Google Search top results, if you cannot guess…

The winner of the Freakonomics contest is: “Our Worst Critics Prefer to Stay.” All of the leading entries cling to such a naive faith in an ideal of democracy which, to my way of thinking, is little more .than a fairy tale. And, yet, yes, most of the time I prefer to stay.

Kabul government controls just a third of Afghanistan (Wired Dispatch)

Mark Frauenfelder’s summary of what Blackmore, the author of The Meme Machine, said at TED 2008:

Coming this spring. [Lest you think this sounds like an ad for Micro$oft, it is just that this seems charming.]

A long thoughtful piece in one of my new favorite foreign policy analysis weblogs, Just World News, contrasts the position of McCain and other Republican ideologues on the simultaneous winnability of the Iraq and Afghani wars with the Democratic candidates’ tradeoff model.

Also:

Maternal Infanticide Associated With Mental Illness: Prevention and the Promise of Saved Lives

Psychiatrist Margaret Spinelli’s 2004 academic review of the topic from the American Journal of Psychiatry (full text available freely).

ACM, fellow weblogger, FmH reader, and web friend, celebrates an addition to the family. My heartiest wishes. All happiness to you and yours.

And: 

Ms. Medley is expecting too, in June. All the best!

Yesterday was the tenth anniversary of my daughter’s arrival on the planet. How soon the two of you will be looking back on ten years! Carpe diem.

“He ruled out the possibility that he would prevent a Democratic victory in 2008. ‘Not a chance,’ he said. ‘If the Democrats can’t landslide the Republicans this year, they ought to just wrap up, close down, and emerge in a different form.'” (New York Times ) Misguided, pitiful, arrogant man…

Also:

Maternal Infanticide Associated With Mental Illness: Prevention and the Promise of Saved Lives

Psychiatrist Margaret Spinelli’s 2004 academic review of the topic from the American Journal of Psychiatry (full text available freely).

Secret document leaked and posted to Wikileaks

Start with the well-known Creeley poem, ‘I Know a Man’:

As I sd to my
friend, because I am
always talking, – John, I

sd, which was not his
name, the darkness sur-
rounds us, what

can we do against
it, or else, shall we &
why not, buy a goddamn big car,

drive, he sd, for
christ’s sake, look
out where yr going.

A timeline of recent campus shootings and speculation about what it is about campuses and schools that attracts deranged shooters. (The Lede, The New York Times)

Herbert Spencer (1851): “As a corollary to the proposition that all institutions must be subordinated to the law of equal freedom, we cannot choose but admit the right of the citizen to adopt a condition of voluntary outlawry. If every man has freedom to do all that he wills, provided he infringes not the equal freedom of any other man, then he is free to drop connection with the state – to relinquish its protection and to refuse paying toward its support. It is self-evident that in so behaving he in no way trenches upon the liberty of others, for his position is a passive one, and while passive he cannot become an aggressor. It is equally self-evident that he cannot be compelled to continue one of a political corporation without a breach of the moral law, seeing that citizenship involves payment of taxes; and the taking away of a man’s property against his will is an infringement of his rights.”

Bertrand Russell (1943): “To avoid the various foolish opinions to which mankind are prone, no superhuman genius is required. A few simple rules will keep you, not from all error, but from silly error.”

In his book, Shepard takes issue with the experience of Barbara Ehrenreich, who in Nickeled and Dimed found she was not able to make ends meet or progress beyond a series of menial jobs when she tried self=imposed poverty as a social experiment. Could gender and age be making the difference? Or could it be preconceptions? I haven’t read the book (but I heard him interviewed on NPR) and he sounds vivacious and unjaded, in contrast to Ehrenreich’s well-worn and well-founded cynicism and rage against the machine.

A Guide to Using Caffeine Right. (Developing Intelligence)

…and its future in DSM-V. This editorial from the January 2008 British Journal of Psychiatry from Gerald Rosen, Robert Spitzer and Paul McHugh is music to my ears. It questions the validity and the future of the post-traumatic stress disorder (PTSD) diagnosis because the symptoms it describes are already covered by other depressive and anxiety disorder diagnoses. THe concept of PTSD emerged as a diagnosis with DSM-III in the context of the ’60’s feminist and antiwar movements. I believe it was an expression of the sentiment that victims of abuse and returning Vietnam veterans had experienced something more extraordinary than other sufferers, and therefore that the extremity of their reactions needed to be codified in a new diagnosis. Very quickly, then, insensitivity to the PTSD diagnosis came to seem like insensitivity to the plights of various classes of the downtrodden and oppressed. And, from the patients’ point of view, it has been a very appealing diagnosis to carry, given that it serves to remove the stigma of mental illness from the person and locate the defect in the horrendous external event that befell them.

