Archive for the ‘Mental Health’ Category
Adam Grant has an interesting column in the NY Times:
What does it take to be a good parent? We know some of the tricks for teaching kids to become high achievers. For example, research suggests that when parents praise effort rather than ability, children develop a stronger work ethic and become more motivated.
Yet although some parents live vicariously through their children’s accomplishments, success is not the No. 1 priority for most parents. We’re much more concerned about our children becoming kind, compassionate and helpful. Surveys reveal that in the United States, parents from European, Asian, Hispanic and African ethnic groups all place far greater importance on caring than achievement. These patterns hold around the world: When people in 50 countries were asked to report their guiding principles in life, the value that mattered most was not achievement, but caring.
Despite the significance that it holds in our lives, teaching children to care about others is no simple task. In an Israeli study of nearly 600 families, parents who valued kindness and compassion frequently failed to raise children who shared those values.
Are some children simply good-natured — or not? For the past decade, I’ve been studying the surprising success of people who frequently help others without any strings attached. As the father of two daughters and a son, I’ve become increasingly curious about how these generous tendencies develop.
Genetic twin studies suggest that anywhere from a quarter to more than half of our propensity to be giving and caring is inherited. That leaves a lot of room for nurture, and the evidence on how parents raise kind and compassionate children flies in the face of what many of even the most well-intentioned parents do in praising good behavior, responding to bad behavior, and communicating their values.
Stinking mentally ill people don’t deserve treatment, seems to be the US attitude. Of course, some few of the mentally ill are treated outside the correctional system, but for more than 90% the US approach is to put the patient in prison or jail. And people think the US is uncaring!
Here’s the article. And here’s the ugly fact:
Jails and prisons now house 356,268 inmates with severe mental illness — more than 10 times the number in state hospitals, according to a report published Tuesday by the Treatment Advocacy Center.
In 44 states, the largest prison or jail holds more individuals with serious mental illness than the largest psychiatric hospital.
One must fight despair, but the US seems to be circling the drain in many ways. The way the US treats the mentally ill is Dickensian: mid-19th-century England, with debtors’ prisons (which the US is also bringing back in a de facto sort of way). Our treatment of the mentally ill recalls the Bethlem Royal Hospital (“Bedlam”) of that era.
UPDATE: And it’s not exactly surprising that using prisons to treat the mentally ill worsens the mental-health crisis.
I’m astonished by the sentence of 25 years in prison. The guy is obviously having some sort of schizophrenic break (hearing voices, 23 years old), and he should be in a (secure) mental-health facility. Oh, wait… we’re not that kind of country. We’re the kind that puts mentally ill people in prisons—and clearly not with an eye to helping some incapacitated.
At any rate, read the story.
Sy Mukherjee writes at ThinkProgress:
Cook County Sheriff Tom Dart isn’t mincing words when it comes to his frustrations with Chicago’s — and America’s — broken and underfunded mental health care system.
“Every single day, I am faced with the mental health crisis in this county,” said Dart during testimony before the House Energy and Commerce Committee’s Subcommittee on Oversight and Investigation on Wednesday. “The unfortunate and undeniable conclusion is that because of dramatic and sustained cuts in mental health funding, we have criminalized mental illness in this country, and county jails and state prison facilities are where the majority of mental health care and treatment is administered.”
Illinois made the fourth-largest cuts to mental health services of any state in the country between 2009 and 2012, including the shuttering of two state-run psychiatric facilities. Combined with a lack of affordable housing units, those cuts have propagated a system wherein Americans with mental illnesses wind up in jails rather than clinics.
Dart said that the Cook County Jail houses approximately about 3,500 inmates with serious mental illnesses on any given day (about a third of its total inmate population), making it the largest de facto mental health provider in the nation.
To be clear, these inmates shouldn’t be in a jail setting. The most common illnesses that Dart encounters are mood and psychotic disorders, including severe depression, bipolar disorder, and schizophrenia. And many wind up in jail because they’re simply trying to grapple with a mental health safety net riddled with holes. “While some mentally ill individuals are charged with violent offenses, the majority are charged with crimes seemingly committed to survive, including retail theft, trespassing, prostitution and drug possession,” said Dart.
Keeping the inmates in jail is a pricey endeavor, as caring for a prisoner with mental illness is “easily” two or three times as expensive as the $143 per day that it costs to keep an average person in jail, according to Dart. The care isn’t particularly effective, either. Dart told ThinkProgress that the doctors who treat inmates with mental illnesses are more focused on simple triage rather than holistic care. “Their mission is to get [the inmates] stabilized, make sure they’re on their meds, and when they’re on their way out, [the doctors] give them a plastic baggie with two weeks’ worth of meds,” he said.
Dart also recounted several tragic stories about sick prisoners who were released into a society where they had little recourse for medical care or even simple housing during Wednesday’s hearing. “We’ve had inmates get released and try to break back into the jail so they can keep getting treatment,” he told the House committee. He then urged the committee to consider legislation that would make it easier to keep track of severely mentally ill patients’ cases.
One bill that might go a long way toward achieving that goal has actually . . .
Here’s a Change.org petition I just signed. At the link:
My name is Sargeant Ryan Begin United States Marine Corps (Ret). I served two tours in Iraq. During my second tour on August 1, 2004, I was hit by an improvised explosive device, also known as a roadside bomb. I lost my right elbow and endured over 30 surgeries. On that day my elbow saved my life in two seperate ways. First it physically saved me by absorbing the shrapnel and blocking my vital organs from being ripped apart. The second way it saved me would not reveal itself until last winter, seven years later. It qualified me for medical marijuana in the state of Maine due to the intractable pain. I have also been diagnosed with severe PTSD, and although people with PTSD do not “qualify” for medical marijuana, it was my PTSD condition that received the greatest benefit from medical marijuana.
Every day veterans are returning home from combat and once they return they face their biggest battle, dealing with the PTSD they now suffer from. We know it works and we want research to be done so that we can find out how and why. Sadly, the National Institute on Drug Abuse (NIDA) and DEA refuse to allow research to be done on medical marijuana and PTSD.
The FDA has approved a protocol to study the therapeutic potential of marijuana for veterans suffering from PTSD. But amazingly, NIDA has a monopoly on the cannabis used for research in the U.S. and they continually refuse to allow researchers to purchase their marijuana for this study. Their decision is clearly political, and it’s impending research and prolonging suffering for America’s troops who have sacrificed so much for their country.
NIDA’s refusal also comes at a time when physicians themselves are recognizing the medical value of medical cannabis. Recently, the California Medical Association told the Los Angeles Times that the question of whether marijuana is a medicine “can only be answered once it is legalized and more research is done” (“California Medical Assn. calls for legalization of marijuana”, October 15, 2011).
Scientists, veterans, physicians, public health officials, and state governments are now calling for an end to the U.S. government’s blockade of medical marijuana research. I hope you’ll join us and sign this petition. . .
Not at the time, necessarily, though of course a gang member encounters many risks while active in the gang, but most will leave the gang after around 3 years or less and move into adulthood—whereupon they encounter ill health (mental and physical) more than those who did join a gang.
