We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
Unfortunately, the advice to eat less saturated fat probably isn't going away anytime soon. Like the baseless ideas that calories are calories, or fat people simply lack willpower, fear of dietary fat has become entrenched in our thinking about nutrition, and won't die no matter how many times it's debunked. But if we're going to be lead to believe that saturated fat is harmful to our brains, the link should be based on more than observational research. I'm certainly not convinced that I need to eat less bacon, anyway.
This is part of why my high-meat, zero carb weight loss program (fixed) works: all calories are not handled the same way (and bacon and eggs are a good, healthy diet breakfast). More here:
There are and always have been populations around the world who are both poor and very physically active who have obesity rates very similar to those of the United States and other Western societies. Under this paradigm, there are certain foods — mainly carbohydrates — that stimulate an insulin response and cause weight gain. Avoiding these foods is probably a good idea for those of us who easily store body fat.
Like I said, if you want to lose weight, cut out the carbs and eat meat. Calory-counting does not work because it's the insulin that stores the carbs.
It's because of "jumping genes." These genes may be residues of viral genes which, over millions of years of cellular evolution, inserted themselves into the DNA of cellular forms of life.
... the pace of scientific discovery is slow. This does not mean that we need to hide every step of it from view until we get the results that we deem worthy of sharing. On the contrary, I agree with those who think that sharing at the more interim steps can only improve what we do. Yet the innumeracy, fame and fortune are forces that put such free sharing in peril by misrepresenting it as the final answer to everything. And when the answer is changed, which is not only expected, but indeed desired in scientific pursuits, the public opinion punishes science.
That’s the whole substance of the paper. Straight-ahead chemistry, exploring a possible explanation for an observed phenomenon and drawing out one tentative prediction. “Showing that it could have happened this way is not the same as showing that it did,” the author most properly concedes. He should have quit while he was ahead. What imp of the perverse induced him to add two more sentences?
Such life forms could well be advanced versions of dinosaurs, if mammals did not have the good fortune to have the dinosaurs wiped out by an asteroidal collision, as on Earth. We would be better off not meeting them.
That the “rich and powerful” are identical to conservatives and Republicans—Edsall’s assumption—is a hoary idea dear to many Democrats and essential to their self-image as the opponents of privilege. It persists even though many of the plushest and most powerful institutions of American life are in the hands of liberal Democrats: public and private universities, government bureaucra-cies, nonprofit foundations, movie studios, television networks, museums, newspapers and magazines, Silicon Valley . . . Among the fabled “1 percent,” according to Gallup, the number of self-identified Republicans is only slightly greater than the number of Democrats. As Christopher Caldwell has pointed out in these pages, political donations from 19 of the 20 richest ZIP codes in the United States go overwhelmingly to Democrats, by a ratio of four to one or more. Democrats are the party of what Democrats used to call the superrich. Only Democrats seem not to realize this.
In the U.S, the DSM boils down to three critical issues: reimbursement, reimbursement and reimbursement. It should be renamed the American Diagnostic and Reimbursement Manual, so that those who use it outside the U.S. better understand the influences behind it.
A therapy patient of mine recently sat thoughtfully for a few minutes, then exclaimed "Oh my God, I've been acting as if I really had power over all these things, as if I had the power to prevent bad things from happening."
"Yes you have," I said. "That's your good insight for the day."
"I've been doing this all my life. Am I crazy?"
"Not at all," I said. "You just discovered one of your underlying assumptions about things. We call them 'unconscious fantasies' - or we call them that until you become aware of them."
One of the rewards of my work is helping people discern their hitherto unattended-to, unexamined, "unconscious" operating principles. When these are held up to the light, it can be disorienting, humbling, and distressing for many to realize that much of their problematic or ineffective behavior has been determined by following a false map, as it were. To mix metaphors even further, to realize that they were standing on unsolid ground.
My very pleasant businesswoman patient came to the realization that one of her dominant operating principles was to keep everybody in her world, everyone she knew, safe from distress, worry, discomfort, disease, and misfortune. Not only did this principle run her ragged, but it often failed. When it failed, she blamed herself for not having done enough. The unconscious fantasy she uncovered might be called a "fantasy of omnipotence."
Everybody operates, to varying degrees, according to unconscious fantasies about themselves, others, and the world in general. Nobody is 100% in reality. Problems can arise depending on how far the hidden assumptions diverge from reality. Reality is the harshest teacher, and never spares the rod.
What are these things made of? Freud discovered/defined them, although writers and students of human nature have always been interested in the irrational consistencies of personality. Freud said that they are constructed from wishes, fears, hopes, dreams, experiences, temperaments, and especially defenses. I think that is true. During maturation, they become organized like pieces of mental software. Like the beating heart and the digesting bowel, they are part of what and who we are while operating outside our awareness.
Unfortunately, we cannot ask people what their deep operative fantasies are, because they are, by definition, unaware of them. That's where Psychoanalytic skills come in, like soul-surgeons, to try to biopsy and, perhaps, extract the problem software. However, our medical rule is primum non nocere so we try not to let the best become the enemy of the good-enough.
Fortunately, the human mind seems to have a relatively limited repertoire of unconscious fantasies, so we experts are expected to be able to identify them, in time. That's a topic for another post, maybe.
Forget the "Obesity Crisis." That's a crock. Abundant, good food is a blessing and a rarity in human history so it is a great privilege and luxury to be overweight. It certainly is true that, when tasty food is cheap, people will eat a lot of it and their bodies will kindly store what they don't need to survive today, to the detriment of our knees, hips, appearance, comfort, and general vigor. Trouble is, we won't need that storage tomorrow - or ever. It's like hoarding.
We can all be as fat or fit as we wish to be. It's a free country, and being fat (but not obese) isn't terrible for your health unless you are diabetic or want to be able to get around energetically. But don't listen to the Dieticians and Nutritionists. They will want you to get in shape slowly and in a "sustainable" way. In your heart, you know that will never happen. If you are bothering to read this, you just want to get in shape as quickly as you can without liposuction or use of the vomitorium.
This can be a one- to three-month program as desired. Maintenance is another topic.
