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.
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.
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.)
We have periodically posted here about eating obsessions, whether overeating, anorexia, "organic" preoccupations, people whose approach to food verges on the medicinal, vegetarianism, food fads and food quackery, etc. We shrinks call it all "orality."
As we have often said here, anybody in the Western World would need to make a full-time effort to avoid an adequate diet. Furthermore, medical science has yet to come up with a consensus on what a "healthy diet" really is. Eskimos thrive on seal fat and sea gull meat. Despite what Mrs. Obama or anybody else tells you, it's all Old Wives Tales. We all would enjoy believing that we can control Fate in some way by one sort of magic or another. Eat fruit? Why? It's pure carbs and just makes you fat. Spend good money on vitamins? Why? It's all Magical Thinking.
During most of human history, any food was scarce and costly to obtain. We have tons of good food, cheap. If anything, too much and too tasty, and we don't have to do drudge labor in the fields all day to get some of it.
I have seen plenty of sturdy young athletes grow up on nothing but Cheerios, macaroni and cheese, and peanut butter and jelly sandwiches. Eat what you like, and thank God we have food choices.
Where's my Big Mac? I've been waiting here two minutes already.
When is enough pleasure and instant gratification enough?
Oh, maybe never, I hear my readers thinking.
I put the word "addiction" in quotes because I am not referring to physiological addictions such as to narcotics or alcohol, but to the pop culture use of the word, as applied to chocolate, food, sex, money, power, buying, etc. The casual use of the term, of course, refers to the difficulty in stopping the behavior when it doesn't make sense.
Some people are studying the brain to try to understand satiety. Some, interested in overweight, are studying foods. I think they are barking up the wrong tree (Yankees might not realize that that is a reference to coon hunting with coon hounds).
I believe that most of these "addictions" are more subcultural and psychological than physiological. Returning to the topic of food, the well-respected scientific journal Elle points this out in Satisfaction Guaranteed:
As a child, were you encouraged to clean your plate and then go back for seconds? If so, you probably didn’t grow up in France, where children are taught to savor the feeling of longing, or envie, for their next course (just think of the cheese!). Our differing notions of satisfaction were examined in a 2006 study of 133 Parisians and 145 Chicagoans published in the journal Obesity. While the French paid attention to an internal cue, the feeling of fullness, the Windy City-ers relied on the external: when their plate was empty; when their companion had finished eating; or when—quelle horreur!—the credits started to roll on the TV show they were watching.
Many Americans ignore the body’s subtler signals of hunger and fullness, hearing only the clanging gong at each end of the pendulum—Starving! Stuffed!—and rarely pausing to enjoy the much more pleasant midpoint: Ahhh, satisfied.
Some subcultures believe in big eating, some in savoring, some in minimalist eating, and, for some, food is just not a central part of life at all - Northern Europeans, for example. I was raised, for example, to learn that a lady always eats slowly, and never finishes the food on her plate. Not in public, anyway. It's not considered ladylike.
From Yale Psychiatrist (and author of Comfortably Numb: How Psychiatry Is Medicating a Nation) Charles Barber on the above topic in The Wilson Quarterly, a quote:
The new neuroscience has emerged from the last two decades of formidable progress in brain science, psychopharmacology, and brain imaging, bringing together research related to the human nervous system in fields as diverse as genetics and computer science. It has flowered into one of the hottest fields in academia, where almost anything "neuro" now generates excitement, along with neologisms, neuroeconomics, neurophilosophy, neuromarketing. The torrent of money flowing into the field can only be described in superlatives - hundreds of millions of dollars for efforts such as Princeton's Center for the Study of Brain, Mind, and Behavior and MIT's McGovern Institute for Brain Research.
Psychiatrists have been in the forefront of the transformation, eagerly shrugging off the vestiges of "talk therapy" for the bold new paradigms of neuroscience. By the late 1980s, academic psychiatrists were beginning literally to reinvent parts of the discipline, hanging out new signs saying Department of Neuropsychiatry in some medical schools. A similar transformation has occurred in academic psychology.
A layperson leafing through a mainstream psychiatric journal today might easily conclude that biologists had taken over the profession. "Acute Stress and Nicotine Cues Interact to Unveil Locomotor Arousal" and "Activity-Dependent Gene Expression in the Prefrontal Cortex" are titles of typical offerings. The field has so thoroughly cast its lot with biology, and with the biology induced by psychoactive drugs, that psychiatrists can hardly hope to publish in one of the mainstream journals if their article tells the story of an individual patient, or includes any personal thoughts or feelings about the people or the work that patient was engaged with, or fails to include a large dose of statistical data. Psychiatry used to be all theories, urges, and ids. Now it's all a search for genes, receptors, and neurotransmitters.
A few comments: He correctly describes the currents in Psychiatry today - the emphasis on the mechanistic view. Of course, this is just one view of the elephant, and you cannot eliminate the words "mind" or "soul." After all, the main role of current neuroscience is to understand "the mind." I try to take a balanced view. I am fascinated by the neurosciences, and I think our psychiatric medicines are Godsends for many. But, for many problems - let's use addictions as an easy example - I believe that a soul-change is needed, and is possible. I think it's best if we shrinks remain modest about our knowledge and our powers.
Another quote from Barber:
If there's any lesson to be gleaned from the recent history of psychiatry, it is, in the anthropologist Tanya Luhrmann's words, "how complex mental illness is, how difficult to treat, and how, in the face of this complexity, people cling to coherent explanations like poor swimmers to a raft."