So, since the inception of the diagnosis in the early 1980’s, there has been a momentum to apply it from both clinicians and patients. As FmH readers will be aware, this bandwagon effect is one of my pet peeves. I have opined that the diagnosis has come to be applied sloppily and indiscriminately whenever an inexperienced, earnest and naive clinician felt that something terrible, deserving of empathy, had happened to their patient. The orthodox adherents of PTSD have claimed that horrendous traumatic experience beyond the pale of what the human nervous system was designed to endure altered neurophysiological functioning in distinct and specific ways, accounting for the defining symptoms of PTSD and justifying the need for such a diagnosis. When the diagnosis was handed out nonchalantly to anyone who had suffered a stress or a loss, in contrast, it lost its specificity, as the sufferer really did not embody such a profound alteration in neurophysiological functioning. What was being described was more run-of-the-mill depression or anxiety in response to expectable stresses and losses. The indiscriminate use of the PTSD diagnosis has also reinforced rampant victim culture in our society.

But this new editorial may represent even a more profound objection to the diagnosis of PTSD than I have been making. It may not be invalidated by being applied too broadly; it may be entirely invalid in the first place. Whwere in the diagnostic pigeonholes were the PTSD sufferers before there was PTSD? They carried depression and/or anxiety diagnoses. Should they be there again? This makes sense to me for several reasons.

First, the description of PTSD involves three symptom clusters — intrusive recollections of the trauma, exaggerated emotional and physiological reactivity when triggered by memories or reminders of what has happened, and self-protective avoidance and constriction of emotion in reaction. In learning and teaching about this diagnosis, I have felt hardpressed to explain how these are different from anxiety, depression, and compensatory efforts. So, in terms of the severity of a trauma, exactly where are we to draw the line between those that merely bum one out, those that cause depression, and those that cause PTSD?

Secondly, it has long been known that resilient individuals do not necessarily develop PTSD symptoms in response to traumatic experiences similar to those that produce the syndrome in others. Since it is shaped by constitutional factors in the suffferer, the concept of a distinctive response to extreme trauma is further watered down.

Thirdly, some argue that there are depressive disorders, there are anxiety disorders, and there is the somewhat unusual fusion of the two symptom complexes in PTSD. But many psychiatrists, myself included, feel we have rarely seen a ‘pure’ depressive or anxiety disorder case, that patients always embody a combination of the two, and that the depressive and anxiety disorders are not as distinct as the diagnostic scheme would have use believe. Among other lines of evidence contributing to this impression is the fact of the overlap in efficacy of therapeutic agents for depression and anxiety. Antidepressants are good anxiolytics (perhaps better than Valium and its modern family of anti-anxiety derivatives, the benzodiazepines). Anti-anxiety medications have a venerable history for the treatment of depression. Treatment for PTSD, in any case, is little more than targeting some combination of anxiety and depressive symptoms, anyway.

Finally, most of the neurobiological explanations for the etiology of PTSD emphasize the impact of activation of the fight-or-flight response, and the bathing of the brain in stress hormones, at the time the trauma is experienced. This supposedly damages the brain and changes its emotional reactivity, its memory processing, etc. thereafter. But, increasingly, depression too has come to be understood as a syndrome of altered brain function and tissue damage from the physiological effects of stress, in a similar way. One interesting trend throughout the mental health field, as it has emphasized biological factors more and more to the exclusion of psychological and emotional, is arguably the lessening separation of heretofore distinctive diagnoses. I have recently heard theoretical speculation that schizophrenic and bipolar (manic depressive) psychoses may not be separate entities either. Indeed, the central distinction in diagnostic psychiatry between disorders of mood and of thought makes less and less sense than we have thought.

In psychiatric epistemology, there has always been a tension between the ‘lumpers’ and the ‘splitters’. Modern developments in diagnostic nomelnclature embodied in recent editions of the Diagnostic and Statistical Manual (“DSM”) have clearly been in the hands of the splitters, to a sometimes baroque and ridiculous extent. Distinctions have proliferated, pigeonholes have multiplied. Interestingly, one of the co-authors of this editorial, Robert Spitzer, has been the maven of the DSM process for the past several decades. The reconsideration of PTSD signified by this editorial may represent a long-overdue resurgence of lumping. As a generalist and synthesist in the field, this is very appealing to me…