1. Our basic exercise plan is simple. Assuming you do not do physical labor 8-10 hours/day, our minimum is simply 30-50 minutes of any form of vigorous aerobics per day. Intensity to maximum tolerated, whatever that may be for your fitness level. Have to get the body wakened and moving. Ordinary mall-walking doesn't count, nor do sexual encounters regardless of how athletic they may be.
2. Here's the simple diet plan: Almost Zero Carbs:
- Go easy on the volume. 2 meals/day, plus a small lunchtime snack if you cannot tolerate midday deprivation (eg two shrimp, or one slice of meat, or a hard-boiled egg, a pickle, and salad at the most). If you feel hungry between meals, do somethinginteresting or useful instead and the craving will pass in a few minutes. - Any sort of grilled, stewed, or baked meat you want. Steak, shellfish, lobster, anything. Fatty fish (salmon, tuna, Bluefish, etc) are fine. Sauces for them are fine, too. Your dinner will be meat and low-carb vegetables or salad. - Eggs are good, and so are bacon and sausage in small doses - All the vegetables and greens you want (but no beans of any sort, no peas, no corn, and no root vegetables at all - including no carrots or beets. No winter squash. Summer squash is fine. Tofu is fine too.) - Oil and vinegar dressing is fine. Butter is fine. - No cereals or grains in any form - No nuts - No milk or dairy (including no yoghurt), beer, or sugared soft drinks. Coffee and tea, wine and cocktails are ok. - Essentially no fruit. Fruit is just flavored sugar, warm popsicles. Three strawberries, or 1/4 of an apple, or a handful of blueberries daily. No more than that. - Obviously, no rice, pasta, potato, bread, grits, polenta, pastry, sweets, sugar, or desserts - a sugar-free Gatorade or two if you sweat a lot
If you cheat once on the diet, you will reset the program back by several days or a week. It's really not worth it for a momentary pleasure. You are training your body to make the extra effort required to burn your fat, not carbs, so why un-train it? Your body thinks of your body fat as precious money in the bank, but for you it's just a load of unpleasant lard and as useless and burdensome as gold ingots on a desert island.
In a few weeks, your stomach itself will shrink and you will be more easily satisfied by a modest meal. Once you have gotten close to your target and raised the level or duration of your aerobics, you can add 1/2 cup of oatmeal (no milk) daily and 5 or 6 almonds or walnuts per day.
You will lose 1/2 to 1 lb per day on this plan if you make no exceptions - or your money back.
In my view, this whole DSM enterprise is one big Obsessional Disorder driven, in considerable part, by insurance requirements and by pharmaceutical companies.
Learned helplessness was what my wife and I observed then, and still do today, in social-democratic Spain. The recession, rigid labor markets, and excessive welfare spending have pushed unemployment to 24.4%, with youth joblessness over 50%. Nearly half of adults under 35 live with their parents. Unable to earn their success, Spaniards fight to keep unearned government benefits.
Meanwhile, their collective happiness—already relatively low—has withered. According to the nonprofit World Values Survey, 20% of Spaniards said they were "very happy" about their lives in 1981. This fell to 14% by 2007, even before the economic downturn.
That trajectory should be a cautionary tale to Americans who are watching the U.S. government careen toward a system that is every bit as socially democratic as Spain's.
Humans are very responsive to incentives, even to their own detriment (eg addiction).
It's not a polygraph, and complicated by left-handed and ambidextrous people and left-eyed people.
Do you know how to determine whether you are left- or right-eyed? Roll up a sheet of paper like a telescope, and see which eye you put it to. Most people have a dominant eye. Shooters care about this.
As I see it, the modern myth of true love involves these beliefs: True love is passionate love that never fades; if you are in true love, you should marry that person; if love ends, you should leave that person because it was not true love; and if you can find the right person, you will have true love forever. You might not believe this myth yourself, particularly if you are older than thirty; but many young people in Western nations are raised on it, and it acts as an ideal that they unconsciously carry with them even if they scoff at it. (It’s not just Hollywood that perpetrates the myth; Bollywood, the Indian film industry, is even more romanticized.)
I believe that "true love" is an adolescent fantasy, a psycho-utopian fantasy. All real relationships have problems and challenges. And real life presents endless problems and challenges which effect relationships lasting longer than days or months. In Western, monogamous cultures, the trick is making it work. What else do I believe? That there is no single "right person" for anybody, that humans are not emotionally monogamous, and that many people expect far too much emotional fulfillment from their spouses than any one person can provide.
I would never disparage feelings like passion, desire, "urge to merge," and "chemical attraction". These things are intoxicating. They have prevented Homo sapiens from going extinct. However, they are temporary, and often not sturdy foundations for building a life or raising a family.
Discovering that your long-term partner isn’t really the person you thought she was can be shattering. It’s not just a loss of love and a certain way of life, it’s feeling like you’ve lost your ability to see the world accurately, protect yourself, and know whom to trust. Suddenly, your marriage seems like the Matrix.
More fundamentally, you can no longer trust your ability to know what’s meaningful and what’s predatory. In case you think you’re alone, think of all the novels and films made about this phenomenon. You’ve been stripped of a pillar of your self-confidence, and you have to build yourself back up. At least you’re just searching for your self-esteem and not a one-armed man.
Nobody is who you thought they were, and vice versa.
Unthinking is the ability to apply years of learning at the crucial moment by removing your thinking self from the equation. Its power is not confined to sport: actors and musicians know about it too, and are apt to say that their best work happens in a kind of trance. Thinking too much can kill not just physical performance but mental inspiration. Bob Dylan, wistfully recalling his youthful ability to write songs without even trying, described the making of “Like a Rolling Stone” as a “piece of vomit, 20 pages long”. It hasn’t stopped the song being voted the best of all time.
I am asked to do a brief post about Disability and have been sent a couple of links. "Disability," as in our Social Security Disability welfare program, is one about which I have unpleasant feelings which some might view as cruel. I prefer to view it as Tough Love.
However, it comes from experience. The fact is that I will not consult with anybody on Disability, nor will I participate in anybody's Disability application unless they are in a coma, severely brain-damaged, or the like. Can people with (treated) schizophrenia work, be useful, and maintain some dignity? Of course they can. Every patient of mine with schizophrenia works, except for one housewife.
