Why Bush won’t attack Iran

… and why Cheney might: “The left — and much of the old-school, realist right — fears that Bush means to bomb Iran sometime between now and next spring. Both would like to rally public opinion against the strike before it happens. The neoconservative right, meanwhile, is asserting that we will bomb Iran but that we need to get to it posthaste.

But both sides are advancing scenarios that are politically useful to them, and both sides are wrong. Despite holding out a military option, ratcheting up tensions with Iran about meddling in Iraq and Afghanistan, and deploying carrier strike-force groups in the Persian Gulf, the president is not planning to bomb Iran. But there are several not-unrelated scenarios under which it might happen, if the neocon wing of the party, led by Vice President Cheney, succeeds in reasserting itself, or if there is some kind of “accidental,” perhaps contrived, confrontation.” (Salon)

Another Tactical and Strategic Blunder

Ed Fitzgerald captures my frustration perfectly with observations about yesterday’s antiwar protest in Washington.

“The Bush Administration is on the ropes, it’s reeling from the pain of a thousand cuts, the last thing we would want to do is to give them some encouragement to believe that perhaps their position is somewhat more tenable than it appears. At this juncture, they don’t have the people on their side, all the polls show that, but looking at Saturday’s feeble, badly-conceived march, all they could possibly feel is encouraged, because all they saw there were the nutjobs and wackos they expected to see.

…I think perhaps a large part of the problem is that people don’t think hard enough about what they want to achieve with their actions, and instead focus on what they feel they need to do. The resulting action, therefore, becomes primarily about people feeling good about themselves.”

(unfutz)

Does art have a place in hospitals?

Artist Grayson Perry:

“Our conversation got me thinking about the healing potential of art. I believe that art is good really for one thing only and that is giving aesthetic pleasure. Any other positive function is a lucky side-benefit, but don’t depend on it giving measurable results. Most of my works would serve as admirable doorstops but I tend not to promote them as such.” (Times Online via boing boing)

Another Tactical and Strategic Blunder

Ed Fitzgerald captures my frustration perfectly with observations about yesterday’s antiwar protest in Washington.

“The Bush Administration is on the ropes, it’s reeling from the pain of a thousand cuts, the last thing we would want to do is to give them some encouragement to believe that perhaps their position is somewhat more tenable than it appears. At this juncture, they don’t have the people on their side, all the polls show that, but looking at Saturday’s feeble, badly-conceived march, all they could possibly feel is encouraged, because all they saw there were the nutjobs and wackos they expected to see.

…I think perhaps a large part of the problem is that people don’t think hard enough about what they want to achieve with their actions, and instead focus on what they feel they need to do. The resulting action, therefore, becomes primarily about people feeling good about themselves.”

(unfutz)

When a ‘Duplicate’ Family Moves In

New York Times article on the Capgras syndrome, a terrifying psychiatric symptom in which patients believe that people — usually those dearest to them — have been replaced by inexact duplicates. Sometimes this extends to their entire community or even the physical objects around them, such as their house or car. Capgras occurs in both psychotic illnesses, such as the case of which Dr. Berman writes in this article, and in some types of brain damage, such as carbon monoxide poisoning. I have thought of it as a malfunction in the brain’s fairly specific familiarity circuitry. Early in my career, I was fascinated by Capgras and other unusual psychiatric syndromes (such as Cotard’s, Fregoli’s, etc.) and lectured about them to my colleagues and students. (The Fregoli delusion, by the way, is in some ways the flip side of Capgras’.) Psychiatry has gone through ‘lumping’ and ‘splitting’ phases; in the latter, these would be considered unusual, standalone disorders, and in the former considered to be symptoms or facets of other, more familiar conditions. Alas, the era of exotic, esoteric syndromes seems to have passed. Not so with our patients — I diagnosed a patient I saw last week with Capgras’ delusion.

Dr. Berman was right, I think, to end her essay with a reference to Invasion of the Body Snatchers. Apart from the banal analyses seeing the original film (1956) as either an allegory about the Communist threat or a veiled critique of McCarthyism, I have always felt that the terror evoked by this film relied on its profound challenge to our dependence on the sense of the familiar. I have seen all four versions of the film, including the recent Nicole Kidman vehicle (2007) which, despite the fact that the central character remains a psychiatrist, lacks the subplot all the others featured involving a mental health professional dismissing as crazy those alarmed by the perception that their loved ones “were not themselves”. In the Kidman version, in fact, the pod people have lost so much of their terrifying quality that it is difficult to believe they fool anyone. Whereas, in the original, those taken over by the aliens retained their ability to convey emotion but were always a little ‘off’, as if they were imitating genuine emotion (a clear evocation of Capgras’), in the latest version, they are merely emotionless and robotic. This misses the point.

