Medical marjuana doesn't work for anxiety or depression, duh

Dizzy Wright, possibly medicating his anxiety and depression.

"A comprehensive review of dozens of clinical trials that have tested medical marijuana for 10 conditions finds that there’s very little reliable evidence to support the drug’s use. The review, by an international team of researchers, was published Tuesday in the Journal of the American Medical Assn.  

Patients who use medical marijuana to treat chronic neuropathic pain or cancer pain would probably have the least to fear from an FDA review. The JAMA study considered 28 studies involving 2,454 patients and concluded that there was “moderate-quality evidence” from at least a dozen studies showing that cannabinoids – chemicals in marijuana that produce pharmacologic effects inside the body – reduced pain in such patients by modest amounts.  

However, trials testing the pain-relieving effects of medical marijuana in people with fibromyalgia, HIV-associated sensory neuropathy, rheumatoid arthritis, multiple sclerosis and other conditions did not show that it worked. 

The other condition for which medical marijuana proved useful was muscle spasticity in people with multiple sclerosis. After assessing 14 studies with 2,280 patients, the JAMA authors determined there was “moderate-quality evidence” to support its use in these patients, although many of the studies reported improvements that weren’t quite big enough to qualify as statistically significant. 

The findings were even weaker for other conditions.  

The researchers found “low-quality evidence” that medical marijuana could relieve nausea and vomiting in patients undergoing chemotherapy, that it could stimulate appetite in people with HIV to help them gain weight, that it could help people with insomnia and other sleep disorders get more rest, and that it could reduce the severity of tics in people with Tourette syndrome. 

The JAMA authors also examined studies of medical marijuana to treat depression, anxiety disorder and psychosis, and to reduce eye pressure in glaucoma patients. There was no reliable evidence that cannabis was useful in any of these cases.
One of the things the studies showed most clearly is that people who use medical marijuana had a “much greater risk” of side effects, including serious problems like kidney, liver and psychiatric disorders. The most common adverse effects included dizziness, confusion and disorientation, according to the JAMA report.  

The results show that something is amiss in the 23 states (plus the District of Columbia) that allow the use of medical marijuana, according to the authors of an editorial that accompanies the JAMA review.  

The authors, from the Yale University School of Medicine, lamented the fact that state approval of medical marijuana had been based on “low-quality scientific evidence, anecdotal reports, individual testimonials, legislative initiatives, and public opinion." 

“Imagine if other drugs were approved through a similar approach,” they wrote. 

To win FDA approval, drug makers typically have to show that a medicine works in not one but two randomized clinical trials. But for most conditions that qualify for medical marijuana treatment, “the evidence fails to meet FDA standards,” according to the editorial.

 

 

 

 

 

 

 

 

To say that the Confederacy was not pro-slavery is either delusional or dishonest

I'm sure Benedict Arnold didn't think of himself as a traitor either. Nor Marcus Brutus or Cassius.

NYT

"The case against Lee begins with the fact that he betrayed his oath to serve the United States. He didn’t need to do it. The late historian Elizabeth Brown Pryor demonstrated that 40 percent of Virginia officers decided to remain with the Union forces, including members of Lee’s family.

As the historian Allen Guelzo emailed me, “He withdrew from the Army and took up arms in a rebellion against the United States.” He could have at least sat out the war. But, Guelzo continues, “he raised his hand against the flag and government he had sworn to defend. This more than fulfills the constitutional definition of treason.” 

More germane, while Lee may have opposed slavery in theory he did nothing to eliminate or reduce it in practice. On the contrary, if he’d been successful in the central task of his life, he would have preserved and prolonged it. 

Like Lincoln he did not believe African-Americans were yet capable of equality. Unlike Lincoln he accepted the bondage of other human beings with bland complaisance. His wife inherited 196 slaves from her father. Her father’s will (somewhat impractically) said they were to be freed, but Lee didn’t free them. 

Lee didn’t enjoy owning slaves, but he was considered a hard taskmaster and he did sell some, breaking up families. Moreover, he supported the institution of slavery as a pillar of Confederate life. He defended the right of Southerners to take their slaves to the Western territories. He fundamentally believed the existence of slavery was, at least for a time, God’s will."

See also: Robert E. Lee's Oedipal Complex

As Kingfishers Catch Fire -- Gerald Manley Hopkins (1844-1889)

 

As kingfishers catch fire, dragonflies draw flame;

As tumbled over rim in roundy wells

Stones ring; like each tucked string tells, each hung bell's

Bow swung finds tongue to fling out broad its name;

Each mortal thing does one thing and the same:

Deals out that being indoors each one dwells;

Selves — goes itself; myself it speaks and spells,

Crying Whát I dó is me: for that I came.

I say móre: the just man justices;

Keeps grace: thát keeps all his goings graces;

Acts in God's eye what in God's eye he is —

Chríst — for Christ plays in ten thousand places,

Lovely in limbs, and lovely in eyes not his

To the Father through the features of men's faces.

 

 

 

 

Fly Me to the Moon -- Julie London (1964)

Fly me to the moon
And let me play among the stars
Let me see what spring is like
On Jupiter and Mars

 In other words
Hold my hand
In other words
Darling, kiss me

 

Fill my heart with song
And let me sing forever more
You are all I long for
All I worship and adore

 

In other words
Please be true
In other words
I love you

 

Fill my heart with song
And let me sing forever more
You are all I long for
All I worship and adore

 In other words
Please be true
In other words
I love you

 

Songwriters
BART HOWARD

 

 

Should the Jefferson Memorial come down?

