinction and separate relevance of disease and illness to both medicine and health. The claim is that medicine and health are distinct concepts and that a recognition of them as separate is beneficial. Medicine is a means for humans. Health is an end of humans and is the prototypical condition of "how life ought to be." An understanding of medicine and health as separate concepts is beneficial to the development and utilization of medicine and to the meaning and pursuit of health. Furthermore, the separation of medicine and health clarifies the importance of medicine to disease and the significance of illness to health. / Graduation date: 2003

Diss. Linköping : Univ.

In “Bodies of Wisdom,” I reassert the primacy of the body in the philosophical practices of two early modern French authors, Michel de Montaigne (1533-1592) and Blaise Pascal (1623-1662), whose writings have been associated with the ancient tradition of “philosophy as a way of life.” Harkening back to the Classical understanding of philosophy as a form of medicine, these authors’ works rely a good deal on somatic and/or medical terminology to describe states of the soul and philosophical practices more generally. While there exists a wide body of literature that addresses the medical analogy in Hellenistic philosophers, few commentators have ventured to read the analogy literally, and none thus far have done so for authors of the early modern period. In this dissertation, I reclaim the literal relationship between medicine and philosophy by examining instances in both authors where descriptions of health and illness can be read both metaphorically (“spiritually”) and literally (“somatically”). Philosophy is not just like medicine in that it seeks to bring about individual well-being; it is medicine in the fullest sense, because the exercises intended to bring about well-being must pass through the body in order to give lasting shape to the life of the practitioner. Many scholars have acknowledged Pascal’s inheritance of Montaigne’s moderate skepticism, and as one of history’s most astute – and sometimes acerbic – readers of Montaigne, Pascal was uniquely poised to highlight those aspects of Montaigne’s philosophy that attenuated the reader’s belief in the power of human reason. This meant that for both authors, there had to be some more reliable alternative to the reasoning mind to arrive at an understanding of truth. The body, it turns out, served just such a purpose. Although Montaigne and Pascal had very different purposes in writing the Essais and the Pensées, respectively, I show how a mutual concern for empirical certainty amidst the tenuousness of philosophical and religious opinion precipitated a return to bodily experience, as the most viable means of knowing the self and the world. Despite the widespread conception of the early modern period as one of “thoroughgoing” – and one might say, Cartesian – dualism between body and mind, I argue that Montaigne and Pascal are evidence of a countertrend: their writings suggest that we cannot think our way to philosophical virtue; we must enact that virtue through our bodies, using them as tools for interpretation and modification of our internal states. I thereby call into question a distinction that is commonly made between somatic techniques, on the one hand, and spiritual exercises, on the other, in much of the literature on philosophy as a way of life. The implications of this are far-reaching: if the suffering that philosophy purports to treat is at once spiritual and somatic, then the “spiritual” exercises designed to address this suffering also borrow a great deal from the soma, and should be advertised as such. Further, if spiritual health is indeed contingent on our relationship to the soma, then the classic definition of philosophy as a “spiritual” practice (namely, one associated with the logos) needs to be expanded to include the material and/or somatic dimensions of the discipline. Although I try to provide a clear roadmap for how these authors go about spiritual healing, I recognize that the trajectory to spiritual health is seldom very direct. Surely, we can find examples of somatic exercises that appear to have a predictable effect on the mind and, inversely, spiritual exercises that yield positive physical results. However, the process of effecting change and training for virtue is almost never unidirectional. The constant trafficking between body and mind, evidenced most abundantly by the passions, belies a much less tidy relationship between the two faculties. To describe this relationship, I rely both on early modern medical therapeutics and on Pierre Bourdieu’s twentieth-century conception of habitus. Viewed through the lens of habitus, the practice of philosophy can be conceived as a process of embodiment, wherein the practitioner appropriates and accommodates in a bodily way the virtues traditionally aligned with the good life—before realizing that, as habitus, he or she is always, already well-adapted to the good and thus endowed with a certain form of health from the beginning.

