“A close aide to Saddam Hussein says the Iraqi dictator did in fact get rid of his weapons of mass destruction but deliberately kept the world guessing about it in an effort to divide the international community and stave off a U.S. invasion.

The strategy, which turned out to be a serious miscalculation, was designed to make the Iraqi dictator look strong in the eyes of the Arab world, while countries such as France and Russia were wary of joining an American-led attack. At the same time, Saddam retained the technical know-how and brain power to restart the programs at any time.

U.S. defense officials and weapons experts are considering this guessing-game theory as the search for chemical, biological and nuclear weapons continues. If true, it would indicate there was no imminent unconventional weapons threat from Iraq, an argument U.S. President George W. Bush used to go to war.” Taiwan News

This update on the mysterious disease of which I wrote yesterday describes the fifteen cases as separated in time — “three fell gravely ill with pneumonia in March, three more in April, two in May, three again in June and four in July, according to the army.” — and space — “according to the defence officials, the pneumonia has afflicted soldiers deployed in various parts of Iraq and belonging to different units” — , to answer some of my questions. al jazeerah.info

Ben Kerschberg’s Blog on Mental Health:

Ben Kerschberg is a graduate of Yale Law School and the University of Virginia. Since graduating from law school, he has clerked for a federal court of appeals judge, practiced law, and worked as an industry analyst for a public software company in Silicon Valley… He will spend the next two years as a Fellow at Yale Law School, where he hopes to write a book about the manner in which American society stigmatizes mental illness.

Ben Kerschberg knew at age seven that he would one day attempt suicide. … It was not an idea he toyed with. He just knew. And he was right.

In (his book) Piercing The Veil, Kerschberg takes us with unflinching candor on a journey that begins in his sophomore year of college, when he suffers the first of a series of repeated and calamitous nervous breakdowns precipitated by daily suicidal ideations. His lifetime battle with his inner demons culminates, at age 30, in a failed suicide attempt and hospitalization in a psychiatric institution. His astonishing tale opens the eyes of those who have never suffered from mental illness and empowers those who have but feel that their truth must be bottled, corked, and sealed with wax. At times disarmingly funny, but more often poetically tragic, Kerschberg’s account breaks onto the scene with a powerful voice that will leave people reaching out to their friends and loved ones.

The weblog is a labor of love, doing a good job covering mental health-related media items. I haven’t looked at the book but it is available for free download here.

“The funeral touched off an

‘They know when I’m lying and when I’m not…’: “So after he drifted into a neighbor’s room the other day to visit a friend who is also a convicted child molester, he quickly reported to his landlady that he had spied a tiny photograph of a blond girl. A day later, corrections officers who work closely with the landlady searched the room and confiscated a huge stash of pornographic pictures and videos, a miniature Barbie doll and a stack of photographs of children.

Within hours (his) neighbor was under arrest for violating the conditions of his probation and was on his way back to jail.” NY Times

“If you’re going to be a Master of the Universe in London, you’d better watch your manners. At least that’s the message from an English court.” NY Times

The curator of European decorative arts at the Art Institute of Chicago says that Dan Brown’s New York Times bestselling thriller, which “unabashedly adapts Leonardo’s art and theories, which he says on his Web site he researched extensively, to his own fictional requirements”, doesn’t have much of a clue. NY Times

“The tangled relationship of art, illusion and the marketplace being what it is — an ongoing melodrama, set to the strains of keening violins — it so happened that 250 tuxedoed, gowned and bejeweled members of the patronage class showed up for an Italianate palace ball one night this spring at a defunct train station in a Jersey City marsh. Guests were met at the gate by a young man in a pleated skirt, pointy black slippers and a frilly blouse under a gold brocaded vest, who bowed theatrically and said, ”Buona notte, signori e signore.” The title of the ball was Palazzo di Cremona, and the domed terminal of the Central Railroad of New Jersey was done up for the evening with garlands of citrus leaves and blood oranges. Three former governors of New Jersey were present, along with Paolo Bodini, mayor of Cremona, Italy, a 2,300-year-old town north of Milan. Cremona occupies a status among violin aficionados akin to that of Detroit among car buffs, having been the ground on which such violin-making luminaries as Niccolo Amati, Giuseppe Guarneri and, above all, Antonio Stradivari thrived. Mayor Bodini was a guest of the evening’s honorees, an elderly couple named Evelyn and Herbert Axelrod, who had gained vast wealth by addressing themselves to the needs of caretakers of guppies, goldfish, parakeets, lizards, gerbils and the like, and who elicited, throughout the evening, comparison to the beneficent Medicis of Florence.” NY Times Magazine

