Maggie's FarmWe 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. |
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Tuesday, December 27. 2011A re-post: Is the brain a mindless obsession?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:
Read Barber's whole essay here. 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:
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Wednesday, December 21. 2011The bad news: Eating less keeps your brain younger and more vigorous (with comments on satiety)You have to be skeptical about any report, but this is worth consideration. 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. Where's my Eggnog?
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Friday, December 9. 2011Locating the "Locus of Control" the American Way"Locus of control" is a psychological concept popularized and studied by psychologist Julius Rotter. It refers mainly to the extent to which a person thinks 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.
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Thursday, December 8. 2011IllusionFreeman Dyson discusses Daniel Kahneman's Thinking, Fast and Slow in the NYRB. A quote:
His "System One" is more prone to illusions, but it takes less mental effort, as does getting through Dyson's intelligent article.
Wednesday, December 7. 2011A civil war within Psychiatry and Clinical PsychologyFrom Jung At Heart (h/t to Dr X, who also posts a follow-up to that post), More than a civil war:
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. Tuesday, November 29. 2011Bitter or disappointed about life? Shamed by your life? It's because you believed the rainbow pony BS"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. Tuesday, November 22. 2011"Doctors urged to limit practices"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.
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Thursday, November 17. 2011Is there an "I" in a person, or are people just a jumble of gooey tissues with neurons firing all around?We have all been posting about Gazzaniga's new book Who's in Charge?: Free Will and the Science of the Brain?, for a couple of weeks. 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. In the WSJ, a review of the book: Rethinking Thinking - How a lumpy bunch of tissue lets us plan, perceive, calculate, reflect, imagine—and exercise free will. From the review:
Indeed, when I am gone they can study my brain all they want in the lab but they will never find The Barrister in there. Friday, November 11. 2011In which I play the Sociologist on income and asset inequality, and the "root causes" of very low incomesLike 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 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. Tuesday, November 8. 2011Patients' attitudes towards paying my billsI 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.")
Thursday, November 3. 2011Analytic textsDr. X posted a list of the texts which have most helped or influenced him in his work. It's a good list, and I endorse it except for the Kohut. I cannot understand Kohut. My list would also include: A couple of Roy Shafer's books A couple of Charles Brenner's books A couple of Glen Gabbard's books
Wednesday, November 2. 2011Medical charityI 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.
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Tuesday, November 1. 2011More on brain science and accountabilityFrom an interview with Michael Gazzaniga:
Prof Gazzaniga is a good, humble scientist who knows the limits of what his area can offer us. Saturday, October 22. 2011Adolescents At Home and Abroad, with Eric HofferThe 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.
Continue reading "Adolescents At Home and Abroad, with Eric Hoffer" Wednesday, October 19. 2011A Psychiatric fraud: Multiple PersonalityRemember Sybil? Schniederman provides the update on all of that. 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. Tuesday, October 18. 2011Child-rearing views which I endorseFour Small Things Good Parents Do That Hurt Their Kids in Big Ways. It begins:
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Thursday, October 13. 2011The End of Evil?If you can't find utility in the concept of sin and evil, then I don't know how you can find utility in the concept of the good. At Slate on evil, Neuroscientists suggest there is no such thing. Are they right? A quote:
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. Relevant good book: Columbia Prof Andrew Delbanco's The Death of Satan Sunday, October 9. 2011WillpowerKlavan seems interested in this book. A quote at Amazon:
From Klavan's post:
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 and many others. Tuesday, October 4. 2011Is anybody responsible for their actions?I shouted out, No, it was not you and me. That was the voice of Lucifer speaking. "What's puzzling you is the nature of my game..." Says Daniel Greenfield in The Power of Weakness:
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.
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Sunday, October 2. 2011Nature vs. NurtureFrom Does brain plasticity trump innateness?
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.
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Monday, September 26. 2011"Love is all there is...": Love slavesIt 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.
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Wednesday, September 21. 2011Never trust anybody under 30Schneiderman's advice to Freshmen: Join things to find out where you belong. 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.
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Wednesday, September 14. 2011Culture and personality traits: TrustTrust 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. Here's a study by nationality: Do You Think Most People Try to Take Advantage of You? 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. Wednesday, September 7. 2011Everybody is an amateur PsychiatristOne 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 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.
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