Letteratura scientifica selezionata sul tema "Trans-subjective therapy"

Purpose The purpose of this study was to prospectively examine changes in gender-related voice domain of pitch measured by fundamental frequency, function-related domains of vocal quality, range, and habitual pitch level and the self-perceptions of transmasculine people during their first year of testosterone treatment. Method Seven trans men received 2 voice assessments at baseline and 1 assessment at 3, 6, 9, and 12 months after starting treatment. Results Vocal quality measures varied between and within participants but were generally within normal limits throughout the year. Mean fundamental frequency (MF0) during reading decreased, although to variable extents and rates. Phonation frequency range shifted down the scale, although it increased in some participants and decreased in others. Considering MF0 and phonation frequency range together in a measure of habitual pitch level revealed that the majority of participants spoke using an MF0 that was low within their range compared with cisgender norms. Although the trans men generally self-reported voice masculinization, it was not correlated with MF0, frequency range, or habitual pitch level at any time point or with MF0 note change from baseline to 1 year of testosterone treatment, but correlations should be interpreted with caution due to the heterogeneous responses of the 7 participants. Conclusion In trans men, consideration of voice deepening in the context of objective and subjective measures of voice can reveal unique profiles and inform patient care.

The aim of the current study was to test the long-term predictive validity of the trans-contextual model in accounting for variance in adolescents’ out-of-school physical activity measured by self-report and accelerometer based-devices over a one-year period. Secondary school students ( N = 265) aged 11 to 15 years completed a three-wave survey on two occasions in time, spanning a one-year interval, measuring perceived autonomy support in physical education (PE), peer and parent autonomy support in leisure-time, autonomous and controlled motivation in PE and leisure-time, attitude, subjective norms, perceived behavioural control, intention, and out-of-school physical activity both by self-report and accelerometer-based devices. A variance-based structural equation model using residualized change scores revealed that perceived autonomy support from PE teachers predicted autonomous motivation in PE, and autonomous motivation in PE predicted autonomous motivation in leisure-time. In addition, peer and parent autonomy support predicted autonomous motivation in leisure-time. Autonomous motivation in leisure-time indirectly predicted physical activity intention mediated by attitude and perceived behavioural control. Intention predicted self-reported physical activity participation, although the effect was in the opposite direction to our prediction, but not physical activity measured by accelerometer-based devices. Results support some tenets of the trans-contextual model over a one-year time period, particularly the determinants of physical activity intentions. The introduction of COVID-19 restrictions may explain the negative relationship between intention and self-reported physical activity. Further longitudinal studies are needed to verify the results of the current study.

AimsEmotion regulation (ER) impairments are central trans-diagnostic phenomena across the spectrum of eating disorders (EDs) and obesity, where maladaptive eating behaviors act to suppress negative emotions. Self-report assessments are the most commonly used tools for assessing an individual's ER capacity, however, subjective self-reporting is limited by a tendency toward response bias and issues with common method variance. Prior empirical and theoretical research supports the use of heart rate variability (HRV) to objectively assess individual differences in ER capacity. Several studies have examined the association between HRV and ER in EDs and obesity. However, to date, no review synthesising the overall findings exists. This review aimed to summarise the empirical evidence that has examined the relationship between ER and HRV in adults with EDs/obesity, in addition to assessing the validity of HRV as a physiological biomarker of ER in these populations.MethodA comprehensive search was performed on PubMed, MEDLINE and PsycINFO, with identified studies screened against a priori inclusion/exclusion criteria. Eligible studies underwent quality-assessment using the Joanna Briggs Institute Critical Appraisal Tools, and data were synthesised qualitatively.Result17 publications were included, consisting of data on participants with obesity, binge eating disorder (BED), bulimia nervosa (BN), anorexia nervosa (AN), and/or subclinical presentations. Studies were small (average sample size n = 46.4), predominantly female (87.9%), and were highly variable in methodology, with different diagnostic tools, self-report measures, and emotional tasks/paradigms used.ConclusionThe evidence suggests that HRV is a valid, objective biomarker of ER impairments in AN, BN, BED, emotional eating, and obesity. Despite some inconsistencies, likely attributable to methodological heterogeneity, EDs/obesity appear to be characterised by irregular resting state vagal activity and abnormal stress reactivity. Furthermore, the autonomic dysfunction observed across EDs/obesity may be reversible by novel effective interventions such as HRV-biofeedback or PlayMancer videogame therapy.