Here are my reasons for that, from a psychiatric standpoint:
1. Nobody with a treated mental problem is incapable of doing something useful 2. Helping a patient obtain Disability is a way of saying that you have given up on their future 3. Many people on Disability give up on making a life, and just mope around for years 4. I see people with severe disabilities working all sorts of jobs, maintaining their pride and independence 5. The scam component is huge, I believe: free money. I've seen it plenty of times. I even get spam emails weekly inviting me to fill out a form for Disability lawyers: "Find out if you're entitled." Also, lots of people with Disability seem to work off the books.
Few people have any idea of how easy it is to get on Disability these days. Here is one of the links: Workers Comp. and Unemployment
The DSM, like the Psychiatric section of the ICD-9, was developed to provide a common language to people who work in mental health. Actually, for four basic purposes: a common language, as a basis for research, as clinical guidelines, and for filling out insurance forms and disability forms.
In our daily work, many Psychiatrists do not take it too seriously but use it as a rough guideline. Unfortunately, the DSM has been over-medicalized, reified, such that everything in there is sometimes regarded as a real, discrete, "disease." Some are, some are not. In many cases, it doesn't matter, because we approach each patient as an individual human and not as a diagnostic code.
As one of my wise old mentors says, "I've never seen a patient of mine in the DSM."
The fact is that the MCAT contained, until 1977, a major component called "General Knowledge." This covered areas like history, geography, art, music, psychology, and literature, and was far too broad-ranging to possibly study for. I don't know why that part was removed.
For chocolate for baking or candy-making, I use World Wide Chocolate's site for their baking chocolate section. That's where many pastry chefs get their chocolate. There's a right chocolate for any culinary need. It's best to avoid products with under 70% cacao.
For the best chocolate candies, La Maison du Chocolat is probably the best source in the US. Their truffles are extraordinary.
It's been a giant cultural change in medicine. Half of medical students are women these days. Many of them are Asians.
Today, college men are beginning to consider it to be a chick profession. Including cardio-thoracic surgery. Heck, I even know a lady urologist in Boston. Why not?
Many of the young women I know are going into Emergency Medicine. If you walk into your local ER, you will see if full of cute young ER MDs. Women going into medicine today tend towards the areas where they can work definite hours for a paycheck, work part-time, and have no on-call duties. ER, Radiology, Dermatology. They want a regular paycheck, benefits, and regular hours, and do not want the burdens, stress, and risks of opening a private practice. And, as as a gender, I think we tend to be more comfortable with rules and protocols than men and thus make better employees. Male docs hate rules and enjoy defying them.
The culture of medicine is changing, for better or worse. The older male docs will say, in confidence, that medicine is becoming "pussified." Their old school view is that medical practice is not meant to be either convenient, comfortable, or a partial dedication, but rather more like a priesthood.
Worse case, I can see a future of salaried docs happy to be working in government clinics. You patients will not like that.
Physicians, like clergy, are more comfortable with terminal illness and death than others. Routine proximity to death and dying makes it feel natural and normal instead of a great enemy. From the WSJ'sWhy Doctors Die Differently - Careers in medicine have taught them the limits of treatment and the need to plan for the end:
Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. It was diagnosed as pancreatic cancer by one of the best surgeons in the country, who had developed a procedure that could triple a patient's five-year-survival odds—from 5% to 15%—albeit with a poor quality of life.
What's unusual about doctors is not how much treatment they get compared with most Americans, but how little. Charlie, 68 years old, was uninterested. He went home the next day, closed his practice and never set foot in a hospital again.
It's a rare doc who elects heroic and torturous treatments for his own terminal ailment.
Of course expensive and extensive testing is ordered, these days, partly because of malpractice. Any doc will say so. It's about CYA.
As a consequence, young docs are being trained to rely more on the tests they can order than on old-fashioned inexpensive clinical, hands-on evaluation and diagnosis. Thus a vicious cycle begins. And it's all free, because "insurance pays for it." So you get the patient's family in on it too: "Doc, we want you to do every possible thing and do every possible test to check out Granny." Is that an argument a physician wants to have?
No doctor enjoys being on the witness stand answering the question "So, Dr., you elected not to order a CAT scan for Mrs. Jones' headache because you trusted your clinical judgement, and felt the expense-benefit ratio was wrong?"
Thus (obviously) if you are 20 lbs. overweight, your knees experience it as equivalent to an 80 lb. backpack - plus the normal effect of the rest of your ideal weight. Knees were not designed for 80-lb. backpacks 24 hrs./day. Over years, the damage increases of course until, one sad day, you finally begin to feel the accumulated damage.
...individuals who lost 10 lbs. would be subject to a total of 48,000 less pounds of pressure for every mile walked.
Walking when overweight is brutal to knees and, from the knee point of view, probably is to be minimized until losing weight. Driving is kinder. Being carried by slaves in a litter is even better because it is kinder to Gaia.
Besides trauma (eg accidents, athletic injuries, athletic overuse and related overuse as in dance), extra weight is the main cause or exacerbation of knee arthritis. It's all about gravity and the pounding your knees take with every step.
Unless the idea of knee replacement appeals to you, the kindest thing you can do for your knees (or your hips, for that matter), is to lose weight - or to be carried around town. Or, like you see in WalMart, maybe Medicare will buy you a $25,000 electric wheelchair.
Americans eat too much, and far too many carbs than is good for them. (Soon, I'll repost the Dr. Bliss diet which I follow diligently to stay under 130 - plus lots of athletics. It is essentially carb-free, except at Birthday Parties and special occasions. Absolutely no fruit allowed - fruit is sugar and a sugary dessert, and there is nothing "healthy" about it.) Here are some links about weight and arthritis.
Glenn Reynolds, with his finger on the pulse of the zeitgeist, captured something yesterday that I had been collecting a few links about, in Faith in science? Why skepticism is rising. A quote:
...while one should trust science as a method — honestly done, science remains the best way at getting to the truth on a wide range of factual matters — there’s no particular reason why one should trust scientists and especially no particular reason why one should trust the people running scientific institutions, who often aren’t scientists themselves.
In fact, the very core of the scientific method is supposed to be skepticism. We accept arguments not because they come from people in authority but because they can be proven correct — in independent experiments by independent experimenters. If you make a claim that can’t be proven false in an independent experiment, you’re not really making a scientific claim at all.
