Israel agrees to 48-hour suspension of bombing. (Yahoo! News)

<a href=”http://abcnews.go.com/International/wireStory?id=2” title=””>Suspension over. (ABC News)

Israel agrees to 48-hour suspension of bombing. (Yahoo! News)

<a href=”http://abcnews.go.com/International/wireStory?id=2” title=””>Suspension over. (ABC News)

Or is it? Opposed in principle to the practices of the Coca Cola Corp. but compelled by their customers who crave the real thing, the managers of an alternative cinema in Bristol are on a quest to replicate the recipe themselves. (Guardian.UK)

In last month’s “Medlogs controversy” here, the anonymous commenter contrasted my printing of lengthy excerpts from the New York Times with his/her ‘true’ journalism. Apart from the fact that (a) commentary is not journalism; and (b) the commenter betrayed her/his lack of understanding that excerpting and logging is one of the original traditional forms of weblogging, a news story like this one illustrates potently how some stand on their own without need for fatuous pseudo-punditry and that I have served the purpose I intend merely by pointing you to them.

My point for a long time with regard to the atrocities committed by US forces in Iraq has been that the influences, if not the direct orders, shaping them emanate from the top, by intention, despite insidious efforts from the right to portray each of the burgeoning number of such events as attributable to some ‘rogue’ soldiers who snapped, or who were sociopaths to begin with. Draw your own conclusions. And, please, by all means, shoot the messenger once you have done so!

The fabulous furry Freakonomics brothers said:

While testosterone can be an aid in training, it is not a night-before performance enhancer, and it is much more useful in sports performance requiring explosive bursts of energy rather than the endurance challenges of the Tour de France. If Landis’ impetuous use of an illegal drug after his disastrous performance in the prior stage had been the explanation of his comeback, I would have expected him to use something like epoeitin instead. And as for the comparison with Bode Miller, Landis drank in despair, he says, for one night when he thought he was washed up. Miller’s debauchery was part of his training regimen, it seems, and one reason for his performance deficits. Why, then, is testosterone among the banned substances, one commenter to this post asks. For part of the answer, listen to the interviews with the head of the World Anti-Doping Agency and tell me if there doesn’t seem to be a veneer of religious zeaoltry and missionary zeal there. [thanks, walker]

• Nexcare Home Safety First Aid Tips, free from 800-537-2191

This is a movement spurred by civic organizations mostly concerned with — shudder! — declining consumption of US goods and declining tourist revenue, it seems. Instead of diverting the rest of the world from their largely accurate perceptions of US policy — selfish, unilateral, swaggering and exploitive — and the behavior and values of the ‘ugly Americans’ — boorish, materialistic, ignorant and xenophobic — these civic groups should be expending their effort on regime change and culture change at home. Otherwise, it is more of the same — attempting to bully the rest of the world into doing it our way, to meet our selfish ends!

Extraordinary Russian experiments suggest that many other characteristics of domesticated animals — physical characteristics such as changes in coloration, rolled tails and differences in skull shape — come along if all you breed for is ‘tameness’, i.e. tolerance of humans. This work, which has been done in foxes and rats, seems to hold across species. A relatively small number of genes — or perhaps even one — may control the traits associated with domestication. And the factor linking all this may be the embryonic neural crest, a structure which is the source of cells that will form the face, skull, pigment, elements of the nervous system and the adrenal glands, which control stress hormone release and aspects of the fight or flight reaction. If you select for animals with less constitutional fear, they may be able to see humans as social collaborators instead; they may appear ‘smarter’ than their wild forebears. It is not outlandish to speculate that selecting for tame animals is selecting for underdevelopment, or delayed development, of the neural crest.

And… there are some suggestions that humans are self-selecting themselves for domestic attributes, which may bear some genetic and embryonic similarity (although you would not know it if you look at the state of disharmony and belligerency in the world…) (New York Times via abby)

Does anyone remember the witty and clever 1980 film by Alain Resnais, Mon Uncle d’Amerique? Resnais made it as a collaboration with French biologist Henri Laborit and an homage to his theories about the ways in which the conditions of civilized life inherently conflict with our human nature. Some of the most hilarious moments of the film, in which Resnais jumpcuts from the dilemmas the main characters face to analogous vignettes with lab rats in their cages, upon which Laborit expounds, suggest that the central problem of modernity is the demand that the fight or flight reaction be inhibited. The highly original pathos of the film, and Resnais’ and Laborit’s compassion for their characters, is framed through this lens. But if we are, as the new research leads one to speculate, auto-domesticated, perhaps we ought not to be the objects of Laborit’s sympathetic gaze after all. Perhaps, instead, we should be pitied for having the spunk bred out of us altogether.

