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.
Yes, you do have one of those psychobabble things.
Your inner child is selfish, self-centered, greedy, jealous, envious, angry, spiteful, grudge-bearing, hyper-sensitive; feels deprived, entitled, fearful, passive-aggressive, and often destructive. It's a nasty thing and results in misery (for others) in life.
My general advice is to avoid being "in touch with" one's inner child as much as possible. Reaching down and finding one's inner adult is a much better plan.
The last fad diagnosis was ADHD: every little boy who didn't act like a good little girl had it. Now, it is Bipolar Disorder for all kids with unruly emotions. In Newsweek, Mommy, Am I Really Bipolar?
A quote from the article:
I believe... that there is no scientific evidence to support the belief that bipolar disorder surfaces in childhood. In fact, the opposite seems to be the case: the evidence against the existence of pediatric bipolar disorder is so strong that it’s difficult to imagine how it has gained the endorsement of anyone in the scientific community. And the effect of this trendy thinking can have devastating consequences. Such children are regularly prescribed medications that are not effective in kids and have unwelcome side effects.
Diagnostic faddishness is rampant in Psychiatry, and an embarassment to the field. Why does it occur? It occurs because our descriptive diagnostic categories are so elastic, and so fundamentally unvalidated, that there is room for much mischief. Not to mention that the drug companies always welcome new opportunities to sell their wares.
We humans flatter ourselves when we claim to "think" things through, because often our starting point is our conclusion. We rationalize our conclusions and biases, and are attracted to information which confirms them. However, that does not mean that our thoughts are always misguided or wrong.
Anyone who does not know why they hold a particular viewpoint cannot judge fairly whether it should be kept or abandoned. There’s no point in arguing with them.
That's the point. It is in fact a Psychoanalytic point. Two good rules of thumb for introspectives are these: "Don't believe everything you think," and the old AA aphorism, "Feelings aren't facts."
Mark Edmundsen has written a piece at The Chronicle about one of my favorite bugabooos in Health Now: A Provocation. Here's a quote:
Francis Fukuyama glances at this matter in a passage from The End of History and the Last Man. "In America today, we feel entitled to criticize another person's smoking habits, but not his or her religious beliefs or moral behavior. For Americans, the health of their bodies—what they eat and drink, the exercise they get, the shape they are in—has become a far greater obsession than the moral questions that tormented their forebears."
I entirely believe in the value of remaining fit, strong, trim, sexy, and attractive but it is the fetishizing of health and the common delusions about food that annoy me the most. In the end, we are not in control of our fates. And I hate brown rice, don't know why anybody would eat it willingly. The Chinese won't eat it.
I found Dr. Bob's post to be honest, sad, and deeply discouraging. I hear things like that all over from my colleagues these days. Here's a quote from his Still Breathing…
... I am weary. After nearly 30 years in private practice, I am not sure which straw broke the camel’s back, but it is most surely broken. It is a weariness born of 14 hour days; of dictating charts and finishing paperwork until 8 or 9 pm each night, after starting the day at 7 am; of endless audits by the insurance industry and Medicare; of the constant threat of litigation; of the crushing burden of one more federal requirement mandated but never recompensed; of a host of ever-expanding administrative burdens having nothing to do with patient care, and everything to do with bureaucratic micromanagement of the profession. And this before we have even begun to see the nightmare which Obamacare will inflict. Camels weren’t designed to carry such a load.
That's the loss of just one more doctor who would know you and your family, and care about you and your life - and who would be working for you, and you only. Soon enough, the tort lawyers and government bureaurats will have the pleasure of going to an assembly line government clinic, staffed by docs trained in Russia, Mexico, and Croatia, to take care of them in 4 minutes according to a government protocol, with only approved and cost-effective methods depending on your age (and potential productivity).
Life has hardened my cynicism about power and government. I am not a paranoid sort, but I think the Fathers had it right about their determination to limit power. They own half my labor now, and want to own more of it - and my body too. For my own good, of course.
As a traditionalist Yankee born and bred, I somehow cannot find any gratitude in me for such unwanted favors.
On this video, Dr. Buziszewski teaches, or preaches, what I have been teaching and preaching for years about the region in which religion, morality, and psychology are intertwined, inseparable. This is a good primer on the topic.
Whether you agree or not, it's an important concept.
PTSD is one of those fad diagnoses which won many adherents in the past ten years, even gaining admission to the DSM.
As I have written before, very few of the descriptive Psychiatric diagnoses have validity - all most of them (with a handful of notable exceptions) have is varying degrees of reliability. In my field, a diagnosis does not mean a disease in the usual medical sense (which is why we call them "disorders").
What is termed PTSD is presumed to be a collection of complaints which some (but not most) people experience following significant emotional trauma. There is no doubt that people are distressed by, and, I think, permanently altered by significant emotional trauma. It doesn't have to be bad experiences in combat, because many things in life can constitute emotional trauma (depending on the person's psychological make-up). The reason PTSD is so often studied in combat vets is because that's where the research money is. (In the past, such symptoms were classed as ""nervous in the service," "combat fatigue," "shell shock," "traumatic neurosis," and the like.)
I have seen a lot about schools lately on these internets, and it causes me to reflect on my medical and pre-medical education.
Unlike today, when I went to medical school there were a few Asians, lots of Jewish boys, only about 20% girls, and almost no black kids. That was not very long ago, either.
My medical college expected a 20% flunk-out, wash-out, or drop-out rate. In pre-med, of course, it's much worse than that: most quit after their first B or B+ in college (there was no grade inflation then) and went off to do other things. In med school, one lousy grade, or one lousy report from a prof, and you were outta there. Packing your bags with profound humiliation. People who couldn't take the pressure just disappeared without a trace, like somebody falling off a ship.
For each course or clinical rotation, we had both written and oral exams. The oral exams, maybe, were the toughest, because the profs sought the limits of your knowledge, which they could only do by pushing past your limits, making you painfully aware of your ignorance (the oral exams were administered by panels of senior docs who were checking to make sure the junior profs were doing their jobs).
Interest and fear were the motivations. Especially fear, because we all wanted to be docs of some sort. At the same time, we enjoyed acquiring the priestly expertise. Nuns with rulers were not required.
There is an optimal level of anxiety at which a person learns best - high, but not so high as to short-circuit the synapses. The problem is, that point varies for every individual. For doctors, pilots, ship captains, and the like, you need people with high anxiety tolerance who do not lose it or get confused when the anxiety level ramps up and the sh-t hits the fan.
My point, however, was to raise the topic of fear in education. I believe it to be a great motivator, even for those highly self-motivated students but especially for those who are not. Most kids in most schools are the latter.
Do we really know how kids would learn if, instead of having mandatory education, we threw them out of school if they did not measure up or take advantage of the incredible opportunities for learning we offer everybody in America? I mean, from High School and on. Problem is, they need those warm bodies to get the dollars.
He is talking about the subject of what we term "symptom choice." Of course, we do not generally mean that people set out to select a symptom, but we do mean that, except for those with serious brain disorders, the mind has only a set number of outlets for inner turmoil. Some of them are dysfunctional and some are not.
Many factors: cultural, personality-based, familial, genetic, etc. feed into the symptom "choice" of neurotics. I would say that eating disorders (which I view as a sort of obsessive-compulsive symptom) partake of all of the above. However, toying with an eating disorder because of fashion does not create a serious or persistent eating disorder. It's not like heroin.
One of my favorite topics to get annoyed about here are the American (and northern European) food fetishes.
Indeed it is a symptom of prosperity that a civilization can obsess about what they eat rather than whether they eat. This occurrence is an anomaly in the short history of Homo sapiens. In the past couple of decades, many have fetishized their food as if what you eat were a major determinant of your fate in life (fatness aside - but recent studies say being fat isn't so bad for health either). "Eat this - it's good for you." Says who? Grandma? Brown rice and whole grains? Are you kidding me?
I have had four main categories of gripes:
1. What the latest research says. Eat Broccoli, then it's Avoid Broccoli. Avoid salt, but now salt is encouraged. Potatoes are carcinogenic. Avoid fats, but now it's avoid carbs (carbs will fatten you up and fat won't). My point is that whatever you read will be obsolete in a few years. Nobody on earth knows what the ideal human diet is, and that is because humans are basically opportunistic omnivores, designed to feed on whatever they can find.
2. "Supplements": A major scam and rip-off with a remarkable marketing machine, but I will not talk about that today.
3. "Genetic engineering": Unless you collect your food in the woods, pretty much everything you eat has been genetically engineered for thousands of years (except maybe mushrooms).
4. "Organic food": Back to clever marketing again directed to those who know no science or biology. Finally, Scientific American has a piece ripping apart the entire "organic" food fetish. Mythbusting 101: Organic Farming. Want to pay extra for "organic" for no reason whatsoever? Whole Foods shareholders thank you very much.
Sometimes I think that food fetishes must be a mild, verging on normative, form of eating disorder. I'll have my hot dogs with chopped onion and extra bright yellow mustard, thanks, with Lay's potato chips and a cold beer. Is there anything better on a summer day?
When I was in training, a wise old Doc told me to tell the old folks to eat all the salt they like, but to take their blood pressure medicines if they have hypertension.
Still, if you have congestive heart failure, it might help your management to limit salt intake.
There are countless myths about diet and health. The truth is that most of it is driven by wishful thinking, the wish that we might control our fates as easily as by deciding what to have for supper.
The only dietary-related thing (besides basic sustenance) that probably helps health to some extent is to get your Vitamin D from plenty of natural sunlight (instead of from pills or diet) over much of your body, while avoiding sunburn and avoiding obsessive use of sunblock.
Thirty years ago, the training and practice of medicine was deeply rooted in "inherited" values as much as craft. Physicians were in a noble discipline recast into paladins protecting society, even a bit of its soul, against an implacable adversary. Training was both arduous and flawed (inflated egos and autocratic mice that roared) but with a central purpose. When done well, doctors successfully confronted their most difficult internal challenges, fear of the power of illness and the willfulness to make important decisions when the consequence was uncertain. This "old" medical culture was best expressed by a single term: "My patient." It was as far from provider and client as you could possibly get. "My patient" conveyed both bond and responsibility.
We are about to burn the bridges to this tradition from both ends.
Read it all, because this is what is coming to your town soon with Obamacare. Some of you have already seen it. Mass-market medicine, by the rule-book, "delivered" by anonymous "providers" to the masses. I plan to stick with the old ways for as long as I can.
We humans have a remarkable talent for rationalizing our feelings and behaviors. The world is full of hot guys and hot babes, and all sorts of other tempting things. One cannot have them all.
In the Western world, beach bathing is a late 18th-19th Century phenomenon.
Bathing became fashionable because, like taking spa water, it was thought to be healthful. A form of "taking the cure" for neurasthenia or whatever.
Furthermore, before then nobody went to the beach anyway, and having a tan was for peasants only. It was a sign that you labored outdoors. Nobody knew how to swim, either (as in Italy today).
Native peoples, especially in warm climates, knew how to swim. The Front Crawl, aka Australian Crawl (now universally used for Freestyle racing), was adopted by Western Civ around the turn of the century, via Solomon Islanders who used this speedy stroke.
Here's a history of women's bathing attire. They definitely did not swim in these things. You would rapidly drown. Maybe they just got a little wet up to their knees, and splashed some water on their faces.
Even today, most people do not go to the beach to swim. They go to read, to watch their kids play in the sand and waves, to obtain some beneficial rays of the sun, to enjoy a sea breeze blowing over their near-naked body, to take a cooling dip, or to surf or body surf where there are good waves.