What do religions do and how do they do it? In The Elementary Forms of Religious Life, Émile Durkheim claims that religions are “grounded in and express the real” and center upon a set of ritualized practices that enact and embody in a distinctively intense and potentially transformative form the truth regarding the constitutive relations in which we stand to one another. With the help of Heidegger’s account in “The Origin of the Work of Art” of the way in which works of art work, along with Kierkegaard’s relational account of the health and sickness of the self in The Sickness Unto Death, I attempt in this dissertation to develop an improved version of the basic Durkheimian picture. The central claim is that religious practices are in the game of cultivating and actively integrating the fundamental relationships upon which our being as persons in a most radical and literal sense depends. Where successful, the heightened modes of relationality enacted in such practices transform us into more active, vital, and unalienated agents capable of tackling the concrete normative situations in which we lead our lives. For these reasons, I argue that religious practices aren’t going and shouldn’t go anywhere. If anything, we have grounds for leaning into them more if we hope to develop the existential resources to tackle the various forms of relational breakdown that constitute the true ground of the problem of “disenchantment” and with which our alienated, lonely, and unjust world is saturated.

<b>Background:</b> Defined by their mechanisms, social and psychological interventions are those interventions that work through mental processes and social phenomena. They are often complex and challenging to evaluate, so understanding randomised controlled trials (RCTs) of these interventions requires detailed reports of the interventions tested and the methods used to assess them. However, reports of these RCTs often omit important information. Poor reporting hinders critical appraisal and synthesis of RCTs in systematic reviews, thereby impeding the effective transfer of research evidence to policy and practice. The Consolidated Standards for Reporting Trials (CONSORT) Statement is a reporting guideline that has contributed to improvements in the quality of RCT manuscripts in journals publishing medical research. However, studies have shown persistent deficiencies in the reporting quality of social and psychological intervention trials. A new CONSORT extension for these interventions may be needed given their distinct and complex features. This DPhil thesis reports on a project to develop and disseminate an official CONSORT Extension for Social and Psychological Interventions: CONSORT-SPI. <b>Structure:</b> Following a preface, this DPhil thesis includes eight chapters. Chapter 1 provides an overview of the conceptual rationale that prompted the CONSORT-SPI project. Chapter 2 details the project protocol, which consists of a five-phase methodology that follows current best practices for reporting guideline development and dissemination. Chapter 3 discusses systematic literature reviews to assess reporting guidelines for and the reporting quality of publications of social and psychological intervention RCTs. Chapter 4 discusses an online, international Delphi process to generate a prioritised list of possible items to include in the CONSORT-SPI extension. Chapter 5 discusses a formal consensus meeting to select reporting items to add to or modify for the CONSORT-SPI Extension checklist. Chapter 6 involves drafts of the CONSORT-SPI checklist as well as a template for the Explanation and Elaboration (E&E) document providing detailed advice and examples of good reporting for each checklist item. These drafts have not yet been circulated to co-authors or other members of the project team; their purpose in this thesis is to give an indication of how previous project phases have led into initial prototypes of the checklist and E&E, which will undergo further development and revision by the project team before publication. Chapter 7 proposes a coordinated dissemination and implementation strategy informed by theoretical frameworks and tools used to guide the implementation of clinical guidelines and empirically-supported interventions. The final chapter summarises the information gained from the CONSORT-SPI project to date, assesses strengths and limitations of the project methodology, and discusses implications for future research. <b>Conclusion:</b> A CONSORT-SPI Extension could improve the reporting quality of social and psychological intervention RCTs. This extension could also facilitate better critical appraisal of this body of research and its use in evidence-based decision-making. With successful dissemination and implementation, the guideline will hopefully contribute to the improvement of intervention evaluations—as well as the methodology underpinning these studies—within the social and behavioural sciences.