Hillel Braude - Academia.edu (original) (raw)
Papers by Hillel Braude
University of Illinois Press eBooks, Nov 16, 2018
Autism 360°
Abstract Brain growth and development occurs most rapidly during a child's first two years of... more Abstract Brain growth and development occurs most rapidly during a child's first two years of life. This accelerated pace of neurodevelopment suggests that the earlier the intervention for ASD, the greater the likelihood of producing a positive therapeutic outcome. This study evaluated effectiveness of early intervention among two groups of infants and toddlers diagnosed with autism who underwent the Mifne Approach. The first group consisted of 39 toddlers aged 24-36 months; and the second group consisted of 45 infants aged 12-24 months. Clinical variables analyzed were divided into four categories – Engagement, Communication, Play, and Functioning. While both groups of infants and toddlers benefited from the therapeutic intervention, the infants demonstrated more statistically significant improvements across all measured variables. These findings support the clinical hypothesis emphasizing the importance of early diagnosis and treatment for infants with ASD from 12 months of age.
My methodology in this review is to provide philosophical reflection on aspects of Thinking and D... more My methodology in this review is to provide philosophical reflection on aspects of Thinking and Doing that speak to the association between Moshe Feldenkrais and the Method that he spent a lifetime developing. This reflective method is particularly appropriate, since as with few other disciplines, Feldenkrais the person, and the development of his Method exploring the physical basis of human conscious experience, are so intertwined. Tracing the conscious and unconscious influences on Feldenkrais’ development is akin to determining the “phenomenological clues” (Leitfaden), which point back to various modes of consciousness (Zaner 1981:173). Reviewing Thinking and Doing with hindsight knowledge of the Feldenkrais Method is a bit like the detective who starts off with the clear knowledge of the villain, but who still needs to retrace the actual course of events leading to the fatal murder. (See, in this Volume of the Feldenkrais Research Journal, Sondra Fraleigh’s application of the de...
Service marks: The terms Feldenkrais®, Feldenkrais Method®, Awareness Through Movement®, A... more Service marks: The terms Feldenkrais®, Feldenkrais Method®, Awareness Through Movement®, ATM®, Functional Integration®, and FI® are service marked terms of the International Feldenkrais ® Federation (IFF) and Feldenkrais professional guilds and associations in many countries. In keeping with academic conventions, they will not be service marked in the entire text as may be required in nonacademic use, but only for the first and most prominent use of the terms. In recognition that these phrases are formal terms referring to specific practices within the Method, and to the Method as a whole, capitalization of all the words in each term has been retained.
University of Illinois Press, 2017
In this chapter, the author discusses the radical transformative power of somatics and the ways t... more In this chapter, the author discusses the radical transformative power of somatics and the ways that somatics practice directly affects the precognitive sensibility of the Other; he calls this transformation of the Other “somatics affecting.” Drawing on his current research that integrates approaches to medicine and somatics in the emergent field of neuroethics, the author explains how somatics, especially through kinesthesia, provides a means of bridging the distinct realms of phenomenology and neuroscience. To this end, he analyzes the transformative qualities of somatics in terms of neurobiology and phenomenology, and especially the radical idea adapted from the phenomenological writings of Maurice Merleau-Ponty and Emmanuel Levinas. He elucidates the relation between somatics and phenomenonology as disciplines of subjectivity by linking them to the natural sciences. Finally, he illustrates the transformative potential of somatics affecting through a comparison with the social ne...
