Wednesday, May 31, 2006

New Treatments For Depression

OK, I'm Not Really A Cowboy has a post on treating depression via stimulation of the Vagus Nerve. It makes some intuitive sense, as that would activate parasympathetic responses. But the time frame (1-2 years) suggests something else might be happening.

I would like to add to that the work Sidney Kennedy is doing in Canada on Deep Brain Stimulation. Goldberg down at Brown University noted the same thing anecdotally when they were using DBS for treating Parkinson's, but I don't know if they're doing anything more.

Hollywood Frontrunners

I saw a stars magazine at the doctor's office: People, or Entertainment Weekly or something like that, from December of 2001. It had a special article about Hollywood stars who were going to entertain the troops overseas. Mariah Carey, Tom Cruise, Jennifer Lopez - it was all very nice. (I had never seen Mariah Carey before. Very pretty woman.)

Two names jumped out at me. I had thought that George Clooney and Julia Roberts were among the recent antiwar crowd. Huh. But there they were, hugging up to soldiers during the Afghan War.

Harder To Imagine

Summary: Climate change is a popular problem to solve because it looks easy and straightforward. The costs are mostly invisible and the dangers easy to imagine. Contrasted to this, the costs of the GWOT are highly visible and the dangers hard to imagine.

The costs of reducing carbon emissions will be borne by Someone Else, won’t they? We’ll make the auto manufacturers have higher gas standards, which will cost us an extra coupla hundred when we buy a new car, which is hardly ever. Painless. Plus we’ll be able to smile contentedly when all those yahoos have to ditch their SUV’s. They’re the ones ruining it for the rest of us, y’know. We’ll make the oil companies refine better, or look harder, or something. But mostly we’ll stop them from ripping us all off with their big salaries and stock options and whatever. Make them look under the sofa cushions for a change, the bastards.

It’s hard to imagine jobs that don’t get created, isn’t it? What do the jobs look like? Do they make things, or sell things, or move information, or what? So all that blather about slowing down the economy sounds dire in theory, but nobody actually gets hurt, right? Or at least we won’t be able to identify who got hurt. My job doesn’t have anything to do with oil. Conservation is the key. The kids have been bringing home save-the-environment posters from school for years with great ideas of how we can recycle and use less energy. It’s just a matter of putting your mind to it, like taking your vitamins or cutting down on fats. We can do it!

If we don’t do it, it means dead wallabies. Those are awful cute. Dead fish, which make the lake look gross. We’ll lose biodiversity, meaning that we’ll have fewer kinds of plants and animals, but more of each kind. And this is bad because… because eventually it gets away from you, and nothing can live anymore. We may have already passed the point of no return.

Hunks of glacier falling into the ocean, which makes the oceans rise. Fast. Didn’t you see the movie? Hurricanes, floods, tsunamis, all killing people and showing up on the news. That’s what will happen if we don’t reduce our carbon emissions now.


The opposite is true. Kyoto-style changes are going to cost you personally a bundle. Just because it’s not visible, like gas prices or an ATM fee, doesn’t mean it’s not real. It will be the better job you’ll never get, the lack of opportunity - which encourages your kids to move away, the year of college that you had to take on in debt, the fewer times you travel to see your grandkids. And the drastic environmental consequences you imagine aren’t going to happen. Aren’t going to happen because of carbon emissions, that is.


The GWOT, now, those costs actually are being borne by only a few. The cost to you actually is more like an ATM fee. It’s soldiers and their families that are paying the price. The cost to the US in citizen’s lives is not only a high cost, but a highly visible cost. Airport security delays are highly visible. (Phone surveillance can be made to seem highly visible, conjuring images of some creepy guy listening to your wife’s calls.) Also, the big numbers of dollars that fly across the page, the cumulative total of four years of war, that makes us nervous. We were spending about half that keeping Iraq contained anyway. Because it’s money spent, rather than money never made, we think of it as real money instead of pretend money, and of money in one lump sum instead of spread out over time. It’s an understandable error; but it’s still an error. If it’s that hard to imagine, try picturing yourself without a job, or one of your kids without a job. Money not made is real money.

Tuesday, May 30, 2006

Diversity Training

In previous years we had hospital-wide training on back safety, confidentiality, and infection control, so I suppose it was only a matter of time before we would all get herded in to conference rooms in groups of 20-30 for political training.

Sensitivity to foreign cultures is fine, but that’s not where our problem is. People who go into mental health have generic liberal prejudices. We are more likely to be fascinated by foreign cultures than disapproving. I grant that the fascination is often na├»ve and can be condescending. But for ill-disguised contempt, nothing beats our attitudes to certain American groups.

Diversity training was done in PowerPoint, of course. A woman from Colombia opened by lecturing us in Spanish, illustrating to us that we don’t speak Spanish and she does. Perhaps it’s news to some folks that when you don’t speak a language, you have trouble understanding what others are saying, but I thought I had that idea down pretty well already. Ironically, Gisella’s Spanish is now a bit hesitant, as she has been in the US for 40 years. She shared her “personal story.”

Next there was a short cartoon of a wombat who explained to us that we’re all in this together because there’s only one planet. Trees, insects, rocks, cute kids in may hues, it’s all together, y’know? All one. Diversity training seemed to be suddenly veering off into environmental and religious instruction when we were quickly returned (whew!) to Cambodian folk medicine. Not that this will help you understand Ghanian or even Thai folk medicine when you encounter it, but it’s definitely cool, and not to be despised. Got that, you bigoted buffoons? Maybe the wombat wasn’t so bad after all.

I noted to the diversity instructor that translators often bring problems of their own, because they are often drawn from a different class in society. Translating gives them one of their few remaining opportunities to exercise their old hatreds, as friends of ours found when they tried to get accurate school testing for their new Romanian gypsy daughter. My suggestion was unwelcome. Translators are the chosen solution.