And saying, “trust us,” while denouncing skeptics as — horror of horrors — “skeptics” doesn’t count as science, either, even if it comes from someone with a doctorate and a lab coat.
There are a number of reasons it makes good sense to be always skeptical of scientific claims (as scientists are trained to be). Here are a few:
1. Careerism and greed - there is big money to be made in science these days, especially if you come up with the "right" results 2. The use of computers for data-mining - which is not the scientific method 3. The reluctance of journals to publish negative results in favor of positive results 4. The lack of scientific literacy in journalism 5. The impression that scientists often have an ax to grind and cannot be impartial about their pet ideas
There are others. Those are just for starters.
Without getting into the huge global climate boondoggle, here are just a few examples from my medical profession:
On Tuesday, a committee of the National Academy of Sciences heard testimony that the number of scientific papers that had to be retracted increased more than tenfold over the last decade; the number of journal articles published rose only 44 percent.
Ferric Fang of the University of Washington, speaking to the panel, said he blamed a hypercompetitive academic environment that fosters poor science and even fraud, as too many researchers compete for diminishing funding.
"The surest ticket to getting a grant or job is getting published in a high-profile journal," said Fang. "This is an unhealthy belief that can lead a scientist to engage in sensationalism and sometimes even dishonest behavior."
44% is not very good. More on that story: Can Most Cancer Research Be Trusted? - Addressing the problem of "academic risk" in biomedical research
...yes, Wall Street may have a significant percentage of self-serving, ruthless, and manipulative psychopaths and almost psychopaths. And, yes, this fact might be of considerable importance in assessing the "moral fiber" of an investment bank. Whether this is a new phenomenon, though, is a separate question. And, in the current zeal to castigate Wall Street, let us not lose sight of the fact that about one out of every 100 people is a psychopath and 15 out of every 100 people are almost psychopaths. They are husbands, wives, doctors, lawyers, teachers, and store clerks.
And they are a lot closer to you than Wall Street.
Silver views psychopathy (aka Antisocial personality) as a spectrum, from little to lots. That fits my life experience and my professional experience. When I encounter "almost sociopathy", I term it "antisocial traits." The world of finance, indeed, has no monopoly on sociopathic traits. I suspect the world of politics has far more, proportionately.
An interesting feature of antisocial traits, like narcissistic traits, is that their owners tend not to know they have them. People who worry about having them probably don't have much of it.
Besides "social media," it's interesting to me how others keep in touch with their old friends, how they reach out and make new friends, and, in general, how they keep their interpersonal lives alive, vibrant, and stimulating.
Readers know that I like to host parties at home, both formal and informal. Even if it isn't a time to have deep, intimate conversations as one does in other settings like in restaurants or clubs, it's a way of letting people know that that you view them as a part of your life that matters. That is an important signal to send to people (assuming that they care).
I know the Bird Dogs like to host formal dinners, and especially big semi-formal multi-course game dinners for 25-30, but that sounds like work to me. Sounds like a holiday effort, but they seem to be used to doing it joyfully and without much expense, and take it in stride.
At my house, we are partial to hosting semi-stuffy formal dinners for 12 at least monthly from October to March (why else have a formal dining room?), and casual family clambakes, barbecues, pig roasts, or the like in the summertime. Sometimes in the winter it is good to host a decadent after-church brunch with champagne and bloodies, with a guy making omelettes to order, and bacon n' sausage n' pancakes. A big brunch at home is not an expensive party, and people love to come in the winter for good cheer with the fireplaces blazing. People have been known to get good new jobs at our get-togethers.
Every few years, I think it's a good idea to find an excuse to throw a big cocktail party or Christmas party and cast a wide net of hospitality. Inviting people into your home, however humble, means a lot to people. Doing those things right, of course, can be a little bit costly but makes life much more fun.
I enjoy people. If I don't do it, who will?
Friends of ours, recent empty-nesters, have come up with another idea which I like. They term it "Suppertime." Once a week, they just call a couple to join them for an ordinary supper on the kitchen table after work. A cocktail by the fire first, of course. Nothing fancy, no big deal, just a visit for an hour or two at most. Salad and spaghetti, or a grilled ribeye and mashed potatoes, or whatever, and some fruit for dessert.
It turns out that I am afflicted not just with pharmacological Calvinism but with mindfulness skepticism as well. For while I believe, in theory, that learning to coolly regard my anxiety as a purple, hairy monster I could stash in my tote bag, as Mennin suggests, might steady my pulse on sleepless nights, I am suspicious of any cure that requires more effort and expense on my part and more hours away from my work and my family. In this skepticism, I am like my anxious peers. “We go through rough patches, and we do things that make us feel better,” says Lisa Colpe, an epidemiologist at the NIMH, with the vocal equivalent of a shrug. A lot of people with anxiety would simply prefer to live with it; they know that when it becomes unbearable, the drugs will be there.
A cure isn’t what the PR executive with the occasional Klonopin habit wants. “My own personal experience is that there’s a healthy level of anxiety, and I don’t believe ‘healthy’ is the absence of anxiety,” she says. “I live in a world that puts unreasonable demands on me, and sometimes I need help. I wish I could do it without the pills, but I can’t.”
There are more-or-less three sorts of non-major-mental-illness-related anxieties.
One is anxiety about worrisome real situations, one is anxiety related to real guilt, one is neurotic anxiety. Some would place the anxieties of minor emotional problems, eg phobias, OCD, GAD, etc., among the neurotic category, and some would place them in another (non-major) Mental Disorder category.
Thus anxiety (fearfulness) is mainly a symptom of something, and usually not a "disease" in and of itself. Frequently, we find that what people think they are anxious about is not what they think it is.
Regardless of category, we indeed do have pills to put a band-aid on all of these sorts of anxieties.
In his “Works of Love,” Kierkegaard remarks that all talk about the spirit has to be metaphorical. Sometimes anxiety is cast as a teacher, and at others, a form of surgery. The prescription in “The Concept of Anxiety” and other texts is that if we can, as the Buddhists say, “stay with the feeling” of anxiety, it will spirit away our finite concerns and educate us as to who we really are, “Then the assaults of anxiety, even though they be terrifying, will not be such that he flees from them.” According to Kierkegaard’s analysis, anxiety like nothing else brings home the lesson that I cannot look to others, to the crowd, when I want to measure my progress in becoming a full human being.