I think that the difference is that, while Jefferson owned slaves, he was not a traitor (or, if you prefer, rebel). I am a bit concerned for VMI's statue of Stonewall Jackson, however. It is a state college. If they take down the Jefferson Davis and Robert E. Lee statues at University of Texas, Austin, then why wouldn't the same arguments apply to re-locating the Jackson statue?

Article 3, Section 3 of the Constitution of the United States:

Treason against the United States, shall consist only in levying War against them, or in adhering to their Enemies, giving them Aid and Comfort. No Person shall be convicted of Treason unless on the Testimony of two Witnesses to the same overt Act, or on Confession in open Court. The Congress shall have Power to declare the Punishment of Treason, but no Attainder of Treason shall work Corruption of Blood, or Forfeiture except during the Life of the Person attainted.

LA Times

"This week, the Jefferson Memorial was drawn into the national debate about race following the shooting deaths of nine people in a predominantly black church in South Carolina last week. It joins other public statues depicting Southern or Confederate figures, including Jefferson Davis and Robert E. Lee, that some are arguing represent the country's racist past and should be removed.

CNN anchor Ashleigh Banfield [She's still around?] this week questioned whether the Jefferson Memorial should be taken down because Jefferson owned slaves. "There is a monument to him in the capital city of the United States. No one ever asks for that to come down," Banfield said."

Dallas Morning News

"UT Austin President Gregory L. Fenves announced Tuesday that he will convene a committee of students, faculty and alumni to “discuss the future of the Jefferson Davis statue” and present him with recommendations.

Gregory Vincent, vice president for the Division of Diversity and Community Engagement, will lead the committee and expects to make recommendations this summer concerning the Davis statue and potentially three other Confederate-affiliated statues on campus."

Terror Management Theory: The Worm at the Core

 

 

 

Chronicle of Higher Education

"In a new book surveying that work, The Worm at the Core: On the Role of Death in Life (Random House), Solomon, Greenberg, and Pyszczyn­ski argue that fear of death drives our actions to a much greater extent than people realize. "The terror of death has guided the development of art, religion, language, economics, and science," they write. "It raised the pyramids in Egypt and razed the Twin Towers in Manhattan. It contributes to conflicts around the globe. At a more personal level, recognition of our mortality leads us to love fancy cars, tan ourselves to an unhealthy crisp, max out our credit cards, drive like lunatics, itch for a fight with a perceived enemy, and crave fame, however ephemeral, even if we have to drink yak urine on Survivor to get it."

...

But how could they test Becker’s other claims, about the death-denying functions of our beliefs about reality? They settled on an experimental model in which some subjects would be reminded of their mortality while others would not. If terror-management theory were correct, they reasoned, then people who got the death reminders should more intensely cling to their culturally acquired beliefs.

In their first experiment, the psychologists had municipal-court judges in Tucson set bail in what looked like an actual case involving a woman cited for prostitution. Half of them first filled out a questionnaire designed to remind them of death. It consisted of two questions: (1) Please briefly describe the emotions that the thought of your own death arouses in you; and (2) Jot down, as specifically as you can, what you think will happen to you as you physically die and once you are physically dead.

The results were striking. Judges not reminded of their mortality set an average bond of $50, the typical amount. Those who had thought about death set an average bond of $455. Hypothesis confirmed. "The results showed that the judges who thought about their own mortality reacted by trying to do the right thing as prescribed by their culture," the psychologists explain in The Worm at the Core. "Accordingly, they upheld the law more vigorously than their colleagues who were not reminded of death.""

Occupations with the Lowest Suicide rates

"Welcome aboard! Why so glum? No matter, you'll soon take heart out on the open sea!"

 

1. Ship Captains, Mates, Deckhands [lowest]

2. General Office Clerks

3. Advertising and Sales Managers

4. Nursing, Psychiatric, and Home Health Aides

5. Dishwasher Occupations

6. Logging Occupations

7. Health Care Support (Assistants, Drivers, Aides)

8. Supervisors, Food Preparation and Service Occupations

9. Cooks, Chefs, and Bakers

10. Boilermakers and Operational Engineers



1 From Moby-Dick: "Whenever I find myself growing grim about the mouth; whenever it is a damp, drizzly November in my soul; whenever I find myself involuntarily pausing before coffin warehouses, and bringing up the rear of every funeral I meet; and especially whenever my hypos get such an upper hand of me, that it requires a strong moral principle to prevent me from deliberately stepping into the street, and methodically knocking people’s hats off—then, I account it high time to get to sea as soon as I can. This is my substitute for pistol and ball. With a philosophical flourish Cato throws himself upon his sword; I quietly take to the ship."

http://clinicalpsychreading.blogspot.com/2014/07/moby-dick-whaling-as-suicide-prevention.html

2 I suppose Bartleby was an outlier

3 Why Don Draper didn't end up killing himself?

4 and 7 Short-term employment, mostly by females, who are at lower risk for suicide

5, 8, 9  There seems to be something protective about working with food, or at least in a kitchen

6 and 10  Really manly men don't die by suicide? Or does the work/drink kill them before they get a chance to kill themselves?