Lauren Kirchner writes in Pacific Standard:
Gangs are a favorite topic among social scientists and criminologists. Research has consistently shown that, when kids join gangs, they immediately increase the risks that they will commit crimes and be incarcerated, become addicted to drugs, drop out of school, and be on either the giving or receiving end of violence. None of these findings are particularly surprising. But what about the long-term impact? Most gang stints are relatively short, with kids joining in their early teens and getting out a few years later. Then what? Amanda Gilman, a doctoral candidate in the University of Washington School of Social Work, saw a gap in this field.
“We think of gang membership as being an adolescent phenomenon, but what happens when they grow up and have their own families, and become adults?” asked Gilman, who is the lead author of a new paper out in the American Journal of Public Health. “Our theory was that we would see some of these negative outcomes in adulthood, but to some extent we were surprised to see how pervasive this sort of risky lifestyle of being in a gang could be in transitioning to adulthood.”
Gilman found that the impact of those risks and stress were very pervasive indeed. Most people in the study who said that they had been in gangs said their memberships lasted for only three years or less. Even so, they felt the impact of this set of choices for years. Compared to those people who had never been members of a gang, former gang members reported much worse overall health—both mental health and physical health. Former gang members were more likely to suffer from depression, anxiety, alcoholism, and “poor general health” physically when they were 27, 30, and 33. They were also three times as likely to be addicted to drugs.
The results stayed the same “even after controlling for individual, family, peer, school, and neighborhood characteristics.” It was gang membership that made the difference. And these negative effects of the gang life are so significant, the authors explained, that they go beyond the realm of mere community crime and disorder, and can actually impact the level of the overall health of a community.
“Gang membership has always been under the discussion of criminologists; it’s been like a juvenile justice issue, or a criminological issue,” says Karl Hill, a research associate professor and co-author on the paper. “What Amanda’s showing here is that it’s a bigger issue than that; it’s a public health issue. It’s not just the corrections systems and the police that need to be concerned about it, because it has broader public health impact.”
Aside from these particular findings, the source of Gilman’s data is also pretty remarkable. . .
Well worth reading and quite interesting. John Gravois writes at Pacific Standard:
All the guy was doing was slicing inch-thick pieces of bread, putting them in a toaster, and spreading stuff on them. But what made me stare—blinking to attention in the middle of a workday morning as I waited in line at an unfamiliar café—was the way he did it. He had the solemn intensity of a Ping-Pong player who keeps his game very close to the table: knees slightly bent, wrist flicking the butter knife back and forth, eyes suggesting a kind of flow state.
The coffee shop, called the Red Door, was a spare little operation tucked into the corner of a chic industrial-style art gallery and event space (clients include Facebook, Microsoft, Evernote, Google) in downtown San Francisco. There were just three employees working behind the counter: one making coffee, one taking orders, and the soulful guy making toast. In front of him, laid out in a neat row, were a few long Pullman loaves—the boxy Wonder Bread shape, like a train car, but recognizably handmade and freshly baked. And on the brief menu, toast was a standalone item—at $3 per slice.
It took me just a few seconds to digest what this meant: that toast, like the cupcake and the dill pickle before it, had been elevated to the artisanal plane. So I ordered some. It was pretty good. It tasted just like toast, but better.
A couple of weeks later I was at a place called Acre Coffee in Petaluma, a smallish town about an hour north of San Francisco on Highway 101. Half of the shop’s food menu fell under the heading “Toast Bar.” Not long after that I was with my wife and daughter on Divisadero Street in San Francisco, and we went to The Mill, a big light-filled cafe and bakery with exposed rafters and polished concrete floors, like a rustic Apple Store. There, between the two iPads that served as cash registers, was a small chalkboard that listed the day’s toast menu. Everywhere the offerings were more or less the same: thick slices of good bread, square-shaped, topped with things like small-batch almond butter or apricot marmalade or sea salt.
Back at the Red Door one day, I asked the manager what was going on. Why all the toast? “Tip of the hipster spear,” he said.
I had two reactions to this: First, of course, I rolled my eyes. How silly; how twee; how perfectly San Francisco, this toast. And second, despite myself, I felt a little thrill of discovery. How many weeks would it be, I wondered, before artisanal toast made it to Brooklyn, or Chicago, or Los Angeles? How long before an article appears in Slate telling people all across America that they’re making toast all wrong? How long before the backlash sets in?
For whatever reason, I felt compelled to go looking for the origins of the fancy toast trend. How does such a thing get started? What determines how far it goes? I wanted to know. Maybe I thought it would help me understand the rise of all the seemingly trivial, evanescent things that start in San Francisco and then go supernova across the country—the kinds of products I am usually late to discover and slow to figure out. I’m not sure what kind of answer I expected to turn up. Certainly nothing too impressive or emotionally affecting. But what I found was more surprising and sublime than I could have possibly imagined.
IF THE DISCOVERY OF artisanal toast had made me roll my eyes, it soon made other people in San Francisco downright indignant. I spent the early part of my search following the footsteps of a very low-stakes mob. “$4 Toast: Why the Tech Industry Is Ruining San Francisco” ran the headline of an August article on a local technology news site called VentureBeat.
“Flaunting your wealth has been elevated to new lows,” wrote the author, Jolie O’Dell. “We don’t go to the opera; we overspend on the simplest facets of life.” For a few weeks $4 toast became a rallying cry in the city’s media—an instant parable and parody of the shallow, expensive new San Francisco—inspiring thousands of shares on Facebook, several follow-up articles, and a petition to the mayor’s office demanding relief from the city’s high costs of living.
The butt of all this criticism appeared to be The Mill, the rustic-modern place on Divisadero Street. The Mill was also, I learned, the bakery that supplies the Red Door with its bread. So I assumed I had found the cradle of the toast phenomenon.
I was wrong. When I called Josey Baker, the—yes—baker behind The Mill’s toast, he was a little mystified by the dustup over his product while also a bit taken aback at how popular it had become. “On a busy Saturday or Sunday we’ll make 350 to 400 pieces of toast,” he told me. “It’s ridiculous, isn’t it?”
But Baker assured me that he was not the Chuck Berry of fancy toast. He was its Elvis: he had merely caught the trend on its upswing. The place I was looking for, he and others told me, was a coffee shop in the city’s Outer Sunset neighborhood—a little spot called Trouble.
THE TROUBLE COFFEE & Coconut Club (its full name) is a tiny storefront next door to a Spanish-immersion preschool, about three blocks from the Pacific Ocean in one of the city’s windiest, foggiest, farthest-flung areas. As places of business go, I would call Trouble impressively odd.
Instead of a standard café patio, Trouble’s outdoor seating area is dominated by a substantial section of a tree trunk, stripped of its bark, lying on its side. Around the perimeter are benches and steps and railings made of salvaged wood, but no tables and chairs. On my first visit on a chilly September afternoon, people were lounging on the trunk drinking their coffee and eating slices of toast, looking like lions draped over tree limbs in the Serengeti.