Theoretical Medicine and Bioethics, 2016
Handbook of the Philosophy of Medicine, 2015
The terms “skilled know-how,” “virtuosity,” and “expertise” all denote forms of technical mastery... more The terms “skilled know-how,” “virtuosity,” and “expertise” all denote forms of technical mastery. Applied to medicine they refer to different aspects of medical expertise. Yet, what exactly is medical expertise? Is it a kind of cognition, or action, or a combination of both? Additionally, what aspects of clinical practice does technical expertise refer to? In this chapter technical expertise in clinical practice is analyzed in terms of three identified components: cognition, motoric action, and interpersonal relations. Furthermore, the three components of technical mastery are related to Aristotle’s concept of practical wisdom, or phronesis. In his Nicomachean Ethics, Aristotle differentiated between two different forms of human action: techne and phronesis. In broad terms techne refers to an action that results in the production of external objects, while phronesis refers to an action that has its end in itself. This distinction provides the architectonic keystone of this analysis of expertise in clinical practice. This approach presents an alternative to the predominant cognitive conception H.D. Braude (*) The Mifne Center, Rosh Pinna, Israel e-mail: hillel.braude@mcgill.ca # Springer Science+Business Media Dordrecht 2015 T. Schramme, S. Edwards (eds.), Handbook of the Philosophy of Medicine, DOI 10.1007/978-94-017-8706-2_68-1 1 of technical expertise in clinical practice. A full understanding of technical expertise, skilled know-how, and virtuosity is not possible without highlighting the important role of intentionality in action and other forms of pre-reflective knowing in clinical practice. Definition of Key Terms Action A movement of the body, resulting from specific mental preparation and aimed at some goal that the agent desires to achieve. Cognition All mental processes related to knowledge, including but not limited to memory, attention, perception, representational schemas, consciousness, and language. Doctrine of double effect Ethical principle that gives moral legitimacy to an equivocal action provided that the good and not harmful effect is intended, even though the unintended harmful effect may be foreseen. Metacognition The processes involved in thinking about and monitoring one’s own cognitive activity. Phenomenological introspection Philosophical method to become self-aware of prereflective states of consciousness. Praxis Practical activity that is intended to further human well-being or the good and is not associated with any particular end product external to the act. Poiesis Any human activity that results in a product external to the human activity itself. Phronesis The moral capability to evaluate the means and ends of a particular action. In clinical reasoning phronesis affords the means of linking and integrating different cognitive processes. Tacit Knowing Knowledge that functions at the periphery of attention and makes explicit knowledge possible. Techne An action associated with craftsmanship, resulting in the production of external objects. 2 H.D. Braude
Theoretical Medicine and Bioethics, 2015
Philosophy, Psychiatry & Psychology
Drawing on philosophical ideas about suffering and neurobiological research on pain, this paper a... more Drawing on philosophical ideas about suffering and neurobiological research on pain, this paper analyzes the question of suffering as a clinical entity. In particular it provides a critical re-examination of physician and medical humanist Eric Cassell’s classic study, The Nature of Suffering. Two continental philosophers—Karl Jaspers and Emmanuel Levinas—provide different philosophical critiques of suffering that are useful for this analysis. Jaspers provides an immanent “ontological” critique of the medicalization of subjectivity, whereas Levinas provides a critique of suffering as transcendent to cognitive conceptualization. Literature in the neurobiology of placebos and pain provides a useful tool with which to navigate through the philosophical question of whether suffering should be treated as a medical phenomenon.
Philosophy, Psychiatry & Psychology
The title of my paper, “Affecting the Body and Transforming Desire,” (Braude 2012a) is inspired f... more The title of my paper, “Affecting the Body and Transforming Desire,” (Braude 2012a) is inspired from Plato’s Symposium, where the physician Eryximachus presents a purely neurophysiological discourse on love. James Giordano’s and Gerrit Glas’s commentaries on my paper have the timbre of a contemporary symposium, in this instance to discern the nature of suffering. Thus, I take Giordano’s and Glas’s commentaries to be generally sympathetic to my offering, although providing further critical insights that deepen the multidimensional understanding of suffering and the correct ethical and medical response. From different perspectives both commentators zone in on one central aspect of my analysis, that is, the importance of hermeneutic approaches in the way that medical practitioners deal with pain and suffering. Giordano cites Karl Jaspers to support the idea that effectively treating pain requires both acknowledging the “facts and realities of pain” and translating these into the “thera...