Source: http://www.cdc.gov/niosh/topics/NOMS/

Occupations with the Highest Suicide rates

This guy must think about killing himself all day long.

1. Dentists

2. Pharmacists

3. Biological, Life, and Medical Scientists

4. Diagnostic/Radiologic Technicians

5. Power Plant Operators

6. Physicians

7. Registered Nurses

8. Crane and Tower Operators

9. Appraisers and Real Estate Agents

10. Lawyers and Judges


1, 2, 6, 7 have access to lethal drugs and knowledge about "proper" dosing.
2, 3, 4, 6, 7 know about fatal, progressive diseases and the chances of surviving them.
5 and 8 seem like high stress jobs done mainly by heavy drinking men who own firearms.
7 really surprised me.
9 seems like the kind of job that people try after they have failed at a couple of other careers
10 was traditionally heavy drinking men, probably used to be higher on the list, but now that women comprise the majority of law school grads, might fall off the Top Ten.

College professor (or rather, Teacher, Postsecondary) was number 13, followed by Writers, Authors, Editors, and Technical Writers.

Source: http://www.cdc.gov/niosh/topics/NOMS/

Hiring for cultural fit

"You played lacrosse for Harvard? Me too. Welcome aboard."

"[I]n many organizations, [selecting new hires based on cultural] fit has gone rogue. I saw this firsthand while researching the hiring practices of the country’s top investment banks, management consultancies and law firms. I interviewed 120 decision makers and spent nine months observing the recruiting practices of one firm in particular. The professionals I spoke with, who were charged with reviewing applications and conducting interviews, consistently underscored the importance of cultural fit in hiring. While résumés (and connections) influenced which applicants made it into the interview room, interviewers’ perceptions of fit strongly shaped who walked out with job offers.

Crucially, though, for these gatekeepers, fit was not about a match with organizational values. It was about personal fit. In these time- and team-intensive jobs, professionals at all levels of seniority reported wanting to hire people with whom they enjoyed hanging out and could foresee developing close relationships with. Fit was different from the ability to get along with clients. Fundamentally, it was about interviewers’ personal enjoyment and fun. Many, like one manager at a consulting firm, believed that “when it’s done right, work is play.”

To judge fit, interviewers commonly relied on chemistry. “The best way I could describe it,” one member of a law firm’s hiring committee told me, “is like if you were on a date. You kind of know when there’s a match.” Many used the “airport test.” As a managing director at an investment bank put it, “Would I want to be stuck in an airport in Minneapolis in a snowstorm with them?”

Discovering shared experiences was one of the most powerful sources of chemistry, but interviewers were primarily interested in new hires whose hobbies, hometowns and biographies matched their own. Bonding over rowing college crew, getting certified in scuba, sipping single-malt Scotches in the Highlands or dining at Michelin-starred restaurants was evidence of fit; sharing a love of teamwork or a passion for pleasing clients was not. Some (former) athletes fit exclusively with other athletes; others fit only with those who played the same sport. At one hiring committee meeting I attended, I watched a partner who was an avid Red Sox fan argue for rejecting a Yankees supporter on the grounds of misfit."

 

Much Madness is divinest Sense -- Emily Dickinson (1862)

 

Much Madness is divinest Sense -

To a discerning Eye -

Much Sense - the starkest Madness -

’Tis the Majority

In this, as all, prevail -

Assent - and you are sane -

Demur - you’re straightway dangerous -

And handled with a Chain -

 

 

 

 

 

One Less Bell to Answer -- Sheryl Crow and Burt Bacharach

Burt Bacharach: Whatever happened to pop music for grown-ups?

One less bell to answer
One less egg to fry
One less man to pick up after
I should be happy
But all I do is cry
Cry, cry, no more laughter

I should be happy
Oh, why did he go
I only know that since he left
My life's so empty
Though I try to forget
It just can't be done
Each time the doorbell rings
I still run

I don't know how in the world
To stop thinking of him
Cause I still love him so
I spend each day the way I start out
Crying my heart out

One less bell to answer
I should be happy
One less egg to fry
One less man to pick up after
No more laughter, no more love
Since he went away

One less bell to answer
One less egg to fry
One less man to pick up after
No more laughter, no more love
Since he went away
He went away

 

Songwriters
DAVID, HAL / BACHARACH, BURT

 

 

Wall Street Suicides

 

NYT

"[T]he string of deaths on Wall Street appears to rise above the level of simple coincidence. Last February, Fortune ran an article titled: “Is there a suicide contagion on Wall Street?"

Studies have suggested that financial service employees are at higher risk than those in many other industries. According to the National Occupational Mortality Surveillance, individuals who work in financial services are 1.5 times more likely to commit suicide than the national average. The highest suicide rates in the United States are among doctors, dentists and veterinarians.

It is possible that the finance industry attracts more people with depression, just as it is possible that the pressure-cooker work environment overwhelms some people who have been high achievers their entire lives. It could be a tragic combination of multiple factors. Wall Street has always thrived, in part, on its eat-or-be-eaten culture. Would curbing its competitive nature cut into its success?

Most top Wall Street firms have sought to change their work policies for young investment bankers in recent years, in part to combat some of the problems and because they are increasingly in heated competition with Silicon Valley for top talent and are seeking to make themselves more attractive.