The paper addresses the relations between N. Berdyaev's philosophy and currently accepted attitudes in psychoanalysis and existential therapy in their connection with Byzatine mystical theology. It suggests that both traditions trace their roots back to an intuitive-symbolic way of searching for the truth, characteristic of mystical theology. The main emphasis is on the bodily dimension of experience, which supports the apophatic way of cognition. Hermeneutics of methodological principles is used in Berdyaev's philosophy and psychoanalysis with elements of historical and philosophical reconstruction of the question of ways of a pre-symbolic way of cognition. Like the psychoanalysis of Z. Freud, the Russian tradition of the early twentieth century is involved in an ontological turn, as a result of which the concept of corporeality and flesh is one of the key in understanding the nature of the subject and his cognitive experience. First part of the paper addresses the Byzantine mystical theological understanding of apophasis, based on the works of Denys the Areopagite. Then, a parallel is drawn with how N. Berdyaev understands the mystics, indicating that symbolic knowledge is rooted in the bodily dimension of experience. The latter means that the knowledge recorded in words represents for the mystic a form of personal experience. In the second part of the article, the idea of flesh unfolds in the problem of love and transference. It is concluded that the personal dimension of analysis, in which the other takes the place of a lover, is synonymous in mystical tradition and religious personalism, where God takes the place of the Other. In addition, the article summarizes the Christian, Orthodox concept of personality, which implies a trans-subjective experience of communication. The article sets the original consideration of the Russian philosophical tradition in terms of psychoanalysis and the mystical tradition of the past.

Introduction: A wide variety of non-invasive treatments has been proposed for the management of hypertrophic burn scars. Unfortunately, the reported efficacy has not been consistent, and especially in the first three months after wound closure, fragility of the scarred skin limits the treatment options. Extracorporeal shock wave therapy (ESWT) is a new non-invasive type of mechanotherapy to treat wounds and scars. The aim of the present study was to examine the objective and subjective scar-related effects of ESWT on burn scars in the early remodelling phase. Material and methods: Evaluations included the Patient and Observer Scar Assessment Scale (POSAS) for scar quality, tri-stimulus colorimetry for redness, tewametry for trans-epidermal water loss (TEWL) and cutometry for elasticity. Patients were randomly assigned to one of two groups, the low-energy intervention group or the placebo control group, and were tested at baseline, after one, three and six months. All patients were treated with pressure garments, silicone and moisturisers. Both groups received the ESWT treatment (real or placebo) once a week for 10 weeks. Results: Results for 20 patients in each group after six months are presented. The objective assessments showed a statistically significant effect of ESWT compared with placebo on elasticity ( P = 0.011, η2 P=0.107) but revealed no significant effects on redness and TEWL. Results of the clinical assessments showed no significant interactions between intervention and time for the POSAS Patient and Observer scores. Conclusion: ESWT can give added value to the non-invasive treatment of hypertrophic scars, more specifically to improve elasticity when the treatment was already started in the first three months after wound closure. Lay Summary Pathological scarring is a common problem after a burn injury. A wide variety of non-invasive treatments has been proposed for the management of these scars. Unfortunately, the reported efficacy of these interventions has not been consistent, and especially in the first three months after wound closure, fragility of the scarred skin limits the treatment options. Extracorporeal shock wave therapy (ESWT) is a relatively new non-invasive therapy to treat both wounds and scars. The aim of the present study was to examine the scar-related effects of ESWT on burn scars in the early phase of healing. The scars were subjectively assessed for scar quality by the patient and an observer using the Patient and Observer Scar Assessment Scale (POSAS). Objective assessments included measurements to assess redness, water loss and elasticity. Forty patients were randomly assigned to one of two groups, the low-energy intervention group or the placebo control group (the device simulated the sound of an ESWT treatment but no real shocks were applied), and were tested at four timepoints up to six months. All patients were treated with pressure garments, silicone and moisturisers. Both groups received the ESWT treatment (real or placebo) once a week for 10 weeks. The objective assessments showed a significant improvement of elasticity in the intervention group when compared with placebo but revealed no significant effects on redness and water loss. Results of the clinical assessments showed no differences between the groups for the POSAS Patient and Observer scores. ESWT can give added value to the non-invasive treatment of pathological scars more specifically to improve elasticity in the early phase of healing.

The subjectivity of researchers has received little attention in occupational research of trans and/or gender diverse (TGD) lives. Secondary thematic analysis of a peer ethnography was conducted to explore the meaning and epistemological significance of a cisgender/transgender dichotomy for TGD adults. The primary research comprised an occupational analysis of participation in a secret Facebook group (“Virtually Trans”) for TGD adults who were assigned female at birth and live in Melbourne, Australia. Three themes were developed from this secondary analysis of the experiences of 12 group members. First, an oppositional cisgender/transgender dichotomy was salient and significant to all participants. Second, belonging norms, while profoundly felt, also obscured intragroup differences and opportunity for outgroup contact. Finally, participants recognized the need for self-reflexive allies to document the varied occupational experiences and priorities of this cohort. A cisgender/transgender dichotomy is a significant ontological distinction that must be attended to in TGD occupation-focused research.

