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    Li, Rita Yi Man. Rogers, P. Jalal, and J. Boyd An Introduction to Sustainable Development. Sianipar, C. European Journal of Sustainable Development , 2 4 , Social justice and ecological teaching relocates the meaning of early childhood education from school readiness to social and emotional learning and intellectual development. It offers another way to understand childhood, reminding us that this is a time when children ought to be developing core social and ecological dispositions rather than cramming for the tests ahead. In these ways, social justice and ecological teaching becomes a form of resistance to the view that early childhood education is unskilled work, important only in as much as it prepares children to recite the alphabet, identify colors, and count to Social justice and ecological teaching is intellectually and emotionally engaging work; it sustains, rather than drains, teachers and caregivers.

    This is a far remove from scripted curricula and preplanned lessons; it is authentic teaching—and it is the kind of teaching our society urgently needs. We need teachers who are engaged and curious, who create in their classrooms cultures of deep listening, compassionate perspective-taking, and critical thinking.

    Now, though, Head Start directors, community childcare leaders, administrators in state-funded preschools, and other early childhood educators are coming together with colleagues in elementary and secondary education to strengthen the movement against packaged curricula and assessments. The push to create universal prekindergarten UPK programs offers another entry point for activism on behalf of children, families, and teachers.

    Yet UPK classrooms typically adopt often by the mandate of funding agencies standardized curricula characterized by rote learning and skill-and-drill teaching. This compromises the assertion that these are top-quality programs.

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    In addition to these contradictions, UPK threatens to disrupt community-based childcare programs, as families and teachers exit these programs to move into UPK classrooms. UPK is in its infancy; this is the time for concerned educators, parents, and community members to get involved in shaping how it unfolds.

    Another challenge that carries us into action beyond our daily teaching arises from the ongoing discrimination that early childhood educators face. In the late s, teachers and caregivers of young children began to organize in protest of the unlivable wages and lack of benefits that characterize early childhood education. They created the Child Care Employees Project, a national effort to draw attention to poor working conditions in early care and education and to jumpstart initiatives that would make early childhood education a sustainable career.

    The Child Care Employees Project gave rise to the Worthy Wage Campaign, as early childhood educators across the country took part in creative, bold acts of protest and challenge, and began to form and join unions in an effort to improve working conditions. In the three decades since this movement began, important ground has been won—and new struggles have emerged. There is work for us to do beyond our classrooms, stepping into the terrain of broad social action aimed at transforming the working conditions for early childhood educators.

    There is an even broader arena of social concerns to acknowledge. There is much work to be done, and all of it is interconnected. Caring about young children means caring about—and taking action to improve—the social conditions that shape their lives and determine their opportunities. References 1. Loris Malaguzzi. Renzo Barazzoni, ed. Reggio Emilia, Italy. Reggio Children. Dorrie Seavey. Washington, D. Institute for Future of Aging Services.

    Terry Tempest Williams. The Open Space of Democracy. Great Barrington, Mass. The Orion Society. We asked the contributors to Rethinking Early Childhood Education to recommend some of the resources that they find useful in their work. Below are their recommendations. Organizations and Websites in html or as a PDF.

    Cookies are required for this website to present certain basic features. Continue Shopping Checkout. It has been suggested that the more cohesive cultural, ethnic, and religious structure of Indian, Pakistani, and Bangladeshi communities may confer greater social support than in other groups that may otherwise share similar levels of discrimination. That the excess risk of psychoses for Asian immigrants in our sample appeared to be restricted to women provides anecdotal support for the social defeat hypothesis given the additional pressure of marginal status faced by some women in Indian, Pakistani, and Bangladeshi communities Coid et al.

    If we are to take culture seriously—and it is high time we did—it is these types of aspects emigration systems, social integration, etc. To begin with, the epidemiological, family, twin, and adoption studies on which this myth is based do not adequately support such assertions Leo, , ; Crow, ; Fleming and Martin, ; Joseph, ; James, However, and as these authors stress, the question is not the accuracy of the percentage, but rather the inextricability of genetics and environment, insofar as genetics itself is modulated by the environment even while we are in the womb.

    The fact that schizophrenia runs in the family does not mean that it is in the genes; after all, religion and accent, for example, also run in the family. Furthermore, the passing on of schizophrenia via the family would be surprising, seeing as these individuals are by no means the most prolific reproducers Hare, , chap.

