The nocebo effect : a clinicians guide

Objective: This paper aims to provide an overview on the nocebo effect, focusing on recognition — its phenomenology, at-risk demographic profiles, clinical situations and personality factors, as well as discriminating somatic symptoms in the general population from treatment-related adverse effects. Lastly, the paper addresses available evidence-based strategies for management and minimisation of the nocebo effect.

Method: Data for this paper were identified by searching PubMed using the search terms "nocebo" and “nocebo effect”, augmented by a manual search of the references of the key papers and the related literature.

Results: The nocebo effect refers to non-pharmacodynamic, harmful or undesirable effects occurring after inactive treatment, a phenomenon that also occurs in the context of active therapy. Known drivers include classical conditioning and negative expectations concerning treatment. Recent meta-analyses have reported a considerable prevalence, ranging from 18% in the symptomatic treatment of migraine, to more than 74% in multiple sclerosis. Recognition of the nocebo-driven adverse effects presents a challenge, especially because of its non-specific nature and the similarity to the active medication’s expected profile. Traits such as neuroticism, pessimism and type A personalities may predispose individuals to this phenomenon. Clinical management of the nocebo effect includes awareness and recognition, changing the manner of disclosure of potential drug-related adverse effects, shaping patients’ expectations and enhancing the treatment alliance.

Conclusion: The nocebo effect is a common, clinically significant, yet covert driver of clinical outcomes. Increased awareness of its features, as well as knowledge of strategies on how to manage it, are fundamental so that clinicians can mitigate its impact on clinical practice.

The online identity : towards a hermeneutic phenomenological approach

In order to better understand how artists working in countercultural or ‘fringe’ creative practice use social media to create online persona I am using a hermeneutic phenomenological approach to investigate the lived experience of both online and offline persona creation by tattoo artists, street artists, craftivists, and slam poets. The use of phenomenology to investigate artists’ lived experience is particularly appropriate, as ‘artists are involved in giving shape to their lived experience, the products of art are, in a sense, lived experienced transformed into transcended configurations’ (Van Manen 2006: 74). This paper will outline the methodological underpinnings of this project, using these underpinnings to explore the benefits offered by phenomenology to internet studies.

Understanding how people use online social media sites to construct personas can benefit greatly from understanding the lived experience of those who use these technologies, the decisions they make in persona construction, and the online/offline, public/private continuums. A phenomenological approach ‘seeks to revel and richly portray the nature of human phenomena and the experiences of those who live through them’ (Grace & Ajjawi 2010: 197) and offers both the researchers and the participants a way to interrogate and interpret the experience of constructing online personas. A phenomenological approach allows for ‘an intimate awareness and deep understanding’ (Saldana, Leavy & Bertvas 2011: 8) of the experience of persona construction in online and offline spaces, and could equally be used to interrogate other aspects of internet use. 

The artist in a networked society

Artists are under pressure from two conflicting sets of sociocultural expectations. On the one hand, they are expected to conform to the historically grounded myth of the artist as heroic genius. On the other hand, they must meet the expectations of the state (plus ensure their own survival) as economic contributors. One way  that these conflicting pressures are managed by artists working within the traditional art world is by separating the creator from the labourer through the use of intermediaries such as dealer galleries, critics, publishers and agents. This allows the artist to symbolically distance themselves from the economic structures that allow them to continue to work. However, for those artists working outside of these systems of support, legitimization and representation, the positioning of the individual as ‘artist’ becomes a much more complex task.

The construction of artists persona in online spaces can be seen most clearly in those artists who operate outside of the traditional art world. Lacking the symbolic distance between the economic producer and the bohemian, mythical genius, these individual artists instead negotiate a place to stand in direct relation to  their audience of fans, followers and audiences. Using examples from a range of fringe, alternative or counter-culture creative practice, this paper investigates artistic persona by linking the artist myth, economic considerations, and networked society to explore current presentation strategies. 

Ghosts in the machine : do the dead live on in Facebook?

Of the many ways in which identity is constructed and performed online, few are as strongly ‘anchored’ to existing offline relationships as in online social networks like Facebook and Myspace. These networks utilise profiles that extend our practical, psychological and even corporeal identity in ways that give them considerable phenomenal presence in the lives of spatially distant people. This raises interesting questions about the persistence of identity when these online profiles survive the deaths of the users behind them, via the practice of ‘memorialising’ social network profile pages. I situate these practices within a phenomenology of grief that accounts for the ways in which the dead can persist as moral patients, and show how online survival in this case illuminates an important difference between persons and selves within contemporary philosophy of personal identity. Ultimately, the online persistence of the dead helps bring into view a deep ontological contradiction implicit in our dealings with death: the dead both live on as objects of duty and yet completely cease to exist.

