Monday, October 05, 2015


You will note that I have said little or nothing about what the US should do in the long stretch of territory from Bosnia to Pakistan.  This is because I have no idea what the hell we should do. I sense at some primitive level that Obama has erred enormously in giving away wars that we actually won at great cost in Iraq and Afghanistan.  But as to what he actually should do in a positive sense, or what we should absolutely avoid doing, I throw up my hands.

I fear that the only solutions will be the Asian ones, where one or more tribes is simply eliminated forever. It is perhaps easy to step back and say "We are not called to this.  The US or the UN is not the World Enforcer. Let it go, it is not our battle."  Intellectually, this is what I believe.  But there are real children, real fathers supporting families, real teachers... real fishermen and shopkeepers and farmers and barbers and midwives and breadbakers in all of this.

Sometimes we must embrace the evil that is least bad in foreign affairs.  Yet I cannot even say what that is. Save them all. Kill them all. Ignore them all.

Monday, September 28, 2015

We have No "Right To Happiness."

Christopher B's apposite comment under my post about evangelical shift on gay marriage put me in mind of a C.S. Lewis Essay We Have No "Right To Happiness" This is hardly surprising as many things remind me of a Lewis essay.  Sample
The real situation is skillfully concealed by saying that the question of Mr. A.’s “right” to desert his wife is one of “sexual morality.” Robbing an orchard is not an offense against some special morality called “fruit morality.” It is an offense against honesty. Mr. A.’s action is an offense against good faith (to solemn promises), against gratitude (toward one to whom he was deeply indebted) and against common humanity.

Saturday, September 26, 2015

Ronald Reagan Roast

Gloucestershire Folksongs

For those who like their folk music authentic there's this site of hundreds of collected songs and dances from Gloucestershire (SW England, Welsh border). Many are in original recordings from decades ago. What impresses one at first is how rough the quality of singing is, but how unselfconscious the singers are about this. Remembering Chesterton's admonition that all should be able to sing the songs of their land with full voice, they clearly have something going that we now lack. We, in our shyness unless we are of performance quality, have lost much of what singing is actually for. It's for doing more than hearing.


 When Bernie Sanders spoke at Liberty University I ground my teeth at his predictable, condescending all-religions-teach-the-same-thing nonsense. It immediately put me in mind of Chesterton in Orthodoxy:
The things said most confidently by advanced persons to crowded audiences are generally those quite opposite to the fact; it is actually our truisms that are untrue.
The (excellent) chapter as a whole discusses the claim that Buddhism in particular has great overlap with Christianity, including another of my favorite quotes:
Students of popular science, like Mr. Blatchford, are always insisting that Christianity and Buddhism are very much alike, especially Buddhism.
There isn't much more one would expect of Sanders, of course, as his entire program is half-baked ideas popular among people who don't think things through, delivered in a tone of outrage by a white-haired guy. It is quite as buffoonish as anything Trump says*, but it's a brand that appeals to a different market.

A more interesting question is why the idea continues to appeal, a century after GKC wrote about it. It always flows in the same direction. Some Christians - or people who want to at least retain some Christianity in their journey - like mystical experience, and so get drawn into eastern practices to get some o' that. Mystical experiences are pretty much the same worldwide - either quiet meditative Oneness or ecstatic shared ceremonies. Buddhism gives a nice structure to the former, but there are plenty of westernised versions of contemplation that can give you the same feeling.  People seek that kind of experience to get away. They may return to the workaday world refreshed and ready, but it's the getting away part that attracts. Nothing automatically wrong with that.  There are Christian versions of it as well - hence the term retreat.

But to make the mystic experience primary, whether in its Buddhist, Native American, or Hindu version is to retreat in a deeper and ultimately worse way. I have seen it in Christian practices as well.  It is to increasingly remove oneself from the congregation, which is ultimately to leave the faith. It's getting away from people that draws folks to contemplations about their own personalities and development, and the meaning of everything. Because people are icky and stupid and irritating. They say mean things and act selfishly, even the ones that are fun sometimes. Having friends that you just pal with, plus having independent spiritual experiences is a lot cheaper, really. Easy to see why it attracts.

Except Christians aren't offered that choice.

*Donald and Bernie's platforms are actually pretty similar, just dressed in different clothes.

Are Evangelicals Shifting On Gay Marriage?

Russell D. Moore over at First Things doesn't think so. I don't know myself, but his first three paragraphs are exactly how he should go about it.  People who interview him just assume that there must be a shift.  Because Millennials. Because others have. Because you're-on-the-wrong-side-of-history.

He asks what the evidence is.  There's a thought.