Social Science & Medicine, 2009
Theoretical Medicine and Bioethics, 2009
Despite its phenomenal success since its inception in the early nineteen-nineties, the evidence-b... more Despite its phenomenal success since its inception in the early nineteen-nineties, the evidence-based medicine movement has not succeeded in shaking off an epistemological critique derived from the experiential or tacit dimensions of clinical reasoning about particular individuals. This critique claims that the evidence-based medicine model does not take account of tacit knowing as developed by the philosopher Michael Polanyi. However, the epistemology of evidence-based medicine is premised on the elimination of the tacit dimension from clinical judgment. This is demonstrated through analyzing the dichotomy between clinical and statistical intuition in evidence-based medicine's epistemology of clinical reasoning. I argue that clinical epidemiology presents a more nuanced epistemological model for the application of statistical epidemiology to the clinical context. Polanyi's theory of tacit knowing is compatible with the model of clinical reasoning associated with clinical epidemiology, but not evidence-based medicine.
Theoretical Medicine and Bioethics, 2011
Journal of Medicine and Philosophy, 2013
This paper compares clinical intuition and phenomenological intuition. I begin with a brief analy... more This paper compares clinical intuition and phenomenological intuition. I begin with a brief analysis of Husserl's conception of intuition. Second, I review the attitude toward clinical intuition by physicians and philosophers. Third, I discuss the Aristotelian conception of intellectual intuition or nous and its relation to phronesis. Phronesis provides a philosophical ground for clinical intuition by linking medicine as both a techné and praxis. Considering medicine as a techné, Pellegrino and Thomasma exclude clinical intuitions from their philosophy of medicine. However, in modeling clinical reasoning on phronesis, they link Aristotelian nous with clinical reasoning. While supporting the application of phronesis to clinical reasoning, I consider Pellegrino and Thomasma's model deficient for eliminating intuition as an inalienable element of clinical reasoning. Rather, clinical intuitions are necessary in linking medicine as both art and practice. This becomes more obvious through the phenomenological analysis of clinical intuitions. Clinical reasoning and phenomenological intuitions are similar in joining the perceptual and intellectual aspects of human judgment. Furthermore, clinical intuitions can be extended to become phenomenological intuitions through phenomenological reflection. Clinical intuitions may be examined phenomenologically for their originary foundations. In this way, medicine acts as a phenomenological clue. Phenomenology provides a method to restore the Hippocratic synthesis of empirical observation and wholism associated with clinical intuitions.
University of Illinois Press eBooks, Nov 16, 2018
Autism 360°
Abstract Brain growth and development occurs most rapidly during a child's first two years of... more Abstract Brain growth and development occurs most rapidly during a child's first two years of life. This accelerated pace of neurodevelopment suggests that the earlier the intervention for ASD, the greater the likelihood of producing a positive therapeutic outcome. This study evaluated effectiveness of early intervention among two groups of infants and toddlers diagnosed with autism who underwent the Mifne Approach. The first group consisted of 39 toddlers aged 24-36 months; and the second group consisted of 45 infants aged 12-24 months. Clinical variables analyzed were divided into four categories – Engagement, Communication, Play, and Functioning. While both groups of infants and toddlers benefited from the therapeutic intervention, the infants demonstrated more statistically significant improvements across all measured variables. These findings support the clinical hypothesis emphasizing the importance of early diagnosis and treatment for infants with ASD from 12 months of age.
My methodology in this review is to provide philosophical reflection on aspects of Thinking and D... more My methodology in this review is to provide philosophical reflection on aspects of Thinking and Doing that speak to the association between Moshe Feldenkrais and the Method that he spent a lifetime developing. This reflective method is particularly appropriate, since as with few other disciplines, Feldenkrais the person, and the development of his Method exploring the physical basis of human conscious experience, are so intertwined. Tracing the conscious and unconscious influences on Feldenkrais’ development is akin to determining the “phenomenological clues” (Leitfaden), which point back to various modes of consciousness (Zaner 1981:173). Reviewing Thinking and Doing with hindsight knowledge of the Feldenkrais Method is a bit like the detective who starts off with the clear knowledge of the villain, but who still needs to retrace the actual course of events leading to the fatal murder. (See, in this Volume of the Feldenkrais Research Journal, Sondra Fraleigh’s application of the de...
