Bad Treatment Quotes

Instead of treating your child like how you were treated. Treat them with the same love and attention you wanted from your parents while growing up.

The smell of good bread baking, like the sound of lightly flowing water, is indescribable in its evocation of innocence and delight... [Breadmaking is] one of those almost hypnotic businesses, like a dance from some ancient ceremony. It leaves you filled with one of the world's sweetest smells... there is no chiropractic treatment, no Yoga exercise, no hour of meditation in a music-throbbing chapel. that will leave you emptier of bad thoughts than this homely ceremony of making bread.

It sounded old. Deserve. Old and tired and beaten to death. Deserve. Now it seemed to him that he was always saying or thinking that he didn't deserve some bad luck, or some bad treatment from others. He'd told Guitar that he didn't "deserve" his family's dependence, hatred, or whatever. That he didn't even "deserve" to hear all the misery and mutual accusations his parents unloaded on him. Nor did he "deserve" Hagar's vengeance. But why shouldn't his parents tell him their personal problems? If not him, then who? And if a stranger could try to kill him, surely Hagar, who knew him and whom he'd thrown away like a wad of chewing gum after the flavor was gone––she had a right to try to kill him too. Apparently he though he deserved only to be loved--from a distance, though--and given what he wanted. And in return he would be...what? Pleasant? Generous? Maybe all he was really saying was: I am not responsible for your pain; share your happiness with me but not your unhappiness.

Avoiding triggers is a symptom of PTSD, not a treatment for it.

Chuck Norris’s tears cure cancer. Too bad he’s never cried.

Remember that the best medical treatment is a sense of relativism. No matter how badly you might feel, take comfort in knowing there's someone who feels much worse.

... when a poor man's wronged, he becomes a very difficult customer. To start with, he gets a lot of sympathy: and then he takes his bad treatment not just as an injury, but as a personal insult.

optimism, n. The doctrine, or belief, that everything is beautiful, including what is ugly, everything good, especially the bad, and everything right that is wrong. It is held with greatest tenacity by those most accustomed to the mischance of falling into adversity, and is most acceptably expounded with disproof - an intellectual disorder, yielding to no treatment but death. It is hereditary, but fortunately not contagious.

Sometimes I wonder how I could have been so oblivious to the fact that proper treatment for pain is, well, not a bad thing.

Perhaps this war will make it simpler for us to go back to some of the old ways we knew before we came over to this land and made the Big Money. Perhaps, even, we will remember how to make good bread again. It does not cost much. It is pleasant: one of those almost hypnotic businesses, like a dance from some ancient ceremony. It leaves you filled with peace, and the house filled with one of the world's sweetest smells. But it takes a lot of time. If you can find that, the rest is easy. And if you cannot rightly find it, make it, for probably there is no chiropractic treatment, no Yoga exercise, no hour of meditation in a music-throbbing chapel, that will leave you emptier of bad thoughts than this homely ceremony of making bread.

I didn’t need to be kissing a man who’d ruthlessly cut me out of his life. Didn’t need to reward his shitty treatment of me. Jess had an m.o. for dealing with badly behaving males—she called it ABC: Always Be Crazier.

The overseer beat him, tried to starve him, wouldn't let him have any shoes, treated him so badly that he had a very intense, passionate hatred for white people. My grandfather was the one who instilled in my mother and her sisters, and in their children, that you don't put up with bad treatment from anybody. It was passed down almost in our genes,

Treat me well and I will tell... Treat me bad and I feel sad. Treat me good, change my mood. Treat me sweet and call it quits!

The usual treatment is psychotherapy.” “I know.” I didn’t explain that I was single. Therapy is for couples. So is Christmas. So is camping. So is beach camping.

But that tech also led to nuclear power, cancer treatments and long-range space exploration, right? Tech can be good and bad.

vital that people who have survived violence become habituated to ordinary cues and reminders woven into the fabric of daily life.31 Avoiding triggers is a symptom of PTSD, not a treatment for

I would like the expert physicians who are condemning me for my action, which has proven their ability, to take a perfectly sane and healthy woman, shut her up and make her sit from 6 A. M. until 8 P. M. on straight-back benches, do not allow her to talk or move during these hours, give her no reading and let her know nothing of the world or its doings, give her bad food and harsh treatment, and see how long it will take to make her insane. Two months would make her a mental and physical wreck.

[Hot flashes] are the prime cause of sleep disruption in women over age fifty, Suzanne Woodward of Wayne State University School of Medicine reports. Her studies show that hot flashes in sleep occur about once an hour. Most prompt an arousal of three minutes or longer. Independently of their hot flashes, women who have them still awaken briefly every eight minutes on average. The sleep process dramatically blunts memory for awakenings, Woodward said, and in the morning women seldom realize how poorly they slept. Instead, they often focus on the daytime consequences of poor sleep, which include fatigue, lethargy, mood swings, depression, and irritability. Many women and their doctors, Woodward said, dismiss such symptoms as "just menopause." This is a mistake, she suggested, because treatment can reduce or eliminate hot flashes, aid sleep, relieve other symptoms, and improve a woman's quality of life. Treatment also helps keep frequent awakenings from becoming a bad habit that continues after hot flashes subside.

Julia never asked herself why bad things happen to good people, for she already knew the answer: bad things happen t everyone. Not that this was an excuse or a justification for wronging another human being. Still, all humans had this shared experience- that of suffering. No human being left this world without shedding a tear,of feeling pain,or wading into the sea of sorrow. Why should her life be any different? Why should she expect special, favoured treatment? Even Mother Teresa suffered, and she was a saint.

Substance abuse is a very real trap. Drugs and alcohol are very much like an abusive lover who treats you well at first and then beats you up, apologizes, gives you nice treatment for a while, and then beats you up again. The trap is in trying to hang in there for the good while trying to overlook the bad. Wrong. This can never work.

That big glorious mountain. For one transitory moment, I think I may have actually seen it”. For one flash, the Mommy had seen the mountain without thinking of logging and ski resorts and avalanches, managed wildlife, plate tectonic geology, microclimates, rain shadow, or yin-yang locations. She’d seen the mountain without the framework of language. Without the cage of associations. She’d seen it without looking through the lens of everything she knew was true about mountains. What she’d seen in that flash wasn’t even a “mountain”. It wasn’t a natural resource. It had no name. “That’s the big goal”, she said. “To find a cure for knowledge”. For education. For living in our heads. Ever since the story of Adam and Eve in the bible, humanity had been a little too smart for its own good, the Mommy said. Ever since eating that apple. Her goal was to find, if not a cure, then at least a treatment that would give people back their innocence. “The cerebral cortex, the cerebellum”, she said, “that’s where your problem is”. If she could just get down to using only her brain stem, she’d be cured. This would be somewhere beyond happiness and sadness. You don’t see fish agonized by wild mood swings. Sponges never have a bad day.

Treatments worked well enough for us to get by. Most people lived into old age, but the medication, like everything else, has never been free. Life was a privilege, not a right, apparently. Something you had to struggle for when you were unlucky enough to be born at the intersection of poverty and bad genes.

A slow but steady transformation of deviance has taken place in American society. It has not been a change in behavior as such, but in how behavior is defined. Deviant behaviors that were once defined as immoral, sinful, or criminal have been given medical meanings. Some say that rehabilitation has replaced punishment, but in many cases medical treatments have become a new form of punishment and social control.

HUMAN BILL OF RIGHTS [GUIDELINES FOR FAIRNESS AND INTIMACY] I have the right to be treated with respect. I have the right to say no. I have the right to make mistakes. I have the right to reject unsolicited advice or feedback. I have the right to negotiate for change. I have the right to change my mind or my plans. I have a right to change my circumstances or course of action. I have the right to have my own feelings, beliefs, opinions, preferences, etc. I have the right to protest sarcasm, destructive criticism, or unfair treatment. I have a right to feel angry and to express it non-abusively. I have a right to refuse to take responsibility for anyone else’s problems. I have a right to refuse to take responsibility for anyone’s bad behavior. I have a right to feel ambivalent and to occasionally be inconsistent. I have a right to play, waste time and not always be productive. I have a right to occasionally be childlike and immature. I have a right to complain about life’s unfairness and injustices. I have a right to occasionally be irrational in safe ways. I have a right to seek healthy and mutually supportive relationships. I have a right to ask friends for a modicum of help and emotional support. I have a right to complain and verbally ventilate in moderation. I have a right to grow, evolve and prosper.

I recovered from recovering so no longer celebrate not doing bad things to defend myself as good. I added new bad for good measure.

The more perfect a thing is, the more susceptible to good and bad treatment it is.

But Carol Gill says that it is differential treatment—disability discrimination—to try to prevent most suicides while facilitating the suicides of ill and disabled people. The social science literature suggests that the public in general, and physicians in particular, tend to underestimate the quality of life of disabled people, compared with our own assessments of our lives. The case for assisted suicide rests on stereotypes that our lives are inherently so bad that it is entirely rational if we want to die.

Randomisation is not a new idea. It was first proposed in the seventeenth century by John Baptista van Helmont, a Belgian radical who challenged the academics of his day to test their treatments like blood-letting and purging (based on ‘theory’) against his own, which he said were based more on clinical experience: ‘Let us take out of the hospitals, out of the Camps, or from elsewhere, two hundred, or five hundred poor People, that have Fevers, Pleurisies, etc. Let us divide them into half, let us cast lots, that one half of them may fall to my share, and the other to yours … We shall see how many funerals both of us shall have.