To psychologists and social workers, it's hunters who are suspect. No one comes right out and says that, of course, but the sudden seriousness of murmur and catch in the voice is unmistakable. “There are guns in the house,” or “he owns a gun.” That’s a reasonable concern if the person has threatened violence or suicide, but it’s also used as code-speak for possible wife-beater, limited coping skills. “Isn’t there something we can do to get the guns out of the house?” “We should ask the wife if she feels safe.”

Threatening actual violence to a president is a mixed bag. If you just smash paintings in the gallery of college presidents because you think they’re George Bush and Pat Robertson, all you will draw is covered smirks. Even if you wave a knife around later. At least, that’s what happened here last week. Laughingly suggest it would be a good idea to shoot Bush and Cheney? That won’t raise any red flags – just jokes that my colleagues thought were out of my hearing. Trying to run into the Bush motorcade with your car? Are we sure she’s crazy? Ha ha. Some of us wish she’d succeeded. Ha ha. I’ve been here long enough to recall how seriously comments about Clinton were taken. I remember the quiet declarations then: I’m very uncomfortable letting this person back onto the streets.

It’s not only PC prejudices, of course. Clinicians try not to obviously stereotype gay couples, but they do covertly. Gay therapists seem especially hard on the transgendered. It’s not always easy to see the difference between “understanding gay/Sudanese/reservation/urban black culture” and “stereotyping gays/Sudanese/Navajos/urban blacks.” There is an interesting dynamic with the prejudices of the line staff, however. Your diagnosis, and thus how insulting and difficult to manage you are, will be a much bigger issue than whether you are rich, poor, gay, straight, or what color you are. They might tie your pathology to your group memberships and say the most impolitic things about you, but if you are pleasant and polite they will turn around next day and see your sociopolitical status as a positive: He’s just a sweet old gay guy, but that bothers his neighbors so they’re harassing him. The exception to this would be a child molester. Your politeness will only make people more nervous then.

But hey, back to the training, what? Slide 15: Immigrants come from many places. Slide 16: Not all Hispanic dialects are the same.

There are bigotry buttons you can press all day in the psych biz, and no one will raise a brow. Some kinds of diversity are not to be celebrated, and no one creates animations with wombats and cute kids to make sure you’re treated well.

The military is a place for people who “need a certain amount of structure.” As opposed to say, lawyers and university professors, right?

Serious Catholics are “rigid” but find “comfort” in their faith. (They probably also have hidden sexual issues.) Unlike those of us who work for large government social service bureaucracies.

People from states which voted 51-49 red are less educated and more violent than people who came from states which went 51-49 blue.

For more of the same, see my earlier post on multicultural tips for human services.

Monday, May 29, 2006

More World Cup Info (for you ungrateful clowns)

You've already shown you aren't interested in the preliminaries designed to reduce the 32 remaining teams to 16. But if you have any national feeling at all, you have to be alert to the draw for the US team. We have the most difficult draw of any team in the tournament. We are in the only group of four which has 3 excellent teams (France and Spain, in contrast, should walk through to the round of 16), and if we finish second in that group (very possible, as the Czechs are #2 in the world), we will be rewarded by playing Brazil, #1 in the world, in the next round.

Technically, I suppose, you could say the Italians have a tougher draw because they have to play the US, ranked anywhere from #5-9 in the world, as well as the Czechs and Brazilians.

The Czech Republic has some injuries. That might help us squeeze by.

Sunday, May 28, 2006

Girl Names, Boy Names

Names given to boys have been more stable over time. Michael became the most popular name for boys over fifty years ago, and has been #1 most years since. David supplanted it for a few years in the 1960's and Jacob has pushed it into 2nd in the 21st C, but that's a very long run. In that time, Mary, Lisa, and Jennifer have each enjoyed runs of about 10-15 years atop the list. None of these have even been in the top 10 since 1992, when Jessica rose to the top, quickly replaced by Emily.

My son Benjamin, looking over the lists from the 1940's, commented that people still do name their sons James, Robert, John, William, Richard, David, Thomas, and even Charles, though most of those names are gone from the top 10 lists; but no one is naming their girls Barbara, Patricia, Carol, Judith, Betty, Nancy, or Linda.

Debra and Deborah fairly scream "born in the 50's!"

Boys' names start to show more rapid turnover in the late 1980's. With the exception of the addition of Joshua and Justin, the others on the1990 list would not have seemed odd to people in the 1930's: Michael, Christopher, Matthew, David, Daniel, Andrew, Joseph, and James. At that point the rapid change starts, with Nicholas, Brandon, Ryan, Zachary, Jacob, and Austin jumping in.

The girls' names were already in 70% turnover per decade by the late 60's and are now up to almost 80% turnover. Only Samantha and Ashley remain from the 1995 list. For those who haven't been keeping up with this, Emma, Madison, Olivia, Isabella, and Hannah are now the fashionable names. I knew only one Hannah growing up: Hannah Handler, the rabbi's daughter, on whom I had a crush in 4th grade.

Do we regard "decorating" our daughters with avant garde names more important? If there is a stereotype, which way does it flow? Is it a positive that we work so hard to find something special for the girls, while boys can just be given any regular ol' name? Or is this specialness a sort of frilly unseriousness about females?

And hey, why do girls get to keep stealing boys' names, rendering them useless to guys forever?

Thursday, May 25, 2006

Reprise of the Psychbloggers

I read so many things worth saving, but can't take on the weight of the world with that. I'm not really a link-site sorta guy. But I thought I could reprise some comments from other psychbloggers, helping their ideas resist the long twilight of digital storage.

Actually, that they will be stored at all, to be absorbed in seconds by robots smarter than us in 2040 after the Singularity, is a better fate than most thinkers have had before the 21st C. But until then, we poor humans must do the work ourselves, sharing wisdom as we find it. The following articles are buried in psychblogger archives but have stayed with me and seem worth exhuming.

Gagdad Bob over at OneCosmos had an analysis of the liberal ghost dance that I found truly original and provoking.

