Maggie's Farm

I plan to pose a number of questions to our readers this week because I have some talks to give on Saturday and would love some fresh ideas.

I hope our brainy and learned readers will rise to the occasion.

First, why are so many American middle-class and poor people (especially women) fat or overweight, while wealthier and better-educated women tend to be svelte?

Got a theory? Is it really class-related, or is that coincidence? Or is it a matter of fashion, wherein some social groups are just more accepting of fat? Some guys do prefer fat girls.

Our Editor posted that he had just visited the Nazi stadium, the Zeppelinfeld, in Nuremberg, and that he had felt creeped out by standing there. It isn't "history," - it's recent past.

Hitler, Stalin, Pol Pot, Saddam Hussein, Osama, etc. are just icons of evildoing. Scapegoats, in a way. The evil is not so importantly in them as it is in the effective unleashing of the evil in the hearts of their supporters. We eagerly forget that Hilter was elected. Some charisma helps, but does charisma come from popularity and power, or does it inspire popularity?

I will not reflect on my own potential for evil, or the dark side of my heart, on a website, but I know it exists and I know a bit about it. I am not making moral equivalences here, a la Pogo. There's a big difference between containing some darkness and acting on it. One thing I pray for is for God to always lighten my darkness.

Readers know that I accept the notion of evil, and refuse to medicalize or sociologize it. Readers also know my thoughts about utopianisms of all sorts, and especially what I term Psycho-utopianism. Anybody who has been analysed knows about the dark side of the Force, and does not need Hannah Arendt to inform us about it.

The "problem of evil" is a manufactured, trumped-up "problem" for and of the Enlightenment. Rousseau and all that noble savage stuff. Reason has its limits, and people are not "good."  Most of us strive to be good, however, which is interesting and remarkable in itself, and evidence for many of the spark of the divine in humankind. Judaism and Christianity have no "problem of evil" because they accept the reality of man's fallen condition.

Our friend, the retired prison shrink Dr. Ted Dalrymple, who ought to know as much about the topic as anybody, takes on the subject.

Ed: I guess that is something of a Christian Rosh Hashanah post. Why not? Same roots. Reminds me of this (gotta love the fish fry):

Don't steal, don't lift
Twenty years of schoolin'
And they put you on the day shift
Look out kid
They keep it all hid
Better jump down a manhole
Light yourself a candle
Don't wear sandals
Try to avoid the scandals
Don't wanna be a bum
You better chew gum
The pump don't work
'Cause the vandals took the handles.

The deal is the social contract and the contract of civility.

By some fluke, in the past month I have consulted with three teens who have run afoul of the law, including one 16 year-old who could be facing many years in jail.

Not one of these kids realized or had ever considered that what they had done was criminal. It got me to thinking.

In my parents' generation, the kids took a course called "Civics." It was about our government, laws, civil behavior, civic responsibility, how to be a citizen of a free republic, etc. It was replaced, in time, by some strange Dewey-ish thing called "Social Studies" in public schools (but private schools, like mine, never did "Social Studies). My guess is that nowadays it's about recycling, respecting "others," and appreciating Serbian cuisine and folk dress.

When I met with the parents, I discovered that the parents had never discussed the laws with their kids. They figured they had "basically good kids."

Whatever that means.

I'd like to launch a movement to re-institute Civics. I'd like to see kids get classes from cops and criminal and non-criminal lawyers about the laws and the legal process. I'd like to see kids taught about being a citizen in a free repubic, and their duties and reponsibilities. I am certain that not all parents convey those things today, but if kids aren't taught these things they will find out the hard way. It takes lots of people to teach a kid how to be an acceptable member of society.

A good parental example is a good start, but not enough. They need feedback and simple information.

When I went to boarding school we had daily chapel. We acknowledged God and Jesus plenty, but most of the brief homilies were about how to be a decent member of a community. Those messages stuck, even to wanna-be sophisticated and wanna-be jaded young hipsters like I tried to be.

The core of the problem is the modernist assumption of "basic goodness." Frankly, that is pure BS.

A 16 year-old boy fondled a precocious and eager 14 year-old in his car after school. Another kid told the parents, parents called the cops, and the 16 year-old is facing many years in jail on pedophilia counts. The prosecutor has him as an adult pedophile. Nobody ever told him.

It's not the sort of topic that comes up over the dinner table, but somebody could have and should have told him about the laws. 

"The war inside." Interesting story, from a combat doc. Not all people are natural warriors. Few, really, unless their own home or family is threatened.