    In , these authors were confident that molecular genetics would confirm the statistical genetics. While the human genome has been described and ground-breaking methods and projects have been developed, the genes for schizophrenia are still nowhere to be seen. From the most comprehensive genetic association study of genes previously reported to contribute to the susceptibility to schizophrenia, based on reasonable candidate genes, a large, rigorously phenotyped sample and a dense set of single nucleotide polymorphisms SNPs Sanders et al.

    Although the disappointing study focused on candidate genes may possibly continue, genetic research is adopting the genome-wide association studies GWAS paradigm. In contrast to gene-specific candidate-driven studies, GWAS investigate the entire genome, in which hundreds of thousands of SNPs are tested for association with a disease in hundreds or thousands of persons.

    GWAS have revolutionized the search for genetic influences on complex traits, identifying hundreds of genetic variants that contribute to a variety of common traits and illnesses.

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    But even though dozens of genes have been linked to a trait or disease, the individual and cumulative effects are disappointingly small, and far from sufficient for explaining the previously estimated heritability Manolio, Larger and larger samples are showing smaller and smaller effect sizes James, ; Leo, This disappointing finding has turned the issue of personal genomes into the case of the missing heritability, a veritable mystery Zuk et al. There are several possibilities.

    A possibility is that the missing heritability consists, partly, in copy-number variations CNVs , emerging de novo , in an individual without family history of mutation Bassett et al. In reality, the majority of the genetic variants so far identified Sekar et al.

    A further possibility is that such or so much heritability simply does not exist, because it is over-estimated. As more is known about the genetics of schizophrenia, environmental factors appear to be the most important Stepniak et al. Epigenetics shows how there is environmental regulation of the genome and its functions, whereby the different genomic, contextual, and environmental components interact non-additively throughout development Gottlied, The behavior of organisms themselves, in this case the phenotype, influences the genome, both through its influence on the environment and directly.

    Thus, in relation to schizophrenia, it has been possible to identify epigenetic mechanisms such as DNA methylation, histone modifications, and chromatin remodeling Rutten and Mill, What is important to highlight here is that these epigenetic changes occur in response to life adversities known to be associated with schizophrenia, such as abuse in childhood Read et al. Possible vulnerability to future experiences due to early epigenetic changes should be understood in the context of original and continued life adversities, according to bi-directional causality Gottlied, ; Laland et al.

    The linear G-E model should give way to one of reciprocal influences that incorporates the phenotype van Os et al. The environment can shape phenotypes as well as inducing epigenetic changes. Phenotypes, that is, people's psychotic symptoms and adaptive efforts, can build environments which in turn induce and select epigenetic changes. Although phenotypes are never separated from the environment, we can conceive of their direct epigenetic influence, as way of life or continued pattern of response.

    Genetic dispositions can select environments and influence phenotypes, which in turn feedback influence in terms of genetic stability. In any case, what is involved is an ongoing and intricate interplay: environment-behavior-genetics. However, the treatment of choice for schizophrenia is so-called antipsychotic medication.

    Notwithstanding the fact that it would be difficult to dispense with it, the truth is that antipsychotic medication presents at least three problems as the treatment of choice: 1 It is merely symptomatic, insofar as it ignores the circumstances that have led to the crisis. Medication becomes the topic of subsequent visits—whether to maintain it, reduce it, change it, etc. The condition sine qua non in the psychotherapy of schizophrenia is a particular kind of therapeutic relation. This interpersonal encounter would be more focused on an understanding of the person's altered being-in-the-world experience than on repairing the supposed malfunctioning of a mechanical system Nelson et al.

    Phenomenology offers a vision that situates patient's disorders not in the hidden circuits of their brains, nor in remote corners of their minds, but in the real word of their lives with others, in the Lebenwelt , which is, after all, the only world in which psychotherapy takes place Fuchs, An empathic bridge between the therapist and the patient is at the basis of possible recovery in schizophrenia. The space necessary for a person to emerge from the illness is opened up by means of the person being perceived by others as more than his or her illness Davidson, , p.

