Maggie's Farm

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.

From a piece about Kierkegaard, The Danish Doctor of Dread:

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.

Case in point: Health care wasn't broken

Here's Megan McArdle: Liberals Are Wrong: Free Market Health Care Is Possible

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.

He also touted this book: King of Hearts: The True Story of the Maverick Who Pioneered Open Heart Surgery . Reads like a thriller, he says.

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.

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.

How about "a girlfriend experience" without the hassle? The Sugar Daddy recession.

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.

(Unrelated, how TED became brain candy)

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.

This article at Neuroanthropology is excellent: Slipping into psychosis: living in the prodrome.

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.

Otherwise, I'd be out of touch.

 Photo is a 1923 Silvertone radio

Our internet friend Dr. X seems to raise two questions about religious charitable organizations to which I will try to respond as an "amateur bloviator."

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.

It's a classic, here. He concludes:

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.

Adults get to decide what they want to do. As we pointed out earlier today,Most recent: First Global Warming - Now Global Sweetening!:

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):

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.

This post is prompted by a good essay on Maslow and the culture: Abraham Maslow and the All-American Self

The Knishman nails the zeitgeist here: Food Fights and Class Warfare.

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.

The "for Dummies" series is spotty, but this one is quite good: Neuroscience for Dummies.

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.

Character is destiny.

Sigmund Freud

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.

I have been posting recently about satiable and insatiable appetites for pleasures - food and for other things, here: For the New Year: Satiety, the Animal Pleasures, the Cardinal Sins, and "Addiction," Part 2  and here The bad news: Eating less keeps your brain younger and more vigorous (with comments on satiety)

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.

Teaching honesty is no longer a priority in our schools:

...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.

It's about time, too. Schneiderman: Empty Praise.

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.)