Leaked Memo: Coal Industry Coordinating Propaganda Blitz Attacking Global Warming Science (Think Progress)

Or: What has become of the Che icon? (The Sun)

“Physicist Costas Soukoulis and his research group at the U.S. Department of Energy’s Ames Laboratory on the Iowa State University campus are having the time of their lives making light travel backwards at negative speeds that appear faster than the speed of light. “

31-year old author’s Measuring the World, whose main character is astronomer/mathematician Carl Gauss (who discovered the curvature of space), is outselling Dan Brown and J.K. Rowling. (Guardian.UK)

Ask MetaFilter thread compiling a “list of famous people with science-related qualifications.” The poster wants to persuade his students “that studying science does not mean you have to become a scientist.” Some interesting and surprising people on the list; perhaps the most unexpected is Dolph Lundgren.

Here are more:

• Famous people with a philosophy degree
• List of musicians by academic degree
• Famous “nonmathematicians”

[The full article is available only to premium subscribers, but you get the picture…]

Darn, I just saw this; otherwise there would have been 600,000,001. Did it work, I wonder?

Actually, I think the only serious debate is between those who think Bolton has been a major player in advancing the cause of US isolation and those who feel he is merely holding his own with the sorry state of global US foreign policy failure he inherited. [Click the link, it is unbelievable…literally.]

[And how should PETA be defined in the dictionary, one might ask?]

It has long been said that people with autism are fixated on imagery but have difficulty processing words and language. Confirmation comes from a new brain scanning study showing that an autistic patient’s parietal cortex, active in others only when sentences contain imagery, is relied upon even when interpreting sentences without any imagery. Ironically, ‘focusing on the picture’ may cause them to ‘miss the big picture’. (New Scientist)

[And how should PETA be defined in the dictionary, one might ask?]

Congress has held a hearing to investigate Bush’s use of the statements, a bipartisan advocacy group has condemned their use, and Democratic Rep. Barney Frank has introduced a bill that would allow Congress to override content in them that contradicts signed legislation. But stronger action is called for in the face of this most outrageous and egregious exemplar of the despotic imperial presidency. Now a task force of the American Bar Association will recommend that Congress legislate judicial review of the signing statements. This might amount to asserting a Congressional right to sue. (U.S. News)

Error rates must certainly vary by hospital! I have never seen anything like one medication error per day per patient, even adjusting for those that do not come to light, in my hospital work. In fact, I think that is inaccurate by something like two orders of magnitude.

“How Asian horror films put the fear back into America’s scary movies — and brought the A list to a B genre.” (New York Times Magazine)

Neocons Are Nuts To Join Israel-Hezbollah Conflict. I’m sorry, I can’t make a reasoned, longwinded response to this latest neocon nonsense. Gingrich is so defensive about the idiocy of this assertion, that the Israel-Hezbollah conflict is WWIII and that the US should not wait to get on the right side of the conflict — specifically by taking out Iran, Syria and while we’re at it that bastion of the worldwide anti-American Islamist conspiracy North Korea as well — that each time he defends it in the media his blowhard list of bits of evidence from around the world inflates more and more (in parallel with the inflation of his jowls and his presidential aspirations). In a sense, though, he is right, the enemies of the West, or the US in particular, are mustering, emboldened in solidarity around the world. The only problem is that the neocons do not notice that it was the US’s arrogant unilateral bellicosity they largely whipped up which engendered it.

Senate Renews 1965 Voting Rights Act (ABC News) Worth celebrating, but in a just society there would not even be a question.

Dropping out of the rat race… but where?? (Wired)

Off-the-cuff conversation between US President George W Bush and UK Prime Minister Tony Blair during a break at the G8 conference in Russia (BBC ), an interchange which begins with Bush’s “Yo, Blair…” and encompasses Bush’s breathtaking and incisive reference to a critical geopolitical crisis as if it were excrement. As if you needed any confirmation, it reveals an ignorant boorish redneck about as far from presidential caliber as you could imagine. I expect him to appear in public with his baseball cap backward. Pity is that that appears to be what somewhere in the vicinity of half of the American people want in the way of leadership.

Addendum: a version with video, thanks to reader alireza.

Does ‘train-wreck editing’ alienate or endear listeners, Jack? (Wired) One of the best things about migrating to listening to music via iPod, IMHO, is that I keep it on shuffle almost all the time. 6000+ carefully selected songs and I am constantly surprised and almost always delighted by what comes up next.

Snakes on a Plane — another sign of Hollywood’s demise or the triumph of the blogosphere? The essay is not at all about the merits (ha!) of the film, and all about the title choice:

The grotesquerie here is, of course, Rice’s unbelievable statement. Orwellian Newspeak had nothing on the Bush administration.