When making penal law regulations, the legislator is faced with axiological choices of tremendous impact, hence it should take into consideration the moral conditions that are inherent to the specific civilisation and culture, particularly interpreted from constitutional axiology. In the doctrine of penal law and penal sciences that aspire to influence the content of penal legislation, the perspective of constitutional values, principles and norms should always be taken into account. However, the constitutional context does not only offer strict and express legal rules, precisely formulated guarantees, imperatives and prohibitions, constitutional or competence-related provisions but also generally worded optimising norms and, often only implicit preferences, assumptions and axiological views of the author, among them the vision of human nature. The specific anthropological concept that the constitution-maker has assumed as the axiological basis of its law-making decisions proves to be heterogeneous and becomes a necessary reference point for various law-making and law-applying bodies, all recipients of legal norms, and also the representatives of scientific disciplines recommending changes to the law.The anthropological stance adopted in the Constitution can be inferred primarily from the principle of human dignity as well as from the foremost position of the personal freedom of the individual in the hierarchy of constitutional values or from the interpretation of the constitutional concept of common good. The principle of human dignity entails the axiomatisation of the normative content of the Constitution. The Constitution of the Republic of Poland, in its Article 30, does not aspire to re-invent the concept of the human being or prioritise specific rights and freedoms but only confirms that they exist and obliges public bodies to respect and protect them. The analysis of the content of the Constitution of the Republic of Poland reveals that it is founded on the personalistic concept of a human being. This indeterministic concept implies that the individual takes rational and free choices and socially relevant decisions manifested in their actions and is subject to liability, including penal liability, based on these actions. This is relevant to the definition of the paradigm of expert assessments of penal law and to the legislative effort.Under effective constitutional law, it is impossible to develop a system of penal law response based on such anthropological concepts as behaviourism, determinism, post-humanism, anti-humanism, trans-humanism, biotechnology, trans-species approaches, etc. The idea of the rejection of the subjective nature of a human being and departure from the classic rules of penal liability based on the perpetrator’s actions and guilt are out of the question. These notions should be interpreted in the light of personalistic anthropology. Any concepts that rationalise penal sanctions exclusively on the grounds of protection of public safety or crime prevention which make penal liability instrumental and objectify perpetrators are in conflict with constitutional axiology. Moreover, constitutional anthropology cannot endorse solutions that implement a strictly behavioural vision of crime response, that is, one in which the application of penal sanctions is understood as a kind of social engineering or correctional tool separated from liability. The perpetrator of a prohibited act cannot be subject to interventions regarded as forced therapy or psychotechnical correction of non-conformist attitudes and pathological personality. It is also unacceptable to attempt to treat animals or artificial intelligence as subjects of law or making them fall under penal liability.All in all, due to the hierarchical structure of the sources of law, any proposals and conclusions in the field of penal law-making and interpretation must be aligned not only with the norms but also with the axiology of the Constitution of the Republic of Poland. If criminology and other penal sciences do not want to turn into purely theoretical science, detached from the axiological, legal and social reality of combating crime, and if their findings are to be taken into account in practical state policy, they must follow a paradigm consistent with the context of the fundamental values and norms embedded in the Constitution. From the perspective of constitutional anthropology, the paradigm of penal sciences that corresponds to the axiological assumptions behind the existing political system is the classical paradigm in which a human being is perceived as a rational, self-determining and free being, creating and responsible for their own actions. The property of scientific pursuits within the classical paradigm also confirms the repeated references of the constitution-maker to the concept of justice and the treatment of justice as the fundamental and universal value of the legal system.

Abstract Background: Person-based cognitive therapy (PBCT) was developed as a treatment for psychosis. The effectiveness of group PBCT was examined in the Mindfulness for Voices (M4V) randomized controlled trial and generated promising results. Group PBCT was implemented as a trans-diagnostic treatment for distressing voices within the Sussex Voices Clinic (SVC), a specialist secondary care mental health service. Aim: To conduct a service evaluation of engagement, outcomes and cost of group PBCT within SVC, and to compare engagement and outcomes from routine practice with the M4V trial. Secondary aims were to explore predictors of levels of engagement and change in group PBCT. Method: Service level data from 95 SVC patients were evaluated. Descriptive statistics, hypothesis tests and linear regression models were used. The primary clinical outcome was voice-related distress. Engagement levels and pre–post effect sizes were estimated; associated predictors were explored. Results: Fifty-nine per cent of patients completed group PBCT within SVC, compared with 72% within M4V. Completers within SVC had lower baseline depression scores compared with non-completers. There were significant improvements in voice-related distress (Cohen’s d = –0.47; p = 0.001), subjective recovery (Cohen’s d = 0.35; p = 0.001) and depression (Cohen’s d = –0.20; p = 0.044); these outcomes were comparable to M4V. Higher baseline subjective recovery and lower depression both predicted improvement in voice-related distress. Therapy within SVC cost an average of £214 per patient. Conclusion: PBCT groups can be delivered trans-diagnostically in routine clinical practice. Engagement was lower when compared with an RCT, but outcomes were comparable. The low level of resources involved suggests that group PBCT can offer value for money.

