What’s Love Got To Do With It?

If you have read any of my recent blogs, you may have noticed the following quote from Lao Tsu, an ancient Chinese philosopher: “to be loved deeply gives you strength, to love deeply gives you courage.”

 

The wisdom of those words explain much about behaviors I observed and attempted to treat as a psychiatrist. Feeling unloved was indeed a common complaint and the cause of a great deal of pain and misery.  Without the experience of feeling loved one is weakened, and thus may lack courage to face even the ordinary demands of life.  This may progress to a conviction that one is not only unloved but unlovable, resulting in self-loathing, depression, thoughts of harming oneself, and according to Anthony Storr, may generate violent aggression which he says is: “a complex mask for a repressed longing for love.”

WHY DO THEY DO IT?

There seems little doubt that we are now in the midst of an era of increased incidence of depression and unsanctioned violent aggression. Mass murders by otherwise ordinary people of all ages are now occurring at a level never before seen in the U.S.  Most perpetrators have a history of relative anonymity.  Neighbors usually describe them as quiet and unassuming, a person to whom they would speak to in passing but never engage in conversation.  Acquaintances when found describe their relationship as superficial, and express profound surprise that the person was capable of violence.  There is little evidence of any closeness let alone intimacy in their lives.  Could such horrible deeds be as Storr said: a result of anger over the lack of love in their life?

THE THIRD MOST COMMON CAUSE OF DEATH

There has been an alarming increase in the number of kids diagnosed with clinical depression which is not limited to those who are disadvantaged or abused.  A recent Center for Disease Control and Prevention survey of young people between the ages of 10 and 24 years resulted in shocking statistics. They report 4600 lives lost each year by suicide (most experts feel the actual number is higher due to a tendency for many to go unreported), and that rate has nearly tripled since 1940.  Emergency rooms throughout the country report 157,000 young people treated for self-inflicted injuries each year.  In their Nationwide survey of high school students, the CDC reported 13% admitted to seriously considering suicide, and 8% actually made an attempt to take their own life.  The report goes on to list a number of risk factors however; at a time in their lives when they are dependent on others to establish an identity and self-worth, it seems to me that relationships deserve to be at the top of the list.  Indeed, many teen-age suicides do implicate such problems as precipitating factors.

MORE OF THE SAME, ONLY WORSE

Rollo May in his 1960’s book LOVE AND WILL, says  “Our culture pushes people toward becoming more detached and mechanical,” but that observation doesn’t come close to what we see now that the digital age has enveloped us.  The addiction of our children to cell phones and other electronic gadgets contributes to their alienation.  Consolidation of schools and overcrowded classrooms have made it easier for kids to fall through the cracks.  Social media has become a convenient vehicle through which kids can be disparaged or bullied.  They are often attacked where they are most vulnerable i.e. their lovability consequently; the common theme “no one likes you” can be devastating to developing minds.  Now we hear there has been a dramatic increase in suicides in recent years among not only teenagers but pre-teens.   Although there is no proof of a link to feeling unloved, logic suggests there often is.

DON’T CARE? SURE YOU DO

There is ample evidence that we are herd animals, consequently; it is not surprising that I spent many hundreds of hours listening to patients with relationship problems, for when people are so very important in our lives, dysfunction can present problems.  Although we often attempt to comfort ourselves by professing to not care what others think, in truth we usually do care more than we would admit.  During all those years I spent in the shrink business I must have seen hundreds of people who were contemplating suicide or had actually made serious attempts.  Although there are obviously many factors that may lead one to seriously consider killing oneself, I recall often hearing: “Nobody cares.”

DO WE KNOW WHAT IT IS?

It would indeed be presumptuous of me to attempt to explain what love is all about.  It has certainly been a popular topic for poets, philosophers, musicians, theologians, and artists, through the ages.  The stories of wonder, ecstasy, and tragedy associated with love resonate in pop culture to this day. There have been myths, and legends and attempts to define love by categorizing it (erotic, agape, filial, spiritual, etc.), but the force responsible for this peculiar phenomenon remains a mystery to me.  My favorite definition of the term is from psychoanalyst Harry Stack Sullivan, as follows:

The validity of such explanations is confirmed by the intense love relationships experienced by warriors throughout the ages.  The myriads of reports of heroic efforts put forth by battle hardened veterans to protect their comrades, even risking or forfeiting their lives in the process gives credence to Sullivan’s ideas.  Indeed, when questioned as to why those who would in other situations have been considered unlikely heroes are questioned about their behavior, they will acknowledge that it had nothing to do with military or political beliefs, or patriotic fervor, but rather their devotion to their buddies (“No greater love hath man……”). That phenomenon has not been lost on those charged with training the military, consequently; camaraderie is encouraged and interpersonal dependency guarantees bonding.  One cannot wonder as to the part that the loss of relationships, solidified by the heat of battle, factor in the alarming rate of depression and suicide among our veterans.  Many report they worry about their comrades who are still fighting which may  also account fir the significant number who volunteer for additional tours of duty with their old outfits in spite of the known horrors they will likely confront.

WORTH THE TROUBLE?

Obviously, love has been a major contributor to the success of the human race.  Humans isolated from their kind rarely survive.  Sullivan posits that love is caring for others as for oneself and the old Chinese dude says as a result of love for each other, man gained the strength and courage to take on woolly mammoths and those guys in the next village who were trying to muscle in on their territory.  It is the latter part of that statement that has caused a lot of problems.  We seem to know a great deal as to the effects of love, but little about from whence it comes.  The neuro-physiologists and brain mappers continue to look for specific love loci, and geneticists will likely say that it is in our DNA, but I doubt that CRISPR will ever be able to install a love gene.  It would be great if such could be done, for we currently have little treatment for those who seem incapable of love, i.e. psychopaths.

I KNOW IT WHEN I FEEL IT

It may be that love is like the dark matter of our universe in that we know it exists and feel its effects even though we are unable to see, hear, smell or touch it.  Could it be that love is simply a product of evolution?  If so, how could we have survived long enough for natural selection to kick in?  The creationists insist that God snapped his fingers and we instantly appeared on the scene fully equipped.  Atheists on the other hand think the whole thing was an accident.  Others see love as spiritually endowed.  There are 4300 religions in the world with Christianity leading the pack and Muslims close behind.

WHAT ABOUT RELIGION?

Since I have been reared as a WASP, I have very little understanding of the other religions of the world or in particular where they stand on the love thing, but am pleased that love is at the core of Christianity.  When it comes to Biblical scholarship, I am a dunce, but I do find inspiration in those first few pages of Corinthians which are all about love.  The first 2 of the 10 commandments are also about love, and love is said to be the greatest of all, never fails, and is even better than faith or hope.  There is also that thing about loving your enemies and turning the other cheek, but most of all were the teachings of Christ who was all about love.  Of course, many see an inconsistency in a loving God who lets crappy things happen in spite of being all-powerful.  Since Christians are people it is not surprising to find they have found ways to subvert the love philosophy, and resort to violence with all sorts of rationalizations.