Dr. Sanity plays on the themes of defense mechanisms as they relate to groups quite often, and is impossible to summarise on that. But her analysis (she tag-teamed nicely with neo-neocon on this) of shame and guilt cultures is an excellent introduction to her thought.

Neo-neocon writes thoughtfully and wisely on a wide range of subjects, and her commenters are often worth reading as well. I chose her series on the varieties of pacifism as particularly good, and I liked her thoughts on why therapists tend to be liberal.

Shrinkette tends to be a link site, so I don't have anything special from her, but she finds things no one else does and is always interesting. GM's Corner and Sigmund, Carl, and Alfred also link heavily, but I have kept the former's reflections on cancer and the latter's psychiatrist's observations on a meeting both stuck in the memory.

Shrinkwrapped tends to have continuity of subject without being repetitive. The series on Narcissism, Malignant Narcissism, and Paranoia was particularly good.

OK So I'm Not Really A Cowboy is new, I think, and trying to start up a Carnival of Psychbloggers. I'm not going to single anything of his out, as I've only been reading him a few days. Smart and funny.

Dr. Helen doesn't need any help from me, right?

You can touch down anywhere in my archives and become rapidly wise, of course. It's a natural talent I have.

Welcome To The Coliseum

Watergate was a fox-and-hounds story and had a nice linear plot that people could follow. That oversimplification was never true, of course. There were legitimate constitutional and separation of powers issues, and the usual horde of folks angling how they could advance their careers in the confusion. But these rapidly became entirely secondary to the main chase. We are used to these sorts of political narratives – Ham Jordan, Oliver North, Clarence Thomas, Newt Gingrich, Bill Clinton. Buy a program, root for your side, but the story line remained linear. Like a good crime thriller, there might be false trails and entertaining side plots, but the good Aristotelean unity remained.

In retrospect, the linearity was already fraying with the Gingrich and Clinton episodes, but only in the 21st C has the dynamic changed sufficiently that we need a new sports metaphor. It is not just the Democrats and Republicans taking turns at fox-and-hounds. The Department of Justice battles the Congress. CIA competes with State to undermine the FBI conspiring with the NSA against the DoD, and each agency has internal factions as well. It is now the Coliseum, with bears, dogs, lions, wolves, and men all thrown in together, an unclear melee with unclear plot. Ashcroft wanted to reform INS, Rumsfeld wants to remake the Pentagon, Condi Rice wants to get the State department to carry out American policy rather than override it, and all of this plays out in front of us.

Plays out in front of us. That is the difference. That is the Alvin Toffler Future Shock adjustment that we are making. The new media not only reveals the subterranean struggles which have always been present in these events, but changes them as well. The moves and countermoves between parties, branches, and agencies used to take place in measured time. Now the scandals and accusations ebb and flow so quickly that reaction time has become part of the battle. We the spectators influence events with our roars and judgements.

What we are seeing in Washington in the last few months is a sort of information anarchy. Have we won or lost the war, or are we still plodding? Is illegal immigration an emergency or a long-term advantage? Is the congress defending the constitution or covering its butt? Is the president intruding on our liberties or just fighting the war? We have always wanted to know the answers to these questions, but in 2006 we want to know the answers now. Because the answer to the first question influences our response to the fourth question, which helps us answer the second and third. There is no longer time to let an answer settle down before we respond. The spinmeisters used to worry about changing peoples’ minds; now they just manage impressions temporarily.

An agency or politician with a scandal used to hope to ride it out, deflecting attention until the news cycle tired of the story. If the spotlight shifted to another circus ring in time, they could briefly hide, lick wounds, and heal. Now the light is never completely off. The spotlight switches rings more rapidly, but darkness no longer provides cover. The lights can come up full again at any moment.

Playing Defense Against Your Children

Your children are trying to become evil. Whatever else is part of the package of Original Sin, selfishness is hardwired. Our attempts to raise children as responsible members of society and fulfilled children of God looks a lot like playing a team sport against them. Metaphors don’t usually provide any spectacular insight, but they do make ideas easy to remember in moments of stress. Plus, guys like to reduce everything to sports metaphors.

To be technically correct, you are playing against the forces of barbarism and evil as they present in your children, with scoring on offense being like “putting good things into your children,” but that makes for an overcomplicated metaphor. Also, it doesn’t feel like that day-to-day. On the front lines, parenting is a lot like basketball defense against children who are attempting score by doing something they shouldn’t.

You can go for the full-court press, a smothering, in-your-face approach designed to keep your children as contained and as far from the basket as far as possible. It’s great, but it’s wearing. Worse, just as in basketball, once they learn to beat the press (usually involving deft passes to siblings and friends) you are wide open. You had better have something else you can do, saving the press for special occasions.

You can play a soft zone, leaving your child enormous room to maneuver so long as they don’t get easy shots (a private door to the outside, as I had in highschool, would be an easy shot). Playing a physical defense with spankings and intimidation is fine, but it’s easy to get carried away and start fouling – and you really don’t want to foul out, Jack. Or you can concentrate on interceptions and rebounding and surprise your children in fast-break transition. That’ll teach the little bastards to get cocky.

Your personal failings are like scoring on your own team. Doofus.

Personally, I prefer the half-court trap, lulling your children into a false sense of security and then unloading the double-team on them. But the actual point of this entire metaphor is that you need them all at various times. No one type of defense works forever.

Wednesday, May 24, 2006

That 60's Theology

Almost 20% of the faculty at Boston College has signed a letter by two theology professors protesting that institution granting of an honorary degree to Condi Rice. An excellent summary of the issue by Anil Adyanthaya is here.

Because Dr. Rice is one of the architects of an "unjust war," and her article in 2000 in Foreign Affairs, the professors believe that her ideas are incompatible with Catholic and Jesuit thought, and should not be thus exalted.

