Later On

A blog written for those whose interests more or less match mine.

Archive for March 7th, 2019

Yale psychiatrist: Trump’s pathology is spreading like a disease — and America might not be able to save itself

leave a comment »

Tana Ganeva writes in Raw Story:

On Tuesday, President Donald Trump attacked Democrats for conducting investigations into potential misdeeds by the Trump campaign and administration.

“The greatest overreach in the history of our Country,” Trump tweeted. “The Dems are obstructing justice and will not get anything done. A big, fat, fishing expedition desperately in search of a crime, when in fact the real crime is what the Dems are doing, and have done!”

“PRESIDENTIAL HARASSMENT!” he added.

The attack on Democrats echoed his rambling speech at CPAC over the weekend, in which the President accused Clinton foundation staffers of being killers.

Raw Story spoke with Yale psychiatrist Bandy X. Lee about the President’s recent outbursts.

Lee is a forensic psychiatrist at Yale School of Medicine who teaches at Yale Law School. She edited the New York Times bestseller, “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President,” to be released in an expanded edition later this month. She is president of the World Mental Health Coalition and currently organizing an interdisciplinary conference with top experts of multiple fields from around the country, to happen in Washington, DC, on the date of the book’s launch.

Raw Story: President Trump’s CPAC speech seems to have brought his mental health back into the spotlight over the weekend. Lawrence O’Donnell even quoted from your book the other night. What are your thoughts about the speech?

Bandy X. Lee: A member of the public asked, “When Donald Trump wrapped his arms around the flag, it evoked Lennie from Of Mice and Men squeezing the mouse until it’s dead. Is the president going to destroy our country?”

I didn’t tell her this, but my answer would have been that he is well on the way, as long as we let him. How are we letting him? By colluding on the most basic point: by telling ourselves that the mental unwellness we see is not what we are seeing. Allowing him to give as long a speech as he did, allowing him to continue on Twitter, allowing him to remain in his position, and allowing his staff to turn over so that he has no one left but those who enable his illness—all this is the opposite of the proper treatment that he needs.

Containment and removal from access to weapons, urgent evaluation, and then the least restrictive means of management based on the evaluation, is the medical standard of care.

Even the president deserves medical standard of care, and he is not getting it. The natural course of disease is that it will engulf the afflicted persons and lead them to destruction, if left without resistance. In medicine there is no difference between physical and mental disease, but mental disease will be experienced differently in that the afflicted person willingly, even fervently, goes to her destruction, bringing others down in the process.

I have a colleague at the World Health Organization, Dr. Gary Slutkin, who approaches this human destructiveness as an infectious disease. If we do not treat this phenomenon as an affliction of the mind, a symptom, but rather as a political strategy or an otherwise “normal” process, then we will surely lose. Think about not containing an Ebola infection and allowing it to spread freely; the image may be horrifying, and yet we are dealing here with something much more dangerous than Ebola.

Raw Story: How do you tell disease apart from healthy choices?

Bandy X. Lee: Often it takes a specialist with a lot of experience to make the distinction, since disorders are usually not entirely new but are extremes of traits that many people normally have. You have to know to what degree that constitutes pathology.

You also have to know a little bit about what the different diseases look like. A cancer cell, on its own, looks very healthy and is very efficient in sucking up all the nutrients around it and reproducing rapidly—it looks like success, but it eventually depletes the organism supporting it and brings everything down, including itself.

Raw Story: Trump tweeted, “The Dems are obstructing justice and will not get anything done. A big, fat, fishing expedition desperately in search of a crime, when in fact the real crime is what the Dems are doing, and have done!” He calls it “PRESIDENTIAL HARASSMENT.” What do you make of his words?

Bandy X. Lee: In mental disease, a useful clue is the level to which the person denies any possibility that something could be wrong with oneself. If one denies it vehemently, then that is already a clue. After a certain point, you start using the formula of taking the opposite of what the person is saying to be true, and taking all assertions to be projection—and by now I have more high-quality data on Mr. Trump than any patient I have ever treated. So what he is really saying is: “I will obstruct justice, since it looks like they are getting a lot done. I’m on a big, fat fishing expedition in search of a way out of this, since I know the real crime is what I am doing, and have done.”

