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Is there a connection between the exchange of vows and the fighting and suffering of couples that are unique to the institution of marriage? This essay introduces the concept of Shadow Vows, the unacknowledged assumptions, agreements, and obligations each partner brings to the relationship, which the authors believe are often responsible for longstanding marital discord and strife. The authors ground the existence of shadow vows in Jung's quaternity, alchemy, typology, archetypal theory, and depth approaches to couple therapy. The essay concludes with a list of themes indicative of shadow vow enactments in clinical work with couples. Y a-t-il un lien entre l’échange des vœux et les conflits et souffrances des couples, un lien qui serait spécifique à l’institution du mariage ? Cet article introduit le concept de « vœux de l’ombre » - les présomptions non-reconnues, les compromis, les obligations que chaque partenaire amène dans la relation. Les auteurs pensent que de tels vœux sont souvent responsables de discorde et querelles durables dans un couple marié. Les auteurs fondent l’existence de ces vœux de l’ombre dans la quaternité Jungienne, l’alchimie, la typologie, la théorie des archétypes et la thérapie de couple selon la psychologie des profondeurs. L’article se termine par une liste de thèmes révélateurs des mises en acte de ces vœux de l’ombre dans le travail clinique avec des couples. Gibt es eine Verbindung zwischen dem Austausch von Gelübden und den Kämpfen und Leiden von Paaren, die einzigartig für die Institution der Ehe sind? Dieser Essay stellt das Konzept der ‘Schattengelübde' vor - die uneingestandenen Annahmen, Vereinbarungen und Verpflichtungen, die jeder Partner in die Beziehung einbringt, die nach Ansicht der Autoren oft für langjährige Zwietracht und Streit in der Ehe verantwortlich sind. Die Autoren begründen die Existenz von Schattengelübden in Jungs Quaternität, Alchemie, Typologie, Archetypentheorie und Tiefenansätzen in der Paartherapie. Der Aufsatz schließt mit einer Liste von Themen, die auf das Ausagieren von Schattengelübden in der klinischen Arbeit mit Paaren hinweisen. C’è una connessione tra lo scambio di promesse e la lotta e la sofferenza delle coppie che sono peculiari nell’istituzione del matrimonio? Questo saggio introduce il concetto di ‘promesse ombra’ - i presupposti, gli accordi e gli obblighi non riconosciuti che ogni partner porta nella relazione, che gli Autori ritengono siano spesso responsabili delle durature discordie coniugali e dei conflitti. Gli Autori basano l’esistenza delle promesse ombra nella quaternità, nell’alchimia, nella tipologia, nella teoria archetipica e negli approcci approfonditi di Jung alla terapia di coppia. Questo saggio si conclude con una lista di temi indicativi della messa in atto delle promesse ombra nel lavoro clinico con le coppie. Существует ли связь между брачными обетами и ссорами и страданиями пар, характерная исключительно для института брака? В статье обсуждается концепция “теневых обетов” - неосознаваемых допущений, соглашений и обязательств, которые каждый партнер привносит в отношения и которые, по мнению авторов, часто являются причиной длительных супружеских разногласий и раздоров. Авторы обосновывают наличие “теневых обетов” с помощью юнговских концепций четверичности, алхимии, типологии, теории архетипов и глубинного подхода к терапии супружеских пар. В конце статьи приведен перечень тем, в которых проявляется разыгрывание теневых обетов в клинической работе с парами. Existe una conexión entre el intercambio de votos y el conflicto y sufrimiento de las parejas, que es única a la institución del matrimonio? El presente ensayo introduce el concepto de ‘sombra de los votos’ - las asunciones, acuerdos y obligaciones no reconocidas que cada integrante de la pareja trae a la relación, las cuales los autores creen que a menudo son responsables de largos conflictos y desavenencias en el matrimonio. Los autores basan la existencia de la sombra de los votos en la noción de cuaternidad de Jung, alquimia, tipología, teoría arquetipal, y los abordajes en psicología profunda a la terapia de pareja. El ensayo concluye con una lista de temas indicativos de actuaciones del lado sombrío de los votos en el trabajo clínico con parejas. 当左手接触时:影子誓言和荣格的夫妻关系 誓言的交换与婚姻制度特有的夫妻间的争斗和痛苦之间是否存在着联系?这篇文章介绍了 “影子誓言 ”的概念--每个伴侣都在关系中投入了一些未获承认的假设、协议和义务, 作者认为这往往是造成长期婚姻不和和争吵的原因。作者将影子誓言的存在建立在荣格的夫妻关系、炼金术、类型学、原型理论和夫妻治疗的深度方法之上。文章最后给出一个主题列表, 它们提示了在夫妻临床工作中所颁布的各类影子誓言。.
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Jeanne Marrazzo, an HIV prevention researcher, sees need for more "holistic" approach to community health problems.