The shop itself is about the size of a single-car garage, with an L-shaped bar made of heavily varnished driftwood. One wall is decorated with a mishmash of artifacts—a walkie-talkie collection, a mannequin torso, some hand tools. A set of old speakers in the back blares a steady stream of punk and noise rock. And a glass refrigerator case beneath the cash register prominently displays a bunch of coconuts and grapefruit. Next to the cash register is a single steel toaster. Trouble’s specialty is a thick slice of locally made white toast, generously covered with butter, cinnamon, and sugar: a variation on the cinnamon toast that everyone’s mom, including mine, seemed to make when I was a kid in the 1980s. It is, for that nostalgic association, the first toast in San Francisco that really made sense to me.
Trouble’s owner, and the apparent originator of San Francisco’s toast craze, is a slight, blue-eyed, 34-year-old woman with freckles tattooed on her cheeks named Giulietta Carrelli. She has a good toast story: She grew up in a rough neighborhood of Cleveland in the ’80s and ’90s in a big immigrant family, her father a tailor from Italy, her mother an ex-nun. The family didn’t eat much standard American food. But cinnamon toast, made in a pinch, was the exception. “We never had pie,” Carrelli says. “Our American comfort food was cinnamon toast.” . . .
Since the Federal government has already decided that marijuana has no medical benefit (and is highly addictive to boot), the FDA is unwilling to allow studies that might contradict the Federal position. (Marijuana is a Schedule I drug: those are drugs that have no medical benefit and a high potential for abuse.) April Short describes a 14-year effort to get approval for a study of marijuana’s effects on PTSD:
As a psychiatrist and physician focused on internal medicine, Sue Sisley of Arizona treats first responders and military veterans on a regular basis. Many of them suffer from some form of post-traumatic stress disorder (PTSD). After years observing and speaking with patients she learned that many were using an alternative medicine—cannabis—to successfully manage their symptoms.
“We ran these patients through the gauntlet of every FDA-approved medicine, and either nothing worked or it had really onerous side effects,” said Sisley. “So all these patients were gradually, on their own, starting to use cannabis as an alternative way to treat their symptoms, and talking to me about it.”
While Sisley describes herself as a lifelong Republican who has never tried an illicit drug and doesn’t drink, she became curious to know why and how cannabis was helping so many of her patients.
“This is a dire need, understanding PTSD, not just for combat vets but for all our citizens who are plagued by this,” she said, noting that 22 veterans kill themselves per day in the U.S. according to statistics from the Department of Veterans Affairs. “Any physician who’s also a human being can’t rest when we know that there’s something out there, in this case a plant, that has the potential to reduce human suffering.”
She began to look into studying the plant, but came up against the same wall that has blockaded any attempts at clinical research on cannabis outside of limited research by the U.S. government for the last 40 years. Due to the demonization of cannabis by drug war propaganda, the plant falls under Schedule I classification. This is the most restrictive possible scheduling, and means that officially, pot is considered dangerous and devoid of any potential medical use.
“I started asking more and more questions about why we couldn’t research this drug properly and why these studies were being suppressed,” she said. “[Cannabis] has proven itself over and over again in literally thousands, millions of patients across the country, and when you know that, you can’t rest and just allow this plant to be forced out. I think we have a duty as physicians to demand that this plant be rigorously studied.”
Her curiosity and determination led her to meet Rick Doblin, the executive director of MAPS (the Multidisciplinary Association for Psychedelic Studies). The California-based nonprofit organization has been trying for 14 years to complete federally sanctioned clinical research studies on cannabis. So far, however, the National Institute on Drug Abuse (NIDA)—which has a DEA-protected monopoly on the only legal supply of cannabis for use in FDA-regulated research—has refused to sell them cannabis.
Doblin and Sisley worked to develop protocols for a study that would look at cannabis’ effects on treatment-resistant combat veterans with PTSD, with Sisley as principal investigator. After years of back and forth, the study’s protocols were approved by the Food and Drug Administration three years ago. They were also approved by the University of Arizona Institutional Review Board (IRB), and the University of Arizona has agreed to play host.
There’s just one problem: they still need NIDA approval in order to purchase federally sanctioned weed, and NIDA won’t sell until a third review process is completed by the U.S. Public Health Service (PHS), as required by a 1999 guideline.
This additional review is not required for research on any other Schedule I drug, but was tacked onto the regular approval requirements and is governed by the U.S. Health and Human services department, under NIDA.
After the original study protocol was rejected by PHS in September 2011, MAPS resubmitted a revised protocol on Oct. 24, 2013. Ever since, the line has gone dead. Unlike FDA protocols which require a response within 30 days, there is no timeline requiring PHS to respond. The PHS guidance has effectively blockaded the study of cannabis by failing to respond.
Sisley called the PHS review process redundant, and said the only real reason for it to exist is to keep the war on drugs alive.
“If their motive is to suppress any research that might prove the benefits of marijuana, then it’s understandable they don’t want that data out there because that conflicts with their mission,” she said.
Brad Burge, communications director for MAPS, points out that President Obama has the authority to terminate the extra requirement at any time. The Secretary of Health and Human Services could also legally revoke the guidance as it was issued within HHS.
“We’re hoping with this pressure, with enough public attention, HHS will make a statement or Obama—especially given his recent statements on medical marijuana—will decide to eliminate the hold, and to eliminate the process,” he said.
Thousands of veterans nationwide swear by marijuana’s effectiveness in reducing their PTSD symptoms and advocate for better access to cannabis as an alternative to the pharmaceuticals they’re regularly prescribed. Perry Parks, a Vietnam combat veteran and decorated retired military officer called the limits on access to medical marijuana a “healthcare tragedy few people recognize.” Oaksterdam University has a new scholarship program to help train more veterans to grow their own plants and work in the cannabis industry.
Despite the vocal and increasingly recognized call for veterans’ access to cannabis, the study in question would be the world’s first-ever controlled clinical study on using the herb to treat PTSD in human patients. Burge notes that prior animal studies, among them a study using lab rats published in the scientific journal Nature, have shown that cannabis helps calm an overactive fear system. . .
Lois Beckett has a good article in Pacific Standard:
Chicago’s Cook County Hospital has one of the busiest trauma centers in the nation, treating about 2,000 patients a year for gunshots, stabbings, and other violent injuries.
So when researchers started screening patients there for post-traumatic stress disorder in 2011, they assumed they would find cases.
They just didn’t know how many: Fully 43 percent of the patients they examined—and more than half of gunshot-wound victims—had signs of PTSD.
“We knew these people were going to have PTSD symptoms,” said Kimberly Joseph, a trauma surgeon at the hospital. “We didn’t know it was going to be as extensive.”
What the work showed, Joseph said, is, “This is a much more urgent problem than you think.”
Joseph proposed spending about $200,000 a year to add staffers to screen all at-risk patients for PTSD and connect them with treatment. The taxpayer-subsidized hospital has an annual budget of roughly $450 million. But Joseph said hospital administrators turned her down and suggested she look for outside funding.
“Right now, we don’t have institutional support,” said Joseph, who is now applying for outside grants.
A hospital spokeswoman would not comment on why the hospital decided not to pay for regular screening. The hospital is part of a pilot program with other area hospitals to help “pediatrics patients identified with PTSD,” said the spokeswoman, Marisa Kollias. “The Cook County Health and Hospitals System is committed to treating all patients with high quality care.”
Right now, social workers try to identify patients with the most severe PTSD symptoms, said Carol Reese, the trauma center’s violence prevention coordinator and an Episcopal priest.
