Pathology Related Quotes

I've always been uncomfortable with compliments, though I have a pathological need for them.

We do know that patriarchal masculinity encourages men to be pathologically narcissistic, infantile, and psychologically dependent on the privileges (however relative) that they receive simply for having been born male.

I have asked them to pay attention to what they have just said. In particular to their use of the phrase “mental illness”. While it is true, i continued, that people in deprived situations are likely to suffer a great deal more than those who are more affluent, on what grounds are we correct to use medical language to describe that suffering? Do we use it because we have simply been taught to use it or because we have objective that it is somehow better to medicalise such suffering than it is to view it as many social scientists might as non-medical, non-pathological yet understandable human response to harmful social, relational, political and environmental conditions?

We began then to see trauma-related disorders not as disorders of events but as disorders of the body, brain, and nervous system. The neurobiological lens also resulted in another paradigm shift: if the brain and body are inherently adaptive, then the legacy of trauma responses must also reflect an attempt at adaptation, rather than evidence of pathology. Through that neurobiological lens, what appears clinically as stuckness and resistance, untreatable diagnoses, or character-disordered behavior simply represent how an individual’s mind and body adapted to a dangerous world in which the only “protection” was the very same caretaker who endangered him or her. Each symptom was an ingenious solution by the body to create some semblance of safety for the developing child or endangered adult. The trauma-related issues with which the client presents for help, I now believe, are in truth a “red badge of courage” that tell the story of what happened even more eloquently than the events each individual consciously remembers.

often has no suspicion of the causal connection between the precipitating event and the pathological phenomenon.

It is in the nature of paradox that "equations" based on it do not work out. Where paradox contaminates human relations, disease appears.

In human relations, all prediction is connected in one way or another with the phenomenon of trust.

Many survivors of relational and other forms of early life trauma are deeply troubled and often struggle with feelings of anger, grief, alienation, distrust, confusion, low self-esteem, loneliness, shame, and self-loathing. They seem to be prisoners of their emotions, alternating between being flooded by intense emotional and physiological distress related to the trauma or its consequences and being detached and unable to express or feel any emotion at all - alternations that are the signature posttraumatic pattern. These occur alongside or in conjunction with other common reactions and symptoms (e.g., depression, anxiety, and low self-esteem) and their secondary manifestations. Those with complex trauma histories often have diffuse identity issues and feel like outsiders, different from other people, whom they somehow can't seem to get along with, fit in with, or get close to, even when they try. Moreover, they often feel a sense of personal contamination and that no one understands or can help them. Quite frequently and unfortunately, both they and other people (including the professionals they turn to for help) do misunderstand them, devalue their strengths, or view their survival adaptations through a lens of pathology (e.g., seeing them as "demanding", "overdependent and needy", "aggressive", or as having borderline personality). Yet, despite all, many individuals with these histories display a remarkable capacity for resilience, a sense of morality and empathy for others, spirituality, and perseverance that are highly admirable under the circumstances and that create a strong capacity for survival. Three broad categories of survivorship, with much overlap between them, can be discerned: 1. Those who have successfully overcome their past and whose lives are healthy and satisfying. Often, individuals in this group have had reparative experiences within relationships that helped them to cope successfully. 2. Those whose lives are interrupted by recurring posttraumatic reactions (often in response to life events and experiences) that periodically hijack them and their functioning for various periods of time. 3. Those whose lives are impaired on an ongoing basis and who live in a condition of posttraumatic decline, even to the point of death, due to compromised medical and mental health status or as victims of suicide of community violence, including homicide.

