Wednesday, May 25. 2022
Soul Doctors. A new book takes an unsparing look at psychiatry's past and future.
The problem with that book review, and maybe with the book, it that it sounds as if "mental illness" were a unitary phenomenon and as if treatment approaches were somewhat unitary too.
Believe it or not, we have many ways to be of help to people with all sorts of problems. True "cures" are relatively unusual in all areas of medicine.
Thursday, May 12. 2022
Essay at Quillette. It is about trauma.
Tuesday, May 3. 2022
Purification Rites:
I wanted to transition because my body was my enemy, and my body was the enemy of the world. I hated myself and wanted to punish myself. It was the same feeling that motivates cutting, binge-eating, anorexia, and lashing oneself. My very nature meant I deserved pain. I couldn't remove my whiteness from myself, but maybe I could remove my maleness...
Tuesday, February 15. 2022
Sunday, February 13. 2022
Your son wants to be a girl, and your wife agrees with him/her them. Legal problems ensue.
Tuesday, February 8. 2022
I have written on that topic over the years. Do any readers want to read something by David Brooks in The Atlantic?
If so, he makes some good points. THE NUCLEAR FAMILY WAS A MISTAKE. The family structure we’ve held up as the cultural ideal for the past half century has been a catastrophe for many. It’s time to figure out better ways to live together.
According to Ruggles, in 1800, 90 percent of American families were corporate families. Until 1850, roughly three-quarters of Americans older than 65 lived with their kids and grandkids. Nuclear families existed, but they were surrounded by extended or corporate families...
Tuesday, December 28. 2021
Monday, November 15. 2021
"Diet and exercise" are typical suggestions for the sedentary or over-eaters. However, strict nutritional plans rarely work for overweight people in the long run, and exercise has minimal effect on fat loss (but is essential for general fitness). Nutritional self-control is difficult for most people. Most, not all. 70% of Americans are overweight by some measure.
Metformin is a typical medicine for overweight, pre-diabetes, etc. In my experience, it is not very effective and has many side effects.
In my view, semaglutide might be the current gold standard. It's a tiny weekly injection, done easily at home. Like everything, it has some side effects but not much. It can be labeled as Wegovy or as Ozempic. You have to qualify as meaningfully overweight to get a prescription. It definitely reduces appetite, but has other beneficial physiological effects especially on the insulin system. Can it permanently re-jigger your food compulsions after months of use? It is not clear.
Semaglutide is on-label for Type 2 diabetes, or pre-diabetes, and off-label for weight loss alone.
If you have overweight issues, discuss it with your doctor as an option. It could save your joints, your heart, maybe your life (for a while). I would try it, if eating were one of my hobbies.
Friday, November 12. 2021
Tuesday, November 2. 2021
The world does not do a good job with people with the most serious mental illnesses. It is partly the world's fault, but it is partly because many of the seriously-ill reject the sorts of help which can be offered. Or, in many cases, can't get their act together enough to avail themselves of it.
From Michael Shellenberger, Madness for Decivilization
Wednesday, October 13. 2021
Tuesday, October 12. 2021
What Light Does ‘Three Identical Strangers’ Throw on the Nature/Nurture Debate?
Thursday, September 9. 2021
That is the wrong question but James Q. Wilson's 2004 essay (re-posted at City Journal for 9-11) is good.
Why is it the wrong question? Because it makes it sound as if terrorism were some sort of pathology rather than a form of war for those without large armies and weapons.
Wednesday, September 8. 2021
The Truth about Autogynephilia
After having spoken with many people, over decades, about their lives and sometimes their wildest sexual fantasies, I still find the gender identity issue sort of strange. I suppose I have heard it all, but have never seen a patient who was worried about their gender expression. I have seen plenty of gay men who were afraid to come out of the closet though. That was usually prompted by wives who wondered about their husbands' lack of sex drive.
Wild fantasies are normal, at least in people lacking in the usual sorts of repression of taboos. Perhaps the political climate is making way for the overcoming of sex and gender taboos.
Friday, August 20. 2021
From Marilyn Simon's The Language of Sex, at Quillette:
My students, for instance, are surprised to learn that of the 154 love sonnets that Shakespeare wrote, the first 126 of them are to a young man. (The final 28, give or take, are love sonnets to the “dark lady,” who is characterized as both sexually experienced and sexually active, with desires and a will of her own. A woman adored and respected, deserving of admiration and love. So much for repressive patriarchy.) The question students invariably ask, then, is: “So… Shakespeare was bi?” To which I reply, “I think Shakespeare would have simply characterized himself as a man, a husband, and a father, though he clearly had an attraction to the beautiful young man of the sonnets, to say nothing of his many characters who demonstrate sexual flexibility in identity and desire.” “But then he’s bi!” they insist. To which I reply, “I think Shakespeare would have found our need for precise labels strange. Why do we have the need to define and to categorize human desire? Why this compulsion to attach precise labels to attraction, lust, and pleasure? If what Oscar Wilde says is true, ‘To define is to limit,’ then is it really Shakespeare and his contemporaries who are more repressed than us moderns because they didn’t self-identify as a category? Or is it us who try to contain our sexuality by itemizing every possible iteration of lust and attraction? Are we ready to assume that because we attach a label to human sexuality, we somehow understand better than Shakespeare did? Are we in a cultural position to say that Shakespeare’s insight into human nature is limited compared to the average 19-year-old student’s today?”
