Maggie's Farm

It's the same game, whether played from the right or from the left. Scare you into herding yourself into a malleable collectivist mass.

Well, maybe from the Conservatives a bit when they weaken, but the power-greedy Left in America rarely misses an opportunity to declare "market failure", followed by a grandiose plan to expand the power of the Federal state. FDR wrote the playbook, with Lenin's help.

Whether it's oil profits, climate, medical treatment, schools, risky mortgages, income differences, etc, there's always a "plan" for a grab for money and power.

That is why I am always highly skeptical about manufactured and trumped-up crises.

Medical insurance is a case in point. TigerHawk has a solid piece on the subject, in response to a piece by Ezra Klein which tries to convince the reader that American medical care is terrible, and the NYT piece by Mankiw that we linked yesterday. All worth a read.

And one more comment, re the "fully-socialized VA system." I have worked in a VA hospital attached to a major teaching center, and it worked just fine as long as you worked within the decreed limits. That's beside the point. VA patients have the choice of where to go for medical treatment, and they use those choices because the VA only offers clinic-style medicine, much like the charity clinics most kindly hospitals provide to their communities.

The Post Office works pretty well too (except for the USSR-style lines at the window), but we also have UPS, FedEx, etc as welcome alternatives to a government-controlled, lazy-bureaucrat-operated, arrogant monopoly which has no incentive - and no heart - to give a damn about you.

A conversation I heard yesterday on Sean Hannity's radio program was a stark reminder to me of what Conservatives and the liberty-loving are up against with the woman voter.

The caller was an obviously bright, cheerful, likeable, married young mom from Long Island. Sean was his usual polite and friendly self, but he did press her on her points. She wanted free medical care for her kids, and for herself. Then it evolved that she also wanted free day care, and then it became clear that she wanted free housing available too, and auto insurance and medicine. Sean asked her if she felt that the government should give her a free car, to which she said no, noting that the government already provides bus service where she lives - but her family has cars. She said twice that in Europe, people are "taken care of." I think Sean also asked her about free food, but I don't recall.

Sean was, appropriately, trying to find the limit of what she thought other people should buy for her. She believed that everyone should be taxed at 50% as a minimum, in exchange for "services." The notion of markets was irrelevant to her, as were such abstract notions as freedom.

I believe that this is a particularly female view of life, and related to my post of neo-neo's 2-part essay on marriage and divorce today. Women with kids want to feel safe and secure. It's the biological priority. In a world full of divorce, without tribe or the tight extended families of the past, it should be no surprise that women look elsewhere for security.

Women's Lib, with its leftist leaders, spoke about independence and autonomy and freedom but acted, politically, as if they wished to exchange dependence on men for dependence on the taxpayer: that has become the family farm, and the "village," and the "tribe" of the present.

Neo-neocon, who is a rara avis - a conservative psychotherapist - has a fine piece on marriage (and divorce), titled Getting Married: What's in it for me?

Part 1 

Part 2 

We posted Bruce Thornton's fine piece in City Journal titled Fighting at a Disadvantage a while ago. I wish to correct his use of the concept of a "therapeutic sensibility" which makes excuses for Islamist war and terror.

BT has probably never been in therapy: if he had been, he would know that finding excuses ain't part of it - nor is sympathetic hand-holding and commiseration. If you were in therapy with me, Mr. Thornton, you would  find me pushing you towards your maximal degree of responsibility for your own fate and your own life. The notion that therapy entails making people feel good by the shrink allying themselves to the patient's weakest parts is way off. The best therapeutic sensibility is usually to be kind and respectful, and yet tough as nails, I believe, which is why many people cannot handle it. It can be like surgery without anesthesia.

We therapists do not charge money for hugs: it is another, older profession which does that.

I like everything else Thornton writes, however.

Our editor sent me this report in the useless rag USA Today, which says it ranks jobs by incidence of depression, with the implication that the job is the problem.

Rather than using it as a starting point for a discussion of depression, it looks like a better opportunity to step on The Barrister's turf and say that is is a fine example of the informal logical fallacy of cum hoc ergo propter hoc.

Reporters are notoriously ignorant of science and statistics. More likely than not, an arrow of causality can be postulated such that people with emotional frailties tend towards certain lines of work in which they can succeed, and in which they will not feel overly stressed.

I enjoyed The Barrister's intro to Signalling Theory, especially the lengthy biology link. It's really all just about non-verbal communication, isn't it?

To what extent is my public presentation (hair, clothes, deportment,  jewelry, etc.) designed to signal things about myself which I might want known, or to signal things about myself which might not be true?

And how much of conventionality and conformity is an effort to not signal anything personal? After all, there are many occasions in life when one's personal "stuff" is not welcome, wanted, or appreciated. And signaling one's conventionality is, in fact, signaling that one is clued in enough to know how to do that, when necessary.

At work in the office or at my Boston hospital, I tend towards Ann Taylor and Brooks  Brothers business wear, with either simple jewelry, or none. If everything is "text," as the dopey lit profs say these days, what's my message?

I suspect that people get into the most trouble when they signal messages unwittingly.

Our Editor wonders what this young Theo lady in the photo might be signaling, above and beyond "Check me out, dude."

U VA's Mark Edmundson writes about his new book, The Death of Sigmund Freud: the legacy of his last days, in The Chronicle Review. One quote:

The Death of Sigmund Freud began as a book about death and dying. I wanted to understand what it might mean to die a good death — a good secular death. From what I knew of Freud's last days, when he was dying of cancer, he had done exactly that. In fact, as I studied his life, I found that to the end he was tough, brave, and resolutely secular. His final public act was to publish his most controversial book, Moses and Monotheism. "Quite a worthy exit," he said of the volume, and it was. So I began writing about Freud's heroic demise.

But the true subject of a book is often about 20 degrees away from the author's original intention, and so it was here. As I studied Freud's old age and his late work, I came to see that the problems he encountered were in many ways still ours. Both religious fundamentalism and political tyranny threatened Freud in old age, and in quite immediate ways. Freud worked on his Moses book under the shadow of the repressive Roman Catholic Church of Austria, which surely would have moved to suppress the book if he had tried to publish it in Vienna. When he was 81 years old, Nazi Germany invaded Austria and threatened Freud and his family with death.

Read the whole piece. Quite remarkable the way Anna was brought for interrogation by the Gestapo - with a suicide pill in her pocket. Tyranny has always been fearful of psychoanalysis due to the centrality it grants to the individual soul and spirit.

Remember that famous lady who sued Winnebago after she put her RV into cruise control on the highway, then walked to the back for a cup of coffee?

She claimed that Winnebago had not made it sufficiently clear to her that cruise control couldn't drive the vehicle.

When some people do idiotic things that defy the most elementary common sense resulting in "accidents," they see dollar signs. When most people do dumb things, however, they just blame themselves and leave it at that. What is the difference between those two categories of people?

Read about Slate's Emily Bazelon at Overlawyered. How can any manufacturer anticipate every moronic thing a person might do with a product? They would need to hire teams of morons as product testers.

Are such cases really about personal responsibility, or are they just about a class of greed-intoxicated people who are comfortable with ripping off businesses and their insurors?

Image: A Winnebago of the sort that cannot drive itself down the road. For that, you need the more expensive model.

I met Erik Erikson on a couple of occasions, and was an admirer of the man. A lovely, sweet, gentle, dignified guy. Apparently, some think his work is obsolete. I think Young Man Luther, about Martin Luther, is wonderful work even if I don't agree with most if not all of his premisses.

His outlining of the typical "stages" of life, with their typical conflicts, holds up very well. The psychological capacity to handle the challenges that life presents is the key to relative satisfaction in life (the links in the quote box don't work):

1. Basic trust v. Mistrust. Birth to 1 year. From warm, responsive care infants gain trust or confidence that the world is good.

2. Autonomy v. Shame and Doubt. 1-3 years. Children start to use new mental and motor skills, and want to choose for themselves. Autonomy is created when the parents alow reasonable freedom and don't force or shame the child.

3. Initiative v. Guilt. 3-6 years. Children use play to experiment with what kind of person they might become. If the parent demand too much self-control the child might become insecure with who they are.

4. Industry v. Inferiority. 6-11 years. Children learn to work and cooperate with others. Negative experiences may lead to feelings of incompetence and inferiority.

5. Identity v. Identity diffusion. Adolescence. The adolescence tries to discover 'Who am I, and what is my place in society?' The resolution (or not) of this will result in your views on your future adult roles.

6. Intimacy v. Isolation. Young adulthood. Young people work on establishing intimate ties with others. Because of early disappointments an individual may not be able to form lasting relationships.

7. Generativity v. Stagnation. Middle adulthood. Generativity means giving to the next generation through work, children, or caring for other people. Failing to do this can make you feel that your life is meaningless.

8. Ego integrity v. Despair. Old age. In this final stage, people reflect on what type of life they led. If they are not happy with their life, they feel despair and fear death overmuch.

Like all stage theories, his is just a rough guide based on a lifetime of talking with people. "Typical" does not mean "right," and everybody struggles, at least at times, to do life.

Erikson's work fits in well with that of George Vaillant, whose life work has been studying the way people cope with life. Good solid stuff.

The News Junkie referred to academic blackballing this morning. Here's an excellent example of the academic McCarthyism that goes on today, from the NYT. (I hate to use the term "McCarthyism" because, although he was a crank, I am not convinced that Joe McCarthy was all that far off.)

It's about Dr. J. Michael Bailey, a sex and gender researcher. Scientific debate is fine, but you are not supposed to use live ammo. When scientists begin using live ammo they have abandoned persuasion, so it makes you rightly doubt their confidence in their positions.

By the way, we wrote about the Transgender thing here and here. At this point, I believe that there is more politics than science in the whole subject.

Our editor sent me a piece at Hatemonger's Quarterly, in which they note schoolkids using the phrase "You have issues" as an insult. I think that is pretty funny.

That is a new one to me, but I know a phrase that is going around the high schools is "emo." The high school kids call people "emo" who are overly emotional, moody, who take themselves too seriously and appear self-obsessed.

However, my main point is to mention the classic which Hatemonger referred to: Philip Rieff's 1966 The Triumph of the Therapeutic.

It's worth reading, but far from an easy read. The wonderful Robert Coles said of the book:

Philip Rieff has become out most learned and provocative critic of psychoanalytic thinking and of the compelling mind and character of its first proponent. Rieff's Freud: The Mind of the Moralist remains the sharpest exegesis yet to be done on the moral and intellectual implications of Freud's work. It was a critical masterpiece, worthy of the man who inspired it; and it is now followed by a work that suffers not at all in comparison. No review can do justice to the richness of The Triumph of the Therapeutic."

I predict that every life problem will eventually be labelled a "disease."

I wrote a piece on Post-Traumatic Stress Disorder earlier this week, in which I suggested that some new diagnoses are being invented in psychiatry more for insurance and pursuit-of-disability reasons than because new diseases are being discovered.

Perhaps the trend began in the 1970s, when addictions were declared diseases rather than very bad habits, for the purpose of obtaining insurance reimbursement for addiction rehab. Then "Chronic Fatigue Syndrome" came along around the same time as "Sleep Disorders." Currently, we even have a diagnosis called "nicotine addiction," but I'm not sure whether we have "sex addiction" yet. "Morbid obesity" is surely a disease diagnosis nowadays, but I don't know whether being a fat slob is a diagnosis yet.

We should no longer term such labels "disease diagnoses": We should just call them "Insurance-Codable Conditions (ICC)." For example, pregnancy is not a disease, and to term it a "diagnosis" is odd. Best just to term it an ICC.

To support my view, we have two stories this week:

AMA to vote on whether video game addiction is a disease. They vote on whether something is a disease? 

Disability for heavy metal addiction in Sweden.

See what I mean?

If medicine ever becomes politicized in the US, watch for an explosion of wacky ICCs. I have a few suggestions: Anger Disorder, Television Addiction Disorder, Unhappiness Disorder, Geriatric Disorder, Politics Addiction Disorder, Shopping Disorder, Hates-To-Go-Shopping Disorder, Can't Stand my Spouse Disorder, Carbon Abuse Disorder, and Ordinary Imperfect Person Disorder. Almost forgot an important one - Conservative-Thinking Disorder: the Libs will want to lock me away for that one.

Photo: Dr. Emil Kraepelin, the father of Psychiatric diagnosis

That is, "Post-traumatic stress disorder." Our readers don't know me, or my credentials, so you have no reason to believe me. I will tell you anyway: "PTSD" is a highly dubious diagnosis about which there is little agreement - but much recent discussion - in Psychiatry.

Because "trauma" is entirely subjective, and "stress" is entirely subjective - and often a positive thing - the notion of PTSD is difficult to discuss.

My colleagues are known to use it as a "diagnosis of convenience." We may put it down on a form, but that doesn't mean that we mean it. Psychiatrists are forced to write diagnoses on government forms and insurance forms, but human difficulties do not commonly lend themselves to such labels, and we tend not to take them overly seriously.

There is a recent story about PTSD in our soldiers, at WaPo. I strongly disagree with blog friend Raven, who views PTSD as a disease and not as an ordinary part of life.

Life events impact people. Life is traumatic, by definition, unless you live in bubble-wrap. That is not a disorder; it is normal. Many jobs are scary and "stressful", whatever "stress" is. Recent work shows that those who cope poorly with life events - and end up diagnosed with PTSD - generally have pre-existing, underlying vulnerabilities which may deserve attention.

PTSD is on its way to becoming a legal scam, in my opinion. In fact, the entire movement to create new diagnoses, and to label more folks "disabled," is destructive to human dignity.

Wasn't the whole idea of the "Americans with Disabilities Act" to get the disabled back to work, and to help them regain their autonomy and dignity? Switzerland recently decided that "job therapy" might be a good treatment for the disabled, and I think most shrinks would agree with that.

I was stumped today by a question about how a 9 year-old and an 11 year-old should address their divorced dad's new wife.

"Mom"? No way.

"Peggy"? No. Children should never address adults by their first names.

"Aunt Peggy"? Hmmm. Not sure.

"Mrs. H." Seems strange.

Maybe some invented nickname, the way some grandparents like to be called? Like Muffie or Buffy? (So they don't have to be called "Granny." Many modern women hate to be called Granny: it seems to detract from their sex appeal.)

Ideas?

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.