There are other films, from the ’50’s as well, which evoked the same terror. Most memorable were The Thing (1951) and Invaders from Mars (1953). (If you’re interested, for my money you can forget the more recent remakes. Go right back to the originals.)

//www.dvdbeaver.com/film/DVDReviews25/a%20invasion%20of%20the%20body%20snatchers/de%20ws%20invasion%20of%20the%20body%20snatchers%202043.jpg' cannot be displayed]

Giant Communal Texas Spider Web

Spiders worked together to weave massive web. “Tuesday afternoon, thousands of spiders were back at it again, working to rebuild the massive web that at one time stretched about 200 yards, covering bushes and trees to create a creepy canopy.

Researchers say they think thousands of spiders from different species worked together to make one large, all-encompassing web, unusual from the traditional individual webs that normally would be woven. Together, the spiders have built and rebuilt a web that has caught potentially tens of thousands of flies and bugs and the attention of people nationwide.” (Seattle Times [via boing boing])

Getting ready for Halloween, perhaps?

R.I.P. James Longcope, 70

A close friend and psychiatric colleague died suddenly on Labor Day, just when he was readying himself to enjoy his retirement. Jim exemplified all that is best, and is rapidly being lost, about psychiatric healing. Jim once said to us, “I’m just conspiring to commit good medical care.” Just that. More important, he was simply a good person, unassailably and irreducibly. All who knew him are devastated. (Boston Globe Obituary) //cache.boston.com/resize/bonzai-fba/Globe_Photo/2007/09/13/1189737627_3549/300h.jpg' cannot be displayed]

last.fm users: How eclectic is your musical style?

This script takes your top 20 artists on Last.FM. For each of these artists, collect the top 5 similar artists. The resulting number of unique artists is your eclectic score. If the score is small (extreme = 5) your musical preferences are very limited, and if it is large (larger than 80, extreme = 100), then you have an eclectic musical preference. You can compute your own score at:

My eclectic score is currently:

77/100

The 77 related artists for my profile are Aimee Mann (2), Andrew Bird, Ani DiFranco, Beulah, Bleeding Hearts, Bloc Party, Bob Dylan (2), Bob Mould, Bright Eyes, Broken Social Scene, Bruce Springsteen (3), Cat Power (2), Cat Stevens, Cream (2), Crosby, Stills, Nash & Young, David Bowie, Death Cab for Cutie, Elvis Costello, Elvis Costello & The Attractions, Emmylou Harris, Fiona Apple, Guided by Voices, Interpol, Iris DeMent, Iron & Wine, James Taylor, Jimi Hendrix, John Lennon, John Vanderslice, Led Zeppelin, Lou Reed, Lucinda Williams, Lyle Lovett, Martha Wainwright, Mary Chapin Carpenter, Modest Mouse (2), My Morning Jacket, Neil Young (3), Neutral Milk Hotel, Nick Drake, Okkervil River (2), Paul Simon, Pavement, Pete Yorn, Phish, Pink Floyd, Queen, Rachael Yamagata, Regina Spektor, Rev Hammer, Ryan Adams, Show of Hands, Simon & Garfunkel (2), Spoon, Steeleye Span, Sufjan Stevens (2), Talking Heads, Tegan and Sara, The Albion Band, The Allman Brothers Band, The Arcade Fire, The Band, The Beatles, The Byrds, The Decemberists (5), The Dismemberment Plan, The Doors (2), The Mountain Goats, The New Pornographers, The Replacements, The Rolling Stones (2), The Shins (4), The Who, Tori Amos, Van Morrison (3), Warren Zevon, Yo La Tengo.

Can Lobbyists End the War?

