Maggie's Farm

Like the Barrister in his fine piece on the subject of poverty, I am interested in understanding who the poor are in the US, and why. What lies behind the census data and stats?

In medicine, we of course deal with many people who are poor due to various physical and mental dysfunctions and disabilities, and our charities and government programs offer them a great deal of help and support. In fact, the poor in general are beneficiaries of a huge safety net in the USA thanks to the generosity of our citizens.

But what I found most interesting in The Barrister's piece was this notion of the "voluntarily poor." In America, we are too quick to assume that everybody wants to be rich.

Indeed, I think no sane person would refuse a $160,000,000 check from Powerball, but the word "voluntary" refers to behavior, not to idle thoughts and dreams. If you aren't willing to move from Podunk, Maine to Charlotte, NC to get a good job, you are indeed voluntarily poor. And if you would rather drop out of high school and have four kids as a single Mom in St. Johnsbury, VT, you are also voluntarily poor. If you are an uneducated, illiterate immigrant, you are voluntarily poor - but presumably better-off than at home.

I would like to be able to look behind the poverty stats to try to understand what choices in life the poor have made, with the understanding that these choices probably reflect a part of what they want in life. Not everyone is materially-driven, and most people are only partially materially-driven. Some people are driven to nothing at all, including basic self-respect. Some are, in fact, motivated by dependency.

There are only two facts that I know for certain: Single moms are often poor, and people who do not work full-time are often poor. Gals who get knocked up without "a ring and a date" are deeply foolish. Government support (if it were included as income) would bring them out of the poverty stats, however - but that support from their neighbors rewards bad decisions made by folks who have not been taught better, or who simply haven't made any life plan. Life lived recklessly sometimes - but very rarely - works out.

I'd like every kid to be taught, by example and by words, that they have something of value to add to their families, their country, and to other people, but that none of that will be be realized without making smart choices and without making a plan.

Freedom demands a lot of maturity from people because it offers so many choices.

LaShawn has a piece on the subject: Why Mothers Need to be Married. The recent, widely-quoted piece in The Economist makes it clear that getting and staying married correlates highly with good kids and correlates highly with a secure life.

Apparently, if you graduate from high school, get married before having kids, and if at least one of the couple has a job, and if you have no more kids than you can afford, things tend to work out fairly peachy in the USA.

However, the post hoc ergo propter hoc fallacy implied is not addressed. In the end, do the data say anything more circular than "People who run their lives well do well in life"?

One of our team posted a piece written by a psychiatric nurse, of all people, about peoples' views of God. It's a wonderfully provocative subject.

Often, when Christians discuss the pagan or heretical things that people worship, we discuss the things that we are tempted to put above God - the false gods: ego, money, comfort, power, worldly success, pleasure, toys, popularity, etc.

I cannot claim to know exactly why we were given the gift of Jesus and His sacrifice, but He sure made it easier to worship God. However, when we think of God himself, what do we think of?

The answers are highly varied. It's like a Rorschach test, probably telling more about the person's psychology than about the nature of God.

My opinion? The face and mind and nature of God is too big for any human to get his mind around. Is that a theological cop-out?

Can personality change? Well, it depends on how you define "personality" and on how you define "change."

Certainly manner of behavior and attitudes can change over time as people adapt and "grow," but the deep foundations of personality are genetically hard-wired (we term that "temperament"), along with the first few layers above that (which we often think of using concepts like "character structure" or "constellations of unconscious assumptions/fantasies about people, one's self, and the world"), are highly resistant to alteration - which is where psychoanalysis comes in.

That question was asked in the context of two movies at PsyBlog, who took the trouble to review the best of the psychology blogs: Part 1 and Part 2.  (h/t, Neurophilosophy.) I am going to check them all out.

I am not aware of any dedicated psychoanalytic blogs. There should be at least one, but analysts tend not to be compulsive talkers and, when they write, it is always too long-winded and jargon-packed for the average ADD reader. The shrinks on our blogroll are more politically-driven than focused on the art and science of the analytic therapies.

I found Dr. Helen's discussion of the psychiatrist, Dr. Richard Friedman, who stated in the New York Times that he made politically-correct referrals, a good one, but I was confused by Dr. Friedman's premises.