Goldman, for example, has required that analysts take Saturdays off. Credit Suisse, too, has made employees take Saturdays off, with employees instructed to avoid even email. Bank of America has instituted a policy that requires analysts to “take four days off a month” on the weekends. And JPMorgan Chase has said that one weekend a month should be protected.

Many of those steps were taken after a 21-year-old intern died at Bank of America Merrill Lynch’s London office in summer 2013 after reports indicated he had pulled three consecutive all-nighters. The official cause of death was epilepsy."

Transgender is so yesterday; let's talk about the transabled!



"Chloe Jennings-White adjusting her leg braces at her home on May 16, 2013 in Salt Lake City, Utah. Chloe-Jennings White wears leg braces and uses a wheelchair, even though her legs work fine, and she does not need them."



National Post

"When he cut off his right arm with a “very sharp power tool,” a man who now calls himself One Hand Jason let everyone believe it was an accident.

But he had for months tried different means of cutting and crushing the limb that never quite felt like his own, training himself on first aid so he wouldn’t bleed to death, even practicing on animal parts sourced from a butcher.

“My goal was to get the job done with no hope of reconstruction or re-attachment, and I wanted some method that I could actually bring myself to do,” he told the body modification website ModBlog.

His goal was to become disabled.

People like Jason have been classified as ‘‘transabled’’ — feeling like imposters in their bodies, their arms and legs in full working order.

...

As the public begins to embrace people who identify as transgender, the trans people within the disability movement are also seeking their due, or at very least a bit of understanding in a public that cannot fathom why anyone would want to be anything other than healthy and mobile.

But this has been met with great resistance in both the disability activist community and in transgender circles, argues [researcher Alexandre] Baril, a visiting scholar of feminist, gender and sexuality studies at Wesleyan University in Middletown, Connecticut [who also happens to be both disabled and transgender, and Canadian].

“They tend to see transabled people as dishonest people, people who try to steal resources from the community, people who would be disrespectful by denying or fetishizing or romanticizing disability reality,” Baril says, adding people in both transgender and disabled circles tend to make judgmental or prejudicial statements about transabled people. “Each try to distance themselves.”"

See also: A New Way to be Mad

"The phenomenon is not as rare as one might think: healthy people deliberately setting out to rid themselves of one or more of their limbs, with or without a surgeon's help. Why do pathologies sometimes arise as if from nowhere? Can the mere description of a condition make it contagious?"

Michael Oakeshott: Conservative Philosopher

 

"What there is, [English philosopher Michael] Oakeshott believed, is conversation—unending conversation about the complexities of life and life’s proper ends. This conversation, he held, ought never to lapse into argument. Nor is it hierarchical. Every thoughtful person can participate. In “The Voice of Poetry in the Conversation of Mankind,” he wrote that “conversation is not an enterprise designed to yield an extrinsic profit, a contest where a winner gets a prize, nor is it an activity of exegesis; it is an unrehearsed intellectual adventure.” Life, for Oakeshott, as he put it in “A Place of Learning,” is “a predicament, not a journey.” The predicament is how to make the best of it and get the best out of it.

The answer for Oakeshott, as he set out most emphatically in “On Being Conservative,” is to cultivate 

a propensity to use and to enjoy what is present rather than to wish for or to look for something else; to delight in what is present rather than what was or what may be. .  .  . To be conservative, then, is to prefer the familiar to the unknown, to prefer the tried to the untried, fact to mystery, the actual to the possible, the limited to the unbounded, the near to the distant, the sufficient to the superabundant, the convenient to the perfect, present laughter to utopian bliss. 

...

Oakeshott found more reinforcement for these views in Montaigne and Pascal and Hume than in Burke or Bentham.

Politics did not hold out much promise for Oakeshott. He believed that government 

is a specific and limited activity, namely, the provision and custody of general rules of conduct, which are understood, not as plans for imposing substantive activities, but as instruments enabling people to pursue the activities of their own choice with the minimum frustration, and therefore something which it is appropriate to be conservative about.

Oakeshott had his own religious sentiments and complex morality, but he felt that neither religion nor morals had to do with politics, and politics had nothing whatsoever to do “with making men good or even better.” Dreams of perfect justice or perfect freedom ought to be excluded from politics, for “the conjunction of dreaming and ruling generates tyranny.” 

The role of government should be much simpler: “to keep its subjects at peace with one another in the activities in which they have chosen to seek their happiness.”  

...

The problem, Oakeshott felt, was not only that “politics is an uninteresting form of activity to anyone who has no desire to rule others” but that those it attracts are, too often, unimpressive human beings. At one point he calls them “scoundrels.” What isn’t required, but is too often evident, in politics is “manufacturing curable grievances.” What is needed is the assurance of “the little things: to go where we like & when; having paid my taxes to spend my money on what I wish.” His final word is this: “Politics is the art of living together & of being ‘just’ to one another—not of imposing a way of life, but of organizing a common life.”

So much of Oakeshott’s political thought is propelled by his unshakeable belief in the imperfectibility of human beings. Montaigne is his intellectual hero here, the Montaigne who understood that all human judgment and wisdom is fallible. In “A Place of Learning,” Oakeshott disavows a belief in human nature, asserting that “there are only men, women and children responding gaily or reluctantly, reflectively or not so reflectively, to the ordeal of consciousness, who exist only in terms of their self-understandings.” Self-understanding, though, is a rarity. “The intellectual life of the majority of men and women,” he writes in the Notebooks, “is cankered by a passion for indiscriminate knowledge.”

