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.

 

 

 

 

 

 

 

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!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CAN’T WE ALL JUST GET ALONG?

rodney king

It has been 27 years since Rodney King, an alcoholic drug-addicted Los Angeles cab driver, tearfully uttered those words. Rodney was a troubled soul whose beating by police officers was filmed by a bystander and precipitated the L.A. race riots which resulted in the death of 63 people, hundreds of injuries and massive property damage. The answer to Rodney’s question remains moot, for we are still not getting along very well. Perhaps we need to spend more energy on learning why this is still true.
REAL CHANGE OR WINDOW DRESSING?
It is true there has been progress in race relations, the issue of police brutality is being seriously addressed, and the “metoo” movement has garnered some traction, but we continue to expend a great deal of energy in fruitless debate which never seems to find resolution. This is especially true in our current political scene where vituperative language has become the norm, and both democrats and republicans cling so rigidly to their positions that compromise is impossible. Disagreements have become personal. Name calling and character assassinations are routine.
A PERFECT STORM
Not since the civil war has there been so much divisiveness or tribalism as is the currently fashionable term. It appears to me that there are multiple reasons why we can’t “all just get along,” one of which is the nature of our political campaigns. Somewhere along the way experts in such matters determined that so-called negative campaigns are the most effective strategy, and that has become the modus operandi for all kinds of kinds of candidates from dog-catcher to president. With the candidates continually trading insults and accusations, there is little relevance paid to issues and the undecided voter is left to decide which of the candidates is worse. Since his vote is based largely on his disdain for the character of his hero’s opponent rather than issues he is likely to retain very negative feelings towards the one whom he voted against. Such feelings may be carried forward and make it more likely that when a discussion ensues between two on opposite sides of an election civility is less likely.
NEWS. ARE YOU KIDDING?
So-called cable TV news stations have also in my opinion contributed to this giant schism in our political discourse. I use the term so called for they can hardly be called news outlets, but are dominated by political commentary to be generous or perhaps more accurately political propaganda outlets. Fox News leads the pack with the most viewership and the most conservative commentary. Their current star Sean Hannity is said to be one of Trump’s most trusted political advisors yet they have the temerity to call themselves “Fair and Balanced.” At the other end of the political spectrum is MSNBC who no longer attempt to hide their pro democratic bias. Then comes CNN which makes a pretense of being neutral, but fails miserably. They do have some conservative consultants on their staff which they bring in on occasion for their group discussions.
WHERE IS THE MIDDLE?
One thing these networks have in common is their programming which consists mostly in bringing in groups of experts (there must be a lot of experts in Washington for they never seem to run out) and have a group discussion with participants representing more extreme positions on both sides of an issue. Consequently; a viewer is likely to choose a more radical position. The days of political reporting in which both sides of an issue are elaborated upon by a single person with no skin in the game seems to be long gone. Only PBS seems to follow that old-fashioned format of simply presenting the facts and allowing the viewer to draw his own conclusions.
GROUP THINK
During my career as a Psychiatrist my patients taught me much about our desire or perhaps more accurately said our need for validation. As such we are inevitably drawn to those who share our beliefs and perceptions, and therein lies the effect of today’s dueling media outlets. Those of us who harbor conservative beliefs will be drawn to Fox while the more liberally oriented will stick with MSNBC or CNN, “and never the twain shall meet”. The same phenomenon is operant with “talk radio” and with the internet which is becoming a news source for increasing numbers of people. As we continue to be immersed in one particular viewpoint and converse only with people of like mind we find ourselves rigidly attached to one particular political philosophy having convinced ourselves that we are the only custodians of truth.