Saturday, July 10. 2021
Where did the cultural habit of three square meals per day come from?
It's quite recent, actually, and really a European cultural concept. More specifically, a British aristocratic concept because even today an Italian breakfast (except for the tourists) is an espresso or latte and a biscotti, and a typical French breakfast is a cafe au lait and a croissant. Typical Italian supper? Soup and bread, or cheese and leftovers.
"Eating between meals"? I suspect people might feel better with 5 mini-meals - balanced snacks, really, because stuffed and lazy after supper is not an effective life plan. Stuffed and lazy after any meal is not a good plan except on Thanksgiving. Serious exercisers and athletes tend to discipline themselves to a 5 meal program to keep the nutrients flowing. They have to eat when they aren't hungry to maintain their level of fitness and power, and to keep their weight up.
A mini-meal for many can be something like a couple of slices of chicken and a handful of olives, or an apple and some cheese slices, maybe a slice of pizza or a cup of yoghurt or oatmeal with berries. Volume and details depending, of course, on total muscle mass, body frame, daily physical demands, physical goals, etc. Body-builders need 4-5 full meals daily to put on muscle mass, while the old-fashioned three squares/day will make most adults flabby if not obese.
To understand what your body needs, look at it nude in the mirror. One look will tell you what it needs in fitness and nutrition in terms of muscular development, leanness or fatness, posture, etc. When it comes to food, we can't listen to our body too much. It's a liar because it was programmed for scarcity a long time ago, before agriculture. Humans seem to have the instinctive inclinations (eat, nap, fight, play, sex, and repeat until dark when the predators come out) of monkeys, chimps, and gorillas but we have some added higher capacities, or so the scientists claim.
A brief history of the origin of three meals/day.
Part 2 tomorrow will deal with hunger, appetite, and satiety.
Tuesday, July 6. 2021
From Mate Selection for Modernity:
This mathematical model offers key insight into our unbalanced sexual marketplace. The number and weight of a woman’s mate preferences is negatively correlated with the number of eligible mates that are available to her. Thus, the distance of a prospective mate to a woman increases with each new preference she adds. Put simply, the more you demand, the less you receive.
More generally, there’s a disconnect between what women want and what is actually available to them. Whereas greater male attainment increases the number of romantic options a man has, greater female attainment reduces the number of options a woman has.
Monday, June 7. 2021
Loneliness is a sad human condition. Misanthropists, socially-phobic, and the overly-narcissistic might see it differently, but I feel that having a solid group of pals is an essential ingredient in my life. A few close friends, a bunch of lunch and couples pals, and plenty of enjoyable social friendlies. There are many things best talked about with friends instead of with spouses.
In tribal societies, everybody is, by necessity, connected but most Western people do not live that way now. Still, humans are social creatures. Humans also need support systems.
I once wrote a post about thinking about concentric social circles, from intimate confidantes to casual social aquaintances to work colleagues. It was a good post, but I can not find it.
Scott Adams did a brief chat about how to make friends, at the 42-minute point.
Many people could use such advice. He hints that one thing to do is to join groups, and he is right about that. You also need to have something positive, pleasant, fun, or interesting to bring to the table. Having things in common helps a lot. Alas, some people are just not very likeable, and that is a handicap.
I know people who still have friends from grammar school, high school, and college. Lifetime friends are a blessing.
Tuesday, May 25. 2021
These Mental Health Symptoms of Menopause Don’t Get Mentioned Enough but Affect the Majority of Women
Psychiatrists are often more alert to perimenopausal mood and cognitive changes. Whether estrogen replacement treatment is always the best solution is another question.
Thursday, May 20. 2021
The complexities of human sexuality are all out in the open nowadays. Our Greek and Roman cultural ancestors never fussed much about it. They seemed to do whatever they felt like, especially if aristocrats.
Most people just have no issues with it, but surely for some number of people sexual and/or love interests are different or variable. I have seen it many times. It's a given that sex life and love life are important parts of life. As an MD, I remain a skeptic about the trans fad because I know that people have fantasies about everything. Fantasies are always interesting.
Lesbians Aren’t Attracted to a Female ‘Gender Identity.’ We’re Attracted to Women
Thursday, April 29. 2021
I think this is about polyamorous households rather than just multiple amorous relationships. Polygamy, basically.
It seems to work out for some Mormons and many Moslems.
Polyamory’s Bourgeois War On Normality. Haven’t you heard? Consensual non-monogamy is totally normal and respectable.
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