He underscored the wretched condition of “people who have no selves other than those created by ‘experts’ who tell them what they are.” Others walk about with heads “so full of ideas that there is no room for sense.” In a world of boundless distractions, serious education—not “education [that] is merely instruction in the current vulgarities”—is the only (if somewhat dim) hope: “To be educated is to know how much one wishes to know & to have the courage not to be tempted beyond that limit.” Genuine culture, he held, teaches that “there is much that one does not want to know.”

For Oakeshott the trick was somehow to be above the humdrum world and yet also be in it. “One is under an obligation to be happy with the here & now,” he writes, a sentiment he expresses more than once. Yet he also notes that “it is certain that most who concentrate upon achievement miss life.” On his gravestone, he wanted this bit of verse from the Scottish poet William Dunbar:

Man, please thy Maker, and be merry,

And give not for this world a cherry."

 

 

 

 

The Whig Interpretation of History

An Indian massacre of Virginian settlers, 1622

"Bailyn’s 2012 book The Barbarous Years, which deals with the early-17th-century origins of the English colonies, has been criticized for being too narrow and for not including Canada and Spanish Florida in its narrative. And the Indians, well, no matter how much space Bailyn gives to them, no matter how sensitive his analysis of the native peoples, it would never be enough. To his critics, Bailyn’s Indians remain simply a “faceless offstage menace.” Bailyn’s vivid and detailed descriptions of the brutal and vicious treatment of the Indians by the English have boomeranged on him: His critics now complain that he didn’t fully appreciate the Indians’ contribution to English well-being and the extent to which the native peoples provided the economic glue that tied the separate colonial regions together. In other words, unless the Indians became the main characters in his story, Bailyn couldn’t win. 

No historian, including Bernard Bailyn, denies the importance of the native peoples in shaping colonial America. But it is a question of proportion, of fitting the Indians into a story in which, tragically, they become steadily marginalized and eventually overwhelmed. Nevertheless, for us today, looking back through centuries, the whites’ treatment of the Indians seems totally immoral and inexcusable. Can history ever evade that kind of moral judgment? Can putting the past in context help? Bailyn quotes Herbert Butterfield from his remarkable little book of 1931, The Whig Interpretation of History, to emphasize the importance of context in history. “The dispensing of moral judgments upon people or upon actions in retrospect,” wrote Butterfield, is the “most useless and unproductive of all forms of reflection.” And still it goes on."

Albert Ellis explains REBT

This is a nice little clip of Albert Ellis explaining his Rational-Emotive Behavioral Therapy (REBT). The man embodied the spirit of the treatment he developed. Read the piece below, repeatedly practice what you learn, and change your life -- or don't bother, and just keep on living like the schmuck you are.

 

 

 

3-minute therapy.com 

"Rational Emotive Behavior Therapy (REBT), was developed by Dr.Albert Ellis in 1955. It has since flourished and spawned a variety of other cognitive-behavior therapies. REBT's effectiveness, short-term nature, and low cost are major reasons for its popularity.

REBT's comprehensive approach works best for individuals desiring a scientific, present-focused, and active treatment for coping with life's difficulties, rather than one which is mystical, historical, and largely passive

REBT is based on a few simple principles having profound implications:

1. You are responsible for your own emotions and actions,
2. Your harmful emotions and dysfunctional behaviors are the product of your irrational thinking,
3. You can learn more realistic views and, with practice, make them a part of you,
4. You'll experience a deeper acceptance of yourself and greater satisfactions in life by developing
   a reality-based perspective.

REBT distinguishes clearly between two very different types of difficulties: practical problems and emotional problems. Your flawed behavior, unfair treatment by others, and undesirable situations, represent practical problems. Regrettably, your human tendency is to upset yourself about these practical problems, thereby unnecessarily creating a second order of problems--emotional suffering. REBT addresses the latter by helping you:

1. Take responsibility for your distress. The first lesson in healthy emoting and relating was stated by the Roman philosopher Epictetus more than 2000 years ago: only you can upset yourself about events--the events themselves, no matter how undesirable, can never upset you.
   Recognize that neither another person, nor an adverse circumstance, can ever disturb you--only you can. No one else can get into your gut and churn it up. Others can cause you physical pain--by hitting you over the head with a baseball bat, for example--or can block your goals. But you create your own emotional suffering, or self-defeating behavioral patterns, about what others do or say.
   
2. Identify your "musts." Once you admit that you distort your own emotions and actions, then determine precisely how. The culprit usually lies in one of the three core "musts:"
   
   • "Must" #1 (a demand on yourself): "I MUST do well and get approval, or else I'm worthless." This demand causes anxiety, depression, and lack of assertiveness.
   • "Must" #2 (a demand on others): "You MUST treat me reasonably, considerately, and lovingly, or else you're no good." This "must" leads to resentment, hostility, and violence.
   • "Must" #3 (a demand on situations): "Life MUST be fair, easy, and hassle-free, or else it's awful." This thinking is associated with hopelessness, procrastination, and addictions.
   Ascertain what you're demanding of yourself, of your significant others, or of your circumstances. Not until you have discovered the "must" can you then go on effectively to reduce your distress.
   