LOGIC BE DAMNED
An argument can be defined as a person or group attempting to convince others that they are wrong. It is also true that political issues can have serious consequences therefore; political arguments can and often do become emotional. I recall as a child hearing the admonition that one should avoid discussions of politics or religion in polite company, and indeed these are the two subjects about which people are likely to have the most intense feelings. Since I am a peace-loving man and something of a wimp to boot I must admit that I tend to shy away from raising the issue of politics with friends whom I know to be on the opposite side of the fence. I submit that this same phenomenon exists throughout society and deters us from discussions of the issue that divide us and hopefully learn to compromise or at least respect the opinions of those with whom we disagree.
Advertisers have long proven that repetition in TV ads will sell everything from Viagra to Tylenol, so why not politicians. The Washington Post reports that $6.5 billion dollars were spent on the 2016 election much of which undoubtedly went to television ads leaving us drowning in a sea of powerful messages describing how terrible are all those candidates for office. Little wonder that elected officials now share the worst favorability ratings ever, and that disgusted citizens are so sickened they don’t even bother to vote.
BAD GUYS EVERWHERE
Among the most powerful motivators are anger and fear, and those masters of propaganda who manage elections are adapt at using them as weapons. Naturally when one votes for a person because he is persuaded that the other candidate is a threat other issues will become irrelevant adding more fuel to that fire which inhibits reasonable discussion.
Our prevaricator in chief has proven himself to be a master at eliciting those feelings and continues to describe the press as “the enemy of the people” and members of the Democratic party as “evil”. There are also the warnings about immigrants characterizing them as criminals, rapists, murderers, drug dealers and subversives. His talent for instilling such feelings is well demonstrated by the behavior of some of the attendees at his rallies. History shows us that a very effective way to unite a group of people is to find a common enemy, and his followers revel in chanting “lock her up”.
THERE REALLY IS “FAKE NEWS”
Last but certainly not least is the effect of the internet and social media which held such promise in bringing people together has now become a powerful weapon to interfere in our elections primarily by propagating conspiracy theories and lies of all kinds so numerous that it is virtually impossible to rein them in. Artificial intelligence has further sharpened these tools so that individuals can be targeted with false information tailored to their own particular biases or prejudices, and can reach millions of people in short order with very little expense. Nearly everyone except Mr.Trump agree that the Russians were very involved in such shenanigans in our last election and although we are told the effects on the election cannot be determined there is little doubt that it has contributed to much confusion and misinformation designed to enhance our divisiveness.
WISHFUL THINKING
The other day when I began writing this I thought there were signs of at least some yearnings for a coming together to work out problems. Niki Haley in her retirement announcement appeared to break from her boss and indicate that she did not think political opponents to be enemies. There was commentary on our need to come together, but those hopes were soon dashed with the pipe bombs, and now the senseless shooting of 2 black people in Kentucky followed by the mass murder of Jews in Pittsburg.
SOME BEHAVIOR IS PREDICTABLE
With such horrors filling the headlines you might think they would provoke serious talk about bridging the now toxic divide that separates, but after expressing regrets and sympathies yesterday our fearless leader is back on track today blaming the news media for causing the tragedies. Apparently, the false flag theory which named the Democrats as the perpetrators didn’t fly so he was forced to go to his fall back strategy. Nevertheless, we once again hear talk of our need to come together in spite of our differences. Will we follow through this time?  Hope springs eternal!

Rebuttal to Op/Ed

When we officially abandon civil discourse | Christine Flowers

Hoping that a child will be raped is the vilest thought that can be formed in the civilized brain.  There is no “larger picture,” no justification, no explanatory context. You cannot say, “Well, yes, that’s bad, but what I really meant to say was that the kids of any conservative who supports that bastard Brett Kavanaugh deserve to be treated the same way (she says she) was.”
Hoping that a child will be raped is inhuman, but it is no longer out of bounds in social discourse.  Recently, I came across a public posting on Facebook, which means the author wanted the world to have access to her thoughts.  It was a jeremiad against Donald Trump, which is unexceptional these days, since he seems to turn certain people into human volcanoes that spew rivers of hateful prose.  I avoid them when I see them scroll through my Facebook news feed.

 

But this one caught my attention because I love children, spend a lot of time with them, and used to teach them. I also represent them in immigration court, like the little girl whose hand I held as she told the judge the other day that she was from Honduras, and that she was 5, and that pink was her favorite color.

So when I saw these words, I froze:

 

“Time to burn everything to the [expletive] ground, when  it comes to this vile, non-human garbage who by stealing and cheating ended up in the White House.  Are we going to take as any kind of truth an ‘investigation’ that isn’t one? Are we going to take his a–hole supporters who say ‘lock her up’ to Dr. Ford? I’m a good and nice person, a peace-loving person but let every one of them and their sons and daughters get raped, accosted by one of those ‘boys will be boys.’ ”

 

It went on.  I reported the post to Facebook, and as of this writing, it’s still there.  That’s Mark Zuckerberg’s problem now, because I’ve blocked the poster.  But it was important for me to not simply shake my head as I used to do and move on, narrowing my group of friends to those with whom I could share photos of my sweet black Labs and funny anecdotes from my family along with political essays and ruminations.  I’ve resigned myself, ruefully, to the realization that this political and social climate is choosing for me, without my permission, the comfortable echo chamber, where even though I hear kindred thoughts, I miss some of the kindred spirits who didn’t share them.

In other words, I am becoming increasingly isolated from liberal ideas because it is much harder these days to have a civil conversation. And yet I have very good, very decent, liberal friends, like Robin and Donna, Jennie and David, John and Victor, who would never in a million years write about the rape of children in the same breath as they wish death on a president they can’t stand.  They make me realize that this is not a partisan disease, even though many of my conservative friends urge me to see “the other side” as the enemy.

 

I have to admit that these past two weeks, the “other side” has been Dixie to my Union, the Axis powers to my Allies, guillotine-wielding Jacobins to my aristocracy.  The Democrats, for whom I have vowed to never again cast a vote, have morphed into a caricature of their former selves in their duplicitous crusade to destroy a man and his reputation. I see nothing there that reminds me of the party I belonged to for 37 years. But that is political, and I understand that there are just as many Democrats and liberals who read my words defending Brett Kavanaugh last week and felt the same revulsion for me that I feel for the despicable assault on the judge.

I would sincerely hope that even they, disgusted with our president and with the people he has chosen to represent him in the cabinet and now on the court, would recoil from the suggestion that my hypothetical children and the children of Kavanaugh supporters should be raped.

 

You might say that this is anger speaking, and of course it is. But the appropriate place for that anger to burn is in the deep and quiet recesses of the mind, hidden from view. That we have now reached the point that assaulted children are considered appropriate conversational tender sterilizes the soul and induces a nausea that can’t be eliminated by blocking the person who dares to write the words.

And not even the confirmation of a Supreme Court justice will make it better.

http://www2.philly.com/philly/columnists/christine_flowers/facebook-social-media-civility-conversation-20181004.html

RESPONSE from ESHRINK

Dear Ms. Flowers:

Perhaps you are right that we should limit discourse on the subject of sexual assault on children, after all hiding  such incidents has worked quite well for the Catholic church [editors note: the movie Spotlight is a peek into the importance of a free press and the commitment real reporters have to exposing the truth].  However; you should be congratulated on your effective use of the time honored strategy of blaming the victim, or even better to further politicize it by holding democrats responsible.  Little wonder that you “feel revulsion for the….despicable assault on the judge.”  After all he has lived a life of privilege and as he frequently reminded us was an honor student at Yale, which should immunize him from any such accusations.

As a recently retired psychiatrist I have many memories of times spent with patients who have been unable to dismiss the pain from having been violated, often as children.  That pain often results in a lifetime of impairment.  Dr. Ford’s story was very familiar to me as was Kavanaugh’s response, which was to release an explosion of suppressed rage.  His behavior has been excused by his supporters who suggest he has a right to be angry however;  were he seen by me as a patient I would consider him a good candidate for anger management training.  In the interest of full disclosure, I am one of those “liberal democrats” who would very much enjoy having that “civil conversation” which you say is lacking in your life.

HARASSMENT IN THE WORKPLACE

Not since the 1920s has there been more activism on the part of women in protest against male domination. Their current complaint is much different than that of the suffragettes, for it involves sex. This was a taboo topic for women of the ’20s, who were products of the Victorian era. The unintended consequence of such societal restrictions gave men free rein to sexually harass, abuse, humiliate, and denigrate women who would be too embarrassed to publicly complain. She could also be subjected to the time-honored policy of blaming the victim.

There has been much news recently about a big-time movie mogul who is currently under the gun from a platoon of gals alleging not only harassment but assault. This brought up memories from my childhood when there was a lot of talk about how movie starlets “screwed their way to the top.” It was said by those supposedly knowledgeable about the industry that the road to stardom was via a producer’s couch (the “casting couch”), and of course, people said that it was the directors who were taken advantage of, for they were seduced. I don’t recall ever hearing an actress, or anyone else for that matter, complain about sexual abuse. What suffering they may have endured was done silently.

Ah, but how times have changed. Women have come out of the closet en masse, determined to seek retribution in spite of their fears and embarrassment; they instantly changed from shamed to heroic. It doesn’t hurt that one third of all judges in the country are now women and that women can no longer be depended upon to vote the same as do their husbands. Consequently, they have become a political force to be reckoned with.

Among the torrent of disclosures are stories of workplace abuse going back decades. Although I have always found physical abuse abhorrent, I must confess that in years past I was oblivious to the discomfort that even off-color remarks could actually inflict on a woman. Were she to complain, I would undoubtedly accuse her of lacking a sense of humor. When such situations evolved in social situations, Barb was usually there to set me straight. However, when such behaviors occur in the workplace it becomes much more complicated. Indeed, in any situation in which there is a hierarchical power structure, sexual harassment, or even unwanted physical contact, will be initiated by the more powerful person almost without exception.

Of course, this leaves the victim in an untenable position, often forced to choose between tolerating the abuse or putting his or her job in jeopardy. Defensiveness is likely to curry disfavor with her superior which could result in disaster. Not only could chances for promotion become limited, victims could even lose their jobs. They then could be labeled as troublemakers and carry that label with them as they search for a new job. Larger companies are likely to have a Human Resource department where one can lodge a complaint, but they may be more interested in protecting the company than the employee.

The increased number of harassment and abuse charges in the workplace is certain to provide another cash cow for the lawyers who could find such cases as lucrative as auto accidents. For many years, businesses have been concerned about the problem of sexual harassment in the workplace. Many have spent large sums on programs designed to educate employees regarding rules for interactions with fellow employees of the opposite sex. As a matter of fact, I was told by a person who had previously worked in a supervisory position for a fortune 500 company that he had been required to repeat such a course annually.

He also said that those accused of sexual improprieties were subject to immediate dismissal. In spite of these efforts, there continued to be complaints of harassment. Those complaints may have been exaggerated at times, for the company, apparently more concerned with reputation than money, initiated a policy of negotiating payments to these complainants in return for a pledge of secrecy without regard to the legitimacy of their complaints.

But, the most flagrant example of the payment of hush money was by the recently exposed Congressional Accountability Office. It was revealed in the November 15th, 2017 issue of USA Today that this office, under direct control of our elected representatives, had paid out over 17 million dollars of taxpayer money with the proviso that such payments remain secret. This had all occurred since the agency was established in 1995, and it got some attention since it involved dollars from the voter’s pocketbook. The inherent assumption that these alleged perpetrators were falsely accused was exemplified by the the caveat that the victims, not the accused, must agree to engage in counseling, another example of blaming the victim without any attempts to confirm or negate the claims.

This reminded me of problems that similar policies caused during the height of the epidemic of medical malpractice suits several years ago. Nearly all physicians carried malpractice insurance, but many found that when they were sued, their insurance company found it cheaper to settle than to fund a court case. Doctors who felt the charges against them were unfounded wanted their “day in court,” but found the terms of their policy did not give them that option unless they wanted to pay the expenses of a trial.

It was a tidy arrangement: the plaintiff could pick up a few thousand bucks, the lawyer would get 20 or 30% of the take for not much more effort than it takes to write a letter, the insurance company avoids the risk of getting one of those multimillion dollar judgments from an unusually sympathetic jury, and everyone is happy except for the doctor who will find himself registered in the National Practitioner Data Bank with a forever sullied reputation. He will be looked on with suspicion when applying for hospital privileges or virtually any professional activity, and if he is unfortunate enough to be sued for the second time, he will probably be forced to hang it up, as he will undoubtedly become uninsurable. I knew a physician whom I thought to be very competent who was forced to end his career prematurely this way. A few of the uninsured risked losing everything by “going bare” i.e. practicing without insurance.

None of this should be construed as to minimize the importance of this issue or to excuse the centuries in which women have been left powerless to defend themselves. It does appear to me that women are on the threshold of finding tools with which they can exert more control over their own lives, and defend themselves from those behaviors they find abhorrent. That is not only as it should be, but as it must be as women gain credibility and status. They may even prove themselves superior in areas previously exclusively occupied by men and, consequently, come to occupy positions of leadership in spite of long held exclusionary policies.

With leadership comes power. Let us hope women will use that power in a more judicious manner than have men, and the traditional “battle of the sexes” will no longer be played out in the workplace. This appears to me to be unlikely, as I believe the reasons for the continuation of the love-hate relationships between the sexes are deeply ingrained in our species, perhaps even in our DNA. This is an issue which I discussed in a previous blog. The women’s movement has a stated goal of equality. After they achieve that goal, perhaps there would even be more problems should they move onto a quest for domination.

Workplace problems do not have a simple solution. There are people of both sexes who have longstanding anger towards members of their opposite gender. How can accusations be adjudicated? Does the policy of paying hush money give the rich license to violate as they please? On the other hand, does it allow those falsely accused to be legally blackmailed? How about flirting—when does it cross the line? When is a friendly attitude mistaken for an invitation to be intimate? It is reported that many office romances end in marriage—would they happen if all were able to ignore another’s appeal? What about relationships between co-workers outside the workplace? What about the use of “feminine wiles” to advance one’s position at the expense of another competing for favorable treatment?
If my assessment of the male’s need to dominate is correct, those who attempt to solve these problems are in for an uphill struggle, for despite society’s best efforts, there remains in mankind only a thin veneer of civilized behavior. Nevertheless, our culture is changing in ways which often conspire to make traditional male-female relationships dysfunctional. I read somewhere that some smart guy said change only occurs with revolution, and revolution is accompanied by chaos. We now appear to be in the midst of the next phase of a revolution that began over 100 years ago. Change is needed. Let us hope that the chaos will be limited and that the change pendulum will not swing too far.

THE GOOGLE SCREED

As I was contemplating the recent brouhaha at Google over diversity in their workforce, I clicked on CNN just in time to hear that the engineer, James Damore, who dared utter his words of dissent over the company’s diversity policy, had been discovered and promptly fired.

Maggie had forwarded a copy of the so called anti-diversity screed to me, and I was contemplating adding my own biased opinion to the mix before receiving this latest news, which has added an entirely new dimension to the story.

VIVE LA DIFFÉRENCE

The author’s basic premise was that women are different from men biologically and those differences make them less fit to do the kinds of work required at Google. In a previous blog post, I presented evidence that there were indeed many differences between men and women; however, I presented evidence that those differences were more of an asset than liability in today’s corporate structure. One study indicated that women in general were more effective in positions of leadership than men. In a vigorous exercise of convoluted logic, our hero used the same study I had referenced as alleged proof of female lack of leadership skills. His conclusion was the exact opposite of the conclusion the authors of the study proposed.

Additionally, common stereotypical myths were validated as fact e.g. that women are by nature emotionally less stable than men. He goes on to posit that women’s superior ability to relate and empathize with others is a handicap and that such concerns might interfere with their function since “being emotionally unengaged helps us reason better about the facts.” However, I suggest the opposite is true and that observations from La La Land are more likely to be distorted than when one is acting as a fully functioning human being. This is only a partial critique of this 10-page rant, but to go further would definitely violate the Maggie rule that brevity is more likely to result in readership.

SEXISM? OF COURSE NOT.

The impetus for the rendering of this document was the initiation of a program to ensure diversity within Google after the Department of Labor found evidence of a gender gap in pay. Mr. Damore disposed of this problem by using the time honored strategy of blaming the victim. His explanation for the disparity is that women do not pursue higher salaries as aggressively as do men, then goes on to say, “We need to stop assuming that gender gaps imply sexism.” One might respond that such gaps certainly don’t eliminate that possibility.

TRUTH TO POWER?

In spite of my very negative assessment of Mr. Damore’s manifesto, which by the way seems to be shared by many, the reaction of Google raises the issue of an even more fundamental threat: freedom of speech.

Freedom of speech is a fundamental guardian for any democracy, and this is the one issue in which Damore’s statements ring true. Indeed, his statement that many fellow employees agree with his position on these issues, but would never have the courage to say or defend their position because “of our shaming culture and the possibility of being fired.” This was confirmed by the CEO’s statement that accompanied the news that Google was firing Damore for “advancing gender stereotypes in our workplace.” It seems to me this statement indicates that employees must not only follow the company’s directives, but only have thoughts and opinions approved by Google.

HERE’S TO YOU MR. ORWELL

Are we to assume that there exists within the confines of this giant corporation a “thought police” department? Should anyone who questions company policy be fired? “WIRED”  reports that the screed “thrust company executives in a tight spot” in that those espousing free speech would be at odds with those who would want to see Damore punished. There would be no “tight spot” were Google to endorse a policy welcoming critiques of their policies. If such were the case, he would be judged on his willingness to adhere to company policies rather than what he thought of them. One feminist, Elizabeth Ames, insisted he be fired for espousing a “very divisive issue.” How different is that from the situation in which a woman is fired for complaining about her treatment in the workplace? Interestingly, it was a woman, Evelyn Beatrice Hall, who actually coined the phrase “I disapprove of what you say, but I will defend to the death your right to say it.”

CAN’T WE JUST ALL GET ALONG?

Recently, there have been a spate of situations in which there have been attempts to silence objectionable viewpoints. The screed author correctly points out that there is little hope of resolving conflicts without free and open discussions of the differences. The lack of such give and take in our society seems pervasive. The country both in government and the electorate is divided and personal insults have replaced honest debate in many cases. In my opinion, it is also true that politically correctness is now overdone. In such an environment, is it any wonder that mutual respect is missing and divisiveness enhanced?

WE DON’T WANT TO HEAR IT

Of particular concern to me are recent reports of students in our major universities effectively holding demonstrations to prevent those with unpopular views from speaking on their campuses. These so-called institutions of higher learning have encouraged such learning to be about the good, the bad, and the ugly, and have always been open to all points of view. They have taken great pains to preserve the freedom of their professors from efforts to limit their speech by providing tenure (a policy that is now being eroded). In addition to being recognized as bastions of free and open speech, they have been incubators of fresh ideas in all areas of life. The censorship of information, ideas, or opinions is anathema to their mission and is not only dangerous but disgraceful.

WHOSE OX IS BEING GORED?

In spite of the fact that Mr. Damore was full of crap in much of what he wrote, he did make an important point which is well worth considering: without the freedom to express one’s views, there is no chance of finding resolution to differing opinions. He did demonstrate the courage of his convictions and paid a price for that. Many others have also paid a price due to discrimination by Google. This begs the question as to who is the culprit here?
It seems to me that Google missed an opportunity to contribute to a closing of the gap between these so-called liberal and conservative viewpoints. Engagement in dialog rather than an attempt to silence dissent could have at least promoted some mutual respect. It also seems to me such an approach would be self-serving, as one would expect employees to function at a higher level in an environment where freedom of expression is encouraged rather than punished.