Terry Gross’ interview with Vernor Vinge for NPR’s Fresh Air: “The author of 16 books of science fiction, he gained a cult following for his early role in writing about cyber-culture and the Internet. His new book Across Realtime, came out earlier this year. He talks about the difficulty of writing science fiction when technology out dates itself as rapidly as it does.” Realmedia/Windows Media

Der Spiegel interviews George Akerlof, winner of the 2001 Nobel Prize in Economics. “Past administrations from the time of Alexander Hamilton have on the average run responsible budgetary policies. What we have here is a form of looting.”

Recent Decisions on Gays, Affirmative Action Does Not Outweigh ‘Dubious Rulings,’ She Says. Washington Post

on the Down Low: “To their wives and colleagues, they’re straight. To the men they have sex with, they’re forging an exuberant new identity. To the gay world, they’re kidding themselves. To health officials, they’re spreading AIDS throughout the black community.” NY Times Magazine

“The man who performed a shrinking trick on previous versions of Windows claims today that he’s reduced Win95 to under 10MB.

Windows 95, he says, works in real (safe) mode and doesn’t require the registry but simply SYSTEM.INI.

Nor, he says, does it need a swap file to run and it can be run from a RAMdisk using a free utility.

He claims that the 10MB version of Windows 9X will support multiple MS DOS Windows, and he claims that it can be shrunk even further.” The Inquirer

“Some scientists hope blueberry burgers will be coming to a restaurant, supermarket or school cafeteria near you.

Al Bushway, a food scientist at the University of Maine, says his lab has been stirring blueberry puree or blueberry powder into beef, chicken and turkey patties. The researchers are trying to boost the nutritional value of burgers and help farmers improve their berry sales.

Blueberries add cancer-fighting antioxidants to the patties and may slightly reduce the fat content of burgers.” Salon

Past becomes present:

“The Massachusetts Museum of Contemporary Art is a sprawling complex of old brick mill buildings given new life while retaining a sense of history: Layers of paint, for instance, were deliberately left intact as a visual echo of the past.

For this year’s big show at MASS MoCA, ”Yankee Remix,” nine artists browsed though the archives and storage of the Society for the Preservation of New England Antiquities, borrowed a wide array of artifacts, and wove these fragments of history into new installations. It’s another case of reviving the past, drawing it into the present.” Boston Globe

I was at MassMoCA last weekend and was not nearly as impressed by this exhibit as the reviewer. However, Robert Wilson’s overwhlmingly powerful, magical, disturbing reconceptualization of the Stations of the Cross needs to be seen.

And here’s another renovated factory space serving up outsized art for the Northeast. Boston Globe

No, due to wildlife: “Colorado authorities joined their colleagues in Utah on Friday in blaming 45 Denver-area cat slayings in the past year on wildlife, ending weeks of suspicion that budding psychopaths and devil worshippers were killing the pets.” azcentral [via Daily Rotten]

Car Crash Reveals Racist Church: “A car crash this week in a town near New Orleans revealed that a building thought to be a home improvement business was actually a white supremacist church, police said on Friday.

The vehicle smashed into the brick storefront in Chalmette, Louisiana, after colliding with two other cars and came to rest amid stacks of racist books and pamphlets, including Adolf Hitler’s Mein Kampf, they said.

A sign proclaimed the building the ‘Southern Home Improvement Center,’ said Lt. Mike Sanders of the St. Bernard Parish Sheriff’s Department, but investigators found out it was the New Christian Crusade Church and headquarters of the Christian Defense League.” Reuters You’ve got to admire their logic — church as “home improvement”?