We don't know much, but we should know just enough to recognize how primitive and crude our understanding of psychiatric drugs is, and how limited our understanding of the biology of mental disorder. The unfortunate fact remains that the ills of this world have a tantalizing way of eluding simple explanation. Our only hope is to be resolute and careful, not faddish, in assessing new developments as they arise, and to adopt them judiciously within a tradition of a gradually but steadily growing arsenal in the fight against genuine human suffering.
After all, there is no doubt that eating less does keep one's body younger, more sexual, and more vigorous, and, as with sleep, the older you get the less food you need. For women, there is a definite connection between weight, insulin-resistance, and breast cancer too.
Works for me. I have not finished a meal in a restaurant for 20 years, and I never would. We prosperous, overweight Americans probably need to re-learn when enough is enough, to re-learn to identify the inborn sensation of satiety if we wish to be fit, strong, and light on our feet. Tasty and abundant food is wonderful, but we need very little of it to remain healthy unless we spend the day digging ditches with shovels.
Carbs? I only touch them on weekends, and in small amounts even if we do daily work-outs and plenty of recreational sports. No, I am far from being anorectic, but I will never leave my muscular Size 6 Tall.
It's not all that much about grim "self-control" as it is about identifying the point at which hunger is alleviated. It doesn't take much food to do that. Unless you're a growing kid, amazingly little. A small handful of almonds or olives will do it. The best, tastiest restaurants serve the tiniest portions for good reason. You pay for the flavor and the quality, not for volume.
In the Western world, and increasingly everywhere on earth, prosperity and food abundance make it possible for every day to become a secular Feast Day of some sort, making the sensation of satiety fade into the background. Still, being able to identify satiety is a more general theme, whether in possessions, substances, money, love, food, etc. I should expand on the topic here, someday. Not at Christmastime, though, when saturnalian greed and self-indulgence were somehow added to the Roman Mass and Feast Day of the Nativity of Christ. I blame those three wise men for that, even though I'm sure they meant well.
In the end, I believe that what we are insatiable for, if we feel insatiable, is for relationship with God. We displace that hunger elsewhere, into the fun and easy stuff. I guess it's all good, but not great.
"Locus of control" is a psychological concept popularized and studied by psychologist Julius Rotter. It refers mainly to the extent to which a personthinks of himself as master of, or at least as prime determinant of, his life and fate. Captain of his ship, so to speak, or at least Navigator.
In America, we consider an "internal locus of control" as a sign of character strength (associated with determination, a can-do spirit, resilience, etc), and "external locus of control" as a sign of characterologic frailty (associated with blaming, excuses, scapegoating, dependency, complaints of unfairness, etc).
I say "in America" because some cultures support external localization while some cultures disparage the tendency to attribute unwelcome results to external forces, whether human, luck, God, or whatever. Northern European cultures tend towards the "no excuses," "take your lumps and learn from them" end of the spectrum.
Character is Destiny, or so claimed the ancient Greeks - and Freud.
People who tend towards the external side of things (in my field, we term it "externalizing," or "externalizing defenses") are often less successful in pursuing their goals. These are the people who are unlikely to admit "I screwed up," or "I was wrong," "I failed at so-and-so," "I handled that poorly," or "I don't understand it." The externalizing sorts of defenses are most commonly used to maintain a positive, or inflated, self-image in the face of disappointment but, on the other hand (revealing the internal contradiction) such people are the first to take credit for their successes and achievements.
The modern classic line which dramatizes the two ends of the spectrum is Jimmy Buffet's "Some people claim there's a woman to blame, but I know it's my own damn fault." In America, rightly or wrongly, our traditions respect those who say "It's my own damn fault" instead of blaming external circumstances, life history, bad luck, etc.
We preach that every move we make, or do not make, is a decision for which moral and practical responsibility must be taken, and the consequences of which we must man-up and deal with. Women must man-up, too.
The American ideal of self-reliance and self-responsibility comes into regular conflict with Christian views of God's will and evil forces, with ego-enhancing psychological defences, and also with dependency and victimization attitudes, ideologies and politics. It all keeps life interesting.
Freeman Dyson discusses Daniel Kahneman's Thinking, Fast and Slowin the NYRB. A quote:
(A) theme of Kahneman’s book, proclaimed in the title, is the existence in our brains of two independent sytems for organizing knowledge. Kahneman calls them System One and System Two. System One is amazingly fast, allowing us to recognize faces and understand speech in a fraction of a second. It must have evolved from the ancient little brains that allowed our agile mammalian ancestors to survive in a world of big reptilian predators. Survival in the jungle requires a brain that makes quick decisions based on limited information. Intuition is the name we give to judgments based on the quick action of System One. It makes judgments and takes action without waiting for our conscious awareness to catch up with it. The most remarkable fact about System One is that it has immediate access to a vast store of memories that it uses as a basis for judgment. The memories that are most accessible are those associated with strong emotions, with fear and pain and hatred. The resulting judgments are often wrong, but in the world of the jungle it is safer to be wrong and quick than to be right and slow.
System Two is the slow process of forming judgments based on conscious thinking and critical examination of evidence. It appraises the actions of System One. It gives us a chance to correct mistakes and revise opinions. It probably evolved more recently than System One, after our primate ancestors became arboreal and had the leisure to think things over. An ape in a tree is not so much concerned with predators as with the acquisition and defense of territory. System Two enables a family group to make plans and coordinate activities. After we became human, System Two enabled us to create art and culture.