So, in a sense, it may not be that all or most post-traumatic stress is really depression and anxiety; it may be that all or most depression and anxiety disorders may really be post-traumatic. Much has been written about Freud’s betrayal of the trauma concept. In early vesions of psychoanalytic theory, he had recognized the impact of external events in the etiology of neuroses, but in revising his theory he increasingly focused on internal fantasies. Critics have suggested he was avoiding his own irresolvable conflicts about his relationships with the women in his life. In any case, this was the first of two major betrayals of the patient’s reality in mental health treatment which has shaped the conception of mental disorders and the approach to treatment for the ensuing century or more; the second has been the reductionistic biological focus of the last two decades, removing us even more from the core reality of the patient’s experience. Arguably, it has gotten to the point that third party payors, in a sense, only want to pay for “endogenous” disorders that do not arise from life events, relegating “reactive” syndromes to lesser diagnostic categories which are less reimbursable. In a way, I may have been dead wrong in complaining that PTSD was diagnosed too often and arguing for the more precise use of the concept. The impact of trauma may not be recognized or acknowledged nearly enough.

Reflections from Vaughan’s ever-excellent Mind Hacks:

*Dawdy:

“Yesterday, I wrote about the murder of a psychologist in New York City and wondered aloud and somewhat innocently at why this nonsense happens and continues to happen in our culture. I don’t hear too many stories of Brits hacking their psychiatrists or psychologists to death–OK, I know of zero cases like that in the UK. The post received several comments that I find disturbing and unacceptable, forcing me to ponder why I am even bothering to do this blog if the best I can get out of readers is a bunch of inhumane BS and tired anti-psychiatry polemics.”

As FmH readers know, I maintain an interest in privacy and its violations, although it has largely become a lost cause. In The Anonymity Experiment, a correspondent for Popular Science attempts to obscure her tracks for just a week, in accordance with the following directives:

I heard of this from kottke, and the foregone conclusion was that it would not be very successful. His teaser left me curious about how she would measure the results. The piece is well-documented and I learned a few things about how to cover my tracks better. But her conclusion? Predictably, that you can never know how successful you have been, and that there is more information out there about you than you can ever know.

Speaking of ingrained paranoia, I recently sent out Freedom of Information Act requests to ten government agencies I thought might have records on me from my prior activities. Most wrote back that they found nothing about me, a fact to which I had a complicated reaction. I was (a) relieved; (b) surprised that my lifelong countercultural activities had apparently not attracted the attention I had expected; (c) dismayed I was being thus denied an odd sort of badge of courage; (d) of course, mistrustful of the denials; and (e) mindful of the fact that submitting FOIA requests might per se place me on a watch list or two (which I had not worried about in writing the letters, expecting that I was already on file). The Dept of Homeland Security, by the way, did not answer in the negative, saying instead that it was a matter of national security whether I was being monitored for national security purposes, and therefore declining to answer my request. By the way, don’t we think Carnivore, or some sophisticated government data mining equivalent or improvement, whatever it might be called, is monitoring this post to the internet and flagging me for further concern?

What do FmHers think? Was the whole endeavor foolish on my part?

In his book, Shepard takes issue with the experience of Barbara Ehrenreich, who in Nickeled and Dimed found she was not able to make ends meet or progress beyond a series of menial jobs when she tried self=imposed poverty as a social experiment. Could gender and age be making the difference? Or could it be preconceptions? I haven’t read the book (but I heard him interviewed on NPR) and he sounds vivacious and unjaded, in contrast to Ehrenreich’s well-worn and well-founded cynicism and rage against the machine.

A neurobiological dissection of the complexities of that simplest and most natural of acts. Including speculation on why most of us tip our heads to the right instead of the left when we kiss. (Hint: it has something to do with basic human hemispheric asymmetry). (Scientific American)

The drug is a simple concoction of the food preservatives BHA and BHT, with a novel mechanism to deliver them where they can do some good.

“Marketers spend a billion dollars a year targeting influentials. Duncan Watts says they’re wasting their money.” (Gasp) Could Gladwell have gotten it wrong? Fast Company

Maybe You Should. Psychologists have long known of what is called the Imposter Syndrome, in which people have a secret sense they are less competent than they appear to others. The idea that you’re a phony has been seen as a tormenting reflection of self-doubt in an anxious personality type. But it may be subtler than that. New research clarifies that those suffering from Imposter Syndrome, rather than being phonies, may in effect really be “phony phonies.” Adopting self-deprecation may lower others’ expectations and take pressure off one, preserving or even inflating self-serving confidence. New York Times

Long saga about one of the things that’s wrong with DRM. Fortunately, something of a happy ending. No surprises here to any of you who have thought about the issue of DRM, but it is a first-person illustration.