We say, "It wasn't that bad. It was all my fault. I’m making all this stuff up. " All my life, I spoke bitterly of my mother's treatment of me as a child. Friends asked, “What did she do to you?“ I couldn't really describe it, and in frustration would say, “Well, she didn't lock us up in closets." in fact, my mother behaved much worse than that, but by focusing on the empty closet, I avoided looking at what waited beyond it.

When clients relinquish symptoms, succeed in achieving a personal goal, or make healthier choices for themselves, subsequently many will feel anxious, guilty, or depressed. That is, when clients make progress in treatment and get better, new therapists understandably are excited. But sometimes they will also be dismayed as they watch the client sabotage her success by gaining back unwanted weight or missing the next session after an important breakthrough and deep sharing with the therapist. Thus, loyalty and allegiance to symptoms—maladaptive behaviors originally developed to manage the “bad” or painfully frustrating aspects of parents—are not maladaptive to insecurely attached children. Such loyalty preserves “object ties,” or the connection to the “good” or loving aspects of the parent. Attachment fears of being left alone, helpless, or unwanted can be activated if clients disengage from the symptoms that represent these internalized “bad” objects (for example, if the client resolves an eating disorder or terminates a problematic relationship with a controlling/jealous partner). The goal of the interpersonal process approach is to help clients modify these early maladaptive schemas or internal working models by providing them with experiential or in vivo re-learning (that is, a “corrective emotional experience”). Through this real-life experience with the therapist, clients learn that, at least sometimes, some relationships can be different and do not have to follow the same familiar but problematic lines they have come to expect.

The good news is that we have effective treatments for the symptoms of depression; the bad news is that medication will not make you happy. Happiness is not simply the absence of despair. It is an affirmative state in which our lives have both meaning and pleasure.

The truth is that The Wild One -- despite an admittedly fictional treatment -- was an inspired piece of film journalism. Instead of institutionalizing common knowledge, in the style of Time, it told a story that was only beginning to happen and which was inevitably influenced by the film. It gave the outlaws a lasting, romance-glazed image of themselves, a coherent reflection that only a very few had been able to find in a mirror, and it quickly became the bike rider's answer to The Sun Also Rises. The image is not valid, but its wide acceptance can hardly be blamed on the movie. The Wild One was careful to distinguish between "good outlaws" and "bad outlaws," but the people who were most influenced chose to identify with Brando instead of Lee Marvin whose role as the villain was a lot more true to life than Brando's portrayal of the confused hero. They saw themselves as modern Robin Hoods ... virile, inarticulate brutes whose good instincts got warped somewhere in the struggle for self-expression and who spent the rest of their violent lives seeking revenge on a world that done them wrong when they were young and defenseless.

A person who complains about any aspect of breast cancer treatment in public is often drowned out by a chorus of people, many of whom have never had cancer, accusing her of ingratitude, saying she is lucky, warning her that her bad attitude may kill her, reminding her she could be dead.

The uncomfortable, as well as the miraculous, fact about the human mind is how it varies from individual to individual. The process of treatment can therefore be long and complicated. Finding the right balance of drugs, whether lithium salts, anti-psychotics, SSRIs or other kinds of treatment can be a very hit or miss heuristic process requiring great patience and classy, caring doctoring. Some patients would rather reject the chemical path and look for ways of using diet, exercise and talk-therapy. For some the condition is so bad that ECT is indicated. One of my best friends regularly goes to a clinic for doses of electroconvulsive therapy, a treatment looked on by many as a kind of horrific torture that isn’t even understood by those who administer it. This friend of mine is just about one of the most intelligent people I have ever met and she says, “I know. It ought to be wrong. But it works. It makes me feel better. I sometimes forget my own name, but it makes me happier. It’s the only thing that works.” For her. Lord knows, I’m not a doctor, and I don’t understand the brain or the mind anything like enough to presume to judge or know better than any other semi-informed individual, but if it works for her…. well then, it works for her. Which is not to say that it will work for you, for me or for others.

The nine in our list are based on a longer list in Robert Leahy, Stephen Holland, and Lata McGinn’s book, Treatment Plans and Interventions for Depression and Anxiety Disorders. For more on CBT—how it works, and how to practice it—please see Appendix 1.) EMOTIONAL REASONING: Letting your feelings guide your interpretation of reality. “I feel depressed; therefore, my marriage is not working out.” CATASTROPHIZING: Focusing on the worst possible outcome and seeing it as most likely. “It would be terrible if I failed.” OVERGENERALIZING: Perceiving a global pattern of negatives on the basis of a single incident. “This generally happens to me. I seem to fail at a lot of things.” DICHOTOMOUS THINKING (also known variously as “black-and-white thinking,” “all-or-nothing thinking,” and “binary thinking”): Viewing events or people in all-or-nothing terms. “I get rejected by everyone,” or “It was a complete waste of time.” MIND READING: Assuming that you know what people think without having sufficient evidence of their thoughts. “He thinks I’m a loser.” LABELING: Assigning global negative traits to yourself or others (often in the service of dichotomous thinking). “I’m undesirable,” or “He’s a rotten person.” NEGATIVE FILTERING: You focus almost exclusively on the negatives and seldom notice the positives. “Look at all of the people who don’t like me.” DISCOUNTING POSITIVES: Claiming that the positive things you or others do are trivial, so that you can maintain a negative judgment. “That’s what wives are supposed to do—so it doesn’t count when she’s nice to me,” or “Those successes were easy, so they don’t matter.” BLAMING: Focusing on the other person as the source of your negative feelings; you refuse to take responsibility for changing yourself. “She’s to blame for the way I feel now,” or “My parents caused all my problems.”11

We are all, men and women, creatures of desires both good and bad. But everything has a price, and the price of indulging in that which is bad for us is often guilt; and too much guilt results in a sickness of the mind. We have poisoned our conscience, and something poisoned will need treatment one day—or it will rot.

I felt sorry for myself. I knew I wasn’t a bad person, but it did not stop me from carrying on and being argumentative. I felt out of control of my behavior or blamed others for my treatment of them. I felt my brain was moving too rapidly and I was constantly chasing after myself. Except for Terry, nobody seemed to be on my side.

There was another problem with Emma's father, difficult for a small child who already thought of herself as greedy - his way of trying to keep her attention, to bribe her, with gifts. On each vof her visits, he would appear with you presents, beautifully wrapped> And her confusion that she liked - and wanted - the presents, but not the man, was painful. He used 'sparkly Sellotape' and cut things into nice shapes and she wistfully writes: I wish he'd be able to translate that care into his treatment of me.

The process which, if not checked, will abolish Man goes on apace among Communists and Democrats no less than among Fascists. The methods may (at first) differ in brutality. But many a mild-eyed scientist in pince-nez, many a popular dramatist, many an amateur philosopher in our midst, means in the long run just the same as the Nazi rulers of Germany. Traditional values are to be ‘debunked’ and mankind to be cut out into some fresh shape at the will (which must, by hypothesis, be an arbitrary will) of some few lucky people in one lucky generation which has learned how to do it. The belief that we can invent ‘ideologies’ at pleasure, and the consequent treatment of mankind as mere ulh, specimens, preparations, begins to affect our very language. Once we killed bad men: now we liquidate unsocial elements. Virtue has become integration and diligence dynamism, and boys likely to be worthy of a commission are ‘potential officer material’. Most wonderful of all, the virtues of thrift and temperance, and even of ordinary intelligence, are sales-resistance.

God! You hear me, God? Maybe I don't believe in you, but you damned well better believe in me! J. B. Books! See this gun? I kill with it! You kill, too, but I make a slicker job of it. I kill bad men, you kill good. I have reason, you don't. You are killing me hellish slow, and I do not deserve such treatment. You wrong me, and I will not be wronged. So let us have it out, God. Face me! Be a man and face me now if you have the guts - stand and draw or back off! God damn you, God, throw down on me and kill me now or let me live!

Emotions are not good, bad, right, or wrong. The first step to changing our relationship to feelings is to be curious about them and the messages they send to us.

You are a total bitch with no humor. Please go get treatment and ENJOY my latest novel!!!! You old crow!" [Response to a review of her book]

in 2008, shortly after being elected President, Barack Obama demonstrated to many academics and doctors that he had a clear understanding of the deep problems in health care, by committing to spend $1 billion on head-to-head trials of commonly used treatments, in order to find out which is best. In return he was derided by right-wing critics as ‘anti-industry’.

There is a further (non-distributional) consideration that can affect an assessment of a life’s quality. Arguably, once a life reaches a certain threshold of badness (considering both the amount and the distribution of its badness), no quantity of good can outweigh it, because no amount of good could be worth that badness. It is just this assessment that Donald (‘Dax’) Cowart made of his own life—or at least of that part of his life following a gas explosion that burnt two-thirds of his body. He refused extremely painful, life-saving treatment, but the doctors ignored his wishes and treated him nonetheless. His life was saved, he achieved considerable success, and he reattained a satisfactory quality of life. Yet, he continued to maintain that these post-burn goods were not worth the costs of enduring the treatments to which he was subjected. No matter how much good followed his recovery, this could not outweigh, at least in his own assessment, the bad of the burns and treatment that he experienced.