“I’m not going to tell you we have everything we need in place right now, because we don’t,” Reese said. “We have a chaplain and a social worker and a couple of social work interns trying to see 5,000 people. We’re not staffed to do it.”
A growing body of research shows that Americans with traumatic injuries develop PTSD at rates comparable to veterans of war. Just like veterans, civilians can suffer flashbacks, nightmares, paranoia, and social withdrawal. While the United States has been slow to provide adequate treatment to troops affected by post-traumatic stress, the military has made substantial progress in recent years. It now regularly screens for PTSD, works to fight the stigma associated with mental health treatment, and educates military families about potential symptoms.
Few similar efforts exist for civilian trauma victims. Americans wounded in their own neighborhoods are not getting treatment for PTSD. They’re not even getting diagnosed.
Studies show that, overall, about eight percent of Americans suffer from PTSD at some point in their lives. But the rates appear to be much higher in communities—such as poor, largely African-American pockets of Detroit, Atlanta, Chicago and Philadelphia—where high rates of violent crime have persisted despite a national decline.
Researchers in Atlanta interviewed more than 8,000 inner-city residents and found that about two-thirds said they had been violently attacked and that half knew someone who had been murdered. At least one in three of those interviewed experienced symptoms consistent with PTSD at some point in their lives—and that’s a “conservative estimate,” said Dr. Kerry Ressler, the lead investigator on the project.
“The rates of PTSD we see are as high or higher than Iraq, Afghanistan, or Vietnam veterans,” Ressler said. “We have a whole population who is traumatized.” . . .
If the US is going to continue to make guns freely available to everyone, then it has a responsibility to ameliorate the resulting human damage.
I watch a lot of movies, and I note that in some bad movies the characters appear to be angry a lot, with nothing motivating their anger. (One title that in my mind is tagged with this characteristic is Showgirls, but I cannot now recall the specific instances—and I don’t want to watch it again.) My take on that is that the apparent anger is just a quick way to get emotion into a scene, even when the anger is unmotivated.
So I was interested in the study discussed in this article in Pacific Standard by Jesse Singal:
If there’s one thing American media does well, it’s outrage. Take a quick glance at your favorite news source, whether The O’Reilly Factor orPardon the Interruption, and you’ll see it: wide-eyed, incredulous, puffed-up outrage that anyone could be so stupid!
Despite our nation’s saturation with outrage, argue two Tufts researchers, we know very little about how the genre works. So Jeffrey M. Berry, a political scientist, and Sarah Sobieraj, a sociologist, assembled a research team and dove into the spittle-flecked world of outrage media. They listened to and read countless transcripts, coding it for content; interviewed fans of Rush Limbaugh, Glenn Beck, and other superstars; and examined the regulatory and business shifts in American mass media that led to our current screamfest.
In a recent interview, Sobieraj spoke with Pacific Standard about the formula of outrage media, why the right wing dominates it, and the weirdly intimate relationship between talk radio hosts and their listeners. The below transcript is edited for length and clarity.
So what exactly is outrage media, and how do you differentiate it from a regular lack of civility?
When we think about outrage, we think of political speech that is intended to provoke an emotional response. So fear, anger, or moral indignation—that sort of thing. Most of the existing literature on incivility talks about interruptions or sighing or things like that, and what we notice is that outrage is such a muscular negativity that it’s not captured by those kinds of studies or questions. It’s just a whole different ballpark. The research on incivility tended to look at things like political advertisements, for example, and we were thinking about this whole other area, this genre where there is a mainstay of emotionally laden speech and behavior that is really designed to rile up the audience.
Emotion has a place in political speech. It’s actually quite important if you think about something like the civil rights movement or 9/11. People’s stories and the social problems they animate are often very important. But what’s different here are the calculated techniques that they use in an effort to evoke those emotions.
And it sounds like “calculated” is the right word, because you guys write that outrage media is pretty formulaic.
It is. It’s very predictable. In fact, sometimes when I’m having a better day or in a better mood or feeling more tolerant, I can find it in myself to find it amusing, the way that the techniques are so similar on the left and the right.
You know you could hear, for example, a host talk about the fringe far-left and if you’re on another network you can hear them talk about the fringe far-right, and so sometimes the language is literally the same. And not just the language, but the techniques, the things like misrepresentative exaggeration and belittling and conspiracy theories.
Are there any other big markers? Misrepresentative exaggeration, belittling….
Insulting language is another really important one. Calling people idiotic or pompous. Name-calling is definitely one too. I’ve heard, for example, bloggers refer to Obama’s supporters as “Obamatards,” things like that.
As for exaggeration, there is lot in political life, but this is a different level of a very dramatic negative exaggeration. For example, saying that something is intended to bring down capitalism. That would be a good example—very few things are actually designed to bring down capitalism. So I would say that misrepresentative exaggeration, mockery, definitely the ideologically extremizing language like “radical right-wing nut,” “socialist,” “fascist.” Those types of things are probably the most common.
I think a lot of people are skeptical of the claim that it’s as bad on the left as it is on the right, and you did a good job of pulling quotes from folks like Mike Malloy that really are angry and negative and out there. But you did find, overall, that there’s something about this sort of media that appeals more to folks on the right, and there’s a huge gap in the amount of outrage media between the two sides.
Yeah, so there are actually two different questions embedded in there. One is whether it’s the same or different in terms of the intensity and the volume and that sort of thing. Some people have suggested that when we point out that it happens on the left it’s a false equivalency. And that’s actually not what we’re doing at all.
What we notice is that the techniques are very similar on the left and the right. So something like belittling or exaggeration—you’re going to find that with Ed Schultz or Lawrence O’Donnell just like you’ll find it with Bill O’Reilly or Sean Hannity. But the volume is very different, in terms of the sheer number of platforms on the right. Talk radio is over 90 percent conservative so there’s just more of it.
Now the other question that you’re asking is whether outrage is more attractive to those on the right, and I think it is for a number of reasons. It’s actually kind of complicated—there are a lot of things going on. One is that the left is less distrustful or more accepting, depending on how you want to say it, of conventional news. So the right has historically been less comfortable with the major networks or The New York Times, for example, and the left is more comfortable in those spaces.
Another thing that comes into play is that there is some research that suggests that conservatives have a personality type—this is, of course, not all of them—and that there’s a greater propensity for comfort with black-and-white argumentation, which is very common in the outrage genre. There are good guys and there are bad guys. You are with us or you are against us. So there is that type of appeal.
But also, and I think probably most interestingly, since the rise of multiculturalism, with words like “tolerance,” “inclusion,” and “diversity” being viewed as good and important, for those who are conservative, to share your political views on things like same-sex marriage or immigration—those views can be viewed as intolerant and you can feel as though you are being judged and stigmatized. So we think that these shows, or what we hear when we talk to fans, are that these shows and blogs really become a safe space where their views are validated and they’re not criticized.
That struck me actually, because I really did like the interviews you had with fans of Beck and Limbaugh and some other conservative hosts, and there was this genuine fear that I found surprisingly easy to empathize with. They said they feel like they can’t talk about these issues or they’re going to be tarred as racist. . .