His "System One" is more prone to illusions, but it takes less mental effort, as does getting through Dyson's intelligent article.
Steve Diamond made an interesting post last week describing the longstanding tension between the brain/behavioral and the mind/psychodynamic camps in psychology as a civil war. I have written here a number of times about this conflict, one that is at the heart of what is happening in psychiatry as well (if you are interested in the state of affairs in mental health, you really should read 1BoringOldMan who does a superb job of taking apart the trail of studies and inflated promises that got us here). I wish that what we are in were a civil war because then at least there would be active debate and engagement on these issues, but the takeover of psychology by the cognitive behavioral/brain folks is near complete on the academic level so that many younger clinicians have no idea of what is/was missing in their training. My side, the psychodynamic/mind side finds voice mostly through blogs like this one and those of other likeminded psychologists, psychoanalysts and psychiatrists. But together our voices are far less audible than those of the pharmaceutical and insurance companies and those of mental health professionals whose careers have been built on the effort to topple us. And the average person seeking help has no idea that these issues even exist. Yeah, it makes me kind of pessimistic at times.
I often feel that same way. Much of Psychiatric writing today has become so "medicalized," or "pseudo-medicalized," that you get the sense that it is check lists being treated rather than real people. Indeed, the two views of the patient - the hurting person - have developed different languages such that they cannot communicate well, and the alienation has become so extreme that I have heard them accuse eachother of malpractice.
Some of us attempt to straddle the divide, but it is difficult to rapidly alternate world-views.
1 Boring Old Man has been devoting himself to uncovering the Pharma-Psychiatric research cabal, but nobody is really listening. My rule of thumb is to take everything I read with a a few grains of salt.
"We created a group of self-entitled monsters." Hey youths, this is for you. Hey, OWSers, this is for you, too. Adam Carolla tells it like it is (language not entirely SFW, and h/t, SDA):
"Life is difficult." That book did me a lot of good, a few years ago. Got me into a little therapy, changed my life for the better, helped me realize that I was my biggest obstacle in getting on with life. Corny as it sounds, that empowered me. Shrink told me that there was nothing wrong with me except for being a "blaming and excuse-making a-hole" and I had to get my shit together, quit blaming and making self-flattering excuses, and take charge of my life like an adult who was willing to deal with reality instead of fantasies. Mean SOB was spot on. That's why I am, at present, having a very good life in New York City.
It is also why I don't do the morning posts here anymore. I am grandfathered in, to post whatever I want, whenever I want.
This is how it begins: Doctors urged to limit practices. Next come the "guidleines," then come the one-size-fits-all requirements. At that point, the patient becomes helpless and choice-less, and the physician becomes an agent of the state rather than a confidential and private partner with his patient.
At that point, I will reluctantly quit and abandon you suffering patients - and myself when illness comes my way - to whatever unionized government lackeys, technicians, and drones they can find who are willing to pretend to take care of you, between their mandated lunch, coffee breaks, and 1 hour/day study time to master the government treatment manuals which will tell them what they can do for your age and category.
I have seen that kind of medicine, and will not be part of it. Watch for the politicization of medical care. Ugly. Every real and imaginary disease, and every real or imaginary treatment, will have a lobby in DC.
Government contaminates and corrupts almost everything it touches. Why any Psychiatrist or psychotherapist could be anything but Libertarian-minded is beyond my comprehension, because we are all about freedom, individuation, self-determination, and self-reliance.
No time to check the hearts of girls' dollies. A damn shame.
As an old-fashioned person, I always claim, whenever I do something wrong (and I do), "The Devil made me do it."
At the same time that I mean that, I also accept the notion of human agency. Every waking second of life offers choices, and I think a college bs post about Free Will would be sophomoric. All I will say is that what we feel, and how we chose to behave (absent severe mental illness) are entirely different things. Human dignity and civilization itself requires a distance and a delay between the two. Even animals exercise that delay.
A human without a reliably moral, executive "I" is a dangerous entity, an entity to be avoided if not locked away.
Like Megan McArdle, I don't give a darn about income inequality or asset inequality as long as people do not starve in the streets, and have opportunity and freedom to make their own path in life, but, in many years of talking to people, the patterns and major causes of very low reported income - bottom 1-4% - just call it the 1% because Life has a bell curve for economics -are obvious to me:
- Youth, career beginning, and education debt - Single motherhood - temporary unemployment - Life style choice - Lack of marketable skills - Living where there are no jobs to match skills - Very bad luck - Mental illness, addiction, etc. - Lack of cultural mastery, whether via recent immigration or whatever - Chronic disabling illness - A history of poor decision-making and life strategizing - Low IQ - Character traits such as laziness, inability to get along with people, lack of organization, initiative, goals, self-discipline, or ambition, no discipline to save money, impulsivity, poor planning, lousy judgement, etc etc. - Income data gaps due to the numbers of people who work off the books (for a dramatic example, our clinic realised that there was a 30-woman prostitution ring working out of a nearby government housing project) - Choosing to work the welfare/disability/food stamp/child care etc. system (with a couple of kids, the all with full government benefits brings them up to a working class standard of living without working. That ought to be good enough, roughly equivalent to a $40,000 salary). Our support system will bring you close to $30,000/yr in cash and/or benefits including unlimited free medical care) - History of criminality or career criminality
Everybody knows these things, but they are never talked about. I think that list covers pretty much all of the income poverty that I have seen. I have been lucky, and have worked my butt off as a physician, and still am not wealthy. I work because I need to be useful. For wealth-building, being a traditional gal, I rely on my beloved hubby. I stand by my statement, however, that money isn't happiness. It just provides choices.