But this, of course, is not the counsel you are likely to hear these days at the mental health clinic.
Curing the uneasy soul is not so easy. When it's coming from real guilt, it's not even desirable to cure it. The guilty must suffer to learn, just like school. Good shrinks are not about feel-good, we are about dealing with reality. Reality often does not feel good.
How many of us were good Liberals in youth, only to have our naive illusions shattered by the way the big world really works? For example, we have all learned to see through government's ginning up crises, with the collusion of media, which "only federal government can solve." We have also learned that these are power grabs, and that our federal government is no font of wisdom. It's just a font of unprincipled political calculation.
My seatmate at a dinner on Saturday was a vascular surgeon who was touting the wonders of HCG for weight loss, said he lost 30 lbs. in 6 weeks with it. Said he felt no hunger with the 500 cal/day diet that goes with it, and hasn't felt particularly hungry since.
Sorry - I put "sexy" in there to grab your attention and to make a point about words. If you studied cognitive psychology or good old-fashioned linguistics in college, you learned this famous theory about how language determines thought. If you didn't, it's your loss. Their theory is partly wrong, because humans can think without using words, but it is also partly right, because words do effect and shape our thoughts.
But Sapir-Whorf went beyond that. They theorized that language shapes and structures our perceptions of the world - both our output and our input.
Indeed, words and their concepts seem to do that. Goethe said "Man sees what he knows." A birder sees a Parula Warbler, a non-birder sees just a "bird," or doesn't even notice it at all. The universal metaphor of blindness for ignorance is no accident.
Sapir-Whorf is almost an "In the beginning was the word" theory. However right or wrong their theory was, it has been a useful and productive and intriguing one, which is the only true measure of a theory in science.
I refer to Sapir-Whorf because we had two posts a while ago which were, ultimately, about words and how they are used. One about "values," one about "progress." In both cases, these words and their connotations slipped into regular usage and began shaping our thoughts, sometimes without our awareness. After all, "thinking" happens somewhere in the shadowy darkness between awareness and un-awareness.
Cognitive Daily reviews the history of the hypothesis, and recent research on this dusty but still fascinating topic.
"the thing is, tho, that the moral or ethical question of entering consequentially into a stranger's life is not the same question as whether or not one is lonely."
His excellent phrase "entering consequentially into a stranger's life" got me thinking. As a psychotherapeutically-oriented shrink, most of my work is to "enter consequentially into strangers' lives," and that is a privilege and sometimes a frightening position which I am paid to do as a professional person.
Most adults are cautious, aren't we? - about who we permit into our lives, and to what extent. We may make exceptions with relatives, clergy, or people with white coats, but, generally, our interpersonal lives consist of concentric circles, admitting few to our inner sanctum.
The reason for that is, of course, because confiding in someone, being emotionally intimate with someone, cannot be inconsequential for normal people. Relationships affect us and affect our lives, so they are a serious matter and potentially dangerous.
Loneliness is painful. Lonely people, sad to say, and substance-abusers may be less discriminating about whom to let in. Fact is, though, closeness is always somewhat risky for both people involved because we humans get attached and thus vulnerable.
Buddy's comment, however, was on the topic of Sugar Daddies and mistresses, sort-of about the idea of sexual intimacy rather than personal or emotional intimacy. There is the hooking up culture of course. A college student recently told me that if he strikes out and doesn't get laid by a different girl each night of Spring Break in Nassau, he will feel like a loser. But I do not mean to be discussing purely recreational or athletic alcohol-infused sexual adventures.
What I am wondering about is whether it is possible for a Sugar Daddy and the gal, over time, not to form an affectionate attachment despite the basic free-market win-win foundation of the relationship. Or even regular co-workers.
Perhaps some people are more capable of inconsequential intimacy or exploitative intimacy than others. Not perhaps. Definitely.
A young woman recently commented to me that she thought one reason she was in love with a certain man was because he "made her feel safe." "Safe from what?" I asked. She thought for a minute and said "Safe from the world, I guess."
It's not an unusual topic of conversation among some of my more conservative lady pals to speculate about why women have some tendency to vote more Leftist than men do.
We have lots of theories, but more questions than anything else.
For some examples, Women are more caring and nurturing, less aggressive or more needy than men (maybe, possibly, I sort of doubt it but, if so, why would women think of government as a vehicle for those feelings?)
Or, Women are fearful of losing a man, and want government to step in as a husband if needed
Or, many women don't have a man, and would rather lean on government than on charity
Or, Women are more prone to parental transferences to powerful government, while masculine pride resists accepting government "help" because it makes them feel diminished
We have other theories too.
Here's a piece on a related topic at Reason: "Women vs. the State. It’s time to liberate ladies from unequal and unjust government policies."
Why moralism spoils the appetite - Adam Gopnik makes a powerful and entertaining case for why we shouldn’t ruin the aesthetic pleasure of food by adding a side order of moralism.
We have often posted here about food cranks and food Nazis, "organic food" nonsense and "natural food" nonsense, and even the concept of "healthy food". The "moral food" fad is just the latest incarnation of cranky food Calvinism - which is another incarnation of cranky Calvinism.
There is no doubt that guys enjoy variety, or at least the idea of it. They are liars if they claim they do not. Nature made them that way. Good character can make some of them acceptable, however, despite their nature.
It's all about "The Dark Triad." From Yes, Chicks Dig Jerks, and evolutionary science gives us a good idea why:
The Dark Triad is a combination of psychological traits — subclinical psychopathology, subclinical narcissism, and what Professor Jonason calls “Machiavellianism” — that are, he believes, in fact a unitary phenomenon associated with a higher level of sexual success, defined in the literature as a larger number of total lifetime sexual partners. The correlation of the Dark Triad with larger numbers of sexual partners holds true for both men and women, but the effect is much more pronounced in men. This is unsurprising, inasmuch as men’s relative preference for larger numbers of short-term sexual relationships and women’s relative preference for long-term relationships is, as Professor Jonason notes, “one of the most consistent and strongest sex differences in the field.”
So: Machiavellianism, subclinical psychopathology, subclinical narcissism: not exactly the stuff of a Jane Austen romance, but apparently the stuff of sexual success. Professor Jonason concludes: “Together with low amounts of empathy and agreeableness” (I warned you this was depressing stuff) “such traits may facilitate — especially for men — the pursuit of an exploitative short-term mating strategy.”
