'A Home to the Lie': The Contemporary (Per)version of Truth

This paper explores the contemporary trend towards relativization and perversion of truth increasingly prominent in American culture, which, in Bion's terminology (1970), has become an ever more hospitable "home to the lie." The anti-COVID vaccine movement emerging in the United States in 2021, and its related network of conspiracy theories, is presented as an example. To make sense of these phenomena the author presents clinical vignettes illustrating (1) Bion's (1970) notions of catastrophic change, the lie/thinker relation, and the messianic idea; (2) Freud's (1921) thinking on group leaders; and (3) Matte-Blanco's (1975) bi-logical theory of mind. According to Bion, the lie is mobilized to avoid the psychological upheaval associated with catastrophic change. The author suggests that developments in American life experienced as threatening catastrophic change provide a hospitable environment for the lie, making the recognition of truth more elusive. In line with Matte-Blanco's bi-logical theory, the author suggests that creation of opportunities for dialogue giving weight to both conscious and unconscious ways of thinking is necessary for re-establishing a culture of truth.

On Bion's Concept of Truth in an Extra-Moral Sense

The paper explores the concept of truth in Bion's theory and in the post-Bionian context of the analytic field. Truth is addressed on three levels: epistemological, metapsychological, and clinical. Bion criticizes positivism in psychoanalysis, and the same vertex when it appears in psychoanalysis itself, stating that the search for truth at all costs is similar to the arrogance and stupidity of the psychotic part of the personality. He revolutionizes the analytic concept of truth by orienting it to the function of the emotional linking between analyst and patient rather than to content. Post-Bionian analytic theory further develops these concepts. In a field or radically intersubjective perspective, the author emphasizes the shift from an "I/you" perspective to a "we" perspective. The treatment is less about the abstract search for supposed truths and more about the truth being expressed in the process of emotional and affective attunement.

Human verifications: Computable with truth values outside logic

Cognitive scientists treat verification as a computation in which descriptions that match the relevant situation are true, but otherwise false. The claim is controversial: The logician Gödel and the physicist Penrose have argued that human verifications are not computable. In contrast, the theory of mental models treats verification as computable, but the two truth values of standard logics, true and false, as insufficient. Three online experiments (n = 208) examined participants' verifications of disjunctive assertions about a location of an individual or a journey, such as: 'You arrived at Exeter or Perth'. The results showed that their verifications depended on observation of a match with one of the locations but also on the status of other locations (Experiment 1). Likewise, when they reached one destination and the alternative one was impossible, their use of the truth value: could be true and could be false increased (Experiment 2). And, when they reached one destination and the only alternative one was possible, they used the truth value, true and it couldn't have been false, and when the alternative one was impossible, they used the truth value: true but it could have been false (Experiment 3). These truth values and those for falsity embody counterfactuals. We implemented a computer program that constructs models of disjunctions, represents possible destinations, and verifies the disjunctions using the truth values in our experiments. Whether an awareness of a verification's outcome is computable remains an open question.

"Put a mark on the errors": Seventeenth-century medicine and science

Error is a neglected epistemological category in the history of science. This neglect has been driven by the commonsense idea that its elimination is a general good, which often renders it invisible or at least not worth noticing. At the end of the sixteenth century across Europe, medicine increasingly focused on "popular errors," a genre where learned doctors addressed potential patients to disperse false belief about treatments. By the mid-seventeenth century, investigations into popular error informed the working methodology of natural philosophers, rather than just physicians. In 1646, Thomas Browne published Pseudodoxia Epidemica, a large volume on popular error. Despite Browne's formal training as a physician, this work examined only a few medical errors and instead aspired to be an encyclopedia of error. Pseudodoxia Epidemica was highly popular, running to six editions, and was known by the Fellows of the Royal Society. Influenced by Browne, alongside Bacon's theory of the idols, natural philosophic practice in the late sixteenth and seventeenth century developed a focus on error that revised traditional attention to the discovery of knowledge. Fellows such as Robert Boyle and Robert Hooke proposed new ways to secure truth under the far-reaching influence of Bacon's refutations of "natural human reason" distorted by false idols, of syllogistic logic, and of "theories," his label for traditional philosophical systems that bias thought toward falsity. In three parts, this article traces the progression in early modern scientific approaches to handling error, and especially medical error - from physicians' efforts to identify and eradicate it through collaborative effort, to the striking tension in Browne's work between seeking to eliminate error while also showing a marked tolerance for it, to the Royal Society's Baconian objective of instrumentalizing error to find truth. Error emerges as its own epistemic category that serves as a driving force toward knowledge production.

Repeatedly Encountered Descriptions of Wrongdoing Seem More True but Less Unethical: Evidence in a Naturalistic Setting

When news about moral transgressions goes viral on social media, the same person may repeatedly encounter identical reports about a wrongdoing. In a longitudinal experiment (N = 607 U.S. adults from Mechanical Turk), we found that these repeated encounters can affect moral judgments. As participants went about their lives, we text-messaged them news headlines describing corporate wrongdoings (e.g., a cosmetics company harming animals). After 15 days, they rated these wrongdoings as less unethical than new wrongdoings. Extending prior laboratory research, these findings reveal that repetition can have a lasting effect on moral judgments in naturalistic settings, that affect plays a key role, and that increasing the number of repetitions generally makes moral judgments more lenient. Repetition also made fictitious descriptions of wrongdoing seem truer, connecting this moral-repetition effect with past work on the illusory-truth effect. The more times we hear about a wrongdoing, the more we may believe it-but the less we may care.