You have to have things and people that you love, independence, and integrity, to make a good life.
I have had a few interesting experiences with my patients and bill paying over the past few weeks.The business aspect of my practice is usually routine and unremarkable, but these stood out:
1. Phone message from a wealthy law firm partner one hour before his initial consultation: "Dr. Bliss, I just found out that you are not on my insurance so I decided not to come in."
(I threw a fit.)
2. An email from a college student patient with no money who I have seen on a charity basis "Dr. Bliss, my Dad" (who is unemployed) "and I were talking, and decided that we need to pay you something for the phone time and emails to adjust my medicine while I'm away at school. Please calculate something and put it on my account."
(I explained that I do not charge for brief phone calls or emails.)
3. Patient in the office "Dr. Bliss, you made a mistake on last month's bill." "Oh I did. I'm sorry." "Yes, it's the second time in two years when you undercharged me. Please correct it."
(I was naturally pleased by her honesty.)
4. Patient in the office: "My husband nickels and dimes me about every expense for the kids, and last week he went out and paid cash for a new Escalade for himself." "Did he?" I replied, "That's funny, because he told me on the phone that you all had no cash and asked that I give you a discount for a while." "Oh yes," she said. "I'm not surprised. His rule is 'Only suckers pay retail.'"
(I told her that as of today, it will be the full original fee because I was not pleased being one of his suckers.)
5. Business guy: "Doctor, will you take a discount for cash?"
("No. I happen to be one of those people who reports all of my income.")
I have a GI friend and colleague who makes most of his living sticking tubes down people's esophagi and up their behinds.
He told me that he recently took on a 1 day/week job at a Medicaid clinic to keep busy in this economy, and to do some low-fee work for the benefit of the community. Apparently people who pay or partly-pay for their own scopings are putting it off.
After four months of it, he was frustrated. He told me that over half of the scheduled patients do not keep their office appointments, and 2/3 do not show up for their scope appointments. He is quitting that experiment (leaving them without any GI person), and told me "No wonder these people are on Medicaid. If they cannot at least treat their doctors' time with respect, how can they hope to function in the normal world? It almost seems like they just do whatever they feel like doing. I end up just sitting there, like a chump while I pay my malpractice insurance bills to cover the work."
Well, yes, often enough. That is, of course, not an effective life plan for them. A sense of entitlement will get you nowhere in life.
Readers know that I donate one day each week to a charity clinic at which I decided to take no compensation. It is a component of my tithing. I told him that I give my charity patients two chances, but he rightly explained to me that, as a specialist with only consultation appointments, people feel no ongoing relationship with him, view him as a free government technician while he wants to be caring, engaged, and of help to them. Their physician, in other words.
I told him what he had already learned. The poor often do not have good health stats because they do not take care of themselves, and are often stuck in bad circumstances because they do not function reliably or behave respectfully in the world. I advised him that he was wrong to take it personally. He said that he could not help but to take it personally because he had made a serious decision to be of help to people in need and could not tolerate the lack of gratitude and respect. Said he would rather be on the golf course where his frustration would be on his own terms.
Also, forgot to mention his relevant unpleasant detail that when they do show up, they often have not accurately followed the pre-scoping directions, making his job impossible and disgusting. "It's a set-up for lawsuits," he said. "Can't see a freaking thing. I am not Roto-Rooter."
I tell him that that is the same as people who lie to me. He is right that some greedy and dishonorable people are looking for lawsuits anywhere they can find them, but you cannot practice good medicine with that at the top of your mind. Medical care is not a "service," it is a very human collaboration. Fortunately or unfortunately, you cannot "service" your body and/or mind like you do your car.
That is something that the bureaucrats just don't get. They will want us docs to be auto mechanics.
Brain science “will eventually begin to influence how the public views justice and responsibility,” Dr. Gazzaniga said at a recent conference here sponsored by the Edge Foundation.
And there is no guarantee, he added, that its influence will be a good one.
Prof Gazzaniga is a good, humble scientist who knows the limits of what his area can offer us.
The OWS movement embodies certain qualities which we don't seem to fully understand. It's neither a generational or an issue-driven movement. It lacks solutions. It has no direction or focus. There is a reason for this, defined many years ago by Eric Hoffer.
Hoffer was skeptical of mass movements, feeling they epitomized juvenile behaviors. He was able to determine why, pointing to a lack of self-esteem which the protesters exhibited. Hoffer felt self-esteem was critical in the development of adult behaviors. He outlined how widespread affluence and the rapid changes in modern society lead to a desire to attain adulthood more quickly, but with certain rites of puberty being shortchanged, particularly with regard to work and endeavor.
In his view an extended adolescence led many to seek outlets for their inability to define themselves. These people, lacking in self-identity, defined themselves as they saw themselves described by others. There was an intense self-loathing and guilt regarding position and place. This was a direct result of low self-esteem. Self-esteem was not being cultivated as many of those in protest movements didn't work, and were incapable of understanding their responsibilities. From this perspective, all mass movements were interchangeable, regardless of what they sought to promote.
