Maggie's Farm

Bradley Manning Is Not a Woman - Pronouns and delusions do not trump biology.

I have been slow to get to this over-worked story, but It's an excellent article about the surgical approach to identity confusion. I suspect that the vast majority of American Psychiatrists would agree with the author's point of view.

Michael Jackson thought he was Elizabeth Taylor, but he was not.

 Re-posted from earlier this year -

On the top of Maggie's Farm, we seem to reject being subject to the efforts of do-gooders. Is the road to hell paved with good intentions? Do-gooders always seem to either want my money, or want to control me.

This morning, we linked James Taranto's brief discussion of a remarkable paper in the Proceedings of the National Academy of Sciences, titled Concepts and Implications of Altruism Bias and Pathological Altruism.

In just eight dense pages, Prof. Oakley covers a lot of ground and goes far beyond the Law of Unintended Consequences. She touches on psychology, science, medicine, philosophy, and politics. It's a remarkable paper which indeed pulls enough threads together to represent a potential paradigm shift. One quote:

The bottom line is that the heartfelt, emotional basis of our good intentions can mislead us about what is truly helpful for others. Altruistic intentions must be run through the sieve of rational analysis; all too often, the best long-term action to help others, at both personal and public scales, is not immediately or intuitively obvious, not what temporarily makes us feel good, and not what is being promoted by other individuals, with their own potentially self-serving interests.

Indeed, truly altruistic actions may some-times appear cruel or harmful, the equivalent of saying no to the student who demands a higher grade or to the addict who needs another hit. However, the social consequences of appearing cruel in a culture that places high value on kindness, empathy, and altruism can lead us to misplaced "helpful" behavior and result in self-deception regarding the consequences of our actions.

From Dr. Sally Satel, James Q. Wilson and the Defense of Moral Judgment:

One purpose of The Moral Sense was, as Wilson put it, “to help people recover the confidence with which they once spoke about virtue and morality.” The other goal was to trace the origins of human morality. Summoning an array of anthropological evidence, Wilson elaborated on the idea that our moral sense is innate, acquired not through learning but through evolution. These sentiments do not spring to life fully formed; instead, they are cultivated within family and society. Adam Smith and Thomas Jefferson had advanced the idea of inborn moral affinity but Wilson enlarged upon it, proposing that the moral sense rested upon four foundational pillars: sympathy, fairness, self-control, and duty.

Having a good-sized hippocampus helps a lot in life, but can it be too large and effective?

Marilu Henner remembers everything.

We all know that loneliness sucks. Often, not having enough alone time sucks too. Sociality takes effort and thought, and can be draining at times. At it best, it is effortless, delightful, supportive, and life-enriching.

I count myself lucky in having so many pals, friends, and good acquaintances. I do not know why life evolved that way, but I guess God gave me a fairly appealing personality. I figure that I was raised properly, have pleasant manners, know how to dress and to make cheery dinner table conversation, have a decent sense of humor about life and an abundance of interests and controversial opinions.

For those who were born socially awkward or unskilled, life can be especially difficult. Socializing agreeably requires some training, example, and experience, and perhaps a little talent for it. Most of all, it requires remembering that it's not about YOU.

Every human feels rejected, unwanted, or like an outsider sometimes. That is normal. Some people give up on making connections, and that is a shame. We all need people around who can just open the front door without knocking and walk in, knowing that they are welcome for a coffee or a beer or a glass of Scotch. We all need people who are willing to take a chance to seek us out, too, for connection. That is a blessing.

Here's the article: The Lethality of Loneliness.

Social isolation can lead to sorts of inbred craziness and impaired social reality-testing. Chicken or egg? Who can tell?

Reposted -

Like some other readers, I found Charles Murray's presentation fascinating.

I have been thinking about it. As I commented then, sociologists tend not to discuss psychology. A good rule of thumb is that a person's character traits - personality traits - determine a lot about their adaptation to life and to reality - their success in making goals, and pursuing their goals, for themselves.

It doesn't matter where character traits come from: genetics, examples, or wherever. What matters is the balance between the useful ones and the detrimental ones.

Furthermore, some character traits, like obsessionalism, are good for some things (eg being a pilot or surgeon) but detrimental for others (eg being a jazz musician, or displaying emotion in relationships). For another example, the capacity for controlled violence (useful for cops and soldiers and, in fact many other jobs too including my own, at times). People are even beginning to talk about the usefulness of Asperger's traits.