But you knew that already, if you are a homo even half sapiens and went to high school.
That's all true of my experience with skirt-chasing seducers. They know how to say exactly what you need to hear but, in the end, you will never be enough for them because, Psychiatric as it may sound, they are really manchilds looking for Mommy while having fun with pseudo-adult seduction, romance and sex along the way.
Image is Luigi Bassi in the title role of Don Giovanni in 1787, via Wiki.
This is as fresh as the day he wrote it. The great (young) man himself conducted the premiere of this astonishing (comic?) opera in Prague, in 1787:
I think a connectome could be rephrased as a soul, but I am not sure what difference renaming it makes. At TED via The Age of Connectome at Cocktail Party Physics.
Remember how Russell Crowe in Beautiful Mind gradually slid into a paranoid psychosis, letting the audience experience some of the reality-confusion along the way? Ron Howard depicted this process well in that movie; the creepy feeling that things are getting a little strange.
It may not be a general-interest topic, but it is an issue which Psychiatrists are frequently presented. You consult with a late teen or young adult, usually on the urging of a parent, who has shown some decline in functioning and has some new anxieties and some peculiar symptoms.
A seasoned shrink thinks "Hmmm. This smells sort-of pre-psychotic but of course I might be wrong." (Much of medical care is as much art and experience as it is science. Never, ever go to a young doctor.)
Apparently our instincts in this area are right at least 50% of the time, which isn't very good.
We docs see this all the time, and some docs seem to almost encourage it: "There is always hope," etc.
Aggressive treatment of terminal cancer can be the worst. Refusal to give in to nature's natural processes. Death as the great enemy. Guilt. There is always a time to let go of relationships, and a time to let go of life.
It is often said that "old age is not for sissies," but I have seen terminal torture treatment which the Geneva Convention would hold illegitimate. A friend lost her 52 year-old sister to pancreatic cancer yesterday. Due to heroic efforts, her last three months on earth were made hell when she could have had a peaceful, morphinized passage.
What's the difference between wholesome obsessions, distractions, avoidances and diversions - and unhealthy ones? (I am not speaking clinically about obsessions and compulsions here, but just in the layman's sense of the words.)
The difference is in the purpose, not so much in the thing itself. The most common ones we all see in daily life are:
- TV, radio, and listening to music - Shopping - Reading - Surfing the net - Sports, exercise - Sleeping and napping - Socializing - Hobbies - Sex and erotic activities - Computer games - Drinking and drugs - Work, chores, and projects of all sorts - Mental preoccupations of all sorts
That covers most of life, doesn't it? Trust me - I am all in favor of fun and productivity. Not one of these things is necessarily unwholesome - except when they are used as avoidance of something or things. That usually - but not always - means when they are not done in moderation and in proportion.
Why do so many of us have our best thoughts and insights in the shower? Because we aren't doing any of those things in the shower...generally speaking.
Only the mentally strongest people - and I do not include myself in that category - routinely face their anxieties, worries and fears; routinely deal with every responsibility or burden immediately, or routinely face their relationships or the realities of themselves: their weaknesses, their guilts, their unsettling thoughts and feelings, their disappointments and sadnesses, regrets and remorse, boredom, loneliness, or empty feelings - or just "being with oneself."
There is an expression in AA: "Move a muscle, change a thought." It's good advice if one is avoiding a dangerous thought but it's bad life advice if one is avoiding thoughts that need to be considered and faced and maybe even acted upon.
If I decide on a Saturday nap after two hours of tennis in 90 degrees, fine. But if I decide on a nap (maybe without realizing it) because I am worried about paying the bills, not so fine.
Having kids is a great diversion and distraction. For years, it will fill your life with preoccupations and duties which have the advantage of being truly responsible and loving. But when they get older, you face yourself again.
Therefore, whenever I find myself immersing myself in something, I try to remember to ask myself why. That's not obsessive navel-gazing, it's just common sensical self-monitoring. "Metacognitive," as they say.
And when I drive, I try to leave the radio off - so I can listen to the real news about what is going on with me, my soul, and my life.
His first is to ask, what about, say, Muslim patients who refuse to see other-sex doctors (and but hey - what about the nurses and the gay docs?)
Second, he considers whether it is up to the government, via the Big Government payors Medicaid and Medicare or (slightly indirectly) Obamacare, to decide what they want to pay for.
As for the first question, no problem. They should get their care from whomever they choose in whatever form they choose (unless trying to die in the ER). It's called freedom. (Last I read, however, Muslims may be waivered from ObamaCare anyway because it's not Sharia or whatever reason.)
As for the second question, of course government payors can decide what to be willing pay for, given whatever Congress, the bureaucracy, and etc decides. However, that does not, or should not, require that it be provided. The requirement is the rub, and it constitutes a federal takeover, an overreach, an intrusion into choice.
Of course, the larger issue is the politicization and governmentalization of medical care, which promises to create endless explosions if ObamaCare proceeds. Dr. X is quite right that we are headed towards turning the corner where medical coverage is no longer insurance, but plain payment with the feds as the Grand Medical Commission in DC.
Rather than ObamaCare, I would have liked to have seen a wide-open, nation-wide market for private (including charitable) medical coverage of every size, shape, and sort with no federal involvement, and subsidies for the poor of any age - old or young. (Medicare was a giant error, since the elderly, statistically, are wealthier than the young who pay those bills with their taxes.) Muslim policies for Muslims if they want them, Muslim clinics and hospitals if they want them, Catholic policies if Catholics want to buy them, etc. etc. If unrestrained by government, the market would be providing for every individual or family want. Unfortunately, we never had a wide-open market for medical insurance due to the state insurance commissions' protectionism, or whatever it has been.
We mentioned that theme here yesterday. Compassion without discernment is generally moral vanity or spiritual-ish pride; often foolish, often counterproductive or destructive, and often humiliating to the recipient. It reminded me of this well-known speech by Ivan Illich (not Ivan Ilyich, who died) on the topic of paternalistic "help." The intro:
An address by Monsignor Ivan Illich to the Conference on InterAmerican Student Projects (CIASP) in Cuernavaca, Mexico, on April 20, 1968. In his usual biting and sometimes sarcastic style, Illich goes to the heart of the deep dangers of paternalism inherent in any voluntary service activity, but especially in any international service "mission." Parts of the speech are outdated and must be viewed in the historical context of 1968 when it was delivered, but the entire speech is retained for the full impact of his point and at Ivan Illich's request.