Sense of place in urban natural landscapes

Landscape perception from the cultural ecology perspective can help us understand what urban natural landscapes mean to people from different cultures, and how they make sense of place through landscape experience. While there are key anthropological studies on culture and environment, there is not extensive literature about how post-war and more recent immigrants appropriate, use and perceive natural environments? And do migrants' culture and experience of nature in their previous places of dwelling affect their perception and experience in a new landscape? In a global world conditioned by mobility, it may be important to understand the factors that affect immigrants' perception of place and the phenomenon of the sense of belonging as mediated by their approach to nature. This paper explores the experience of migration in relation to urban natural landscapes, and studies the role of natural environments in their place making and identity.

Narrative inquiry and auto-ethnography: Interpretive approaches to research

Hermeneutic phenomenology informed two qualitative methodologies used in my doctoral research: narrative case studies and auto-ethnography. Through these methodologies I investigated the phenomenon of place and identity in visual artistic practice. Four narrative case studies of four artists were developed using experience-focused narrative inquiry and thematic analysis. Auto-ethnography was used to investigate the phenomenon of place and identity within my own practice as visual artist. This involved analysis of my artworks that encompassed place and identity and writing from different contexts of my past. Rather than relying on memory recall. This became textural writing in the phenomenon rather than describing what I already knew. This enabled me to challenge conventional ways of telling my story (big stories) and produced “small stories” from which new insights could be interpreted. The insights gained from my auto-ethnography in turn assisted me to encourage story telling to find the small stories of my artist participants.

Integrating the human factor into the holistic understanding of sustainability

Using a number of literary sources with sustainable design and architectural phenomenology as their foundation, this paper uses Integral theory, drawing on the writings of Ken Wilber and Mark DeKay to justify the importance of human architectural experience in the holistic view of sustainable design. The literature critiques modern practices and ideas of sustainability and identifies factors that contribute towards the success of sustainable building. It explores the implications for an Integral approach to sustainable design and then uses it to analyse the relationships that exist between the objective and the subjective value spheres of Integral theory.

Time, philosophy and chronopathologies

This essay is an elaboration on some central themes and arguments from my recent book, Chronopathologies: Time and Politics in Deleuze, Derrida, Phenomenology and Analytic Philosophy (Rowman and Littlefield 2012). There is hence an element of generality to this essay that the book itself is better able to justify. But a short programmatic piece has its own virtues, especially for those of us who are time poor (which is pretty much everyone in contemporary academia). Moreover, it adds a dimension to the above book by more explicitly situating it in relation to what is an emerging view in some recent scholarship (such as John McCumber, Len Lawlor, David Hoy, and before this Liz Grosz) that time is central to the identity of continental philosophy, as well as considering some of the work that in different ways contests this kind of interpretation of the identity of continental philosophy (e.g. Simon Glendinning, and, tacitly, Paul Redding). In continuing to side with the former over the latter, I will also develop my argument that time is one of the most significant factors in the divided house that I think ontemporary philosophy remains, and I conclude by offering a series of negative prescriptions regarding how we might better avoid particular chronopathologies, or time-sicknesses, that are endemic to these philosophical trajectories, and that are also present (to greater and lesser degrees) in the majority of individual philosophers standardly labeled analytic and continental. To the extent that such sicknesses are at least partly inevitable, akin to a transcendental illusion, this paper consists in a call to be more attentive to this tendency, and to the methodological, metaphilosophical, and ethico-political consequences that follow from them.

Merleau-Ponty: Key Concepts

Having initially not had the attention of Sartre or Heidegger, Merleau-Ponty’s work is arguably now more widely influential than either of his two contemporaries. Merleau-Ponty: Key Concepts presents an accessible guide to the core ideas which structure Merleau-Ponty’s thinking as well as to his influences and the value of his ideas to a wide range of disciplines. The first section of the book presents the context of Merleau-Ponty’s thinking, the major debates of his time, particularly existentialism, phenomenology, the history of philosophy and the philosophy of history and society. The second section outlines his major contributions and conceptual innovations. The final section focuses upon how his work has been taken up in other fields besides philosophy, notably in sociology, cognitive science, health studies and feminism.

Squatting at the digital campfire: researching the open source software community

This paper describes an internet-mediated netnography of the open source software (OSS) community. A brief history of OSS is presented, along with a discussion of the defining characteristics of the phenomenon. A theoretical rationale for the method is then offered and several unique features detailed. The evolution of the methodology in practice is described and salient lessons highlighted. In addition to gathering a large volume of rich data as intended, early phases of the implementation of this method produced a number of unanticipated but significant findings. The paper concludes by summarising the key methodological considerations for conducting a phenomenology of a true online community

Interpretative phenomenological analysis

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