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.
Our Recent Essays Behind the Front Page
Wednesday, March 5. 2014
A new study: High suicide rates for soldiers in, out of war
A while ago, Junk Science put in a well-deserved plug for Dr. Paul McHugh and Dr. Sally Satel in his piece, in which he notes that the majority of military suicides have never been near combat.
I could discuss the topic of suicide and suicidality for days. Suicide is not one thing. It is endlessly complex, and definitely not always accompanied by clinical depression or other mental illness. Shame, guilt, loss, or anger are often prominent components, along with personality disorders, Bipolar, psychosis, and other things.
PTSD? Readers know that I tend to think that it is not a "disorder" but a normal variant. The people who put the DSM together can't tell the difference.
Here's the article by Elise Cooper to which he was reacting: Suicide in the Armed Forces: Not a Disgrace
Tuesday, March 4. 2014
Some of our readers enjoy Allen's movies. I do. My first date with the future Mrs. BD was to see Sleeper. Does the man have any moral foundation? I doubt it. Talent? Undoubtably. What is wrong with the people in the film biz?
A shrink friend sent me this comment:
Taki is a blessed human being; one of the fortunate ones for whom life itself is a blessing and who can spread it to others.
Saturday, March 1. 2014
Psychiatry has seen its share of damagingly-erroneous fads over the years: multiple personality, satanism, "recovered memories." It's important to learn from such fads and errors, not to hide them in embarrassment.
Every branch of medicine, and of science in general, experiences erroneous fads and false enthusiasms. Only a few years ago, the climate scientists were going nuts about global cooling, and soon, perhaps, they will do so again.
The only cure is chronic skepticism.
Sunday, February 23. 2014
Monday, February 17. 2014
"Oppressing everyone to avoid oppressing anyone is the egalitarian ethos gone mad."
Of course, we are talking about the sorts of insoluble problems that arise in a non-totalitarian society, problems rooted in the many "flaws" in human nature. Another quote:
No society or culture can be conflict-free, nor can even any family or tribe or anything. We must be humble when thinking about "solutions" of all sorts. It has been said that Conservatives like me temperamentally embrace the Tragic View of life as contrasted with utopian views, and there is something to that. It is, indeed, the story of man's fall - broken from the very start.
Tuesday, February 11. 2014
Editor's note: Dr. Azeff will be a regular contributor on medical topics
"Surviving Anxiety" was the cover story of The Atlantic magazine for January/February written by its editor, Scott Stossel.
One is a little flabbergasted when reading this man's story. While portraying himself as virtually crippled by anxiety in all of its forms, generalized anxiety, post traumatic stress, panic disorder and multiple phobias, he functions as the editor of a prestigious magazine which means likely conflicts with aggressive publishers and super-sensitive, if not querulous, writers. He is a writer himself and therefore a person expected to show up for promotional talks and for lectures. How does he do it? He begins his article, excerpted from his book, by describing his drug regimen for public speaking; xanax, inderal and scotch or vodka. As a clinician one is immediately tempted to take the bait and challenge the doses of his medication and balk at his use of ethanol which he acknowledges is risky at best, dangerous more honestly. From there we are led on a trip through his life and through the evolution of psychiatric treatments over the past thirty years, the good the bad and the ugly.
His first doctor who started treating him at age eleven and saw him twice a week for 25 years is roughly of my generation, I'll be 75 in a few months, Dr. L as he is called is probably in his early eighties. Analytically oriented therapy mixed with play therapy mixed with pharmacotherapy at the outset, progressing over decades to everything as it came along including EMDR and self-actualizing therapy whatever that means. One can appreciate the changes over the years as a picture of the evolution of a modality seeking a scientific framework. Just as edema was initially seen as a unitary "disease" called dropsy until science deconstructed the multiple causes of this symptom, so many of our psychiatric illnesses may be no less than psychological dropsy. I'll wager in the next ten years "schizophrenia" will be at least four different conditions of different etiology, and anxiety may follow suit as well.