Jacob has taken a stand on this issue on his own weblog:

With this, he lays to rest the anonymous complainer’s campaign to oust me from Medlogs syndication. Of course, I heartily agree, even though I did not think the complaint was ever really about the relevance of politics to medical practice but rather an attack on my particular political ‘rants’.

If I had fallen for anon.’s ‘troll’ anymore than I did, had I wanted to devote even more indignant energy to my response than I already had, it would have been along exactly the same lines. I would have written about how ridiculous it is to try to separate politics, even very specific anti-Bush and antiwar rhetoric, from healthcare concerns. It is axiomatic that the practice of medicine is embedded inherently in a political and social context, and that is particularly true of mental health care.

Most people, especially these days, fast-track from college right into medical school and then their medical careers. One of the advantages of my taking time to live a life before studying medicine and becoming a doctor was that I brought well-formulated political activist sentiments into the medical sphere. So my credentials around the inherent politicization of the practice of medicine go way back. To wit: during medical school, I became a student leader in Physicians for Social Responsibility, was privileged to be mentored by Robert J. Lifton MD and Helen Caldicott MD, and organized a national conference addressing the nuclear arms race as a public health emergency. (Yes, I studied medicine as well…)

My anonymous complainant will doubtless scoff at all this. In a comment of his/hers which I have since deleted, s/he threatens to “reveal myself” and mount a sympathy campaign for support to exclude my weblog (and, I would surmise, those of others with similar sentiments) from syndication. So we do agree on one thing at least — the advantages of taking the issue public rather than sniping from a position of cowardly anonymity. Nonetheless, I expect this is the end of this matter. I thank FmH’s readers for your patience with this idiocy.

Update: I posted this a week ago and got no responses back from Medlog readers, although there are a few comments here. I am reposting it again to solicit comments for a second week, after which I will consider myself to have discharged my responsibility and will close the matter. The anonymous poster referred to below has continued to post provocative comments here on FmH, which I have begun expunging as I threatened to do if s/he had nothing new to say on the matter. I have still heard nothing from Jacob Reider, the sysop of Medlogs. If you are reading this on Medlogs and have an opinion on this matter, please enter a comment on the copy of this post on FmH, identifying yourself as a Medlogs reader. Please don’t share the complainant’s cowardice by remaining anonymous.

Here’s the repost: For readers of FmH — unless you read the comments under the post to which this link points on my weblog Follow Me Here, you would probably not know that FmH is syndicated at medlogs.com.

For readers via Medlogs — I am posting this largely for you. Recently, an anonymous Medlogs reader, in the midst of a mutually rather acrimonious exchange with me in the comments section of FmH, let me know on FmH that s/he has complained to the sysop of Medlogs about my posts syndicated there. She/he claimed that the problem was the volume of posts with non-medical content originating from FmH; I think the issue is really that s/he does not like my political position. Her/his original derogatory comment on FmH did not even mention any supposed concern about medlogs.com:

Only when pressed about the commenter’s demeanor, and defensive, did s/he mention that s/he felt I was hogging the bandwidth at Medlogs:

You can read the rest of the exchange by scrolling down from here. (Not me at my best…)

(Ironically, this complaint about the volume of my posts and the offensiveness of my politics was in response to an item I had put up on FmH considering the decreasing volume of my posts at this point in my weblogging career. In particular, I am posting less political material, as I explain in the post in terms of “Bush fatigue.”)

But back to the issue at hand. My impression is that medlogs.com is not a weblog for medical posts but rather a weblog syndicating medical webloggers’ posts; as you can see, an important distinction. To my way of thinking, it is a dull medical professional who is interested in nothing but medical content, and most medical professionals I know are interested in a broader range of their colleagues’ thoughts. That’s my notion of the medical community crystallized by medlogs.com. FmH represents a cross-section of the thoughts and interests of a psychiatrist (albeit a leftwing antiwar anti-Bush one); seemed to have a place on Medlogs.

I would imagine that if I was offbase in that respect I would have long since heard from Jacob Reider or other Medlogs readers. The page to add a site to Medlogs says, “We will get to feed requests ASAP.” I take that to mean that Reider reviews sites applying for admission to medlogs.com to see if they are appropriate; for just this reason, it would be a great gamble not to do so. In that case, my content was deemed to be in the acceptable ballpark. In any case, I wrote to Reider about this difference of opinion and asked him to clarify. I told him that, although he might be reluctant to kick me off in response to concerns about my content because the action might have the appearance of political censorship, I offered that I would voluntarily withdraw FmH from Medlogs syndication if he thought it would be the right thing to do . I have yet to hear back from Reider.