Service marks: The terms Feldenkrais®, Feldenkrais Method®, Awareness Through Movement®, A... more Service marks: The terms Feldenkrais®, Feldenkrais Method®, Awareness Through Movement®, ATM®, Functional Integration®, and FI® are service marked terms of the International Feldenkrais ® Federation (IFF) and Feldenkrais professional guilds and associations in many countries. In keeping with academic conventions, they will not be service marked in the entire text as may be required in nonacademic use, but only for the first and most prominent use of the terms. In recognition that these phrases are formal terms referring to specific practices within the Method, and to the Method as a whole, capitalization of all the words in each term has been retained.
University of Illinois Press, 2017
In this chapter, the author discusses the radical transformative power of somatics and the ways t... more In this chapter, the author discusses the radical transformative power of somatics and the ways that somatics practice directly affects the precognitive sensibility of the Other; he calls this transformation of the Other “somatics affecting.” Drawing on his current research that integrates approaches to medicine and somatics in the emergent field of neuroethics, the author explains how somatics, especially through kinesthesia, provides a means of bridging the distinct realms of phenomenology and neuroscience. To this end, he analyzes the transformative qualities of somatics in terms of neurobiology and phenomenology, and especially the radical idea adapted from the phenomenological writings of Maurice Merleau-Ponty and Emmanuel Levinas. He elucidates the relation between somatics and phenomenonology as disciplines of subjectivity by linking them to the natural sciences. Finally, he illustrates the transformative potential of somatics affecting through a comparison with the social ne...
Theoretical Medicine and Bioethics, 2016
Handbook of the Philosophy of Medicine, 2015
The terms “skilled know-how,” “virtuosity,” and “expertise” all denote forms of technical mastery... more The terms “skilled know-how,” “virtuosity,” and “expertise” all denote forms of technical mastery. Applied to medicine they refer to different aspects of medical expertise. Yet, what exactly is medical expertise? Is it a kind of cognition, or action, or a combination of both? Additionally, what aspects of clinical practice does technical expertise refer to? In this chapter technical expertise in clinical practice is analyzed in terms of three identified components: cognition, motoric action, and interpersonal relations. Furthermore, the three components of technical mastery are related to Aristotle’s concept of practical wisdom, or phronesis. In his Nicomachean Ethics, Aristotle differentiated between two different forms of human action: techne and phronesis. In broad terms techne refers to an action that results in the production of external objects, while phronesis refers to an action that has its end in itself. This distinction provides the architectonic keystone of this analysis of expertise in clinical practice. This approach presents an alternative to the predominant cognitive conception H.D. Braude (*) The Mifne Center, Rosh Pinna, Israel e-mail: hillel.braude@mcgill.ca # Springer Science+Business Media Dordrecht 2015 T. Schramme, S. Edwards (eds.), Handbook of the Philosophy of Medicine, DOI 10.1007/978-94-017-8706-2_68-1 1 of technical expertise in clinical practice. A full understanding of technical expertise, skilled know-how, and virtuosity is not possible without highlighting the important role of intentionality in action and other forms of pre-reflective knowing in clinical practice. Definition of Key Terms Action A movement of the body, resulting from specific mental preparation and aimed at some goal that the agent desires to achieve. Cognition All mental processes related to knowledge, including but not limited to memory, attention, perception, representational schemas, consciousness, and language. Doctrine of double effect Ethical principle that gives moral legitimacy to an equivocal action provided that the good and not harmful effect is intended, even though the unintended harmful effect may be foreseen. Metacognition The processes involved in thinking about and monitoring one’s own cognitive activity. Phenomenological introspection Philosophical method to become self-aware of prereflective states of consciousness. Praxis Practical activity that is intended to further human well-being or the good and is not associated with any particular end product external to the act. Poiesis Any human activity that results in a product external to the human activity itself. Phronesis The moral capability to evaluate the means and ends of a particular action. In clinical reasoning phronesis affords the means of linking and integrating different cognitive processes. Tacit Knowing Knowledge that functions at the periphery of attention and makes explicit knowledge possible. Techne An action associated with craftsmanship, resulting in the production of external objects. 2 H.D. Braude
Theoretical Medicine and Bioethics, 2015
Philosophy, Psychiatry & Psychology
Drawing on philosophical ideas about suffering and neurobiological research on pain, this paper a... more Drawing on philosophical ideas about suffering and neurobiological research on pain, this paper analyzes the question of suffering as a clinical entity. In particular it provides a critical re-examination of physician and medical humanist Eric Cassell’s classic study, The Nature of Suffering. Two continental philosophers—Karl Jaspers and Emmanuel Levinas—provide different philosophical critiques of suffering that are useful for this analysis. Jaspers provides an immanent “ontological” critique of the medicalization of subjectivity, whereas Levinas provides a critique of suffering as transcendent to cognitive conceptualization. Literature in the neurobiology of placebos and pain provides a useful tool with which to navigate through the philosophical question of whether suffering should be treated as a medical phenomenon.