The punishment approach and bad consequences approach to treatment is the kind of thinking that is prevalent in every residential substance abuse treatment center in the United States of which I'm aware.

The default to studying men at times veered into absurdity: in the early sixties, observing that women tended to have lower rates of heart disease until their estrogen levels dropped after menopause, researchers conducted the first trial to look at whether supplementation with the hormone was an effective preventive treatment. The study enrolled 8,341 men and no women. (Although doctors began prescribing estrogens to postmenopausal women in droves - by the midseventies, a third would be taking them - it wasn't until 1991 that the first clinical study of hormone therapy was conducted in women.) An NIH-supported pilot study from Rockefeller University looked at how obesity affected breast and uterine cancer didn't enroll a single woman. While men can develop breast cancer - and a small number of them do each year - as Rep. Snowe noted drily at the congressional hearings, 'Somehow I find it hard to believe that the male-dominated medical community would tolerate a study of prostate cancer that used only women as research subjects.

a review of trials of acupuncture for back pain showed that the studies that were properly blinded showed a tiny benefit for acupuncture, which was not “statistically significant” (we’ll come back to what that means later). Meanwhile, the trials that were not blinded—the ones in which the patients knew whether they were in the treatment group or not—showed a massive, statistically significant benefit for acupuncture.

Aside from all this, for several of the most important and enduring problems in medicine, we have no idea what the best treatment is, because it’s not in anyone’s financial interest to conduct any trials at all.

The Christian approach begins with a different analysis of the situation. We believe that, as badly wounded as persons may be, the resulting self-absorption of the human heart was not caused by the mistreatment. It was only magnified and shaped by it. Their mistreatment poured gasoline on the fire, and the flame and smoke now choke them, but their self-centeredness already existed prior to their woundedness. Therefore, if you do nothing but urge people to “look out for number one,” you will be setting them up for future failure in any relationship, especially marriage. This is not to say that wounded people don’t need great gentleness, tender treatment, affirmation, and patience. It is just that this is not the whole story. Both people crippled by inferiority feelings and those who have superiority complexes are centered on themselves, obsessed with how they look and how they are being perceived and treated. It would be easy to help someone out of an inferiority complex into a superiority complex and leave them no better furnished to live life well.

That you do not have to like a person in order to learn from him/her/it. That loneliness is not a function of solitude. That it is possible to get so angry you really do see everything red. What a ‘Texas Catheter’ is. That some people really do steal—will steal things that are yours. That a lot of U.S. adults truly cannot read, not even a ROM hypertext phonics thing with HELP functions for every word. That cliquey alliance and exclusion and gossip can be forms of escape. That logical validity is not a guarantee of truth. That evil people never believe they are evil, but rather that everyone else is evil. That it is possible to learn valuable things from a stupid person. That it takes effort to pay attention to any one stimulus for more than a few seconds. That you can all of a sudden out of nowhere want to get high with your Substance so bad that you think you will surely die if you don’t, and but can just sit there with your hands writhing in your lap and face wet with craving, can want to get high but instead just sit there, wanting to but not, if that makes sense, and if you can gut it out and not hit the Substance during the craving the craving will eventually pass, it will go away — at least for a while. That it is statistically easier for low‐IQ people to kick an addiction than it is for high‐IQ people.

Here we will see that pharmaceutical companies spend tens of billions of pounds every year trying to change the treatment decisions of doctors: in fact, they spend twice as much on marketing and advertising as they do on the research and development of new drugs. Since we all want doctors to prescribe medicine based on evidence, and evidence is universal, there is only one possible reason for such huge spends: to distort evidence-based practice.

Medical journals from 1905 to 1915 are rife with articles on “vibratory massage” and the many things it cures. Weakened hearts and floating kidneys. Hysterical cramp of the esophagus and catarrh of the inner ear. Deafness, cancer, bad eyesight. And lots and lots of prostate problems. A Dr. Courtney W. Shropshire, writing in 1912, was impressed to note that by means of “a special prostatic applicator, well lubricated, attached to the vibrator, introduced to the rectum” he was “able to empty the seminal vesicles of their secretions.” Indeedy. Shropshire’s patients returned every other day for treatment, no doubt also developing a relationship with the vibration machine.

One cannot say that a major poet writes better poems than a minor; on the contrary the chances are that, in the course of his lifetime, the major poet will write more bad poems than the minor.... To qualify as major, a poet, it seems to me, must satisfy about three and a half of the following five conditions. 1. He must write a lot. 2. His poems must show a wide range in subject matter and treatment. 3. He must exhibit an unmistakable originality of vision and style. 4. He must be a master of verse technique. 5. In the case of all poets we distinguish between their juvenilia and their mature work, but [the major poet's] process of maturing continues until he dies....

Cognitive therapy’s revolutionary idea is that depression is not an emotional disorder. The bad feelings we have in depression all stem from negative thoughts, therefore treatment must be about challenging and changing those thoughts.

to really get a mass atrocity going you need idealism—the belief that your violence is a means to a moral end. The major atrocities of the twentieth century were carried out largely either by men who thought they were creating a utopia or else by men who believed they were defending their homeland or tribe from attack.30 Idealism easily becomes dangerous because it brings with it, almost inevitably, the belief that the ends justify the means. If you are fighting for good or for God, what matters is the outcome, not the path. People have little respect for rules; we respect the moral principles that underlie most rules. But when a moral mission and legal rules are incompatible, we usually care more about the mission. The psychologist Linda Skitka31 finds that when people have strong moral feelings about a controversial issue—when they have a “moral mandate”—they care much less about procedural fairness in court cases. They want the “good guys” freed by any means, and the “bad guys” convicted by any means. It is thus not surprising that the administration of George W. Bush consistently argues that extra-judicial killings, indefinite imprisonment without trial, and harsh physical treatment of prisoners are legal and proper steps in fighting the Manichaean “war on terror.

If you’re asking the schools to be the answer, you’re also asking a lot. If you take a kid from a bad background and expect the overburdened teachers to turn him around in seven hours a day, it might or might not happen. What about the other seventeen hours in a day? People often ask us if, through our research and experience, we can now predict which children are likely to become dangerous in later life. Roy Hazelwood’s answer is, “Sure. But so can any good elementary school teacher.” And if we can get them treatment early enough and intensively enough, it might make a difference. A significant role-model adult during the formative years can make a world of difference. Bill Tafoya, the special agent who served as our “futurist” at Quantico, advocated a minimum of a ten-year commitment of money and resources on the magnitude of what we sent into the Persian Gulf. He calls for a wide-scale reinstatement of Project Head Start, one of the most effective long-term, anticrime programs in history. He doesn’t think more police are the answer, but he would bring in “an army of social workers” to provide assistance for battered women, homeless families with children, to find good foster homes. And he would back it all up with tax incentive programs. I’m not sure this is the total answer, but it would certainly be an important start. Because the sad fact is, the shrinks can battle all they want, and my people and I can use psychology and behavioral science to help catch the criminals, but by the time we get to use our stuff, the severe damage has already been done.

When I was fifteen I got sick. No cure, only treatment. When I was sixteen I was assaulted. I used to joke that at least I got the bad stuff out of the way early, as if there was a cap on how much pain a person could endure over the course of their life. - Obviously, I had never been in love

The public like to insult poets because they are individual, but once they have insulted them, they leave them alone. In the case of the novel and the drama, arts in which the public do take an interest, the result of the exercise of popular authority has been absolutely ridiculous. No country produces such badly-written fiction, such tedious, common work in the novel form, such silly, vulgar plays as England. It must necessarily be so. The popular standard is of such a character that no artist can get to it. It is at once too easy and too difficult to be a popular novelist. It is too easy, because the requirements of the public as far as plot, style, psychology, treatment of life, and treatment of literature are concerned are within the reach of the very meanest capacity and the most uncultivated mind. It is too difficult, because to meet such requirements the artist would have to do violence to his temperament, would have to write not for the artistic joy of writing, but for the amusement of half-educated people, and so would have to suppress his individualism, forget his culture, annihilate his style, and surrender everything that is valuable in him.

Were she your equal in situation—but, Emma, consider how far this is from being the case. She is poor; she has sunk from the comforts she was born to; and, if she live to old age, must probably sink more. Her situation should secure your compassion. It was badly done, indeed!—You, whom she had known from an infant, whom she had seen grow up from a period when her notice was an honour, to have you now, in thoughtless spirits, and the pride of the moment, laugh at her, humble her—and before her niece, too—and before others, many of whom (certainly some,) would be entirely guided by your treatment of her.

The list of correlations to that night is as long as the Jersey coast. And so is the list of reasons I shouldn't be looking forward to seeing him at school. But I can't help it. He's already texted me three times this morning: Can I pick you up for school? and Do u want 2 have breakfast? and R u getting my texts? My thumbs want to answer "yes" to all of the above, but my dignity demands that I don't answer at all. He called my his student. He stood there alone with me on the beach and told me he thinks of me as a pupil. That our relationship is platonic. And everyone knows what platonic means-rejected. Well, I might be his student, but I'm about to school, him on a few things. The first lesson of the day is Silent Treatment 101. So when I see him in the hall, I give him a polite nod and brush right by him. The zap from the slight contact never quite fades, which mean he's following me. I make it to my locker before his hand is on my arm. "Emma." The way he whispers my name sends goose bumps all the way to my baby toes. But I'm still in control. I nod to him, dial the combination to my locker, then open it in his face. He moves back before contact. Stepping around me, he leans his hand against the locker door and turns me around to face him. "That's not very nice." I raise my best you-started-this brow. He sighs. "I guess that means you didn't miss me." There are so many things I could pop off right now. Things like, "But at least I had Toraf to keep my company" or "You were gone?" Or "Don't feel bad, I didn't miss my calculus teacher either." But the goal is to say nothing. So I turn around. I transfer books and papers between my locker and backpack. As I stab a pencil into my updo, his breath pushes against my earlobe when he chuckles. "So your phone's not broken; you just didn't respond to my texts." Since rolling my eyes doesn't make a sound, it's still within the boundaries of Silent Treatment 101. So I do this while I shut my locker. As I push past him, he grabs my arm. And I figure if stomping on his toe doesn't make a sound... "My grandmother's dying," he blurts. Commence with the catching-Emma-off-guard crap. How can I continue Silent Treatment 101 after that? He never mentioned his grandmother before, but then again, I never mentioned mine either. "I'm sorry, Galen." I put my hand on his, give it a gentle squeeze. He laughs. Complete jackass. "Conveniently, she lives in a condo in Destin and her dying request is to meet you. Rachel called your mom. We're flying out Saturday afternoon, coming back Sunday night. I already called Dr. Milligan." "Un-freaking-believable.

here had been times when I’d wandered around in a daze for as long as two weeks after a shock treatment, living in that foggy, jumbled blur which is a whole lot like the ragged edge of sleep, that gray zone between light and dark, or between sleeping and waking or living and dying, where you know you’re not unconscious any more but don’t know yet what day it is or who you are or what’s the use of coming back at all—for two weeks. If you don’t have a reason to wake up you can loaf around in that gray zone for a long, fuzzy time, or if you want to bad enough I found you can come fighting right out of it. This time I came fighting out of it in less than a day, less time than ever.

While the Scripture encourages us to give up our liberties for the good of each other, the goal is not conformity. We sacrifice for each other because we are in relationship with each other, not in order to stay in relationship with each other. This nuance is essential because it helps us discern the difference between healthy and unhealthy communities. Because as much as healthy communities can lead us to wisdom and goodness, unhealthy communities can actually hinder our developing discernment. Another point that Jacobs makes in How to Think is how often we conform to community expectations and toe the party line, not because we are convinced it’s right or good, but because speaking out against it would jeopardize our membership in the group. Sometimes this may mean accepting bad treatment for ourselves, as in abusive relationships, or enabling the abuse of others, all in order to stay in the group. Jacobs says that we can tell the difference between an unhealthy community and a healthy one by its attitude toward discernment. An unhealthy community “discourages, mocks, and ruthlessly excludes those who ask uncomfortable questions. … The genuine community is open to thinking and questioning, so long as those thoughts and questions come from people of goodwill.”9 In fact, the dissenting voice is so important to finding goodness that God has equipped certain people with a particular gift for discernment.

Any substantive conversation about treatment in this country must reckon with the toll levied when a culture encourages one approach to the exclusion of all others, especially when that culture limits the treatment options for suffering people, ignores advances in understanding addiction, and excludes and even shames the great majority of people who fail in the sanctioned approach.

Dr Stewart Wolf took the placebo effect to the limit. He took two women who were suffering with nausea and vomiting, one of them pregnant, and told them he had a treatment which would improve their symptoms. In fact he passed a tube down into their stomachs (so that they wouldn’t taste the revolting bitterness) and administered ipecac, a drug that which should actually induce nausea and vomiting. Not only did the patients’ symptoms improve, but their gastric contractions—which ipecac should worsen—were reduced. His results suggest—albeit it in a very small sample—that a drug could be made to have the opposite effect to what you would predict from the pharmacology, simply by manipulating people’s expectations. In this case, the placebo effect outgunned even the pharmacological influences. More

It didn’t occur to him to think that better is not the same as well. Was he fooling himself? He would not have said so. Even at twenty-two, when his diagnosis was confirmed, he was realistic. Most suffer. Everyone dies. He knew how, if not when. Now more than ever, he was determined to cheat the Fates of entertainment, but naturally, his time would come. When it did, he believed he would accept death as Socrates had: with cool philosophical distance. He would say something funny, or profound, or loving. Then he would let life fall gracefully from his hands. Horseshit, as James Earp would say, of the highest order. The truth is this. On the morning of August 14, 1878, Doc Holliday believed in his own death exactly as you do—today, at this very moment. He knew that he was mortal, just as you do. Of course, you know you’ll die someday, but … not quite the same way you know that the sun will rise tomorrow or that dropped objects fall. The great bitch-goddess Hope sees to that. Sit in a physician’s office. Listen to a diagnosis as bad as Doc’s. Beyond the first few words, you won’t hear a thing. The voice of Hope is soft but impossible to ignore. This isn’t happening, she assures you. There’s been a mix-up with the tests. Hope swears, You’re different. You matter. She whispers, Miracles happen. She says, often quite reasonably, New treatments are being developed all the time! She promises, You’ll beat the odds. A hundred to one? A thousand to one? A million to one? Eight to five, Hope lies. Odds are, when your time comes, you won’t even ask, “For or against?” You’ll swing up on that horse, and ride.

There were always such dwellings--the abode of the cook or the man who tended the yard, or the woman who did the washing and ironing; so normal and unexceptionable as to attract no attention, the places where lives were led in the shadow of the employer in the larger house. And the cause, Mma Ramotswe knew from long experience, of deep resentments and, on occasion, murderous hatreds. Those flowed from exploitation and bad treatment--the things that people would do to one another with utter predictability and inevitability unless those in authority made it impossible and laid down conditions of employment. She had seen shocking things in the course of her work, even here in Botswana, a good country where things were well run and people had rights; human nature, of course, would find its way round the best of rules and regulations.

The man had received a chemical treatment, the article explained, to lighten his complexion. He had paid for it with his own money. He expressed some regret about trying to pass himself off as a white man, was sorry about how badly things had turned out. But the results were irreversible. There were thousands of people like him, black men and women back in America who’d undergone the same treatment in response to advertisements that promised happiness as a white person. I

KFC insists it is “committed to the well-being and humane treatment of chickens.” How trustworthy are these words? At a slaughterhouse in West Virginia that supplies KFC, workers were documented tearing the heads off live birds, spitting tobacco into their eyes, spray-painting their faces, and violently stomping on them. These acts were witnessed dozens of times. This slaughterhouse was not a “bad apple,” but a “Supplier of the Year.” Imagine what happens at the bad apples when no one is looking. On

He shut the door, and stood looking across the room at her. 'Cressy, what did you mean when you told that harridan that your affections were engaged?' The colour deepened a little in her cheeks, but she replied lightly: 'Well, she talked so much like someone in a bad play that I became carried away myself! Besides, I had to say something to convince her! I could see she didn't quite believe me when I said I wasn't going to marry your brother.' He let his breath go in a long sigh, and walked forward, setting his hands on her shoulders, and saying: 'You don't know how much I have wanted to tell you the truth! Cressy, my dear one, forgive me! I've treated you abominably, and I love you so much!' Miss Stavely, who had developed an interest in the top button of his coat, looked shyly up at this. 'Do you, Kit?' she asked. 'Truly?' Mr Fancot, preferring actions to words, said nothing whatsoever in answer to this, but took her in his arms and kissed her. Miss Stavely, who had previously thought him unfailingly gentle and courteous, perceived, in the light of this novel experience, that she had been mistaken: there was nothing gentle about Mr Fancot's crushing embrace; and his behaviour in paying no heed at all to her faint protest could only be described as extremely uncivil. She was wholly unused to such treatment, and she had a strong suspicion that her grandmother would condemn her conduct in submitting to it, but as Mr Fancot seemed to be dead to all sense and propriety it was clearly useless to argue with him.

The most notorious story is the Trovan antibiotic study conducted by Pfizer in Kano, Nigeria, during a meningitis epidemic. An experimental new antibiotic was compared, in a randomised trial, with a low dose of a competing antibiotic that was known to be effective. Eleven children died, roughly the same number from each group. Crucially, the participants were apparently not informed about the experimental nature of the treatments, and moreover, they were not informed that a treatment known to be effective was available, immediately, from Médecins sans Frontières next door at the very same facility. Pfizer argued in court – successfully – that there was no international norm requiring it to get informed consent for a trial involving experimental drugs in Africa, so the cases relating to the trial should be heard in Nigeria only. That’s a chilling thing to hear a company claim about experimental drug trials, and it was knocked back in 2006 when the Nigerian Ministry of Health released its report on the trial. This stated that Pfizer had violated Nigerian law, the UN Convention on the Rights of the Child and the Declaration of Helsinki.

In fact, some might argue that starting C-PTSD treatment by diving into the back of your closet and chasing out your scariest, most deeply buried skeleton is a terrible idea. You could find a murderous clown in the storm drain of your life, and he could start haunting your everyday existence. You could dig up something that triggers you badly and makes your symptoms worse or is so unpleasant to look at that you just quit therapy and never come back. That’s why many trauma therapists try to set up a strong framework of coping mechanisms before people launch into their foundational traumas.

Long before there were effective treatments, physicians dispensed prognoses, hope, and, above all, meaning. When something terrible happens-and serious disease is always terrible-people want to know why. In a pantheistic world, the explanation was simple-one god had caused the problem, another could cure it. In the time since people have been trying to get along with only one God, explaining disease and evil has become more difficult. Generations of theologians have wrestled with the problem of theodicy-how can a good God allow such bad things to happen to good people? Darwinian medicine can't offer a substitute for such explanations. It can't provide a universe in which events are part of a divine plan, much less one in which individual illness reflects individual sins. It can only show us why we are the way we are, why we are vulnerable to certain diseases. A Darwinian view of medicine simultaneously makes disease less and more meaningful. Diseases do not result from random or malevolent forces, they arise ultimately from past natural selection. Paradoxically, the same capacities that make us vulnerable to disease often confer benefits. The capacity for suffering is a useful defense. Autoimmune disease is a price of our remarkable ability to attack invaders. Cancer is the price of tissues that can repair themselves. Menopause may protect the interests of our genes in existing children. Even senescence and death are not random, but compromises struck by natural selection as it inexorably shaped out bodies to maximize the transmission of our genes. In such paradoxical benefits, some may find a gentle satisfaction, even a bit of meaning-at least the sort of meaning Dobzhansky recognized. After all, nothing in medicine makes sense except in the light of evolution.

So should patients born under Libra and Gemini be deprived of treatment? You would say no, of course, and that would make you wiser than many in the medical profession: the CCSG trial found that aspirin was effective at preventing stroke and death in men, but not in women;30 as a result, women were undertreated for a decade, until further trials and overviews showed a benefit. That is just one of many subgroup analyses that have misled us in medicine, often incorrectly identifying subgroups of people who wouldn’t benefit from a treatment that was usually effective. So, for example, we thought the hormone-blocking drug tamoxifen was no good for treating breast cancer in women if they were younger than fifty (we were wrong). We thought clotbusting drugs were ineffective, or even harmful, when treating heart attacks in people who’d already had a heart attack (we were wrong). We thought drugs called ‘ACE inhibitors’ stopped reducing the death rate in heart failure patients if they were also on aspirin (we were wrong). Unusually, none of these findings was driven by financial avarice: they were driven by ambition, perhaps; excitement at new findings, certainly; ignorance of the risks of subgroup analysis; and, of course, chance.

War means endless waiting, endless boredom. There is no electricity, so no television. You can't read. You can't see friends. You grow depressed but there is no treatment for it and it makes no sense to complain — everyone is as badly off as you. It's hard to fall in love, or rather, hard to stay in love. If you are a teenager, you seem halted in time. If you are critically ill — with cancer, for instance — there is no chemotherapy for you. If you can't leave the country for treatment, you stay and die slowly, and in tremendous pain. Victorian diseases return — polio, typhoid and cholera. You see very sick people around you who seemed in perfectly good health when you last saw them during peacetime. You hear coughing all the time. Everyone hacks — from the dust of destroyed buildings, from disease, from cold. As for your old world, it disappears, like the smoke from a cigarette you can no longer afford to buy. Where are your closest friends? Some have left, others are dead. The few who remain have nothing new to talk about. You can't get to their houses, because the road is blocked by checkpoints. Or snipers take a shot when you leave your door, so you scurry back inside, like a crab retreating inside its shell. Or you might go out on the wrong day and a barrel bomb, dropped by a government helicopter, lands near you. Wartime looks like this.

Feelings of rage and murderous revenge fantasies are normal responses to abusive treatment. Like abused adults, abused children are often rageful and sometimes aggressive. They often lack verbal and social skills for resolving conflict, and they approach problems with the expectation of hostile attack. The abused child’s predictable difficulties in modulating anger further strengthen her conviction of inner badness. Each hostile encounter convinces her that she is indeed a hateful person. If, as is common, she tends to displace her anger far from its dangerous source and to discharge it unfairly on those who did not provoke it, her self-condemnation is aggravated still further.

So why are we unable to acknowledge the truth? Dr. Fung’s answer is simple: we doctors lie to ourselves. If type 2 diabetes is a curable disease but all our patients are getting worse on the treatments we prescribe, then we must be bad doctors. And since we did not study for so long at such great cost to become bad doctors, this failure cannot be our fault. Instead, we must believe we are doing the best for our patients, who must unfortunately be suffering from a chronically progressive and incurable disease. It is not a deliberate lie, Dr. Fung concludes, but one of cognitive dissonance—the inability to accept a blatant truth because accepting it would be too emotionally devastating.

Initially, we thought that all memories might be susceptible to disruption by reconsolidation blockage. But Nader, who is now a professor at McGill University, found that strongly conditioned memories (those conditioned with an especially intense US) were protected from reconsolidation blockade.135 This was bad news for those who had hoped that reconsolidation blockade could be used as a treatment for PTSD, because this disorder usually results from very strong memories having been created in response to horrific situations. But Diaz-Mataix and Doyère found that strong memories can indeed undergo reconsolidation if new information is incorporated into that memory—in other words, if the memory is updated.

For us, the possibility of kindly use is weighted with problems. In the first place, this is not ultimately an organization or institutional solution. Institutional solutions tend to narrow and simplify as they approach action. A large number of people can act together only by defining the point or the line on which their various interests converge. Organizations tend to move toward single objectives -- a ruling, a vote, a law -- and they find it relatively simple to cohere under acronyms and slogans. But kindly use is a concept that of necessity broadens, becoming more complex and diverse, as it approaches action. The land is too various in its kinds, climates, conditions, declivities, aspects, and histories to conform to any generalized understanding or to prosper under generalized treatment. The use of land cannot be both general and kindly -- just as the forms of good manners, generally applied (applied, that is, without consideration of differences), are experienced as indifference, bad manners. To treat every field, or every part of every field, with the same consideration is not farming but industry. Kindly use depends upon intimate knowledge, the most sensitive responsiveness and responsibility. As knowledge (hence, use) is generalized, essential values are destroyed. As the householder evolves into a consumer, the farm evolves into a factory -- with results that are potentially calamitous for both.

First up, Blackwell [1972] did a set of experiments on fifty-seven college students to determine the effect of colour—as well as the number of tablets—on the effects elicited. The subjects were sitting through a boring hour-long lecture, and were given either one or two pills, which were either pink or blue. They were told that they could expect to receive either a stimulant or a sedative. Since these were psychologists, and this was back when you could do whatever you wanted to your subjects—even lie to them—the treatment that all the students received consisted simply of sugar pills, but of different colours. Afterwards, when they measured alertness—as well as any subjective effects—the researchers found that two pills were more effective than one, as we might have expected (and two pills were better at eliciting side-effects too). They also found that colour had an effect on outcome: the pink sugar tablets were better at maintaining concentration than the blue ones. Since colours in themselves have no intrinsic pharmacological properties, the difference in effect could only be due to the cultural meanings of pink and blue: pink is alerting, blue is cool. Another study suggested that Oxazepam, a drug similar to Valium (which was once unsuccessfully prescribed by our GP for me as a hyperactive child) was more effective at treating anxiety in a green tablet, and more effective for depression when yellow. Drug

The evaluation of the merits of medical treatments for madness has always been a calculation made by doctors and, to a certain extent, by society as a whole. Does the treatment provide a method for managing disturbed people? That is the usual bottom line. The patient’s subjective response to the treatment—does it help the patient feel better or think more clearly?—simply doesn’t count in that evaluation. The “mad,” in fact, are dismissed as unreliable witnesses. How can a person crazy in mind possibly appreciate whether a treatment—be it Rush’s gyrator, a wet pack, gastrointestinal surgery, metrazol convulsive therapy, electroshock, or a neuroleptic—has helped? Yet to the person so treated, the subjective experience is everything.

If you had asked Dan during that period whether he still loved his wife, he would have looked at you in total confusion and said, “Of course!” Although his wife was at that very moment wallowing in despair over his treatment of her, he perceived things to be fine between them. This isn’t because he is dense; it’s just that after a lifetime of having people mad at or disappointed with him, Dan weathers periods of anger and criticism by mostly ignoring them. And, because people with ADHD don’t receive and process information in a hierarchical way, Maria’s suffering enters his mind at about the same level as everything else he perceives—the lights on the radio clock, the dog barking, the computer, the worrisome project he has at work. “But wait!” you say. “It doesn’t matter—she’s still alone!” You would be right. Regardless of whether Dan was intentionally ignoring his wife or just distracted, actions speak louder than words. She becomes lonely and unhappy, and her needs must be addressed. But recognizing and then identifying the correct underlying problem is critical to finding the right solution. In marriage, just like in middle school math, if you pick the wrong problem to solve, you generally don’t end up with a satisfactory result. Furthermore, the hurt caused by the incorrect interpretation that he no longer loves her elicits a series of bad feelings and behaviors that compound the problem. This is the critical dynamic of symptom–response–response at work.

Some have estimated that the pharmaceutical industry overall spends about twice as much on marketing and promotion as it does on research and development. Regardless of how those two figures compare to each other, the fact that they are in the same ballpark gives one pause, and this is worth mulling over in various contexts. For example, when a drug company refuses to let a developing country have affordable access to a new AIDS drug it’s because – the company says – it needs the money from sales to fund research and development on other new AIDS drugs for the future. If R&D is a fraction of the company’s outgoings, and it spends a similar amount on promotion, then this moral and practical argument doesn’t hold water quite so well. The scale of this spend is fascinating in itself, when you put it in the context of what we all expect from evidence-based medicine, which is that people will simply use the best treatment for the patient. Because when you pull away from the industry’s carefully fostered belief that this marketing activity is all completely normal, and stop thinking of drugs as being a consumer product like clothes or cosmetics, you suddenly realise that medicines marketing only exists for one reason. In medicine, brand identities are irrelevant, and there’s a factual, objective answer to whether one drug is the most likely to improve a patient’s pain, suffering and longevity. Marketing, therefore, one might argue, exists for no reason other than to pervert evidence-based decision-making in medicine.

To call for close reading, in fact, is to do more than insist on due attentiveness to the text. It inescapably suggests an attention to this rather than to something else: to the ‘words on the page’ rather than to the contexts which produced and surround them. It implies a limiting as well as a focusing of concern - a limiting badly needed by literary talk which would ramble comfortably from the texture of Tennyson’s language to the length of his beard. But in dispelling such anecdotal irrelevancies, ‘close reading’ also held at bay a good deal else: it encouraged the illusion that any piece of language, ‘literary’ or not, can be adequately studied or even understood in isolation. It was the beginnings of a ‘reification’ of the literary work, the treatment of it as an object in itself, which was to be triumphantly consummated in the American New Criticism.

A 2016 study published in Proceedings of the National Academy of Sciences of the United States of America suggested that health care providers may underestimate black patients' pain in part due to a belief that they simply don't actually feel as much pain - a myth that dates all the way back to the days of slavery. For centuries, the claim that black people were biologically different from whites was 'championed by scientists, physicians, and slave owners alike to justify slavery and the inhumane treatment of black men and women in medical research,' the authors wrote. Black people were thought to have 'thicker skulls, less sensitive nervous systems,' and a super-human ability to 'tolerate surgical operations with little, if any, pain at all.' In the first phase of the study, over two hundred white medical students and residents were asked whether a series of statements about differences between black and white patients were true or false. Some of the statements were true, while others - for example, 'blacks' skin is thicker than whites' and 'blacks' nerve endings are less sensitive than whites' - were false. They found that a full half of the respondents thought that one or more the false statements - many of which were 'fantastical in nature' - were possibly, probably, or definitely true. Also, notably, many of them didn't agree with the statements that were actually true; only half of the residents knew that white patients are less likely to have heart disease than black patients are. When asked to read case studies of two patients complaining of pain, one white and one black, the respondents who had endorsed more false beliefs were more likely to believe that the black patient felt less pain, and undertreated them accordingly.

1:THE “CRISIS”: Although Chief Judge Bazelon said in 1960 that “we desperately need all the help we can get from modern behavioral scientists”69 in dealing with the criminal law, the cold facts suggest no such desperation or crisis. Since the most reliable long-term crime data are on murder, what was the murder rate at that point? The number of murders committed in the United States in 1960 was less than in 1950, 1940, or 1930—even though the population was growing over those decades and murders in the two new states of Hawaii and Alaska were counted in the national statistics for the first time in 1960.70 The murder rate, in proportion to population, was in 1960 just under half of what it had been in 1934.71 As Judge Bazelon saw the criminal justice system in 1960, the problem was not with “the so-called criminal population”72 but with society, whose “need to punish” was a “primitive urge” that was “highly irrational”73—indeed, a “deep childish fear that with any reduction of punishment, multitudes would run amuck.”74 It was this “vindictiveness,” this “irrationality” of “notions and practices regarding punishment”75 that had to be corrected. The criminal “is like us, only somewhat weaker,” according to Judge Bazelon, and “needs help if he is going to bring out the good in himself and restrain the bad.”76 Society is indeed guilty of “creating this special class of human beings,” by its “social failure” for which “the criminal serves as a scapegoat.”77 Punishment is itself a “dehumanizing process” and a “social branding” which only promotes more crime.78 Since criminals “have a special problem and need special help,” Judge Bazelon argued for “psychiatric treatment” with “new, more sophisticated techniques” and asked: Would it really be the end of the world if all jails were turned into hospitals or rehabilitation centers?79

Angina is the pain you get when there’s not enough oxygen getting to your heart muscle for the work it’s doing. That’s why it gets worse with exercise: because you’re demanding more work from the heart muscle. You might get a similar pain in your thighs after bounding up ten flights of stairs, depending on how fit you are. Treatments that help angina usually work by dilating the blood vessels to the heart, and a group of chemicals called nitrates are used for this purpose very frequently. They relax the smooth muscle in the body, which dilates the arteries so more blood can get through (they also relax other bits of smooth muscle in the body, including your anal sphincter, which is why a variant is sold as ‘liquid gold’ in sex shops). In the 1950s there was an idea that you could get blood vessels in the heart to grow back, and thicker, if you tied off an artery on the front of the chest wall that wasn’t very important, but which branched off the main heart arteries. The idea was that this would send messages back to the main branch of the artery, telling it that more artery growth was needed, so the body would be tricked. Unfortunately this idea turned out to be nonsense, but only after a fashion. In 1959 a placebo-controlled trial of the operation was performed: in some operations they did the whole thing properly, but in the ‘placebo’ operations they went through the motions but didn’t tie off any arteries. It was found that the placebo operation was just as good as the real one—people seemed to get a bit better in both cases, and there was little difference between the groups—but the most strange thing about the whole affair was that nobody made a fuss at the time: the real operation wasn’t any better than a sham operation, sure, but how could we explain the fact that people had been sensing an improvement from the operation for a very long time? Nobody thought of the power of placebo. The operation was simply binned. That’s

It is unlikely that those who provide housing, food, medicine or a host of other goods and services, can continue to provide us with the same quantity and quality of these when the costs involved in providing that quantity and quality of goods and services cannot be recovered. . This may not be immediately obvious, a reason why price controls are popular, but the consequences are long-lasting and usually get even worse over time. Homes do not disappear immediately when there is rent control, but they deteriorate over time without being replaced by newer and more suitable ones. Currently available medicines do not disappear when price controls are implemented, but new medicines for the treatment of cancer, AIDS, Alzheimer's and others will probably not continue to be developed at the same speed, when the money to pay for their development is no longer there. Present. But everything takes time to be noticed and the memory of most people may be very short-term and they cannot connect the bad consequences they suffer with the popular policies they supported a few years ago.

The “remarkable sodium and water retaining effect of concentrated carbohydrate food,” as the University of Wisconsin endocrinologist Edward Gordon called it, was then explained physiologically in the mid-1960s by Walter Bloom, who was studying fasting as an obesity treatment at Atlanta’s Piedmont Hospital, where he was director of research. As Bloom reported in the Archives of Internal Medicine and The American Journal of Clinical Nutrition, the water lost on carbohydrate-restricted diets is caused by a reversal of the sodium retention that takes place routinely when we eat carbohydrates. Eating carbohydrates prompts the kidneys to hold on to salt, rather than excrete it. The body then retains extra water to keep the sodium concentration of the blood constant. So, rather than having water retention caused by taking in more sodium, which is what theoretically happens when we eat more salt, carbohydrates cause us to retain water by inhibiting the excretion of the sodium that is already there. Removing carbohydrates from the diet works, in effect, just like the antihypertensive drugs known as diuretics, which cause the kidneys to excrete sodium, and water along with it. This

IN THE PAST, when dying was typically a more precipitous process, we did not have to think about a question like this. Though some diseases and conditions had a drawn-out natural history—tuberculosis is the classic example—without the intervention of modern medicine, with its scans to diagnose problems early and its treatments to extend life, the interval between recognizing that you had a life-threatening ailment and dying was commonly a matter of days or weeks. Consider how our presidents died before the modern era. George Washington developed a throat infection at home on December 13, 1799, that killed him by the next evening. John Quincy Adams, Millard Fillmore, and Andrew Johnson all succumbed to strokes and died within two days. Rutherford Hayes had a heart attack and died three days later. Others did have a longer course: James Monroe and Andrew Jackson died from progressive and far longer-lasting (and highly dreaded) tubercular consumption. Ulysses Grant’s oral cancer took a year to kill him. But, as end-of-life researcher Joanne Lynn has observed, people generally experienced life-threatening illness the way they experienced bad weather—as something that struck with little warning. And you either got through it or you didn’t.

Ask the right questions. Julianne and I were recently at our first rehearsal for a new dance tour we’re putting together. The first part of the morning went great--we were having a blast, and we hadn’t danced together in years so it felt amazing to be working off each other. We were excited, just ripping through stuff. We sat down for lunch and I had an idea for a lift. We decided to try it. Jules was in sneakers, and I flipped her around and her foot stuck. I heard a pop and saw her face. Pain rippled across it. We both knew it was bad but resisted the urge to panic. Her first question was, “How can we get this fixed fast?” Not “Why me?” or “Why did this have to happen today?” There was no self-pity or “Woe is me.” The right questions put you in a positive place to deal and heal. Pain happens, but suffering is a choice. After Julianne asked me that, we got on the phone with our list of people who had great doctors and made the calls. She had X-rays and MRIs, and she’s now in a boot to treat a torn tendon. But it’s getting better every day thanks to laser and ultrasound treatments. Here’s the thing: powerful people never throw pity parties for themselves. You will never hear my little sister moaning, “Why me?” when something goes wrong.

They stood around a bleeding stump of a man lying on the ground. His right arm and left leg had been chopped off. It was inconceivable how, with his remaining arm and leg, he had crawled to the camp. The chopped-off arm and leg were tied in terrible bleeding chunks onto his back with a small wooden board attached to them; a long inscription on it said, with many words of abuse, that the atrocity was in reprisal for similar atrocities perpetrated by such and such a Red unit—a unit that had no connection with the Forest Brotherhood. It also said that the same treatment would be meted out to all the partisans unless, by a given date, they submitted and gave up their arms to the representatives of General Vitsyn’s army corps. Fainting repeatedly from loss of blood, the dying man told them in a faltering voice of the tortures and atrocities perpetrated by Vitsyn’s investigating and punitive squads. His own sentence of death had been allegedly commuted; instead of hanging him, they had cut off his arm and leg in order to send him into the camp and strike terror among the partisans. They had carried him as far as the outposts of the camp, where they had put him down and ordered him to crawl, urging him on by shooting into the air. He could barely move his lips. To make out his almost unintelligible stammering, the crowd around him bent low. He was saying: “Be on your guard, comrades. He has broken through.” “Patrols have gone out in strength. There’s a big battle going on. We’ll hold him.” “There’s a gap. He wants to surprise you. I know. ... I can’t go on, men. I am spitting blood. I’ll die in a moment.” “Rest a bit. Keep quiet.—Can’t you see it’s bad for him, you heartless beasts!” The man started again: “He went to work on me, the devil. He said: You will bathe in your own blood until you tell me who you are. And how was I to tell him, a deserter is just what I am? I was running from him to you.” “You keep saying ‘he.’ Who was it that got to work on you?” “Let me just get my breath. ... I’ll tell you. Hetman, Bekeshin. Colonel, Strese. Vitsyn’s men. You don’t know out here what it’s like. The whole town is groaning. They boil people alive. They cut strips out of them. They take you by the scruff of the neck and push you inside, you don’t know where you are, it’s pitch black. You grope about—you are in a cage, inside a freight car. There are more than forty people in the cage, all in their underclothes. From time to time they open the door and grab whoever comes first—out he goes. As you grab a chicken to cut its throat. I swear to God. Some they hang, some they shoot, some they question. They beat you to shreds, they put salt on the wounds, they pour boiling water on you. When you vomit or relieve yourself they make you eat it. As for children and women—O God!” The unfortunate was at his last gasp. He cried out and died without finishing the sentence. Somehow they all knew it at once and took off their caps and crossed themselves. That night, the news of a far more terrible incident flew around the camp. Pamphil had been in the crowd surrounding the dying man. He had seen him, heard his words, and read the threatening inscription on the board. His constant fear for his family in the event of his own death rose to a new climax. In his imagination he saw them handed over to slow torture, watched their faces distorted by pain, and heard their groans and cries for help. In his desperate anguish—to forestall their future sufferings and to end his own—he killed them himself, felling his wife and three children with that same, razor-sharp ax that he had used to carve toys for the two small girls and the boy, who had been his favorite. The astonishing thing was that he did not kill himself immediately afterward.

It would be a mistake to imagine that drug companies are the only people applying pressure for fast approvals. Patients can also feel they are being deprived of access to drugs, especially if they are desperate. In fact, in the 1980s and 1990s the key public drive for faster approvals came from an alliance forged between drug companies and AIDS activists such as ACT UP. At the time, HIV and AIDS had suddenly appeared out of nowhere, and young, previously healthy gay men were falling ill and dying in terrifying numbers, with no treatment available. We don’t care, they explained, if the drugs that are currently being researched for effectiveness might kill us: we want them, because we’re dying anyway. Losing a couple of months of life because a currently unapproved drug turned out to be dangerous was nothing, compared to a shot at a normal lifespan. In an extreme form, the HIV-positive community was exemplifying the very best motivations that drive people to participate in clinical trials: they were prepared to take a risk, in the hope of finding better treatments for themselves or others like them in the future. To achieve this goal they blocked traffic on Wall Street, marched on the FDA headquarters in Rockville, Maryland, and campaigned tirelessly for faster approvals.

Military analysis is not an exact science. To return to the wisdom of Sun Tzu, and paraphrase the great Chinese political philosopher, it is at least as close to art. But many logical methods offer insight into military problems-even if solutions to those problems ultimately require the use of judgement and of broader political and strategic considerations as well. Military affairs may not be as amenable to quantification and formal methodological treatment as economics, for example. However, even if our main goal in analysis is generally to illuminate choices, bound problems, and rule out bad options - rather than arrive unambiguously at clear policy choices-the discipline of military analysis has a great deal to offer. Moreover, simple back-of-the envelope methodologies often provide substantial insight without requiring the churning of giant computer models or access to the classified data of official Pentagon studies, allowing generalities and outsiders to play important roles in defense analytical debates. We have seen all too often (in the broad course of history as well as in modern times) what happens when we make key defense policy decisions based solely on instinct, ideology, and impression. To avoid cavalier, careless, and agenda-driven decision-making, we therefore need to study the science of war as well-even as we also remember the cautions of Clausewitz and avoid hubris in our predictions about how any war or other major military endeavor will ultimately unfold.

To Greg, who had suffered from bouts of depression throughout his life, this seemed like a terrible approach. In seeking treatment for his depression, he—along with millions of others around the world—had found that cognitive behavioral therapy (CBT) was the most effective solution. CBT teaches you to notice when you are engaging in various “cognitive distortions,” such as “catastrophizing” (If I fail this quiz, I’ll fail the class and be kicked out of school, and then I’ll never get a job . . .) and “negative filtering” (only paying attention to negative feedback instead of noticing praise as well). These distorted and irrational thought patterns are hallmarks of depression and anxiety disorders. We are not saying that students are never in real physical danger, or that their claims about injustice are usually cognitive distortions. We are saying that even when students are reacting to real problems, they are more likely than previous generations to engage in thought patterns that make those problems seem more threatening, which makes them harder to solve. An important discovery by early CBT researchers was that if people learn to stop thinking this way, their depression and anxiety usually subside. For this reason, Greg was troubled when he noticed that some students’ reactions to speech on college campuses exhibited exactly the same distortions that he had learned to rebut in his own therapy. Where had students learned these bad mental habits? Wouldn’t these cognitive distortions make students more anxious and depressed?

Mindy runs to the DVD player and delicately places the disk in the holder and presses play. “Will you sit in this chair, please, Princess Mindy?” I ask, bowing deeply at the waist. Mindy giggles as she replies, ”I guess so.” After Mindy sits down, I take a wide-tooth comb and start gently combing out her tangles. Mindy starts vibrating with excitement as she blurts, “Mr. Jeff, you’re gonna fix my hair fancy, ain’t you?” “We’ll see if a certain Princess can hold still long enough for me to finish,” I tease. Immediately, Mindy becomes as still as a stone statue. After a couple of minutes, I have to say, “Mindy, sweetheart, it’s okay to breathe. I just can’t have you bouncing, because I’m afraid it will cause me to pull your hair.” Mindy slumps down in her chair just slightly. “Okay Mr. Jeff, I was ascared you was gonna stop,” she whispers, her chin quivering. I adopt a very fake, very over-the-top French accent and say, “Oh no, Monsieur Jeff must complete Princess Mindy’s look to make the Kingdom happy. Mindy erupts with the first belly laugh I’ve heard all day as she responds, “Okay, I’ll try to be still, but it’s hard ‘cause I have the wiggles real bad.” I pat her on the shoulder and chuckle as I say, “Just try your best, sweetheart. That’s all anyone can ask.” Kiera comes screeching around the corner in a blur, plunks her purse on the table, and says breathlessly, “Geez-O-Pete, I can’t believe I’m late for the makeover. I love makeovers.” Kiera digs through her purse and produces two bottles of nail polish and nail kit. “It’s time for your mani/pedi ma’am. Would you prefer Pink Pearl or Frosted Creamsicle? Mindy raises her hand like a schoolchild and Kiera calls on her like a pupil, “I want Frosted Cream toes please,” Mindy answers. “Your wish is my command, my dear,” Kiera responds with a grin. For the next few minutes, Mindy gets the spa treatment of her life as I carefully French braid her hair into pigtails. As a special treat, I purchased some ribbons from the gift shop and I’m weaving them into her hair. I tuck a yellow rose behind her ear. I don my French accent as I declare, “Monsieur Jeffery pronounces Princess Mindy finished and fit to rule the kingdom.” Kiera hands Mindy a new tube of grape ChapStick from her purse, “Hold on, a true princess never reigns with chapped lips,” she says. Mindy giggles as she responds, “You’re silly, Miss Kiera. Nobody in my kingdom is going to care if my lips are shiny.” Kiera’s laugh sounds like wind chimes as she covers her face with her hands as she confesses, “Okay, you busted me. I just like to use it because it tastes yummy.” “Okay, I want some, please,” Mindy decides. Kiera is putting the last minute touches on her as Mindy is scrambling to stand on Kiera’s thighs so she can get a better look in the mirror. When I reach out to steady her, she grabs my hand in a death grip. I glance down at her. Her eyes are wide and her mouth is opening and closing like a fish. I shoot Kiera a worried glance, but she merely shrugs. “Holy Sh — !” Mindy stops short when she sees Kiera’s expression. “Mr. Jeff is an angel for reals because he turned me into one. Look at my hair Miss Kiera, there are magic ribbons in it! I’m perfect. I can be anything I want to be.” Spontaneously, we all join together in a group hug. I kiss the top of her head as I agree, “Yes, Mindy, you are amazing and the sky is the limit for you.

Depression: What depressed person doesn’t think of himself or herself as a miserable, unredeemable failure? Anger: As in “STAY AWAY or you will see me, and what you see won’t be pretty.” Look for the paradoxical combination of self-loathing and arrogant judgment. Men are specialists at this.       Anorexia: The deep logic of anorexia is that you are unworthy and deserve nothing, so you give yourself nothing. If you give yourself nothing, perhaps you will disappear, or at least less of you will be seen.       Fear and withdrawal: You might as well avoid other people since you feel like you don’t belong with them. You don’t want to be seen.       Exhibitionism: The person who is the life of the party acts shameless in the hope that such a thing is possible.      Addiction: This will both cause shame and cure it, at least temporarily.       Cutting: This seems like the perfect treatment. It punishes you for being “bad,” and the blood makes you feel punished and therefore cleansed. Of course cutting silences shame for only an hour or so, but at least that’s something.       Fears of being exposed: Among the socially or financially successful can lurk a persistent sense that they are only one misstep from being found out and humiliated.       Suicide: Sadly, some people who expect to be exposed and humiliated feel as if they have no alternative but suicide. Many others who live with shame wish they could take their lives, but they are too afraid of what death might bring.       Doubts that God could ever love you: Who could love something so gross?       “I can’t forgive myself”: You might be saying, “I believe God has forgiven me, but something is still wrong. I still feel dirty.”       “I’m just a failure”: Who hasn’t thought that? Of course, families remain the hotbed for shame.

If anyone had questioned how deeply the summer's activities had penetrated the consciousness of white America, the answer was evident in the treatment accorded the March on Washington by all the media of communication. Normally Negro activities are the object of attention in the press only when they are likely to lead to some dramatic outbreak, or possess some bizarre quality. The March was the first organized Negro operation which was accorded respect and coverage commensurate with its importance. The millions who viewed it on television were seeing an event historic not only because of the subject, but because it was being brought into their homes. Millions of white Americans, for the first time, had a clear, long look at Negroes engaged in a serious occupation. For the first time millions listened to the informed and thoughtful words of Negro spokesmen, from all walks of life. The stereotype of the Negro suffered a heavy blow. This was evident in some of the comment, which reflected surprise at the dignity, the organization and even the wearing apparel and friendly spirit of the participants. If the press had expected something akin to a minstrel show, or a brawl, or a comic display of odd clothes and bad manners, they were disappointed. A great deal has been said about a dialogue between Negro and white. Genuinely to achieve it requires that all the media of communication open their channels wide as they did on that radiant August day. As television beamed the image of this extraordinary gathering across the border oceans, everyone who believed in man's capacity to better himself had a moment of inspiration and confidence in the future of the human race. And every dedicated American could be proud that a dynamic experience of democracy in his nation's capital had been made visible to the world.

We all know that there are harsh passages toward others in the Bible as well: dispossess the Canaanites, destroy Jericho, etc. But, as I said earlier, the evidence on the ground indicates that most of that (the Conquest) never happened. Likewise in the case of the destruction of the Midianites, as I described in Chapter 4, this was a story in the Priestly (P) source written as a polemic against any connection between Moses and Midian. It is a polemical story in literature, not a history of anything that actually happened. At the time that the Priestly author wrote the instruction to kill the Midianites, there were not any Midianites in the region. The Midianite league had disappeared at least four hundred years earlier. As we saw in Chapter 2, it was an attested practice in that ancient world to claim to have wiped out one's enemies when no such massacre had actually occurred. King Merneptah of Egypt did it. King Mesha of Moab did it. And, so there is no misunderstanding, the purpose of bringing up those parallels is not to say that it was all right to do so. It is rather to recognize that, even in what are possibly the worst passages about warfare in the Bible, those stories do not correspond to any facts of history. They are the words of an author writing about imagined events of a period centuries before his own time. And, even then, they are laws of war only against specific peoples: Canaanites, Amalekites, and Midianites, none of whom exist anymore. So they do not apply to anyone on earth. The biblical laws concerning war in general, against all other nations, for all the usual political and economic reasons that nations go to war, such as wars of defense or territory, do not include the elements that we find shocking about those specific cases. ... Now one can respond that even if these are just fictional stories they are still in the Bible, after all, and can therefore be regarded as approving of such devastating warfare. That is a fair point to raise. I would just add this caution: when people cherry-pick the most offensive passages in the Bible in order to show that it is bad, they have every right to point to those passages, but they should acknowledge that they are cherry-picking, and they should pay due recognition to the larger--vastly larger--ongoing attitude to aliens and foreigners. In far more laws and cases, the principle of treatment of aliens is positive.

I DON'T WANT to talk about me, of course, but it seems as though far too much attention has been lavished on you lately-that your greed and vanities and quest for self-fulfillment have been catered to far too much. You just want and want and want. You believe in yourself excessively. You don't believe in Nature anymore. It's too isolated from you. You've abstracted it. It's so messy and damaged and sad. Your eyes glaze as you travel life's highway past all the crushed animals and the Big Gulp cups. You don't even take pleasure in looking at nature photographs these days. Oh, they can be just as pretty as always, but don't they make you feel increasingly ... anxious? Filled with more trepidation than peace? So what's the point? You see the picture of the baby condor or the panda munching on a bamboo shoot, and your heart just sinks, doesn't it? A picture of a poor old sea turtle with barnacles on her back, all ancient and exhausted, depositing her five gallons of doomed eggs in the sand hardly fills you with joy, because you realize, quite rightly, that just outside the frame falls the shadow of the condo. What's cropped from the shot of ocean waves crashing on a pristine shore is the plastics plant, and just beyond the dunes lies a parking lot. Hidden from immediate view in the butterfly-bright meadow, in the dusky thicket, in the oak and holly wood, are the surveyors' stakes, for someone wants to build a mall exactly there-some gas stations and supermarkets, some pizza and video shops, a health club, maybe a bulimia treatment center. Those lovely pictures of leopards and herons and wild rivers-well, you just know they're going to be accompanied by a text that will serve only to bring you down. You don't want to think about it! It's all so uncool. And you don't want to feel guilty either. Guilt is uncool. Regret maybe you'll consider. Maybe. Regret is a possibility, but don't push me, you say. Nature photographs have become something of a problem, along with almost everything else. Even though they leave the bad stuff out-maybe because you know they're leaving all the bad stuff out-such pictures are making you increasingly aware that you're a little too late for Nature. Do you feel that? Twenty years too late? Maybe only ten? Not way too late, just a little too late? Well, it appears that you are. And since you are, you've decided you're just not going to attend this particular party.

Thus polyvictimization or complex trauma are "developmentally adverse interpersonal traumas" (Ford, 2005) because they place the victim at risk not only for recurrent stress and psychophysiological arousal (e.g., PTSD, other anxiety disorders, depression) but also for interruptions and breakdowns in healthy psychobiological, psychological, and social development. Complex trauma not only involves shock, fear, terror, or powerlessness (either short or long term) but also, more fundamentally, constitutes a violation of the immature self and the challenge to the development of a positive and secure self, as major psychic energy is directed toward survival and defense rather than toward learning and personal development (Ford, 2009b, 2009c). Moreover, it may influence the brain's very development, structure, and functioning in both the short and long term (Lanius et al., 2010; Schore, 2009). Complex trauma often forces the child victim to substitute automatic survival tactics for adaptive self-regulation, starting at the most basic level of physical reactions (e.g., intense states of hyperarousal/agitation or hypoarousal/immobility) and behavioral (e.g., aggressive or passive/avoidant responses) that can become so automatic and habitual that the child's emotional and cognitive development are derailed or distorted. What is more, self-integrity is profoundly shaken, as the child victim incorporates the "lessons of abuse" into a view of him or herself as bad, inadequate, disgusting, contaminated and deserving of mistreatment and neglect. Such misattributions and related schema about self and others are some of the most common and robust cognitive and assumptive consequences of chronic childhood abuse (as well as other forms of interpersonal trauma) and are especially debilitating to healthy development and relationships (Cole & Putnam, 1992; McCann & Pearlman, 1992). Because the violation occurs in an interpersonal context that carries profound significance for personal development, relationships become suspect and a source of threat and fear rather than of safety and nurturance. In vulnerable children, complex trauma causes compromised attachment security, self-integrity and ultimately self-regulation. Thus it constitutes a threat not only to physical but also to psychological survival - to the development of the self and the capacity to regulate emotions (Arnold & Fisch, 2011). For example, emotional abuse by an adult caregiver that involves systematic disparagement, blame and shame of a child ("You worthless piece of s-t"; "You shouldn't have been born"; "You are the source of all of my problems"; "I should have aborted you"; "If you don't like what I tell you, you can go hang yourself") but does not involve sexual or physical violation or life threat is nevertheless psychologically damaging. Such bullying and antipathy on the part of a primary caregiver or other family members, in addition to maltreatment and role reversals that are found in many dysfunctional families, lead to severe psychobiological dysregulation and reactivity (Teicher, Samson, Polcari, & McGreenery, 2006).