Self-esteem and self-contempt have specific odors; they can be smelled. ~Eric Hoffer
As he points out, this nonsense led indirectly to the terrible child abuse "hidden memory" epidemic which destroyed many peoples' lives before finally being fully discredited.
We may now have scores of sophisticated books written by highly esteemed PhDs and a well-tread, lollipops over Castor oil, time-outs over spankings parenting path, but our progressive march through human history has ultimately produced adults that are… well, still childish.
Worse, we’ve managed to add an extra decade to adolescence.
Of course, people still commit innumerable bad actions, but the idea that people make conscious decisions to hurt or harm is no longer sustainable, say the new brain scientists. For one thing, there is no such thing as "free will" with which to decide to commit evil. (Like evil, free will is an antiquated concept for most.) Autonomous, conscious decision-making itself may well be an illusion. And thus intentional evil is impossible.
Many people do make conscious decisions to be hurtful or destructive. What could be more obvious? These neuroscientist folks can't see the mind for the neurons, it seems to me. As always in such cases, however, a conversation with the scientists would reveal that they do, themselves, lead lives in which good, evil, and choice are operative. Otherwise, they would deserve no recognition for their research because it was just their neurons making them do it.
In Willpower, the pioneering researcher Roy F. Baumeister collaborates with renowned New York Times science writer John Tierney to revolutionize our understanding of the most coveted human virtue: self-control.
In what became one of the most cited papers in social science literature, Baumeister discovered that willpower actually operates like a muscle: it can be strengthened with practice and fatigued by overuse. Willpower is fueled by glucose, and it can be bolstered simply by replenishing the brain's store of fuel. That's why eating and sleeping- and especially failing to do either of those-have such dramatic effects on self-control (and why dieters have such a hard time resisting temptation).
Baumeister's latest research shows that we typically spend four hours every day resisting temptation. No wonder people around the world rank a lack of self-control as their biggest weakness. Willpower looks to the lives of entrepreneurs, parents, entertainers, and artists-including David Blaine, Eric Clapton, and others-who have flourished by improving their self-control.
From Klavan's post:
Willpower surpasses even intelligence as a predictor of success in life. And Baumeister has performed a number of experiments that convinced him that willpower is something like a muscle: it can be strengthened, conserved, and fatigued...
But in the question period after the presentation, I asked Baumeister how else, aside from eating well, could willpower be strengthened. His response was this: Exercise strengthens willpower just as it strengthens muscles. Even a meaningless exercise of will — training yourself to use your left hand for a task instead of your right, for instance — can make the will stronger over time. He added — I quote from memory: “When I was a boy, I used to be baffled by the idea of profanity. I used to wonder why there should be all these words that everyone knew but nobody used. But now I understand: that strengthens willpower.”
Well, right. In other words, behaving well, behaving responsibly, learning the norms of politeness and refusing to abandon them without good reason tend to make you a more self-controlled, successful, and finally better person.
This is precisely the wisdom my generation threw away. Their promiscuity, adolescent foul-mouthedness, bad manners, and disregard for tradition — all of which they claimed were a new kind of freedom — were in fact the precursors to the very oldest kind of slavery: slavery to one’s own impulses and desires. This slavery, packaged in the Sixties as “identity” or “culture” or “the right to be yourself,” ultimately leads to enslavement by others as it makes you indolent and irresponsible and in need of protection and restraint by the powers that be. A poor black man’s journey from hip hop culture to prison is a perfect example. So is a middle class white man’s journey from moral license and unwarranted praise to his sniveling need for an all-providing — oh, and by the way, all-powerful — state.
Ditto to that, Mr. Klavan. I have always thought of willpower as mental or moral muscle. I've been practicing telling myself for years that I will do, or will not do, one thing or another several times daily. It gets easier, just like running that extra mile.
Willpower and persistence are surely important in pursuing one's goals in life, but I would add other items too, for examples:
Comportment Good vibes Sense of duty Social intuition Good, sane judgement Constructing good life plans - if you want to
On the collective scale, choice is nearly irrelevant. Only people with power have choices. The idea that the man waiting in the alley with a knife has a choice is a heresy because he is not a man with a knife, he is a collection of social statistics which assign him an automatic level of responsibility based on his race, gender, socioeconomic status and all the other variables. Whether or not he stabs someone with a knife, is not up to him, it's up to how society treats him.
Similarly financial troubles are not personal, they are social. Whether you can pay your bills has nothing to do with you, but with your race and class. If you succeed when the statistics say that you should fail, then you are an outlier. A rogue exception that only goes to prove the rule. Likewise if you fail when the statistics say that you should succeed. Individual actions can never disprove the collective snapshot of how society is.
If every person is wired into society like a giant bank of servers, then every individual malfunction is actually a social malfunction. If a man kills, then it's because his connection with society was bad. To understand why it was bad, the left examines the nature of the connection. If it was a privileged connection, then he was warped by his excessive access to the innate racism, sexism, classism and all the other bad "isms" of the society. If it was an underprivileged connection, then he was warped by his lack of access to the benefits that society had to offer him and being marginalized, he went off the reservation.
Blame-shifting is always fun, isn't it? Maggie's has been hot on this topic recently. "It's the hippies' fault." It's Bush's fault." It's my genes' fault." "It's my husband's fault." "It's society's fault." "It's my parents' fault." "It's my boss' fault."
But if things go well, it's to my credit, right?