Workers' Perspectives on Workplace Disclosure of Serious Mental Illness and Their Employers' Responses

Persons with serious mental illness are often reluctant to disclose their disability to an employer because of the intense stigma associated with their illness. Yet, disclosure may be desirable to gain access to employer-provided job accommodations, or to achieve other goals. In this article, we aimed to (1) describe the contexts in which workers in regular employment disclose a mental illness to their employer and (2) describe employer responses to disclosure, as perceived by the workers themselves. Semi-structured interviews were conducted with 40 workers, who were currently or formerly employed in a mainstream, regular job, post-onset of mental illness. Workers were asked to describe the circumstances that led to disclosure, and to describe their employers' responses to disclosure. Conventional content analysis was applied to identify common themes in the transcribed interviews. Analyses revealed five mutually exclusive disclosure contexts: seeking job accommodations, seeking protection, seeking understanding, responding to an employer's symptom-based inquiries, or being exposed by a third party or event. Analyses also revealed a wider range of employer responses-positive, negative, and ambiguous-than has been suggested by studies in which employers described their reactions to worker disclosure. Some themes were more prevalent among current versus former workers. Overall, the disclosure process appeared to be more complex than has been described by extant frameworks to date, and the linkages between disclosure contexts and employer response themes suggested that many workers did not receive the responses they were seeking from their employers.

Enforced Disappearances and Torture Today: A View from Analytical Psychology 2. Torture Survivors and the Unthinkable: A Hyper-Present Body in the Therapeutic Process: 2. Torture Survivors and the Unthinkable: A Hyper-Present Body in the Therapeutic Process1

In very rare cases, individuals survive the atrocities of abduction, imprisonment and torture that are part of the hallmark of enforced disappearances. Cases of people who survive torture and seek asylum in a third country help us understand some important aspects related to the crime of enforced disappearance. In the psychotherapy of torture survivors, at an early stage and for a long time, words often do not convey the core of the patient's experience. Survivors usually have tormented bodies in which individual and collective violence, hatred, anger, guilt and shame are painfully inscribed. Corporeal countertransference becomes the only possible way for a therapist to get in touch with a survivor's experience through a kind of body-to-body communication. The centrality of the body in these therapies suggests that the body is the involuntary recipient and container of mass political atrocities and, for this reason, the place where, in the case of horrific social violence, the possibility of social "knowing" is stored and can be retrieved. Thus, when it comes to forced disappearance, the determination of the relatives to get to the truth through the discovery of the remains of their disappeared demonstrates the importance of the body as the final witness of what happened, beyond any possible manipulation.

Spirituality in Surgery-A Double-Edged Scalpel

Investigating, respecting, and working with surgical patients' spiritualities is as critical a skill as the proficient technical performance of operations. When spirituality is ignored, sacred patient values remain undiscovered, authentic trust is hindered, and healthy shared decision-making processes suffer. These are instances when the other edge of the spiritual scalpel comes back to cut us as surgeons, but more importantly, upon withdrawal of spiritual understanding, it deeply injures our patients and their families. Spiritual screening, spiritual history taking, engaged, active listening, and big-picture prognostic truth-telling while promoting hope are critical skills for efficacious whole-person surgical care and the healing of our surgical patients' suffering-in all aspects of their humanity. These skills require surgeon introspection and vulnerability, however, as well as regular practice, and can be quite difficult; frequently leading to understandable discomfort, particularly when the surgeon does not share the patient's spiritual orientation or religious commitments. This literature-based essay addresses all of these issues, providing surgeons with a variety of new spiritual tools for their holistic armamentarium to promote healing, rather than further injury.

Beyond the pandemic: The truth of life after COVID-19

This study focused on how to deal with the psychological trauma from the perspective of a doctor on the front line of the fight against COVID-19. As the pandemic continues to ravage our world, post-pandemic psychological counseling urgently needs to be addressed. Based on the experience of fighting the epidemic, this study discusses the psychological changes since the COVID-19 outbreak in 2020. Taking a 19-year-old with breast cancer as an example, this study considered how to find spiritual comfort, and examined how to find meaning in today's complicated world and lives, as well as turning the crisis into an opportunity for spiritual renewal and adding meaning to our lives. It is hoped that this study will inspire readers to overcome the difficulties of the epidemic, find strength and see it as a life-changing opportunity.

George Orwell, objectivity, and the reality behind illusions

Illusions are commonly defined as departures of our percepts from the veridical representation of objective, common-sense reality. However, it has been claimed recently that this definition lacks validity, for example, on the grounds that external reality cannot possibly be represented truly by our sensory systems, and indeed may even be a fiction. Here, I first demonstrate how novelist George Orwell warned that such denials of objective reality are dangerous mistakes, in that they can lead to the suppression and even the atrophy of independent thought and critical evaluation. Second, anti-realists assume their opponents hold a fully reductionist metaphysics, in which fundamental physics describes the only ground truth, thereby placing it beyond direct human sensory observation. In contrast, I point to a more recent and commonly used alternative, non-reductive metaphysics. This ascribes real existence to many levels of dynamic systems of information, emerging progressively from the subatomic to the biological, psychological, social, and ecological. Within such a worldview the notion of objective reality is valid, it comes in part within the range of our senses, and thus a definition of illusions as kinds of deviations from veridical perception becomes possible again.

EXPRESS: What is required for the truth of a general conditional?

General conditionals, if p then q, can be used to make assertions about sets of objects. Previous studies have found that people generally judge the probability of one these conditionals to be the conditional probability of q given p, P(q|p). Two experiments investigated the qualitative relation between the exhaustive possibilities, p & q, p & ¬q, ¬p & q, and ¬p & ¬q, and truth and possibility judgments about general conditionals. In Experiment 1, for truth judgments, people evaluated a general conditional as "true" in sets containing p & q cases but no p & ¬q, and "true" judgments depended only on P(q|p). In Experiment 2, for possibility judgments, people's responses implied that only p & q cases have to be possible in a set for a general conditional to be true of the set. Our results add to earlier findings against representing a general conditional as the material conditional of extensional logic, and they provide novel disconfirmation of two recent proposals: the modal semantics of revised mental model theory and certain inferentialist accounts of conditionals. They supply new support for suppositional theories of conditionals.

