Evidence Based Practice in Mental Health Nursing Essay Example for Free

Evidence Based Practice in Mental Health Nursing Essay One of the most common and disabling psychological disorders encountered within mental health and general medical settings is that of an anxiety disorder (Dattilio Kendall 2000). Research has indicated that people with learning disabilities are more prevalent to psychological disorders than the general population (Hassiotis et al 2000) consequently it could be hypothesised that prevalence rates of anxiety disorders are similar if not greater within the learning disabled population. Professional literature suggests that cognitive-behaviour therapy (CBT) has been an effective treatment against anxiety disorder (Beck 1995) however; this literature has predominately concentrated its focus to within the confines of mental health and general medical settings (Dattilio Kendall 2000). The ability of people with learning disabilities to identify, evaluate and respond to their dysfunctional thoughts and beliefs, fundamentals of CBT (Beck 1995) have put into question the very use of this treatment programme for this particular client group (Kroese et al 1997). From a professional and personal perspective and through the utilisation of the Seedhouse (1998) Ethical Grid responding to an anxiety disorder by way of CBT could be considered an ethically acceptable clinical intervention. Nationally and locally through government directives, Valuing People (Department of Health 2001) and initiatives such as Health Action Plans (Department of Health 2002) services have recognised that they need to be more responsive to the mental health needs of people with learning disabilities. As a learning disability nurse wishing to ascertain the effectiveness of CBT as a practical intervention when presented with the dual-diagnosis of anxiety disorder and learning disability, is through the use of evidence-based practice. When deciding on the best possible clinical intervention for an identified practice problem it seams logical to convert the issue into a single answerable question (Colyer Kamath 1999). Several authors have identified that the use of frameworks to inform the development of the clinical question provide the practitioner with a systematic process of formulating an answerable question (Sackett et al 1997 Ridsdale1998). One such framework as described by Sackett et al (1997) is a four- stage process, known by the acronym PICO: Patient or Population Intervention or Indicator Comparison or Control Outcome The construction of an answerable question is the basis of evidence-based practice and should guide the practitioner to how to find an answer (Ridsdale 1998). It is important that each variable under the PICO framework is clearly defined, being as detailed and explicit as possible in order to extend clarification to the question. Working through PICO methodically the practitioner would instigate the process by defining the Patient or Population. Characteristics such age, gender and diagnosis would need to be deliberated and whilst the aforementioned were easily recognised in the practice area as adult male, identifying appropriate terminology for diagnosis can prove problematic. The term Learning Disability is often used interchangeably in literature with terms such as, Mental Retardation and Intellectual Disabilities. Learning Disability is a term with contemporary usage within the United Kingdom to describe a client group with significant development delays (Gates 1996). Whilst the idiom Learning Disability is the preferred terminology for the question due to its contemporary usage it must be accepted that its a term not internationally recognised nor is it a term used for long in the United Kingdom (Gates 1996). Anxiety disorder comes in many facets and can be described as severe psychological disorders in which abnormal or chronic anxiety interferes with daily living (Adams Bromley 1998). The client in the practice area had described psychological and physiological symptoms that were diagnosed as a social anxiety disorder through rating scales and self-report measures. It is crucial that the practitioner is aware that the term identified for the question as social anxiety is often recognised by the synonyms, social phobia or panic disorder (Dattilio Kendall 2000). The recognition of this inconsistent terminology will enable an evaluation to  take place between the relationships of the chosen term to symptoms displayed by the client. The identification of existing clinical interventions is a valuable part of the process of developing evidenced-based interventions (Meijel 2003). Literature suggests that CBT is an effective treatment for a number of psychological disorders (Embling 2002 Hatton 2002). Central to the model of CBT is that distorted or dysfunctional thinking is prevalent in all psychological disorders (Beck 1995). Analysis of accumulated experience of existing interventions and the aforementioned evidence of