While people make their decisions, plans, and choices for all sorts of reasons, it is a necessary premise in a free society that an individual is responsible for every one of his actions. In some cases, perhaps, a necessary fiction.
The bar mitzvah (a modern innovation, as I just learned) has it: "Today I am a man" and thus responsible for all of my actions.
The delicious pleasures of blame-shifting have never been permitted in the Bliss household.
...we know the brain can “change itself”. You could say that is one of its main jobs in fact – altering itself in response to experience to better adapt to the conditions in which it finds itself. For example, as children learn a language, their auditory system specialises to recognise the typical sounds of that language. Their brains become highly expert at distinguishing those sounds and, in the process, lose the ability to distinguish sounds they hear less often. (This is why many Japanese people cannot distinguish between the sounds of the letters “l” and “r”, for example, and why many Westerners have difficulty hearing the crucial tonal variations in languages like Cantonese). Learning motor skills similarly improves performance and induces structural changes in the relevant brain circuits. In fact, most circuits in the brain develop in an experience-dependent fashion, summed up by two adages: “cells that fire together, wire together” and “use it or lose it”.
Given the clear evidence for brain plasticity, the implication would seem to be that even if our brains come pre-wired with some particular tendencies, that experience, especially early experience, should be able to override them.
I would argue that the effect of experience-dependent development is typically exactly the opposite – that while the right kind of experience can, in principle, act to overcome innate tendencies, in practice, the effect is reversed. The reason is that our innate tendencies shape the experiences we have, leading us to select ones that tend instead to reinforce or even amplify these tendencies. Our environment does not just shape us – we shape it.
Indeed, smart people have been saying for many years that we have the power to shape our world, our realities, and our experience. There is a real reality out there somewhere, presumably, and real truth and Real Truth, but these things are elusive to our limited brains.
In daily life, we don't even consider that we live on a little rapidly-moving and spinning ball of rock in some sort of curved Space-Time in a frightening and awe-inspiring cosmos that few of us can comprehend. It's the stuff of college bull-sessions: Did the world make us, or do we make the world?
It's all good fun, but we do have to run our lives while we're here. Or not.
It is? What kind of "love"? What did Lennon/McCarthy mean, and who made them experts?
Our link yesterday morning from F- Feelings was excellent: Love Slaves. "The bad news is that most love won’t work, and you’ve got to leave it alone when you know it won’t."
If we let emotion control our lives, we are animals. If we let reason control our lives, we are robots.
There are more kinds of love than the Eskimos have (proverbially) kinds of snow. I once tried to make a list, and gave up. People vary enormously in their needs or wants for all of those sorts of need, desire, addiction, and attachment.
That is excellent advice from someone over 30. Social isolation breeds all sorts of strange and unreasonable habits of mind, while social interaction helps us define ourselves, learn about ourselves, and, especially, to learn what our limits are. Isolation nurtures delusions of grandeur or delusions of inferiority, and prevents acceptance of reality.
I attended a faculty cocktail party last night, and, for some reason, the advice I had received many years ago came into my head as a shy person during boarding school: "When you enter a gathering, make sure you say hello to, or introduce yourself to, a dozen people. Then you can leave if you want to. Never act like a shmoozing politician, but it's your job to let people know that you exist. They might want to know you, or they might not. Either way, it's learning. Learning sometimes hurts."
At my age, with genteel breeding and with my life experience, it's a little silly for me to still need that reminder. People tend to enjoy and seek my company.
Trust is a fascinating topic mingling, as it does, personality tendencies (especially extent of projection of one's own evil impulses and thoughts) with cultural or subcultural norms and rational expectations. There are trust cultures and distrust cultures.
Life has slowly taught me to be less trusting than I am naturally inclined to be, given my cocooned upbringing. I am most trusting, rightly or wrongly, of my own sort of people amongst whom, on the whole, there are strict and agreed-upon codes of behavior.
One aspect of being "socialized" humans is the capacity to appraise the people we have any meaningful contact with. Most people get better at this, over time. Older is wiser, usually. We get too soon old, and too late smart.
These appraisals happen automatically. We know that most human "thought" takes place as non-deliberately as our digestion. We call that intuition: "I like the cut of his jib;" "She seems like a superficial ninny;" "There's something off about them but I can't put my finger on it;" "He's crazy;" "She strikes me as a strong, upright person;" "He feels calculating and devious;" "She seems full of fun, sexiness, and vitality;" "A schmoozer-saleman-type who, if you offer them your hand, takes you by the arm;""The guy seems very shrewd and clever;" "He's a gloomy Gus;" "Too needy;" "What a phony;" "She's a flake, but a good kind of flake;" "He's an Old Soul;" "He's got a personal agenda;" "This kid will go far."
We get a quick "feel" for people. Vibes. Our brains have a remarkable ability to form automatic and almost instant impressions of a person, accurately or not, from an abundance of information: social presentation, tone of voice, body language, posture, facial expressions, dress and grooming, use of words, style of interacting, and social signaling of all sorts. It takes around a fifth of a second, after all, to fall in love or in lust, and not much longer to think that you might, or might not, want to consider getting to know somebody. Of course, it pays to be careful, but most people mean well unless they are on the make in some calculating way, and everybody wants some things - but perhaps not from you.