Abstract Introduction Myositis can be infective, metabolic or immune-mediated. Idiopathic inflammatory myopathy, which is immune-mediated, tends to be subacute, with symmetrical symptoms, overlap clinical features and positive autoimmune serology. We present a case of acute onset lower limb seronegative inflammatory myopathy with a normal creatinine kinase (CK), a marked acute phase response that responded promptly to immunomodulatory therapy. Case description A 68-year-old man presented with a 2-week history of lower limb pain with subjective weakness, on a background of well-controlled type 2 diabetes mellitus and hypertension. He was admitted with worsening symptoms of marked left thigh pain, night sweats, and fevers. On admission, he had swinging pyrexia (above >39 °C) while remaining haemodynamically stable. He had focal tenderness over the left anterolateral thigh, with a good range of movement, normal power and no signs of focal collection or cellulitis. There were no extra-muscular features to suggest systemic infection or overlap connective tissue disease. Bloods showed C-reactive protein (CRP) 225, normal CK 212 and negative blood cultures. X-rays knee, femur and pelvis were normal. Magnetic resonance imaging (MRI) on T2, fat-suppressed STIR sequences demonstrated increased signal/oedema both thighs throughout the anterior muscle compartment and along the fascial plane, notably most severe in the left vastus lateralis. He was treated empirically for infective myositis. Despite 14 days of broad-spectrum antibiotics, he remained febrile with persistently elevated CRP. There was no focal collection, lymphadenopathy or occult malignancy on CT abdomen and pelvis. Trans-oesophageal echocardiogram showed no evidence of infective endocarditis but revealed incidental moderate aortic stenosis. The patient described persistent now bilateral thigh pain with continued normal CK and high CRP. Full autoimmune screen (ANA, ANCA, ACE and complement studies) was negative. Despite negative nuclear and cytoplasmic HEp-2 immunofluorence, extended myositis immunoblot was negative. Muscle biopsy from the left vastus lateralis demonstrated inflammation within the perimysium and perivasculature. In view of biopsy findings and no response to anti-microbial therapy, prednisolone (0.5mg/kg) with significant clinical response (resolution of fever and pain) with concurrent normalisation in CRP. The patient remains in remission following steroid reduction with no additional immunomodulatory therapy required. Discussion We report a case of idiopathic inflammatory myopathy presenting with predominantly asymmetrical symptoms, normal CK, marked inflammatory response and negative myositis autoantibodies. Diagnosis was confirmed on MRI and muscle biopsy. The normal CK can be explained by the histology demonstrating inflammation in perivascular regions and around muscle fibres, rather than inflammation or necrosis in the muscle fascicles and fibres themselves. Idiopathic inflammatory myopathy including sporadic inclusion-body myositis, dermatomyositis, overlap CTD myositis and polymyositis/necrotising myopathy subsets are distinguishable based on clinical features, autoantibodies, MRI and biopsy features. The table below summarises the atypical aspects of this case. Differential diagnoses for this case include atypical infection, sarcoid myopathy and amyloid myonecrosis secondary to diabetes. Table: Features of typical idiopathic inflammatory myopathy compared with this atypical case.Idiopathic inflammatory myopathiesOur patient- typical featuresOur patient- atypical featuresSymptomsPain, fever, weakness.Pain and fever.Normal power.Clinical distributionSymmetrical, proximal muscle groups.Predominantly asymmetrical (worse on left), only in thighs.AntibodiesMyositis associated autoantibodiesSeronegativeMuscle enzymesElevated CKNormal CK.Inflammatory markersNormal to slightly elevated CRPMarkedly raised CRP and WCC.MR imaging resultsFocal muscle oedema in affected musclesDiffuse and speckled muscle oedema Key learning points Early idiopathic inflammatory myopathy can have inflammation around the muscle fascicles in the perimysium. Normal CK does not rule out a diagnosis of idiopathic inflammatory myopathy. Idiopathic inflammatory myopathies can present atypically with fevers >39 °C, significantly raised inflammatory markers, and asymmetrical symptoms and MRI findings. In the absence of overlap features, normal CK and negative serology, MRI and biopsy can delineate the type of myositis and direct management. Conflicts of interest The authors have declared no conflicts of interest.