its validity led to the application of CBT as the question intervention. It is not imperative for the question to have a comparison intervention and this was the situation in the clinical problem described, therefore the conclusive element utilising the PICO framework was outcome. The outcome should be measurable (Sackett et al 1997) and after initially trivialising with the term used it became evident that this would not develop into something that could be measured. Discussing whether or not an intervention is effective however would provide the question with a measurable outcome. Revision of the terminology identified through the PICO framework would consequently translate the question as Is cognitive-behaviour therapy an effective intervention for adult males with learning disabilities diagnosed as suffering from social anxiety? A well-formulated search strategy is an essential component in gathering appropriate evidence (Hewitt-Taylor 2002). Ridsdale (1998) discusses a four-stage search strategy that helps to translate the question into a meaningful search a) Identify the subject elements of the question b) Define the relationship between the subject elements c) Convert the subject elements into search themes d) Decide on the scope of the search Assistance to define the subject elements can be found within the PICO framework Patient Learning Disability, Social Anxiety Intervention CBT Outcome Effectiveness Once identified an effective means of linking the subject elements of a question for the search process is through the use of operators. Operators such as: And Or Not, form a logical link between the elements of the question and can be used collectively or individually in any electronic database search (Ridsdale 1998). All of the subject elements of the question were required in order provide a conclusive answer therefore the operator required for the search strategy could be identified as And. The subject elements then require conversion into terms by which references can be retrieved (Ridsdale 1998). A keyword search would apply the terms identified as the subject elements, however making a list of the known synonyms of the subject elements such as Intellectual Disability and Mental Retardation, for inclusion, would substantially develop the search process. Finally the scope of the search decides what is wanted from the search. In order to identify the most appropriate type of evidence that is required for the practice problem the type of question asked must be identified (Sackett et al 1997). The question developed through the PICO framework can be readily identified as questioning, the effectiveness of a therapy. Sackett et al (1997) proposes that the best available evidence to answer this type of question is comparative / prospective studies and ideally random controlled trials (RCTs) which in turn determine the choice of database (Ridsdale 1998). Sackett et al (1997) provides a comprehensive catalogue of information resources such as databases, journals and web sites along with descriptions  of the type of evidence that can be found within these resources. It was established previously that the best type of evidence for the question would be RCTs and comparative / prospective studies. From the descriptions supplied by Sackett et al (1997) it could be identified that the Cochrane Library supplies the user with full text systematic reviews of effects of health-care interventions along with bibliographies of controlled trials. Further electronic databases identified through Salford University library information services were PsycINFO that contains citations and summaries of journal articles and books in the field of psychology chosen for its congruity with the clinical intervention. Swetswise an electronic journal aggregator that provides access to full text publications from several major health care related academic publishers and IngentaConnect which offers full text availability for all core Blackwell science and medical journals were chosen due to familiarity of use and extensive subject matter. Other databases considered were CINAHL, EMBASE and AMED however all were discounted due to their general nursing bias. Despite the recognition of Ridsdales (1998) four-stage search strategy and its systematic approach the initial search were completed exploiting familiar strategies through the IngentaConnect database. Preconceptions from previous endeavours searching for relevant evidence furnished the belief that a similar strategy would provide sufficient evidence to answer the question. A number of the subject elements were used through keyword searches whilst the operator And was used to link each in turn (See Appendix). This easy to use search strategy produced a number of hits however none matched the criteria identified as being the most appropriate type of evidence to answer the question. The search revealed that almost all of the evidence found belonged in either mental health (Heimberg 2002) or general medical settings (Scholing Emmelkamp 1999). Whenever the term learning disability or mental retardation was utilised they invariable appeared indiscriminately amidst the title or abstract of the article providing no specific relevance to the question. The frustration born out of this strategy led to further searches of electronic databases firstly through another familiar database, Swetswise. Ridsdale (1998) identifies that too many hits will be recovered if the subject element is to general  and this was evident in the first keyword search. The term learning disabilities produced 548 hits (See Appendix) far too many to feasibly scan. The subsequent four searches failed to produce a single hit a possibility also recognised by Ridsdale (1998) who suggests alternative synonyms are utilised in this circumstance. Due to the inability to find any relevant material of value towards answering the question Ridsdales (1998) four-stage strategy was then conscientiously adopted in conjunction with the knowledge acquired through lectures received at Salford University. A further search of Swetswise database was completed (See Appendix) which revealed significantly less hits than previously achieved but produced a literature review (Hatton 2002) specifically aimed at the use of CBT and people with learning disabilities. Whilst this evidence did not fulfil previous identified criteria it established that pursuing Ridsdales (1998) strategy could provide some success. A similar approach was undertaken while searching the Cochrane Library database which allows the user to restrict the search to the acquisition of systematic reviews and controlled trials whilst using a simple keyword option. Again the subject elements were utilised along with the recognised operator and despite new found confidence and kno wledge the search strategy revealed no evidence of systematic reviews or RCTs with regards to the question (See Appendix). All systematic reviews or RCTs retrieved belonged within general and mental health settings. The final electronic database to be utilised was PsycINFO (via Ovid) where again Ridsdales (1998) four-stage strategy was conscientiously adopted. PsycINFO requires the user to have some prior knowledge of how to use electronic databases and their search strategies, which initially can prove bewildering to the novice. Once familiar with the database and its ability to combine search strategies either through keyword, journal or author the user should find it a practical resource (See Appendix). No systematic reviews or RCTs were found within the results however a further literature review (Feldman Rivas-Vazquez 2003) aimed at psychosocial interventions and people with intellectual disabilities was unearthed along with evidence from child and adolescence services (Dadds Spence 1997) and psychiatric services (Carmin Albano 2003). Hatton (2002) suggests that research evidence on the effects of psychosocial interventions  for people with learning disabilities is sparse, whilst Kroese (1998) adds that therapists are reluctant to engage into therapy with this client group due to their dislike of having to relate to them. In an attempt to discover any type of evidence relating to people with learning disabilities and CBT the Salford University library catalogue was searched (See Appendix). A simple keyword search revealed one book (Kroese et al 1997) attaining the subject elements however again it did not produce the type of evidence recognised as the most appropriate to answer the question. Sackett et al (1997 p.2) defines evidence based practice as: the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. With this definition in mind it should be established as to what constitutes current best evidence and its implications for the practitioner wishing to implement evidence based practice. Belsey Snell (2001 p.2) states that, evidence is presented in many forms and the value of evidence can be ranked according to the following classification in descending order of credibility: I. Strong evidence from at least one systematic review of multiple well-designed randomised controlled trials II. Strong evidence from at least one properly designed randomised controlled trial of appropriate size III. Evidence from well-designed trials such as non-randomised trials, cohort studies, time series or matched case-controlled studies IV. Evidence from well-designed non-experimental studies from more than one centre or research group V. Opinions of respected authorities, based on clinical evidence, descriptive studies or reports of expert committees In accepting this hierarchy of evidence practitioners should concede that the systematic review of multiple well-designed RCTs constitutes best available evidence (Colyer Kamath 1999). Sullivan (1998) adds weight to this argument when he states that RCTs constitute the strongest source of evidence and that the scientific community prefer the quantitative research technique that makes use of empirical data following a systematic