I am here to suggest that you voluntarily renounce exercising the power which being an American gives you. I am here to entreat you to freely, consciously and humbly give up the legal right you have to impose your benevolence on Mexico. I am here to challenge you to recognize your inability, your powerlessness and your incapacity to do the "good" which you intended to do.
I am here to entreat you to use your money, your status and your education to travel in Latin America. Come to look, come to climb our mountains, to enjoy our flowers. Come to study. But do not come to help.
In the past week, we have had links about government (and doctors) advocating against salt and sugar. I don't mind my doctor giving me advice (I pay him for it), but when docs try to get governments to control what to do, I get annoyed. As I understand it, it is the job of doctors to offer advice, not to provide control.
From the same sort of academic busybodies who gave us the ever-popular global warming panic comes a new prediction of catastrophe. This newest ginned up rationale for enabling Liberal-Progressive-Democrats (L-P-Ds) to have more control over the behavior of ordinary citizens hasn't been given catchy name yet, so rather than wait for the mainstream media to compare notes on JournoList, let's all agree to call it...global sweetening!
Yes, my friends, President Obama's fellow travelers within the progressive movement have decided that they have to find a new excuse for imposing government controls since climate change (née global warming) failed to achieve their overarching goal of controlling the car you drive; the fuel you're allowed to use; the type of light bulb you are allowed to use; and, after they get the "smart grid" in place, how warm you'll be allowed to keep your home.
Mayor Bloomberg, of course, is the poster child for obnoxious Nannyism. Here's the ultimate governmental rationale for these sorts of controls: Ideology, not science. A quote from Dr. Keane's piece (from Australia):
It is extremely frustrating when reports of harm are used to justify forcibly overriding autonomy, completely ignoring the other side to the equation. In this regard, ‘promoting healthy lifestyles' is no longer enough; they are now being enforced whether you like it or not.
Internationally, the public health debate is somewhat more balanced than in Australia, as represented by Eli Feiring, an academic from the University of Oslo, Norway: ‘Given that respect for the autonomous choices of patients runs deep in modern healthcare, there are strong reasons to value the claim that competent and well-informed individuals are the best interpreters of their own interest and that they should be free to make choices others would regard as non-beneficial to them.'
Many academics demonstrate a fundamental misunderstanding of the importance of autonomy.
Indeed. Experts tend towards arrogance, not towards autonomy (freedom). And, in the long run, academic experts usually turn out to have been wrong anyway.
How do you carve nature at its joints, when there are no joints? This is good, from Sailer: If race doesn't exist ... He quotes:
...as any psychiatrist involved in the making of the D.S.M. will freely tell you, the disorders listed in the book are not “real diseases,” at least not like measles or hepatitis. Instead, they are useful constructs that capture the ways that people commonly suffer. The manual, they go on, was primarily written to give physicians, schooled in the language of disease, a way to recognize similarities and differences among their patients and to talk to one another about them. And it has been fairly successful at that.
and
“The D.S.M. has been taken too seriously,” another expert told me. “It’s the victim of its success.”
When people think of Maslow, they tend to remember two things: the notion of "self-actualization," and his hierarchy of motives.
Maslow made several mistakes (one being the assumption that everybody is just like him, and another being his relative discounting of unconscious motive), but what is most interesting is how some of his ideas became absorbed into the culture in distorted ways.
To what extent Maslow studied Nietzche I do not know, but his post-modern glorification of "self" owes plenty to Nietszche. In the brave new world, Self replaced God, and the value of "self-actualization" replaced - for some - sturdier old values such as duty, honor, perseverence, integrity, decency, and - yes - selflessness.
To what extent Maslow played a role in todays pop-culture "It's all about me" theme I can not say, but what I can say, from speaking with a great many people over the years, that the idea that the person must strive to become a heroic manifestation of his Self has led far more people onto the rocks of life than I can count. One reason is, of course, that nobody's "Self," however talented or untalented, is really all that great, and is packed with the flaws with which each of us stuggles daily.
Furthermore, the culture's version of Maslowism leads to much feeling of failure. After all, if I have not fulfilled my potential" or "become who my inner self really is" or "fully actualized my precious self," a person can feel like a failure in life, a certain narcissistic defeat. We all use our gifts as best we can, given our ambition, inspiration, and industriousness, but I view "sef-actualization" as a false idol.
He is right that weight is a class and/or cultural thing to some degree. There is a sort of logic to it in an era of plentiful or unlimited cheap carbohydrates in the Western world. Being heavy no longer displays prosperity, while being trim and fit shows that you have the ability to delay gratification for more important goals, such as being more vigorous and sexy, and less of a couch potato.
However, unlike Lefties, I don't care what other people chose to be or what they eat. From Knish,
Social medicine politicizes food consumption and a globalized economy politicizes food production. And the politicized American plate has less on it and at a higher price. While the left obsessively pursues its mission of destroying fast food in the name of lowering social medicine costs and being fairer to farmers, what they are truly accomplishing is to take affordable and filling food off the shelves, as they have done with countless other products that they have targeted.
As lefty pols go, in the last photo I saw, Al Gore looked like a fattie, living off the fat of the land. Last photo I saw, Obama looked semi-anorectic for a middle-aged man-boy. Clinton got fat, had a heart attack, and then got scrawny and ill-looking living on arugula salad.
Here is a brief history: The Real Skinny: Expert Traces America's Thin Obsession. What that brief post misses is that, today, in our culture, trim and fit is sexy and appealing to both men and women. In a way, it seems to say that you have not given up on life, or at least that you have not given up on caring about your body. In fact, "studies show" that being trim and fit helps you get a job, or keep one.
I love a Big Mac once in a while. Who doesn't? A Big Mac and Fries is around 1000 calories. To walk that off takes 4-5 hours of vigorous walking, at least. About 3 hours on the elliptical.