‘An audio tape purportedly from top al Qaeda official Ayman al-Zawahri warned the United States on Sunday it would pay a high price if it harmed detainees at a U.S. base in Cuba, saying the “real battle” had not yet begun.’ Reuters

And: Afghan Political Violence on the Rise: “Instability in South Grows as Pro-Taliban Fighters Attack Allies of U.S.-Led Forces” Washington Post

“Only future historians will be able to sort out the Iraq war’s ultimate validity. It is too late or too early for the rest of us.” — Thomas L. Friedman, NY Times op-ed

“Maybe the president and his swaggering circle should think about a “Queer Eye for the Straight Guy” makeover.” — Maureen Dowd, NY Times op-ed

Why are Liberian soldiers wearing fright wigs?: “Few things exemplify the chaos of Liberia more than the sight of doped-up, AK-47-wielding 15-year-olds roaming the streets decked out in fright wigs and tattered wedding gowns. Indeed, some of the more fully accessorized soldiers in Charles Taylor’s militia even tote dainty purses and don feather boas. Why did this practice begin and what is the logic behind it?” Slate [via walker‘s uncanny eye for such stuff!]

A reader asked me what I thought about Peter Breggin’s longstanding critique of modern psychiatric practice, as reflected in this review of one of his recent books. My first reaction was, “Oh, no, Breggin again.” I have such difficulty with his argument with psychiatry (and such curiosity about what personality factors and life experiences congealed as such rabid fervor in him) that I usually just dismiss him. But (sigh) this reader, concerned by the antimedication arguments here, asked for a response.

As the reviewer encapsulates it, this book “neatly summarizes many of the best arguments against biological psychiatry”, and that is precisely the problem. They are simply arguments against, with no balanced deliberations. Breggin feels it is a mistake to view depressed feelings as a disease; in doing so, he is reacting to an outmoded version of psychiatric theory which had not demonstrated the structural and functional brain changes we now can see in untreated severe depression. Admittedly, the dividing line between ‘normal’ depressed feelings — which are a part of everyone’s mood variations — and the pathological process is difficult to draw, but that is the challenge every mental health practitioner faces, some better than others at refraining from pathologizing the ‘normal variants’ but on everybody’s minds. I actually join Breggin in criticizing those of my colleagues who have lost their perspective on the distinction completely, and the trend toward what Peter Kramer MD (in Listening to Prozac) has called ‘cosmetic psychopharmacology’, which has its sources in both conceptual confusion on the part of prescribers and the vested interests in the field which want to widen the scope of permissible prescribing targets. But to castigate the entire field for the excesses of its least perspicacious would deprive those clearly suffering from a correctable physiological disturbance bringing them ongoing distress and dysfunction (which worsens if not treated) a scientific and systematic approach to alleviating their suffering.

I would also join Breggin in his criticism of those for whom medication is the end-all of their treatment attack, but, again, that is not the norm in the field. It is well acknowledged that the best treatment approach to most mental illnesses such as, say, depression as Breggin discusses it here, is a combination of therapy and medication, so much so that a non-medical therapist who fails to recognize the indications for medication and make the recommendation to her/his severely depressed patient can be sued for malpractice. I like to tell my patients that medication is like a bicycle — the most efficient human-powered vehicle to get from point A to point B, but you still have to pedal. The analogy only goes so far, however, because when you get there there is still much more work to do when and if you dismount.

Breggin also faults the field for the fact that we do not know how medications work on a cellular level; this is true. But is naive to assert that all the speculation about how the medications work is designed solely to promote the drugs. We know the medications work, empirically; people feel better and get better when they are treated with them, as established (contrary to breggin’s assertion) by countless studies meeting the gold standard of scientific method — the double-blind placebo-controlled methodology. There are examples throughout medical science of medications being used because they have been shown to be beneficial, while the explanation of their mechanism remains purely speculative. The dirty secret for all of medicine is that the emperor often has no clothes when s/he speaks authoritatively in certainties about the mechanism of action of the magic bullets s/he dispenses. Arguably, healing, no matter in what medical subspecialty, depends in large measure on what has been called the priestly function of the physician, enlisting the supplicant by authority and charisma into a shared belief system which mobilizes the patient’s own mind’s and body’s best resources for the restoration of their health — with physiological help from medication effects.