I have known some military docs. Some were warriors, most were not. Quite a few Vietnam vets ended up in medical school. There was an ex-company commander in my class. Tough SOB. Went into Psychiatry like me.

No, you can not. Everybody has his personal limits; limits in talent, limits in intelligence, limits in endurance and perseverence, limits in initiative, limits in social skills, limits of personality style, limits in stress-tolerance, limits in judgement-making, etc, etc.

When people push against their limits, it is admirable. When they go past them, it is usually sadly obvious because, without great luck, defeat and failure are almost certain. Life and reality are stern schoolmasters.

I am a believer in rigorously honest self-appraisal as well as a "seaching, fearless moral inventory." These things are narcissistically injuring - but liberating. Furthermore, they can help us steer our ship and avoid the rocks.

A quote from The Spirit of Independence: The Social Psychology of Freedom at The American:

In 1966, American psychologist Julian Rotter published a paper that introduced the concept known as locus of control. Human beings, according to Rotter, could be divided into two basic groups: those who believed their locus of control was within themselves, and those who see themselves as under the control of forces located outside themselves, such as luck, or fate, or other people whose will cannot be resisted. The first group, called internals, believe that they are the masters of their own destiny; they tend to be high-achievers, optimistic about their ability to improve their lot, and to discard bad habits. They believe in willpower and positive thinking. They are determined to control their own lives, for better or worse. Members of the second group are called externals. They look on themselves as victims of circumstances, the playthings of fate. If they go to bed drunk, light up a cigarette, and burn their house down, they explain the disaster as another instance of their bad luck, and not their poor judgment, much less their bad habits. On the other hand, if a drunk driver hits an internal, the internal will scold himself that he should have been more alert at the wheel, he should have seen the drunk coming and swerved in time to avoid him.

Yes, there is a spirit of freedom and a spirit of slavery and dependence. Another quote:

To natural libertarians, there can be no more existential conflict than the one they face today. Are they destined to perish from the earth along with their cherished cultural and religious traditions, pushed aside by those who claim to champion progress but who in fact promote learned helplessness in the general population, however benevolent their intentions? Will the natural libertarians’ roadblock to serfdom simply be brushed aside without a fight? Or will these roadblocks turn into barricades, to be manned by those who are willing to make the last sacrifice to preserve their spirit of independence?

The old saw about Eskimos having 40 words for different kinds of snow is an urban myth, but it is true that English is impoverished in its language for attachments.

In Psychoanalysis, we talk about "attachments" to try to keep it simple and clear. Then we add an adjective to specify.

I recently got on this topic in a consultation with a fellow who was torn up and confused about his love for his wife of 38 years and his exciting relationship with a woman at work.

"Cupid is mischievous," said I, "and he never rests. He especially loves to target guys, but making trouble, creating restlessness, and making even grown people go crazy is his game." I said "Love and desire are not zero-sum games, and, besides there are many kinds of love which coexist all the time."

I explained to him the various forms of love for which the ancient Greeks had useful names, but wiki does a better job with it:

Greek distinguishes several different senses in which the word "love" is used. For example, Ancient Greek has the words philia, eros, agape, storge, and xenia. However, with Greek (as with many other languages), it has been historically difficult to separate the meanings of these words totally. At the same time, the Ancient Greek text of the Bible has examples of the verb agapo having the same meaning as phileo.

Agape (????? agáp?) means love in modern-day Greek. The term s'agapo means I love you in Greek. The word agapo is the verb I love. It generally refers to a "pure," ideal type of love, rather than the physical attraction suggested by eros. However, there are some examples of agape used to mean the same as eros. It has also been translated as "love of the soul."

Eros (???? ér?s) (from the Greek deity Eros) is passionate love, with sensual desire and longing. The Greek word erota means in love. Plato refined his own definition. Although eros is initially felt for a person, with contemplation it becomes an appreciation of the beauty within that person, or even becomes appreciation of beauty itself. Eros helps the soul recall knowledge of beauty and contributes to an understanding of spiritual truth. Lovers and philosophers are all inspired to seek truth by eros. Some translations list it as "love of the body."

Philia (????? philía), a dispassionate virtuous love, was a concept developed by Aristotle. It includes loyalty to friends, family, and community, and requires virtue, equality, and familiarity. Philia is motivated by practical reasons; one or both of the parties benefit from the relationship. It can also mean "love of the mind."

Storge (?????? storg?) is natural affection, like that felt by parents for offspring.

Xenia (????? xenía), hospitality, was an extremely important practice in Ancient Greece. It was an almost ritualized friendship formed between a host and his guest, who could previously have been strangers. The host fed and provided quarters for the guest, who was expected to repay only with gratitude. The importance of this can be seen throughout Greek mythology—in particular, Homer's Iliad and Odyssey.

(There was also this thing called Platonic Love, a notion which entailed the idea of a sublimation of ordinary Eros to a love of the divine and the sublime.)

The fellow concluded that he could keep some of his philia and storge for his wife, but that he needed more eros before he got older. He thanked me profusely for the conversation, overpaid his bill (doubled it), and I never saw him again.

My work is mostly never so quick and easy.

Image is Caravaggio's Cupid.

Our editor recently remind me of Steven Pinker's 2002 book, The Blank Slate: The Modern Denial of Human Nature. From an Amazon review:

His fundamental message is: Yes, Virginia, there is a human nature. People of all cultures are born with a host of inborn predispositions - to acquire language and music, to favor kin over strangers, to desire sex and to be ashamed of it, to value even trades and to punish cheaters, and dozens more. Our common nature springs from our common biology; it is not very malleable, and it is not "socially constructed." Cultural diversity is marvelous, but it is all a variation on an immutable theme; and there have never been any human cultures free of war, of greed, or of prescribed gender roles. (Any more than there have ever been any free of conflict resolution techniques, altruism, and shared parenting.)

His secondary theme is that the differences between people, so much smaller than what we have in common, are also primarily biologically determined. A juggernaut of data has finally put the nature/nurture controversy to rest, at least from a scientific standpoint, and the final score is pretty much nature one, nurture zero. Fifty to seventy percent of the variation between individuals - in intelligence, in personality, in political leanings, or just about any other mental character you care to name - derives from the genes; zero to ten percent derives from the home environment; and the mysterious remainder is due to chance or to non-parental environment.

We have been conditioned in recent decades to think of both these contentions as shocking...

Shocking only to those with a Marxist agenda, "the new man" and all that nonsense. Pinker's book reaffirms what everybody's Grandma knows.

I recently met for consultation with a civil engineer who grew up in Romania under Ceausescu, in Budapest.

He walked in and said "I need somebody to talk to, but I have a few questions first." Typical engineer, to need data first.

"Shoot," I said.

"OK, first, are you Christian?"

"What's that got to do with it?" said I.

"You do not seem to understand me. I need to know, are you a Christian?"

"Yes," I replied.

"You have a Romanian Easter egg on your shelf."

"You are observant," I said. "Yes I do, a lovely gift."

"Are you a communist?"

"You seem to want to know more about me than I usually talk about, but no. Quite the opposite."

"OK then. I will feel at home here, and I will tell you my story."

The guy grew up under the Commies, and still has to vet anybody he confides in. My job is an amazing privilege. Not paranoid, just trained by the commies to distrust.

This is a repost from 2006 (so you need to right-click on the links)

What if the part of human nature which wants paternalism, or maternalism, in the State is sometimes, or often, stronger than the part that wants freedom, autonomy,  self-reliance and self-determination?

What if we are wrong to imagine, as Bush claims, that an aspiration for freedom lives in the hearts of all mankind?

What if that aspiration is a simple error of a uniquely American culture, which combined northern European Calvinism which rejects any hierarchy in church or in life; a personal relationship with God; Lockeian liberalism; a distinctly northern European moral code in which honor, reliability, hard work, personal responsibility, generosity, and integrity are the measure of a person; a frontier attitude which expects life to be difficult but remains optimistic, and an innate distrust of government and politicians - is a very strange brew?

Maybe a strange brew which permits people to make the most of their lives and their "inner lives" - or the least of them, if they so chose -  but requires more practical and psychological independence and liberty than most humans desire. Maybe?

We know that our revolutionary ancestors were in the minority, here in the colonies. The most vociferous, for sure. But most were Loyalists until the tide finally turned. Zogby polls would not have supported rebellion against the Crown. Neither King George, nor Lord North, were evil people, by any means. Well-intentioned, but confused by the new American spirit.

These are hardly original questions, but they come up because of a series of bits that stuck in my mind. One was a piece at Daily Pundit, about the Russian comfort with Putin's moves towards autocracy. A piece by Callick at TCS asks Is the world moving beyond liberal democracy? Another was a piece also posted on Maggie's about the blue-ification of my once-granite-ribbed New Hampshire, where I own the ancestral family farm, and where I live Thursday night-Monday morning. Also, Dr. Sanity's piece, which said it better than I could: Come for the Equality, Stay for the Bestiality and Tyranny.

As a shrink and a psychoanalyst, I am philosophically - and spiritually - biased towards the idea of an environment in which people can find their own way, and discover and use their strengths and individual gifts and talents in life. I am fond of telling my psychiatry students that "reality is always on your side."

But I also know that, in the big world, this view is often odd, blasphemous, antisocial, or rebellious. After all, few cultures even would embrace the notion of Erikson's idea of individuation - much less his notions of development. For us, the independent individual is King - but not so everywhere. Our Western near-sanctification of the individual is unusual, unique perhaps.

The revolutionary notion of the Individual As King is why we have guns, and private property, and educational chances for all, and a zillion places of worship, and clubs, and blogs, and a million volunteer organizations and charities and land trust and conservation organizations. And why we rely on our families before anything else, and why we distrust what the experts say. And it is why we have opportunity - not material equality - but opportunity for all, to make our own choices and decisions as grown-ups about how to plan a life. Economics is just one of many considerations in life, for most (not that we all would not welcome a bit more money).

Europe has embraced state parentalism - little different from its monarchical past: the fantasy that smart, powerful persons know best, or deserve power over us, is a piece of our childhood which we are reluctant to give up. A left-over from the time of nobility and serfdom. Our American culture may label that "childish," but probably most do not. Since psychosocial development is driven by the need to adjust to reality, the endurance of the parental fantasy must distort development for many people, similar to what happens commonly to the kids of the very wealthy.

Give me liberty or give me health care and more freebies: The American Left has similar aspirations, and a similar condescending attitude towards the human potential for autonomy and self-determination on the part of its policy-makers. "We'll take your money you earn, and fix it for you - because we care." AKA "It takes a village." (And, by the way, in my opinion it does "take a village" - but not a federal government.) The classic and revealing argument of the Left for idolizing the thug and murderer Castro is "But they have free health care."  It's close to what they always said about Mussolini: "He made the trains run on time." (And that is saying a lot, in a place like Italy.)

State parentalism is one step from totalitarianism. And not just psychologically, but also in reality. First, you get the people used to the idea that they can depend on the government to take care of you and to solve your problems (rather than simply to defend you, and to keep life reasonably fair), and, having slowly softened them up, you build on that until you can't smoke a cigarette in your car without getting fined, or find a decent fried chicken take-out in NYC. 

I always thought that Jack Kennedy's "Ask not..." (listen to it) was a fine call to maturity, and Reagan often echoed JFK in his speeches. The more powerful government becomes, the more the people will tend to regress psychologically, just as the more of their money you take from them, the less motivated they will feel to work hard, and to be inventive and creative with life. Necessity is the mother of invention, and a thoughfully planned life is necessary for most of us.

Happy human cattle is my nightmare. And yet every human is prone to the regressive, almost gravitational, pull, to childhood and relative helplessness. We must thank God for the adolescent rebel which lingers in all of us, however mature and effective in the world we may or may not be.

The bottom line is this: What if most humans do not feel that they have what it takes to handle life in freedom, and to deal with their own basket of challenges in life? What if most of them, both in the US and abroad, do not share my Yankee ideals? What if most people do not want to be kings of their own domains? Then what?

Image: Time Magazine named Joseph Stalin "Man of the Year" in 1939 and 1942.

You may not have read my piece this week, Preventive Medicine: Drive carefully, and make sure you have good genes. It's not the best post in the world, but it makes my point.

A propos of that topic, see Docs running to stand still in The American. A quote:

The general popularity of widespread preventive care rests on the shaky presumption that such medical services head off more serious medical conditions, save lives, and reduce healthcare costs. A lengthy literature actually challenges each of those premises; at least when recommended preventive care services are not limited to a shorter list of medical interventions and targeted to the most appropriate types of patients likely to benefit from them. But the broader political argument often is that “cost” should not be a disincentive to greater demand for such presumably necessary services, particularly when society as a whole is supposed to benefit in the long run from better population health.

Readers know I am a bit of a skeptic on the topic of ADD (but not of ADHD in childhood).

To give you a sense of why I am a skeptic, I include a screening test (below the fold) from this website.

Let us know how you scored, in the comments. We'll pretend this is a random sample.

As an intro, see the fourth toon down. I am not willing to pay $45. to post it. (I would pay up to $3. to use it.)

When I was a lowly intern, I was presiding over an ER when we got a radio call around 9 pm about an accident in a mall parking lot involving two cars with kids in them. A head-on, both cars going about 35 mph (that equals a 70 mph accident). When the ambulances arrived, four kids grey, not breathing. DOA. A Mom, still almost pink but dying with head trauma. A Dad, straight to trauma surgery for internal bleeding.

I have never assigned so many people, so quickly, to body bags and the morgue.

So when I read pious government utterances about "preventive care," I just have to laugh. People who talk about that have no idea what they're talking about. Doctors advise people to lose weight, to exercise, to quit smoking, to lower their carb intake, to drink only two wines/day, to wear bike helmets, to use condoms, to eat your vegetables (why? I don't know), to take their medicines, etc., every day. Blah, blah, blah. I might as well advise them to never leave the house because they might get hit by a bus. In the end, people do what they want, and adults are adults. Nobody lacks information and, in my view, if you want to be fat, then go for it.

Personally, I intend to remain trim, fit, athletic and energetic, but I am not interested in sacrificing my life and fun and adventure on the altar of "health" and "safety." There is no vitality or joie de vivre in that. I enjoy a little danger, stress, and excitement. I have crossed crevasses and climbed mountains and kayaked Grade 5 rapids (and almost drowned) and spent many hours on the back of motorcycles. I faced a p-ed off Cape Buffalo (and killed it. Regret it now - there was no point to it), and I sky-dived once. We always drove too fast. We quit all those things when we had young kids, despite the fact that my brother could have raised them very well indeed, and we had good life insurance.

Since everybody dies, and, with modern medicine, dies in a lengthy and expensive and often wretched drawn-out process (80% of US medical costs are in the last year of life), all "preventive medicine" can even hope to do is to delay the process a little bit.

However, it cannot even do that, really. It's 90% wishful thinking: The Big Lie of Preventive Care.

Another good toon from The New Yorker: "Tell me straight, Doc. How long do I have to ignore your advice?"

Neither man nor life is perfectable. Indeed, it would be difficult to find agreement on "perfection" anyway.

Some people in the psychological health professions have an unspoken and even unacknowledged notion that, given proper therapy and/or proper medicines, we could all be brought to "normality" or "mental health." I term that "psycho-utopianism," and I hold the copyright for the term.

My view of all utopianisms is that they represent infantile wishes; that they are unrealistic dreams. Dreams of Eden. "If only..., this organization would run better." "If only we had..., we'd be happier." "If only the country would..., life would be better." "If only I were more motivated to (work out, make more money, get a better job, Etc.), I'd be happy."

In Psychoanalysis, we often use the term "normal neurotic" for those whose defenses and adaptations are in the normal range, ie not too dysfunctional and not too misery-creating. Most people are in that category. Psychoanalyst Dr. Joyce McDougall wrote a wonderful book in 1992, Plea For A Measure Of Abnormality, which addresses the topic.

I am not a therapeutic nihilist. I try to be a realist. Everybody has character flaws and weaknesses and immaturities, and always will regardless of the next miracle drug or the next whatever. The trick is to know oneself, to know one's strengths and weaknesses and flaws, same as it is to know the limits of external reality. A good life is a struggle with both.

It would not be difficult to preach on this topic at long and tedious length with the implications for how it applies to many or most human endeavors in the post-Eden world, but I'll save my ammunition for another time.

- From Sandel in The Atlantic (2004), The Case Against Perfection - What's wrong with designer children, bionic athletes, and genetic engineering.

- Ars Psychiatrica discusses the ailments of prosperity: The Age of Anomie?

- Yet another normal neurosis may get an "official" diagnosis: Internet Addiction - "What once was parody may soon be diagnosis." Same thing goes for "sex addiction" in my opinion. It's like shopaholics and chocaholics: from Oprah to DSM 5 in one easy step.

- If "Borderline Personality" is up to 10% of the population, is it really all that abnormal?

- One in five Californians say they need mental health care. Those are just the folks who want to deal with their "issues." Willingness to address one's "issues" is partly cultural.

Unrelated, but interesting: A Simulation Of What It’s Like To Experience Schizophrenic Symptoms.  h/t, Linkiest

Conscious guilt causes agony while unconscious guilt can shape a person.

I tend to see more people wracked with conscious guilt. Sometimes it's neurotic (ie, irrational in proportion), and sometimes it is good old ordinary guilt for rotten behavior and/or evil thoughts.

There are many causes of self-defeating or self-sabotaging behavior besides unconscious guilt (for examples, avoidance of difficult things or avoidance of risky challenges), but guilt is always on the list of considerations.

Dr. X discusses the topic here and here.

People love to make fun of Psychiatry, but here's a sample of what life could be like in a world without us.

Remember that Dr. Benjamin Rush, the founder of American Psychiatry, was a signer of the Declaration of Independence. He was vehemently opposed to the chaining of the mentally ill, and proposed treating them with compassion and understanding. He also opposed slavery.

Image is Benjamin Rush, MD. Charles Wilson Peale, 1818.

Medicine has always abounded with quackery, and placebo effect is real. Hope springs eternal...

However, when tax dollars are expected to pay for it, it's another matter: Europeans Cast Critical Eye on Homeopathy.

In a free country, folks are welcome to buy their own quackery if they want, on their own nickel. Most docs privately think of Chiropractic as quackery, but the Chiropractors have a lobby in DC, and I believe there is a legal injunction against MDs terming chiropractors "quacks" in public. They sometimes do help people with sore backs. I am just imagining the debates about whether federal guidelines will include crystal therapy and massage therapy.

American medicine itself has little intentional quackery, but many treatments which are of dubious value. For examples, futile treatments for terminal cancer, or those $15,000 treatments for "Chronic Lyme". Thus far, in America you can pretty much get whatever medical treatment you want regardless of its usefulness for you. Problem is, others are usually paying for it.

My prediction is that government-controlled medical care will be determined by politics and, to some extent, politically- or bureaucratically-oriented docs. That is not good medicine.

Good medicine is individualized, not based on statistics.

Our Editor asked me to comment on McArdle's post of the above title. Happiness is, as I have discussed here in the past, undefineable.

Joy is defineable, peace of mind is, contentment is, delight is. Pursuit of happiness is a fool's errand. (Is it true that Jefferson's first draft was "pursuit of property", but that was edited out?)

Key quote from her post:

Instead of asking parents and non-parents whether they are happy right now, we might ask whether they are becoming more like the people they want to be. And then we might see children not as factors that may or may not be contributing to our happiness, but as opportunities to practice what most of us -- perhaps me most of all -- need to do more often, which is to put someone else before ourselves.

Shrinkwrapped's post on sociopathy is a good update, and raises intriguing, age-old questions about free will and responsibility which go far beyond the topic of sociopathy. The Greeks understood these things better than we do. Fate, personality temperaments, and all that.

Everybody's brain seeks excuses for their body's wrong or irresponsible behavior: My Brain Made Me Do it.

I might revise the title to "My brain made me blame my brain." That's the one I use when I screw up.

I have no answers to these conundrums (conundra?).

Erik Erikson said "Psychotherapy begins where common sense ends."

Well, common sense isn't all that common. In fact, it is as rare and precious a thing as honesty.

The shrink proprietor of F*ck Feelings is darn good with common sense. As they say in The Program, "Feelings aren't Facts." I always like to apply common sense first, then other things if that doesn't help.

Sociopathy seems to be, to some extent, bred in the bone. As I have discussed here in the past, it's about a cool indifference to others, often while presenting a mask of warm caring and self-sacrifice (the so-called Mask of Sanity). It's about an easy ability to lie to your face, and it's usually not about violence and murder.

High IQ sociopaths fool shrinks all the time and we kick ourselves every time we finally realize it. Often, they confess things as red herrings for us. They tend to have ulterior motives, but do not mention them to us at all. People who repeatedly lie to shrinks generally have sociopathic traits, at the least. They tend to have an assortment of other symptoms and problem behaviors also, such as substance abuse, shame, narcissism, blaming, exploitative relationships, and anxiety. They always have an excuse at the ready, tend to be impulsive, and always have their self-interest in mind.

At Gene Expression's Bad to the Bone:

Could a psychopath mount a legal defense by saying “my brain made me do it”? Or my “genes made me do it”? Is this any different from saying my rotten childhood made me do it? Psychopaths know right from wrong – they just don’t care. That is what society calls “bad”, not “mad”. But if they are constitutionally incapable of caring, can they really be blamed for it? On the other hand, if violent psychopaths are a continuing danger to society and completely refractory to rehabilitation, what is to be done with them?

Don't ask me. Just keep them out of my office. They are Very Bad News for soft-hearted gullible trusting folks like me.

I have been mulling over the notion of doing a post on ineffectiveness in people, but every time I thought about it, the subject just got too big to tackle. There are so many ways to be ineffective in life, ways of not addressing reality - and oneself - firmly.

Schneiderman is keeping it simple: "The 7 Habits of Highly Ineffective People"