“The playbook for opposing a war has changed markedly since the street-protest ethos of the anti-Vietnam movement. Tie-dyed shirts and flowers have been replaced by oxfords and BlackBerries. Politicians are as likely to be lobbied politely as berated. And instead of a freewheeling circus managed from college campuses and coffee houses, the new antiwar movement is a multimillion-dollar operation run by media-savvy professionals. “They are to the left what the N.R.A. is to the right,” says a Democratic strategist with close ties to the party’s congressional leadership.” (New York Times Magazine)

Resize This

David Pogue, in his New York Times technology weblog, points to an amazing new image cropping and resizing algorithm. Watch the embedded video if you have any interest in picture manipulation. The commenters to Pogue’s post mention disturbing implications for truth in journalism but it seems to me we are way beyond worrying about the technologies for image manipulation in that regard. We have to worry, and have for a long time, far more about the personal integrity of the manipulators than the techniques they have at their disposal.

Apparently, the day after this was posted on YouTube, Adobe snatched up the developer. [thanks to walker]

Resize This

David Pogue, in his New York Times technology weblog, points to an amazing new image cropping and resizing algorithm. Watch the embedded video if you have any interest in picture manipulation. The commenters to Pogue’s post mention disturbing implications for truth in journalism but it seems to me we are way beyond worrying about the technologies for image manipulation in that regard. We have to worry, and have for a long time, far more about the personal integrity of the manipulators than the techniques they have at their disposal.

Apparently, the day after this was posted on YouTube, Adobe snatched up the developer. [thanks to walker]

U.S. Must Support Peacekeeping Mission

Take Action: “The UN has authorized a joint United Nations-African Union peacekeeping mission for Darfur. Our task now is to ensure that President Bush upholds the U.S. commitment to support this mission when the UN General Assembly meets on September 18th. Our goal is to send 100,000 messages in the next three weeks urging the president to uphold his commitment to the peacekeeping mission. Help us reach our goal! Fill out the form below to add your name to a petition urging President Bush to live up to our commitments…” //img.getactivehub.com/08/custom_images/savedarfur/rotator.jpg' cannot be displayed]

Interview: Professor Elyn Saks

Professor of Law and Psychiatry Discusses Her Battle with Schizophrenia, depicted in her recent memoir, The Center Cannot Hold, with a weblogger. As FmH readers know, one of my ongoing concerns in my work as a psychiatrist is the stigma attached to mental illness and how my patients suffer for it. Saks has much to say about that. My curiosity, simply put, is whether she rises above the stigmatization because she is exceptional, or whether she is exceptional because she has somehow managed to rise above the stigmatization. Her story reinforces my impression, from years of working with schizophrenics, that one’s IQ score helps. While intellect is by no means protective against the devastation of a psychotic illness (in some cases, quite the contrary, because of greater insight into what is being lost!), those with the most rehabilitative potential are usually those with the greatest intellectual capacity either premorbidly or at least retained . In Saks’ case, as well, some questions about whether she truly had the devastating disease of schizophrenia arise.

Two by Hayden Carruth

On Being Asked To Write A Poem Against The War In Vietnam

Well I have and in fact
more than one and I’ll
tell you this too

I wrote one against
Algeria that nightmare
and another against

Korea and another
against the one
I was in

and I don’t remember
how many against
the three

when I was a boy
Abyssinia Spain and
Harlan County

and not one
breath was restored
to one

shattered throat
mans womans or childs
not one not

one
but death went on and on
never looking aside

except now and then
with a furtive half-smile
to make sure I was noticing.

When I Wrote A Little

poem in the ancient mode for you
that was musical and had old words

in it such as would never do in
the academies you loved it and you

said you did not know how to thank
me and in truth this is a problem

for who can ever be grateful enough
for poetry but i said you thank me

every day and every night wordlessly
which you really do although again

in truth it is a problem for how can
life ever be consonant with spirit

yet we are human and are naturally
hungry for gratitude yes we need it

and never have enough oh my dear i
think these problems are always with

us and in reality have no solutions
except when we wash them away on

salty tides of loving as we rock in
the dark sure sea of our existence

Blow Back

ADHD Drug Tested as Treatment for Crack Addiction. Atomoxitine, a nonaddictive medication used for ADHD, may be enough of a mild mimic of the pharmacological effects of cocaine in the CNS that it might substitute for it, the reasoning goes. When used in cocaine rehab, however, patients often relapse. So the efffects and dangers of mixing atomoxetine and cocaine were investigated in a study to be published in Drug and Alcohol Dependence but available online in pre-print. The verdict was that there was mild additive cardiovascular danger and no consistent blockade of the pleasurable effects of the cocaine. In other words, the combination was “safe but of questionable effectiveness”, investigators concluded.