The mechanisms of most drugs that affect complex physiological systems such as the cardiovascular are, on some level, opaque to analysis, although Breggin is right to be more troubled about the issue with neuroscience and psychiatry than with other medical fields. He ignore two simple facts with the most profound significance. First, in brain disease, the affected organ is the very same one that is the vehicle for perceiving and describing the dysfunction, unlike what patients can tell us relatively unimpeded when their heart, lungs or abdominal organs are malfunctioning. Secondly, by and large (this is not fully true, but enough for my argument here) there is no animal model for human consciousness, so experimental methods to establish pathophysiology or the effects of medication upon that pathophysiology are inherently impossible. There is no adequate animal model for any psychiatric disease for that reason, researchers’ arguments to the contrary. So, Dr. Breggin, the brain will always be a black box. But that doesn’t mean we have no way of knowing how effective our treatment approaches are; don’t confuse the two different epistemological realms.

His next point, that the psychiatric drugs “impair our emotional awareness and our intellectual acuity”, and thus “impede the process of overcoming depression”, that that is all they do, is patently absurd. But the crux of the argument comes in his next assertion, that “If a drug has an effect on the brain, it is harming the brain,” i.e. that psychiatric drugs are, plain and simple, poisons. In particular, he works himself into a fever pitch about imagined “potential hazards” of SSRIs for which there is no substantiation. And to claim that “there are so many… that no physician is capable of remembering all of them” (and thus no patient adequately informed by their physician) makes me glad he does not himself use his medical license to treat patients, with such seemingly scarce memory capacity. As readers of FmH know, I have discussed at length the bogus claim that SSRIs provoke or worsen suicidality, or promote interpersonal violence. Breggin would do well to criticize careless use by inattentive or undertrained personnel, as I have written, but not to throw the baby out with the bathwater. His argument is rife with misinformation, distortion and selective attention to prove an a priori conclusion, and logical and epistemological fallacies. His constituency is the rather small absolutist anti-psychiatry movement, the members of which it shold be pointed out have mostly been motivated to object to not antidepressants but antipsychotic medications, for which the evidence of damaging effects, impairing judgment, equivocal effctiveness, and use as tools of social oppression has far more ‘teeth’ than anyone reasonable asserts for antidepressants.

I think there is a role in the psychiatric profession for a histrionic gadfly like Breggin (just as there is a role in the medical debate over assisted suicide for Jack Kevorkian!), if his polemic forces a reexamination and acknowledgement of the grain of much exaggerated truth at its core. But his irresponsible reductionism and overgeneralization leave him without the credibility to take his role responsibly. I’ll go back to just dismissing him, I suppose. As Malcolm Lowry once said, “How many wolves do we feel on our heels, while our real enemies go in sheepskin?”

A reader asked me what I thought about Peter Breggin’s longstanding critique of modern psychiatric practice, as reflected in this review of one of his recent books. My first reaction was, “Oh, no, Breggin again.” I have such difficulty with his argument with psychiatry (and such curiosity about what personality factors and life experiences congealed as such rabid fervor in him) that I usually just dismiss him. But (sigh) this reader, concerned by the antimedication arguments here, asked for a response.

As the reviewer encapsulates it, this book “neatly summarizes many of the best arguments against biological psychiatry”, and that is precisely the problem. They are simply arguments against, with no balanced deliberations. Breggin feels it is a mistake to view depressed feelings as a disease; in doing so, he is reacting to an outmoded version of psychiatric theory which had not demonstrated the structural and functional brain changes we now can see in untreated severe depression. Admittedly, the dividing line between ‘normal’ depressed feelings — which are a part of everyone’s mood variations — and the pathological process is difficult to draw, but that is the challenge every mental health practitioner faces, some better than others at refraining from pathologizing the ‘normal variants’ but on everybody’s minds. I actually join Breggin in criticizing those of my colleagues who have lost their perspective on the distinction completely, and the trend toward what Peter Kramer MD (in Listening to Prozac) has called ‘cosmetic psychopharmacology’, which has its sources in both conceptual confusion on the part of prescribers and the vested interests in the field which want to widen the scope of permissible prescribing targets. But to castigate the entire field for the excesses of its least perspicacious would deprive those clearly suffering from a correctable physiological disturbance bringing them ongoing distress and dysfunction (which worsens if not treated) a scientific and systematic approach to alleviating their suffering.