Psychiatry is not all about empathy. In fact, empathy is just one of many tools in ye olde toolbox. When patients ask for a certain gender, age, color, etc. for a referral, I like to explore why. Usually it is a "resistance," ie based on the idea that someone might go easy on them and not challenge what needs to be challenged.

All shrinks have seen people who search until they find someone who will "support" them rather than shake up their world and challenge their inner problems. Kindly, one would hope, but also aggressively, because life is short. For example, a black patient might chose a black psychiatrist because "he would better understand my life." Nonsense. He just maybe might understand your surface outer life, but we deal with inner life. That is our special expertise.

I have been known to say "What you are saying sounds full of shit," and it has been quite helpful - and truly "empathic" - because it was true.

Empathy is just a tool for speaking the truth.

Depth psychotherapy for character flaws is about the doctor doing battle with a series of resistances. When one is cut down, the next resistance in line pops up. Psychoanalytic psychotherapy is a high-falutin' game of Whack-A-Mole.

I will never forget one consultation I did with a fancy, somewhat condescending  middle-aged WASP lady, to assess her appropriateness for psychoanalysis. She mentioned that, if possible, she would prefer a Jewish analyst. Why? "I guess maybe because I wouldn't worry about what I said to a Jew." There was Resistance #1 handed to me on a platter: shame about what she might say or reveal. Thus she told me that shame was one of her surface resistances - part of the easy work before the subtler transference resistances kick in.

Neo-neo commented on Dr. Helen's piece, and said that she knew therapists who would not treat a Republican. In my opinion, such a "therapist" is a fraud and not prepared to help anyone, because they are clearly so caught up in their own self that they do not welcome the adventure of trying to enter another person's mental world.

Can you imagine a surgeon caring more about your politics than about your appendix? There is a little thing called the Hippocratic Oath.

A re-post from Dr. Bliss in October, 2006, after the Amish school slaughter. Few are talking about evil, re VT. Why not? Evil deeds deserved to be labelled as such.

In reply to Lawrence Auster, re the lack of moral judgementalism around the Amish murders:

People do not like to talk about evil, especially on TV. Some of them don't believe that evil exists, some of them do not want to sound preachy or morally sanctimonious, and probably some of them just want to avoid the unpleasant subject of evil so the watchers don't switch channels.

I suspect that essentially everyone feels judgemental about the murders, but public moral judgement is out of fashion these days, except against Republicans, where it is always fashionable (as in the Foley story). Probably only a handful of misguided clergy, social workers, and academics truly withhold judgement from heinous acts.

But many bloggers have no problem discussing evil. Dr. Sanity engages the subject regularly, as does Shrinkwrapped and One Cosmos. And we do too, here and here, for example. If the MSM did all that it should, most bloggers could retire.

I hate the term "sociopath," because it sounds more like a medical diagnosis, or one of those phony Soviet diagnoses, than what it truly is, which is a disorder of the soul - an incapacity for guilt or remorse, and a capacity for putting of one's self and one's emotions before all else - above the rules, and above other people. It's a disorder for which there is no doctor's cure. They are built wrong, so they act wrong. They are better known as Evil People.

There are also non-Evil people who have very nasty thoughts, or who do morally wrong things, but that's another subject. This child-killer is the face of evil, disguised as a regular harmless person.

Remarkable to me, in this story, is the speed with which the Amish speak of forgiveness. It comes too soon for it to be convincing to me, but I know what it is they seek. They seek to have God cleanse their souls of hatred because a soul burdened and contaminated by hate or chronic anger is alienated from God and from one's spiritual community. But at the same time, I suspect (but I don't know any Amish) that they would expect to see this guy executed.

Forgiveness is not a gift to a wrong-doer; it's a blessing which, with God's help, is conferred on ourselves to release us from the burden of hatred and vengefulness. It is difficult and it is not natural: it is supernatural  soul-maintenance, like an oil change from above.

I have written three versions of a short piece on the VT massacre, but was not satisfied with any of them.