Truth, hope and the disclosure of a dementia diagnosis: A scoping review of the ethical considerations from the perspective of the person, carer and clinician

This paper explores contemporary approaches to balancing truth with the provision of hope during the disclosure of a dementia diagnosis. We discuss the ethical significance of these practices as they relate to each member of the triad - the person, the carer and the clinician - at the point of diagnosis and beyond. The process of disclosing a diagnosis of dementia is complex. It encompasses breaking bad news while balancing hope, with truth about a progressive life-limiting condition. The process of receiving the diagnosis likewise challenges the person who may be unprepared for the diagnosis, while carers seek information and supports. The impact of receiving a diagnosis of dementia can be life-changing and harmful at the personal level - for both the person and carer. This risk of harm becomes a critical consideration for clinicians when deciding on the level of truth: what information should be relayed and to whom? That risk is also balanced against the ethical issue of patient autonomy, which includes the right to know (or not) and make informed decisions about therapeutic interventions. While the consensus is that the autonomy of the person living with dementia must be upheld, controversy exists regarding the extent to which this should occur. For instance, at diagnosis, it is common for clinicians to use euphemisms rather than the word dementia to maintain hope, even though people and carers prefer to know the diagnosis. This practice of therapeutic lying is a pervasive ethical issue in dementia care, made more acceptable by its roots in diagnosis disclosure.

Wired to Doubt: Why People Fear Vaccines and Climate Change and Mistrust Science

We all want to be right in our thinking. Vaccine hesitancy and global warming denial share much in common: (1) both are threats to personal, community and global health, (2) action is contingent on co-operation and social policy, and (3) public support relies on trust in science. The irony is, however, as the science has become more convincing, public opinion has become more divided. A number of early polls showed that ~70% of people supported COVID-19 vaccine use and global warming, ~20% adopted a wait-and-see approach, and ~10% were staunch objectors. Although these percentages are approximate, what factors are responsible for the differences in engagement, doubt and distrust? How can we reduce the consensus gap? One approach is to return to grass roots and provide a brief history of the issues, understand the difference between fact and opinion, truth and falsehood, the problem of certainty, and how scientific consensus is reached. To doubt is a healthy response to new information, and it too has a scientific basis. Doubt and distrust reside in that region of the brain called the dorsolateral prefrontal cortex, which is responsible for suppressing unwanted representations. Bridging the consensus gap requires shifting human thinking patterns from doubt to belief, and belief to action. Education and improved public messaging are key, and social media providers require urgent oversight or regulation to remove false and harmful/dangerous content from our digital lives. Delays to vaccinate and failure to reduce greenhouse gases will dramatically change the way we live. The new norm may be more deadly COVID variants, strained healthcare systems, extreme weather patterns, diminished food supply, delays in goods and services, damage to world's economies and widespread global instability.

Where are the children? An autoethnography of deception in dementia in an acute hospital

An acute hospital environment is a confusing place for many patients requiring admission, especially when they are presenting as acutely unwell. This can be particularly difficult for people living with dementia. As cognition changes it is not uncommon for people living with dementia to have difficulties with their ability to orientate to time, place and person. These disorientating moments can lead to personal distress, and at times behavioural changes. As well as being distressing for the person living with dementia, it can also be emotionally and ethically challenging for acute hospital staff, including nurses. One area found to be particularly challenging is the concept of whether actively engaging with a person living with dementia's living truth is deceitful. This raises further questions of what forms of nurse responses to temporal disorientation might be constituted as lying, colluding, or alternatively validating. This article uses autoethnography as a research methodology with which to explore a mental health nurse's lived experience of the challenges of responding truthfully to disorientation and distress in an acute hospital. This article is not attempting to offer conclusive answers to these challenging ethical questions. It is instead re-opening and re-visiting the discourse of what is truth in dementia from a personal and professional nurse perspective through a lived narrative. The conclusion to the concept of truth in dementia is complex, nuanced and individualized. However, it is essential that a nurse's response to disorientation and distress is always person and living present focused, and not lie focused.

Caring by lying

Caring for loved ones with dementia can sometimes necessitate a loose relationship with the truth. Some might view such deception as categorically immoral, and a violation of our general truth-telling obligations. I argue that this view is mistaken. This is because truth-telling obligations may be limited by the particular relationships in which they feature. Specifically, within caregiving relationships, we are often permitted (and sometimes obligated) to deceive the people with whom we share them. Our standing to deceive follows from certain features of caregiving relationships. Specifically, they are relationships that involve obligations to promote a person's interests and values (and not simply their autonomy), that often permit us to assume the hypothetical consent of the person with whom we share them, and in which we are often entitled to act out of self-interest. Once we appreciate these features, we will be able to recognize that the truth-telling norms governing our relationships with loved ones with dementia do not represent a radical departure from our general truth-telling obligations, but are instead consistent with truth-telling norms that feature in other caregiving relationships. In addition, we will be able to understand why we may feel conflicted about lying to loved ones with dementia, even when lying is permissible.