All of a sudden (after having to reinstall Windows XP for a reason having nothing to do with itunes) itunes tells me that 122 purchased songs (m4p’s) will not be transferred to the ipod on synchronization because I am “not authorized to play them on this machine.” This happened to me several years ago and I recall the solution was arduous, but for the life of me I no longer remember what I did back then to solve the problem (I think I should keep a log of these bedevilling Windows quirks with which I struggle and eventually solve, to recreate them in the future. Because it sseems almost certain they will recur.). Burn me once, shame on you; burn me twice, shame on me, don’t they say that? So why the heck have I continued to buy music from the itunes store???

I start at the obvious place, by DEauthorizing the machine and REauthorizing it with the itunes store, over and over again. It tells me, each time, that authorization was successful and I have now authorized 3 out of my allowed 5 machines (altho I only have ever had itunes installed on one machine). No matter, it obviously sees the machine as changed and therefore as having a different identity. That’s okay, at least I’m authorized now, I’ll deal with deauthorizing the ‘phantom’ machines later. But, even tho’ successfully authorized, I still cannot transfer those 122 tunes to the ipod and itunes still tells me I am not authorized to play them.

Oh yeah, now I remember, you’re supposed to click on one of the “disallowed” songs in itunes and try and play it, and it will get you authorized in a more enduring way. So I do that but it will not play any of the songs in the “purchased” folder no matter how I try.

The old time-honored solution to de-DRM songs, which is to burn the “purchased” playlist to a CD and then re-import the music from the CD into itunes aas plain mp3s, doesn’t work because you can’t burn music you are not authorized to play in itunes. So I research the software the freedom-lovers have made available out there to de-DRM itunes music, like TuneBites. People say it works great. I download a trial version. One fatal hitch, the clever way it works is that it plays your .m4p tune to a virtual CD device it sets up and then rips it back to itunes as an .mp3, de-DRM’ed. Great. You have to be able to play the tune in itunes in the first place to convert it. I guess that makes a twisted sort of sense, since the point of TuneBites is not to steal music but just to allow you to truly own what you bought and paid for, without DRM, to do with as you please. But it will not work for me in this situation.

More research. I look for non-itunes music software for my desktop machine that would play .m4p’s. Maybe then I can burn them or convert them somehow. There’s a plugin for Winamp that’s supposed to do that, but damned if iI can get it to work for me, despite the fact that I know what I’m doing.

Finally I come across a shareware program called m4p2mp3.exe. Download it, install it, let it loose on the 122 songs. It succeeds in converting *most* of them to unprotected mp3s (can’t for the life of me figure out what the difference is between the ones it fails at and those it succeeds with, despite several trials.) Almost good enough, I’ve freed around 100 of the 122 songs. The converted mp3s are perfect copies. Yep, they play great. So I pay for the shareware, in gratitude, and reimport the 100 mp3’s into itunes. I’m gonna “find duplicates” and remove all the DRM’ed original versions, keeping the free versions. But for some reason I click on one of the originals, just to try it one last time before erasing it now that I have a sanitized duplicate of it, and by God it plays. SO DO All THE ORIGINAL M4P VERSIONS OF THOSE 122 SONGS!! Somehow I got reauthorized to play them along the way! I can transfer them to the ipod, burn them to CD, etc etc etc.

WTF?

Still probably a good idea to free everything with my nifty new conversion software (as long as it continues to work, til Apple catches up with it). From now on, I am going to convert anything I buy from the itunes store to a plain ‘ol .mp3 and get rid of the protected .m4p version.

The 2007 winners are in.

Have Cosmologists Lost Theirs?: “It could be the weirdest and most embarrassing prediction in the history of cosmology, if not science…” I love it. (New York Times )

I can’t believe this was posted on a humor site! (And I can’t believe I’ve blinked about both Mad and Cracked, neither of which I have thought about in more than forty years, on the same day.)

…asks the New York Times

The mourners’ kaddish is one of the most powerful prayers in Jewish liturgy, recited by the grieving to reify their loss before the rest of the congregation. The writer yearned to join the other mourners and recite the kaddish for her father, but could she? He had not died, but, she felt, had been just as lost to mental illness. (Tikkun)

From Mind Hacks, a description of a folk remedy for depression, probably from the 16th or 17th century:

…Bringing a sledge hammer to work tomorrow.

Philosopher Nick Bostrom argues that the pharmaceutical industry should be encouraged to develop cognition-enhancing drugs without having to tie them to a specific disease indication.

Bostrom, by the way, sounds like he works at an interesting venue, the “Future of Humanity Institute of the James Martin 21st Century School” at Oxford.

Potential Hazards of the Protect America Act (crypto.org pdf). One example of a generalized principle, that ill-conceived solutions are not just ineffective but often exacerbate the problems they are designed to address. This cuts across disciplines but is particularly prevalent in social policy interventions as well as the area with which I am more familiar, the practice of medicine (e.g. antibiotic use increasing the risk of virulent infections).