And yet this crime against humanity is common in our penal system. And it causes physical change, reports Nicole Flatow at ThinkProgress:
Solitary confinement has been called a “living death,” cruel and unusual, and torture. Studies of the prison practice of placing inmates in a solitary, often concrete windowless cell for 23 hours a day with almost no human contact, have found that the psychological impact is dramatic after just a few days.
A University of Michigan neuroscientist suggested Friday that the physical impact on the brain could be just as significant if not moreso, and could “dramatically change the brain” in just a matter of days. Speaking on a panel about solitary confinement, neuroscientist Huda Akil said inaccess to inmates has prevented much formal study on brain changes while held in confinement. But she said a number of other studies have documented how each of the factors involved in solitary confinement change the physical shape of the brain. The lack of physical interaction with the natural world, the lack of social interaction, and the lack of touch and visual stimulation alone are each “by itself is sufficient to dramatically change the brain,” Akil said at the American Association for the Advancement of Science annual meeting.
She said particular parts of the brain that are subject to extreme stress can “actually shrink,”including the hippocampus, which is responsible for memory, spatial orientation, and memory.
Robert King, a member of the “Angola 3″ who was held in solitary confinement for years before his conviction was overturned in a racially charged murder case based on flimsy evidence, said his eyesight and physical orientation are permanently impaired. “My geography is way off,” he said. “I get lost sometimes in my own neighborhood. I believe that this is a result of my solitary confinement.” Two of King’s fellow defendants remained in solitary, one until just days before his death in October.
Other psychological impacts documented by psychology professor Craig Haney include“extreme paranoia, self-mutilation, hypersensitivity to sound, light and touch, and severe cognition dysfunction among prisoners.”
One recent psychological study concluded, “The restriction of environmental stimulation and social isolation associated with confinement in solitary are strikingly toxic to mental functioning.” And prisoners, many of whom are later released, have described developing rage and violent tendencies while confined.
“To me, the separation of the mental and physical is highly artificial, because there are definitely physical consequences of these experiences,” said Akil.
The prolonged, isolated confinement of inmates has been held unconstitutional as applied to the mentally ill, and at least two courts have now held that indefinite, unreviewed confinement is also unconstitutional. But the practice remains common, and has not been invalidated outright. At least 80,000 U.S. prisoners are held in solitary confinement by some estimates, and it is frequently used not to segregate dangerous prisoners, but as a means of social control, or mental health treatment. In California, more than 500 inmates have reportedly been kept in confinement for 10 to 28 years.
This sort of facility seems like an excellent idea, and apparently it results in improved happiness and health for its residents. I bet it’s a more pleasant place to work than the usual assisted-living home. With Baby Boomers aging, this would be a good thing to initiate as publicly-owned (taxpayer-supported) facilities. This is exactly the sort of thing you do NOT want to run on a profit motive, which inevitably leads to cuts in quality of service and higher prices over time due to the inexorable drive to grow profits.
I think it would be more efficient and save money overall if the mentally ill could go or be taken to a local mental health clinic and get expert treatment by a staff trained in and knowledgeable about mental health illnesses and treatments, thus taking a burdensome and inappropriate responsibility from the police and ERs.
But I don’t think that will happen because, much as with the poor, the controlling powers (Congressional majorities, business interests) simply do not care about people in that category, and so no government money is released to provide the resources. Instead, the problem is to a great degree simply ignored. Somehow we avert our gaze.
But services for this group very much are aligned with promoting the general welfare.
Lauren Kirchner writes in Pacific Standard:
The last time Virginia state senator Creigh Deeds made national headlines, the occasion was a shocking family tragedy. In November, Deeds’ son Gus, who had been on and off medication for bipolar disorder and crippling paranoia, repeatedly stabbed Deeds, before ending his own life. Now, a recovered but visibly scarred Deeds is back in the news, publicly urging his colleagues in Richmond to help him reform the state’s mental health laws.
On the night before his son attacked him, Deeds told Scott Pelley in a 60 Minutes interview, the family had taken Gus to an emergency room and tried to place him in a psychiatric facility, because they worried that he might hurt himself or someone else. Under Virginia state law, Gus could only be hospitalized against his will for six hours, or until an available bed in a psychiatric facility could be located. But no bed was free, and so Gus went home. Deeds is now working to get Virginia to extend the length of those emergency stays, and to build a state-wide computer database that would make finding open psychiatric beds easier.
Deeds’ story was just one part of the 60 Minutes segment, called “Nowhere to Go: Mentally Ill Youth in Crisis.” Scott Pelley interviewed a number of parents who have had to repeatedly bring their children and teens to the hospital for short-term stays and unsatisfying, piecemeal mental healthcare, for things like bipolar disorder, schizophrenia, and major depression disorder. Long-term psychiatric care is just so much harder to come by. Pelley explains that their experiences today illustrate the result of a half-century-long systemic deinstitutionalization of mental health care in America:
In the decades after the 1960s most large mental institutions were closed. It was thought that patients would get better treatment back in their communities. But adequate local facilities were never built. The number of beds available to psychiatric patients in America dropped from more than half a million to fewer than 100,000. That leaves many kids in crisis today with one option: the emergency room.
But what if those people suffering from mental illness aren’t minors, and they don’t have parents or support systems to bring them in to emergency rooms? If those people are adults, and they’re out in the world, disturbing people with antisocial behavior, then chances are that at some point, they’re going to have a brush with the law.
In a recent NPR report from the nation’s largest jail, Cook County in Illinois, Laura Sullivan described the spare, padded cells that many of the inmates are housed in. At least a third of the 10,000 inmates in Cook County are mentally ill, and the jail’s staff sounded absolutely overwhelmed.
Staff members called the situation they’re facing “staggering” and the policies that caused it “ridiculously stupid.” Sullivan reported that in the past three years, budget shortfalls caused Chicago to cut funding to six of the area’s 12 mental health clinics, and three nearby state hospitals. Those clinics and hospitals had provided mentally ill patients in the community with counseling and medication; without them, many of those patients tend to end up in jail.
Cook County is doing what it can to process the flow, and provide medicine and help to the people who need it—and this help, in turn, attracts more people who need it. Sullivan interviewed one inmate/patient who told her that after his local mental health clinic closed, he started relying on the jail to get regular access to the medication he has been taking for decades to manage his illness. In fact, he regularly commits small crimes just to get sent to jail, where he’ll then stay, until he goes before a judge to receive his sentence. This situation is not only incredibly ineffective in serving the community’s needs, it’s also incredibly expensive, as Sullivan describes: . . .
When crime rates began to drop across the U.S. during the 1990s, city officials and criminologists were thrilled—but baffled. Violent acts, most often committed by young adults, had reached an all-time high at the start of the decade, and there was no sign of a turnaround.
By the close of the ’90s, though, the homicide rate had declined more than 40% throughout the country. Economists and criminologists have since proposed reasons for the unexpected plummet. Some have pointed to an increase in police officers. Others have suggested a rise in the number of offenders put behind bars. Economist and “Freakonomics” coauthor Steven D. Levitt famously hypothesized that the legalization of abortion in 1973 even played a role. Once the Supreme Court decided Roe v. Wade, he argued, fewer unwanted babies grew into disturbed, crime-prone adults two decades later.