My main points were to have been that such events are unpreventable, and so rare as to make planning for them almost absurd. Many college kids act strange, and are quirky; many write Quentin Tarantino-type stuff, and many are angry about one thing or another, but it doesn't mean a thing.

And, often enough, sadly, college-age kids have psychotic breaks that can go relatively unnoticed for periods of time. I am not asserting that that is what happened, because often mass murderers are not clinically psychotic, but it seems likely from today's new information. My point is that the often-mentioned  "clear warning signs" are always retrospective.

Everybody is a genius at connecting dots in retrospect. And no-one, I believe, is an expert on murder sprees: they are too rare, and the inner demons are too variable.

Classical Values summarizes the shrink-related thoughts from other bloggers, and SISU has additional summaries. I can refute many of the quoted assertions, but I won't.

The overarching psychological issue, I believe, is the notion that terrible things should not occur in life. Random terrible things happen every day to many people all over the globe, and always will. Tsunamis will come, and earthquakes, hurricanes, mudslides, and diseases and plagues; people will go berserk, wars will happen, and bombers will plant bombs; multi-car crashes will occur, and roller-coasters will collapse.

The idea that random terrible events are preventable, and that life could somehow be made thoroughly safe, sanitary, and secure, is a childish fantasy, or even a delusion. We bubble-wrapped Americans specialize in that fantasy, but most of the rest of the world understands better that life is a dangerous enterprise, and not Disney World.

We linked this piece from the Pittsburg Trib the other day. It compares American and Korean kids on their views of their math proficiency.

The American kids think they're good, but they aren't. The Korean kids think they're bad, but they aren't.

Their findings are consistent with my own observations. However, I am not sure whether it can be blamed on the schools. I have written many times about the ridiculous notion of "self-esteem," and the absurdity of the idea that this is something schools - or anyone else - should or could instill.

I think the differences might be plain cultural, though I do not mean to minimize the insidious reality of the "dumbing down" movement in education.

David Warren has a fine piece on The Date of Inversion. He thinks it was August 10, 1969. A quote:

At the end of the earlier school year, the old principal had been fired: he was a drill sergeant (literally, ex-military). The new principal was a "reformer": a nice guy, a sensitive guy. Overnight, Ontario’s Hall-Dennis Report had also swept through, with its smug title, “Living and Learning.” Half the subjects had become "electives": 300 pupils in Grade IX Latin, became four pupils in Grade X. The bottom had fallen out of educational standards that had already been slung very low.

My view of "lower education" is that it ought to try to instill humility about their ignorance, try to excite curiosity, and to provide the basic information people need to know to understand the basics of their history, their culture and the world, and to handle life.

To carry kids along as far as their talents, interests, drive, self-discipline, and abilities can handle requires plenty of structure, demands and expectations. I see LaShawn has recently written a piece on the self-regulation aspect.

Editor:

- David Warren responds to the attention given to his piece linked above, here.

- Right Wing Nation looks at the differences between what high school teachers consider to be good college preparation, and what college teachers consider good preparation

Lean into the screen. What do you see? Step back 10' from your screen (if you can) and you will see something entirely different.

How do the eye and brain interpret visual input? Neurophilosopher, (h/t, Dr. X, from whom we borrowed the image, and who always has interesting photos).

There is a moral in this. 

Stanley Milgram's famous Yale experiment set the standard for uncovering the capacity for sadism in ordinary people. The results came as no big surprise to parents of multiple kids.

Philip Zimbardo's Stanford Prison Experiment ("SPE") took the subject much further - as far as any researcher would want to take it. He is the author of The Lucifer Effect: Understanding How Good People Turn Evil.

Dr. Zimbardo is interviewed this week in the NYT Science Times.

The evil lurking in people only comes as a surprise to those who know nothing of themselves. Dealing with it is one of the challenges of being human. And dealing with the vicissitudes of human aggression and sadism/sado-masochism (and anger too, which is another subject entirely) is a major challenge in psychiatry, both theoretically and practically. Freud found it necessary to posit a "death instinct" to account for some of these things, but he was never entirely satisfied with the idea.