3. Dispute your "musts." The only way you can ever remain disturbed about adversity is by vigorously and persistently agreeing with one of these three "musts." Thus, once you've bared them, then relentlessly confront and question your demands.
   Begin by asking yourself: "What's the evidence for my 'must?' " "How is it true?" "Where's it etched in stone?" And then by seeing: "There's no evidence." "My 'must' is entirely false." "It's not carved indelibly anywhere." Make your view "must"-free, and then your emotions will heal.
   
4. Reinforce your preferences. Conclude, therefore:
   • Preference #1: "I strongly PREFER to do well and get approval, but even if I fail, I will accept myself fully,"
   • Preference #2: "I strongly PREFER that you treat me reasonably, kindly, and lovingly, but since I don't run the universe, and it's a part of your human nature to err, I, then, cannot control you,"
   • Preference #3: "I strongly PREFER that life be fair, easy, and hassle-free, and it's very frustrating that it isn't, but I can bear frustration and still considerably enjoy life."

Assuming that you take the above suggestions to heart and thereby greatly reduce your anxiety, hostility, depression, and addictions, what remains? Will you exist robot-like, devoid of human feeling and motivation? Hardly! Without your turmoil, you'll more easily experience love, involvement, and joy. And without your addictions, you'll be freer to engage in the gratifying experiences of spontaneity, commitment, and self-actualization. 

As you can see, REBT will appeal to you if you relish quickly taking control of your own life, rather than remaining dependent upon a therapist for years. By giving you tools for identifying and overcoming the true source of your difficulties, it will prepare you to act in many ways as your own therapist. And by helping you to reinforce realistic, self-benefitting beliefs, it will enable you to eliminate present emotional and behavioral problems, and to avoid future ones."



Gilgamesh -- David Ferry (trans.)

Tablet X

v

The old man spoke and said to Gilgamesh:
"Your face is bitten by hunger or by sorrow.

Why do you look like one who has undergone
a terrible journey? Why do you look like one

who grieves? Why do you wear the skin of a beast?
Why is it that you roam the wilderness?"

And Gilgamesh spoke to the old man and said:
"I look like one whose grief lives in his heart,

Because of the death of Enkidu the companion.
Together we made the journey across the mountains

through the dangerous passes to the Cedar Forest;
he told me how the dreams were fortunate;

together we made the festal gate of cedar.
We fought the Bull of Heaven together and killed him,

and after we killed the Bull sat down and rested.
Two brothers, we washed our hands in the calm waters.

Enkidu, the companion, whom I loved,
who went together with me on the journey

no one has ever undergone before,
now Enkidu has undergone the fate

the high gods have established for mankind.
I saw the worm drop out of Enkidu's nose.

Must I die too? Must I too be like that?
I wandered the desert seeking Utnapishtim,

he who is called by men the Faraway;
I lived on the flesh of beasts I hunted down,

lions, and tigers, the bear, the hyena, the panther;
I wore the skins of beasts I had hunted down.

There was no sleep for me in the deserts or mountains.
The tavern keeper shut her door against me.

I lay in the dirt as if I were a beast."
The old man spoke and said to Gilgamesh:

"You who were born the son of a goddess mother,
why do you grieve because of a mortal father?

How long does a building stand before it falls?
How long does a contract last? How long will brothers

share the inheritance before they quarrel?
How long does hatred, for that matter, last?

Time after time the river has risen and flooded.
The insect leaves the cocoon to live but a minute.

How long is the eye able to look at the sun?
From the very beginning nothing at all has lasted.

See how the dead and the sleeping resemble each other.
Seen together, they are the image of death.

The simple man and the ruler resemble each other.
The face of the one will darken like that of the other.

The Annunaki gathered in assembly;
Mammetum, Mother Goddess, she was with them.

There they established that there is life and death.
The day of death is set, though not made known."

Anyone who had a heart -- Dionne Warwick (1964)





Recorded (in one take) just days after the JFK assassination.



Anyone who ever loved could look at me
And know that I love you
Anyone who ever dreamed could look at me
And know I dream of you
Knowing I love you so

Anyone who had a heart
Would take me in his arms and love me too
You couldn't really have a heart and hurt me
Like you hurt me and be so untrue
What am I to do?

Every time you go away, I always say
This time it's goodbye, dear
Loving you the way I do
I take you back, without you I'd die, dear
Knowing I love you so

Anyone who had a heart
Would take me in his arms and love me too
You couldn't really have a heart and hurt me
Like you hurt me and be so untrue
What am I to do?

Knowing I love you so

Anyone who had a heart
Would take me in his arms and love me too
You couldn't really have a heart and hurt me
Like you hurt me and be so untrue

Anyone who had a heart would love me too
Anyone who had a heart would surely take me in his arms
And always love me, why won't you?
Anyone who had a heart would love me too, yeah
Anyone who had a heart would surely take me in his arms
And always love me, why won't you? Yeah
Anyone who had a heart would love me too, yeah

 

Songwriters
DAVID, HAL / BACHARACH, BURT

 

 

 

Media Portrayals of Psychotherapy, Part V: The Sopranos

My psychotherapist hero.
 

 

 

 

 

 

Carmela gets a second opinion

 

 

Carmela: Every marriage has problems.

Krakower: Is he seeing other women?

Carmela: "Yeah, you can make that plural. Yes, he sees other women. I sort of look the other way. I want to help him."