But recently, experts have been kicking around another possible player in the crime drop of the ’90s: lead. Cars burning leaded gasoline spewed the heavy metal into the air until 1973, when the Environmental Protection Agencymandated the fuel’s gradual phaseout. Lead-based paint was banned from newly built homes in 1978. Because of these actions, children born in the mid- to late-1970s grew up with less lead in their bodies than children born earlier. As a result, economists argue, kids born in the ’70s reached adulthood in the ’90s with healthier brains and less of a penchant for violence.
Today, the Centers for Disease Control & Prevention considers 5 micrograms per deciliter of lead in a child’s blood to be abnormal. Studies have shown that people who grew up with blood-lead levels at or above this threshold are more likely to have impaired cognition than those who grew up with less lead in their blood. In 1976, the average U.S. resident had a blood-lead level of 16 µg/dL, according to the National Health & Nutrition Examination Survey. By 1991, when there was less lead in the air and in housing, the average had dropped to 3 µg/dL.
As the lead-crime hypothesis gains traction in economics circles, critics are invoking the “correlation does not equal causation” mantra. But scientists argue that there is evidence that lead exposure increases aggression in lab animals. And even though lead, one of the oldest known poisons, affects the brain in a dizzying number of ways, researchers are beginning to tease out some of the mechanisms by which it might trigger violence in humans.
During the 1960s, doctors couldn’t label a child as lead poisoned unless he or she had a blood-lead level of at least 60 µg/dL—CDC’s defined limit at the time. But researchers like University of Pittsburgh psychiatrist Herbert L. Needleman questioned the cut-off value. Surely if 60 µg/dL was toxic, 50 µg/dL couldn’t be completely harmless.
Needleman and others began observing “silent lead poisoning” in children with blood-lead levels below the established limit. Rather than overt physical symptoms like hallucinations and kidney damage, these kids had low IQ scores, attention problems, and antisocial tendencies. As more and more reports of these deficits filtered in, CDC lowered the blood-lead level it deemed acceptable for kids further and further: In 1970, the amount was 40 µg/dL, and by 1991, it was 10 µg/dL.
Some physicians noticed that children exposed to blood-lead levels below 50 µg/dL could also be aggressive or violent. In 1996, Needleman and his group followed up on these anecdotal observations by examining a few hundred 12-year-old boys in the Pittsburgh area. The researchers measured the amount of lead in the boys’ bones with X-ray fluorescence to get an idea of how much of the heavy metal their participants were exposed to during childhood. The boys rated worst by their parents and teachers in terms of aggressive and antisocial behaviors had been exposed to the highest levels of lead (J. Am. Med. Assoc. 1996, DOI:10.1001/jama.1996.03530290033034). . . .
Continue reading. Later in the article:
. . . Research has shown that lead exposure does indeed make lab animals—rodents, monkeys, even cats—more prone to aggression. But establishing biological plausibility for the lead-crime argument hasn’t been as clear-cut for molecular-level studies of the brain. Lead wreaks a lot of havoc on the central nervous system. So pinpointing one—or even a few—molecular switches by which the heavy metal turns on aggression has been challenging.
What scientists do know is that element 82 does most of its damage to the brain by mimicking calcium. Inside the brain, calcium runs the show: It triggers nerve firing by helping to release neurotransmitters, and it activates proteins important for brain development, memory formation, and learning. By pushing calcium out of these roles, lead can muck up brain cell communication and growth.
On the cell communication side of things, lead appears to interfere with a bunch of the neurotransmitters and neurotransmitter receptors in our brains. One of the systems that keeps popping up in exposure experiments is the dopamine system. It controls reward and impulse behavior, a big factor in aggression. Another is the glutamate system, responsible in part for learning and memory.
On the brain development side of things, lead interferes with, among other things, the process of synaptic pruning. Nerve cells grow and connect, sometimes forming 40,000 new junctions per second, until a baby reaches about two years of age. After that, the brain begins to prune back the myriad connections, called synapses, to make them more efficient. Lead disrupts this cleanup effort, leaving behind excess, poorly functioning nerve cells.
“If you have a brain that’s miswired, especially in areas involved in what psychologists call the executive functions—judgment, impulse control, anticipation of consequences—of course you might display aggressive behavior,” says Kim N. Dietrich, director of epidemiology and biostatistics at the University of Cincinnati College of Medicine….“Overall, the evidence is sufficient that early exposure to lead triggers a higher risk for engaging in aggressive behavior,” says U of Cincinnati’s Dietrich. “The question now is, what is the lowest level of exposure where we might see this behavior?” . . .
Craig Whitlock points out in the Washington Post another area in which the military is falling woefully short, and an area at the heart of their competency: command leadership. (In addition, of course, there is the rape culture aspect of the military, along with the enormous number of Air Force members who routinely cheat on their readiness tests: these are the troops responsible for our nuclear weapons, not a group one wants to see compromised.) Whitlock’s report:
There are miserable bosses, and then there are toxic military commanders.
Air Force Maj. Gen. Stephen D. Schmidt was unquestionably among the latter in the view of some staff members under his thumb. A profane screamer, he ran through six executive officers and aide-de-camps in a year. He retired this month after an Air Force inquiry concluded that he was “cruel and oppressive” and mistreated subordinates.
More than a dozen people who worked with Brig. Gen. Scott F. “Rock” Donahue, a retired commander with the Army Corps of Engineers, reported him as a verbally abusive taskmaster. One was so desperate to escape from division headquarters in San Francisco that he asked for a transfer to Iraq. An Army investigation cited the general for “exhibiting paranoia” and making officers cry.
Troops who served under Army Brig. Gen. Eugene Mascolo of the Connecticut National Guard, described him as “dictatorial,” “unglued” and a master of “profanity-fused outbursts.” An Army investigation found widespread evidence of “verbal mistreatment.” He received a written reprimand but remains in the National Guard.
U.S. military commanders are not trained to be soft or touchy-feely. But over the past two years, the Pentagon has been forced to conduct a striking number of inspector-general investigations of generals and admirals accused of emotionally brutal behavior, according to military documents obtained under the Freedom of Information Act.
The affliction of abusive leadership has even infected some civilian leaders at the Pentagon, raising questions about the Defense Department’s ability to detect and root out flaws in its command culture.
Inspector-general files show, for example, that Army officers described the working atmosphere under Joyce E. Morrow, a powerful civilian official at Army headquarters, as “toxic,” corrosive” and “like you were in a prisoner of war camp.” Officers complained of menial servitude and said they were forced to fetch Morrow’s iced tea, which she would refuse to drink if it was not served in a cup with a lid and a straw, but no ice.
Most military commanders are upstanding and well-respected by their troops. Many are hailed as heroes, particularly after more than a dozen years of war. But in recent months, the armed forces have been shaken by an embarrassing number of generals and admirals who have gotten into trouble for gambling, drinking and sleeping around, among other ethical lapses.
Some current and former officers say those cases are symptomatic of a more damaging problem: a system that promotes and tolerates too many lousy leaders.
“This is a larger issue of not only officer misconduct involving ethical issues, but let’s call these guys for what they are: toxic leaders,” said Christopher Walach, a retired Army lieutenant colonel and battalion commander who served two combat tours in Iraq.