Data becomes something of a mirror in which people see themselves reflected. (Sorapure 270)In a 2014 essay for The New Yorker, the humourist David Sedaris recounts an obsession spurred by the purchase of a Fitbit, a wearable activity-tracker that sends a celebratory “tingle” to his wrist every 10, 000 steps. He starts “stepping out” modestly but is soon working hard, steadily improving on the manufacturer’s recommended baseline. “But why?” asks Sedaris’ partner Hugh: “Why isn’t twelve thousand enough?” “Because,” I told him, “my Fitbit thinks I can do better” (n.p.).The record of daily, incidental activity that the Fitbit collects and visualises is important to Sedaris as a record of his (increasing) bodily fitness but it is also evidence in another way, a testament to virtue and a correlate of self-improvement: “The tingle feels so good,” Sedaris says, “not just as a sensation but also as a mark of accomplishment” (n.p.). Improvement is presented as both traceable and quantifiable; data and self are inextricably, though also ironically, linked. With his Fitbit, Sedaris accesses new and precise degrees of bodily information and he connects himself to a visible community of wearers. At first, Sedaris is smug and optimistic; by the time he begins “rambling” compulsively, however, and achieving his “first sixty-thousand-step day,” he has also had an epiphany: “I staggered home with my flashlight knowing that I’d advance to sixty-five thousand, and that there will be no end to it until my feet snap off at the ankles. Then it’ll just be my jagged bones stabbing into the soft ground” (n.p.). When the device finally “dies,” Sedaris experiences an immediate feeling of freedom; within five hours he has “ordered a replacement, express delivery” (n.p.).In their book Self-Tracking, Gina Neff and Dawn Nafus note that both digital technology and a turn to biomedicalisation in the broader culture have amplified the capacity and reach of quantification practices in everyday life. Wearable activity trackers, of which the Fitbit is arguably the most iconic, offer individuals the ability to track minute or previously imperceptible permutations of bodily sensation within an everyday and non-medical context. It is a technological capacity, however, thoroughly embedded in a mobilising rhetoric of “health,” a term which itself has “become a loaded word, not merely a description of a bodily state but also a euphemism for what the speaker believes is desirable” (Neff and Nafus 19). The Fitbit measures movement, but it also signals something about the wearer’s identity that is framed, in the device’s marketing at least, in positive and desirable terms as an indication of character, as a highly desirable aspect of self.In a recent discussion of new forms of online life writing, Madeline Sorapure argues that acts of interpretation and representation in relation to biometric data are “something very similar to autobiographical practice. As in autobiography, subject and object, measurer and measured, are collapsed” (270). In its capacity to track and document over time and its affective role in forming a particular experience of self, the Fitbit bears a formal resemblance to autobiographical practice and specifically to modes of serial self-representation like diaries, journals, or almanacs. The discursive context is crucial here too. Early self-trackers use the pre-formatted almanac diary or calendar to better organise their time and to account for expenditure or gain. The pocket calendar was an innovation that had mass-market appeal and its rapid circulation in the early twentieth century directly shaped diary and account-keeping habits amongst historical populations, and to this day (McCarthy). Such forms are not simply passive repositories but bear cultural ideology. As popular templates for practices of accounting, self-documentation, and affecting, pocket calendars shape what content an individual across their individual day or week is coaxed to attend to or record, and effects what might then be relegated “marginal” or less consequential in relation.How do the technological affordances of the Fitbit similarly coax and shape self-knowledge or ideas of value and worth in relation to personal experience? What kinds of formal and discursive and resonance might there be drawn between wearable personal devices like the Fitbit and historical forms of tracking self-experience, like the diary? Is a Fitbit a diary? In this discussion, I consider pre-formatted diaries, like the almanac or pocket calendar, as discursive and technological precursors or adjuncts to wearable personal trackers like the Fitbit and I explore some assertions around the kinds of subject that digital forms and modes of self-tracking and personal data might then seem to coax or imagine.Tracking SelvesSelf-tracking is a human activity, one far more interesting than the gadgets that have made it easier and far more widespread. (Neff and Nafus 2)In 1726, at the age of 20, the inventor and polymath Benjamin Franklin recorded in his journal the inception of a plan to improve his character. In a chart created to track goals of virtue and progress in character, “black marks” are literal and symbolic, denoting when he has failed to live up to his expectations—two black marks represent a particularly bad effort (Rettberg 438). At age 79, Franklin was still tracking his progress when he wrote about the project in his Autobiography:It was about this time I conceived the bold and arduous project of arriving at moral perfection. I wished to live without committing any fault at any time; I would conquer all that either natural inclination, custom, or company might lead me into. (89)Franklin’s desire to document and chronicle the self-conscious development of his character drives his interest in the form. He was as an almanac devotee and an innovative publisher of the form, which gained immense popularity at this time. Franklin added blank pages to the almanacs he helped produce in the mid eighteenth century and this addition expanded the possibilities for the kinds of