I am posting this now because I think it would be responsible of me to solicit other Medlogs’ readers opinions about whether I am sullying their reading experience and whether I should leave Medlogs. Do you share the concerns of the scurrilous, anonymous complainant? Do you find my posts on Medlogs out of place or is the content I add acceptable in light of what you understand Medlog’s raison d’etre to be? I know there is some selection bias in phrasing a question in this manner; I ask sympathetic readers to consider replying as readily as others might do it in antipathy. You can let me know by going to the copy of this post on FmH and entering a comment. Please identify yourself as a Medlogs reader (and don’t share the complainant’s cowardice by remaining anonymous, please). Thank you for your input, and I would be happy to leave Medlogs if the preponderance of opinion supports that. I would be happy to see Anon. eat crow if the preponderance of the evidence supported that outcome… (but I will not hold my breath).

Too good not to click on [thanks, paula]

“Massachusetts officials on Wednesday ordered every road and tunnel in the city highway system examined after inspectors found at least 60 more trouble spots in the Big Dig tunnel where a woman was crushed to death on Monday by three-ton ceiling tiles.” (New York Times ) Perhaps it is because this is my city and I have driven through the new tunnels countless numbers of times, but I think everyone should be distressed by the fact that this is how it goes in one of the largest public works projects in American history. And the numerous faulty bolts (at least sixty more trouble spots as of last report) holding three-ton concrete ceiling slabs in place are probably the tip of the iceberg of the substandard and cost-cutting job done at the expense of innocent commuters’ lives. Should we have expected differently? Do we have a right to? If there is more than one way to do a job and one of them will end in disaster, someone said, than somebody will do it that way. But I suspect the fault does not lie in the engineering or technological realm as much as that of human malfeasance and sloppiness.

From the Richmond Times Dispatch

“A new theory suggests that creativity comes in two distinct types – quick and dramatic, or careful and quiet.” Wired is all over this supposedly ingenious theory of Chicago economist David Galenson, “nothing less than a unified field theory of creativity.” Only it is not a new theory at all. Writers on creativity have long distinguished the brash immature version, often a flash-in-the-pan, from the more measured mature creativity which emerges later in life and seems to build more on a lifetime’s groundwork. There also seems to be a relationship between the respective style of creativity and either iconoclasm or reverence, not surprisingly. It strikes me that it is sometimes more difficult to recognize mature creativity, and a fortiori to proclaim it genius, since it is a matter of opinion whether it is anything more than mere synthesis of, or even borrowing from, the prior creative work in whose tradition it is embedded and on which it draws. There may be an inverse correlation between the frequency with which someone is proclaimed a mature genius and the critic’s familiarity with what has already been done in the field. Perhaps that is why the Wired writer is so enamored of Galenson’s work.

Before the court ruling, the administration repeatedly stated that the detainees were not subject to the protections of the Geneva Conventions; now they are, but mealymouthed administration spokesmen feel the most important point to make about this announcement is that it is not a change of policy. Let us hope there is a fight brewing in Congress about an imperious administration now needing to crawl hat in hand to them to rubberstamp its abuses of power.

Given that the Army has said it has discharged the accused ringleader of the massacre for having a “personality disorder”, the reporter wonders why this evidence of a serious mental disorder was not recognized sooner and the soldier quickly discharged before he could do any damage.

Psychopaths, the reporter explains (using a term which has been an imprecise synonym for antisocial personality disorder), feel no tension over the moral implications of their actions. He concludes that the atrocities in Iraq are few and that “just a few soldiers cause big trouble.” First of all, where did this writer get the notion that a ‘normal’ war crime is done in the heat of vengeance? This is a convenient explanation but is mostly in the service of his thesis that a few cold calculating sociopaths can turn a good war bad. Moreover, what one calls a war crime or atrocity is at issue here. Arguably, the entire invasion and occupation of Iraq is one enormous atrocity which has massacred and maimed tens if not hundreds of thousands of innocent Iraqis.

The author fails to draw on a distinction we make in clinical psychiatry between personality ‘traits’ and ‘disorders’. ‘Personality disorders’ are unlike the major mental illnesses the reporter hopes would be screened out of the military because of the stress intolerance and distress that they cause their sufferers. A personality disorder is merely an accentuation of a personality style, or set of traits (a person’s typical coping strategies, defense mechanisms and interactional style), which rigidly dominates the person’s personality and is relied upon inflexibly to a dysfunctional extent. In some cases this causes suffering to the affected individual (think, for example, of a person with disabling compulsiveness or shyness). In other cases, the personality disorder is — one might say — a successful adaptation insofar as it prevents the individual from feeling distress, instead inflicting it on those around him or her. This is true of many of the more notorious personality disorders we face in clinical psychiatry — borderline, narcissistic, paranoid and, as discussed in this article, antisocial states. A personality disorder is lifelong, enduring and maladaptive in most or all of the settings in which a person finds themselves in life. But even if a person does not have a pervasive personality disorder, their predominant personality traits can be a poor interactive fit with the particular social circumstances s/he finds h’self embedded, such as the Army or a war, at a given moment.