I would also join Breggin in his criticism of those for whom medication is the end-all of their treatment attack, but, again, that is not the norm in the field. It is well acknowledged that the best treatment approach to most mental illnesses such as, say, depression as Breggin discusses it here, is a combination of therapy and medication, so much so that a non-medical therapist who fails to recognize the indications for medication and make the recommendation to her/his severely depressed patient can be sued for malpractice. I like to tell my patients that medication is like a bicycle — the most efficient human-powered vehicle to get from point A to point B, but you still have to pedal. The analogy only goes so far, however, because when you get there there is still much more work to do when and if you dismount.

Breggin also faults the field for the fact that we do not know how medications work on a cellular level; this is true. But is naive to assert that all the speculation about how the medications work is designed solely to promote the drugs. We know the medications work, empirically; people feel better and get better when they are treated with them, as established (contrary to breggin’s assertion) by countless studies meeting the gold standard of scientific method — the double-blind placebo-controlled methodology. There are examples throughout medical science of medications being used because they have been shown to be beneficial, while the explanation of their mechanism remains purely speculative. The dirty secret for all of medicine is that the emperor often has no clothes when s/he speaks authoritatively in certainties about the mechanism of action of the magic bullets s/he dispenses. Arguably, healing, no matter in what medical subspecialty, depends in large measure on what has been called the priestly function of the physician, enlisting the supplicant by authority and charisma into a shared belief system which mobilizes the patient’s own mind’s and body’s best resources for the restoration of their health — with physiological help from medication effects.

The mechanisms of most drugs that affect complex physiological systems such as the cardiovascular are, on some level, opaque to analysis, although Breggin is right to be more troubled about the issue with neuroscience and psychiatry than with other medical fields. He ignore two simple facts with the most profound significance. First, in brain disease, the affected organ is the very same one that is the vehicle for perceiving and describing the dysfunction, unlike what patients can tell us relatively unimpeded when their heart, lungs or abdominal organs are malfunctioning. Secondly, by and large (this is not fully true, but enough for my argument here) there is no animal model for human consciousness, so experimental methods to establish pathophysiology or the effects of medication upon that pathophysiology are inherently impossible. There is no adequate animal model for any psychiatric disease for that reason, researchers’ arguments to the contrary. So, Dr. Breggin, the brain will always be a black box. But that doesn’t mean we have no way of knowing how effective our treatment approaches are; don’t confuse the two different epistemological realms.

His next point, that the psychiatric drugs “impair our emotional awareness and our intellectual acuity”, and thus “impede the process of overcoming depression”, that that is all they do, is patently absurd. But the crux of the argument comes in his next assertion, that “If a drug has an effect on the brain, it is harming the brain,” i.e. that psychiatric drugs are, plain and simple, poisons. In particular, he works himself into a fever pitch about imagined “potential hazards” of SSRIs for which there is no substantiation. And to claim that “there are so many… that no physician is capable of remembering all of them” (and thus no patient adequately informed by their physician) makes me glad he does not himself use his medical license to treat patients, with such seemingly scarce memory capacity. As readers of FmH know, I have discussed at length the bogus claim that SSRIs provoke or worsen suicidality, or promote interpersonal violence. Breggin would do well to criticize careless use by inattentive or undertrained personnel, as I have written, but not to throw the baby out with the bathwater. His argument is rife with misinformation, distortion and selective attention to prove an a priori conclusion, and logical and epistemological fallacies. His constituency is the rather small absolutist anti-psychiatry movement, the members of which it shold be pointed out have mostly been motivated to object to not antidepressants but antipsychotic medications, for which the evidence of damaging effects, impairing judgment, equivocal effctiveness, and use as tools of social oppression has far more ‘teeth’ than anyone reasonable asserts for antidepressants.

I think there is a role in the psychiatric profession for a histrionic gadfly like Breggin (just as there is a role in the medical debate over assisted suicide for Jack Kevorkian!), if his polemic forces a reexamination and acknowledgement of the grain of much exaggerated truth at its core. But his irresponsible reductionism and overgeneralization leave him without the credibility to take his role responsibly. I’ll go back to just dismissing him, I suppose. As Malcolm Lowry once said, “How many wolves do we feel on our heels, while our real enemies go in sheepskin?”