Let me guess. Their step-by-step through the Just War doctrine specifies the UN as the legitimate authority. Yes, I believe it was Athanasius, or perhaps Anselm who specified that the legitimate authority was a collection of the governments of many nations, regardless of their individual moral authority. No other answer is possible.

I have commented previously on the holiness that the American left assigns to transnationalism. Because the Church is transnational, it must follow, as the night does the day, that transnational groups are holier than the merely national. To seek America's best interest is necessarily flawed; universal interest must dictate our affairs.

I am curious whether the professors apply that principle more universally. They are educators, and their job is to educate the young. But if BC recruits a professor from a larger school, isn't BC's educational excellence achieved at the expense of the larger world? If BC accepts talented students, are they not stealing them from Brandeis? The idea that a person might be assigned by God to protect a certain interest or group of people seems incompatible with the professors' contention.

That 70's Show

Hillary Clinton gave a major energy speech before the National Press Club and promises a major energy proposal shortly. Her solutions:

Okay, before we get to that, is there anyone who didn't guess her solutions beforehand? Conservation, of the "if everyone gave one used bicycle tire per week, no kitties would ever die" variety. Research, of the unspecified alternative energy type. And leadership, of the not-what-George-Bush-is-doing variety, to definitely include sticking it to the auto industry and the oil companies.

She was right on target with these, with a speech that reads like a Mother Earth News editorial from 1978. But there are cute additions that I think you should know about. She thinks there should be signs at every gas station reminding you to check the air in your tires. 55 mph "where people would support it." Eliminating drafts around doors and windows. Reasearch now avoids the scientific-sounding but unknown "geothermal" and replaces it with the scientific-sounding but unknown "biomass." The leadership involves Bush sitting down with the automakers, oil companies, as well as both the public and private sectors, presumably to make everyone straighten up and fly right.

But wait, there's more! The Clinton energy plan now comes with ethanol! And not just any ethanol, Binky, but cellulosic ethanol. How many of you think Hillary Clinton knew the word "cellulosic" before this energy speech was planned? I don't want to keep seeing the same hands here. It's a wonk word, inserted to show that she has really, really thought about these issues, people. Not like the other candi- that is, public servants.

This degree of understanding would not win a ribbon at a middle school science fair, even with "cellulosic" sprinkled on every stapled-up poster.

Tuesday, May 23, 2006

Explaining the Law to Lawyers

It used to be rather amusing, when some attorney acting out of specialty or out of state advocating on behalf of one of my patients would insist that the hospital should take a particular action – usually to let the person go. “But he’s being held there against his will.” Yes, almost all our patients come here against their will; this is not a new concept to me after thirty years. “She has a right to hire whatever attorney she wants. She doesn’t have to accept counsel appointed by the state.” Yes, that’s true. But if it were me, I’d prefer the court-appointed attorneys who can do these hearings in their sleep. “He has the right to refuse treatment.” Yes, and we then have the right to hold him here as a danger to society. What’s your point, counselor?

I am certainly much their inferior in general questions of law. Rules of evidence? I'm guessing. Required procedure for submission? No clue. But mental health law in NH? Unless you're one of a dozen attorneys in the state (and I know you're not, clown), don't try to explain it to me. It's how I earn my daily bread.

Even I was never quite this snippy in my answers, though I was often tempted. Yet this mean pleasure does get old after awhile. New probable cause judges try the same tired things, which we let go for a few times if it doesn’t affect the patient, dropping hints or trying to explain. Very occasionally, we have to become more blunt. “That interpretation has been tried. It was overturned in 1991 in the Taylor decision.” It’s not that these legal minds are trying to sell bad ideas. These are usually reasonable approaches on first look. But laws overlap and contradict each other, and have to be sorted out on appeal. We shouldn’t have to keep going over it, unless someone’s got a new angle.

An unfair rule of thumb: the more angry and intimidating an attorney becomes about a broad principle, the less likely it is that s/he will prove correct in the end. (A friend who is a hearings officer tells me that the phrase “fundamental fairness” usually telegraphs that the attorney has no real case according to the statute.) The attorney can often make political points along the way, in both local and national cases. Institutions, corporations, or powerful individuals can be accused and made to look guilty. When the case is lost, accusers can complain that the defendants were let off “on a technicality,” or it can be hinted that they were favored in some unfair way. Such things happen, of course, especially if you’re a Kennedy in Massachusetts. But it’s good to have your antennae up and twitching. Sometimes the technicality is that there’s no hard evidence, and what you read in the papers was less than half the story.

Treatment of Sex Offenders - Important Side Issue

Team treatment of sexual offenders has advantages. Contrary to popular opinion, they are not all the same. While the various attempts to categorize them are not always in accord, it doesn’t take long in the field to learn that Charlie and Sam, accused of the same crime, are wildly different.

The threads of evasiveness, dishonesty, and reframing are quite consistent, however. It may be difficult to tease out whether the offender is lying to himself; there may not even be a clear answer to that. But however it is spun, the web of ambiguity will be there, like the plot of a spy novel with its red herrings, double-checks, and reversals. The first obstacle is getting clear, verifiable information. Rumors spring up and will not die. The victim was a fifteen and a half year old prostitute who accused him to get herself out of trouble. He intimidated little boys so effectively that none would testify. He was stalking his ex-wife. He has fantasies of torturing and killing people. He’s not dangerous, he just steals women’s underwear and it creeps them out. The offender is often a walking Rorschach test, a screen that the staff can use to display their general opinions.

Tangent: For those who enjoy a good paranoid fantasy, this is fertile ground. To be wrongly accused of a sexual crime would be an enormous Catch-22: the more harmless and normal you tried to appear, the more frightening you would become. Imagining yourself in any of the supporting roles of therapist, attorney, or family are other scripts that can be written in a variety of entertaining ways.