You can test this method elsewhere: when he says he believes President Barack Obama “was ready to go to war…. Anybody else but me, you’d be in war right now,” you can interpret it as his saying he is ready to go to war and that we are likely soon to be in a war like nobody else but he would incite.

When he calls Democrats “angry, angry people…. All killers,” he is giving us information that he is an angry, angry person who is akin to being a killer. So when mental health professionals come out with assessments about the president’s dangerousness or mental impairment, we are not trying to call him names but applying scientifically validated formulations that make revelations about him, such as chaos in the White House, very unsurprising.

Seasoned professionals knew it all from the start. This is why the law in all 50 states gives us the right to contain someone who presents enough psychological evidence to be a danger, whereas law enforcement can only do so after something has happened.

This past week was symbolic of two of the greatest dangers of this presidency: those of nuclear war and of civil war. We cannot expect a leader who is highly attracted to nuclear weapons and war to continue efforts toward peace when they do not bring him distraction or accolades, and when his former fixer Michael Cohen said there may never be a peaceful transition were Mr. Trump to lose in 2020, I cannot say I disagree.

Raw Story: What can we do?

Bandy X. Lee: We really need to begin with a proper evaluation. Medical evaluations and legal investigations have a lot in common, as I have learned from teaching at a law school for over 15 years. You gather evidence to support each of your statements, make use of precedent for your current evaluation (in medicine, this is scientific research and observation over multiple similar cases), and dispense the right treatment based on your discoveries.

This is our grounding in reality, and the reason why Congress, it seems to me, is focusing heavily on the special counsel’s investigations, even though you do not need criminal indictment to proceed with impeachment, for example. Similarly, Section 4 of the 25th Amendment may not need a medical finding to be implemented, but medical evidence is what grounds it in reality and keeps it from becoming a purely partisan game.

Medical professional opinion is admissible in court as evidence; in other words, it has the status of fact. A former White House counsel told me that “Capacity” should be up there with “Corruption” and “Collusion”, and I thought that was a very astute observation. Just as there is the Robert Mueller investigation, there should be an evaluation of the president’s mental capacity. Yet, Mr. Trump’s new White House doctor, with his “11 different Board certified specialists,” did no valid mental health assessment.

The American Psychiatric Association—which I criticize often because the public needs to know what information it is being depriving of—confounded “professional opinion” (a diagnosis) with “any opinion of a professional,” blocking a whole profession from saying a word about this president (the rule used to prohibit only diagnosis). Even the New York Times selectively published a handful of psychiatrists willing to say that the president is “just a jerk” or “does not have narcissistic personality disorder” or that psychiatrists have nothing to offer—and they are all connected to the APA.

In fact, the whole Editorial Board came out with a statement early last year that mental health professionals have nothing to offer about the president—without being an expert, how do they know the limits of the expertise? The ethics of being an expert is first to state the limits of your knowledge—it is not for a newspaper to say. This is actually egregious, and I equate it to the moment when the paper failed to warn against Nazism by burying reports about it.

Clinical psychologist Elizabeth Mika describes tyranny as a “beast” that encroaches on us as a steady creep until it is too late.

Our public-service book, to which she contributed, had three warnings: . . .

Continue reading. Her conclusion is grim: it may already be too late.

Written by LeisureGuy

7 March 2019 at 10:30 am

John Bolton Shows the Dangers of a Weak President

leave a comment »

Jonathan Bernstein writes in Bloomberg:

Just how weak a president has Donald Trump become? For an illustration, see a terrific Washington Post article on the foreign-policy decision-making process since John Bolton became Trump’s national security adviser. Or, rather, the absence of anything resembling a process.

As Heather Hurlburt pointed out when Bolton took the job, he’s ill-suited for it. Bolton is a policy advocate, not the honest broker that the position calls for. That’s a particular problem for Trump. Because the president is inexperienced in national-security matters, he doesn’t know whether Bolton is speaking for the experts on a policy question or just advocating for his own preferences. Because Trump knows little about the executive branch, Bolton can use his bureaucratic skills to advance his own agenda — including impeding Trump’s plan to withdraw U.S. troops from Syria.