Each of us is our own stew of traits and strengths and weaknesses. Mature adults do not blame the world or others for their difficulties, but look at themselves, try to identify their shortcomings, and try to improve them if they chose to.

I do not view social class or income as a measure of life success or life adaptation. In my professional world, we use other, less superficial measures such as quality and stability of relationships, breadth of interests, responsibility and reliability, self-control, active engagement in life, and so on.

However, as Murray implies, social class can be a very rough measure of human adaptation for people with material ambitions: people in the upper middle class tend to be more adaptable and able socially and intellectually, and those in the lower class tend to either have more adaptive problems, or to cause more problems for others (which includes governmental or charitable dependency, crime, disorder, etc).

Before I run out of space, I want to say a word about social capital, as I constructed my own practical understanding of it. In my simple-minded way, applying one's social capital means participating in and contributing to one's community, whatever that may be. Being a constructive part of it, beyond the bare minimum of holding down a job or raising a family.

Whether it's as simple as introducing people to each other, throwing holiday parties, getting a stop sign on a corner, helping a kid find a job, volunteering at church, raising money to sustain the local chamber group, running a Boy Scout troop, attending town meetings, joining clubs, starting a softball team, or coaching soccer, we all have ways to contribute to our social network, our neighborhoods, and to our communities. I do know how corny all that sounds, but I believe it is very important.

Our social capital is truly the kind of capital which we must either spend or waste before we die. People who do not jump in and spend theirs before they die are selfish, mean, and un-American, in my book.

The Old Man discusses his journey as a Psychiatrist amongst the most severely ill. The TED video at the end is remarkable.

The comments are interesting, too.

Our commenter Buddy offered this thought a while ago on They keep changing the name of it:

"the thing is, tho, that the moral or ethical question of entering consequentially into a stranger's life is not the same question as whether or not one is lonely."

His excellent phrase "entering consequentially into a stranger's life" got me thinking. As a psychotherapeutically-oriented shrink, most of my work is to "enter consequentially into strangers' lives," and that is a privilege and sometimes a frightening position which I am paid to do as a professional person.

Most adults are cautious, aren't we? - about who we permit into our lives, and to what extent. We may make exceptions with relatives, clergy, or people with white coats, but, generally, our interpersonal lives consist of concentric circles, admitting few to our inner sanctum.

The reason for that is, of course, because confiding in someone, being emotionally intimate with someone, cannot be inconsequential for normal people. Relationships affect us and affect our lives, so they are a serious matter and potentially dangerous.

Loneliness is painful. Lonely people, sad to say, and substance-abusers may be less discriminating about whom to let in. Fact is, though, closeness is always somewhat risky for both people involved because we humans get attached and thus vulnerable.

Buddy's comment, however, was on the topic of Sugar Daddies and mistresses, sort-of about the idea of sexual intimacy rather than personal or emotional intimacy. There is the hooking up culture of course. A college student recently told me that if he strikes out and doesn't get laid by a different girl each night of Spring Break in Nassau, he will feel like a loser. But I do not mean to be discussing purely recreational or athletic alcohol-infused sexual adventures.

What I am wondering about is whether it is possible for a Sugar Daddy and the gal, over time, not to form an affectionate attachment despite the basic free-market win-win foundation of the relationship. Or even regular co-workers.

Perhaps some people are more capable of inconsequential intimacy or exploitative intimacy than others. Not perhaps. Definitely.

Most animals need sleep, but we do not know why.

Sleep patterns in humans are culturally-established. Some cultures have their siesta, for example. Many American males like their weekend naps.

European families, and many American families up until the early 20th Century, often shared beds unless they were prosperous. In the old days, Europeans had two sleeps - a first and a second. Two sleeps with sex or prayer, or both, in between. Both sounds good to me.

Andrew Klavan considers the topic of drunk sex.

Dr. Phil got crucified for asking about it, but it's an entirely valid and reasonable question. Sex and alcohol have an ancient history together.

Why can’t we talk about IQ?

That Richwine article generated plenty of heat. Truth is, everybody talks about or at least thinks about IQ all the time. At the least, every time we see somebody do something stupid, or express something without basis or thought. We also think about it when somebody says something that opens our eyes.

IQ is just one of the many personal traits across which individuals vary. It happens to be a valuable trait, but it is never determinative in life outcome. However, there is no measure for life outcome anyway. Life's outcome is death.