Walach said he left the Army in 2008 largely because of what he described as a destructive command climate. “It destroys the message that draws many into the ranks of the military in the first place,” he said.
Leaders at the Pentagon said they haven’t looked into whether the number of toxic or unethical leaders has increased. . .
Continue reading. Leaders at the Pentagon seem inclined to preserve their ignorance.
A sidebar to the piece:
Find out what witnesses had to say about leadership from the reports on Schmidt, Donahue, Mascolo and Morrow. Go read.
An interesting read, which introduced to me the idea of IED—not “improvised explosive device” but an analogous psychological condition, “intermittent explosive disorder,” in which innocuous stimuli evoke disproportionate responses. Lauren Kirchner writes in Pacific Standard:
A recent car fatality in upstate New York, involving a single car that flipped over twice on a highway median, was a mystery to first responders until witness reports came in. Other drivers that had been on the road at the time described two cars that had been engaging in “a deadly road-rage game of cat and mouse,” as cops told a local NBC reporter. One car was aggressively pursuing the other; when one car flipped and crashed, witnesses said, the other one “just kept going.” Police said that the 27-year-old woman’s death was “being treated as a case of road rage.”
Congested roads, busy schedules, and idiots on the road are a fact of life. But road rage can escalate, to fatal extremes, very quickly. Urban planners and neuroscientists alike have studied the external and internal factors that contribute to aggressive, reckless, and vengeful driving. They’ve shown just how complicated and contagious it is, and how there’s no easy answer to such a persistent problem.
Emil Coccaro, a professor and psychiatrist at the University of Chicago, has studied Intermittent Explosive Disorder (IED) for many years. People with this disorder repeatedly respond with violent or verbally aggressive outbursts, disproportionate to any given situation. (Not all road-ragers have IED, but road rage can be a symptom of it.) He says that the psychological root of this behavior is often something called Hostile Attribution Bias—the belief that every accidental injury or threat is purposeful, and personal. People with IED over-personalize every interaction, and then over-react with immediate aggression.
It’s a dangerous combination when this happens to someone behind the wheel of a car on the road. And it’s also risky to drive carelessly in such a way that could provoke drivers like that in unpredictable ways. Coccaro explains the unique psychological effect of being in the driver’s seat of a car, which can be akin to a state of denial, combined with a heightened sense of power.
“You’re in a car, and it’s kind of a weapon, and you’re in a protected environment, and you think no one’s going to be able to get to you,” Coccaro says. So, if you get cut off by another driver, you might feel that you can give them the finger without any direct consequence. But the problem is, you don’t have any idea how the other person will respond to that provocation. “I say that to people all the time, ‘Don’t assume that the other person is you,’” he says. “You don’t know how nuts they are. You don’t know that they don’t have a gun in their glove compartment.”
Guns in the glove compartment and altercations on the road can obviously be a deadly combination. Last week, . . .
Continue reading. One interesting point later in the article contradicted the assumption that “an armed society is a polite society”: it turns out that being armed makes people act more aggressively (cf. George Zimmerman):
. . . [R]esearch has shown that the presence of a gun in a car might have a catalyzing effect on car-to-car pissing contests, even if the guns don’t ever come out of the glove compartments. A group of researchers from the Harvard School of Public Health found just that, in their study, “Is an Armed Society a Polite Society? Guns and Road Rage,” published in the journal Accident Analysis & Prevention.
David Hemenway, Mary Vriniotis, and Matthew Miller found in their national survey that people who drive with guns in their cars are more likely to “make obscene gestures at other motorists” and “follow aggressively behind” other cars. (The survey asked people a wide range of questions about their lives and worldviews; results found that road rage was most prevalent in “males, young adults, binge drinkers, those who do not believe most people can be trusted, [and] those ever arrested for a non-traffic violation” as well as those driving with guns.)
So, are people who are naturally aggressive—on the road and in life—more likely to own and carry guns? Or, as this study suggests with its title, does the presence of a gun nearby in the car make people drive more aggressively? . . .
Lying turns out to use a lot of energy—and that’s while you’re still getting away with the lie. Even more energy is burned once the lie is exposed, as so many have found. (No James Clapper jokes, please.) Paul Bisceglio writes in Pacific Standard:
Lying is bad. That’s a lesson many were taught growing up: It’s mean. It breeds distrust. It makes the world an unknowable mess.
Everyone does it nonetheless, of course. But even when people lie with the best intentions, isn’t there something about it that still feels a little wrong?
According to two recent studies, in fact, yes—but not for any moral reasons. A team of researchers from universities in China and Canada monitored the brain activity of people lying and telling the truth, and found that telling the truth is just a lot easier on the brain.
The researchers, led by Xiao Pan Ding at Zhejiang Normal University in China, asked participants to play deception-based games while hooked up to devices that measured the neurological effects of two different kinds of lying. One study looked at “first-order deception,” in which a person being lied to doesn’t expect to be lied to, and the other study looked at “second-order deception,” in which a person being lied to is well-aware of the liar’s intent to deceive—as in poker, for example.
The brain-reading devices, which are part of a new neuroimaging method called near-infrared spectroscopy, revealed that in both cases participants got more satisfaction out of gaining advantages in the games by telling the truth as opposed to gaining advantages by lying.
Telling the truth, in other words, felt better, even when it was used as part of a grander strategy to mislead.
For anyone who has played a few good rounds of Mafia, these findings may not be too surprising. Lying, after all, is hard. The flip side of the researchers’ results showed . . .
The experiment was conducted not by CBT practitioners but by psychoanalytic therapists. Daniel Freeman and Jason Freeman write in the Guardian:
“Everybody has won and all must have prizes,” declared the dodo in Alice in Wonderland when asked to judge the winner of a race around a lake. As judgements go, it is admirably even-handed and optimistic. But in the world of mental health the dodo’s decision has come to symbolise a bitter dispute that strikes at the very heart of psychotherapy.
The “Dodo Bird Verdict”, first suggested in the 1930s by the American psychologist Saul Rosenzweig, proposes that the many and various forms of psychological therapy are all equally effective. It makes no difference whether, for example, a person is being treated with techniques drawn from psychoanalysis, neurolinguistic programming, or cognitive behaviour therapy (CBT). What really helps a patient to recover are straightforward factors such as the opportunity to discuss their worries with a skilled and sympathetic therapist or the degree to which they are prepared to engage with the treatment.
Understandably, the Dodo Bird Verdict has ruffled many feathers within the profession, and provoked a slew of studies aiming to corroborate or disprove the idea. Are some types of psychotherapy really more effective than others for particular conditions? There is plentiful data to suggest that the answer to that question – contrary to Rosenzweig’s theory – is “yes”. But that data tends to come from research conducted by proponents of the ostensibly superior therapy, leaving sceptics to conclude that their conclusions are not impartial.
This makes the results of a study of treatments for the eating disorderbulimia nervosa, published this month in the American Journal of Psychiatry, all the more convincing. Bulimia is characterised by binge eating, followed by attempts to compensate by making oneself vomit, taking laxatives or diuretics (water tablets), fasting, and/or exercising frantically. Underlying this behaviour is an intense concern – an obsession, even – with body shape and weight.