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Negotiating sexual agreements in combination with couples' voluntary HIV counseling and testing (CVCT) may help further reduce HIV transmission in Zambian concordant HIV-negative couples (CNC). Though CVCT has been shown to reduce HIV transmission in CNC by 47%, approximately half of residual infections occur in this group. We developed a "Strengthening Our Vows" video session to foster communication and negotiation of explicit sexual agreements to reduce concurrent sexual exposures and prevent HIV transmission to the spouse due to unprotected, extramarital sex. CNC were recruited through CVCT services at five clinics in Lusaka and Ndola in 2016. Enrolled CNC attending the facilitated group video sessions were encouraged to discuss sexual agreements at home and return 1-2 weeks later for follow-up assessment. One-fourth of the 580 CNC returning reported a history of extramarital partners and/or a sexually transmitted infection (STI) prior to enrollment. More than 95% reported a friendly, supportive 15-60 min negotiation culminating in an agreement to remain monogamous or disclose sexual contacts and use condoms together until a repeat HIV test 30 days after an outside sexual exposure. Two-thirds of participants identified at least one threat to adherence of their agreements including alcohol use, financial pressures, travel, discord in the home, and post-partum or menstrual abstinence. CNC negotiated explicit sexual agreements to avoid exposure to HIV through concurrent partnerships and protect the spouse in the event of an outside sexual contact. Open communication was a consistent theme to facilitate mutual protective efforts. Long-term follow-up of HIV/STI incidence is ongoing to assess the impact of these agreements.Trial registration This sub-study is part of a trial retrospectively registered on ClinicalTrials.gov (Identifier: NCT02744586) on April 20, 2016.
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Most people living with dementia are supported by their spouse and/or an adult child, yet little is known about how husbands and sons approach dementia caregiving. Using an exploratory mixed method design, this study examined male dementia carers': approach to help-seeking; motivations to step-into the carer role; expectations of formal services; and appraisal of carer-burden. Qualitative thematic analysis of (n = 32) semi-structured interviews with male carers suggested that masculinity norms shape the male approach to caregiving, summarised under two themes: 'Help-seeking: The way blokes do it'; and 'Sons approach caregiving differently to husbands'. Findings suggest that males typically seek help at crisis point and expect professionals to provide directive task-focused support to manage the crisis. Husbands were motivated to care, as a commitment to their marriage vows, while sons cared as a form of 'pay-back' to their parents. Husbands articulated functional carer-burden, while sons expressed emotional carer-burden. However, quantitative analysis of (n = 22) responses on the 12-item Zarit Burden Interview scale showed no significant difference in carer-burden scores between husbands and sons. These findings could inform the tailoring of formal services for male carers of people with dementia.
This exploratory phenomenological study explores the emotional and spiritual experiences of Muslim mothers in Turkey during breastfeeding, particularly when their infants are hospitalized. Guided by Jean Watson's Theory of Human Caring, in-depth semi-structured interviews were conducted with 19 mothers in the pediatric ward of a university hospital in the Aegean region. Five main themes emerged from the data: emotional, physical, and social changes during breastfeeding; maternal motivation; religious and spiritual practices; perceptions of motherhood; and the influence of sociocultural beliefs. The findings reveal that breastfeeding is not only a biological necessity but also a deeply emotional and spiritual experience. Mothers described breastfeeding as a sacred responsibility and a profound source of inner peace, shaped by religious rituals such as prayer, Quran recitation, and vows. Cultural and familial expectations also significantly influenced their breastfeeding behaviors. These experiences align with Watson's principles of holistic, compassionate, and spiritually sensitive care. The study highlights the importance of integrating emotional and spiritual support into postpartum care. Healthcare professionals-particularly nurses and midwives-are encouraged to acknowledge and support the spiritual and emotional needs of breastfeeding mothers to enhance maternal well-being and promote successful breastfeeding.
BACKGROUND: Primary Health Centers (PHCs) in India face challenges of overcrowding, infrastructure vows, and disarrayed workflows. The 6S management method—Sort, Set in Order, Shine, Standardize, Sustain, and Safety—offers a structured, low-cost approach to improving efficiency, safety, and quality in healthcare delivery. AIM: To examine the feasibility and impact of implementing the 6S method in a PHC setting, focusing on improvements in workplace organization, safety, and healthcare service processes. METHODS: A prospective longitudinal study was conducted at a PHC in India over three months. The 6S method was introduced through staff by conducting training to them, weekly audits, and feedback mechanisms. Pre- and post-intervention assessments were carried out using two structured evaluation tools: one based on quantitative scoring, and another based on operational compliance. Data were analyzed using Jamovi software. RESULTS: Overall workplace performance improved from approximately 30% before implementation to 95% after. The most significant gains were observed in Set in Order (5% to 100%), Shine (0% to 95%), and Standardize (20% to 100%). Evaluations also revealed increased adherence to safety protocols, improved cleanliness, reduced visual cluttering, and better staff discipline. A minor gap remained in achieving paperless standardization, but the transformation reflected a shift from a high-risk environment to a high-performing, lean healthcare facility. CONCLUSION: Implementation of the 6S method significantly improved workplace efficiency, hygiene, safety, and standardization in a resource-constrained PHC setting. The approach is feasible, scalable, and aligned with national healthcare quality improvement priorities.
A new nurse vows to honor the humanity of her patients.