Philosophy, Psychiatry & Psychology
The title of my paper, “Affecting the Body and Transforming Desire,” (Braude 2012a) is inspired f... more The title of my paper, “Affecting the Body and Transforming Desire,” (Braude 2012a) is inspired from Plato’s Symposium, where the physician Eryximachus presents a purely neurophysiological discourse on love. James Giordano’s and Gerrit Glas’s commentaries on my paper have the timbre of a contemporary symposium, in this instance to discern the nature of suffering. Thus, I take Giordano’s and Glas’s commentaries to be generally sympathetic to my offering, although providing further critical insights that deepen the multidimensional understanding of suffering and the correct ethical and medical response. From different perspectives both commentators zone in on one central aspect of my analysis, that is, the importance of hermeneutic approaches in the way that medical practitioners deal with pain and suffering. Giordano cites Karl Jaspers to support the idea that effectively treating pain requires both acknowledging the “facts and realities of pain” and translating these into the “thera...
Social Science & Medicine, 2009
Theoretical Medicine and Bioethics, 2009
Despite its phenomenal success since its inception in the early nineteen-nineties, the evidence-b... more Despite its phenomenal success since its inception in the early nineteen-nineties, the evidence-based medicine movement has not succeeded in shaking off an epistemological critique derived from the experiential or tacit dimensions of clinical reasoning about particular individuals. This critique claims that the evidence-based medicine model does not take account of tacit knowing as developed by the philosopher Michael Polanyi. However, the epistemology of evidence-based medicine is premised on the elimination of the tacit dimension from clinical judgment. This is demonstrated through analyzing the dichotomy between clinical and statistical intuition in evidence-based medicine's epistemology of clinical reasoning. I argue that clinical epidemiology presents a more nuanced epistemological model for the application of statistical epidemiology to the clinical context. Polanyi's theory of tacit knowing is compatible with the model of clinical reasoning associated with clinical epidemiology, but not evidence-based medicine.
Theoretical Medicine and Bioethics, 2011
Journal of Medicine and Philosophy, 2013
This paper compares clinical intuition and phenomenological intuition. I begin with a brief analy... more This paper compares clinical intuition and phenomenological intuition. I begin with a brief analysis of Husserl's conception of intuition. Second, I review the attitude toward clinical intuition by physicians and philosophers. Third, I discuss the Aristotelian conception of intellectual intuition or nous and its relation to phronesis. Phronesis provides a philosophical ground for clinical intuition by linking medicine as both a techné and praxis. Considering medicine as a techné, Pellegrino and Thomasma exclude clinical intuitions from their philosophy of medicine. However, in modeling clinical reasoning on phronesis, they link Aristotelian nous with clinical reasoning. While supporting the application of phronesis to clinical reasoning, I consider Pellegrino and Thomasma's model deficient for eliminating intuition as an inalienable element of clinical reasoning. Rather, clinical intuitions are necessary in linking medicine as both art and practice. This becomes more obvious through the phenomenological analysis of clinical intuitions. Clinical reasoning and phenomenological intuitions are similar in joining the perceptual and intellectual aspects of human judgment. Furthermore, clinical intuitions can be extended to become phenomenological intuitions through phenomenological reflection. Clinical intuitions may be examined phenomenologically for their originary foundations. In this way, medicine acts as a phenomenological clue. Phenomenology provides a method to restore the Hippocratic synthesis of empirical observation and wholism associated with clinical intuitions.