Truth is its own reward: Completeness of information, the feeling of truth knowing, and victims' closure

Victims of crime often want the truth about what happened. Yet, how exactly is truth valuable? Commonly, truth is thought to be instrumentally valuable by providing useful knowledge. Truth would be beneficial for victims because specific information may afford re-appraisals or greater understanding. The present research shows that truth may have inherent value independent from information content by providing truth knowing, a subjective sense of having the complete account, which facilitates closure. In Study 1 (n = 200) and Study 2 (n = 195), participants imagined themselves as victims of crime and were presented with one of two reports identical in content but designed to appear either complete or incomplete. As predicted, the complete report increased truth knowing and not understanding. Truth knowing was associated with greater closure, reduced affect, and greater forgiveness. In Study 3 (n = 157), real crime victims responded to one of two question sets making salient either the completeness or incompleteness of the information available about the crime. Salience of the completeness of information increased truth knowing, increased closure, reduced anger, and was associated with greater forgiveness. Findings suggest that truth knowing may facilitate the recovery of victims independently from instrumental value derived from content.

The truth must prevail: citizens' rights to know the truth during the era of COVID-19

In a recent short report, the necessity of sophisticated practices in gathering records that would facilitate data sharing yields data-driven analysis in time of COVID-19. Consequently, there is a need to present the truth in data analytics in the era of COVID-19. This paper discusses the urgent call for people handling the COVID-19 data to be ethically responsible in their handling, processing, and reporting that impacts the lives of ordinary people especially in this time of pandemic as public health crisis.

The Global Trust Deficit Disorder: A Communications Perspective on Trust in the Time of Global Pandemics

There has been much discussion worldwide about the crisis of trust, with evidence of declining trust in social, economic, political and media institutions. The rise of populism, and the differing impacts of the COVID-19 pandemic between nations, has been drawing attention to wider implications of pervasive distrust, including distrust of the media. In this article, I develop three propositions. First, I identify trust studies as a rich interdisciplinary field, linking communication to other branches of the social sciences and humanities. Second, I argue that we lack a comprehensive account of how trust has been understood in communication, and that doing so requires integrating macro-societal approaches with the "meso" level of institutions, and the "micro" level of interpersonal communication. Third, I propose that a focus upon trust would open up new perspectives on two important topics-the future of news media and journalism, and the global rise of populism.

Be Honest: Individuals' Moral Responsibility within the COVID-19 Context

We recognise that people lie to health professionals for several reasons. However, these incidents endanger the well-being of the professionals and bring us to the question of whether people have an exclusive moral duty to always profess the truth about their health and other facts, particularly in a pandemic crisis. This review argues that an honest patient is a key to undertaking their roles as health professionals and delivering the best services possible to meet the needs of the patient. Greater awareness and comprehension of the potential ramifications of dishonesty, not only helps establish the moral obligation, to tell the truth, particularly in a pandemic situation, but also translates into a better relationship with health professionals. It also enforces an ethical solidarity on every single of us to show tangible moral response to ensure that those most vulnerable to risks from the pandemic illness such as health professionals are protected as far as possible.

The Effect of Repetition on Truth Judgments Across Development

According to numerous research studies, when adults hear a statement twice, they are more likely to think it is true compared with when they have heard it only once. Multiple theoretical explanations exist for this illusory-truth effect. However, none of the current theories fully explains how or why people begin to use repetition as a cue for truth. In this preregistered study, we investigated those developmental origins in twenty-four 5-year-olds, twenty-four 10-year-olds, and 32 adults. If the link between repetition and truth is learned implicitly, then even 5-year-olds should show the effect. Alternatively, realizing this connection may require metacognition and intentional reflection, skills acquired later in development. Repetition increased truth judgments for all three age groups, and prior knowledge did not protect participants from the effects of repetition. These results suggest that the illusory-truth effect is a universal effect learned at a young age.

The Electrocortical Signature of Successful and Unsuccessful Deception in a Face-to-Face Social Interaction

Deceptive behavior, and the evaluation of others' behavior as truthful or deceptive, are crucial aspects of human social interaction. We report a study investigating two participants in a social interaction, performing a deception task. The first participant, the "informant," made true or false autobiographical statements. The second participant, the "detective," then classified these statements as truth or lie. Behavioral data showed that detectives performed slightly above chance and were better at correctly identifying true as compared with deceptive statements. This presumably reflects the "truth bias": the finding that individuals are more likely to classify others' statements as truthful than as deceptive - even when informed that a lie is as likely to be told as the truth. Electroencephalography (EEG) was recorded from the informant. Event-related potential (ERP) analysis revealed a smaller contingent negative variation (CNV) preceding "convincing" statements (statements classified as true by the detective) compared to "unconvincing" statements (statements classified as lie by the detective) - irrespective of whether the statements were actually truthful or deceptive. This finding suggests a distinct electrocortical signature of "successful" compared to "unsuccessful" deceptive statements. One possible explanation is that the pronounced CNV indicates the individuals' higher "cognitive load" when processing unconvincing statements.

The Limits of Conscious Deception Detection: When Reliance on False Deception Cues Contributes to Inaccurate Judgments

People are generally too trusting, which decreases their ability to detect deceit. This suggests that distrust could enhance our deception detection abilities. Yet, a state of distrust may induce deliberative conscious thought. This mode of thinking has been related to worse complex decision making. Hence, we investigate whether contextual distrust decreases the ability to detect deceit via the stronger reliance on consciously held beliefs about which cues betray deception. In two studies, participants were asked to judge videos of either deceiving or truth telling targets. Contextual distrust was manipulated by asking participants to squint their eyes (distrust) or to round their eyes (trust) while watching the videos. Participants’ judgments of targets being deceptive or truthful were measured (Studies 1 and 2) and they were asked on what basis they made these judgments (Study 2). Results showed that distrust especially hampers the detection of truth, which is partly due to more reliance on false beliefs about deception cues. These results corroborate the idea that deliberative conscious information processing may hinder truth detection, while intuitive information processing may facilitate it.

Aging in an Era of Fake News

Misinformation causes serious harm, from sowing doubt in modern medicine to inciting violence. Older adults are especially susceptible - they shared the most fake news during the 2016 US election. The most intuitive explanation for this pattern blames cognitive deficits. While older adults forget where they learned information, fluency remains intact and decades of accumulated knowledge helps them evaluate claims. Thus, cognitive declines cannot fully explain older adults' engagement with fake news. Late adulthood also involves social changes, including general trust, difficulty detecting lies, and less emphasis on accuracy when communicating. In addition, older adults are relative newcomers to social media, who may struggle to spot sponsored content or manipulated images. In a post-truth world, interventions should consider older adults' shifting social goals and gaps in their digital literacy.

"Are You Telling the Truth?" - Testing Individuals' Ability to Differentiate Between Truth and Deceit in Soccer

In the present paper, we tested the ability of individuals to judge correctly whether athletes are lying or telling the truth. For this purpose, we first generated 28 videos as stimulus material: in half of the videos, soccer players were telling the truth, while in the other half, the same soccer players were lying. Next, we tested the validity of these video clips by asking N = 65 individuals in a laboratory experiment (Study 1a) and N = 52 individuals in an online experiment (Study 1b) to rate the level of veracity of each video clip. Results suggest that participants can distinguish between true and false statements, but only for some clips and not for others, indicating that some players were better at deceiving than others. In Study 2, participants again had to make veracity estimations, but we manipulated the level of information given, as participants (N = 145) were randomly assigned to one of three conditions (regular video clips, mute video clips, and only the audio stream of each statement). The results revealed that participants from the mute condition were less accurate in their veracity ratings. The theoretical and practical implications of these findings are discussed.

Psychopathology and Truth: A Defense of Realism

Recently Kenneth Kendler and Peter Zachar have raised doubts about the correspondence theory of truth and scientific realism in psychopathology. They argue that coherentist or pragmatist approaches to truth are better suited for understanding the reality of psychiatric disorders. In this article, I show that rejecting realism based on the correspondence theory is deeply problematic: It makes psychopathology categorically different from other sciences, and results in an implausible view of scientific discovery and progress. As an alternative, I suggest a robustness-based approach that can accommodate the significance of coherence and pragmatic factors without rejecting scientific realism and the correspondence theory of truth.

The Nature of Truth: The Need for Peer Review

The necessity of having peer review is the subject of this column. To that end, the nature of truth, standards by which quantitative and qualitative research studies are judged, and predatory publishing are considered along with an example of the adverse impact of scientific misconduct. Finally, a call for more intense peer review is put forth.

Believability of evidence matters for correcting social impressions

To what extent are we beholden to the information we encounter about others? Are there aspects of cognition that are unduly influenced by gossip or outright disinformation, even when we deem it unlikely to be true? Research has shown that implicit impressions of others are often insensitive to the truth value of the evidence. We examined whether the believability of new, contradictory information about others influenced whether people corrected their implicit and explicit impressions. Contrary to previous work, we found that across seven studies, the perceived believability of new evidence predicted whether people corrected their implicit impressions. Subjective assessments of truth value also uniquely predicted correction beyond other properties of information such as diagnosticity/extremity. This evidence shows that the degree to which someone thinks new information is true influences whether it impacts implicit impressions.

Philosophical Theories of Truth and Nursing: Exploring the Tensions

In this paper, the authors explore three philosophical theories of truth and offer a critique of this foundational area of scholarship for nursing. A brief summary of key ideas related to the three substantial philosophical theories of truth-that is, correspondence, pragmatism, and coherence-serves to highlight various convictions and commitments that facilitate or discourage the growth of nursing knowledge in particular ways. The authors conclude that the coherence theory of truth offers a more inclusive view of truth and best captures and supports the diversity that exists within nursing knowledge and the regulative ideal to which nursing aspires.

Telling the truth to young children: Ethical reasons for information disclosure in paediatrics

When parents ask doctors not to disclose certain information to a child, doctors are challenged to articulate ethical reasons for giving information to children. This paper maps out the professional and legal landscape in which information-giving to children is taking place and identifies the key ethical arguments that have been made for disclosure of information to the child patient. We focus on pre-adolescent children, who have not reached a developmental stage that would see them regarded as 'mature minors'. While doctors can be relatively certain that professional and legal requirements will endorse their disclosure of information to the 'mature minor', guidelines are not clear on information-giving to pre-adolescents (immature minors). We identify six ethical reasons for telling the truth to younger children. It is noteworthy that there are good reasons to tell the truth to children, which are independent of any question of the child's capacity to be involved in decision-making.

ATYPICAL DISCOURSES

This essay outlines novel ways of communicating with patients by altering semantics, syntax, word use, or sounds. Language is viewed as a tool for coping with problems rather than a medium with which to mirror external reality or internal human nature. This view of language emerges from a pragmatic critique of truth. The broader goal of this essay is to weave together the philosophy of pragmatism, especially as it has been articulated by Richard Rorty, with the theory and practice of psychoanalysis. Clinical case examples are discussed.

Reasoning about truth-telling in end-of-life care of patients with acute stroke

BACKGROUND

Ethical problems are a universal phenomenon but rarely researched concerning patients dying from acute stroke. These patients often have a reduced consciousness from stroke onset and thereby lack ability to convey their needs and could be described as 'incompetent' decision makers regarding their own care.

OBJECTIVE

The aim of the study was to deepen the understanding of stroke team members' reasoning about truth-telling in end-of-life care due to acute stroke.

RESEARCH DESIGN

Qualitative study based on individual interviews utilizing combined deductive and inductive content analysis. Participants and research context: A total of 15 stroke team members working in stroke units of two associated county hospitals in western Sweden participated. Ethical considerations: The study was approved by the Regional Ethics Review Board, Gothenburg, Sweden.

FINDINGS

The main findings were the team members' dynamic movement between the categories 'Truth above all' and 'Hide truth to protect'. Honesty was highly valued and considered as a reason for always telling the truth, with the argument of truth as common morality. However, the carers also argued for hiding the truth for different reasons such as not adding extra burden in the sorrow, awaiting a timely moment and not being a messenger of bad news. Withholding truth could both be seen as a way of protecting themselves from difficult conversations and to protect others.

DISCUSSION

The results indicate that there are various barriers for truthfulness. Interpreted from a virtue of ethics perspective, withholding of truth might also be seen as an expression of sound judgement to put the patient's best interest first.

CONCLUSION

The carers may need support in the form of supervision to be given space to reflect on their experience and thereby promote ethically justified care. Here, the multi-professional team can be of great value and contribute through inter-professional sharing of knowledge.

ENCOUNTERS WITH PSYCHOSIS

This essay offers a personal account of one physician's attempt to engage with psychotic patients in an inner-city hospital. It considers some of the obstacles to psychoanalytic work with psychotic patients, including anxiety in the psychotherapist, anxiety in the patient, institutional resistances, and paradigmatic errors. A discussion of paradigmatic errors in Western mental health care is expanded upon. Rorty's () critique of objectivity and Kuhn's () work on scientific paradigm shifts are discussed in an attempt to demonstrate how we might better understand psychosis as an illness and connect with patients across the entire diagnostic spectrum.

[Telling the truth to the patient and their family, an ethical challenge]

Nursing practice encounters a number of areas of uncertainty which are not entirely assuaged by the legal framework or best practice recommendations. Caregivers must demonstrate lucidity and sincerity, with regard to themselves and their patients, and undertake humanist and ethical reflection. Announcing a serious diagnosis is the first difficult stage of a complicated and painful experience, shared between the patient, the family or institutional carers and the health professionals.

When is Deceptive Message Production More Effortful than Truth-Telling? A Baker's Dozen of Moderators

Deception is thought to be more effortful than telling the truth. Empirical evidence from many quarters supports this general proposition. However, there are many factors that qualify and even reverse this pattern. Guided by a communication perspective, I present a baker’s dozen of moderators that may alter the degree of cognitive difficulty associated with producing deceptive messages. Among sender-related factors are memory processes, motivation, incentives, and consequences. Lying increases activation of a network of brain regions related to executive memory, suppression of unwanted behaviors, and task switching that is not observed with truth-telling. High motivation coupled with strong incentives or the risk of adverse consequences also prompts more cognitive exertion–for truth-tellers and deceivers alike–to appear credible, with associated effects on performance and message production effort, depending on the magnitude of effort, communicator skill, and experience. Factors related to message and communication context include discourse genre, type of prevarication, expected response length, communication medium, preparation, and recency of target event/issue. These factors can attenuate the degree of cognitive taxation on senders so that truth-telling and deceiving are similarly effortful. Factors related to the interpersonal relationship among interlocutors include whether sender and receiver are cooperative or adversarial and how well-acquainted they are with one another. A final consideration is whether the unit of analysis is the utterance, turn at talk, episode, entire interaction, or series of interactions. Taking these factors into account should produce a more nuanced answer to the question of when deception is more difficult than truth-telling.

The making of a tragedy: perversion in the perception of truth

A type of wilful blindness can pervert an individual's perception of truth or reality, not because that reality is too much to hold, but because it is distasteful. Undesired. The case of Adam will be used to explore perversion as it twists an analytic process, affecting the transference and countertransference in ways that are difficult to see. Theorists of Freudian, Kleinian, Lacanian, and Jungian traditions are drawn from to explore potential roots to this perverted turn, and the way it can rigidify an individuation process. The anxiety that haunts this case echoes Jung's anxiety as he wondered if the stone saw him or he saw the stone. Object and observer blend when both analyst and patient hide from themselves and one another, knowing the truth of what is being discussed but blind to it.

INSIGHT AGONISTES: A READING OF SOPHOCLES'S OEDIPUS THE KING

In this reading of Sophocles's Oedipus the King, the author suggests that insight can be thought of as the main protagonist of the tragedy. He personifies this depiction of insight, calling it Insight Agonistes, as if it were the sole conflicted character on the stage, albeit masquerading at times as several other characters, including gods, sphinxes, and oracles. This psychoanalytic reading of the text lends itself to an analogy between psychoanalytic process and Sophocles's tragic hero. The author views insight as always transgressing against, always at war with a conservative, societal, or intrapsychic chorus of structured elements. A clinical vignette is presented to illustrate this view of insight.

Trust and truth: uncertainty in health care practice

Uncertainty is the ubiquitous presence across health care. It is usually understood in terms of decision making, 'knowing' the correct diagnosis or understanding how the human body works. Using the work of Ludwig Wittgenstein, Georges Canguilhem and Tim Ingold, I outline a story of journeying and habitation, and argue that while uncertainty for practitioners may be about enhancing theoretical knowledge, for patients it is about knowing how to act in a taken-for-granted and largely unconscious way in a world that has become uncertain, and in which the main tool of action, the human body, no longer functions with the certainty it once had. In this situation, the role of the practitioner is first and foremost to recognize the uncertainty that has emerged in the patient's 'habitation' and to reassure them by enabling them to have a new or restored confidence in their body so that they can act with certainty.

Truth, control, and value motivations: the "what," "how," and "why" of approach and avoidance

The hedonic principle—the desire to approach pleasure and avoid pain—is frequently presumed to be the fundamental principle upon which motivation is built. In the past few decades, researchers have enriched our understanding of how approaching pleasure and avoiding pain differ from each other. However, more recent empirical and theoretical work delineating the principles of motivation in humans and non-human animals has shown that not only can approach/avoidance motivations themselves be further distinguished into promotion approach/avoidance and prevention approach/avoidance, but that approaching pleasure and avoiding pain requires the functioning of additional distinct motivations—the motivation to establish what is real (truth) and the motivation to manage what happens (control). Considering these additional motivations in the context of moral psychology and animal welfare science suggests that these less-examined motives may themselves be fundamental to a comprehensive understanding of motivation, with major implications for the study of the “what,” “how,” and “why” of human and non-human approach and avoidance behavior.

On understanding understanding: how we understand the meaning of the word "understanding"

Psychoanalytic understanding in its status as a hermeneutic activity is different from other forms of understanding. It is distinct, for instance, from psychodynamic psychotherapy, which may be able to establish itself as an empirical science. Empirical science deals with rules and establishes facts, while hermeneutic science deals with meanings, which cover a wider area than facts. Meanings offer a different kind of explanation than facts offer. Psychodynamic psychotherapy can be differentiated from psychoanalysis on the basis of their being different forms of scientific activity. Psychodynamic psychotherapy is not a diminished or lesser form of psychoanalysis, inasmuch as it employs both interpretation and other therapeutic activities, while psychoanalysis is best seen as restricted to interpretation. The understanding that results from psychoanalysis is unique to psychoanalysis.

Understanding human perception by human-made illusions

IT MAY BE FUN TO PERCEIVE ILLUSIONS, BUT THE UNDERSTANDING OF HOW THEY WORK IS EVEN MORE STIMULATING AND SUSTAINABLE: They can tell us where the limits and capacity of our perceptual apparatus are found-they can specify how the constraints of perception are set. Furthermore, they let us analyze the cognitive sub-processes underlying our perception. Illusions in a scientific context are not mainly created to reveal the failures of our perception or the dysfunctions of our apparatus, but instead point to the specific power of human perception. The main task of human perception is to amplify and strengthen sensory inputs to be able to perceive, orientate and act very quickly, specifically and efficiently. The present paper strengthens this line of argument, strongly put forth by perceptual pioneer Richard L. Gregory (e.g., Gregory, 2009), by discussing specific visual illusions and how they can help us to understand the magic of perception.

Rethinking conformity and imitation: divergence, convergence, and social understanding

Social and developmental psychologists have stressed the pervasiveness and strength of humans' tendencies to conform and to imitate, and social anthropologists have argued that these tendencies are crucial to the formation of cultures. Research from four domains is reviewed and elaborated to show that divergence is also pervasive and potent, and it is interwoven with convergence in a complex set of dynamics that is often unnoticed or minimized. First, classic research in social conformity is reinterpreted in terms of truth, trust, and social solidarity, revealing that dissent is its most salient feature. Second, recent studies of children's use of testimony to guide action reveal a surprisingly sophisticated balance of trust and prudence, and a concern for truth and charity. Third, new experiments indicate that people diverge from others even under conditions where conformity seems assured. Fourth, current studies of imitation provide strong evidence that children are both selective and faithful in who, what, and why they follow others. All of the evidence reviewed points toward children and adults as being engaged, embodied partners with others, motivated to learn and understand the world, others, and themselves in ways that go beyond goals and rules, prediction and control. Even young children act as if they are in a dialogical relationship with others and the world, rather than acting as if they are solo explorers or blind followers. Overall, the evidence supports the hypothesis that social understanding cannot be reduced to convergence or divergence, but includes ongoing activities that seek greater comprehensiveness and complexity in the ability to act and interact effectively, appropriately, and with integrity.

Truth

What exactly do we mean by truth? Although the concept is nebulous across the array of theoretical perspectives in psychoanalysis, it is fundamental to all discourses. Is psychoanalysis in a position to offer a theory of truth despite the fact that at present it has no explicit, formal theory regarding the matter? A general metatheory is proposed here that allows for discrete categories and instantiations of truth as metacontextual appearance. In revisiting the ancient notion of aletheia as disclosedness or unconcealment, we may discover a distinct psychoanalytic contribution to truth conditioned on unconscious processes reappropriated from Heidegger's project of fundamental ontology. Construed as a dialectics of truth, this notion accords well with how psychoanalysts understand the dynamic unconscious and how it functions to both reveal and conceal. Given that clinical experience demonstrates the workings of dynamic unconscious activity, psychoanalytic theory may contribute a vocabulary relevant to philosophy by explicating the motives and mechanisms that create the appearances of contextual truth as such, phenomena whose causes have previously gone undescribed.

Disclosing the truth: a dilemma between instilling hope and respecting patient autonomy in everyday clinical practice

BACKGROUND

While medical ethics place a high value on providing truthful information to patients, disclosure practices are far from being the norm in many countries. Transmitting bad news still remains a big problem that health care professionals face in their every day clinical practice.

AIMS

Through the review of relevant literature, an attempt to examine the trends in this issue worldwide will be made.

METHOD

Various electronic databases were searched by the authors and through systematic selection 51 scientific articles were identified that this literature review is based on.

RESULTS

There are many parameters that lead to the concealment of truth. Factors related to doctors, patients and their close environment, still maintain a strong resistance against disclosure of diagnosis and prognosis in terminally ill patients, while cultural influences lead to different approaches in various countries. Withholding the truth is mainly based in the fear of causing despair to patients. However, fostering a spurious hope, hides the danger of its' total loss, while it can disturb patient-doctor relationship.

Analysis of scientific truth status in controlled rehabilitation trials

RATIONALE, AIMS AND OBJECTIVES

Systematic reviews, meta-analyses and clinical guidelines (reviews) are intended to inform clinical practice, and in this sense can be thought of as scientific truthmakers. High-quality controlled trials should align to this truth, and method quality markers should predict truth status. We sought to determine in what way controlled trial quality relates to scientific truth, and to determine predictive utility of trial quality and bibliographic markers.

METHOD

A sample of reviews in rehabilitation medicine was examined. Two scientific truth dimensions were established based on review outcomes. Quality and bibliographic markers were extracted from associated trials for use in a regression analysis of their predictive utility for trial truth status. Probability analysis was undertaken to examine judgments of future trial truth status.

RESULTS

Of the 93 trials included in contemporaneous reviews, overall, n = 45 (48%) were true. Randomization was found more in true trials than false trials in one truth dimension (P = 0.03). Intention-to-treat analysis was close to significant in one truth dimension (P = 0.058), being more commonly used in false trials. There were no other significant differences in quality or bibliographic variables between true and false trials. Regression analysis revealed no significant predictors of trial truth status. Probability analysis reported that the reasonable chance of future trials being true was between 2 and 5%, based on a uniform prior.

CONCLUSIONS

The findings are at odds with what is considered gold-standard research methods, but in line with previous reports. Further work should focus on scientific dynamics within healthcare research and evidence-based practice constructs.

Escaping the behavioural 'spin' of evidence-based psychiatry: Merleau-Ponty's ontology of truth

OBJECTIVE

To explore the limitations of the concept of 'truth' in the ontology of evidence-based psychiatry and to provide expanded ontological foundations for psychiatric practice based instead on the ontology of the French existential-phenomenologist, Maurice Merleau-Ponty.

CONCLUSIONS

Evidence-based medicine is founded on a 'scientific' ontology of 'causality', which equates 'truth' with effecting statistically-significant changes in objective measures of disease by a specified treatment. Because of the absence of biological markers of disease in psychiatry, evidence-based psychiatry equates 'truth' with effecting changes in observable psychometric measures of behaviour. This is the same ontology underlying marketing 'spin' and all attempts to effect pre-determined behavioural change. In contrast, Merleau-Ponty's ontology rejects causality and mind/body duality, and views 'truth' as the expression of our deepest embodied feeling and perception of the world, which establishes all our thinking, and on which all our thinking relies, including 'scientific' thinking. Merleau-Ponty's ontology is therefore a preferable foundation for psychiatric practice, because it allows psychiatrists to consider the 'truth' of clinically important, but non-measurable, aspects of psychiatry while not excluding 'scientific' thinking, but recognising its limitations and potential for misuse.

The Structure of Scientific Evolution

Science is the construction and testing of systems that bind symbols to sensations according to rules. Material implication is the primary rule, providing the structure of definition, elaboration, delimitation, prediction, explanation, and control. The goal of science is not to secure truth, which is a binary function of accuracy, but rather to increase the information about data communicated by theory. This process is symmetric and thus entails an increase in the information about theory communicated by data. Important components in this communication are the elevation of data to the status of facts, the descent of models under the guidance of theory, and their close alignment through the evolving retroductive process. The information mutual to theory and data may be measured as the reduction in the entropy, or complexity, of the field of data given the model. It may also be measured as the reduction in the entropy of the field of models given the data. This symmetry explains the important status of parsimony (how thoroughly the data exploit what the model can say) alongside accuracy (how thoroughly the model represents what can be said about the data). Mutual information is increased by increasing model accuracy and parsimony, and by enlarging and refining the data field under purview.

The problem with science-the context and process of care: an excerpt from remodelling medicine

The goal of science is truth through knowledge. But medicine's truth is not altogether the same as science's truth.Science works with ideas, imagination and intuition, but essentially has to do with facts. Medicine has also to deal with meaning.This is not an argument for less science in medicine, but for more and better science; better in the sense of better attuned to 'the rest of life'.Truthfulness is a core principle of medical practice and medical science.But a kind of untruthfulness is common in day-to-day clinical practice.The fundamental untruth is the illusion of certainty.The inexcusable untruth is to reduce the patient's problem to it to its narrow biomedical parameters and to allow the patient as a person to vanish from our gaze.Science fails medicine by the narrowness of the scope of things it is willing to investigate. Important areas of medicine have been neglected as a consequence.The medical research culture must change if it is to promote science for understanding alongside science for manipulation. We need to be unsparingly critical of the distinction between useful science and wasteful science."Medical knowledge is not knowledge acquired primarily for its own sake (but) for a specific purpose-the care of the sick."(1.)

Audio-video decision support for patients: the documentary genré as a basis for decision aids

OBJECTIVE

Decision support tools are increasingly using audio-visual materials. However, disagreement exists about the use of audio-visual materials as they may be subjective and biased.

METHODS

This is a literature review of the major texts for documentary film studies to extrapolate issues of objectivity and bias from film to decision support tools.

RESULTS

The key features of documentary films are that they attempt to portray real events and that the attempted reality is always filtered through the lens of the filmmaker. The same key features can be said of decision support tools that use audio-visual materials. Three concerns arising from documentary film studies as they apply to the use of audio-visual materials in decision support tools include whose perspective matters (stakeholder bias), how to choose among audio-visual materials (selection bias) and how to ensure objectivity (editorial bias).

DISCUSSION

Decision science needs to start a debate about how audio-visual materials are to be used in decision support tools. Simply because audio-visual materials may be subjective and open to bias does not mean that we should not use them.

CONCLUSION

Methods need to be found to ensure consensus around balance and editorial control, such that audio-visual materials can be used.