This isn’t to say that Bolton’s policies are necessarily wrong; that’s for others to judge. But it creates a real problem for the presidency when top advisers are looking out for their own interests and not the president’s.

On this point, Ronald Reagan’s administration is instructive. By all accounts, Reagan was more informed about policy than Trump is. He was also a pragmatic politician, capable of compromising or even backing down entirely when it was in his interests. Reagan’s weakness, however, was that he could be curiously passive at times, and (like many presidents) too easily swayed by anecdotes. That meant he needed high-level staffers who could serve as honest brokers. His first-term chief of staff, James Baker, allowed him to make good decisions. Baker’s replacement, Donald Regan, failed to do so. Partly as a result, Reagan’s presidency had almost completely collapsed by the time Regan was fired amid the Iran-Contra scandal.

When a weak president — or, as with Reagan, a president with significant flaws — doesn’t have a James Baker around, the administration can turn into a free-for-all, with White House staffers and executive-branch personnel pursuing their own preferences, protecting their turf, and generally disrupting the policy process. That seems to be what happened to George W. Bush in the run-up to the Iraq War; whatever his own views, he was ill-served by everyone, from Vice President Dick Cheney on down, who failed to present him with honest options and instead used bureaucratic skills to lock in the choices they wanted. Similarly, Bill Clinton and Barack Obama both suffered from foreign-policy inexperience, especially early in their presidencies, and made mistakes as a result.

For Trump, the problem is worse. Even if he wanted to replace Bolton, there’s only a tiny pool of people who are both qualified for the job and willing to work in this White House. Which is yet another consequence of presidential weakness: He can’t persuade many people to work for him. And if Trump is getting rolled in an area where presidents have unusually strong authority — in their capacity as commanders-in-chief — imagine how he’s faring in other policy areas. . .

Continue reading.

Written by LeisureGuy

7 March 2019 at 9:56 am

Searching for a shave solution

with 6 comments

I recently heard from a shaver who is frustrated with not being able to get a good shave with a DE razor even after 10 years of using one. He writes that some of his challenges are:

  • hard water – He’s tried distilled/purified water and also try using a pinch of citric acid in a sink half-filled with water.
  • razor burn – He writes he typically gets razor burn. The razors he’s tried are Merkur HD (aka 34C), Merkur Slant (aka 37C), Parker Variant (a Progress clone), and RazoRock Stealth (a slant).
  • nicks – He typically gets some nicks.
  • rough patches – At the end of the shave, rough spots remain.

He asked me what I could recommend, and I’m posting this in case my readers also have suggestions. Here are my thoughts:

Hard water: Best is a water softener, but that option is available only to home owners as a general rule, and many (including myself) are renters. When I did own a home (in Iowa City, which has hard water), I did have a water softener with soft water throughout except for the kitchen cold water and the outside faucets.

Distilled water works best if some of tap water is included: mostly distilled (or purified) water with a glug of tap water so the lather will not be so airy. However, this does require heating the water unless you’re one who enjoys a cold-water shave (and some do). The advantage of the pinch of citric acid in a sink half-filled with water is that you can use hot water from the tap.

Alternatively, you can choose a soap that performs well even in hard water. Arko’s shave stick is reputedly quite good in hard water, and those who don’t like using a shave stick—I’m sure there must be at least a few—can grate the stick on a coarse grater and mash the shavings into a tub or bowl to make a puck. After the first use, the water will weld the shavings together.

So look for soaps that contain EDTA, or citric acid, or sodium citrate, or other chelating agents. Arko uses EDTA:

Potassium Tallowate, Stearic Acid, Potassium Cocoate, Aqua, Sodium Palm Kernelate, Glycerin, Parfum, Paraffinnum Liquidum, CI 77891, Tetrasodium EDTA, Etidronic Acid,Disodium Distyrylbiphenyl Disulfonate, Amyl Cinnamal, Citronellol, Geraniol, Hexyl Cinnamal, Linalool.

The chemicals in boldface are, I believe, intended to combat the effects of hard water. D.R. Harris shaving soap includes as ingredients Citral Tetrasodium etidronate, Pentasodium pentetate, and Tetrasodium EDTA, all of which bind to calcium to nullify—or at least reduce the effects of—hard water.