The ceremonial differentiation of the dietary is best seen in the use of intoxicating beverages and narcotics. If these articles of consumption are costly, they are felt to be noble and honorific. Therefore the base classes, primarily the women, practice an enforced continence with respect to these stimulants, except in countries where they are obtainable at a very low cost. From archaic times down through all the length of the patriarchal regime it has been the office of the women to prepare and administer these luxuries, and it has been the perquisite of the men of gentle birth and breeding to consume them. Drunkenness and the other pathological consequences of the free use of stimulants therefore tend in their turn to become honorific, as being a mark, at the second remove, of the superior status of those who are able to afford the indulgence. Infirmities induced by over-indulgence are among some peoples freely recognised as manly attributes. It has even happened that the name for certain diseased conditions of the body arising from such an origin has passed into everyday speech as a synonym for "noble" or "gentle". It is only at a relatively early stage of culture that the symptoms of expensive vice are conventionally accepted as marks of a superior status, and so tend to become virtues and command the deference of the community; but the reputability that attaches to certain expensive vices long retains so much of its force as to appreciably lesson the disapprobation visited upon the men of the wealthy or noble class for any excessive indulgence. The same invidious distinction adds force to the current disapproval of any indulgence of this kind on the part of women, minors, and inferiors. This invidious traditional distinction has not lost its force even among the more advanced peoples of today. Where the example set by the leisure class retains its imperative force in the regulation of the conventionalities, it is observable that the women still in great measure practise the same traditional continence with regard to stimulants.

The tolerance for subaltern violence stands in inverse relation to the absoluteness of capitalist dominance and the consequent suffusion of a social formation with violence – the American allergy, in other words, is a pathology.

...when different identity states convey contradictory information and then have amnesia for what the other identity states said, the patient may be thought to be lying. This can appear to be characterological mendacity when it is not.

McKusick's belief in this paradigm-the focus on disability rather than abnormalcy-was actualized in the treatment of patients in his clinic. Patients with dwarfism, for instance, were treated by an interdisciplinary team of genetic counselors, neurologists, orthopedic surgeons, nurses, and psychiatrists trained to focus on specific disabilities of persons with short stature. Surgical interventions were reserved to correct specific deformities as they arose. The goal was not to restore "normalcy"-but vitality, joy, and function. McKusic had rediscovered the founding principles of modern genetics in the realm of human pathology. In humans as in wild flies, genetic variations abounded. Here too genetic variants, environments, and gene-environment interactions ultimately collaborated to cause phenotypes-except in this case, the "phenotype" in question was disease. Here too some genes had partial penetrance and widely variable expressivity. One gene could cause many diseases, and one disease could be caused by many genes. And here too "fitness" could not be judged in absolutes. Rather the lack of fitness-illness [italicized, sic] in colloquial terms- was defined by the relative mismatch between an organism and environment.

Does the person report having had the experience of meeting people she does not know but who seem to know her, perhaps by a different name? Often, those with DID are thought by others to be lying because different parts will say different things which the host has no knowledge of.

Thus we arrive at the problem of the relation of religion to the negation of sexual desire. Sexual debility results in a lowering of self-confidence. In one case it is compensated by the brutalization of sexuality, to maintain sexual repression, in the other by rigid character traits. The compulsion to control one's sexuality, to maintain sexual repression, leads to the development of pathologic, emotionally tinged notions of honor and duty, bravery and self-control. But the pathology and emotionality of these psychic attitudes are strongly at variance with the reality of one's personal behavior. The man who attains genital satisfaction, is honorable, responsible, brave, and controlled, without making much of a fuss about it. These attitudes are an organic part of his personality. The man whose genitals are weakened, whose sexual structure is full of contradictions, must continually remind himself to control his sexuality, to preserve his sexual dignity, to be brave in the face of temptation, etc. The struggle to resist the temptation to masturbate is a struggle that is experienced by every adolescent and every child, without exception. All the elements of the reactionary man's structure are developed in this struggle. It is in the lower middle classes that this structure is reinforced most strongly and embedded most deeply. Every form of mysticism derives it's most active energy and, in part, also it's content from this compulsory suppression of sexuality.

