Undiagnosing St Joan: She Does Not Need a Medical or Psychiatric Diagnosis.

ABSTRACT: This article traces the history of Joan of Arc through her brief life that includes leading an army in defense of France at the age of 17 and ending with her death at the stake at the age of 19. In her activities, St Joan reported that she was guided by voices and visions in which she communicated with venerated spiritual figures such as St Michael and St Margaret. Questions have arisen about the nature of these experiences, and various medical and psychiatric diagnoses have been offered by contemporary experts. In our effort to evaluate the diagnostic proposals, we have examined the incidence of voices and visions in the Middle Ages, and we have followed that with a review of nonpathologic voice-hearing in our own era. We then move on to an analysis of some proposed medical and psychiatric diagnoses, all of which we find unconvincing. With this background, we argue that St Joan does not warrant a medical or psychiatric diagnosis. Such a conclusion, however, leaves us with another issue, that of Joan's achievements. How do we understand an adolescent being able to lead an army? Addressing this question proves more difficult than deciding whether St Joan warrants a diagnosis. In addition to her achievements in the war against Britain, Joan of Arc stands out as both the most documented person in Western civilization up until her era, and as the only person who has been both condemned and canonized by the Catholic Church.

Varieties of Religious (Non)Affiliation: A Primer for Mental Health Practitioners on the "Spiritual but Not Religious" and the "Nones".

Given changing demographics of religiosity and spirituality, this article aims to help clinicians understand contemporary trends in patient religious and spiritual orientation. It first identifies and describes the evolving varieties of religio-spiritual orientation and affiliation, as identified in survey studies. Particular attention is given to the examination of those who identify as spiritual but not religious (SBNR) and None (i.e., no religious affiliation), which is important to mental health practice because many patients now identify as SBNR or None. Next, empirical data are considered, including what the literature reveals regarding mental health outcomes and SBNRs and Nones. We conclude with a summary of the main points and five recommendations that mental health practitioners and researchers need to consider regarding this increasingly large portion of the population.

Religion and Psychiatry in the Age of Neuroscience.

In recent decades, an evolving conversation among religion, psychiatry, and neuroscience has been taking place, transforming how we conceptualize religion and how that conceptualization affects its relation to psychiatry. In this article, we review several dimensions of the dialogue, beginning with its history and the phenomenology of religious experience. We then turn to neuroscientific studies to see how they explain religious experience, and we follow that with two related areas: the benefits of religious beliefs and practices, and the evolutionary foundation of those benefits. A final section addresses neuroscientific and evolutionary accounts of the transcendent, that is, what these fields make of the claim that religious experience connects to a transcendent reality. We conclude with a brief summary, along with the unresolved questions we have encountered.

Post-treatment lyme syndrome and central sensitization.

Central sensitization is a process that links a variety of chronic pain disorders that are characterized by hypersensitivity to noxious stimuli and pain in response to non-noxious stimuli. Among these disorders, treatments that act centrally may have greater efficacy than treatments acting peripherally. Because many individuals with post-treatment Lyme syndrome (PTLS) have a similar symptom cluster, central sensitization may be a process mediating or exacerbating their sensory processing. This article reviews central sensitization, reports new data on sensory hyperarousal in PTLS, explores the potential role of central sensitization in symptom chronicity, and suggests new directions for neurophysiologic and treatment research.

From unity to atonement: Some religious correlates of Hans Loewald's developmental theory.

Loewald's understanding of ego development offers a way to conceptualise, from a psychoanalytic perspective, those aspects of religious experience that can reflect or contribute to the enrichment of the ego, in contradistinction to the defensive and regressive elements of religious experience that have been well detailed in the psychoanalytic literature in the past. In Loewald's view, a dynamic and metabolic interplay between ego and reality characterises the developmental process. With increasing levels of internalisation, differentiation, individuation and integration, ego and reality are restructured into increasingly resilient and durable forms. An ongoing dialectical tension between separation and reunion provides the driving force for development. Loewald's emphasis on the synthetic rather than defensive aspects of ego functioning forms the basis for his characterisation of sublimation as a 'genuine appropriation' rather than a defence, thus opening up one way to understand non-defensive aspects of religious experience from a psychoanalytic perspective. In the course of this exploration of Loewald's view of ego development and its implications for an understanding of religious experience, the author offers perspectives on Freud's views of religion, on some extreme forms of religious fundamentalism, and on the dynamics of 'mature' faith as illuminated by Loewald's developmental theory.