Razor burn and nicks: None of the razors he currently has, with the exception of the Stealth, would I classify both as very comfortable (which includes reluctance to nick) and very efficient, and the Stealth is a slant, so I would focus first on getting a good regular razor.

I initially suggested the Dorco PL602 (get on eBay) or the RazoRock Baby Smooth, which is now $20 $40 [it was $20 when I looked at the site as I wrote this post, but now it’s back to $40—the $20 price was either an error or a flash sale – LG] and is available in Black, Silver, and Electric Blue. (There’s also a titanium version for $125.) Both of these razors put an extreme curvature on the blade, and I believe that’s one reason they shave so comfortably and efficiently.

But then I I though of the RazoRock Old Type, also quite comfortable and quite efficient, and so I used it today to verify my impressions—and yep, it’s quite good: extremely comfortable and extremely efficient. The razor is $17, but he can buy the head by itself for $8 and use it with his Stealth handle. (His other razors are two-piece razors so their handles are unavailable.)

I suggest that he try 4-5 new brands of blades—and with any new razor you must try a few different brands of blades since a brand that’s best in one razor may not be best (or even good) in another razor. I suggest getting some samples from Tryablade.com, and I would include: Personna Lab Blue, Gillette Silver Blue, Derby Extra, Gillette 7 O’Clock SharpEdge, Astra Superior Platinum, Voskhod, and Polsilver.

To avoid razor burn and to minimize nicks, keep the handle far from the face, something those accustomed to shaving with a cartridge razor find difficult since a cartridge razor requires the handle be held close to the face and old habits die hard. But if you hold the handle of a typical DE razor close to the face, here come nicks and burn. (The Stealth actually does have the handle closer to the face than most DE razors.)

The general rule is to move the handle away from your face until the razor stops cutting (in a silent bathroom you can clearly hear when the cutting sound stops), and then move the handle a little closer, just until the cutting sound resumes. That’s close to the correct angle. Play with it: closer, farther, closer, farther, until you lock in on the best angle.

One thing that helps here is focusing on keeping the cap (not the guard) touching the face, and by “touching” I mean barely touching. Focus on trying to use too light a pressure, while still making sure the cap touches the face. This is to take care of the other suspect in razor burn: pressing the razor too hard against the skin. While the razor’s head must be in contact with the skin, it should not be more than that. If the skin has a dent where the razor is, that’s way too much pressure.

Rough patches will generally succumb to an efficient razor with a blade that works well for you in that razor, provided you do a classic 3-pass shave: with the grain, rinse, relather, across the grain, rinse relather, against the grain. The only trick is to determine the grain’s actual direction, rather than its putative direction. I had one chronic rough patch on the bottom part of my right cheek. When I carefully mapped the grain of my beard using this interactive diagram, I discovered that the grain in the trouble spot was horizontal and “with the grain” was in the ear-to-nose direction.

As a result, on my first pass I shaved that area across the grain, on my second pass (when I shaved in the direction ear-to-nose) I shaved it with the grain, and on the final pass, I shaved it across the grain in the other direction. I never shaved it against the grain.

So now, on the across-the-grain pass I continue to shave ear-to-nose except for that one spot, where I shave nose-to-ear, thus shaving it against the grain: no more rough patch.

I used Mama Bear’s Energy shave stick this morning with the Green Ray brush, and I continue to be highly pleased by the lather from her glycerin-based soaps. Tallow is nice, but so is glycerin, and indeed the quality of lather in terms of density and consistency seems better than some of my tallow soaps. The Energy fragrance is also very nice: “Citrus, including Grapefruit, Lemon and Lime, with hints of fresh Cucumber and Jasmine, and a touch of Pineapple, Blackberry and Champagne.” The link is to the soap in a tub since the Energy stick seems currently to be out of stock.

I selected the Old Type to remind myself, and it is indeed quite comfortable and highly efficient. I think it would be a good choice, though the Baby Smooth would also be excellent and perhaps a shade more comfortable. But both are top-notch.

A good splash of TOBS Shave Shop finished the shave in fine style.

 

Written by LeisureGuy

7 March 2019 at 8:53 am

Posted in Shaving

%d bloggers like this: