Mindfulness, Mysticism, and Narrative Medicine

The influence of psychological interventions on surgical outcomes: a systematic review

BACKGROUND

An amplified and/or prolonged surgical stress response might overcome the organs' functional reserve, thus leading to postoperative complications. The aim of this systematic literature review is to underline how specific psychological interventions may contribute to improve surgical outcomes through the positive modulation of the surgical stress response in surgical patients.

METHODS

We conducted a comprehensive literature search in the Cochrane Register of Controlled Trials, PubMed, EMBASE, Scopus, PsycINFO, and CINAHL databases. Only studies published in English from Jan 2000 to Apr 2022 and reporting pain and/or anxiety among outcome measures were included in the review. The following psychological interventions were considered: (1) relaxation techniques, (2) cognitive-behavioral therapies, (3) mindfulness, (4) narrative medicine, (5) hypnosis, and (6) coping strategies.

RESULTS

Among 3167 records identified in the literature, 5 papers were considered eligible for inclusion in this review because reporting the effects that psychological features have on neurochemical signaling during perioperative metabolic adaptation and those metabolic and clinical effects that the psychological interventions had on the observed population.

CONCLUSION

Our findings confirm that psychological interventions may contribute to improve surgical outcomes via the positive influence on patients' metabolic surgical stress response. A multidisciplinary approach integrating physical and non-physical therapies can be considered a good strategy to successfully improve surgical outcomes in the perioperative period.

A Medical Sublime

Inspired by a passage from Kate Chopin's The Awakening, this article considers the possibility of a "medical sublime." It works through a history of the sublime in theory and in the arts, from ancient times to the present. It articulates therapeutic dimensions of the sublime and gives contemporary examples of its medical relevance. In addition, it develops the concept of sublime-based stress-reduction workshops and programs. These workshops bring the sublime out of the library and the museum into the lives of the healthcare community-patients, families, clinicians, staff, concerned others-in the service of better navigating human vulnerability and finitude. Opening the cannon of aesthetic theory and the arts as resources for the human condition is at the heart of health humanities. The sublime can be an invaluable tool in this task.

Contemporary Artists' Books and the Intimate Aesthetics of Illness

This essay brings together critical perspectives from the discrete traditions of artists' books and the medical humanities to examine artists' books by three contemporary artists - Penny Alexander, Martha A. Hall and Amanda Watson-Will - that treat experiences of illness and wellbeing. Through its focus on a multimodal and multisensory art form that has allegiances with, but is not reduced to, narrative, the essay adds to recent calls to rethink key assumptions of illness narrative study and to challenge utilitarian approaches. In particular, it draws attention to the aesthetic and imaginative elements of illness communication by exploring how artists' books represent lived experiences in a distinctively palpable way and offer an "intimate authority" that extends beyond narrative legitimacy or a form of struggle against the medical gaze. By interrogating narrative's dominance in medical humanities research, the essay further expands awareness of illness experiences that resist conventional forms of representation (such as chronic illness), and of alternative reflective practices within healthcare education that encourage engagement with both mind and body.