This illustrates a longstanding fallacy in the treatment of drug addiction, IMHO. All too often, no matter what the drug is, addicts are given a medication that produces a mild version of the pharmacological effects of their drug of choice in hopes it will satisfy their cravings or block the stronger effects of the drug and make it less rewarding. Examples include another medication, the antidepressant bupropion, for cocaine; and buprenorphine for opiate addiction. Similar (but even more thoughtless) is the medically contraindicated but widespread practice of maintaining ex-alcohol abusers on tranquilizers for sleep or anxiety. I have rarely seen these work and usually see users begin using their drug of abuse again while still on the supposed treatment, with additive effects. The fallacy lies in the reductionistic pharmacological materialism that equates the reward of the drug entirely with its (poorly-characterized) physiological effects in the CNS. This ignores the psychological needs the drug and its use provide. The habitual and compulsive nature of drug abuse comes from its being a powerful reinforcer in far more ways than just its stimulation of the “pleasure center” of the CNS, as it has become fashionable to describe it. From this point of view, it is not puzzling that patients will revert to their drug of abuse instead of, or on top of, the supposed relapse-preventing medication therapy.

A related phenomenon occurs when other drugs which themselves have abuse potential are used to substitute for the supposedly more damaging street drug, as in the case of methadone for opiate addicts. I’m not arguing about the merits of legalizing addiction here, but if that is what we are doing, let us be honest about it. Not only is there a street trade in diverted methadone itself (as well as suboxone) — more to get high than to self-detox — but the methadone clinics are often vehicles to maintain or even enhance clients’ addictions, in effect diverting addicts’ payments from the drug dealers into the clinic coffers. Call me cynical, but few of the methadone clinics I have seen do what would be medically prudent: (a) carefully assess the patient’s level of tolerance and maintenance need; (b) place the patient on a dose of methadone at or slightly below that level; (c) and embark on a medically prudent and tolerable but inexorably progressive taper of the methadone.

‘Radical Honesty’

No lie: one of the more idiotic psychotherapeutic ideas I have ever seen.

“My boss says you sound like a dick,” I say.

“Tell your boss he’s a dick,” he says.

“I’m glad you picked your nose just now,” I say. “Because it was funny and disgusting, and it’ll make a good detail for the article.”

“That’s fine. I’ll pick my ass in a minute.” Then he unleashes his deep Texan laugh: heh, heh, heh. (He also burps and farts throughout our conversation; he believes the one-cheek sneak is “a little deceitful.”) (Esquire )

What’s Behind the Epidemic of Municipal Wi-Fi Failures?

“The dream of wireless networks bathing U.S. cities in free and pervasive internet access has come to an end, at least for now. As the number of failed or stalled municipal wireless projects continues to rise, the focus has shifted from closing the so-called digital divide to why plans for such networks, in only a year’s time, seem to be dissolving almost daily. Last week, San Francisco, Chicago and St. Louis all announced significant and perhaps fatal roadblocks in their municipal Wi-Fi projects.” (Wired News)

Bush Refuses to Set Timetable for Withdrawal from Crawford

I’m back from a brief vacation but apparently Bush isn’t, and Andy Borowitz explains: “President George W. Bush said today that he understands and respects the views of those who are calling for him to cut short his summer vacation, but warned that an immediate withdrawal from Crawford, Texas would ‘send a terrible signal to the enemy.’

‘The enemy would like nothing better than to see me cut short my vacation and get back to the White House,’ Mr. Bush told reporters. ‘They hate my freedom.'” (The Huffington Post)

Bush Refuses to Set Timetable for Withdrawal from Crawford

I’m back from a brief vacation but apparently Bush isn’t, and Andy Borowitz explains: “President George W. Bush said today that he understands and respects the views of those who are calling for him to cut short his summer vacation, but warned that an immediate withdrawal from Crawford, Texas would ‘send a terrible signal to the enemy.’

‘The enemy would like nothing better than to see me cut short my vacation and get back to the White House,’ Mr. Bush told reporters. ‘They hate my freedom.'” (The Huffington Post)