But what I take away from this verbose, sometimes wry, sometimes antic, sometimes prolix piece is the transgressions of some of his caretakers. Well into Scott's treatment, Dr. L takes his father into treatment as well and uses Scott's sessions to get information about Stossel senior. The porous boundary is something we all grapple with but this is a destruction of the boundary that calls the treatment into question, perhaps from the start. After all, we may change course with a patient but usually with caution and discussion. I hope we are beyond the point of arguing that one cannot do both psychotherapy and psychopharmacology, but can one start with a classic dynamic model and wander into EMDR? Then there is the behavioral psychologist, Dr.M (both of these caretakers are "Boston" and Harvard trained and perhaps even faculty so we all must be clear that they definitely and unimpeachably know what they are doing) who determined his core problem was emetophobia, fear of vomiting, which she would treat with exposure therapy. Using the emetic ipecac which had cured other emetophobes, Stossel attempts the exposure with two doses of ipecac that produce retching and gagging but no vomiting in the course of four hours.
The next day he speaks to Dr. M who eventually relates that she was so shaken by his experience she cancelled all of her afternoon patients and spent the day at home nauseated and vomiting and taking to bed. Once again a transgression of questionable purpose. That treatment was fractured and collapsed fairly soon afterwards. We all have seen patients who are difficult to treat, who have disabling symptoms of anxiety or depression or psychosis, which are not easily medicated. How often do we ask ourselves about the possibility that the patient is consciously or unconsciously engaged in an attempt to make us feel as helpless and demoralized as he feels? Is it "blaming the patient" to weigh this possibility as a cause of intractable symptoms?
There is nothing glaringly obvious pointing to this in the story Stossel tells us and his brave walking through fire story is to be admired, but I'm just saying . . .
Friday, February 7. 2014
An annual re-post, but re-posted again because we seemed to help a number of people with this:
Forget the "Obesity Crisis." That's a crock. Abundant, good food is a blessing and a rarity in human history so it is a great privilege and luxury to be overweight. It certainly is true that, when tasty food is cheap, people will eat a lot of it and their bodies will kindly store what they don't need to survive today, to the detriment of our knees, hips, appearance, comfort, and general vigor. Trouble is, we won't need that storage tomorrow - or ever. It's like hoarding.
We can all be as fat or fit as we wish to be. It's a free country, and being fat (but not obese) isn't terrible for your health unless you are diabetic or want to be able to get around energetically. But don't listen to the Dieticians and Nutritionists. They will want you to get in shape slowly and in a "sustainable" way. In your heart, you know that will never happen. If you are bothering to read this, you just want to get in shape as quickly as you can without liposuction or use of the vomitorium.
Eliminating carbs reduces or eliminates carb craving in most overweight people over several weeks.
This can be a one- to three-month program as desired. Maintenance is another topic.
Details below -
Continue reading "The Official Maggie's Farm Get-Back-in-shape before Summer Plan"
Thursday, February 6. 2014
I never expect honest answers from questions about sex, substance use, or money, so I won't expect perfect honesty here.
However, in an effort to warm up this frigid winter season, here's my scientific Maggie's Farm poll question for today:
How often during a normal day out and about in the world do you think "Hmmm, that's appealing; I think I wouldn't mind having some sex with that guy or gal"?
Honest answers most appreciated.
Sunday, January 26. 2014
Most of the studies he discusses avoid defining happiness, and just let people report. At issue, of course, is that as long as one is not in dire straits, happiness and contentment in life depend on non-economic factors: temperament and personality, relationships, family, hobbies and interests, etc.
There is no one "happiness." Some are most happy when taking risks, others more comfortable when they feel more secure. Material gain is not a universal goal.
Saturday, January 25. 2014
When people get divorced, I usually recommend that a person have a coffee with at least 25-30 candidates, at minimum, before deciding to get involved with anyone. That's because the recently-divorced are usually lonely, unhappy, sex-starved; often hurt or angry or worried about the future, and generally prone to poor judgement and poor choices. However, those things may apply to many single people.
Because of this, I found this fellow's love story interesting: How a Math Genius Hacked OkCupid to Find True Love
Do guys just want sex? That's a topic for another day. That guy wanted true love, whatever that is.
Wednesday, January 22. 2014
I always figured that it was because my friends are friendlier than I am.
Monday, January 20. 2014
Antidepressants fail to help around 70% of depressed patients on the first try.
Antidepressants are now the treatment of choice for anyone with acute or chronic symptoms of "major depression," ie anxiety, disturbed sleep, hopelessness and helplessness, self-hatred, appetite loss, irrational guilty feelings, loss of sex drive, inability to concentrate, sometimes suicidal feelings, and inability to find pleasure or interest in things. In my experience, the vast majority of patients with a fair number of those symptoms feel better with antidepressants, but, in my view, medicine should never be given without psychotherapy of some sort.