When we have any interest and curiosity in a person beyond the superficial (driven by such things as business dealings, attraction, things in common, etc), we have to move past the intuitive impressions, which are often in error and contaminated by emotional and/or transference reactions, put our thinking cap on, and do a little active thinking about a person. People don't do it in the methodical way that shrinks do as trained observers and inquirers, but cover many of the same bases of human interaction. For some examples:
- intelligence, curiosity, fund and depth of knowledge, abilities, talents, wit, good cheer, interests, goals and dreams - do we get along - are we on the same page with shared assumptions and understandings? Same tribe? Do we speak the same language, so to speak? Or are we different in interesting ways? - quirks, eccentricities, weaknesses, criminality, and obvious flaws - respectfulness, decorum, and self-respect - sociability, manners, openness, depth, relatedness or self-centeredness, self-awareness - integrity, honor, self-control, level of BS, reliability, trustworthiness. Are they givers, takers, or neither; general emotional maturity and judgement - level of energy, vitality, and ambition: Are they fun or stimulating to be with? As Imus would say, "What do they bring to the table?" - level of life functioning (that covers a whole lot of territory)
along with other considerations, and, of course:
- Do they want something from me and, if so, what? (eg sex, money, love, favors, attention, status, casual social acquaintanceship, friendship, close friendship, Christian fellowship, help, companionship, collegiality, conversational amusement, or, as in most cases, little or nothing at all, etc.). If we're in an introspective mood, we might also ask ourselves what we want with them, and where we want to locate our boundaries with them.
Shrinks, when at work, attempt character assessment in a way that is analogous to a physical exam (ie "Come into the consulting room and take your social facade off. Strip to your psychological underwear. The doctor will be with you shortly, and you can let her know who you really are, what you are really made of, and what your private struggles are.). I am not impressed that, in the end, we shrinks make many fewer initial errors than the average thoughtful and perceptive person on the street. We just don't use the same lingo.
I began this post with the intention of writing about different levels of life functioning, with this as an intro, but this is already long enough for now. LOF can wait until later.
It's a subject that has been on my mind for quite a while - the phenomenon of perpetual psychological adolescence in us decadent and pampered Americans - so I will look forward to seeing what she has to say about it.
I hope she will mention that the post-war worship of youth, which culminated in the late 60s and 70s, provided social permission, if not incentive, for adults to continue behaving like kids. Even college, once the domain of the serious, has become an extension of high-school. Given the human temptation for regression, and the joys of youth when compared with the rigors, duties, sacrifices, and responsibilities of adulthood, it's no wonder that people welcome the socio-cultural invitation. Every psychiatrist and psychoanalyst in America, and probably in Europe, is well-aware of this. And so are our politicians, who feed into it - and feed on it: Take care of me, Mommy and Daddy Government.
Photo: These mill workers in Georgia around the turn of the century were probably more mature than some of the 40 year-olds I see these days. Yes, I am in favor of children working. All of mine did. I did, too - and it was not "fun." However, I had time to work on my tennis too.
Psychoanalytic theorists have been struggling with trauma theory since Freud first abandoned it when he realized that fantasy can have as large an impact on a person as can real things. He more or less discovered the realm of what we shrinks call "psychic reality."
My take on it all is that dramatic events of all sorts affect people, but that the impact depends on their pre-existing character structure. One person's horror can be another person's excitement.
I have never been able to understand most of that "self-psychology" stuff he talks about, but I do know that everybody is born defective in some ways, and that emotionally-traumatic events or circumstances, generally unavoidable if you live long enough, change people in all sorts of ways. Sometimes they are opportunities for growth and maturation, sometimes they are simply destructive. Often, the destruction leaves a permanent scar, if not an open wound.
We all want to thrive and flourish in life, as best we can. Why not? Life is short. A quote from the Amazon review:
"Positivity is literally the feel-good book of the year, providing a scientifically sound prescription for joy, health, and creativity. Read one to two chapters daily as needed or until grumpiness subsides." —Daniel Gilbert, professor of psychology, Harvard University, and author of Stumbling on Happiness
I have grown fond of Psychiatrist-blogger 1 Boring Old Man. I generally agree with him on things, and I respect his efforts to be more up to date on the latest things than I am. From one of his Awakening Thoughts:
My real complaint about modern psychiatry, besides the corrupting influence of industries of various flavors, is that it lacks the tension and curiosity about things unknown that drives medicine forward. For all the talk of neuroscience, what I mostly see in our literature is "product testing" and the application of any new technology of science that comes along to conditions without creative ideas and hypotheses driving the endeavor. I don’t know why people have Schizophrenia, and I want to know about that. There are thousands of similar questions, and not all of them have to do with neuroscience. I’m sure that people get depressed, have bad anxiety, or behave destructively because of things in their minds, or biographies, or lives – not in their brains. That seems self-evident to me. And I’m tired of having those of us who are interested in that causality discounted as kooks based on complaints about the early theories of Freud or the arrogance of our predecessors.
My profession is currently schizophrenic (in the non-clinical sense).
Why aren't guys growing up these days? Or did guys ever really want go grow up? I don't know. A sociologist named Michael Kimmel has a book out reporting on his new study. For example, meet Jason:
Jason graduated from Dartmouth almost five years ago. Now 26, he works in finance in Boston and shares a Back Bay apartment with five other guys with whom he went to school. He runs and works out, stays fit, and dates lots of different women all in their early twenties. At night, he hangs out at the Dartmouth bars of Boston. Hey, college was supposed to be the best years of your life, right? he explains, with only a trace of defensiveness in his voice. So where is it written that it has to end when you graduate? College is forever, man. That's what the admissions guys say that these will be your friends forever. Well, forever is now.