Bulimia is relatively common. One large US study, for instance, found that almost 1% of adolescents aged 13-18 had experienced the condition at some point in their life. Many of these teenagers reported that their illness made it very difficult for them to have a normal life, and it damaged their relationships with family and friends. The study also found that adolescents with bulimia were more likely to consider, or even attempt, suicide.
Given bulimia’s prevalence and potentially disastrous consequences, it is clearly important that we understand what treatments work best, which is why researchers at the University of Copenhagen recently compared the efficacy of two popular psychotherapies: CBT and psychoanalysis. The results were remarkable.
In the study, 70 patients with bulimia nervosa were randomly assigned either to two years of weekly psychoanalytic therapy or 20 sessions of CBT spread over five months. At the core of the psychoanalytic approach is the idea that bulimic behaviour represents an attempt to control problematic feelings and desires. The therapist helps the client to talk about these buried feelings and to understand how they are related to the bulimia. And when the individual has learned to accept and manage their deepest desires, the theory goes, the distress disappears and with it the symptoms of bulimia.
CBT, on the other hand, is targeted at the symptoms themselves: the aim is to stop the binge eating as quickly as possible. For CBT practitioners, bulimia is driven by the belief that one’s self worth is determined by one’s eating habits, shape and weight. Therapists show the individual how to identify and challenge such beliefs, explain the cycle of binge eating, and promote regular eating patterns and a more flexible and realistic set of dietary guidelines. They work with the patient to devise plans to deal with times when binge eating becomes more likely, and to minimise the likelihood of a relapse.
Even though the participants in the Danish trial received vastly unequal amounts of treatment over an extended timespan – with those given psychoanalysis seeing their therapist far more than those allocated CBT – it . . .
Franklin Delano Roosevelt famously put “Freedom from Fear” high on the list of the freedoms the US valued, but things have changed. Peter Ludlow writes in the NY Times:
The British philosopher Bertrand Russell, writing as World War II was drawing to a close in Europe, observed that “neither a man nor a crowd nor a nation can be trusted to act humanely or to think sanely under the influence of a great fear.” Russell’s point was that irrational fear can propel us into counterproductive activities, ranging from unjust wars and the inhumane treatment of others to more mundane cases like our failure to seize opportunities to improve our everyday lives.
It is hard to dispute Russell’s claim. We all know that fear can impair our judgment. We have passed up opportunities in our personal lives and we have also seen groups and nations do great harm and unravel because of their irrational fears. The 20th century was littered with wars and ethnic cleansings that were propelled in large measure by fear of a neighboring state or political or ethnic group. Given this obvious truth, one might suppose that modern democratic states, with the lessons of history at hand, would seek to minimize fear — or at least minimize its effect on deliberative decision-making in both foreign and domestic policy.
But today the opposite is frequently true. Even democracies founded in the principles of liberty and the common good often take the path of more authoritarian states. They don’t work to minimize fear, but use it to exert control over the populace and serve the government’s principle aim: consolidating power.
Philosophers have long noted the utility of fear to the state. Machiavelli notoriously argued that a good leader should induce fear in the populace in order to control the rabble.
Hobbes in “The Leviathan” argued that fear effectively motivates the creation of a social contract in which citizens cede their freedoms to the sovereign. The people understandably want to be safe from harm. The ruler imposes security and order in exchange for the surrender of certain public freedoms. As Hobbes saw it, there was no other way: Humans, left without a strong sovereign leader controlling their actions, would degenerate into mob rule. It is the fear of this state of nature — not of the sovereign per se, but of a world without the order the sovereign can impose — that leads us to form the social contract and surrender at least part of our freedom.
Most philosophers have since rejected this Hobbesian picture of human nature and the need for a sovereign. We have learned that democratic states can flourish without an absolute ruler. The United States of America was the original proof of concept of this idea: Free, self-governing people can flourish without a sovereign acting above the law. Even though the United States has revoked freedoms during wartime (and for some groups in peacetime), for most of its history the people have not been under the yoke of an all-powerful sovereign.
However, since 9/11 leaders of both political parties in the United States have sought to consolidate power by leaning not just on the danger of a terrorist attack, but on the fact that the possible perpetrators are frightening individuals who are not like us. As President George W. Bush put it before a joint session of Congress in 2001: “They hate our freedoms: our freedom of religion, our freedom of speech, our freedom to vote and assemble and disagree with each other.” Last year President Obama brought the enemy closer to home, arguing in a speech at the National Defense University that “we face a real threat from radicalized individuals here in the United States” — radicalized individuals who were “deranged or alienated individuals — often U.S. citizens or legal residents.”
The Bush fear-peddling is usually considered the more extreme, but is it? The Obama formulation puts the “radicalized individuals” in our midst. They could be American citizens or legal residents. And the subtext is that if we want to catch them we need to start looking within. The other is among us. The pretext for the surveillance state is thus established.
And let there be no mistake about the consolidation of power in the form of the new surveillance state. Recent revelations by Edward Snowden have shown an unprecedented program of surveillance both worldwide and on the American population. Even Erik Prince, the founder of the private military contractor Blackwater Worldwide thinks the security state has gone too far:
America is way too quick to trade freedom for the illusion of security. Whether it’s allowing the N.S.A. to go way too far in what it intercepts of our personal data, to our government monitoring of everything domestically and spending way more than we should. I don’t know if I want to live in a country where lone wolf and random terror attacks are impossible ‘cause that country would look more like North Korea than America.
The widespread outrage over the new surveillance state has been great enough that President Obama announced on Friday that he would scale back some of its programs, but he remained strident in his overall support for aggressive surveillance.
The interesting thing about the security measures that are taken today is that they provide, as Prince puts it, the “illusion of security”; another way to put it is that they provide “security theater.” Or perhaps it is actually a theater of fear.
During the George W. Bush administration we were treated to
the color-coded terror threat meter. It was presented as a way to keep us secure, but constantly wavering between orange and red, it was arguably a device to remind us to be fearful. Similarly for the elaborate Transportation Security Administration screenings at airports. Security experts are clear that these procedures are not making us safe, and that they are simply theater. The only question is whether the theater is supposed to make us feel safer or whether it is actually intended to remind us that we are somehow in danger. The security expert Bruce Schneier suggests it is the latter:
By sowing mistrust, by stripping us of our privacy — and in many cases our dignity — by taking away our rights, by subjecting us to arbitrary and irrational rules, and by constantly reminding us that this is the only thing between us and death by the hands of terrorists, the T.S.A. and its ilk are sowing fear. And by doing so, they are playing directly into the terrorists’ hands.
The goal of terrorism is not to crash planes, or even to kill people; the goal of terrorism is to cause terror. … But terrorists can only do so much. They cannot take away our freedoms. They cannot reduce our liberties. They cannot, by themselves, cause that much terror. It’s our reaction to terrorism that determines whether or not their actions are ultimately successful. That we allow governments to do these things to us — to effectively do the terrorists’ job for them — is the greatest harm of all.
As the Norwegian philosopher Lars Svendsen notes in his book “A Philosophy of Fear,” . . .
Continue reading. There’s a lot more and it’s all good.