Where it gets complicated is that 1. there are many kinds of depression besides major depression; 2., the personality type, and personal strengths and weaknesses can effect the way depression occurs, and whether it occurs at all, and, 3. life circumstances have a real impact on the ability to improve depression with medicine (if your business is going bust, or your child dying with cancer, no antidepressant will make you merry).
I'll try to keep it brief. The generic term "depression" runs the gamut from the heavily-inherited form that occurs in Bipolar Disorder (which is probably a brain-wiring abnormality), to the grief-like depressive reactions to life-events, especially loss, which occur in vulnerable people. In between are sad-sack people with chronic mildy depressed mood, and many people with chronic mood problems due to personality disorders or neurotic problems. My point is that there is not one "depression". The word refers to a group of symptoms, not a diagnosis.
Because depression is not a unitary phenomenon, different forms require different treatment approaches, whether psychotherapeutic or chemical, but the research says preferably both for severe depression.
It is not widely understood that the new SSRI antidepressants are not "mood elevators." They have no effect whatsoever on people without depression, which is why they are never abused.
I will have to follow-up with a Part 2 later, because this is getting too long, according to our blog rules. "Short and sweet." But some subjects are complex and nuanced, as our esteemed French Senator likes to say.
Image is Durer's Melancholia.
Thursday, January 16. 2014
She points out the (rather obvious) practical and economic advantages of committed relationships. I can't imagine handling all of the complexities of life without a partner.
Wednesday, January 15. 2014
It's about subjectivity, mainly - being human, and a defense of Nagel in part. The essay is so rich and deadly-serious that it cannot really be taken in in one reading, and it is difficult to select a representative quote so I'll post a random one:
Well, because we derive our metaphors from the world around us. Freud's first metapsychology was modeled on the steam engine. The essay deserves study. Take a Ritalin and dig into it.
Sunday, January 12. 2014
Samizdata found this gem by Rauch in The Atlantic. A couple of quotes:
Sunday, January 5. 2014
It's a vivid description of what we used to call Anxiety Neurosis but now term Generalized Anxiety Disorder. Stossel says that nothing has helped him except for moderate use of Xanax and/or alcohol. He has concluded that he just needs to live with it, if not to embrace it.
Thursday, January 2. 2014
81% of kids have a mental disorder? "Everybody has Psychiatric symptoms."
The point is, you need a diagnosis for your insurance. Even if you're a troubled normal neurotic, we'll stick a label on you as a favor to you. Dr. Alan Francis, et al (h/t, Boring Old Man)
Saturday, December 21. 2013
Asperger's Syndrome has been removed from the DSM and folded into Autism Spectrum. I'm not convinced that people with Asperger's-like symptoms have anything in common with what was traditionally termed Autism, and my suspicion is that Asperger's is just a normal human variation which, a while ago, might have been termed "slightly eccentric."
The comments here are interesting: Convergence in the meaning of "autism"
Thursday, December 19. 2013
Friday, December 13. 2013
Fortunately, we have ways to quiet these demons nowadays. Hormone replacement, antidepressants, or both.
Wednesday, December 11. 2013
What qualities do people look for in elected (or unelected) leaders? The question applies to all areas of life, not just politics.
What qualities stimulate people to "follow," or choose, a leader? Among others, physical presence, ability to speak, self-confidence, and reliable decision-making play important parts, but some of it is difficult to express. This post stimulates the discussion: What is the "Presidential Presence"?
One component of it, perhaps not a large one, is a person's aptitude for being a target of positive transferences. That, plus the power, is what transforms an employee of the citizens (ie a politician) into something that seems special, probably too special. After Washington, my favorite President was Coolidge.
When it comes to politics in the modern era, one part of it is simply celebrity. "Charisma." TV, video, and film create celebrity, as in "famous for being famous." What qualities support that? Why does anybody listen to, or pay attention to, celebs?
Monday, November 25. 2013
In a short piece discussing shyness vs. Social Anxiety Disorder, Dr. Kristy Dalrymple has this to say (my bolds):
That's what I've been saying for years, but she says it better.
(Page 1 of 26, totaling 628 entries) » next page