process. Whilst a number of RCTs were found (Dadds Spence 1997 Scholing Emmelkamp 1999) whilst undertaking the search strategy none belonged within learning disability settings. The only evidence found specific to the original question were literature reviews and a specialist book (Kroese et al 1997) aimed at CBT and learning disabilities. The literature reviews (Hatton 2002 Kroese 1998) revealed that a number of case studies and a case series had demonstrated the potential feasibility of CBT reducing anxiety amongst people with learning disabilities. Whilst the specialist book (Kroese et al 1997) discussed conceptual and contextual issues of CBT and people with learning disabilities suffering anxiety disorders. This type of evidence appears in the lower reaches of the hierarchy of evidence and as such its subjectivity, reliability and validity can be disputed (Sullivan 1998). Whilst acknowledging the hierarchy of evidence and the proposal that comparative / prospective studies and ideally RCTs were the best forms of evidence to answer this type of question (Sackett et al 1997) it appears that in their absence the evidence revealed is the best available. RCTs are widely acknowledged as the gold standard of evidence-based practice (Rowland Goss 2000) however it is suggested that they bear little resemblance to day-to-day reality (McInnes et al 2001). RCTs can be pragmatic or explanatory the former is concerned with the overall effectiveness of an intervention whilst the latter examines the impact of specific treatment elements on outcome (Parry 2000) however neither considers the perspectives and uniqueness of the respondents. The evidence recovered for the question (Hatton 2002 Kroese 1998) albeit in the lower reaches of the hierarchy acknowledges the feelings of the respondents due to its qualitative nature (patient centred, holistic and humanistic) therefore making it extremely suitable for the study of nursing phenomena (Parahoo  1997) along with its relevance as regards answering a therapy question (Parry 2000). Kroese (1997) offers a number of reasons why there is this lack of quantitative research evidence surrounding the subject elements in the question. He suggests that people with a learning disability are a devalued population, it is impossible to ensure that changes are due to clinical manipulations if individuals (learning disabled) do not have stable cognitions. Finally there is a conjecture that anxiety in people with learning disabilities is the same as in the general population consequently there is no need for specifically focused research. It emerges that learning disability services continue to adapt research evidence from general and mental health settings (Finlay Lyons 2001) a similar approach with the RCTs recovered from the search strategy could make them a valued resource however it would take a skilled clinician to make this a feasible option. Reflection is a necessary component of Continuing Professional Development and is a legitimate method for questioning personal effectiveness and responsibility in all aspects of health care (Driscoll Teh 2001). Through the process of reflection the practitioner recognised his own limitations in identifying appropriate evidence for his clinical problems, along with the often inconclusive, time consuming and frustrating strategies undertaken in the search of evidence in support of his clinical practice. The structured frameworks utilised throughout the process described earlier gave the practitioner a systematic approach to formulating a question, developing a search strategy and identifying appropriate evidence to answer his practice problem. The ability to systematically approach future clinical problems will enable the practitioner to offer his clients a holistic, client centred practice from the best external evidence available. Adams, B. Bromley, B. (1998) Psychology for Health Care Key Terms and Concepts, London, Macmillan Press Beck, J.S. (1995) Cognitive Therapy Basics and Beyond, London, Guildford Press. Belsey, J. Snell, T. (2001) What is Evidence-Based Medicine? [Internet] Available from www.jr2.ox.uk/bandolier (Accessed 7th December 2004) Carmin, C.N. Albano, A.M. (2003) Clinical Management of Anxiety Disorder in Psychiatric Settings: Psychologys Impact on Evidence-Based Treatment of Children and Adults, Professional Psychology: Research and Practice, Vol. 34, No. 2 pp 170-176. Colyer, H. Kamath, P. (1999) Evidence-based practice A philosophical and political analysis: some matters for consideration by professional practitioners, Journal of Advanced Nursing, Vol. 29, No. 1, pp 188-193 Dadds, M.R. Spence, S.H. (1997) Prevention and Early Intervention for Anxiety Disorders: A Controlled Trial, Journal of Consulting and Clinical Psychology Vol. 65, No. 4, pp 627-635. Dattilio, F.M. Kendall, P.C. (2000) Panic Disorder In: Dattilio, F.M. Freeman, A. Cognitive Behavioural Strategies in Crisis Interventions 2nd Edition, London, The Guildford Press. Driscoll, J. Teh, B. (2001) The