As a culture, we seem to have an intolerance for suffering; we tend to want those who have experienced a loss of any kind to get on with their lives as quickly as possible. Often, by minimizing the impact of significant losses, pathologizing those whose reactions are intense, and applauding those who seem relatively unaffected by tragic events, we encourage the inhibition of our own grief.

Recent psychological research on grief favors meaning making over closure; accepts zigzagging paths, not just linear stages; recognizes ambiguity without pathology; and acknowledges continuing bonds between the living and the dead rather than commanding decathexis. But old ideas about grief as a linear march to closure still hold powerful sway. Many psychologists and grief counseling programs continue to consider “closure” a therapeutic goal. Sympathy cards, internet searches, and friendly advice often uphold a rigid division between healthy grief that the mourner “gets over” and unhealthy grief that persists. Forensic exhumation, too, continues to be informed by these deeply rooted ideas. The experiences of grief and exhumation related by families of the missing indicate something more complex and mysterious than “closure.” Exhumation heals and wounds, sometimes both at once, in the same gesture, in the same breath, as Dulce described feeling consoled and destroyed by the fragment of her brother’s bones. Exhumation can divide brothers and restore fathers, open old wounds and open the possibility of regeneration—of building something new with the “pile of broken mirrors” that is memory, loss, and mourning.

Collectively this work suggests that the prefrontal cortex and the amygdala are reciprocally related. That is, in order for the amygdala to respond to fear reactions, the prefrontal region has to be shut down. By the same logic, when the prefrontal region is active, the amygdala would be inhibited, making it harder to express fear. Pathological fear, then, may occur when the amygdala is unchecked by the prefrontal cortex, and treatment of pathological fear may require that the patient learn to increase activity in the prefrontal region so that the amygdala is less free to express fear. Clearly, decision-making ability in emotional situations is impaired in humans with damage to the medial and ventral prefrontal cortex, and abnormalities there also may predispose people to develop fear and anxiety disorders. These abnormalities could be due to genetic or epigenetic organization of prefrontal synapses or to experiences that subtly alter prefrontal synaptic connections. Indeed, the behavior of animals with abmormalities of the medial prefrontal cortex is reminiscent of humans with anxiety disorders: they develop fear reactions that are difficult to regulate. Although objective information about the world may indicate that a situation is not dangerous, because they cannot properly regulate fear circuits, they experience fear and anxiety in these safe situations.

In Women and Madness, Phyllis Chesler writes of what she calls “psychiatric imperialism,” whereby normal responses to trauma are methodically pathologized in science and medicine. At the time of the book’s publication in 1972, few women were coming forward about gender biases in the study and practice of psychology. Chesler felt compelled to bring forward a conversation around gender, race, class, and medical ethics because “modern female psychology reflects a relatively powerless and deprived condition.” Of sensitivity she writes: “Many intrinsically valuable female traits, such as intuitiveness or compassion, have probably been developed through default or patriarchal-imposed necessity, rather than through either biological predisposition or free choice. Female emotional ‘talents’ must be viewed in terms of the overall price exacted by sexism.” Regardless of causation, of note here is that women’s internal lives were barely acknowledged or considered.

No mechanic now for modern cars, no doctor now for modern pathologies. The infinitesimal calculus of viral pathologies, unlocatable by traditional diagnostics, has entirely outstripped the mechanics of the body, just as the electronics of the modern car have outstripped the knowledge of its user. But one can imagine an electronic 'smartness' of the body (like 'smart' cars or houses) that would inform you of all its anomalies, or even, by a kind of GPS effect, of your position in the space of human relations.

In this increasingly interconnected world, we must understand that what happens to poor people is never divorced from the actions of the powerful. Certainly, people who define themselves as poor may control their own destinies to some extent. But control of lives is related to control of land, systems of production, and the formal political and legal structures in which lives are enmeshed. With time, both wealth and control have become increasingly concentrated in the hands of a few. The opposite trend is desired by those working for social justice.