Denial of the capacity for evil in others is called naive, or infantile. Denial of evil in one's self is called "denial," and is usually handled via projection (an immature defense mechanism which "projects" one's own malevolence onto external sources). Those who locate evil only in themselves are often masochistic, or using various defence mechanisms which I will not get into now.

The devil? Many Christians and Jews believe in a devil or devils. Devil or no, there is plenty enough material in humans for a devil to exploit (see Screwtape Letters -  a diabolically fascinating and amusing read). Our first piece on evil is here. 

I have done evil, and I have sinned plenty. Not to brag. I know that evil exists.

A few weeks ago I took a stab at the subject of American medical care, and the relationship between patient and physician, "Providers or Physicians?"

I recently stumbled upon a better piece on the same subject by Dr. Bob in which he explains that "medical care is not a widget," and that the relationship between physician and patient is not a contract, but a covenant. Worth reading, at The Doctor is In

Stumbling and Mumbling takes a look at Dalrymple's piece on The Proletarianization of Doctors.

Indeed, the de-professionalization of physicians is happening all over the US, and not just in countries with socialized medicine. I most recently became disturbed by this when I was told that docs in a certain charity clinic that I am familiar with have been asked to punch time clocks when they come on duty.

Of course, it's all about money and power. When physicians become employees with no independent function as professionals, they can begin to lose their identity as professionals. It already happened to public school teachers when they unionized, but docs, being generally made of sterner stuff, do not fold so easily.

Fact is, this charity clinic I refer to (which has family practice/general practice, OG/GYN, dental, and psychiatric staff) is staffed by docs who want to sacrifice some of their time to the poor, but they have been told that if they all were to quit, they would be replaced overnight with docs from India and Pakistan who would not view the job as charity at all, and who have a different view of medicine that the traditional American view.

Money and power. It all began in the US when hospitals began to be run by managers instead of by doctors, in the 1970s. Hospital boards with an eye on the bottom line wanted compliant employees instead of cranky, demanding, patient-devoted docs running things.

We should have seen it coming when insurance companies replaced the line for "physician" with a line for "provider."  Provider? I am no provider. As a psychoanalyst and psychiatrist, I am quite the opposite: I am a demander, if anything. A demanding friend, whose time is worth a lot. Not a caretaker or care-giver, most of the time.

And that is why I am willing to be paid to teach, but am not willing to be paid to work by anyone other than my patients. Medicine is a fraternity/sorority, and a guild, and a priesthood with daunting responsibilities which extend far beyond the technicalities of medicine into the realms of friendship, love, the soul and the spirit. If that doesn't matter to people, they will live to regret it. 

I have never been sure how much I do want to know myself. Dr. Dalrymple went to a neurosciences conference, and wrote a nifty report. One quote:

It will not have escaped the notice of the observant that Marxism and Freudianism have become a little frayed around the edges of late, and that their adherents are reduced to recalcitrant membership of increasingly beleaguered sects. But the attraction of all-embracing worldviews that explain not only who we are but prescribe how we ought to live remains as strong as ever. Some of the neuroscientists to whom I listened at the conference implied that we were on the verge of such a breakthrough in our self-understanding, thanks to neuroimaging, neurochemistry and neurogenetics and so forth, that Man, proud Man, will no longer be a mystery to himself. The heart of all our mysteries will be plucked out wholesale, as it were; and to understand all will then be not so much to forgive all as to control all, especially our bad habits.

It would solve the terrible AIDS problem, would it not? My Way News. Plus it would solve the entire transgender crisis, and the whole patriarchy problem too.

Let's Think Progressive, Think Feminist, Think Sitzpinkler, and Think Incrementalism: Circumcision Was Just a Start!

You have to wonder what kind of wierd sadistic nut would have thought of it, and don't tell me that God really wanted that. Our God is into neither physical nor mental mutilation, I believe.

But male castration at birth - meaning the whole package -sounds like a good issue for the Left. A natural issue for Hillary. And it is multiculturally sanctified: the Moslems already take the knife to their girls. Why don't they take out the old snippers, and do it to their men too? Fair is fair.

Ed. note: That is Mr. King Cobra. A very fine animal.

My casual post on transsexuals attracted more attention than it deserved, including attention from Laura's Playground. Still, I suspect most interest is plain old morbid curiosity, like slowing down to watch as you pass an accident. "Rubbernecking," as they term it in NYC. It can seem like Coney Island side-show stuff, but so can many medical curiosities and strange ailments.

As a fairly effective and smart shrink, I feel for these people, and yet being a physician isn't all about feeling. My opinion? I dunno what to think.

A reader produced this video at YouTube: Made by Nature. Nothing nasty in it at all. We report; you decide.

I have never treated a patient with a "transsexual" diagnosis (now known as Gender Identity Disorder), and I know little about it.

The case in Germany described in Clayton Cramer's piece, in which a 12 year-old boy is undergoing hormonal treatment in preparation for surgical transformation into a "female," raises the issue. The German Child Endocrinologist says this:

"They are not freaks, nor do they suffer mental illness. They are simply trapped in the wrong bodies. That is why it is best to help them as early as possible and reduce the trauma for them and their families."

Freud made it clear, and he was right, that everyone is psychologically a bit male, a bit female, and, on some level, bisexual. Psychiatrists, and especially psychoanalysts, tend to look for the inner motives for things in general, and to view desires for external change as "externalizations." Just the phrase "trapped in the wrong body" is based on a strange premise. Furthermore, who has the body they really think they want? I was a tomboy myself, refused to wear dresses, and liked guns and sports. However, sometimes things do go awry during early development - before birth - which affect the development of the brain and thus the personality. 

I guess all I can say about this is that I'd like to imagine that there could be some "therapy" for a kid like this that would fall short of dreadful physical mutilation. I'd be willing to give it a try.

And, by the way, I do not believe you could do this thing they are doing in Germany in the US: I doubt any physician would be willing to do it at that age. Primum non nocere.

I thought that I had completed my thoughts about the Psychoanalytic meetings, but I have one more thought to briefly put on paper.

In the US, psychoanalysis is mainly a research tool. It is not, and never will be, a widespread treatment for disorders of the soul because most people cannot use it, and because people have become so dependent on their insurance which will never pay for analytic treatments. Thus it will remain an endeavor for the few, available to the few, and practiced by an elite few (mainly in a handful of metropolitan areas) - the high priests of the craft of psychological treatment.

(Incredibly, in Europe government insurances pay for psychoanalysis, but many believe that if paying for it does not hurt, it will not work. Nobody appropriately values "freebies".)

So, in the US, analysis is a benefit for the few - truly an elective procedure -  but a source of data and information and theorizing which can benefit many. We have yet to find a better method than Freud's for investigating the depths of the heart and soul.

Editor's Note: For Dr. Bliss' recent posts, just click here.

I am back home in Boston. A few final thoughts from the analytic meetings:

1. It makes more sense to speak about "engagement" in treatment than to speak about "treatment alliance" or "therapeutic alliance."

2. A capacity for self-analysis is one good indicator for the end of an analysis.

3. Is psychoanalytic theory, especially its meta-theory, little more than an intellectual crutch for the doctor?

4. Not news, but analysts are prone to all of the obnoxious and nutty human traits that everyone else is.

5. Classical psychoanalysis is for people with mainly neurotic conflicts and personality issues in the neurotic zone, but many are treating less-well put-together people with all sorts of non-classical analysis these days. I always find that interesting, but I am not sure it makes sense. Maybe I am old-fashioned, but I have an analytic tool-kit and a psychotherapy tool-kit, and they are different.

6. How come people who live a short train-ride into the city rarely do anything, but out-of-towners come in and catch a bunch of theater, the NYC Ballet (best in the world), some music, a museum or two like the Neue Gallery, etc. - and feed their souls for a year? Suburban sloth.

Finished my strenuous week in NYC with Jacques Brel is alive and living in Paris, an off-Broadway revival of the 60s hit. Some think that Brel was the greatest songwriter in world history.

I don't think that (David's psalms win the contest, for me), but they are damn good. The music and the singing are extraordinary. Plus they have kept the basics of Brel, but added a bit of appropriate stage movement. And the Zipper Theater (in an old zipper factory) is the funkiest place: you sit on old car seats. They have a bar in front, with a sign that says "Please bring your drinks into the theater."

Brel died in 1978, but he is alive and well at the Zipper. The NY Sun's review is here. The 1966 original recording is at Amazon.

Who really needs a psychiatrist? My wife tells me what's wrong with me every day, for free.

Anon.

More items from the American Psychoanalytic meeting in NY this week:

1. Confidence that antidepressants will work improves their effectiveness by around 40%. I don't know what that means, and I tend to doubt it - but that's the data. Interesting. There are still many analysts who feel that antidepressants interfere with treatment. They could be right.

2. Most psychoanalysts practice very little analysis. It's the nature of the modern world. Analysts regret it, but they feel that their rigorous and lengthy training helps them in whatever they do.

3. I always knew this, but analysts tend to be stiff, unapproachable, stern, and unfriendly people. The presentations are humorless, cold, unrelaxed, and always delivered in a wierd - can I say "hypnotic? - monotone. Very strange, given their profession, in which they are very kind and caring. And yet an analytic meeting is the coldest, most unfriendly sort of "convention" you could ever find. Nobody chats, nobody hoists a few beers at the bar - unless they know eachother already. They are totally isolated at the meeting, which is not fun at all. Even when you sit next to them, they don't acknowledge your existence. It's like an Episcopal Church. A bit schizoid. When you smile at someone and say "hi," you feel like you are intruding. I am not like that, at least since my second analysis. Will ask Nathan to try to explain this unpleasant phenomenon.

4. In semi-contradiction to the above, overheard at the Waldorf lobby bar between a somber but cute youngish analyst gal and a gal friend at 2 pm: "I need a drink or two. And then, let's go do some shopping or something. I need a break." Do not ask me what I was doing at the bar.

5. I always find it amusing that Freud never had a psychoanalysis. He said he did self-analysis, which I am certain that he did. Like any explorer, he opened many doors, and was wrong about some small things, but right about a few very big things. A hero, for certain.

6. "Self-psychology" and object relations theorizing: Just say the term "projected self-object" and I am asleep. Same goes for the words "Melanie Klein." I am outta there. This stuff is gobbledy-gook to me, and I ain't dumb. If you can't explain it to me in the King's English, forget it. No sale. Back to Charles Brenner.

Yesterday was excellent.

Dr. John Meyer did a plenary speech on re-analysis which was very fine. He particularly noted the limitations of training analyses, and the common desire of analysts to do it again, and to go further. General point: Second analyses are better than first.

Overheard in a research poster session between a Belgian analytic researcher and an American attendee, Dr. Y:

Dr Y: Have you read the work of Dr. A in France, and Dr. B. in Sweden, which are closely related to your research?
Belgian Dr: Yes I have...but who are you?
Dr Y: I am Dr. Y.
Belgian Dr: Oh, of course I know who you are. I am so pleased to meet you.
Dr Y: Have you read my book?
Belgian Dr: Yes, of course.
Dr. Y: In the English or in the German?
Belgian Dr: In the German.
Dr. Y: Good. That's the good one.

A thought clarified during a presentation by Dr. Catherine Lee on Romantic Mirroring and Erotic Transference in the Female Analytic Dyad: How come analysts tend to call it homoerotic transference when analyst and patient are the same gender, and erotic when they aren't? That's silly - it's all ordinary human love-seeking in the transference.

A new concept, generated while kidding around waiting for a discussion group to begin: We need to come up with a new diagnosis, called Normal Personality Disorder, with a DSM 4 code, for all of the people who can benefit from psychoanalysis.

Observation: From conversations, more and more analysts are doing couples work. They like it.

More later. Last night, though, dinner with Bird Dog and daughter, and some other folks, at one of my favorite NYC restaurants, Cafe des Artistes - always a special treat - and then to Spamalot, which is a vaudeville-style Bway thing which was constantly hilarious with mindless, adolescent humor with an irreverence which does not spare gays, Jews, Les Miserables, Brits, kings, heros, Vegas, Camelot, Broadway, theatrical cliches, and everything else Eric Idle could think of.

The theatrical talent available in NYC is always utterly mind-boggling - and deeply humbling. I always wonder, Who are these amazing people who can act, dance, tap-dance, sing up a storm, ham it up, and produce laughter with a single eye movement? A perfect ending to the day. "Tis only a flesh wound. Come back here, you filthy coward."

A reader referred this piece on Soft and Hard People at Am. Thinker today. I have many thoughts about this truthful piece, but I'm too tired to write any more tonight. Quote:

... a juxtaposition of Abu Ghraib and Muslim beheadings tells the tale, as too many of us are epitomized by panties while our adversaries are by swords.  While they bat nary an eye at the torture of an innocent, we eat ourselves alive over the humiliation of the guilty.  But what is truly humiliating is when the hard people laugh, watching the soft people play the fools, bray at one another, and commit cultural suicide. 

And make no mistake, they laugh.  Why do you think the Mexican government distributed literature instructing its citizens on how to best violate our southern border?  Why did Islamists issue advice on how to play the victim card in the American legal system?  They don't tolerate such under their dominion, but they know about our lawsuits, protests, pandering politicians and capitulating clergy.  They know the game.  They know us.  And they don't really think we're barbaric or unjust. 

They think we're weak and stupid. 

Soft people and hard people, two sides of the same world.  Of course, we were harder too, a long, long, long time ago.  But it would be nice to find that happy medium, something that seems ever elusive.  A bane of man is that he jumps from blind prejudice to blind tolerance and back again, without ever making a stopover at the ethereal land known as enlightened distinction. 

Spent all day at the American Psychoanalytic Meetings today. Very pleased to see all of the PC stuff gone. No pro-Palestinian psychology, no terror apologetics, no sessions on transgenderphobia. Of course, they had to generate a press release condemning torture, but that is just window-dressing. These folks mostly aren't Jack Bauer fans, or shooters, except me and maybe a few others. (I am opposed to gratuitous or vengeful torture, but entirely in favor of torture to extract life-saving information.) Happily, though, it's pretty much back to basics.

Had a hilarious lunch with our recently-truant Aliyah Diary author, N. Szajnberg, MD, author of two new books of psychoanalytic research, including one on Israeli soldiers, who spoke wonderfully at a morning meeting on the role of theory-generation in the history of science. Will post his books later.

Among others at lunch at the Cafe St. Bart's - Philly's Dr. Elio Frattaroli, author of Healing the Soul in the Age of the Brain. Given his interests, I told him to give One Cosmos a look-see. Nathan claims that Elio's is the best book every written on psychotherapy.

My questions for our lunch-time informal panel:

1. Does anyone really believe our metapsychological theories? (I think not)
2. Do psychoanalysts overvalue the "inner life"? (I think yes, but they undervalue the spiritual life)

This is getting a tad technical, but this was Anna Ornstein's reply to my question about an apparently narcissistic patient in analysis whose narcissism turned out to be a transference resistance against an oedipal transference: "It must have been pseudo-narcissism." Hmmm.

The session I most wanted to attend was Dr. Bob Michels moderating about a case of organizational pathology presented by Dr. Dick Munich. Sold out, with barely standing room in a 100 degree room. Even Dr. Kernberg, my supervisor and boss many years ago, had to stand squeezed, leaning on a table and unable to see the discussion panel. Somebody could have had the grace to give Otto their seat at the table. Very disappointed, but by that point, I would have keeled over had I stuck around.

Overall, a good day to re-center on the basics: process, transference, resistance, defence, assessment, etc. And, for fun, the role of theory in practice. And, again overall - what a bunch of scary smart, literate, thoughtful, kind folks.

The NYT reports that 51% of American women are living without a spouse.

What are the socio-culturo-politico-psycho-biological consequences of this trend? Besides, of course, expecting the government to fill the role - which it surely will, in once sense anyway, which I will not say here.

But, love and comfort aside, who takes out the garbage and replaces the washers in the faucets?

It actually crossed my mind - as a random notion, not as a plan - to try to live-blog the meeting, which is this week in NYC, as always, at the Waldorf. Of course I am going, as a good excuse to spend a week in NY, see a bunch of shrink friends, and visit with my baby brother and his wife. Definitely catch an Otto Kernberg talk, and any panel with Bob Michels on it - smartest guy I ever met.