    Within this approach, the narrative takes on special importance Roe and Lysaker, More specifically, the narrative can serve as a thread for re-authoring lives. What is behind the symptoms is a tormented, disconnected, disintegrated, diminished self. Narratives do not merely recount experience, but actually form it, insofar as the functions of language and hermeneutics are not only expressive, but also constitutive of one's own experience and personal history Raffard et al. Acceptance is important in schizophrenia in relation to upsetting experiences, such as voices, the attempt at control of which is often more pernicious than beneficial.

    Acceptance has much to do with mindfulness, a more common application in cases of psychosis Abba et al. For its part, commitment consists in reorientation toward values significant for one's life, despite the fact that certain experiences persist and disturb. Commitment is acting in the direction of values in spite of the distress caused by the symptoms.

    The question is not to wait until one gets better before going out and living, but rather to act and remake one's life so as to feel better, or at least, to be on the way to something, and not just shut up inside oneself. This reorientation of self-experiences toward values begins with the identification and clarification of one's own values. We have proposed seven reasons, linked together, for a reconsideration of schizophrenia first and foremost as a disorder of the person, not of the brain.

    The argumentational thread is the role of the self, of the subject or of the person in the disturbance for which schizophrenia is diagnosed. This thread is at the basis of each one of the reasons discussed. The first reason deals with the actual conception of schizophrenia as a disorder of the experience of oneself and of the world ipseity , in accordance with criteria of a phenomenologically-informed psychopathology Fuchs, ; Stanghellini, Schizophrenia being an alteration of the basic self or center of gravity, it is understood as affecting the person in toto and his or her way of being-in-the-world Sass, ; Stanghellini and Rosfort, The second reason refers to its modern origin.

    The third reason concerns the juvenile onset of schizophrenia, which has a dual implication in the perspective taken here. One is that adolescence, the period in which schizophrenia usually has its beginnings Harrop and Trower, , is a critical time in the formation of the self Erikson, Thus, certain normal characteristics of adolescence have aspects in common with the clinical manifestations for which schizophrenia is diagnosed Fonseca-Pedrero et al.

    The other implication is that adolescence as a critical age is a historical phenomenon that coincides with the modern origin of schizophrenia, so that it is no coincidence that the name of the disorder avant la lettre —hebephrenia—denoted youth Stanghellini G. The fourth reason, the better prognosis for schizophrenia in developing countries compared to those of the developed world, may also have to do with the role of modernization in the determination and configuration of schizophrenia Cooper and Sartorius, The fifth reason, referring to the high incidence of schizophrenia observed among migrants from traditional communities such as the former colonies of the West Indies in European cities, at the same time as calling into question the well-rehearsed genetic and neurobiological explanation, demands an alternative one in terms of social causes Morgan and Hutchinson, b.

    The exposition of the sixth reason includes a reappraisal of the role of genetics in schizophrenia. Without negating its possible role, but not magnifying it either Joseph, ; Ross, , here genetics is not given primacy, but rather situated in the context of the conditions of life and of development, in accordance with epigenetics, whereby the decisive aspect in genetic terms is what occurs over the whole course of development.

    Thus, environmental factors such as abuse as a child, disorganized attachment or the impact of emigration, may bring about epigenetic changes that predispose one to schizophrenia Read et al. Schizophrenia may indeed be hereditary, without being genetic Jablonka and Raz, The seventh reason, which closes the circle, is the possibility of a psychotherapy of schizophrenia, without detriment to its being complemented by drugs where necessary.

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    Rethinking Schizophrenia in the Context of the Person and Their Circumstances: Seven Reasons

    The sensitivity of schizophrenia to psychological therapy is understood in accordance with the interpersonal context provided, a condition for the recovery of one's sense of self Fuchs, ; Stanghellini and Lysaker, If, as stated in our exposition of the first reason, schizophrenia stems from a crisis of the sense of self, a natural recovery involves the provision of an interpersonal context such as that of psychotherapy Davidson, The possibility of a psychotherapy of schizophrenia is based on the simple but fundamental idea that people diagnosed with schizophrenia are people, and continue to be so.

    The reasons considered situate schizophrenia as a human condition—rather that a natural one—of historical-cultural origin and biographical nature, related to vicissitudes and circumstances of life. In any case, the nature of schizophrenia is and will continue to be controversial and for that very reason is worth a proposal such as the present one, which does not lessen the possibility of future improvements. The hypothesis and theory derives from all authors as a research group.

    MPA drafted the manuscript. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. National Center for Biotechnology Information , U. Journal List Front Psychol v. Front Psychol. Published online Nov 3. Author information Article notes Copyright and License information Disclaimer.

    This article was submitted to Psychopathology, a section of the journal Frontiers in Psychology. Received Jun 8; Accepted Oct 7. The use, distribution or reproduction in other forums is permitted, provided the original author s or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    This article has been cited by other articles in PMC. Abstract We know a great deal about schizophrenia, but the current state of the art is one of uncertainty. Keywords: ipseity-disturbance model, self-disorder, schizophrenia, hyperreflexivity, disociation. Schizophrenia as a disorder of ipseity The conceptualization of schizophrenia presented here mainly follows the developments resulting from the work of US psychologist Louis Sass and Danish psychiatrist Joseph Parnas Sass and Parnas, , among that of many others. The ipseity-disturbance model Alterations of ipseity in schizophrenia have three aspects Sass and Parnas, ; Sass, : hyper-reflexivity, diminished self-affection, and alteration of articulation with the world.

    Table 1 The ipseity-disturbance model. Ipseity Ipseity-disturbance Examples Sense of oneself as existing as a vital and self-identical subject of experience and action and as a first-person perspective on the world. The center cannot hold. There is no longer a vantage point from which to look out, take things in, assess. Hyper-reflexivity: intensified self-consciousness that involves self-alienation. Corporeal sensations; de-automatization; thoughts-aloud etc. Diminished self-affection: diminished sense of existing as the subject of one's own experience and action.

    De-vitalization; feeling influenced; de-personalization. Open in a separate window. Validity of the schizophrenia concept in terms of ipseity The heterogeneity of schizophrenia, which called into question its established nosological and neurobiological conception Keshavan et al. Empirical reasons: notable incidence since the 19th century and a telling absence prior to it Much of the data and hypotheses about the recent origin of schizophrenia are provided by Edward Hare in his compilation of previous works entitled On the History of Lunacy Hare, and by Fuller Torrey and Judy Miller in The invisible plague Torrey and Miller, Conceptual reasons: affinity between schizophrenia and modern culture What is the explanation for the fact that schizophrenia is a relatively recent phenomenon?

    As Stanghellini remarks in this regard: It is legitimate to think that this radical dualism between a subject who is thinking and an object that is conceived of a pure and simple extensive externalness—pure consciousness and pure materialness—is the fundamental eidos of both modernity and schizophrenic depersonalization Stanghellini J. The juvenile onset of schizophrenia Schizophrenia is a disorder with onset at the end of adolescence, its peak age in incidence being around twenty. The historical parallel between schizophrenia and adolescence The historical coincidence should not be overlooked.

    Schizophrenia as a developmental disorder The neurodevelopmental model is well established Catts et al.


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    • Contrary to the neurocentric and individualist approach, the enactive approach foregrounds a different notion of the living body of which the brain is a part in its ongoing sense-making relation to the world. Adversities, dissociation, and schizophrenia Beyond such situations of stagnation in adolescence, it is necessary to consider patterns of attachment and traumatic experiences.

      Figure 1. Better prognosis for schizophrenia in less developed countries Schizophrenia has better prognosis in developing countries than in the developed world. What do less developed countries have that produce a lower incidence of schizophrenia? The high incidence of schizophrenia among migrants High rates of schizophrenia have repeatedly been found over the last 20 years among immigrants from various countries in a range of European cities Coid et al.

      A challenging phenomenon for psychiatry Quite apart from the public health tragedy involved, this phenomenon represents quite a challenge for psychiatry Morgan and Hutchinson, b. Social causes of schizophrenia A number of social factors are involved: urban stress, unemployment, poverty, family separation, racial discrimination, and so on. Similar regarding to Asians: It has been suggested that the more cohesive cultural, ethnic, and religious structure of Indian, Pakistani, and Bangladeshi communities may confer greater social support than in other groups that may otherwise share similar levels of discrimination.

      Figure 2. Conclusions: closing the circle We have proposed seven reasons, linked together, for a reconsideration of schizophrenia first and foremost as a disorder of the person, not of the brain. Author contributions The hypothesis and theory derives from all authors as a research group. Conflict of interest statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. References Abba N. Responding mindfully to distressing psychosis: a grounded theory analysis.

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      Seen, Heard and Counted: Rethinking Care in a Development Context

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