Where the article goes wrong, in attributing a small number of problems to a small number of ‘sick’ individuals, is in ignoring that an illegal and immoral war based on reckless and calculated violation of the rights of others without compunction, for personal gain with no appreciaton of the moral consequences, is a perfect interactive fit for antisocial traits. Even if the recruiters and the basic trainers were good at screening out those with a preexisting fullblown antisocial personality disorder (which would typically have declared itself, unless the recruiters are desperate for anyone, in that the person would likely have had a history of getting themselves into trouble in civilian life), the current conditions will precisely select for, encourage and engender an antisocial style of thinking and behaving. Much as the article I linked to the other day suggested that the conditions of the war make the Army a haven for right wing racialist extremism, the Iraq war is a breeding ground for antisocial behavior and ‘cold and deliberate war crimes’. I argued when the revelations about Abu Ghraib broke that both the perpetrators’ understanding of their mission (aiding in desperate intelligence-gathering at all costs) and the permissiveness of the entire culture of the US military intervention shaped the torture. The scapegoating of the (admittedly depraved) perpetrators was a convenient smokescreen obscuring their superiors’ responsibility, right up to the Pentagon and the White House. The same is true, even moreso, of the current crop of coldblooded massacres and murders. A war that is generally considered just (to the extent that any war can be said to be), where the decision to go to war and support the war effort is a national consensus, is a framework within which the psychological stability of combatants is more preserved, behavior in accordance with the accepted ethical standards of warfare is facilitated, and civilian massacres and detainee torture are much less — or not at all — a way of doing business.

The other point I quibble with is the author’s assertion that there is a relatively low frequency of psychiatric breakdowns in Iraq. This has little to do with the psychological health of the recruits or the impeccabe supportiveness, nurturance and protectiveness of the command structure. Rather, it is a matter of the Army’s callous indifference to the psychological distress suffered both on the battlefield and in returning combat veterans. In Iraq, psychological disterss is ignored or stigmatized and affected individuals bullied back onto patrol, as I have described here in earlier posts. And most psychiatric professionals, especially those who work with combat trauma, project an unprecedented proportion of Iraq veterans will need treatment for post-traumatic conditions. Perhaps the only soldiers immune are precisely those who have been selected for the effective use of antisocial traits, those who are unable to feel any compunctions for the immoral horror they inflict by their invading and occupying presence.

The taunt that made Zidane snap: intense speculation, fantasizing, projecting and, yes, attempts at lipreading off the video clips are consuming many. Suffice it to say, from this U.S. vantage point, that compared to whatever went down on that football field, we here are by comparison woefully inadequate at hurling insults!

And this is suposed to be news??! How far away from the psychedelic era we have ended up, I felt as I read this report of the study, partially federally funded and published in the journal Psychopharmacology. Touted by some as a landmark, it is said to be the first study to ‘rigorously’ study the subjective experiences of hallucinogen users. Charles Schuster, a professor of psychiatry and behavioral neuroscience at Wayne State University in Detroit, Michigan, and a former director of the National Institute on Drug Abuse, commented: “We’ve lost 40 years of (potential) research experience with this whole class of compounds,” he said. Now, with modern-day scientific methods, “I think it’s time to pick up this research field.” Despite the fact that hallucinogens have been used since time immemorial in spiritual ceremonies in all but the most uptight societies, the new work is said to demonstrate drug effects in a new way. Given that users report intense mystical experiences, proponents of the study say they may have a window into the religious experience, for example by doing fMRIs of people under the influence of psilocybin or other hallucinogens. Ah, the ludicrous tragedy of feeling it is somehow more valid to study the ‘subjective’ ‘objectively’! Again, the article talks as if this establishes that hallucinogens might be useful for the treatment of drug addicts or depression in the terminally terminally ill. Of course, these two categories are picked because they are areas in which there is already clinical hallucinogen research and established evidence of effectiveness.

This is from John Faughnan, whose weblog I just found by accident and who seems to resonate with many of my interests. The Fermi paradox is one of his preoccupations, it seems.

For readers of FmH — unless you read the comments under the post to which this link points on my weblog Follow Me Here, you would probably not know that FmH is syndicated at medlogs.com.

For readers via Medlogs — I am posting this largely for you. Recently, an anonymous Medlogs reader, in the midst of a mutually rather acrimonious exchange with me in the comments section of FmH, let me know on FmH that s/he has complained to the sysop of Medlogs about my posts syndicated there. She/he claimed that the problem was the volume of posts with non-medical content originating from FmH; I think the issue is really that s/he does not like my political position. Her/his original derogatory comment on FmH did not even mention any supposed concern about medlogs.com:

Only when s/he became defensive after pressed about her/his demeanor did the commenter mention that s/he felt I was hogging the bandwidth at Medlogs:

You can read the rest of the exchange by scrolling down from here. (Not me at my best…)

(Ironically, this complaint about the volume of my posts and the offensiveness of my politics was in response to an item I had put up on FmH considering the decreasing volume of my posts at this point in my weblogging career. In particular, I am posting less political material, as I explain in the post in terms of “Bush fatigue.”)