Krakower: "Do you? Moments ago you used the word divorce."

Carmela: "I said I was considering divorce. I may be overstepping my boundaries here, but you are Jewish, aren't you?"

Krakower: "Is that relevant?"

Carmela: "Well, us Catholics, we place a great deal of stock in the sanctity of the family. And I am not sure that your people--"

Krakower: "I've been married 31 years."

Carmela: "Well, then, you know. How difficult it can be. He's a good man, a good father."

Krakower: "You tell me he's a depressed criminal. Prone to anger. Serially unfaithful. Is that your definition of a good man?"

Carmela: "I thought psychiatrists weren't supposed to be judgmental."

Krakower: "Many patients want to be excused for their current predicament. Because of events that occurred in their childhood. That's what psychiatry has become in America. Visit any shopping mall or ethnic pride parade. Witness the results."

Carmela: "What we say in here stays in here, right?"

Krakower: "By ethical code and by law."

Carmela: "His crimes. They are, uh, organized crimes."

Krakower: "The mafia."

Carmela begins sobbing. "Oh Jesus." She dabs at her face with a tissue. "Oh so, so what? So what? He betrays me every week with these whores."

Krakower: "Probably the least of his misdeeds."

Carmela shifts forward, as if to leave.

Krakower: "You can leave now, or you can you stay and hear what I have to say."

Carmela: "Well, you're gonna charge the same anyway."

Krakower: "I won't take your money."

Carmela: "That's a new one."

Krakower: "You must trust your initial impulse and consider leaving him. You'll never be able to feel good about yourself. You'll never be able to quell the feelings of guilt and shame that you talked about. As long as you're his accomplice."

Carmela: "You're wrong about the accomplice part though."

Krakower: "Are you sure?"

Carmela: "All I do is make sure he's got clean clothes in his closet and dinner on his table."

Krakower: "So 'enabler' would be a more accurate job description for you than 'accomplice'. My apologies."

Carmela: "So . . . You think I need to define my boundaries more clearly. Keep a certain distance. Not internalize my--"

Krakower: "What did I just say?"

Carmela: "Leave him."

Krakower: "Take only the children, or what's left of them, and go."

Carmela: "My priest said I should try to work with him. Help him to be a better man."

Krakower: "How's that going?"

Carmela: "I--"

Krakower: "Have you ever read Crime and Punishment? Dostoyevsky. It's not an easy read. It's about guilt and redemption. And I think were your husband to turn himself him, read this book, and reflect on his crimes every day for seven years in his cell, then he might be redeemed."

Carmela: "I'd have to, uh, get a lawyer. Find an apartment. Arrange for child support."

Krakower: "You're not listening. I am not charging you because I won't take blood money. And you can't either. One thing you can never say, that you haven't been told."

Carmela: "I see. You're right. I see."

 

 

 

 

 

 



 

 

 

Media Portrayals of Psychotherapy, Part IV: The Sopranos

I was going to say that I'm glad that most of my psychotherapy sessions don't go like this, but, in a way, it's a pretty good session.

 

 

 

 

 

 

 

Media Portrayals of Psychotherapy, Part III: The Billfold Syndrome, MASH

Be careful what you watch on t.v. when you're a kid. This episode of MASH is probably why I went into the mental health field. It's called The Billfold Syndrome and it's from Season 7 of the show; sorry, but I can't find a clip on YouTube.

Ken Levine

"The Billfold Syndrome is an episode of MASH my partner David Isaacs and I wrote in 1978. It’s part of the 7th season if you want to find or rent a copy and watch it. And it’s probably airing right now on three cable channels.

Here’s the premise: A young medic arrives at the 4077th with amnesia. Psychiatrist Dr. Sidney Freedman is summoned, who (along with Hawkeye and B.J.’s help) hypnotize the young soldier to bring him back to the exact time and place he lost his memory. They recreate the battle complete with sounds and role playing. It’s maybe the most dramatic scene we’ve even written. I won’t spoil the ending should you not have seen it yet.

There’s also a subplot where Charles learns he’s been passed over for chief of thoracic surgery at Massachusetts General because he’s in Korea. In frustration he vows never to talk to anyone in the camp again, which of course is laying down the gauntlet for Hawk & Beej who then go to outlandish lengths to get him to talk.

A terrific actor – Kevin Geer played the young medic. Alan Alda directed masterfully, wringing every laugh and tear out of the script.

The title “Billfold Syndrome” is a psychiatric expression: Someone looks at his I.D. or billfold and can’t place himself.

This story came right out research. Larry Gelbart, Gene Reynolds, Burt Metcalfe, and then later me and David, interviewed doctors, nurses, corpsmen, soldiers – anyone who served in Korea. Most of the stories done on MASH were inspired from these interviews."

Media Portrayals of Psychotherapy, Part II: Last Episode of MASH

MAJ Sidney Freeman. Not the clip I was looking for, but not bad.

 

 

"Here's the story: Hawkeye has gone insane and is spending time at a hospital. Throughout the episode, he tells this story about how they were able to go out to a beach and have a great day. Just playing at the beach. They all pile up on a bus to head home. Suddenly, they realize that the enemy is nearby, so they shut off the engine, turned out all the lights and everybody got quiet. Except this woman in the back who has a chicken that won't get quiet."