And how many places can one go out in public and exhibit one's gorgeous, erotic self in what is basically underwear?
First, begin with the idea that love is dangerous and some people are more vulnerable than others. We’ve called love a virus before, and sadly, your emotional immune system is impaired.
While preserving my usual skepticsm about what "studies say...", it does make sense that humans would need a good dose of full- body sunlight daily.
Recent studies say 40 mins/day (without sun block), or 20 minutes per side or until done to taste.
With unblocked sunlight over enough of your body, your skin produces the right sorts of Vit D that you need for full health, vigor, and maybe even cancer prevention. Roofers get enough but, in my experience, roofers often tend to destroy themselves with crystal meth and/or alcohol. It's a roofer thing.
The alternative is to do the research yourself and try to figure out what kind and what amounts of Vit D a person ought to take as pills. As I have posted here in the past, Vit D is the only vitamin I take on the advice of all of my doc friends. However, I also take my shirt off whenever I can.
(Men, middle-aged and above, also probably need a baby aspirin and Vitamin L - Lipitor, but don't take medical advice off the internet. Including mine.)
It is real, and much better than riding horses. I will not tell you how I know this other than to mention the ancient themes of Will and Surrender. Why should such experiences be limited to the women of India?
I do not mean to imply that men are not essential components of a woman's life because, when properly trained, men do have many useful applications and I consider a manly, vigorous, and adventurous male to be an essential component of the modern household.
A patient told me that she had seen something useful on Oprah a while back. Some therapist-type had suggested that, when something about somebody bugs the heck out of you, write a letter to them telling them about it.
But do not mail it. Cross out their name, address it to yourself, and read it as if directed to yourself.
The psychology of how and why we tend to be so annoyed by things in ourselves that we wish to disown, and thus react against in others, is too messy for here. It's enough to say that we all have many tricks that we use, usually unwittingly, to feel OK about ourselves instead of sinking into painful self-reproach. It does not always apply, but applies often enough to be a good rule of thumb.
Give it a try. It is not much fun, but could be educational.
I am a regular reader of fellow Psychoanalyst and Psychiatrist 1 Boring Old Man. Most of his posts go straight to the heart of the turmoil and controversy which is going on in our field today.
That's why I hope he receives this message from me: Your fonts are too small to read, and the color contrast between your print and your background is too slight. Those of us without 25 year-old eyes need a magnifying glass to read your good and interesting posts.
We know, for example, that when a patient goes to his primary-care physician with a very common problem like lower back pain, the physician will deliver the right treatment with real clinical benefit about half of the time. Patients with the same health problem who go to different physicians will get wildly different treatments. Those physicians can't all be right.
Overall, physicians are said to get it wrong around 50% of the time. I suppose that is possible. I get it wrong on a regular basis. Dr. DB says he trusts no-one in medicine, including himself.
More from the Scientific American article:
Give surgeons a written description of a surgical problem, and half of the group will recommend surgery, while the other half will not. Survey them again two years later and as many as 40 percent of the same surgeons will disagree with their previous opinions and change their recommendations. Research studies back up all of these findings, according to Eddy.
Yes, you do have one of those psychobabble things.
Mark Edmundsen has written a piece at The Chronicle about one of my favorite bugabooos in 
I found Dr. Bob's post to be honest, sad, and deeply discouraging. I hear things like that all over from my colleagues these days. Here's a quote from his 
I have seen a lot about schools lately on these internets, and it causes me to reflect on my medical and pre-medical education. 
One of my favorite topics to get annoyed about here are the American (and northern European) food fetishes. 
When I was in training, a wise old Doc told me to tell the old folks to eat all the salt they like, but to take their blood pressure medicines if they have hypertension.
In the Western world, 
While preserving my usual skepticsm about what "studies say...", it does make sense that humans would need a good dose of full- body sunlight daily.