But back to the issue at hand. My impression is that medlogs.com is not a weblog for medical posts but rather a weblog syndicating medical webloggers’ posts; as you can see, an important distinction. To my way of thinking, it is a dull medical professional who is interested in nothing but medical content, and most medical professionals I know are interested in a broader range of their colleagues’ thoughts. That’s my notion of the medical community crystallized by medlogs.com. FmH represents a cross-section of the thoughts and interests of a psychiatrist (albeit a leftwing antiwar anti-Bush one); seemed to have a place on Medlogs.

I would imagine that if I was offbase in that respect I would have long since heard from Jacob Reider or other Medlogs readers. The page to add a site to Medlogs says, “We will get to feed requests ASAP.” I take that to mean that Reider reviews sites applying for admission to medlogs.com to see if they are appropriate; for just this reason, it would be a great gamble not to do so. In that case, my content was deemed to be in the acceptable ballpark. In any case, I wrote to Reider about this difference of opinion and asked him to clarify. I told him that, although he might be reluctant to kick me off in response to concerns about my content because the action might have the appearance of political censorship, I offered that I would voluntarily withdraw FmH from Medlogs syndication if he thought it would be the right thing to do . I have yet to hear back from Reider.

I am posting this now because I think it would be responsible of me to solicit other Medlogs’ readers opinions about whether I am sullying their reading experience and whether I should leave Medlogs. Do you share the concerns of the scurrilous, anonymous complainant? Do you find my posts on Medlogs out of place or is the content I add acceptable in light of what you understand Medlog’s raison d’etre to be? I know there is some selection bias in phrasing a question in this manner; I ask sympathetic readers to consider replying as readily as others might do it in antipathy. You can let me know by going to the copy of this post on FmH and entering a comment. Please identify yourself as a Medlogs reader (and don’t share the complainant’s cowardice by remaining anonymous, please). Thank you for your input, and I would be happy to leave Medlogs if the preponderance of opinion supports that. I would be happy to see Anon. eat crow if the preponderance of the evidence supported that outcome… (but I will not hold my breath).

The only problem is that Ms. Sutherland acts as if she has discovered these verities. Karen Pryor’s brilliant but neglected (because it had the appearance of being a dog training manual) Don’t Shoot the Dog went over the same revolutionary ground, applying reinforcement-based teaching and training to human relational problems, two decades ago.

The growing unpopularity of the war creates an incentive for quota-burdened recruiters to appeal to the basest sentiments in the American mentality, the xenophobia and reptilian tribalism that turn into torture and massacre. But it is misleading although convenient to focus as this report does on recruiting shortfalls as the cause; they only highlight the deeper issue. As this report makes clear, it was folly for the Pentagon to believe that it could eliminate extremism with regulations or policy when the mission of this war as shaped at the highest levels of administration policy is itself xenophobic, manipulative, dishonest and jingoistic.

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Thanks to Dennis Fox, who links to it to assuage his defensiveness at irregular posting, for pointing to this piece by a marketing professor.

Since the Nov.15, 1999 origin of Follow Me Here (2423 days ago), I have posted 14,438 posts (including this one). The argument that prolific isn’t necessarily good certainly applies to FmH. But, as you have no doubt noticed, the frequency of posts has indeed fallen off here recently. Posting less frequently here is done without much anguish at all; I am way past the article’s touted pressure to post daily to establish one’s seriousness (FmH speaks for itself).

I agree, traffic is not generated by daily posting and it is irrelevant to FmH’s ‘success’, such as it is. Whether a significant decrement in post frequency would affect the loyalty of those who frequent FmH remains to be seen, even if you continue to surf over here and check for new posts in a ‘Web 1.0’ way rather than subscribe to my RSS feed á la Web 2.0. I get several hundred hits a day; I have only several dozen RSS subscribers. Certainly, if the posts slow down too much, beyond a certain point loyal readers would find it unproductive to keep surfing over here, but I hope I am still far from that level.

Frequent posting may drive poor content quality and negatively affect the credibility of the ‘blogosphere’, the author says, but I have never posted to meet a quota; I post if I have something to say or if I have something to which I think you would be interested in being pointed. While much weblogging has evolved into either diary, confessional, or pretentious punditry, I have always said that I come from the original late ’90’s weblogging tradition (Rebecca Blood ) in which what you post is — literally — a log of your interesting surfing. If I surf the net, which is an integral part of my self-informing, I hit a few keys and log what grabs me, albeit finding my own voice in the process.

So, then, if there has not been any sudden liberation from the compulsion to post daily, why am I posting less?

• First of all, I am in a busier phase in my career and my community involvements than I was when I started this.
• Secondly, I am sleeping better these days; by comparison, go back and look at the timestamps of my posts during more prolific periods here. It has become far more important to be far less sleep-deprived, and I love my family too much to choose this over them if I cannot have my cake and eat it.
• Third, I have an incredible degree of Bush fatigue; it is not that I cannot get outraged anymore, but there is only a finite roster of ways in which a government can lie, cheat, steal, kill, destroy, and oppress. Bush and his minions have long since done them all; I have long since taken note of them here; nothing surprises me, and my outrage is constant and numbing.
• And I have only a limited tolerance for my own frustration and despondency that a more effective movement of opposition has not arisen in response to his outrages. And I have no confidence that weblogs like FmH are change agents. (I don’t know what would be effective activism these days, I guess, but I can no longer rationalize as I did for so long that FmH was an integral form of activist activity)
• It also seems that the polarization of the blogosphere, like that of the country, has been proceeding apace. I don’t think I have readers with whom I don’t agree on the large issues and I don’t believe dialogue across the culture war in modern America is productive. So my conversation with my readers is or should be more nuanced and subtle; the opportunity for that inherently arises less often than for bolder pronouncements, or maybe it is just my taking the opportunity less often.
• And, yes, the ‘landfill’ of useless blowhard weblogs proliferates, but so too are there more of those who do have something thoughtful to say, or something interesting to link to. They’ve gotten there first and said it better, whatever ‘it’ is.
• Also, I think, the non-blog web is more homogeneous and, well, less interesting, than it was when the original webloggers emerged in the late ’90’s. There may be less cataloguing of interesting sites going on today because there may be less interesting sites, or at least I am finding them less. The quirky early web users have moved on. The web is so much less a place to be quirky and original for the novelty of it. Certainly, in numbers, there are diverse numbers of independent sites around, but many of them are rubbish. So the links to the New York Times, Wired, Salon and the like take over…
• And finally, I do want to be responsive to what I imagine my readers want. Over the years, I have noticed which posts generate comments and discussion. That is a rough indicator, since each individual post doesn’t have a click-through or a hit counter, of what grabs you. And it is not the simple linking posts, but the ones in which I make a comment — insightful, pseudo-insightful, absurd, outrageous, provocative, hackneyed, trite or limited. I am not saying I will be able to do more of that, but it certainly means I will do less of the other.

Comments?

Lo! How the mighty have fallen, one might say. This essay considers Freud’s legacy as he turns 150, describing the state of British psychoanalysis. The authors, one of whom is a British psychiatrist, remind us of the fury and “seriousness with which disputes over psychoanalysis were being conducted in the 1980s” (typified by the controversy over Jeffrey Masson so ably described by New Yorker writer Janet Malcolm back then), and how far toward the edifice passing with a whimper, instead of a bang, we have come in the two decades since.

The British government and, I might add from my perspective, U.S. managed care companies, are gangbusters over cognitive therapy instead these days, insofar as they have any truck with ‘the talking cure’ at all anymore. The article describes cognitive therapy and how it is different from psychoanalytically-based therapy. The article seems to contrast the two first and foremost on the basis of technique — focusing on Freudian analysis’ reliance on free association and the transference. “…The process is classically driven by (these) two mechanisms, and these are essentially all there is to the technique…” I think there are more extensive, and more accessible, ways of capturing what is unique about psychoanalytic therapy. For example, that it is insight-based, that exploration of one’s past is considered important to that insight, that the therapist is attentive to what is avoided and not said by the patient as well as what is being discussed, that there is an emphasis on how the patient functions interpersonally, and that the internal life of wishes, fantasies and dreams is considered important. All of these are largely absent from cognitive therapy.

I also think the essayists are misleading about transference. They describe it as “what takes place between you and the analyst as you become embroiled in an intimate relationship that is unlike any other you might have outside the consulting room”. It is not different; it is simultaneously the same and different! The beauty of analysis of the transference is that the patient will create a relationship with the therapist that cannot escape replicating the rigid and problematic patterns with which they interact with everyone else in their social spheres. All that is different is that the therapist is a trained observer with respect to this process, so that s/he can understand it, comment upon it, and facilitate the patients’ reshaping it, all while staying somewhat above the fray and preventing the relationship from being disrupted. It would not work if it were “unlike any other” relationship the patient has!

Quite rightly, the authors point out that one has to consider not only technique but the theory on which it is based. The true lynchpin of psychoanalysis, the understanding of the human being that it informs, and the therapeutic impact of the insight patients develop through psychoanalytically-based therapy, has been the notion of the unconscious` — that some of the forces which shape how we think, feel and behave are not obvious to us, remain undiscovered and out of our control, and that that is the basis of our distress. The notion of the unconscious has little empirical backing and is different from the subconscious processes that cognitive science posit and the neurophysiological underpinnings of mental function that biological psychiatry and neuroscience suggest.

In contrast to the baroque complexities of psychoanalysis, cognitive therapy is built on the idea that distress is an outcome of dysfunctional and correctable thoughts that patients have aboout themselves. The article has a good description of what a patient can expect to find in a cognitive therapy. The empirical evidence for cognitive therapy’s efficacy is reviewed.

Much is made of the notion that, in psychoanalytic treatment, instead of “tell[ing] you what it is that you’ve got,… [or] explain[ing] how you will get over it,… you embark on a personal exploration during which you find that you don’t only suffer from the symptoms you thought you did, but also a range of other conflicts underlying them.” Arguably, from this perspective, patients do not get ‘better’ in psychoanalysis. Much is made of Freud’s famous (perhaps his most famous) statement that “much will be gained if we succeed in transforming your hysterical misery into common unhappiness.” Certainly, shouldn’t the result-driven governments or insurance companies funding mental health treatment abhor such an empirically unproven, costly and unproductive practice!

In a word, the problem lies in the lack of precision, refinement or specificity about what getting better means. Quite simply, cognitive therapy was developed to deal with depression and anxiety. Along with medications, it is an effective and cost-effective treatment for limited subtypes of the human misery we are dealing with in the mental health field, the bread-and-butter disorders of the field. You may not need to understand yourself better to improve from these and similar conditions and, indeed, understanding yourself better may not help.

But that is a far cry from dismissing psychoanalysis for the “near-uselessness of its insights,” as Janet Malcolm is quoted as saying. Whether empirically proven or not, psychoanalysis works because its practitioners are skillful at spinning a web of belief and enlisting their patients into adhering to a coherent and believable story about why they feel and act the way they do. This exists in an entirely different sphere than that in which you can measure the ‘truth’, or the empirical validity, of what one comes to understand. It is more akin to faith than scientific knowledge; treatment is more akin to going to church to reaffirm and extend one’s belief than going to the doctor’s office. Argue as you might about the damage that faith may bring; there are spheres in which it is important, and in which nothing else works. Paradoxically, perhaps, this is the case for some of our least sick patients, the so-called “walking wounded”; and also some of our sickest, the so-called personality-disordered or character-disordered patients. In contrast to someone undergoing a depressed episode, these are people who have chronic and pervasive maladaptive ways of being in the world and interacting with others throughout the bulk of their adult lives. In these cases, getting ‘better’ may mean not so much repairing anything as it does entering into a new, more comforting and perhaps more empowering storyline about oneself and one’s relationships. Doesn’t it make sense that there might be a distinction between conditions in which relief comes from changing what we cannot bear and others in which it is a matter of bearing what we cannot change? And that different techniques might facilitate those two kinds of solution? As the authors conclude:

Let us not throw the baby out with the bathwater. CBT, medication-based treatment, etc., have largely supplanted open-ended exploratory and revelatory therapy not because they are better or more suitable for all but because they suit a society which has gone overboard with quick fixes, with linear and concrete understanding instead of nuanced analysis, with the romance of the evidence-based, and ultimately with cost-consciousness. This is a society that has excised most of the meaning out of people’s lives already. At least, in my profession, I can draw the line somewhere, and continue to attempt to help patients find meaning in their suffering and value in their lives.

This Prospect Magazine article is by Fred Pearce, an acquaintance of mine in years past from Cambridge who I have always found to be one of the more thoughtful and smart writers on complicated technological issues and their environmental and social impact, but from whom I have not heard much in a few years. As it turns out, he has a forthcoming book, The Last Generation: How nature will take her revenge for climate change. Here he considers whether the dream of fusion power is worth pursuing.

This is a consideration of the other famous literary characters whose authors killed them off (among them Little Nell, Emma Bovary, and Sherlock Holmes, the clamor about whose death was so great that Conan Doyle was compelled to bring him back, as you know) and whether we should really want it any other way:

(New York Times )

“…[A] bear cub sits in a vintage red Buick convertible in a Lake Tahoe neighborhood, in Stateline, Nev., in this Sunday, July 2, 2006 file photo. The bear drew a crowd of spectators as it munched on barbecue-chicken-and-jalapeno pizza in the back seat of the 1964 Buick Skylark. It also apparently washed it down with a swig of a Jack Daniel’s mixer, an Absolut vodka and tonic, and a beer taken from a cooler, the vehicle’s owner said.” (Yahoo! News)