data that might be recorded, particularly personal and anecdotal material. The innovation also earned the publishers a good deal more money (McCarthy 49). The mass production of printed almanacs thus had a profound effect on how individuals engaged in various kinds of daily and temporal and social regulation and documentation, including of the self:At the same time as it kept readers aware of the outside world, the almanac could also direct them to the state of their own being. Almanacs were all about regulation, inside and out. Almanacs displayed a regulated universe governed by the laws of planetary motion, by the church calendar, by the zodiac. It seemed natural, then, that some readers might turn to an almanac to regulate themselves. What better way to do that than in a text that already possessed its own system? All one had to do was insert one’s own data in that printed form, like connecting the dots. (McCarthy 53)Mass-market forms that engender habits of accounting are also cultural templates: pre-formatted journals are systems for private documentation that reflect broader cultural and social ideologies. Rebecca Connor observes that historical gender assumptions in relation to time “well-spent” are frequently visible in eighteenth-century mass-market journals explicitly aimed at women, which tended to allocate more space for “social” engagements versus, for example, financial accounting (18).In the twenty-first century, technologies like the Fitbit promise access to data in relation to personal experience but they also reveal dominant cultural and social attitudes to bodies and selves. Deborah Lupton argues that self-tracking as a phenomenon is essentially connected to specific ideological imperatives: “Underlying many accounts of self-tracking is a barely hidden discourse of morality, which takes the form of championing those who take action to improve themselves” (74). Within these influential discourses, acts of self-tracking, no less than Franklin’s virtue chart, acquire significance as moral activities and as the outward sign of good character.Neither self-tracking nor the ideology of virtue that underwrites it are new phenomena. In their cultural study of weight measurement devices, Kate Crawford, Jessa Lingl, and Tero Karpii have explored how both weight scales and wearable devices “emphasize self-knowledge and control through external measurements” (479). Similarly, Lupton has noted that, the “metrics” generated by personal self-tracking devices are “invested with significance” because “data visualisation” is “viewed as more credible and accurate by participants than the ‘subjective’ assessments of their bodily sensations” ("Personal Data" 345).In various historical cultures, objectivity about one’s self is seen as a desire (if not a fact) in relation to conscious self-examination; externalisation, through written or oral confession, is both a virtue and a discipline. While diary writing is, particularly in popular culture, often derided as an overly subjective and narcissistic mode, the diary is also framed within contexts of therapy, or spiritual development, as a possible methodology for self-improvement. For Puritans, though, the act was also understood to entail risks; recording one’s thoughts into a written journal could enable the individual to see patterns or faults in everyday behaviour, and so to identify and rectify habits of mind holding back personal spiritual development. In the twentieth century, “how-to write a diary” self-help guidebooks remediate the discourse of self-knowledge as self-improvement, and promised to refine the method, advising adherents on the kinds of writing practices that might best circumvent problems of individual bias or subjectivity (a claim of an ever-more objective methodology that reverberates to the current moment). Invariably, the more “unconscious” the diary writing practice, the greater the assumed potential for “objective” knowledge (Cardell 34).Contemporary practices of self-tracking extend the prioritisation of external, objective measurement in relation to documenting personal experience. Crawford, Lingel, and Karppi observe that “the discourse around wearable devices gives the impression of radical new technology offering precise and unambiguous physical assessment: devices that reflect back the ‘real’ state of the body” (480). The technology, of course, is not new but it is “improved.” The ideal of a better, more accurate (because externalised and so auditable by the community) self-knowledge sought by Puritans in their journals, or by Benjamin Franklin in his charts and almanacs, resurfaces in the contemporary context, in which wearables like the Fitbit assume powerful discursive status in relation to ideals of truth and objectivity and where the individual is decentred from the position of as “the most authoritative source of data about themselves” (Crawford, Lingel, and Karppi 479).Data SelvesWhat kind of selves do people develop in relation to the technology they use to record or visualise their experience? “There is no doubt,” writes Jill Walker Rettberg, in Seeing Our Selves through Technology, “that people develop ‘affective ties’ to the data they track, just as diaries, blogs, photo albums and other material archives are meaningful to those who keep them” (87). That the data is numerical, or digital, does not lessen this connection:Apps which allow us to see our data allow us to see ourselves. We look at our data doubles as we gazed into the mirror as teenagers wondering who we were and who we might be. We look at our data in much the same way as you might flick through your selfies to find the one that shows you the way you want to be seen. (Rettberg 87)Crucially, Rettberg sees data as both affective and agential and she observes that data can also be edited and shaped by the individual. Some of this practice is deliberate, taking the form of an engagement with narrative as a “story” of self that underpins the practice of writing autobiography, for example. However, the representation of self can also be more oblique. “The