I would highly recommend it for students before they take any neuoscience-related courses in school. Our learning theory here is that it's best to learn all you can about a topic before you take a course in it. That way, you will at least be oriented. Sometimes, the whole expensive course might end up being redundant.
It's been repeated so often that it's become a mantra. Google search. If you walk or run or elliptical or stairmaster or hoeing the fields or whatever over 10,000 steps daily, you have an "active life;" if under, you fall into the "sedentary life" category.
Nobody wants to think of themselves as leading a "sedentary" life because it sounds slothful and decadent, not luxurious. There are roughly 2000 steps per mile, but it's about the steps, not the distance. It is probably not a bad rule of thumb to do it, just to stay fit, energetic, and vigorous.
Urbanites walk far more, in the course of a day, than suburban or rural folks. My theory is that that is why city folk are trim, and country folk tend towards the bulky, but I am sure that fashion plays a role in it too. City people need to look like they have their act together or they won't get any respect.
"What a coinkydinky. I was just about to call you."
Synchronicity, Serendipity, Seriality, and Simulpathity. It's a fun topic, but I can't tell for sure whether Dr. Beitman is writing tongue-in-cheek or in all seriousness. Or perhaps he's a Jungian, in which case all bets are off.
I know people who say "There are no coincidences." Count me an agnostic on the topic.
One interesting aspect of modern life in the Western World is the pathologizing, or "diseaseifying," of moral and character failures. Putting such failures into the disease category is a popular conceit for a number of reasons, not the least of which is the way it seems to let people off the hook. The victim thing.
But while even AA may make use of the disease metaphor, if you go to a meeting you will hear far more about character flaws than about disease. They are not into disease excuses for problem behavior.
Despite the addiction meme, ordinary people still term those who eat more than they need "pigs," people who buy too much stuff "self-indulgent," people who habitually drink too much "drunks," and people with uncontained sexual efforts as "lechers" or as "nymphomaniacs" or "hos". Ordinary language reflects the common sense moral disapprobation of ungoverned behavior.
To say that they "lack a self-governing function" is the disease model, a defect model, but to use it requires turning a verb idea into a noun idea, by reification. The better form is "They do not govern themselves," or, better yet, "They do not exert themselves to govern themselves." The disease/defect model does not do justice to all of the people who must struggle mightily to resist all of the temptations that life offers.
Pajamas has a piece up about sex "addiction," Sex Addiction 101 - PJM's advice columnist on the Chinese food syndrome of loveless sex: no sooner satisfied, than feeling empty again.
While the article makes the obvious point that people seek pleasure and often seek to replace distress with simple pleasures, it entirely overlooks the moral, spiritual, and character dimensions of lechery as if it were a "chemical imbalance" instead of plain old-fashioned rotten, socially-inappropriate behavior. Sinful too, if anybody believes in sin anymore.
While it seems true that habitual pleasures change the brain a little, so does habitual self-control. Self-control offers many rewards, but few rewards of the instant, animal sort. There are good habits and bad habits. I don't know whether it is a sociological fact, but it seems as if the debauchery and bad habits, once the domains of the very rich and powerful and of the poor, have become democratized and, in the process, excused to some extent (eg the Oval Office BJs).
People I talk to with bad or unrestrained behaviors of all sorts tend to despise themselves for it, and view putting their behavior into a disease category as a condescension. Unless they are guilt-free sociopaths, they know that their behavior is self-indulgent and immoral. People can quit these things, with help and sometimes without help, if they want to or need to, but it means giving up a lot of instant gratification in exchange for, one hopes, better life results and less self-contempt.
...there may be a perception in many key areas of contemporary life—law, business, politics, among others—that expecting honesty on a regular basis is a naïve and foolish attitude, a “loser’s” way of operating. Such a perception is practically a mandate for personal dishonesty and a concession to interpersonal distrust. When we no longer assume that those who communicate with us are at least trying to tell the truth, we give up on them as trustworthy persons and deal with them only in a strictly instrumental manner. The bounds of mutual moral obligation dissolve, and the laws of the jungle reemerge.
Our serious problem today is not simply that many people routinely tell lies. As I have noted, people have departed from the truth for one reason or another all throughout human history. The problem now is that we seem to be reaching a dysfunctional tipping point in which an essential commitment to truthfulness no longer seems to be assumed in our society. If this is indeed the case, the danger is that the bonds of trust important in any society, and essential for a free and democratic one, will dissolve so that the kinds of discourse required to self-govern will become impossible.
I have no way of discerning whether there is anything new here. What I do know is that it is generally a good rule of thumb to let people prove their integrity, rather than assuming that they have any. I have been burned by people enough times to cure me of my optimistic naivete.
Dishonesty and concealment, despite whatever mass culture may do, continues to appall me whether in myself or in others.
I have always asserted here that "feeling good about oneself" can only come from doing right things and from doing hard things. Even so, we all deserve plenty of criticism and nobody deserves to think that they are wonderful. (We are allowed to think that of others, however, or at least to love others despite their flaws.)
This is something that gets obscured in today's medical reporting--everyone, as they get older, will get sick for some reason and die at some point. The biggest risk factor for heart disease and cancer isn't BMI, cholesterol, blood pressure, etc....it's age. And to a large extent, the incidence of those diseases is random; doing everything right lowers your risk of disease, but not to zero, and usually not to that small a fraction of the risk for the general population.
Saturated Fat is Not Bad For Your Brain, and You've Been Lied to
A therapy patient of mine recently sat thoughtfully for a few minutes, then exclaimed "Oh my God, I've been acting as if I really had power over all these things, as if I had the power to prevent bad things from happening." 
How the ‘love myth’ is preventing Americans from finding true love
"Sometimes thinking is a bad idea.
It's been a giant cultural change in medicine. Half of medical students are women these days. Many of them are Asians.
Each 
Besides "social media," it's interesting to me how others keep in touch with their old friends, how they reach out and make new friends, and, in general, how they keep their interpersonal lives alive, vibrant, and stimulating. 
There are more-or-less three sorts of non-major-mental-illness-related anxieties.
It's all about "The Dark Triad." From 
What's the difference between wholesome obsessions, distractions, avoidances and diversions - and unhealthy ones? (I am not speaking clinically about obsessions and compulsions here, but just in the layman's sense of the words.)
The Knishman nails the zeitgeist here: