Papers by Shahram Rafieian
Thure von Uexkull (1920-2001) was a medical doctor and philosopher who made important contributio... more Thure von Uexkull (1920-2001) was a medical doctor and philosopher who made important contributions to both fields of medicine, especially psychosomatics, and philosophy. In medicine, his main contribution was applying a semiotic understanding to medicine, and developing a theoretical framework for psychosomatic medicine and beyond that to give shape to a theory for an integrated medicine. He has contributed to the development of some important concepts, such as “Endosemiotics” and “Subjective Anatomy” among others. In 1994, Thure von Uexkull was awarded an Honorary Doctorate from the University of Tartu in the field of semiotics and psychosomatic medicine (Kull & Hoffmeyer, 2005). It is the result of his efforts that now psychology, sociology, and psychosomatic medicine are obligatory subjects in the curriculum of undergraduate medical training in Germany (Tuffs, 2004). In philosophy, he was one of the founders of the school of biosemiotics. He was inspired by the works of his fath...
Professor Peter Whorwell studied medicine at Guy's Hospital in London. He has the experience ... more Professor Peter Whorwell studied medicine at Guy's Hospital in London. He has the experience of working as a hospital doctor in London, Cambridge, and Southampton, and he also worked for a year in the USA. Since 1981, he has been Consultant Physician and Gastroenterologist at the University Hospital of South Manchester and his main area of interest is functional gastrointestinal (GI) disorders, and he is the director of South Manchester Functional Bowel Service. He is also medical advisor to international foundation for functional GI disorders and member of the European expert panel for functional GI disorders. He is the pioneer of research on use of hypnotherapy for the treatment of irritable bowel syndrome (IBS) and related conditions. He has published over 300 papers or chapters, has written articles for popular magazines and newspapers, and appeared in several radio and television programs on functional GI problems. In this short interview, he has shared some of his ideas ab...
European Journal of Social Theory, 2016
Many theorists, in their search for a better explanation of the dynamics of structure and agency,... more Many theorists, in their search for a better explanation of the dynamics of structure and agency, have expressed the need for a theory in which reflexivity and habitus are reconciled. In this article, we argue that a dissociative theory of mind can provide the essential framework in which habitual routines and reflexivity function in parallel. This is explored using the examples of athletic training and hypnosis, where the interplay between conscious and unconscious mechanisms is displayed. In both settings, there is evidence to show that conscious reflexiveness and intersubjective and unconscious automatic processes are necessary to reach the desired outcome. We conclude that a dissociative theory of mind can shed new light on the relationship between habitus and reflexivity.
BMJ Open Gastroenterology, 2014
Objective: Faecal incontinence (FI) is a devastating condition which is well recognised in the el... more Objective: Faecal incontinence (FI) is a devastating condition which is well recognised in the elderly and those with certain conditions such as inflammatory bowel disease. However, there is surprisingly little information on its prevalence in irritable bowel syndrome (IBS), especially in relation to bowel habit subtype, and this study aimed to answer this question. Design: 500 consecutive new and follow-up secondary care IBS outpatients (399 female, 101 male, age range 15-87, mean age 46) fulfilling Rome III criteria without any significant concomitant disease were studied. They completed a series of questionnaires documenting FI, IBS severity, IBS subtype, non-colonic symptoms, quality of life, anxiety, depression and any other factors that might be associated with FI. Results: 285 patients (57%) reported FI, which was mild in 68 (23.9%), moderate in 99 (34.7%) and severe in 91 (31.9%) and in response to laxatives in 27 (9.5%) with an equal prevalence in males and females. The prevalence of FI in patients classified as having mild, moderate or severe IBS was 62%, 49.5% and 61%, respectively. The prevalence of incontinence was 65.2% in diarrhoea IBS, 63.7% in alternating IBS and, surprisingly, 37.9% in constipation IBS, where it was in response to laxatives in 35.8%. Compared to continent patients, those with FI had a significantly higher prevalence of urinary incontinence, previous abdominal surgery, pregnancy and vaginal as opposed to caesarean delivery. 23.3% had not disclosed their incontinence to anyone and only 50.6% had told their general practitioner. 66% always carried a change of clothes and 30% used incontinence pads on a regular basis. Conclusions: The prevalence of FI in these relatively young patients approached that observed in elderly care homes. Hopefully, recognition of this problem will lead to improved management and reduce the trivialisation that unfortunately still continues to surround this condition.