Media Portrayals of Psychotherapy, Part I: The West Wing

"I didn't earn a doctorate in clinical psychology just so I would have to wear a tie to work." Stanley Keyworth (Adam Arkin) is the supersmart-smug-arrogant psychotherapist. He's real fast with the interpretations, but this is television. I've used the "you can probably stop trying to win the approval/love of your (dead) father/mother, because it's never, ever, going to happen" line dozens of times.

 

 

 

Dr. Philm

"In this episode of The West Wing, Psychiatrist Stanley Keyworth (Adam Arkin), the man who treated Josh (Bradley Whitford) for trauma after the shooting incident, is brought in to address President Bartlet’s post-Iowa insomnia.

This TV session between shrink and patient begins simply. President Bartlet hasn’t slept in 4 nights. Dr. Keyworth runs through initial questioning, intended to reveal any potential physical, lifestyle or environmental factors affecting the President’s ability to sleep. Is there too much too much light in the room? Are there temperature fluctuations? Any noise?

Planes flying overhead are ruled out (planes are not allowed to fly over the White House).

Finding nothing of use he moves on to psychological factors, such as stress. Is there any stress in Barlet’s job?

President Bartlet explains, matter-of-factly that,  “Well, congress was investigating me. And I was censured. Then I had to give the State of the Union. I’m running for re-election, things are blowing up everywhere and I’ve chosen the general assembly of the U.N. to define a tougher foreign policy. Not unusually stressful, no.”

Despite the atypical specifics of Bartlet’s job, Dr. Keyworth is determined to treat him as any other patient.

When Bartlet scoffs at Dr. Keyworth’s $375/hour bill rate, and evades questions, Keyworth replies with what he states he’d “say to any other patient”: 

“… screw around if you want, but it’s your money. It’s about to be my money, and I sleep fine.”

Bartlet begins to open up from there, revealing issues with his father; childhood abuse and his lingering desire for his father’s never-attainable approval. 

Keyworth makes note that Bartlet is graded on a “hell of a curve” these days. “Lincoln freed the slaves and won the Civil War.”  And he did it even though it meant losing half the country.  

Are Bartlet’s actions based on what he feels is right? Or are they for sake of national – and paternal – approval?   

Is the discontinuity between his actions vs. what he knows to be “right” keeping him up at night? 

The 2-hr (double) session ends, at the declaration of Dr. Keyworth. The President expresses shock and states that they are done “when he says they are done”. Dr. Keyworth makes it clear that, in this case, that’s not how things will work.  He intends to be, as he explains to the President, “the only person, in the world, other than your family, who doesn’t care you’re the President.” 

For TV psychiatry, a remarkable amount of time is spent with the Dr. questioning and listening. Dr. Keyworth begins to deliver analyses only during the last 3rd of what we see in the session. Premature in real life. But impressive for a TV portrayal."

 

 

 

 

 

 

 







In the Reading Room -- David Ferry

Hades and Persephone

Alone in the library room, even when others
Are there in the room, alone, except for themselves,
There is the illusion of peace; the air in the room

Is stilled; there are reading lights on the tables,
Looking as if they’re reading, looking as if
They’re studying the text, and understanding,

Shedding light on what the words are saying;
But under their steady imbecile gaze the page
Is blank, patiently waiting not to be blank.

The page is blank until the mind that reads
Crosses the black river, seeking the Queen
Of the Underworld, Persephone, where she sits

By the side of the one who brought her from Enna,
Hades the mute, the deaf, king of the dead letter;
She is clothed in the beautiful garment of our thousand

Misunderstandings of the sacred text.

Santa Monica -- Everclear (1995)

Paddleboard race from Santa Monica Pier to Ocean Park Pier, 1954. It has been 20 years since this song was released. Twenty years from 1995 to 2015. The same length of time as from when this picture was taken to 1974. Or from 1934 to 1954. Doesn't it seem like a lot more changed between 1934 and 1954? Or between 1954 and 1974? What's changed since 1995? Cellphones and the internet, I guess. Big deal.

I am still living with your ghost
Lonely and dreaming of the west coast
I don't want to be your downtime
I don't want to be your stupid game

With my big black boots and an old suitcase
I do believe I'll find myself a new place
I don't want to be the bad guy
I don't want do your sleepwalk dance anymore
I just want to see some palm trees
I will try and shake away this disease

We can live beside the ocean
Leave the fire behind
Swim out past the breakers
Watch the world die

We can live beside the ocean
Leave the fire behind
Swim out past the breakers
Watch the world die

I am still dreaming of you face
Hungry and hollow for all the things you took away
I don't want to be your good time
I don't want to be your fall back crutch anymore

I'll walk right out into a brand new day
Insane and rising in my own weird way
I don't want to be the bad guy
I don't want to do your sleepwalk dance anymore
I just want to feel some sunshine
I just want to find some place to be alone

We can live beside the ocean
Leave the fire behind
Swim out past the breakers
Watch the world die

We can live beside the ocean
Leave the fire behind
Swim out past the breakers
Watch the world die

We can live beside the ocean
Leave the fire behind
Swim out past the breakers
Watch the world die

We can live beside the ocean
Leave the fire behind
Swim out past the breakers
Watch the world die

Yeah watch the world die
Yeah watch the world die
Yeah watch the world die
Yeah watch the world die

Songwriters
ALEXAKIS, ART / MONTOYA, CRAIG / EKLUND, GREG