Loving others as much as oneself is a great idea, but very difficult to implement on a grand scale.  Excessive cheek turning is guaranteed to result in a lot of broken jaws.  Nevertheless, there have been many attempts to use love as a mechanism to provide peace and tranquility, which has been met with success in some instances.  In a rare instance of wisdom, our government eschewed the policy of gathering the spoils of war after WWII.  Instead they initiated a policy aiding even our enemies to rebuild their virtually destroyed countries which lead to their becoming our closest allies.   Of course, I was also around during the “love ins” of the sixties.  Although they seemed to have emphasized the erotic rather than agape version of love, they did call attention to long neglected human rights issues and war mongering.  There was also Nelson Mandela and Martin Luther King who both emphasized reconciliation and learning to love each other.

We certainly could use more love in this world, but the chances of EVERYONE following the Golden Rule seem to be unrealistic.  Nevertheless, when I look back on our history it seems there has been some progress in the love department with more emphasis on inclusivity and acceptance.  Although it may seem that love is in short supply, it is alive in well and we can only hope the day will come when The Golden Rule is ever present. Even as millions of our fellow humans face horrors each day, there are millions of people who devote their lives to helping others individually and through organizations, which gives credence to the dictum that love never fails.

Corinthians 13:4-8 gives tells us everything we need to know: “Love is patient, love is kind. It does not envy, it does not boast, it is not proud.  It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs.  Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres. Love never fails…”

The High Life | Marijuana and Us

It appears that Marijuana use has now become a socially acceptable practice. Not only are states falling in line to legalize recreational use (I don’t like that term for it seems to equate smoking weed to working out at the gym), but I was surprised the other day when I happened on to an interview with Liz Post who is the great granddaughter-in-law of Emily Post, the etiquette guru.  Liz has taken up the etiquette banner and continued as director of Emily’s foundation for the last 30 years. She has written her own books of etiquette, this latest of which caught my attention. It is titled Higher Etiquette, and is all about proper behavior in marijuana involved social situations.

A few days later, I was confronted with a full front-page spread in our local newspaper about our county’s latest industry, a facility for growing marijuana on a large scale. It was hailed as a major success for the area and projected that it would eventually employ more that 100 people. Image result for marijuana

The story featured a half-page picture of the interior of a huge greenhouse inhabited by large plants. Apparently, since the owners realized potheads would see the photo as their idea of heaven on earth, they assured us that the facility would be heavily guarded. Medical marijuana (whatever that is) was legalized in our state in September 2016.

Image result for marijuanaThe new law only authorizes the use of cannabis orally or topically in the form of pills, elixers, tinctures, and lotions etc. Dispensaries were licensed by the state and product can be obtained with a note from a licensed physician confirming that the person is suffering from one of a list of 21 maladies; although the state medical board is authorized to add diagnoses to the list as they see fit. The law prohibits home growing of weed and smoking it, but allows inhalation through a vaporizer. (I would anticipate there will soon be a brisk business in vaporizers). Not only does this and similar laws across the country violate federal law governing the use of marijuana, it appears to me to bypass Federal Drug Administration procedures which require extensive testing for both efficacy and safety before any drug can go on the market.

Efficacy of Cannaboids

There is a great deal of anecdotal information concerning the efficacy of cannabinoids for a variety of medical problems. In the early 1800s an Irish physician found cannabis extracts helpful in relieving stomach pain and nausea in people suffering from cholera, and recently the FDA approved 2 drugs containing THC, Marinol and Syndros, for treatment of nausea and anorexia in patients undergoing chemotherapy for cancer. It is also said to be useful in the treatment of refractory epilepsy, chronic pain problems, glaucoma, and various neuromuscular diseases such as multiple sclerosis to name a few. Prior to the dawn of modern pharmaceuticals, cannabis extracts were widely sold as a treatment for stomach ailments. Now, nearly 200 years later we don’t know much more about them than we did then.

Other Naturally Occurring Plants in Medicine

This is not the first time that a naturally occurring plant would be found to be useful in treating medical conditions. For example, back in the dark ages when I was a general practitioner, digitalis, which was extracted from the foxglove plant was the treatment of choice for a variety of cardiac problems. More recently, taxol, a substance extracted from the bark of the Pacific Yew tree has proven effective in the treatment of ovarian cancer.

The Problem with Pot

The fact that THC is a mood-altering drug complicates the issue of doing the proper research to discern its effectiveness, side effects, and dangers both in the short term and with prolonged use.

There is also the possibility of an enhanced placebo effect. Does drug-induced euphoria tend to mask symptoms, and if so is that bad thing?

The more significant reason for the lack of knowledge as to the effects of marijuania on the human body is due to Federal Drug Administration’s reluctance to allow scientists to possess it in order to evaluate it properly.

In 1970 Nixon signed into law The Controlled Substances Act which listed marijuana as a Schedule 1 drug along with heroin, LSD, and other dangerous and /or highly addictive drugs. This was during the time of the War on Drugs, and the FDA was so uptight that they refused to allow possession of any of these drugs for research purposes. Of course, as usual they zigged when they should have zagged for this was a time when new tools were becoming available to researchers with which to evaluate the effect of drugs on the brain, and an opportunity to learn more about the drug was lost. With such information, they could have been in a position to inform us as to the possible consequences of their use, and perhaps more specifically define how or where they might be useful or harmful.

Follow the Money

With one foot firmly planted in the door with the medical thing it is not surprising that the Marijuana Rights and Regulations Amendment will be on this fall’s ballot. It would legalize the use, possession, and sale of marijuana for persons over the age of 21, and would allow the Ohio General Assembly to enact a tax on its retail sales. As nearly as I could tell there are no proposed restrictions and if passed, potheads can rejoice at their new found freedom. Likewise, entrepreneurs would like to see some of that drug cartel money stay right here in the US of A, and why shouldn’t stoners throw a few bucks into state coffers for the privilege of getting high? Those who grow their own (in limited amount) will pay $50 for a license which is not a bad deal when one considers a cigarette smoker pays $1.97 in taxes for a pack of carcinogens.

If one follows the money, it would seem that the proposed bill would pass, and become law. According to one PR organization (ABCD Inc.) the potential profits are nothing to sneeze at. In their 2018 Cannabis Price Index, they project that in New York city alone 77.44 metric tons of pot was consumed in 2018 with a revenue of well over $8oo million, and if taxed at the same revenue as cigarettes $354 million for the city. I have no idea how they came up with those figures, but if true it is little wonder there appears to be an active campaign espousing the virtues of cannabis involving not only established stoners, but big business and politicians as well.

History of Pot

According to the DEA Museum, the oldest known written record on cannabis use is from the Chinese Emperor Shen Nung in 2727 B.C. There is some evidence that its psychoactive qualities were known then. However, the plant was used primarily for its fibers, which were used to make rope, cloth, and a variety of other products, and is thought to have been low in the concentration of psychoactive chemicals. Although hemp and marijuana are of the same species, i.e. cannabis, it is thought that one variety was developed over time with the goal of increasing the levels of tetrahydrocannabinol (THC), the chemical responsible for its mind-altering effects.

A Higher High

The process of increasing the potency of weed has continued and has accelerated during the last 20 years – not surprising since users are always looking for the “good stuff.” One study found the average potency in Europe and the U.S. to have nearly doubled between 2008 to 2017. The THC levels had gone from 8.9% to 17.1% with one variety reaching 67%.

This same study compared rates of psychosis between areas with different levels of cannabis potency and found that indeed those cities with the more potent stuff reported more psychotic episodes. As a matter of fact, those who had used higher potency stuff were twice as likely to eventually have a psychotic episode compared to those who had never used. Even more worrisome was the stat that daily users of high potency weed were four times more likely to experience psychosis. This raises the question as to whether THC may have long term side effects. This is not at all surprising; after all THC has long been categorized as an hallucinogen even though until now a weak one.

Pot and the Teen Brain

With the frightening (to some of us), statistics as to the prevalence of pot smoking among adolescent and even younger children has come realistic concerns as to the effect of pot smoking on their brains. This has become increasingly worrisome with recent discoveries of the so-called “plasticity” of the developing brain i.e. the effect that various stimuli may have on its structure and function. Such changes may not become readily apparent until years later and to that end the National Institute of Health has instituted The Adolescent Brain Cognitive Development Study that will follow 10,000 children through adolescence hoping to find what sort of factors, including drugs, affect their brains. Unfortunately, it will take many years for the study to be completed.

Not So Fast…

Although such information is incomplete, I feel it is premature to judge cannabis to be an innocuous substance, as many would have us believe. I recall similar reassurances regarding cigarettes, e.g., that they were not addictive, harmless, and simply a relaxation aid. It was true those people on billboards, in the magazine ads, and the movies looked really cool with one between their fingers. I was one of those gullible slobs who tried looking cool for 50 years, and was rewarded with a couple of cancers. I was also left wondering how much damage I had done with all that second hand smoke. Of course, I knew that I was not addicted for I could quit anytime I wanted, it was just that I didn’t want to (the same words I have frequently heard from my pot smoking patients).

We’ve Been Down This Road Before

At the beginning of the 20th century, cocaine was toted as a wonder drug with the potential to cure a potpourri of illnesses including drug addiction. Its health benefits were even extoled by adding small amounts to a soft drink which in honor of the presence of cocaine was named Coca Cola. Two of the best-known pioneers in their respective fields of medicine became addicted as a result of their experiments with the drugs. William Halsted who is credited with devising many of the surgical techniques still in use today became incapable of functioning due to his addiction as did Sigmund Freud who likewise became addicted by testing the use of cocaine for psychiatric illnesses. In the 1960s along comes Timothy Leary a Harvard psychologist who promoted more potent hallucinogens as treatment for depression, to increase awareness of otherwise untapped spiritual states of being and other kooky stuff. He was eventuallyHe was eventually disgraced when he was found to be using prisoners as subjects for his experiments.

Why?

Whenever there are discussions with anti-dopers about mood altering drugs, the question frequently arises as to “why they do it.” Freud attempted to answer that question with his “pleasure principle” theory, an idea which was a couple of thousand years old having previously been described by the Greek philosopher Epicurus. This was the idea that the pursuit of pleasure and avoidance of pain are the essence of life, and therefore all behaviors can be explained by this instinct, furthermore conforming to societal norms is simply to delay gratification of those instincts.

Addiction

The term addiction is not easily defined as it seems to be used in different contexts, but it is clear that the more pleasant the effects of a substance, the more likely it is that one moves on to an insatiable craving. With prolonged use physiologic changes occur as our body adjusts to the presence of the new substance and bad things happen when it is suddenly withdrawn. The extent of its effect on our body/brain is called its potency. A 2- pack-a-day cigarette smoker is apt to have some headaches and grumpy days for a week or so, but a very heavy use of alcohol over a long period of time can result in delirium tremors, a condition which carries a significant mortality rate when untreated. It appears that in some heroin users, the passage from craving to addiction is almost instantaneous.

Of course, the foregoing description of addiction is woefully simplistic for it is a very complex subject with much disagreement among the experts. My point is that without some regulation governing potency of cannabis we may be in for some unpleasant surprises. Having over the course of my career seen large numbers of marijuana smokers, I am convinced that it is by no means innocuous. I also question the conclusion of pot supporters that it is in no way addictive. I believe that it is especially dangerous in children and that many who are exposed at a young age may be permanently damaged.

So, What’s the Answer

Many of you may be thinking: “OK smarty pants, if it is such a big problem, what can be done about it?” The answer is not much. It is clear that the current situation has not worked except to provide opportunities for criminals to make a buck and for addicts to sell in order to finance their habits. Apparently, we did not learn our lessons from the results of prohibition. As with alcohol, cannabis is easy to produce in most any climate and even more difficult to control than opiates, which must be imported. There are some steps I think would be helpful in minimizing the problem:

  • For the states to continue to have their own laws about pot causes confusion. The federal government should legalize the stuff.
  • The FDA should set standards and monitor compliance.
  • It took 100 years for the realization that tobacco companies were spiking cigs with extra nicotine, we should test cannabis for potency.
  • Anyone who gives or sells the stuff to kids should spend significant time in the slammer (I have seen instances where pot smoking is a family affair).
  • Many organizations saved lives with an all-out effort to make smoking uncool, let’s give marijuana the same treatment.
  • With legalization will come more use, encourage NIMH to make research into the drug a priority
  • Please, please, no advertising. Think it couldn’t happen? That’s what the temperance union thought following the repeal of prohibition.

After pushing pills and other remedies for well over a half century I have concluded that there is usually a downside to whatever chemicals we put in our bodies regardless of their positive benefit. In spite of rigorous evaluations, clinical trials and such we often see unexpected side effects…sometimes years later. The current practice of prescribing cannabis based on anecdotal information without benefit of rigorous clinical testing is in my opinion irresponsible.  Nevertheless there is little doubt we have a serious drug problem, and the consensus is that cannabis is safer than most other street drugs. Prohibition offered further proof that “the pleasure principle” thing would not be denied no matter the consequences. Legalizing alcohol did not solve the problem, but it was not as bad as the alternative, and following that model seems to me to be the more sensible approach in dealing with cannabis.

 

 

 

 

 

 

 

The Way It Was| Part 10

   Being deeply loved by someone gives you strength.
While loving someone deeply gives you courage.
Lao Tzu

Editor’s Note: Above is a quote Eshrink found while doing research for this series of blog posts: The Way It Was (a glimpse into how he saw life growing up during The Depression and WWII). He said it might be his all time favorite quote so I decided to put it at the top of each post in this series as a reminder of the power of words and the power of love. Eshrink’s writing illustrates the power of both! In case you missed earlier posts in this series, I’ve provided links below.

EDITOR’S Note:

Welcome to Part 10, the final installment  of “The Way It Was” (Eshrink’s memories of WWII from his perspective as a young boy growing up in Ohio). 

2014-07-08_New_Deal_GI_Bill_Rights_03

President Franklin D. Roosevelt (FDR) signing the G.I. Bill in June 1944.

Our conquering heroes were treated as such. Many would return to their old jobs and families. But colleges, universities and trade schools were flooded with students as nearly 8 million veterans took advantage of the GI bill which paid for tuition, and living expenses for any approved college, high school, technical, or vocational school. Many universities found it necessary to erect quonset huts to handle the influx, while others opened branches in enabling some vets to commute (the latter allowed me to start college).

Low interest mortgages and business loans were made available, along with one year of unemployment compensation if needed. There were some who objected to the policy as being socialistic along with the prediction that it would encourage laziness. It turned out that this time the unintended consequences of a government policy were positive. Teachers and professors almost unanimously applauded the GI’s for their discipline, and dedication to their studies. Employers were recruiting rather than shunning veterans.

Sociologists and economists mostly agree that this massive educational effort contributed in a big way to the post war era of prosperity and to our becoming the dominant force in the world. We gained respect for not only our military prowess, but intellectual and artistic pursuits. For example, It would no longer be advantageous to study medicine in Europe, rather Europeans would now line up to study in the US. The ready availability of an educated workforce allowed us to move ahead of other countries in industrial and scientific research, and to mold our “swords into plowshares.”

Learning from History

Of course, we had a head start in the race for supremacy considering the fact that the rest of the industrial world was in shambles having suffered the brunt of the war’s devastation. In a rare display of good judgement, we seemed to have learned from past mistakes and decided to use our new-found prosperity to create the “Marshall Plan” which was designed to help rebuild and revitalize Europe including Germany and Italy.

This was in marked contrast to the treatment of Germany after the first World War, when they were severely punished. This was undoubtedly a major factor in causing WWII a mere 20 years later. The Marshall Plan, i.e., the general strategy of helping the countries we had just defeated, was roundly criticized by many who felt we were rewarding bad behavior. However, the rebuilding of Europe combined with a similar program for Japan has resulted in the establishment of democratic governments and prosperity for all, but most of all peaceful relations which have lasted for 70 years.

Those postwar years were full of the promise of peace and prosperity. The boys had come home, were going to school, or working better jobs. My Brother and my uncle as beneficiaries of the GI bill were the first in our family to have ever gone to college. As with millions of others, they were soon starting families, and the baby boom began. In 1948 I graduated from high school and worked briefly as a go-fer at an automobile agency, where there was a long list of people waiting to buy a new car. This was true of all kinds of items which had not been produced during the war. There was building everywhere, the economy was booming, and the future looked bright, but that euphoria was short lived when Joseph Stalin entered the picture.

War Makes Strange Bed Fellows

Stalin was at least as ruthless as Hitler, and is said to have executed millions of his political adversaries with even more dying in his gulags as his concentration camps were called. Nevertheless, he had been welcomed into the fold as an ally after he declared war on Germany. He called himself a communist but his definition of communism involved the presence of an all-powerful dictator.

Yalta Conference. Winston Churchill, Franklin

Left to Right: Churchill (PM of England); Roosevelt (President of the USA); Stalin (Leader / United Socialist Soviet Republic-aka: Russia)

At the famed Yalta conference called to decide the fate of post war Europe, Stalin was granted control of Eastern Europe after suckering FDR and Churchill into believing he would keep his word about establishing democratic governments in those countries. His duplicity marked the beginning of the Cold War which would become more frigid with Russia’s development of a nuclear bomb in 1949. This led to the policy of “mutually assured destruction” (a.k.a., a Mexican standoff) and the construction of backyard bomb shelters, air raid drills in schools, and teaching kids to sit under their desks…as if that would do any good in an atomic bomb attack.

air raid picture

air raid info

air-raid advertisement

Why?

It should come as no surprise that since I am a psychiatrist I might have some interest in human behavior, Although you could legitimately question if some of our world’s worst tyrants mentioned in this paper are really human. As a teenager during that great war I was subjected to a lot of news of the atrocities carried out under the direction of these people who at first glance would seem to be free of a mental illness. One of my friends had occasion to spend a great deal of time with Saddam Hussein following his capture. He was surprised to find him quite personable. In one of their conversations Saddam stated that he acted as he did because it was necessary to save his country. I am left to wonder if he really believed that, and if is such a rationalization is common among Tyrants.

After endless years of speculation as to what makes these guys tick, they remain a mystery to me. We psychiatrists are well versed in labeling various conditions, but not so good at finding causes. I am aware and concur that power corrupts, but still after those years of mental gymnastics I remain perplexed as to how these otherwise apparently normal people can do such evil deeds. Even more puzzling is how they are able to convince masses of people to follow their lead and participate in the torture and murder of others.

Nuremberg Trials

020419-nuremberg-trialWith the end of the war members of the Nazi hierarchy were rounded up and charged with “crimes against humanity.” I was 16 years old and found time to follow the trials in Nuremberg in spite having recently found the love of my life.

Nuremberg-trials-8

There apparently was some effort to learn something about these guys for I recently found they were all given Rorschach tests (these tests are now discredited by many). Herman Goering was second in command in Germany under Hitler, and I recently found a transcript of his testimony.  He was surprisingly open about the operation of his government and freely discussed the operation of the concentration camps and how adversaries were ordered to be killed by the SS or Gestapo. He was sentenced to be hanged, but managed to have cyanide smuggled in and killed himself.

goerring 1

Although, I knew the story of Goering’s suicide it was only recently that I learned there was a very interesting and strange sequel to the story. Goering had been examined by an Army psychiatrist by the name of Lt. Col. Douglas Kelly. He apparently shared some of my curiosity as to what made these guys the way they were. He is said to hope he would be able to identify what he called a “Nazi personality” which could be identified before such bad guys could come to power. From the story it sounds as if he was suffering from a serious mood disorder, which must have gone undetected by the army. In any event, after a minor disagreement with his wife he ingested cyanide and killed himself in front of his wife and children a la Goering.

True to the Biblical prophecies we have continued to “hear of wars and rumors of wars.” I was one of the lucky ones for my brief stint in the Navy was in between wars. It seems I will go to my grave with no understanding of why we do what we do to our own species. I have some ideas, but none seem to make sense. Perhaps we should add another diagnostic category called evil people to our diagnostic manual.

Thanks for the Memories

On this cheery note I leave you all to ponder those ways of the world which are beyond my understanding. I do want to thank Peter for suggesting this topic. The reminiscences have been fun, and as I have mentioned before that is the thing we old folks do best. It has also reminded me to be grateful for having been born in a time and place where I was loved, and for the good fortune that has accompanied me all these years.

 

 

Another Brief Interruption of “The Way It Was Series” | The Curmudgeon is back

Talk right or don’t talk at all

            In previous blogs, I have mentioned that a favorite past-time of we old buggers is to reminisce however; those reminiscences are frequently accompanied by complaints that things “aint what they used to be.”   Of course, if offered a ticket to travel back to those those good old days, we would definitely not be first in line.   In the time-honored tradition of curmudgeons everywhere, I try to come up with at least one complaint per day, and today’s version greeted me the first thing this morning when I turned on the TV for my morning CNN fix. 

            This latest complaint has to do with girls.  This has nothing to do with girls in general for I like girls.  I have sired and helped raise three of them and like them a lot.  I have been living with one for 65 years and still like her a lot most of the time (the periods of dislike are brief and usually occur in the heat of battle, and she becomes likeable again as soon as I surrender).  I have found females easier to work with in therapy, and feel that they have received a raw deal from us guys throughout history.  This latest complaint seems to have begun its evolution with the millennials and I believe has become more prevalent with those younger whippersnappers who are referred to as generation Z. Link to article Where Millenials End and Gen Z Begins.

            It has been said that if it quacks like a duck and looks like a duck it must be a duck.  The very attractive young woman who appeared on the TV screen this morning certainly did not look like a duck, but did quack like a duck.  As a matter of fact, I had so much difficulty understanding her, I pulled out my hearing aides to see if they had gone bad.  This was not the first time I had noted this peculiar murder of the rules of good elocution.  Although, I have limited contact with kids these days, I have noted the phenomenon to be prevalent in an even more severe form in teenagers.  Fortunately, my granddaughters have shown no evidence of having suffered this affliction. 

Editor’s Note: Eshrink isn’t alone…this link goes to a story entitled “Old people find millennial women’s voices annoying.”

            It should come as no surprise to those who know me that as a naturally curious person and “scientist wannabe” that I would set out to explore the cause of these peculiar sounds masquerading as speech.  In short order, my research discovered that those sounds could be produced by channeling one’s speech through their nose.  By doing so I found that I could replicate the sound with little effort and produce that quacking sound which makes me cringe much as I did when the teacher made that screeching sound writing with chalk on the blackboard (do they still use chalk?).  This mechanism should come as no surprise as it is known that the quality of sound waves can be modified by the confines through which they travel. 

            While in the midst of my research it occurred to me that the French seem to speak through their noses a lot, but their speech is pleasant, almost melodic in its presentation, and never seems ducklike.  I attempted to find out why there are different types of nasal speech, but the papers I found on the subject were complicated.  I did learn that such speech patterns are usually habitual, and I am concerned that if the practice continues unabated these otherwise normal duck-speak girls will produce babies who will emulate their mothers.  In the interest of saving our great nation from the evils of duck-speak, I was able to  find a website which offers suggestions as to how one can overcome this malady: https://www.sportsrec.com/stop-talking-through-nose-8286305.html.  In the mean-time parents should initiate a “talk right or don’t talk at all” policy.  This should not be much of a problem for the kids as they would rather text than talk anyway.

Editor’s Note: While I couldn’t find much about the nasal situation or “duck talking” Eshrink references, there are many articles about vocal fry, creaky voice, and upspeak. Below are just a few that might be of interest.

The Atlantic: Creaky Voice

News Coverage Video about Vocal Fry

Time Magazine Article

 

The Way It Was| Part 9

   Being deeply loved by someone gives you strength.
While loving someone deeply gives you courage.
Lao Tzu

Editor’s Note: Above is a quote Eshrink found while doing research for this series of blog posts: The Way It Was (a glimpse into how he saw life growing up during The Depression and WWII). He said it might be his all time favorite quote so I decided to put it at the top of each post in this series as a reminder of the power of words and the power of love. Eshrink’s writing illustrates the power of both! In case you missed earlier posts in this series, I’ve provided links below.

EDITOR’S Note:

Welcome to Part 9 of “The Way It Was” (Eshrink’s memories of WWII from the perspective of a young boy). This will NOT be the last chapter of our series as I had written previously. The FINAL installment will be Part 10: Life After Victory (plus, 10 signifies completeness/order…seems odd ending this incredible series on a 9). In this post, Part 9, Eshrink takes us through the end of the war. What he remembers and new information he uncovered during his research. 

The Big 3 WWII, Churchill, Stalin, FDR

The Allied Forces were referred to as the Big 3 WWII. The Big Three were Great Britain, the United States, and the Soviet Union with their leaders being Winston Churchill (right), Franklin D Roosevelt (middle) and Josef Stalin respectively.

After the invasion of German-held countries (D-Day), things began to look up as the allies made substantial gains, although those telegrams kept coming and daily we saw blue stars in many windows turn to gold.  Patriotic fervor never wavered and with better news from Europe there was more focus on the Pacific theater (I always wondered who came up with the term theater, and if he really thought war was entertaining).

FDR

According to the FDR Library/Museum (go to: fdrlibrary.org – it is a wealth of information), this is the last picture of FDR, which was taken April 11, 1945 (the day before his death) at Warm Springs, Georgia.

As you might expect there was wild jubilation in the streets all over the country with the defeat of Germany and Italy (V-E day or Victory in Europe Day) in May 1945, almost a year to the day that my brother had been drafted, and one month after the death of Roosevelt, who had served nearly 12 years in office.

Mussolini was summarily executed and his body mutilated by partisans.  Hitler had committed suicide along with his longtime lover, Eva Braun. Actually, Mussolini was executed with his mistress, Claretta Petacci, also.

I do remember there were rumors that Hitler had escaped and the body found was not his, but there seemed little doubt about the fate of Mussolini as his body was hung out for all to see (Editor’s note: in all fairness, the caption from the picture of Mussolini and his mistress hanging in the center of Milan says the “fascists” who were executed, including Mussolini and Petacci, were hung in the exact spot where civilians from Milan had been hung a year earlier after being executed on Mussolini’s orders for being part of “resistance” activities).

In days, it would all be over and the dancing in the streets would begin with confidence that Japan would soon fall.  The most shocking of all those incidents during the final days was the death of Goebbels, who poisoned his six children before killing his wife and himself.  In some way this seemed the most heinous of all the millions of evil crimes committed by these mass murderers, and it has stuck with me to this day.  It remains beyond my comprehension how someone could kill his own kids, though it is true, he did have a lot of experience murdering innocent children.

All this took place in a matter of weeks after a woefully unprepared new President was sworn in.  Harry Truman was chosen by FDR for Vice President as one who could help him carry the Midwest.  He was not included in FDR’s inner sanctum, and it has been said they did not even like each other.  In July of 1945, the atomic bomb was successfully tested at Los Alamos and Truman was faced with the choice of what to do with it.  He was later discovered to have written: “It is an awful responsibility that has come to us”.  (This links to a series of articles about that difficult decision Truman made). He was of course referring to the decision to use the bomb on Japan.  Having served in WWI as an artillery captain, he knew something of the horrors of war.  He had distinguished himself as a Senator, was the only President of the 20th century that hadn’t attended college, although he was proud to say he had read every book in the Independence Missouri Public Library.  He kept a sign on his desk which said The Buck Stops Here, and indeed in this case, it did, for few would want the responsibility which rested on him.

With the defeat of the Germans, and the Japanese fleet and air force nearly destroyed, it was obvious Japan would not last long.  Nevertheless, there was continued concern about the fighting to come, due to the Japanese honor code, which prescribed that one must fight to the death.  Even more extreme was the requirement that high-ranking officers must literally fall on their swords if defeated in battle.  Thus, the fighting in the island jungles continued.  It was brutal but futile.  To make matters worse, Russia declared war on Japan, and Russians were not known to be very gentle occupiers as evidenced by their European conquests.

My memories of the fall of our European foes are clear, but I don’t know if we were informed as to what was going on with Japan in the time that followed.  I have since learned that Japan had indicated their desire for a peaceful settlement.  I do recall the term “unconditional surrender” voiced a lot by our new President, and I believe I heard the term used once by General MacArthur, the chief of military operations in the Pacific.  An invasion of Japan was in the planning stages and expected to result in as many if not more casualties than in Normandy.  The potential for invasion was achieved during the Battle of Okinawa when we took the island of Okinawa, which proved to be the most bloody conflict of the entire war as mentioned previously.

With the taking of Okinawa, the Japanese mainland was within reach of our bombers and Tokyo was basically destroyed with a firebombing even more devastating and with more loss of life than either Germany’s Blitzkrieg of London or our firebombing of Dresden.  In researching for this blog, I was surprised to learn that those saturation bombings of Japan had killed more people by far than both atomic bombs.  In spite of the obvious hopelessness of their position, the Japanese showed no sign of surrender.  Their kamikaze pilots continued their suicide missions, and many of their soldiers chose suicide rather than capture.  With that in mind, our military predicted invasion of Japan would result in an even higher body count than previous operations.

On August 6, 1945, a B-29 with the name Enola Gay would become famous as the first plane to deliver an atom bomb.

It flew from the Marianna Islands to deliver the most efficient killing machine yet.  Indeed, we had come a long way since those days of one-on-one killings with clubs or spears.

Little Boy The Atom Bomb used to end WWII

The Atomic Bomb nicknamed “Little Boy” before it was loaded onto the Enola Gay.

When the bomb dubbed “little boy” went off, the entire city of Hiroshima, along with 80,000 people, were incinerated.

But that was only the beginning for untold thousands who would subsequently suffer from various forms of cancer, organ failure and genetic diseases in the years to come.  Three days after Hiroshima, Nagasaki would suffer the same fate.

Over 50 years later, I found myself treating a former Navy medical officer who was one of the first to enter the ruins where that city once stood.  He was still tormented by memories of what he saw there.  There is no denying that in spite of the horror of those two days, the strategy was effective. Just a few days after Nagasaki, Emperor Hirohito ordered the “unconditional surrender” demanded by the Allies.

Truman Oval Office announcing surrender of Japan

President Truman in the Oval Office announces the surrender of Japan.

The term “celebration” does not do the public reaction justice, and was probably exceeded only by the elation felt by those troops who were already preparing for the assault on the mainland of Japan. They must have been aware of the thousands who had died on the beaches of Normandy, and there were expectations that a mainland invasion would be even more deadly.

Celebrations in Times Square

The image that has become the symbol of the end of WWII. This was made famous by LIFE magazine. It was taken in Times Square upon the announcement that Japan had surrendered.

The movie newsreels showed images of the wildly spontaneous celebrations throughout the country, but they also showed a mushroom cloud (filmed at Los Alamos) as it rose ominously toward the heavens.  In some ways, that enthusiasm was to be tempered by the implications raised with the development of such an unbelievably destructive weapon.

As more news became available as to not only the deaths but possible long-term effects of radiation exposure, Truman’s decision to use the bomb was called into question by many.  Later, we learned that Germany had been on the verge of developing their own version and the scourge that continues to haunt us was inevitable.  We were now well on our way to developing the power to create our own version of an apocalypse, and the cold war soon began with Russia.

Our boys, as we called them, were soon on their way home to be greeted as heroes.  There were home coming celebrations everywhere.  The patriotic fervor persisted or even increased.  The 4th of July celebrations were spectacular and veterans of all stripes were treated as special.  The marriage business flourished as the vets were reunited with the girls they had left behind, and many brought wives home with them. There were happy days, except for those who returned with injuries or illnesses suffered in the fighting.  Even the politicians were united and nice to each other in spite of some differences in opinions or policies.

My Brother

My brother died a few years ago and at his funeral was an 8×10 photo of him in uniform with an army issue Colt 45 strapped to his waist.  I was amazed at how young and innocent he looked, and I realized that we really had sent kids off to fight a war.  Upon his return, two years after that picture was taken, he had aged beyond his years.  Like most combat veterans, he never wanted to talk of his experiences.  But I once heard him talking to another vet about the cruelty exhibited by some of our soldiers, and in particular one solider in his squad who was ordered to take a prisoner back to the POW camp.  Soon after leaving, they heard a gun shot. The soldier returned with a smile on his face and said “he tried to escape.” This confirmed my opinion that war does terrible things to both the victor and the vanquished.

My brother’s discharge was quietly celebrated.  I was particularly enthralled with the contents of his G-I duffel bag, which proved to be full of all kinds of goodies including a luger pistol which had been confiscated from a German officer.  Then I noticed a blue box with the U S Seal on it, which he quickly took from me saying something like, “That is just some of that junk the Army passes out.” Of course, I would never let that sort of thing rest without my perusal and when I opened it, there was a Bronze Star with the citation that he had made his way through enemy lines at great danger to himself to notify headquarters of his company’s location, which resulted in the rescue of his company that was surrounded by superior forces.  He also brought with him a special gift for me, an attack of scabies, took little note of my protests, and reported that such things were standard issue to dogfaces like himself.

Editor’s Note: Thanks for reading! Stay tuned for Eshrink’s final installment, The Way It Was: Part 10, where he touches on the aftermath of the war, the good and the bad.

The Way It Was| Part 8

Being deeply loved by someone gives you strength.
While loving someone deeply gives you courage.
Lao Tzu

Editor’s Note: Above is a quote Eshrink found while doing research for this series of blog posts: The Way It Was (a glimpse into how he saw life growing up during The Depression and WWII). He said it might be his all time favorite quote so I decided to put it at the top of each post in this series as a reminder of the power of words and the power of love. Eshrink’s writing illustrates the power of both! In case you missed earlier posts in this series, I’ve provided links below.

Welcome to Part 8 of The Way It Was from Eshrink. In Part 7, Eshrink covered Pearl Harbor “A day that will live in infamy” and the beginning of America’s involvement in World War II (the war to end all wars). We left off with the Allies struggling as Hitler dominated Europe. 

The turning point of the war began with the invasion of the German-held countries.  The date of the attack continues to be referred to as D-Day.  In spite of massive casualties on both sides, there was a new-found sense of optimism that we were no longer on the defensive (and that the paper hanger with the Charlie Chaplin mustache would soon get his!). Editor’s Note: This is referring to Hitler. When I searched, I found this book online about underground humor in Nazi Germany…back to Eshrink.

I must be a latter-day Rip Van Winkle for it is impossible that 75 years have passed since that fateful day when we were all transfixed in front of the radio hoping for good news, convinced rightfully so, that the fate of the world was at stake.  There were massive casualties on both sides, but landings were eventually successful.  One of Barb’s favorite uncles later reported to her that he carried a photo of her in his wallet as a good luck charm as he landed on Normandy beach.  It must have worked for he survived.

The War in the Pacific

Meanwhile, the war in the pacific had turned around following the naval victory at Midway, but the heavily fortified islands of the pacific were being stubbornly defended by Japanese troops who were products of a society in which surrender was dishonorable, and death was preferred.  In desperation, their leaders had ordered suicide attacks on our ships, and there was a lot written about these Kamikaze attacks as planes loaded with bombs deliberately crashed onto the decks.  Each island was taken with heavy casualties in an inhospitable climate.   Eventually, MacArthur was able to fulfill his promise, “I shall return,” with carefully staged filming following the retaking of the Philippines. 

kamikaze fighter pilot wwII

kamikaze before slammkng into uss essex 1944We heard much about unfamiliar places like Guam, Iwo Jima, and Okinawa.  The fighting was fierce, often hand to hand.  In Okinawa, for example, 12,500 Americans were killed,  an estimated 100,000 Japanese and at least that many civilians. There must have been more newsmen imbedded in the Pacific as I recall viewing more footage in the Movietone newsreels shown in local theaters (click here to watch the video recording).  There seemed to be more disturbing footage of the Pacific Theater than the European. One that has stuck with me all these years was of a soldier using a flamethrower at the mouth of a cave and the subsequent scene of a Japanese soldier running out totally enveloped in flames.  On the other hand, we cheered wildly at the footage of the now famous flag raising on Mt. Suribachi on Iwo Jima. Editor’s Note: Iwo Jima was the deadliest battle in Marine Corps history with 7,000 soldiers killed during the 36-day battle.us marines 28th regiment of fifth division raise flag atop mt suribachi iwo jima costliest in marine corps history 7k soldiers killed 36 days fighting

us marines go ashore IWO JIMA japanese island feb 1945

Caption: Marines go ashore at Iwo Jima, Japan, in February 1945.

mcarthur wwII oct 1944 phillippines

Caption: General McArthur in the Philippines circa 1944.

A Country Simultaneous United and Divided 

As our troops in Europe advanced to reach the prison camps where an estimated 6,000,000, or perhaps more, Jews were killed, we saw more pictures of the horrific condition of the starving prisoners and of the open mass graves of thousands.  Perhaps this opened our eyes to the dangers of racial prejudice.  At that time, Jews were still not treated well in our town, for example they were excluded from membership in the local country club.  There was also the instance in which a shipload of Jews who had escaped from Germany were refused entrance into the U. S. and were forced to return to Germany.  There seems to be no information as to their fate.  I also recalled all those conversations about the “New York Jews” and was struck by the fact that we were fighting to liberate people whom it seemed we did not like. 

Although the country was perhaps more united than it had ever been politically, we were still divided along racial and country of origin lines.  There were usually a few black kids in the schools that I attended, but my interaction was limited, not by any conscious effort on my part.  I naively thought that they just enjoyed being with their own.  We were not openly segregated as in the deep South, but everyone “knew their place” so to speak.  The fact that there was a separate public swimming pool for “negroes” or that they did not eat in restaurants, that they always sat in the balcony at the movies, or that there was only one night of the week when the skating rink was open to them “was just the way things were,” and I didn’t think much about it. 

Segregation in the Military

As for the military, things were not much different than they had been during the Civil War.  Black troops lived in separate quarters and were organized into different companies which were of course led by white officers, except for those who were assigned duty as stewards or mess hall workers.  There were some exceptions and when given the chance, they proceeded to disprove the notion that they were lazy, stupid, and cowardly. 

Two of the 150 students in my medical school class were black, one of which was Bob Garrison, a very quiet unassuming guy who seemed a bit older than most of us.  A few months ago, I learned that Bob had died after a long career as a family physician.  I managed to secure an obituary and found to my surprise that Bob had been one of the Tuskegee airmen who had distinguished themselves in combat.  It was not until 1948 that Truman would desegregate the services.  Bob had followed the tradition of WWII vets and had not told anyone in our class about his service.  

Some time in the 50s, I happened to be reading an article in an old Reader’s Digest written by the first black guy to be commissioned as an officer in the Navy.  The story was about his rise to this unheard-of position, and the problems he encountered.  There were some enlisted men who could not salute a black person no matter his position.  His problems mounted when he was assigned to sea duty, which meant living in close quarters with a bunch of white guys.  He reported that there was one fellow officer on board who was supportive, and helped him survive the bigotry.  The surprise for me was that the person he named was my second cousin whom I hadn’t seen in years.  It was a nice feeling to know I was related to this person who did the right thing, a sense of pride somehow, even though I hardly knew him.

Women and The War Effort

rosie the riveter dads ww2 blogThere is little doubt in my mind that the war was an additional impetus for opening up opportunities for women.  After all, it had been barely 20 years since women were granted the right to vote.  Although they continued to be treated unfairly in many ways, they were at least given the opportunity to demonstrate their ability to do “man’s work.” It was inevitable that with the incredible expansion of manufacturing for the war effort coupled with the problem of 16 million men serving in the armed forces, there would be a shortage of manpower.  One answer to the problem lay in the attempt to recruit women to leave the kitchen and go to work to support the war effort.  There were posters glorifying “Rosie the Riveter” showing an attractive young woman working on an airplane assembly line.  As I mentioned previously, my mother was a Rosie who seemed happy to return to her kitchen after the war.

In previous wars, the only women directly involved were nurses, but this time a movement was begun to create a women’s branch of the army.  With a great deal of hesitation, the Woman’s Army Corps (WACs) was established soon to be followed by the Navy’s version called Waves.  They were to fill non-combatant roles designed to free up more male soldiers for combat.  The Air Force version of these “helpers” was never inducted into the Air Force and remained civil service employees.  They were to be involved in non-combat missions but nevertheless suffered some casualties.  Although they were never to be involved in combat, some missions, delivering airplanes to a war zone for example, often put them at risk. 

As I reflect on the pre-war days, it seems to me that the greatest change from the war was with women.  Those changes were monumental for them and catastrophic for us guys.  The oft asked question of who wears the pants in the family took on new meaning since women were now routinely wearing pants, which among some groups had previously been considered sinful.  The war finished off those Victorian values that had survived the Roaring 20s. Although detailed discussions remained off limits, a person could now use the word sex the in polite company without being thought “dirty.” Women openly smoked cigarettes, which had always been the province of men, and no longer made any attempt to hide their pregnancies.  The “sugar and spice and everything nice” characterization of females no longer seemed appropriate.  Although the “battle of the sexes” was still in full swing, the stage was being set for the unconditional surrender of our masculinity and admission of defeat.  The evidence is everywhere.  For example, when I went to medical school in the 1950s there were three women in a class of 150 (Class of 1957), while in this year’s class women outnumbered men.  Then, there is that spectacle of all those women in positions of power at the State of the Union address.  Its enough to make a macho guy like me tremble.

There had been certain positions felt appropriate for women such as secretarial work, domestic help, switchboard operators, and cleaning.  School teachers, especially those in the lower grades, were almost all women.  They were usually unmarried, chaste, and expected to remain so.  The nursing profession had a long-held tradition as exclusively female.  Additionally, their long-held position in society as nurturers was felt to make them well-suited for the job.  Some cynics insist that it is more likely due to men’s aversion to emptying bed pans.

American Industry and The War Effort

Meanwhile, this newfound talent participated in what at the time seemed miraculous.  Indeed, some historians have suggested that the war was actually won by the massive mobilization of American industry.  Planes that previously took weeks or even months to build, were now turned out in days.  We heard much about liberty ships designed to carry all the desperately needed instruments of war to Europe.  In just a couple of years, 2,710 such ships were built, and they were sitting ducks for the German U-boats.  I remember hearing much about their dangerous voyages, but it was not until writing these memoirs that I learned more than half of them (1554) were sunk.  It was said that we just decided to build more ships than the Germans could sink.  A new shipyard was built in 150 days and the record time to build a ship was an unbelievable 4 days 15 hours and 25 minutes.  Yankee ingenuity had used Henry Ford’s assembly line procedures and huge sections of the ship were produced in factories all over the country, and sent by railroad flatcar to the shipyard where the sections were put together and the ship was sent on its way.

Editor’s Note: Thanks for reading “The Way It Was: Part 8” I hope you will tune in for the final installment next week.

 

 

 

 

 

 

 

A brief interruption of the “The Way It Was” Series as we return to “Shrink Stuff” | Personality Disorders 101

PERSONALITY DISORDERS

The other night while dining with friends, I was asked for my professional opinion as to the mental health of our President.  My response was not very professional as I responded “I think he is nuts!” There is a caveat, especially important in our business, that one must carefully consider any pre-determined bias before rendering a diagnosis, and my response suggests that I had violated that rule.

In retrospect, I realize that my friend was asking for a less flippant answer to his question.  Anyone who owns a TV (or uses Twitter) would probably agree that Mr. Trump’s behavior is different from what we are accustomed to seeing in our politicians.   His detractors suggest this is evidence of significant mental disorder while his supporters applaud him for being earthy and “unconventional.”

I have previously written (click this link to read that post from 2016) about Mr. Trump in not very flattering terms concerning his mental status, and the non-position taken by the American Psychiatric Association of which I am a lifetime member.  Those mental health professionals who insist that Trump is mentally impaired and therefore unfit to hold office in most cases make a case for the diagnosis of Narcissistic Personality Disorder.  After the conversation with my friend, it occurred to me that most people might be unfamiliar with what signs and symptoms might lead to such an impression

In the first place, it may be helpful to explain what we in the shrink business mean by the term personality disorder as people sometimes overuse a term and its true meaning from a psychiatric standpoint gets watered down (for example: a person who might say upon having a bad day or disappointing day, “I’m so depressed” when in reality they aren’t clinically depressed, just a little down).

Personality Disorders | Definition by Psychiatrists

The general criteria listed in the American Psychiatric Association’s Diagnostic and statistical Manual of Mental Disorders or DSM which is now in its fifth edition. The definition of personality disorder as summarized in DSM IV is “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture” (not caused by such things as drug abuse, or other medical problems).  Unfortunately, for me the criteria as listed in DSM V are more complex, and since I am a simple-minded person I will stick with DSM IV in my discussion (but perhaps more to the point I am reluctant to invest a hundred bucks in another 900 page dust collector for my bookshelf).  In either case, it is clear that those who suffer from a personality disorder are very different.

Signs & Symptoms of Personality Disorders

Signs of personality disorders characteristically have been present for long periods usually from childhood.  These patients are difficult to treat.  Although some psychotropic medications may be helpful, the gold standard remains long-term intensive psychotherapy, a commodity which is in short supply these days.  The symptoms usually serve a protective function. Consequently, patients in treatment have difficulty giving them up.  An even bigger problem is that in many cases people who need treatment most are those lacking in insight. Consequently, they are convinced there is nothing wrong with them.  This is especially true in cases of narcissistic and sociopathic personality disorders.  They believe they are perfect in every way so why in the world would they need a psychiatrist?

Narcissism | Signs | Symptoms | Cause

The term narcissism is from the Greek myth about Narcissus who fell in love with his image while gazing into a pool of water.  This did not work out too well for him for he eventually committed suicide when he realized his true love was himself.  A bit of narcissism is not a bad thing…as a matter of fact most therapists would probably report that low self-esteem is one of the most common problems they see and that they spend a great deal effort trying to help their patients learn to like themselves.  But as with most things in life, it is the extremes which cause us problems.  We all know people who are arrogant and self-centered, but those with a narcissistic personality disorder take that to the level where their self-image is so far removed from reality that it approaches the delusional.

He/she of the narcissistic personality disorder is the master of the superlative.  He is never simply good at something, he is the best.  Others are not bad, they are the worst.  Everything in life is measured against the perfection that only he possesses.  The need to maintain this distorted image of himself dominates his life and leaves no time to consider the needs of others.  He is convinced he is special, and deserves special treatment.  He courts admiration or subservience in relationships, and is pathologically intolerant of criticism.  This preoccupation with self, frequently distorts perceptions and may affect judgement.

As with many mental health problems, the causation is up for grabs.  There may be some abnormality of brain function, environmental factors, or both.  Some postulate that excessive adoration by parents is the cause, while others feel the opposite, namely that excessive criticism is the culprit.  Whatever the cause, most agree that such extremes of narcissism serve the purpose of protecting a very fragile ego.  His need for attention is never satisfied.  Indeed, the tenacity with which the narcissist holds onto and nurtures these false opinions of himself leads one to suspect an underlying desperation at the core of his being.  The most readable synopsis of narcissistic personality symptoms I have found lie in a pamphlet distributed by the Mayo Clinic as follows:

  • They have a sense of entitlement and require constant excessive admiration
  • Have an exaggerated sense of self importance
  • Expect to be recognized as superior even without achievements that warrant it
  • Exaggerate achievements and talents
  • Preoccupied with fantasies of success, power, brilliance, beauty or the perfect mate
  • Believe they are superior and can only associate with equally special people
  • Monopolize conversations and belittle or look down on people they perceive as inferior
  • Expect special favors and unquestioning compliance with their expectations
  • Take advantage of others to get what they want
  • Have an inability or unwillingness to recognize the needs and feelings of others
  • Be envious of others and believe others envy them
  • Behave in an arrogant or haughty manner, coming across as conceited, boastful and pretentious
  • Insist on having the best of everything (for instance the best building, golf course, yacht, wife, etc.–the examples are my words NOT Mayo Clinic’s example–they used car and office)

Narcissism & Trump

So, there you have it – all you need to make a diagnosis.  You Trump watchers have certainly observed enough behaviors to decide if the shoe fits.  If you conclude that the diagnosis of Personality Disorder fits, you should be concerned as to the fitness of POTUS to handle the job.  Those so diagnosed are prone to react in irrational ways when their distorted view of themselves is threatened and consequently are very sensitive to any kind of criticism, often reacting with over-the-top rages.   Mistakes are never acknowledged for to do so would shatter the myth of their perfection.  They react poorly to stress and to change, and there is no doubt that POTUS must be under mountains of stress considering all the investigations currently underway with many of his former supporters on their way to jail.

While in the midst of writing this, I was directed by one of the friends I mentioned in my opening statement to a YouTube presentation by John Gartner, a Ph.D. psychologist at Johns Hopkins. Dr. Gartner is convinced that Trump is demented.  Gartner is adamant in his diagnosis and convinced that he should be removed from office.  In spite of Gartner’s intensely verbalized political views, he does make a good case for an Alzheimer’s type dementia.  However, I believe the evidence he presents is not unusual for one afflicted with a narcissistic personality disorder who is under threat of losing that shield, which protects him from facing the reality of his deficiencies.

Narcissism Exposed (“s#@t hits the fan” time)

As I have mentioned in previous blogs, my major concern is that the current investigations will turn up things which he will not be able to deflect with his usual strategies of denounce, deflect, or deny.  Recently, he has seemed less rational with a 2- hour long rant at the Conservative Political Action Conference, and the strange attempts to demonize John McCain months after his death.  In the so-called Twitter storm from last week, he seems enraged at everyone within range.  It appears that his only respite is the campaign rallies at which he is able to bask in the attention accorded him, confirming to him that he really is “The Greatest.”

Some say our President is “crazy like a fox”.  It is true that he has turned self-promotion into a very successful career, even becoming the world’s most powerful man.  Those same talents have served the additional function of satisfying insatiable ego needs.  I believe that Trump’s narcissism governs every aspect of his life, and explains the “crazy” things he does and says.  I believe that he is psychologically vulnerable and likely to demonstrate irrational and impulsive behaviors if his defenses are destroyed.  With that in mind, I hope all these investigations do not burst the President’s fragile ego for that could be disastrous.

Editor’s Note: I was slow on the editing of Eshrink’s post and so much has happened since he originally wrote this article. The Attorney General released a 4-page summary of the Mueller Report on a Sunday while many of us were watching our brackets bust during the NCAA basketball tournament.  I kept asking why the full report wasn’t being released to the public (the taxpayers paid for it, as POTUS continues to remind us in the context of money wasted) or at least released to Congress (it seems Nancy Pelosi wonders that, too.) However, Eshrink’s post about Narcissistic Personality made me think maybe the inner circle knows more than we think about the stability of POTUS and his psychological vulnerability that could lead to an even worse outcome. History will tell the tale… I’m sure those working inside the Oval Office will have plenty of great material for books once this crazy time in our republic’s history is behind us–if the Republic survives that is. God Bless America. We need all the help we can get!