I can't help him out, even off-the-cuff.  I knew lots of young evangelicals, but they aren't young anymore, and most of them aren't evangelicals. They are nonbelievers, mainstreamers, nonattenders, and evangelicals in vaguely similar proportion. I suspect the current young evangelicals at my own church (which is in a bridge denomination to begin with) are not entirely representative.  It's a wealthy suburban church in New England.

Monday, September 21, 2015

Nobel Laureate on the European Invasion

I had not heard of Imre Kertész until today, but I have been interested in Jewish history since the 1970's, Holocaust history since the 80's, and Hungarian history since the late 90's. Also, I am very interested in what is happening in Central and Southern Europe now. His voice is unexpected on the  anti-migration side. Perhaps it is driven entire by his ethnic Jewishness, but it certainly seems to be drawn from a broad literary and philosophical mind, and a long history of observing Central European behavior.

There was a linked Weekly Standard article today which introduced me to Kertész. I don't know what Europe should do about an invasion which is about 25% pathetic refugees and 75% opportunists with largely economic motives - or worse. I don't blame the young men from Africa and Asia for their desire to move to a place where they might make a decent living, as opposed to the oppressive countries they come from.  But neither do I feel sorry for that group. How do they rescue the one and turn back the other?  Especially as the 25% is a defeated, frightened, kicked-dog group while the other is a defiant, violent sector prepared to punish anyone in their path? And are already complaining that they are not being treated right in accordance with their Muslim sensibilities? If you want a nice multiculti group with decent families moving in to help teach your children that "See?  There are good people all over.  Let's have them for barbecue - oh! or something - next Saturday," then these are not the droids you are looking for.

A Serbian friend, a refugee who works at my hospital said last week. "I hate, hate Milošević. He would kill his mother.  But this is what he said."

A story from 1993. Our family sponsored a Haitian child from about 1986-96. In 1991, Haitians started coming across to Florida in makeshift boats in increasing numbers.  Bush 41 had them steered to Guantanamo or back to Haiti, while we decided what to do with a group which was part political, part economic refugee. Bill Clinton made it a campaign issue, that he would never be so cruel as to not rescue such people, promising the US would help such sufferers under a Clinton administration.

In early 1993 the numbers of Haitians in ridiculously rickety boats suddenly increased in the Atlantic. We didn't actually rescue them in a welcoming Clinton administration. We eventually, quietly, without a lot of reporting, sent them back.  Except for those who had already drowned trying to get here, confident that the calculated risk was now worth it. Their number included the father of our sponsored child.  I don't blame him for trying.  Why wouldn't he believe what an American presidential candidate said?

False kindness kills, and it kills the poorest and most vulnerable. I really don't know what Europe should do, but I don't see how it can absorb the millions who will want to come. They want to come to Germany, and Sweden, and France. They are trying to bypass a dozen warless but poorer nations. Yet Western Europe, for all its rhetoric, is ultimately able to slow the numbers into their countries to a manageable level.  As in the years 640-1683, it will be Italy, Greece, Bulgaria, Serbia, Croatia, Macedonia, Romania, Hungary who pay the price.

Sunday, September 20, 2015

A Small, Reflexive Conservative Trait

I am not certain why this should be a left-right issue, but I find I am almost reflexively on the side of conservatives when it comes to lying about autobiography. They consider it a big deal, and indicative of general character.  People of the left don't seem to regard it as important. Less important, anyway.

It might not be as important as I treat it.  Hierarchies of sin are tough to assign. But when Hillary Clinton claimed she was named after Sir Edmund Hillary, he of the Everest climb (she was five when it happened), she forever had a great deal to overcome for me to trust her. She's had other such statements, such as trying to enlist in the army. I felt similarly about John Kerry's claims of being in Cambodia and getting a special hat from a CIA guy, or Al Gore's claim that the tie-on-the-doorknob sign from Love Story was about him and Tipper. Obama claiming his mother died of cancer because of her insurance company, and all that mess about basketball and the girlfriends. Bill Clinton, let's not even get started.

They are small things, perhaps.  They are fibs, about events which have little effect on us one way or the other. They are just blowhard comments

One major reason may be that I did it for a year myself, when I was 18. Just as I graduated from high school my parents moved to another state, I took a live-in job at a summer resort, and I entered college hundreds of miles away in the fall. I reinvented myself, including my past, because there was no one to say me nay. I sometimes wonder if any of the stories I told about myself that year were true. Most were based on a true story, as they say, exaggerations and partial truths. A few were like Hillary's naming story - they just sounded like cool things that weren't impossible and would be great to have be true. I don't recall an abrupt stop to this behavior, but I can only think of examples from that year. I did continue to repeat some.

So I don't get it when the truth comes out and the person doesn't just slink away out of the public eye forever. When it becomes known that you didn't go to Cambodia and can't possibly have a magic hat, how do you face people? Conservatives seem to lie about the standard stuff - affairs, corruption, money - and when they get caught, get told by others to slink away, and they usually do.  Or sometimes, they try to spin it down without denying it. But they generally have what would be my reaction - humiliation and an attempt to exit gracefully, with apologies. Especially as an adult.

But I don't recall in recent history people of the right getting caught in one of those blowhard things, claiming to have been cum laude when they didn't graduate or being drafted by the Packers when they weren't even starters in college. Different style perhaps. More likely to exaggerate what opponents did, maybe. I'm sure there must be something - Newt Gingrich seems likely, but I can't think of anything. If it is true that a lot of conservatives are like me on this score, they likely removed them from the pool. I can't understand when liberals don't have the same response.

VW Deception?

I am always suspicious of Kevin Drum, but this article does look like there's something to it.  Does anyone know anything about it?

Part Two: Categories of Paranoia

There are two categories of paranoia, and they may not be entirely related. If you follow this link   from the site above, then glance at the other things Ms Stuter has written , we will use these as both as illustrations of the two types.

While it is true with both that the paranoid outlook comes first (I think genetic or prenatal) and the specific content comes later (I think environmental), that is also true for depression, anxiety, buoyancy, and many other attributes.* That’s not enough explanation.  There seems to be a qualitative difference in the paranoia of those who have a single fixed idea that is orthogonal to the experience of the rest of us, versus those who have overlapping paranoid explanations about many things. Diagnostically, it is the difference between a thought disorder versus a personality disorder. 
With the former, a person often has an accompanying physical experience (interpreted broadly) which their brain explains for them in paranoid fashion.  If they hear something, their brain will soon tell them it is a voice or a meaningful signal, which rapidly becomes the embedded explanation. Or they may have waves of a sense of heightened importance in the moment, which they connect to whatever was happening at the time. (“A helicopter went over just as I was getting on the bus, and I just knew it was important.” “I just knew that the TV announcer must be talking directly to me.”) Thirdly but not exhaustively, the sufferer will have an overwhelming impression that things are just not right. In the grip of that, they may think that objects have been moved or replaced, and conclude that someone must be coming in while they are gone, teasing them as a warning or a torment.  Or they no longer believe their family members are real, but have been replaced by imposters. (Capgras Delusion. Can include pets.) This can get frightening when a woman believes such about her young children.

This sort of paranoia is often of later onset, so that the person’s skills and adaptation have proceeded quite typically before the disorder started.  They thus have a lot of functioning intact initially and can continue to work or live independently for years.  But delusions capture more and more of their lives and their impairment increases. My patient whose attempts to prove her delusions put me on to the site linked in Part One believes that she is being “gang-stalked,” and interprets the shouts of kids skateboarding and random marks on the nearby school as evidence that these gangs are trying to torment her. She brandishes Ms. Stuter’s essay with relief and triumph as evidence that she is not crazy, because someone else knows about this. No amount of discussion, forceful or gentle, dissuades her even 1%, nor arouses the slightest doubt.  She knows.

The other type has earlier onset, and applies more to the conspiracy theorists and other political types. They are generalists rather than specialists in their paranoid attribution, and their ideas are more likely to change slowly over the years. If you read Ms. Stuter's essays you don't find further references to gang-stalking (I admit I didn't read it all). If she suffered from this belief, as my patient does, she would be unable to refrain from mentioning it repeatedly. What likely happened is that someone reported this delusional experience to her and she, being a conspiracy-tending person, accepted the story as plausible, reporting it for the benefit of others.

Folks like this don't tend to deteriorate in functioning so sharply. They make lifelong accommodations - to work at jobs that aren't impacted, choose when to let their opinions out and when to keep silent. They can redirect their energies to small victories on school boards or working for causes.  some few have a charisma rather than that "stay away" vibe that paranoid personality disorders give off, and can become successful leaders of nonprofits or writers with an audience. There are plenty of folks against Common Core - with some good reasons - but these would be the most intense of that group, the opponents who not only think it is bad educational practice, but part of deeper plots. Even that is not quite paranoia.  Only when it gets to naming specific individuals or groups would I crest over to calling it that.

So it may actually be a good sign if you are paranoid about more things.  It makes your suspicion more diffuse, less intense.

Here's an interesting bit of interchange I've seen play out.  The specialist, psychotic paranoids are often drawn to the generalists, thinking "Ah, here is a person who gets it. Finally, someone who understands." I speculated that's what happened in Ms. Suter's case. Yet it doesn't play out that way.  The paranoia generalist shakes his head and says "No, you are not the center of the world's evil plots. The few are oppressing the many.  You're one of the many."

It gets interesting

*“I am physically daring because in my neighborhood you had to…” “I have always been disciplined about being on time because my parents instilled…”  No, unlikely.  More likely, you shared much of that quality with one or both parents right out of the gate.  I don’t discount parental intervention and peer influence entirely, but it is weaker than we have said for years.

Friday, September 18, 2015

The House Song

Did anyone ever read an explanation of the lyrics?  It's evocative, but I never understood it.

Paranoia Clearinghouse: Part One

In the course of my professional duties this week I came across News With Views: Where Reality Shatters Illusion. This would be alt-alt media, with lots of paranoid views.  It is mostly right-wing, Christian America stuff, but there is plenty of alt-medicine, Monsanto, Bush Family in New World Order, anti-corporate expose as well. Explanations of the dollar bill, that sort of thing. Energy vortices are usually a hippie thing, aren’t they? Yet in the main, it's trends strongly to endtimes, government overreach, and what-are-they-teaching-in-the-schools-these-days stuff. I've seen crazier. But it's got variety.

Some few of these authors seem to be not just paranoid in approach but specifically delusional in a personal way that seems worrisome.  Yet a lot of it isn’t really paranoid, but more monomaniacal, or merely rigid, or over-willing to believe alternative explanations. As with the occult, the desire to know what others do not, or to embrace an idea because it would be so cool if it were true, is powerful worldwide.  And there’s plenty of it that’s fairly reasonable, even if I don’t agree with it myself.  Most importantly, many of the writers have dozens of opinionated but non-paranoid columns, with the strangeness only leaking out in the occasional sentence or rare column. I didn’t encounter anything anti-Semitic or anti-Catholic, but perhaps I just didn’t click on the correct columnists. So if you want to have a bookmark to provide examples whenever you need to illustrate strange things the paranoids on the right say, this is one. Because it lacks some topics I wouldn’t expect it to be one-stop shopping, however.

If you poke around long enough you detect that there are ongoing arguments with other sites or groups, which upon inspection seem to be similarly paranoid but with different focus. But this site seems to be the cheerful one that is accused more than accusing, only shutting someone down if they get out of hand. It’s one of the reasons I find Southern Poverty Law Center to be more than a bit paranoid in itself. Every time it discovers a new group it perceives this as an increase in the hatred and dangerousness in the country. But it’s a kaleidoscope – the intense suspiciousness of these folks is a huge obstacle to their creating any sort of coordinated action. They keep splitting off, or merely drifting away from one group in order to join or set up another. (SPLC apparently regards this as an additional danger, as they take it as an example of how deeply connected and networked these groups are. People chart these connections.  Just in case. See also Vast Right Wing Conspiracy.)

I'm using an essay from this site as a jumping-off point to discuss varieties of paranoia in Part Two.

Thursday, September 17, 2015

Depression and Cardiac Events

We had Gary Moak speak at Grand Rounds today.  He is our new head of Geriatric Psychiatry (most recently at MGH, I think) who has a book coming out in the spring Beat Depression to Stay Healthier and Live Longer, which focuses on older adults. Today's talk looked across the lifespan, noting how episodes of depression in "young people" (17-39) result in 4x greater mortality from cardiac events down the road. I will note that this is after other factors have been equalised.

Higher mortality has usually been explained, or explained away, by people taking less good care of themselves: they eat poorly, they don't take their medicines as diligently, they drink and smoke more, they don't go to the doctor, they have fewer friends and less exercise, all that. Moak is saying that the higher mortality is there even when those factors are accounted for.

I really didn't want to hear that. I asked hopefully at the end if this damage is along a continuum, with severe depression causing more problems, or is it a threshold phenomenon. He answered that dysthymia is probably worse.  People who have chronic, low-level depression are much more likely to avoid treatment, tough it out, and repeatedly gird up their loins with some promise to try harder. But depression is a chronic inflammation, a perpetual activation of many body systems, which interrupts natural healing responses just as fully as Major Depression. A half-dozen treated episodes of MDD over 30 years gives the body plenty of time to recover and repair in between. Chronic activation, not so much.

I really didn't want to hear that. I'm pretty much already screwed, then, and playing catch-up. One more big risk factor on board.

Interesting new approach.  Depression is being looked at as a sort of accelerated aging - platelets, arteries, telomeres, lots of stuff. Great. Also, the SSRI's have a strong antioxident effect, enough that some stroke centers are prescribing low-dose Prozac to every stroke victim, regardless of whether they have depression or not. Another psychiatrist asked if prophylactic SSRI's might be in the cards for lots of us, and the discussion mostly led to "probably."