In 2005, Aron teamed up with some neurologists and with Helen Fisher, the biologicalanthropologist who devised the questionnaire used to match people on Chemistry.com, a division of Match.com, to conduct a series of experiments. The first experiment placed happily-inlove people in an fMRI scanner to take photos of their brains. They found neural activation in areas of the brain linked with reward, excitement, and euphoria. Aron says this is likely indicative of early-stage love. Over time, the activation in this reward area can diminish. The car runs out of gas.
The processes that keep people together take place elsewhere in the brain. It’s a trait we share with only a few other animals, like the prairie vole.
and
We think of heartbreak as metaphoric, but the body actually does respond to emotional trauma, releasing a flood of stress chemicals like adrenaline that, in some cases, can overwhelm even an otherwise healthy person and cause his or her heart to spasm. Broken heart syndrome, as it’s colloquially known, has been tracked at the nation’s leading heart clinics since 2005, but because its symptoms look so similar to those of a heart attack, it is often misdiagnosed, says Ilan Wittstein, an assistant professor of medicine at the Johns Hopkins Heart Institute and the lead author of a New England Journal of Medicine article first describing the syndrome.
The movement to gradually destigmatize all social deviancies continues apace. For better or worse, we've come a long way from The Scarlet Letter.
I myself am a clinger. I cling to my antique cultural traditions, morals, codes, and religion as my life's foundations, and I lack the wisdom to opine about whether the destigmatizing of adultery, abortion, pornography, promiscuity, divorce (can anybody remember when divorce was socially shameful?), homosexuality, gay marriage, gay child-rearing, LGBTQ and whatever, prostitution, fetishes, many crimes, drug abuse, overtly antisocial behaviors (see all of the defenses of the UK's rioters), single motherhood, etc. is for the best or not. It certainly does represent a socio-cultural shift which some consider decadent. The notion of destigmatizing crime, for sure, seems like a big problem to me but there are significant subcultures even in the US who do.
The social acceptance of many of these behaviors seems to me to be part of the "therapeutic culture" which I, as an MD and practicing psychotherapist, find to be close to insane in its assumption that all would be perfect humans if not for inner conflict or external traumata. Sen. Daniel Moynihan, who I had the pleasure of talking to several times, defined many such things as "definining deviancy down."
Already, Moslem polygamy is sort-of overlooked in Western nations, and I see no fairness in not overlooking it in traditionalist Mormon families - or in anybody else who wants to do it. That's my Libertarian side speaking rather than my more personal, moralistic and Christian side.
Currently, the American Psychiatric Association has, under consideration, a proposal to de-pathologize Pedophilia. Why anybody in the general public cares very much about the opinion of this APA committee is beyond me, but many do. I doubt that they will have the political cojones to actually do that but, to get a little multicultural here, we have to bear in mind that pedophilia has been and continues to be culturally accepted in many cultures and subcultures - most famously, historically, amongst European royalty, the Greeks and Romans, the Moslems, and Africans, and currently amongst some Asian cultures and many Moslem ones. Prepubescent girls are for rent everywhere in south Asia. As a commonly-defined crime, pedophilia is found everywhere in the world.
Bonobo monkeys do it all, so it must be OK. Human fantasy and psychic reality may not be too different from Bonobo behavior.
In my opinion, pedophilia is not so much of a disease in itself as it is a crime - in our culture. It is a very good idea not to commit crimes even though supposedly everybody does, wittingly or unwittingly. In my field of Psychoanalysis, we still define culturally-deviant sexual behaviors as polymorphous-perverse or plain perverse, but even we - the supposed truth-tellers about the human heart - are subject to taboo PC pressures. It is interesting to see how taboos change, but never go away: now it seems that PC defines the taboos.
I remember a gay patient, years ago, who reported to me with some alarm that he had been dancing with a lady at a wedding and found himself feeling aroused and attracted to her. I joked with him that now he was revealing himself, in modern cultural terms, to have a real perversion.
Some people become concerned with who and what they are, and some people just forge onward and never think twice about it.
To keep it simple, I'll tell you how to "find yourself." Engage the world in all the ways you can: socially, spiritually, economically, morally, avocationally in sports, volunteer activities, clubs, going places and doing things, and in hobbies.
By doing those things, the world will tell you what and who you are. Engaging reality is the best teacher. My experience teaches me that people avoid some engagments with the world because they do not want to learn what reality has to teach them about who and what they are.
Generally speaking, Prof. Reality teaches humility as its first lesson, and goes on from there.
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.
The Knishman nails the zeitgeist here: 
When is enough pleasure and instant gratification enough?
From Yale Psychiatrist (and author of Comfortably Numb: How Psychiatry Is Medicating a Nation) Charles Barber on the above topic in The Wilson Quarterly, a quote:
You have to be skeptical about any report, but 
This is how it begins: 
Four Small Things
It's a subject that has been on my mind for quite a while - the phenomenon of perpetual psychological adolescence in us decadent and pampered Americans - so I will look forward to seeing what she has to say about it.
Why aren't guys growing up these days? Or did guys ever really want go grow up? I don't know. A sociologist named Michael Kimmel has a book out reporting on his new study. For example, meet Jason:
We all have them, and have had them.
Yes, you do have one of those psychobabble things.