 Reposted -

Saturated Fat is Not Bad For Your Brain, and You've Been Lied to:

Unfortunately, the advice to eat less saturated fat probably isn't going away anytime soon. Like the baseless ideas that calories are calories, or fat people simply lack willpower, fear of dietary fat has become entrenched in our thinking about nutrition, and won't die no matter how many times it's debunked. But if we're going to be lead to believe that saturated fat is harmful to our brains, the link should be based on more than observational research. I'm certainly not convinced that I need to eat less bacon, anyway.

This is part of why my high-meat, zero carb weight loss program (fixed) works: all calories are not handled the same way (and bacon and eggs are a good, healthy diet breakfast). More here:

Miley Cyrus Gluten Free Diet is a Hoax, and 3 Other Weight Loss Scams

There are and always have been populations around the world who are both poor and very physically active who have obesity rates very similar to those of the United States and other Western societies. Under this paradigm, there are certain foods — mainly carbohydrates — that stimulate an insulin response and cause weight gain. Avoiding these foods is probably a good idea for those of us who easily store body fat.

Like I said, if you want to lose weight, cut out the carbs and eat meat. Calory-counting does not work because it's the insulin that stores the carbs.

Ed Morrissey suspects that the coming failures and costs of Obamacare will turn Americans away from any further, future involvement in medical care.

He may be right. The Dems have been quite outspoken about their expectation that Obamacare is just one step towards single payer medical care by basically putting government bureaucrats in charge of everything.

As a sole proprietor (other than my donated time to a charity clinic), I have thus far been successful in keep government, and insurance companies, out of my practice. However, I do not know how long that will be practical - or even legal.

I believe that I was the Psychiatrist who coined the term "psycho-utopianism." It is the delusional notion, analogous to political and social utopia, that if people could just get enough therapy or analysis, things would happen to perfect a life. Well, it is possible sometimes in some ways for a person's life to improve, but it's a tough world and reality is a harsh master.

Political and social utopian delusions hold that, if the world were correctly organized by the right people (our moral and intellectual superiors), something wonderful would happen, human nature would change. Universal contentment or something like that would ensue. Brave New World.

Ideas about religious utopias of sorts are something I can buy into. Not 72 virgins, or becoming sublime starlight (although I suppose we are, in a sense). The Christian Kingdom of God can and does exist, not the child-like version of heaven and not a theocracy of Christians but the dominion of God in one's heart and soul not after death, but today. The Hereafter is another topic.

Life is a struggle. But I have meandered far off track.

Neuro-utopianism is the fantasy that, if the brain matter itself could be fully understood, life could be peaches and cream and everybody would be nice people or never crazy or neurotic or destructive because the very heart and soul could be dissected and repaired. Repaired, based on whose idea?

That will never happen.

Here's something on the topic: Bursting the Neuro-Utopian Bubble

Whenever you put males and females together, some sparks will fly. Many people manage themselves in such a way as to avoid big trouble, but some don't. Adam and Eve were the first example of really big trouble.

Forbidden fruit: This summer’s hottest teachers who allegedly got busy with students

Reposted -

Call it Psychopathy or Sociopathy or just "bad people," people with an excess of predatorial instincts are all around us. Overwhelmingly most are non-violent, but what Dr X points out is that psychopathy is a matter of degree.

Most people who worry about being bad or evil, are not especially so. Sociopathic people rarely recognize their inner bad, and often think highly of themselves. Significant degrees of sociopathy can be found in people in all walks of life, not just in penitentiaries (in which few penitents are to be found). I knew a brilliant, charismatic Psychologist with abundant psychopathic traits who probably helped more people than I ever will with his charm, warmth, and wisdom. He had enough self-awareness to keep himself out of serious trouble but he had some close calls.

Dr X pointed out this piece at Smithsonian: The Pros to Being a Psychopath - In a new book, Oxford research psychologist Kevin Dutton argues that psychopaths are poised to perform well under pressure. Not sure I agree, but an interesting topic.

Rehab can keep you away from whatever you abuse or are addicted to for a few weeks or even months, and introduce you to various programs, but rehab cannot help build or maintain a life of sobriety and sane behavior.

Neither rehab, nor AA, nor any other program "works." The person has to "work the program," and work it as if their life depended on it. Often, it does.

The questions of whether a program or plan "works" premises a medical patient model, a passive model, as if addiction and abuse were like pneumonia, curable by the best antibiotic. They are not. You do not "go through rehab" any more than you "go through AA."