With the emergence of the “sociology of body” and “sociology of emotions” in recent years, and th... more With the emergence of the “sociology of body” and “sociology of emotions” in recent years, and the explosion of research about placebos and the mechanisms of their action, there is enough grounding now to consider the placebo response from a sociological point of view. These new subfields of sociology have provided enough knowledge about the primacy of action and emotions, and the importance of embodied knowledge and feelings in social interactions. Studies in medicine and psychology show that placebo response is a meaning response which develops in the context of interpersonal relationships. In this process, the embodied experience of the patient and health care professionals and their thoughts, beliefs, emotions and feelings are involved. Lines of research in the fields of placebo response, hypnosis research, doctor-patient relationship, and sociology of body and emotion are converging and provide the evidence for the role of interpersonal interactions in the healing process. Crit...
Studies in Neuroscience, Consciousness and Spirituality, 2016
European Journal of Integrative Medicine, 2008
... Acupuncture, the ancient Chinese treatment method, is based on Chinese general cosmology. The... more ... Acupuncture, the ancient Chinese treatment method, is based on Chinese general cosmology. There are claims that the relationship between acupuncture and modern western medicine is an example of Kuhnian incommensurability between two paradigms. ...
Many theorists, in their search for a better explanation of the dynamics of structure and agency,... more Many theorists, in their search for a better explanation of the dynamics of structure and agency, have expressed the need for a theory in which reflexivity and habitus are reconciled. In this article, we argue that a dissociative theory of mind can provide the essential framework in which habitual routines and reflexivity function in parallel. This is explored using the examples of athletic training and hypnosis, where the interplay between conscious and unconscious mechanisms is displayed. In both settings, there is evidence to show that conscious reflexiveness and intersubjective and unconscious automatic processes are necessary to reach the desired outcome. We conclude that a dissociative theory of mind can shed new light on the relationship between habitus and reflexivity.
With the emergence of the "sociology of body" and "sociology of emotions" in recent years, and th... more With the emergence of the "sociology of body" and "sociology of emotions" in recent years, and the explosion of research about placebos and the mechanisms of their action, there is enough grounding now to consider the placebo response from a sociological point of view. These new subfields of sociology have provided enough knowledge about the primacy of action and emotions, and the importance of embodied knowledge and feelings in social interactions. Studies in medicine and psychology show that placebo response is a meaning response which develops in the context of interpersonal relationships. In this process, the embodied experience of the patient and health care professionals and their thoughts, beliefs, emotions and feelings are involved. Lines of research in the fields of placebo response, hypnosis research, doctor-patient relationship, and sociology of body and emotion are converging and provide the evidence for the role of interpersonal interactions in the healing process. Critical analysis of the placebo response provides the basis for an alternative framework to the current dominant model of health care which is biomedicine. This model is based on the dualisms and is inadequate to provide a place and explanation for psychosomatic and culture related disorders which are currently categorized under terms like "Medically Unexplained Syndromes (MUS)". A possible new model could be constructed based on our new understandings provided by studies on placebo response. In this new model, interpersonal dynamics, intersubjectivity, and intercorporeality are core issues and in the center of attention for research and enquiry.
Cybernetics &# 38; Human Knowing, Jan 1, 2010
Today's dominant paradigm of modern medicine, which is based on a biomechanical concepti... more Today's dominant paradigm of modern medicine, which is based on a biomechanical conception of the human, is not efficient and the need for an alternative multi and trans-disciplinary approach is sensed. For this purpose, although Cybernetics and systems theory can fruitfully ...
Biosemiotics, Jan 1, 2011
A human being is the simultaneous composite of several different levels of being, from atomic and... more A human being is the simultaneous composite of several different levels of being, from atomic and subatomic to the level of complex social interaction, and these levels are nested within the individual hierarchically (lower levels giving rise to higher levels, etc.). One of the most important and influential approaches developed in the history of science has been that of systems theory and systemic thinking, in which the different levels of the hierarchy, and the interactions between those levels, are considered simultaneously. Although this model provides a comprehensive view of biological being, the transition from one level to the other is not well defined in it. Uexküll and Pauli (Advances: Journal of the Institute for 417 the Advancement of Health 3: [158][159][160][161][162][163][164][165][166][167][168][169][170][171][172][173][174] 1986) suggested that semiosis is the translator of the events from one level to the other. From a psychological point of view, a myriad of semiotic events happen inside an individual, and it has been suggested that among other semiotic events, inner speech plays an important role in mediating personal agency. Dialogical theories of the self, Jungian psychology and hypnosis research evidence show that there is a semiotic multiplicity in human agency and consciousness, and that these multiple streams are all converge to a central semiotic singularity. I argue in this paper that by taking a biosemiotic point of view, human 'agency' may be defined as the ability of an individual to direct the incoming and internal streams of semioses and the ability to create an integrative and superordinate new stream of semiosis in addition to the upwardly and downwardly component ones, and how such a view might open a new door for research into the concept of human 'personality' and 'agency'.
Journal of Isfahan …, Jan 1, 2009
Basic & clinical …, Jan 1, 2008
Angiogenic therapy is one of the new treatments of ischaemic heart disease. Oestrogen has angioge... more Angiogenic therapy is one of the new treatments of ischaemic heart disease. Oestrogen has angiogenic properties under hypoxic condition, and if oestrogen also induces angiogenesis under normoxic condition, it could be used in combination with other angiogenic therapies in the treatment of ischaemic heart disease. In this study, we evaluated the angiogenic effect of high-dose oestrogen treatment in normoxic rat heart tissue. Fifty-two ovariectomized rats were randomized in oestrogen-treated and control groups. 17 β -Oestradiol (1 mg /week) and normal saline (1 mg/week) were administered intramuscularly in the treatment and control groups for 2 months. After that, coronary capillary density and coronary vessel permeability were measured. The serum vascular endothelial growth factor (VEGF) level was also measured before and after the treatment. The results indicate that coronary capillary density (number of capillary per square millimetre) and coronary vessel permeability (fluorescence intensity) were significantly higher in the oestrogen-treated group than in the control group (628 ± 26 per mm 2 versus 540 ± 26 per mm 2 ; P < 0.05 and 207 ± 10 versus 147 ± 19 per gram tissue; P < 0.05). Oestrogen treatment increased serum VEGF level in the oestrogen-treated group compared to the control group (52 ± 3 versus 33 ± 6 pg/ml; P < 0.05), but interestingly VEGF was also increased in the control group after placebo treatment. It seems that high-dose oestrogen administration has angiogenic properties even in normoxic conditions. These angiogenic properties may result from oestrogen's direct effect on VEGF or other mechanisms, such as endothelial progenitor cell mobilization. Because of the broad effect of oestrogen on angiogenic growth factors and endothelial cells, more studies are required to clarify angiogenic properties of high-dose oestrogen.
Conference Presentations by Shahram Rafieian
With the emergence of “sociology of body” and “sociology of emotions” in recent years, and the ex... more With the emergence of “sociology of body” and “sociology of emotions” in recent years, and the explosion of research about placebos and the mechanisms of their action, there is enough grounding now to consider the placebo response from a sociological point of view. The new subfields of sociology – sociology of body and emotions- have provided enough knowledge about the primacy of action and emotions and the importance of embodied knowledge and feelings in social interactions. Studies in medicine and psychology show that placebo response is a meaning response which develops in the context of interpersonal relationships between the patient and the health care professionals. In this process, the embodied experience of the patient and health care professionals and their thoughts, beliefs, emotions and feelings are involved. For example, it has been shown that in the pain experience the emotional and conceptual aspects of pain are important and targeting only the physical and biological mechanisms involved cannot solve the problem especially in chronic disorders. Also, apart from the dynamics of communication, the semiotic context in which the treatment is taking place is involved in the development of the placebo response. Lines of research in the fields of placebo response, hypnosis research, doctor-patient relationship, mind-body medicine, neuroscience of emotions and embodiment and sociology of body and emotion are converging and providing the evidence for the role of interpersonal interactions in the healing process. Critical analysis of the placebo response provides the basis for an alternative framework to the current dominant model of health care which is biomedicine. The mechanistic and reductionistic approach of this model has led to medicalization of life events and control of drug and medical technology industries over health care systems. Also, this model is based on the duality of mind and body, individual and society and etc. and is inadequate to provide a place and explanation for psychosomatic and culture related disorders which are currently categorized under the terms like “Medically Unexplained Syndromes (MUS)”. A possible new model could be constructed based on our new understandings provided by studies on placebo response. In this new model, interpersonal dynamics, intersubjectivity and intercorporeality are core issues and in the centre of attention for research and enquiry. This could connect the patterns of intersubjectivity, verbal and non-verbal communication with psycho-neuro-immunological pathways which modulate healing. These connections could be explored in interdisciplinary studies. It also opens up the space for an in context ethics and development of a relational and humanistic medicine in which the patient is considered as a person, not just a physiological and biological machine.
Talks by Shahram Rafieian
Uploads
Papers by Shahram Rafieian
Conference Presentations by Shahram Rafieian
Talks by Shahram Rafieian