potential of reflective practice to develop individual orthopaedic nurse practitioners and their practice, Journal of Orthopaedic Nursing, Vol. 5, pp 95-103 Embling, S. (2002) The effectiveness of cognitive behaviour therapy in depression, Nursing Standard, Vol. 17, Nos. 14-15, pp 33-41 Feldman, L.B. Rivas-Vazquez, R.A. (2003) Assessment and Treatment of Social Anxiety Disorder, Professional Psychology: Research and Practice Vol. 34, No. 4, pp 396-405. Gates, B. (1996) Learning Disability In: Kenworthy, N. Snowley, G. Gilling, C. (Eds) Common Foundations Studies in Nursing Second Edition, London, Churchill Livingston. Hassiotis, A. Barron, P. OHara, J. (2000) Mental Health Services for People with Learning Disabilities, British Medical Journal, Vol. 321, Issue 7261, pp 583-584 Hatton, C. (2002) Psychosocial interventions for adults with intellectual disabilities and mental health problems: A review, Journal of Mental Health, Vol. 11, No. 4, pp 357-373. Hewitt-Taylor, J. (2002) Evidence-based practice, Nursing Standard, Vol. 17, Nos. 14-15, pp 47-52. Department of Health (2001) Valuing People A New Strategy for Learning Disability for the 21st Century, A White Paper, London, HMSO. Department of Health (2002) Health Action Plans and Health Facilitation Good Practice Guidance for Learning Disability Partnership Boards, London, Department of Health. Heimberg, R.G. (2002) Cognitive-Behavioural Therapy for Social Anxiety Disorder: Current Status and Future Directions, Society of Biomedical Psychiatry, Vol. 51, pp 101-108. Kroese, B.S. Dagnan, D. Loumidis, K. (1997) (Eds) Cognitive-Behaviour Therapy for People with Learning Disabilities, London, Brunner-Routledge. Kroese, B.S. (1998) Cognitive-Behavioural Therapy for People with Learning Disabilities, Behavioural and Cognitive Psychotherapy, Vol. 26, pp 315-322. McInnes, E. Harvey, G. Fennessy, G. Clark, E. (2001) Implementing evidence-based practice in clinical situations, Nursing Standard, Vol. 15, No. 41, pp 40-44. Meijel, van B. Game, C. Swieten-Duijfjes, van B. Grypdonck, M.H.F. (2003) The development of evidence-based nursing interventions: methodological considerations, Journal of Advance Nursing, Vol. 48, No. 1, pp 84-92. Parry, G. (2000) Evidence-based psychotherapy In: Rowland N. Goss S. (Eds) Evidence-Based Counselling and Psychological Therapies Research and Applications, London, Routledge. Ridsdale, L (1998) (Ed) Evidence-based Practice in Primary Care, London, Churchill Livingston. Rowland, N. Goss, S. (2000) (Eds) Evidence-Based Counselling and Psychological Therapies Research and Applications, London, Routledge. Sackett, D.L. Richardson, W.S. Rosenberg, W. Hayes, R.B. (1997) Evidence-based medicine: how to practice and teach EBM, London, Churchill Livingston. Scholing, A. Emmelkamp, P.M.G. (1999) Prediction of treatment outcomes in social phobia: a cross-validation, Behaviour Research and Therapy, Vol. 37, pp 659-670 Seedhouse, D. (1998) Ethics The Heart of Health Care 2nd Edition, Chichester, Wiley. Sullivan, P. (1998) Developing evidence-based care in mental health nursing, Nursing Standard, Vol. 12, No. 31, pp 35-38

The Benefits of Medicinal Marijuana Usage Essay -- Exploratory Essays

The Benefits of Medicinal Marijuana Usage All ears were listening intently at what the professor had to say on the subject. Many viewers were in shock and disbelief at what some of the potential medical uses of marijuana are. At the conclusion of the lecture, many whispers filled the courtroom and the judge entered from behind his desk and sat down. Richard Johnson sat in silence waiting in anticipation to hear what he had to say. Johnson and his wife Ellen, were arrested August 24 and charged with numerous drug-related offenses. Authorities seized approximately 1,030 live and dead marijuana plants, worth between $300,000 and $900,000, at their house. The judge positioned his glasses on the tip of his nose and stated, " The Johnsons have pleaded guilty to one charge of cultivating marijuana for the use of terminal cancer patients in conjunction with their chemotherapy treatment. At this time you may be dismissed and this case will resume next week." Richard and Ellen were handcuffed and taken back to their jail cells where they had plenty of time to think about their mishaps. Outside the courtroom, Johnson's attorney, Roger Simms, said he hoped Harvard psychiatry professor's testimony Monday would educate people on various medical benefits of marijuana. Simms stated that there are many books on the subject containing the history of medical use dating back 3,000 years in China. The Chinese emperor, Shen Neng, introduced many pharmaceutical drugs including marijuana. Emperor Shen Neng prescribed marijuana tea for malaria, beriberi, rheumatism, and curiously, poor memory (Earleywine, M. 2002). Marijuana eventually spread from China to India. The sacred Indian text, Atharvaveda, listed marijuana as a holy pl... ...ana. New York: Oxford University Eustice, Carol. (2004). Medicinal Marijuana: A Continuing Controversy. Retrieved March 11, 2004, from http://arthritis.about.com/cs/medmarijuana/a/ marijuanadebate.htm Medicinal marijuana: the struggle for legalization.(1997). Retrieved March 11, 2004, from http://www.cnn.com/HEALTH/9702/weed.wars/issues/background/ Medicinal Marijuana.(2000, August - September). Retrieved March 11, 2004, from http://www.hc-/sc.gc.ca/english/feature/magazine/2000_08/marijuana.htm Medicinal Marijuana. (2002). Retrieved March 11, 2004, from http://www.cannabis-/ seeds.biz/medicinal-marijuana.htm Roffman, R. (1982). Marijuana as Medicine. Washington: Madrona Pubishers Savage, David G. & Bailey, Eric. (2003, October). Medical Marijuana Cause Boosted. Retrieved March 30, 2004 from http://www.cannabisnews.com/news/thread 17573.shtml

Greek Tragedy Essay

Art and literature has existed throughout time to represent and express cultural values, ideals and perceptions. It often portrays the forces that push one’s particular culture onward, mentally stimulating and expanding individual mind and thought. In ancient Greek culture, Art and Literature is combined in a way that represented all of these things to its people. This combination is what we know as ancient Greek Theater, an art of drama and song, with the structure of â€Å"spoken portions interlaced with choral lyrics, all concerned with man’s fate. â€Å"1 Greek tragedy is credited to have developed around 534 B. C when the Greek Thespis created drama in which a main actor conversed with the leader of the chorus (this is where the term â€Å"thespian† originated, it has been used to describe an actor since the early 19th century). 2 Aeschylus, the first of the great 3 tragic poets, added a second actor to his plays and had a chorus of around 12. Sophocles, the second of the great poets, added the third actor and increased the chorus to 15 members. Sophocles is considered to model Greek tragedy, with Aeschylus marking the preparation and Eudripidies the decline. 3 These plays where preformed at Festivals in open-air theaters in which poets competed for prizes. It is widely accepted that these festivals where religious, and honored the Greek god Dionysius (God of Wine). All plays where developed around well-known ancient Greek myth, it was the Poets job to develop character and deepen plot. Each festival included 3 tragic poets to present a â€Å"tetrology. â€Å"(A group of 4 plays) which consisted of 3 tragedies and one satyr. 4 Each play would include anywhere from two to four actors, and an assembly of 12-15 choral members. It was each actor’s responsibility to display the plot through speech, however they where also responsible for singing solos. The chorus was an important tool in Greek tragedy as they commented on each scene and proposed subtleties to the audience, their song also heightened the emotion and atmosphere of the play. 5 Aristotle’s â€Å"Poetics† is considered the most valuable source of guidance for Greek tragedy. Aristotle defines tragedy as † a drama which concerned better than average people (hero’s, kings, gods) who suffer a transition from good fortune to bad fortune and who speak in an elevated language. † 6 It is also defined as † a literary composition written to be preformed by actors in which a central character, called the tragic protagonist or hero, suffers some serious misfortune which is significant in that the misfortune is logically connected with the hero’s actions. â€Å"7 The hero is often host to some â€Å"tragic flaw† (hermatia) for which he himself is responsible, and which leads to his eventual downfall. However, Aristotle describes this tragic flaw to lead to a mistake in which the Protagonist is not aware. The hero’s destruction is often due to his self-ignorance. It is important to understand what Aristotle believes is the purpose for Greek tragedy in order to completely understand some of its main aspects. In Aristotle’s opinion, one of the marks of great tragedy is its ability to create a Cartharsis, the act of purging the soul of â€Å"fear and pity. â€Å"8 Through creating a complex protagonist, a character who is seen as a great man, or â€Å"hero†, the audience in turn creates respect. Through this character’s tragic flaw, and ignorance to his actions, the audience is drawn and starts to pitty the hero. The audience imagines themselves in the hero’s situation, and although they know the outcome of the story (as all Greek tragedy is bases on well-known Greek myth) they suspensefuly await the hero’s reaction to his fate. So this â€Å"purging† allows the audience to shed excess fear, refreshing their conscience so that it can exist in a healthy balance. Aristotle theorized that â€Å"tragedy is rooted in the fundamental order of the universe. â€Å"9 Tragedy is a worse case scenario, which describes the possible effects of simple probability. It creates a â€Å"cause-and-effect chain† in which any individual can envision themselves as part of. We can now understand the importance of certain aspects of the tragic hero’s character and his responsibility to uphold the plot. â€Å"A hero, in the Greek sense, is a man who by his extraordinary career has pushed back the horizons of what is possible for humanity and is then deemed worthy of commendation after his death. â€Å"10 As we know, this hero is not flawless. However, it is important to realise that in what Aristotle values as good tragedy, these flaws often contribute to the very virtues which allow our protagonist to become a hero in the first place. In other words, tragic irony is implicated, and it is the same incidents and qualities of a man which catapult him to hero stature as those which drag him down. Tragedy is concerned with the fate of â€Å"big men. â€Å"11 Aristotle believed that Sophocles’, â€Å"Oedipus Rex† was the perfect tragedy. Why was Oedipus Rex in effect the perfect tragic hero? Oedipus was a great man and King of Thebes. He was self righteous, hasty and suspicious of his friends, but we also see that if it where not for these qualities Oedipus would not have continued with his inquiries. His heroic nature is magnified in his persistence for the truth despite the fact that it became quite obvious that gaining further knowledge would end in disaster and self-destruction. 12 Peripeteia is when a character produces â€Å"an effect opposite to that which he intended to produce. † 13Aristotle firmly believed that all good tragedy proposed some peripeteia within its plot. This is perfectly represented within â€Å"Oedipus Rex. † Oedipus promises his people that he will find the root of the plague that gripped his kingdom. In ancient Greek times, it was believed that illness and plague where signs from the gods that they where upset or a crime against their godly standards had been committed. So as any noble hero would do, Oedipus sets out on a quest for this knowledge. He soon discovers that the murder of Thebe’s prior king, Laius, is the root off his city’s pollution. He vows to discover the murderer, and sets the punishment of death or banishment to whomever was found guilty. This was his intention. We can also see again that Oedipus is a noble hero, as he is a king and he is willing to go to any ends for his people. These traits would have invoked feelings of respect in the minds of the audience. As Oedipus discovers more information, he draws nearer to the conclusion that it is possible that through self-blindness and ignorance, Oedipus himself is the likely murderer of Laius. Through this step in the play we see that again Oedipus carries the qualities of a tragic hero; his murdering of Laius was due to his self-arrogance and lack of knowledge that the man who he was killing was of high status. This murder was indeed due to Oedipus’s tragic flaw of Hubris (‘arrogant disregard for the rights of others’, or â€Å"overbearing pride or presumption† 14) but he was unaware of the consequences and the murder was quite spontaneous. Oedipus continues to search for the truth despite his possible self-guilt, as he states that he must be sure that he is indeed Leuis’s murderer. This, according to human standards, Oedipus not only behaved well in this situation, but he is known to have â€Å"asserted the dignity of manhood. † Alas, more investigation does lead to his definite guilt, and also leads to what is known as an â€Å"Agagnorisis,† or a † change from ignorance to knowledge. â€Å"15 Oedipus had not been born heir to the throne of Thebes. After learning of a prophecy that he would one-day murder his father and marry his mother, he ran away from his ‘parents’ to escape this fate. He had arrived in Thebes just after the time of Laius’s death. A sphinx was afflicting the city at the time, and he defeated it, there-for winning the admiration of the Thebans and stealing the heart of newly widowed queen, Jocasta. Their marriage was nearly instant, and they lived in happiness for some years and produced a number of children. So it was at this â€Å"agagnorisis† when Oedipus learnt that he had been adopted, and that Laius had been his father, and Jocasta his mother. They had discarded him apon a hill after hearing the very same prophocy, hoping they too could escape their fate. This unraveling of the plot is called the â€Å"lusis. â€Å"16 This is where the Peripeteia is for filled. Although Oedipus had always intended to catch and punish the murderer of Leius, he in no way intended that it would be himself who was responsible. This is also ironic in the sense that twice he had unknowingly set the path for his own destruction. Another form of Greek tragedy is the decision that the tragic hero must face once he has reached his agagnorisis. 17 Oedipus had a choice, to continue to live in sin with his mother/wife and perpetuate the slow destruction of Thebes, or to uphold the little dignity he had left, finally accept his fate and finalize the promises he made to his people. Oedipus chooses to do what any hero would do, accept responsibility for his actions and punish himself as he promised to do in the beginning of the play. The knowledge of his sin against his father and mother causes him to blind himself, as he could not bear to look upon the world any longer. This fact again adds irony to the story, as when Oedipus was able to see physically, he was still blind to his past and the consequences of his actions. Through his blinding, he was self-knowing, and he had for the first time accepted his fate. He left Thebes as a blind beggar. Although in some respects Oedipus is now seen as no longer a hero, the audience would have respected his final decisions, and in some way he had corrected his moral flaw through his self-punishment. We can now question the belief of fate and pre-determination. Greek tragedy did indeed deal with the role of the gods in mortal life and to the extend that mortals controlled their actions. Oedipus was responsible for his deeds, as it was by no accident that Laius died, and Oedipus did have a tragic flaw, which led to this murder. But we can also examine the fact that a prophecy existed which laid out the steps that Oedipus would take through out his life. If it where not for Oedipus’s knowledge of this prophecy, would he have ever left his home in Corinth, would he have ever murdered Laius, and married his mother? Or we can look even further into Oedipus’s past; if Jocasta and Leius had not known of this prophecy, they would never had abandoned Oedipus, and perhaps he would never had committed the sins which it seems he was destined to commit. So again we see a cause and effect chain, knowledge leading to ignorance, ignorance in turn leading to knowledge, blindness to sight, sight to blindness. It is also argued that it was the individual’s attempt to escape their fate which was the true crime against the gods. It is at this point we can see how the Cultural Revolution, known as ‘The Greek Enlightenment’, effected these drama’s. It was from this new atmosphere of questioning and individualism in which man started to question the meaning of life beyond the restraints of ‘God rules man. ‘ And not only did Greek tragedy come to question the gods, it also questioned what it meant to be human. 18 1 The Complete Plays of Sophocles. 2 http://www. stemnet. nf. ca/~hblake/tragedy1. html 3 http://www. classics. cam. ac. uk/Faculty/tragedy. html 4 www.depthame. brooklyn. cuny. edu 5 15 Greek Plays 6 The Complete Plays of Sophocles 7 www. depthame. brooklyn. cuny. edu 8 9 www. cnr. edu/home/bmcmanus/poetics. html 10 The Complete Plays of Sophocles. 11 The Complete Plays of Sophocles 12 The Complete Plays of Sophocles 13 www. depthame. brooklyn. cuny. edu 12 American Heritage dictionary 15 www. cnr. edu/home/bmcmanus/poetics. html 16 www. cnr. edu/home/bmcmanus/poetics. html 17 http://www. stemnet. nf. ca/~hblake/tragedy1. html 18 http://www. stemnet. nf. ca/~hblake/tragedy1. html.

Internal Conflict in Barn Burning by William Faulkner and...

The works Barn Burning by William Faulkner and The Chrysanthemums by John Steinbeck at first glance may seem to have no connection, but in spite of different plot they focus on similar ideas. The story Barn Burning by William Faulkner discusses the inner conflict within Sartoris Snopes, a young boy who faced a dilemma. He tries to make a decision of choosing between to lieing in the court under his fathers pressiure who does not want to get into the jail and acting against his father by telling the truth. The main character is influenced by Abner, his father, who tells him, You got to learn to stick to your own blood or you aint going to have any blood to stick to you. ( P 496). I think this quote reflects the main issue of the†¦show more content†¦Sarty still cares for his family in some sense, he still feels love towards his father, even though he understands that what his fathers deeds are wrong and he really had to stop them and cease to be a part of them. The fact that the boy is not able to come back home is not a question of his choice, I think he just canont go back. So, Sartys heart still suffers from some conflict that is not really resolved, even thoug h the situation has really changed. As I have already discussed, at the beginning of the story Sarty feels a strong allegiance to his father, however, finally we learn that his views change radically. The point of culmination is at the end of the story when Sarty has warned Major de Spain of Abners intentions to burn the barn. I think that the main character experiences the burst of emotions, running down de Spains drive and hearing Majors horse galloping behind him. The resolution to the conflict comes when Abner and his elder son are shot. But the real solution happens at night after Abners death, when Sarty is sitting upon the crest of a hill thinking about his actions and future life. Faulkner proves us that it is impossible to sruggle with ones own heart . The moment when Sarty decided to choose morality over the blood pool and warned the de Spains revealed his true character. Though this meant the death of his