And Bird Dog has planned a dinner and theater too Friday night, so that's a good deal.

But I quickly realized that hardly a soul on earth would be interested in these meetings. If they were anywhere but NY, I wouldn't go. So no blogging about it, unless something truly absurd comes up. Which it will.

One of the pleasures of getting into this blog world a bit is seeing, with my own eyes, how many bright people there are out there who see things the way I do. For a Boston person, that's consoling enough, but to find people in my general profession - which tends very liberal and pacifist, if not intellectual/passive - who have arrived by similar paths to a somewhat shared current thinking is plain wonderful.

If we are all wrong, at least we can be wrong and stupid together. I am thinking of such psychologically-minded folks as Neo-neocon, Shrinkwrapped, Dr. Sanity, Assistant Village Idiot, and SC&A.

And One Cosmos. Gagdad Bob's thoughts on Thomas Sowell's recent piece is an example of the kind of applied psychological take on things that gives me delight. One quote:

What most seems to annoy leftist intellectuals about the free market is that, not only is it something that they cannot control or understand, but it accomplishes its task much more effectively and efficiently than the most brilliant person -- or group of people -- ever could. Sowell cites a famous essay which pointed out that no single person knows enough to produce so much as a single lead pencil. That is, "there is no single individual anywhere who knows how to grow the wood, mine the graphite, produce the rubber, and manufacture the paint." And yet, no one need ever worry that there won't be enough pencils, so long as we don't interfere with the process: "Complex economic processes cause all these things to be done and coordinated by a wide variety of people, just in order to produce something as simple as a lead pencil. Multiply that by a hundred or a thousand when it comes to the complexity of producing a car or a computer."

Indeed, it takes a village to make a pencil, but not an African village, and not a village in Afghanistan or in the jungles of Ecuador. A special kind of village, with certain kinds of values and motivations and cultural structures, knowledge, interests, and freedom of opportunity.

I especially enjoy the famous pencil example because, as you may recall, Henry David Thoreau's family made their money from their pencil factory. Henry worked there for a while, and apparently made some significant improvements in the manufacture of the Thoreau Pencil, until he decided that he didn't want to work on Maggie's Farm no more, and decided to be a writer and a public intellectual, living off his family's money.

In addition, of course, the pencil was the original keyboard. Quill pens must have been terrible to write with, and I am sure they scratched the heck out of the monitor screen.

It has been a wonder to me that so many folks in the mind and soul-treating professions are so non-freedom-minded, when these professions are designed to free people from their inner demons which restrict their taking on life freely, cheerfully, and energetically, in the way they see fit, and taking their own chances and making their own choices - in free societies. Freedom is what they are all about, and why psychoanalysis and psychotherapy are never permitted in totalitarian states.

Does every human have a slavish, dependent side to them? Of course. Many days I wish to be nothing but a pampered pet, with a simple life - except I'd be bored in 40 minutes and begin doing something I wasn't told to do. The wonderful possibility is the possibility of governing oneself according to aspirations for higher levels of maturity and autonomy. And that, Dear Readers, is a culture-specific aspiration, rooted in Protestantism; in the notion of "every man his own King," (and every man his own priest as well).

And, with the keyboard, "every man or woman his own pamphleteer," like the wacky Sons of Liberty, pasting our visions of freedom to the walls of the alleys of the world, hoping some passerby will stop and read.

On the same subject, see our recent Liberty, Who needs it?, or, even more recently, Give me Liberty or Give me Health. 

Equality is for farm animals. While Orwell remains one of my political guiding lights, Huxley really nailed the danger of "well-intentioned, rational" soul-crushing tyranny in Brave New World. Pure, soul-less logic requires tyranny, as the wise Plato said. 

Our blogging shrink friends remember that psyche means "soul," not mind, as Bettelheim made so clear in Freud and Man's Soul. The soul needs space!

I will conclude today's rambling sermon with a Dylan quote from My Back Pages:

A self-ordained professor's tongue
Too serious to fool
Spouted out that liberty
Is just equality in school
"Equality," I spoke the word
As if a wedding vow.
Ah, but I was so much older then,
I'm younger than that now.