It can take a lifetime of effort to climb out of the abyss of substance abuse, and a lot of it does not feel very good at all. I have seen plenty of people make the deliberate and conscious choice to live lives of substance abuse. It's a free country. I just resent it when they do it on my nickel.

Schneiderman discusses: Does Rehab Work?

It's about "total pornification."

Do people live like this?

The topic of physical or emotional trauma is complicated as heck. For starters, what is "traumatic" for one person might very well not be for another. What is termed "traumatic" depends on the severity and duration of the effects, not the event or situation itself. There are just too many things to be factored in for each individual. I once had a root canal done without Novocaine. That hurt terribly, but was not traumatic. My first break up was traumatic, and the scar remains and affects me many years later.

A life, lived long enough, will collect many physical and emotional painful or disruptive experiences. Some will scar over, some will remain oozing wounds, and some may be crippling. It's normal life. Shrinks and therapists try to find ways to be helpful with emotional pain, but there is no panacea.

Some thoughts on the topic: Does writing and talking about trauma help? Probably yes for some, no for others.

How is all this a victory for feminism?

"Only later did Haley begin to think of what had happened as rape — a disturbingly common part of many women’s college experience. In a 2007 survey funded by the Justice Department of 6,800 undergraduates at two big public universities, nearly 14 percent of women said they had been victims of at least one completed sexual assault at college; more than half of the victims said they were incapacitated from drugs or alcohol at the time.

Another victory for contemporary feminism!"

Sometimes. 

Emergency help on the street did work for Gerard, but the one time I did a sidewalk CPR the 45 year-old ended up with brain damage, but alive. Of course, the most difficult part for amateurs is to diagnose the need for it. People who turn pale and faint do not need CPR.

From the article:

 Many veteran physicians have begun to opt out of the resuscitation practices they often administer to their patients. In a 2012 article published in The Guardian, "How Doctors Choose to Die," retired physician Dr. Ken Murray reveals that members of his profession frequently turn down everything from chemotherapy to CPR.

He notes that years of witnessing and administering "medical care that makes people suffer" leads many doctors diagnosed with terminal illnesses to choose to spend their last months or years at home and without medical treatment. Murray recalls some fellow physicians who go as far as getting tattoos that read "no code" to remind rescuers to forgo any attempts at revival.

Murray is still an advocate for learning CPR, but he warns against hoping for miracles.

Middle-class Americans tend to lead "child-centric" lives, for better or worse. I think it is often overdone.

I happen to believe that "happiness," however defined, is not necessarily a valid goal in life. Many things are more important. However, moments of joy are always welcome. I am grateful to my parents for having produced and nurtured me. Glad they had sex that winter day. Whether I produced more pleasure or pain for them, I have no idea and would never ask.

The article: Do Children Make Us Happy?

 Readers know that I consider the trend in Psychiatry to obsess about diagnoses and nosology to be a silly pursuit. From Gary Greenberg's latest:

 (Dr. Alan) Frances has become the loudest and most influential public voice questioning the DSM’s latest revamp. “The fact that we had a descriptive system only revealed our limitations,” he says. “If you believe that labels are only labels, you don’t want to keep changing the language arbitrarily. It just confuses everybody.”

Frances has been warning everyone who will listen that the newest DSM revision will turn even more of human suffering into mental illness and thus into grist for the pharmaceutical mill. I once asked him whether he thought a good definition of a mental disorder would establish a bright boundary line that would definitively sort the sick from the unusual and keep psychiatry in its proper place.

“Here’s the problem,” Frances said. “There is no definition of a mental disorder...”

Cui bono? 

Instapundit found this: The Tyranny of Choice.

Fortunately, in America one is free to make the choice not to patronize a therapist who thinks like her. I think she imagines that her problem with freedom is everybody else's problem too.

I'd bet $5 that she is "Pro-Choice." Short version: I think she is as absurd as Cass Sunstein, a "soft totalitarian" whose choice is for me to follow their choices.

Being reasonably sane, I don't need anybody to share my choices in life. This video critique is pretty good, but takes her too seriously.

Madness Made Them Great - Thomas Jefferson, Steve Jobs, Estée Lauder, and Charles Lindbergh suffered from the same mental illness.

I do not think any professional would term obsessionalism to be a "mental illness." It's a character trait which exists on a spectrum, more common in men than in women. A good dose of it can be highly adaptive in life. Too much can be paralyzing.