Back on topic: No matter how experienced and self-examining the individual clinician is, the need to irrationally believe, or irrationally disbelieve the occasional patient is very strong. If the patient has an Axis II disorder, the various rescuings and punishings of him by others complicates this further. A man who shows more-than-average contempt for women will be perceved as more dangerous (not without reason). A female offender will elicit intensified reaction for both rescue and punishment. The most cynical, I-think-they’re-all-lying-scum psych nurses* will inexplicably choose some one patient who they believe is being railroaded and misjudged. We are all susceptible to this, and I suspect some underlying need among human beings that prevents us from disbelieving everyone. There is a skepticism fatigue which lies in wait for us all.

*Not to pick on them in particular, though it may not be accidental that I imagined a psych nurse in that slot. I am also notoriously skeptical, but broaden it to the whole cast of characters. I don’t believe the husband, I don’t believe the wife; I don’t believe the victim, I don’t believe the accused. Nor do I disbelieve them. Yet even I get sucked in.

Monday, May 22, 2006

Reverse Immigration Speculation

Look, it's not like Texas and California are our favorite states, right?

If we give the four southwestern states to Mexico, we will essentially be giving Mexico to our four southwestern states, after a serious drop of two decades of the standard of living in those areas. The 66 million in those states will quickly dominate Mexico's politics. The new nation as a whole will suddenly be the 3rd or 4th largest economy in the world.

Our own national politics will not be unbalanced: we will lose four Republican senators, three Democratic senators, and John McCain. Purplish-red Texas will be offset by purplish-blue California. They should have Mexico's corrupt government up to at least Louisiana standards in twenty years.

Redesigning the flag would not be a problem: four rows of 7, three rows of 6 stars. No need to change the national anthem or America the Beautiful, though we'd have to rework This Land Is Your Land.

All the liberals will no longer have to be bothered by living in a hegemon, the conservatives can take over that huge pile of oil in the Carribean without American fish-huggers interfering.

True, the level of college football will fall off considerably, but that can be rebuilt.

Long Life, Again

I am discovering that the main advocates for living indefinitely seem to all come from small families. That figures. Perhaps the Roman Catholic discomfort at the goosing of human cells and tissues in efforts to extend life is less theological than it is practical experience.

Fr. Patrick: Sure and didn't I tell ye that another fahrty yares wi' your sister would be more than a reasonable soul could bear, Mary? But ye wouldn' listen naow, would ye? So here's both o' ye' wi' new hearts and livers and lookin' to live another fahrty. Fortunately for me, I'll be dyin' soon and be listenin' t' angels instead o' the likes o' the two of ye'.

Brain Links

MIT's Technology Review includes several articles of interest to the psych-interested.

Brain Nanotech and two biotech
articles. The last one discusses implantable devices for long-term medication delivery. What a blessing that would be for our patients.

How Things Look

In several current debates, a disguised form of the argument “But it looks bad” has been surfacing. In the discussion of building a border fence, concerns have been raised about the “message” that it sends, or how sad it is that such a structure symbolizes our relationship with Mexico - thank you Senator Durbin. My worry is whether it will do any good. That seems to me more important than how it looks.

Over at even the more reasonable liberal blogs, the Gitmo detainees and the supposed secret prisons are cause celebre more for appearances than substantive evidence. They are held without trial, or as Pooh might say, The Wrong Sort Of Trial, or they are not allowed to speak to journalists at Gitmo, so naturally the assumption is we must be mistreating them. No, it’s worse than that. We must be torturing them. The secret prisons, if they exist at all, are “in countries which routinely use torture.” But that evades the question of whther they remain under American supervision, and whether they actually are being mistreated. The transfer may be simply a psychological ploy. The stories themselves may be simply a psychological ploy.

But the test as to whether this is torture is very simple. Offer the hypothetical reasonable man a choice. You can be detained by Americans in Romania for an indeterminate length of time or you can be thrown in a shredder. You can be sent to solitary confinement for trying to contact a visiting journalist or the women in your family can be raped in front of you. Gee, that’s an awful tough choice, right?

The lawyerly mind seems to consider not having a hearing or not being able to talk to a journalist to be among the worst of evils. I fully admit it looks bad. I willingly grant that various abuses could be disguised in these ways. US courts may rule that these were inappropriate interventions. It may even turn out detainees were mistreated, and that people should be punished for that. But it’s just not the same thing. How it looks is only a minor point. How it is is what’s important.

I saw a recent photo of George Bush. He looks stupid. The particular expression they caught makes him look fish-faced. This sort of thing apparently bothers some people no end. They feel badly represented to the world by such a figure. Well, get over it. It doesn’t matter.

Thursday, May 18, 2006

Labora est Ora, Ora est Labora

The young man’s idea is that being a seeker after truth is work, a ruthless intellectual endeavor, wrestling with the great eternal issues. After the struggle, a greater calm and self-assurance is supposed to set in. Not that spiritual inquiry is abandoned of course, for one is supposed to be ever ready to resume the quest (fearless, dauntless, facing the world…oh, you know the Don Quixote/Galahad/Skywalker image, right?).

The opposite may be truer. It is worship that is work, seeking that is the hobby. We visited a seeker-friendly church while traveling last week, a true exemplar of Gospel Lite. The music was modern, heavily arranged, well done for what it is. The preacher was affable, unthreatening, mildly humorous, putting forward some ideas about the big picture of life, and how God might fit into that. Such churches often have much more solid work done behind the scenes in their various ministries and small groups, and I don’t begrudge them their different style. But I was struck with how watered-down and easy-to-swallow it all was. The last song was not actually a worship song, but the recent country hit “I Hope You Dance,” which is thought- provoking only in the Today is the first day of the rest of your life school of philosophy.

Not all seekers fit the seeker-church mold, certainly, and I’m sure that there are some few who agonize over the issues just as the myth dictates. But I suspect that the proper synonym for seeking is not "wrestling," but "dabbling." The people I have known going through crises of faith and grand searches after wisdom (including myself at times) have not really wrestled with angels, but with their own reflections. They may be as tired, confused, and miserable as people doing real wrestling, but there’s not a lot of goin’ on going on.

The mask came off “seeking” because of news we received during the service. My wife had forgotten to turn off her cell, which rang just as a song was starting. She was immediately and clearly upset, and I expected that one of our elderly friends or relatives had died – it was clearly a death, or they wouldn’t have called during likely worship time on Sunday morning. But it was more a more shocking and unjust death: an almost 20 year old we have known since he was a baby. I passed the word down along the line of my sons and daughter-in-law, “Adam Bishop is dead.”

Any event, even weekly worship, might seem suddenly superficial in the wake of such news. The death of a young man and the placid proceding of the rest of the world are so incompatible that each seems unreal in turn. But the complete inadequacy of seeker worship was painfully apparent. We requested a room for the family to pray separately in, and they obliged by adding in a pleasant woman who didn’t quite grasp what was going on and wanted to lead the prayer. I think she’s used to doing altar call followups or something. I expect she found us as jarring as we did her.

I missed and needed worship; worship that required preparing, cutting and chewing and digesting, not merely something that slides down like ice cream. Labora est Ora is a motto of the Benedictines (though Benedict didn’t actually say it) “Work is prayer.” Better to reverse that, I think. Ora est Labora, “prayer is work.”

Thursday, May 11, 2006

The Pressure Is On

I will be gone for a week bringing Benjamin back from Kentucky. Everyone write something intelligent while I'm gone, y'hear?

Monday, May 08, 2006

NH Primary

The NH Primary vote is in February 2008. We used to expect candidates to show up about a year before the primary, but it's been creeping backward. So far John McCain has already visited, and I'm sure there are others under the radar, pretending that they just happened by to address the Chamber of Commerce in Warner or Woodstock. Shazzam! Is there a primary here? Well Golleee!

We took the older boys around to the speeches as part of their education when they were younger. Jonathan got to interview Dick Lugar and ask Bob Kerrey a question; Ben got to talk to George Bush and get his autograph. They were both impressed with the Secret Service agents at the free dinner sponsored by Al Gore in '88. The two Romanians are going to miss that experience somewhat. They arrived in 2001 (we celebrate their fifth anniversary here later this month), and in 2004 there was not a lot happening in the Republican primary. The educational experience of watching the Democrats did not appeal to Chris and John-Adrian. Their Romanian background makes them intensely anti-socialist, very pro-life, and pro-military for getting rid of bad guys, so they make me look like Howard Dean by comparison.

Not only have the midterm elections not occurred, the opposition candidates have not announced (In NH, Congressmen Bass and Bradley are moderate Republicans in a state that is slowly becoming Blue). But I expect the Presidential candidates to start showing up with increasing frequency. I might take on attendance at campaign events as a blogging responsibility. In the army of Davids, I actually am a David.

Step On A Crack

Step on a crack, break your mother’s back. It was a game we played as children, and I remember wondering whether the spaces between blocks counted as cracks. I never believed Mom would come to any harm, and don’t know anyone who did – just one of those mild superstitions. Once you had started, however, it was a problem stopping. Even if you didn’t believe there was any direct connection between misstepping on concrete and your mother’s spinal column, actually landing on a crack carried the suggestion that you didn’t care if it did. You, vicious child, were unwilling to make this tiny sacrifice for your Mummy. In front of God and everybody you were declaring that it was perfectly all right with you if she ended up in the hospital on your account. What had started as an amusement took on deep psychological significance, ripe with opportunities for guilt, parentification, revenge, and abandonment fears.

I wonder if something like this drives socialism. Mounds of data which indicate that when nations trade, both benefit, or long depressing observation of poor countries with abundant resources remaining poor because of socialist policies do not seem to dent the socialist mentality. To turn off the spigot of government solution would look as if we didn’t care what happens to the poor. Socialism makes a statement about ourselves that we like, regardless of the practical effect. I suspect this superstition of kindness is a motivator, not because I think leftists are necessarily self-serving, but because they leap so quickly to the accusation themselves. Any free-market proposal brings forth howls that the plutocrats are abandoning the poor, and the rich manipulating the system solely for their own gain. If they think it so readily about others, they must fear it in themselves. Stepping carefully shows that they really care about their mothers. Not like you, you heedless and ungrateful child.

What happens with most children is that they step on cracks through carelessness, clumsiness, or ceasing to play, and return home to find mother in excellent spirits and health. A few repetitions of this, and they can let the whole matter go as just a game. Still, a twinge might still arise the next time the phrase occurs to them. Of course it’s silly, but why take the chance?* Worse, it will eventually occur to them: there are mothers whose backs are broken. Their children must have stepped on a crack sometime in their lives. Could it be…nah! But what if?

Even in rich, free-market countries there are poor people. Does that mean some capitalist stepped on a crack, driving them to destitution? It is an article of faith that one person’s wealth is related to another’s poverty, but I don’t think that connection is established in reality.




*Collect enough of these little rituals you can’t drop, or have some very intense ones, and you have obsessive-compulsive disorder, or OCD. It is now classified as an anxiety disorder; the repetitions and incantations are seen as attempts to bind anxiety. They are often things that do have a meaning or connection with reality, but have gone beyond rationality. It is good to recheck the locks when you leave the house, good to wash your hands, good to make your letters carefully. Checking the locks 5 times is a bit much.

Real World

Benjamin graduates from Asbury College this Sunday. It is traditional at graduation for someone to make snide comments about entering the “real world.” Of course, whatever you do in life, someone will tell you it’s not the Real World. My in-laws complained years ago about a new priest who didn’t have much real world experience. He had previously been running a Korean orphanage. Sounds pretty real to me. I work at a psychiatric hospital, and am paid by the taxpayers via the State of NH. Is that the real world? Dunno.

Those guys in the military, who supposedly need to be told what to do and have trouble adjusting to the real world, or teachers and professors who spend their days with the young, or at-home moms who don’t get out much – I guess that’s not the real world either. If you work off-shifts and sleep when other people are up, or spend most of your day at a computer screen, how real is that? If you trade commodities but never see any actual oil or wheat, then you are clearly not connected to the “real” world. Ministers, retirees, entertainers and athletes, wealthy people, those on wlefare – pretty much everyone, I guess.

The guys at Home Depot – I think they may be real

Friday, May 05, 2006

Emotional versus Actual Content.

A "Far Side" cartoon showed two identical panels of a man complaining at his dog, with only the word balloons different. In the left panel, the man was explaining to “Ginger” exactly what had upset him. The balloon in the right panel, representing what the dog was hearing, said “Blah, blah, blah, GINGER, blah, GINGER. Blah, blah, GINGER, blah, blah.”

The emotional content of a statement can overwhelm the actual meaning of the words. CS Lewis noted in The Screwtape Letters what fun the devil can have with this, getting people to use tones of voice for maximum damage, then backpedalling to the blandest content when challenged. “All I asked was what time dinner would be ready.” We can all imagine the symphony of ways that innocent question could be said which would be insulting.

Some of us are very insistent that the simple word meanings be regarded as the foundation on which all other meanings are only additions. This is particularly true in any abstract discussion. If you want to communicate volumes with catchphrases, sounds, and lifts of the eyebrow, save it for private conversation. In public discourse, the accepted meanings of words are all we can refer back to. We can suggest but not recreate tones of voice on the page, and even video can leave out important context.

I find when conservatives are accused of inflammatory or even hate speech, it usually traces back to this phenomenon of mis-hearing. I have read the complaint that Limbaugh accuses the left of treason, and of being on bin Laden’s side in the WOT. Well, listen louder. I think people are hearing “Blah, blah LIBERALS, blah, blah TREASON, blah, GINGER, blah,” and believing they know what is being said. But when you track down the actual quote, with a minute or so of the context before and after, something different is being said. I catch a few minutes a day of Rush at lunchtime going back to 1988, and occasionally have been able to listen for longer stretches. What is much more likely is that he will quote Osama, then quote Ted Kennedy or Howard Dean, and note the similarities between the statements. He will then play on this theme for several minutes, taking phrases apart, referring back to earlier statements by either, and sum it up several times. “the Democrats and bin Laden are saying the same thing about America. Both are saying that it’s our own fault. You people have got to understand, they are not on our side.”

That’s a conclusion that can be argued with, if you like. You can make distinctions that agreeing with A does necessarily imply agreeing with B, or that the host is overinterpreting. But the statement, though alarming, could be defended and evidence has been offered. Making the counteraccusation that Hannity or Coulter say that liberals are traitors is a misrepresentation.

Thursday, May 04, 2006

American Productivity

I waited in line at 12:03 pm at the cafeteria at work. I hadn't thought that the order of a plain hamburger would be that confusing, but there was a lot of wasted motion behind the counter. "12 Noon seems to catch George by surprize every day" I murmured to the person in front of me in line. The person in front turned and told an amusing story about waiting an hour for a pizza. In Rome. When the pizza was pre-made.

It reminded me of long waits for service in Romania and Hungary, and even, come to think of it, in England, Ireland, and the airport in Frankfurt. Contrast this with the service that barely-supervised highschool kids give you at McDonald's. It was the efficient-under-pressure fast food service that I had automatically compared George to, not to George's advantage.

McDonald's is a cultural synomym for low-talent, bottom end job in America. "You want fries with that?" But notice when traveling abroad how few people can manage that level of efficiency. They seem to do just fine when they immigrate here, but it just isn't happening there. These are the countries whose students are supposedly walloping ours in every competition. If that's the case, why are they unable grill two different sandwiches simultaneously?

I have wondered on this site before how, if our education system is so bad, we keep so far ahead of the rest of the world? People in other places work much harder, but get less accomplished. Productivity is the term used in economics. Japanese productivity in technical and industrial areas approaches or exceeds ours. In service industries, they are far behind. There are islands of efficient information exchange outside of North America (sorry to have excluded the Canadians thus far. Them too), but no one has so many people moving helpful info into the hands of people who need it.

Americans have a gift for spontaneous organization. So what if our pumpkin-headed teenagers forget where Costa Rica is fifteen minutes after the quiz? They can figure out how to get two kids to work, one back from school, and everyone to Emily's house from 8-12 with two cars and little gas. They can figure out that someone needs to move from stocking to bagging for a few minutes. They take awhile to notice and respond, but they get there. Try that in Romania. You will time them with a calendar, not a wristwatch.

Favored stories: I first visited Romania in 1998 or a mission trip. We had
less than two hours to shop in Oradea at the end of the trip, and I had a mission to get to the museum before it closed. We arrived in the van at 2pm and got coffee at the McDonald's on the bottom floor of a shopping center (a shopping center with few things for sale, BTW. Better now). The Romanians began a discussion of where and when we should meet to return. In my head, this was already automatic reasoning: We all know where this place is. Meet back here. We have to be back by five, it's an hour's drive. Allow an extra half hour, everyone meet here at 3:30. Ten minutes later, the Romanians are still discussing the matter. "When Dani comes, maybe she will want to go shopping with the women." "Andrei's church doesn't meet until 7pm. We will already be gone by then." I thought The
average American fifth-grader is more organized than this.
These were intelligent people, but wasted effort doesn't seem to bother them as it does Americans.

In 2001 I visited Chris and J-A just after our permission to adopt came through. John-Adrian's soccer team traveled to Oradea to represent Beius in a tournament on a Saturday morning. I followed the team in a rented car. We got to the field early, but no one was there. The teacher/coach talked to some people, and we drove to another field. No one there either. Finally he talked to someone on his cell and we searched for a third field. We got there late, but three other teams had still not arrived. The coach tried to register the team, but was not allowed - he was supposed to bring everyone's birth certificate. Much complaining and gesticulating followed. The team was allowed to play one exhibition game. Another team had forgotten their birth certs and played an exhibition as well. One team never showed up.

On the way back, the police stopped the coach, discovering that he had not registered his car for six months, nor renewed his license. He had also been letting the boys have drinks as a consolation, but no one worried about that. Eighth grade? No problem.

Five years in America, our boys organize things like Americans. It's not an intelligence issue. But while cursing your wait in line next time, remember that it would be worse anywhere else.

Wednesday, May 03, 2006

Early MH Tx

Not everyone will have an interest in a museum of early mental health treatment. But for those few…The Public Hospital in Colonial Williamsburg in Virginia is a restored replica of the first mental health hospital in America, built in 1773. I was in school in Williamsburg when the museum was still just a room at Eastern State with evil-looking tools for various reworkings of your skull, so the restored building is of some interest to me.

There had been a sharp increase in the number of asylums in England from 1650 onward (especially after the Great Fire of London), but the idea came later to the colonies. Depending on the prevailing culture of each colony the mentally ill were classified with either the poor or the criminals and treated accordingly.

The historical record can be stretched to prove whatever point you like. If you wish to emphasize how enlightened early treatment was compared to treatment from 1850-1950, you can emphasize the spacious gardens and good food required by law in most places, and the frequent mention in official records of the need for quiet and reflection. “…officials such as be charged with the maintenance of the hospital shall endeavor to find congenial work for those in their care” is not far different from the current growing emphasis on creative vocational services. Legislatures and magistrates insisted on kindly treatment.

But if you want to show how barbaric were the times and how deep the aversion to the mentally ill, there is ample evidence for that as well. Bloodletting and purging were common treatments for any illness; most medicines in use were either without effect or mildly poisonous; food could be sparse or ruined; shackling was common and confinement lengthy. Lawmakers might insist, but towns and counties often ignored the law.

You can also find echoes of your favorite modern theory among the ideas in vogue from 1600-1800. Some insisted that all problems were the result of brain and nervous disorders, others saw lack of contemplation or piety as disordering. Eating the wrong foods, insufficient herbs, or having neglectful parents were identified by others as primary causes. Galen’s theories of Four Humours enjoyed a number of incarnations and revivals. Few doctors admitted a variety of causes for illness, lumping epilepsy, postpartum depression, and advanced syphilis together, each explained by a single encompassing theory. It was an age of extremes, in which people either believed that the mentally ill had no control over their actions or were acting entirely with free will.

Trepanning, or drilling holes in your head, was still popular.


For relief of "Lunacy":

Give a decoction of Agrimony four times a day
Or - rub the head several times a day with vinegar, in which ground ivy leaves have been infused
Or - an ounce of distilled vinegar daily
Or - boil the juice of ground ivy with sweet oil and white wine into an oinment. Shave the head, anoint it therewith and chafe it in juice warm every other day for three weeks
Bruise also the leaves and bind them on the head, and give three spoonfuls of juice warm every morning. This will also cure melancholy


For the relief of "Raging Madness"

Apply to the head, cloths dipt in cold water.
Or - set the patient with his head under a great water-fall, as long as his strength will bear: or pour water on his head from a tea-kettle
Or - let him eat nothing but apples for a month.
Or - nothing but bread and milk.

Monday, May 01, 2006

Fair Trade

Based on a suggestion by Dr. Sanity, I have a further proposal for the illegal immigration debate. We have lots of people on the left who believe that the "undocumenteds" deserve citizenship. I think they should be allowed to give their citizenship to an immigrant, receiving citizenship in his country of origin in return.

Jim Wallis in Sunday School

We are going to be studying Jim Wallis in Sunday School. For those who have missed him up until now, Jim Wallis is author of many books on how Jesus was actually a 60’s liberal. Unfair? Read him closely. Wallis is now touting a Third Way, which like all third ways tends to be the Liberal Way with different hand gestures, but this time Jesus Says So.

He gets it wrong right from his base principles. If Jesus’s plan was to found a community that exemplified forgiveness, mutuality, and sharing, why didn’t He mention it more? Why was his first assignment to the disciples to send them out two-by-two to preach? Why did those disciples decide that the best thing they could do after Pentecost was split up? Community is certainly not antithetical to Christianity, but I don’t think Wallis could find many important Christian writers over the last 20 centuries who thought it was the main point.

Second, he believes that the point of the free market is accumulation. For some it is. But the freedom of the marketplace allows the individual to make choices: to forgo making more money for the sake of more free time, or more safety, or more security. You can trade salary for lots of things in the free market. You can decide that living in a certain place is more important, or having a job that allows creativity, or working with congenial people, or doing something you consider meaningful. Wallis gets it exactly backwards. The free market (I consider capitalism an imprecise and outmoded description at this point) allows people an escape from materialism that is available in few places. That some people abuse that choice is beside the point.

Starting out from inaccurate premises and reasoning forward from there, where do you think Wallis ends up? Right where he started. He grabs each straw man of the Right, wrestles it long and hard like Jacob wrestling with the angel, and throws each down in eventual triumph, exclaiming “See? That’s what G-d wanted all along!”

Those Pigs

I have heard it suggested that the conflict between Cain and Abel illustrates the conflict between life on the move and the settled life. Most early societies were either herding groups living by animal husbandry, and settled agricultural groups. The story of Cain and Abel would suggest that G-d preferred his people to keep on being shepherds and goatherds – Yahweh preferred the animal sacrifice, and disciplined Cain by sending him off to wander.

This preference of G-d for people who weren’t settled shows up again in the dietary laws. When archaeologists discover pig bones at a site, it is a sign that those particular people had settled down and become immobile. It’s hard enough to herd goats and sheep. Herding pigs? That’s right out. Once pigs are on the scene, you’re staying put. Shellfish are also tough to manage for mobile groups; bad clams can kill you.

Even for those of you who don’t believe a deity has anything to do with the directions given to the Jews, it’s still an interesting story, recording the cultural competition between the two ways of life. For believers, it raises another interesting question: why did G-d prefer to keep His people on the move so much of the time?