first writing” says Rettberg, “was developed not to record words and sentences but to keep accounts. Arguably, recording quantities of grain or other valuables can be a form of self-representation, or at least representation of what belongs to the self” (10).Like log-books or field notebooks, like calendars or almanacs—prosaic forms of daily sequential recording that are understood to prioritise information capture over self-reflection—the Fitbit is usually presented as a method for accruing and representing personal data. In contemporary digital culture, “data” is a complex and fraught term and recent debates around “big data,” which describes the capacity of machines to make connections and perform calculations that a human might not necessarily notice or be able to perform, has crystallised this. What Melissa Gregg calls the power and “spectacle” of data is an ideological pivot in digital cultures of the twenty-first century, one that turns in conjunction to discourses of evidence and authority that emerge in relation to the visual: “sharing the same root as ‘evidence,’ vision is the word that aligns truth and knowledge in different historical moments” (3).For autobiography scholars exploring how formal modes of capture might also be genres, or how a Fitbit might coax a narrative of self, these questions are formative. Sorapure says: Information graphics that visually represent personal data; collaboratively constructed and template-based self-representations in social media and networking sites; the non-narrative nature of aggregated life writing: in these and other new practices we see selves emerging and being represented through interactions with technologies. (271)In the twenty-first century, self-quantification and tracking technologies like the Fitbit are ever more present in individual spheres of everyday activity. These devices prompt behaviour, affect self-knowledge, and signal identity: I am a fit person, or trying to be, or was. A Fitbit cannot record how it feels to spend 34 minutes in the “peak zone,” but it can prompt recollection, it is a mnemonic, and it provides an account of time spent, how, and by whom. Is a Fitbit a diary? The diary in the twenty-first century is already vastly different to many of its formal historical counterparts, yet there are discursive resonances. The Fitbit is a diary if we think of a diary as a chronological record of data, which it can be. However, contemporary uses of the diary, just like their historical antecedents, are also far more diverse and complex than this.Crucially, the Fitbit, like the diary, signals identity in relation to experience and so it reflects various and shifting cultural values or anxieties over what is worth measuring or documenting, and conversely, over what is not. “The private diary,” as Lejeune asserts, is a way of life: “the text itself is a mere by-product, a residue” (31). Historical diary keeping practices unfold from and emerge within cultures that position self-expression and its documentation of this as a means to self-improvement. Seeing the Fitbit within this tradition draws attention to the discursive ideology behind self-tracking as a personal practice that nonetheless positions itself in relation to cultural norms and to ideals (such as health, or fitness, or conscientiousness, or goodness).ConclusionWhat kind of self-representation is produced by practices of self-quantification, where personal data is amassed continuously and contiguously to individual experience? The legacy of centuries of historical diary-practice has been evident to various scholars exploring the cultures of self-tracking that are evolving in response to wearable technologies like the Fitbit. In her book length study of self-tracking cultures, The Quantified Self, Lupton observes that “self-tracking tools” are inevitably “biographical and personal” and that “contemporary self-tracking tools and records are the latter-day versions of the paper diary or journal, photo album, keepsake and memento box or personal dossier” (73). While, in Self-Tracking, Neff and Nafus argue that new technologies “intersect with the way that people have self-tracked for centuries like keeping diaries or logs. The growth of these digital traces raises new questions about this old practice” (2).What does it mean to think of wearable technology like Fitbits in relation to diaries, and what are the implications of such a conception? Privacy settings allow the Fitbit to comply with popular stereotypes of diaries that exist in popular culture; that is, as a locked or secret record. However, in the case of wearable technology the content is in the form of data. While data often poses as neutral and objective information, seeing this instead as diaristic can draw valuable attention to dominant cultural ideals that shape value in relation to self and technology in the twenty-first century. Crucially, “while self-knowledge may be the rhetoric of wearable device advertising, it is just as much a technology of being known by others” (Crawford, Lingel, and Karppi 493-494).Is my Fitbit a diary? It tracks my body’s movements and gestures and reports them to the conscious self. It stores chronologically accumulated data over time. It enables self-reflection and the visualisation of a set of daily habits, and it may produce or coax new behaviour. Diaries have long performed this function: tracking, recording and, documenting for making sense of later, on reflection, or after enough time has passed. Contemporary advances in technology related to self-tracking and personal data collection make possible a new range of previously unimaginable information in relation to individual experience. However, the diary’s cultural status as a “confessional” form intersects with exigencies around “health” and “self-improvement” that corporations producing devices like Fitbit promote to their customers in ways that will demand further attention.ReferencesCardell, Kylie. Dear World: Contemporary Uses of the Diary. Wisconsin UP, 2014.Connor, Rebecca Elisabeth. Women, Accounting and Narrative: Keeping Books in Eighteenth-Century England. London: Routledge, 2011.Crawford, Kate, Jessa Lingel, and Tero Karppi. “Our Metrics, Ourselves: A Hundred Years of Self-Tracking From the Weight Scale to the Wrist Wearable Device.” European Journal of Cultural Studies 18.4-5 (2015): 470-96.Franklin, Benjamin. The Autobiography of Benjamin Franklin: The Complete Illustrated History. Minneapolis: MN Voyageur Press, 2016.Gregg, Melissa. “Inside the Data Spectacle.” Television & New Media 16.1 (2014): 1-15.Lejeune, Philippe. On Diary. Eds. Jeremy D. Popkin and Julie Rak. Trans. Katherine Durnin. Honolulu: U of Hawai’i P, 2009.Lupton, Deborah. “Personal Data Practices in the Age of Lively Data.” Digital Sociologies. Eds. Jessie Daniels, Tressie McMillan Cottom, and Karen Gregory. Bristol: Policy P, 2016. 339-54.———. The Quantified Self. Cambridge: Polity, 2016.McCarthy, Molly A. The Accidental Diarist: A History of the Daily Planner in America. Chicago: U of Chicago P, 2013.Neff, Gina, and Dawn Nafus. Self-Tracking. Cambridge: The MIT P, 2016.Rettberg, Jill Walker. Seeing Our Selves through Technology: How We Use Selfies, Blogs and Wearable Technology to Shape Ourselves. Basingstoke: Palgrave Macmillan, 2014.———. “Self-Representation in Social Media.” The Sage Handbook of Social Media, Eds. Jean Burgess, Alice E. Marwick, and Thomas Poell. London: Sage, 2017. 429-43.Sedaris, David. “Stepping Out.” The New Yorker 30 Jun. 2014. 18 Apr. 2018 <https://www.newyorker.com/magazine/2014/06/30/stepping-out-3>.Sorapure, Madeleine. “Autobiography Scholarship 2.0?: Understanding New Forms of Online Life Writing.” Biography 38.2 (2015): 267-72.

This thesis contends that older persons, whose mental capabilities remain intact, are capable of expanding their conscious awareness; they have not necessarily passed their prime as they begin the process of retiring. They may be showing a worn and weakened package but this does not mean they cannot live a fulfilling life. This is the reason for the development of a new form of therapy, called 'Trans-subjective Therapy', because it combines the objective and the subjective with the trans-personal, or unconscious levels of consciousness. Trans-subjective therapy connects the various systems of objectivity, subjectivity, and the transpersonal, or unconscious, so that the client can be facilitated into clearer, deeper understanding of themselves and others, and expand their conscious awareness in a wholesome, fulfilling manner. This thesis describes development and testing of this new therapeutic approach, which is designed specifically to enable older persons to experience more fulfilling and aware lives. Although building on existing therapeutic modalities, this new formulation is unique in that every feature of its design was selected, developed and tested with the specific needs of older persons in mind. This approach emphasises the personal responsibility of the client to expand his/her conscious awareness in the direction of personal choice. This has particular application to the needs of older persons, most of whom are at a stage in life where meaning and purpose have either become clarified or a sense of meaninglessness and resentment dominates their lives. Quotes from the transcripts of the author's testing of this approach with 12 individuals who undertook training in this methodology have been used throughout the text to illustrate the application of this approach. Its effectiveness is inferred from the manner in which each person in this group has expressed him/herself at a level of consciousness freely chosen and individually experienced in a manner that will be novel or completely new to the person involved.
Doctor of Philosophy (PhD)

This thesis contends that older persons, whose mental capabilities remain intact, are capable of expanding their conscious awareness; they have not necessarily passed their prime as they begin the process of retiring. They may be showing a worn and weakened package but this does not mean they cannot live a fulfilling life. This is the reason for the development of a new form of therapy, called 'Trans-subjective Therapy', because it combines the objective and the subjective with the trans-personal, or unconscious levels of consciousness. Trans-subjective therapy connects the various systems of objectivity, subjectivity, and the transpersonal, or unconscious, so that the client can be facilitated into clearer, deeper understanding of themselves and others, and expand their conscious awareness in a wholesome, fulfilling manner. This thesis describes development and testing of this new therapeutic approach, which is designed specifically to enable older persons to experience more fulfilling and aware lives. Although building on existing therapeutic modalities, this new formulation is unique in that every feature of its design was selected, developed and tested with the specific needs of older persons in mind. This approach emphasises the personal responsibility of the client to expand his/her conscious awareness in the direction of personal choice. This has particular application to the needs of older persons, most of whom are at a stage in life where meaning and purpose have either become clarified or a sense of meaninglessness and resentment dominates their lives. Quotes from the transcripts of the author's testing of this approach with 12 individuals who undertook training in this methodology have been used throughout the text to illustrate the application of this approach. Its effectiveness is inferred from the manner in which each person in this group has expressed him/herself at a level of consciousness freely chosen and individually experienced in a manner that will be novel or completely new to the person involved.

Thesis (Ph.D.) -- University of Western Sydney, 2002.
A thesis submitted in fulfillment of he requirements for the degree of Doctor of Philosophy at the University of Western Sydney, School of Social Ecology and Lifelong Learning, College of Arts, Education and Social Sciences, Oct. 2002. Bibliography : p. 303-321.