DSM-5 pathologized those who hold on to their stuff for too long, who clutter their homes too much, who do not clean that often, and who harbor too many things. The manual labeled these activities “hoarding disorder” (HD, as it is sometimes called) and gave them an International Classification of Diseases (ICD-9-CM, to be precise) code of 300.3. Legitimized as a psychiatric disease and categorized under Obsessive-Compulsive and Related Disorders, this diagnosis rendered unsound certain relations to certain personal property. Hoarding, it seems, had arrived.

The decline of community life suggests that in the future, we risk becoming secure and self-absorbed last men, devoid of thymotic striving for higher goals in our pursuit of private comforts. But the opposite danger exists as well, namely, that we will return to being first men engaged in bloody and pointless prestige battles, only this time with modern weapons. Indeed, the two problems are related to one another, for the absence of regular and constructive outlets for megalothymia may simply lead to its later resurgence in an extreme and pathological form.

Since we wrote Mindhunter, the prevalence of certain crimes has changed. Violent crime in general has been on a downward trend, but the number of predatory sexually oriented killers has remained relatively the same. The reason, we believe, is because this type of criminal pathology is not as responsive to societal conditions or improved policing as other criminal enterprises. In the past sixteen years we have become concerned with domestic and international terrorism, a phenomenon that was just beginning when we cited the 1995 Oklahoma City federal building bombing.

Our study of psychoneurotic disturbances points to a more comprehensive explanation, which includes that of Westermarck. When a wife loses her husband, or a daughter her mother, it not infrequently happens that the survivor is afflicted with tormenting scruples, called ‘obsessive reproaches’ which raises the question whether she herself has not been guilty through carelessness or neglect, of the death of the beloved person. No recalling of the care with which she nursed the invalid, or direct refutation of the asserted guilt can put an end to the torture, which is the pathological expression of mourning and which in time slowly subsides. Psychoanalytic investigation of such cases has made us acquainted with the secret mainsprings of this affliction. We have ascertained that these obsessive reproaches are in a certain sense justified and therefore are immune to refutation or objections. Not that the mourner has really been guilty of the death or that she has really been careless, as the obsessive reproach asserts; but still there was something in her, a wish of which she herself was unaware, which was not displeased with the fact that death came, and which would have brought it about sooner had it been strong enough. The reproach now reacts against this unconscious wish after the death of the beloved person. Such hostility, hidden in the unconscious behind tender love, exists in almost all cases of intensive emotional allegiance to a particular person, indeed it represents the classic case, the prototype of the ambivalence of human emotions. There is always more or less of this ambivalence in everybody’s disposition; normally it is not strong enough to give rise to the obsessive reproaches we have described. But where there is abundant predisposition for it, it manifests itself in the relation to those we love most, precisely where you would least expect it. The disposition to compulsion neurosis which we have so often taken for comparison with taboo problems, is distinguished by a particularly high degree of this original ambivalence of emotions.

What is it about the ancients,’ Pinker asks at one point, ‘that they couldn’t leave us an interesting corpse without resorting to foul play?’ There is an obvious response to this: doesn’t it rather depend on which corpse you consider interesting in the first place? Yes, a little over 5,000 years ago someone walking through the Alps left the world of the living with an arrow in his side; but there’s no particular reason to treat Ötzi as a poster child for humanity in its original condition, other than, perhaps, Ötzi suiting Pinker’s argument. But if all we’re doing is cherry-picking, we could just as easily have chosen the much earlier burial known to archaeologists as Romito 2 (after the Calabrian rock-shelter where it was found). Let’s take a moment to consider what it would mean if we did this. Romito 2 is the 10,000-year-old burial of a male with a rare genetic disorder (acromesomelic dysplasia): a severe type of dwarfism, which in life would have rendered him both anomalous in his community and unable to participate in the kind of high-altitude hunting that was necessary for their survival. Studies of his pathology show that, despite generally poor levels of health and nutrition, that same community of hunter-gatherers still took pains to support this individual through infancy and into early adulthood, granting him the same share of meat as everyone else, and ultimately according him a careful, sheltered burial.15 Neither is Romito 2 an isolated case. When archaeologists undertake balanced appraisals of hunter-gatherer burials from the Palaeolithic, they find high frequencies of health-related disabilities – but also surprisingly high levels of care until the time of death (and beyond, since some of these funerals were remarkably lavish).16 If we did want to reach a general conclusion about what form human societies originally took, based on statistical frequencies of health indicators from ancient burials, we would have to reach the exact opposite conclusion to Hobbes (and Pinker): in origin, it might be claimed, our species is a nurturing and care-giving species, and there was simply no need for life to be nasty, brutish or short. We’re not suggesting we actually do this. As we’ll see, there is reason to believe that during the Palaeolithic, only rather unusual individuals were buried at all. We just want to point out how easy it would be to play the same game in the other direction – easy, but frankly not too enlightening.

Wandering has long been seen as part of the pathology of dementia. Doctors, carers, and relatives often try to stop patients from venturing out alone, out of concern they will injure themselves, or won’t remember the way back. When a person without dementia goes for a walk, it is called going for a stroll, getting some fresh air, or exercising, anthropologist Maggie Graham observes in her recent paper. When a person with dementia goes for a walk beyond prescribed parameters, it is typically called wandering, exit-seeking, or elopement. Yet wandering may not be so much a part of the disease as a therapeutic response to it. Even though dementia and Alzheimer’s in particular can cause severe disorientation, Graham says the desire to walk should be desire to be alive and to grow, as opposed to as a product of disease and deterioration. Many in the care profession share her view. The Alzheimer’s Society, the UK’s biggest dementia supportive research charity, considers wandering an unhelpful description, because it suggests aimlessness, whereas the walking often has a purpose. The charity lists several possible reasons why a person might feel compelled to move. They may be continuing the habit of a lifetime; they may be bored, restless, or agitated; they may be searching for a place or a person from their past that they believe to be close by; or maybe they started with a goal in mind, forgot about it, and just kept going. It is also possible that they are walking to stay alive. Sat in a chair in a room they don’t recognise, with a past they can’t access, it can be a struggle to know who they are. But when they move they are once again wayfinders, engaging in one of the oldest human endeavours, and anything is possible.

Sullivan described the analyst’s way of engaging the patient as “participant observation.” The patient attempts to draw the analyst into his characteristic forms of interaction. The analyst, like a sensitive instrument, uses her awareness of these subtle interpersonal pulls and pushes to develop hypotheses about the patient’s security operations. But Sullivan did not regard it as helpful for the analyst to get deeply personally involved with the patient. The analyst was an expert at interpersonal relations, and her expert status would keep her from getting drawn into pathological integrations. She needs to be aware enough of minor eruptions of anxiety within herself to avoid engaging in security operations of her own. The competent analyst would not need anything interpersonally from the patient and therefore would have no strong or turbulent feelings for the patient.

It would be futile to delude ourselves that at present, readers find every pathography unsavory. This attitude is excused with the reproach that from a pathographic elaboration of a great man one never obtains an understanding of his importance and his attainments, that it is therefore useless mischief to study in him things which could just as well be found in the first comer. However, this criticism is so clearly unjust that it can only be grasped when viewed as a pretext and a disguise for something. As a matter of fact pathography does not aim at making comprehensible the attainments of the great man; no one should really be blamed for not doing something which one never promised. The real motives for the opposition are quite different. One finds them when one bears in mind that biographers are fixed on their heroes in quite a peculiar manner. Frequently they take the hero as the object of study because, for reasons of their personal emotional life, they bear him a special affection from the very outset. They then devote themselves to a work of idealization which strives to enroll the great men among their infantile models, and to revive through him, as it were, the infantile conception of the father. For the sake of this wish they wipe out the individual features in his physiognomy, they rub out the traces of his life's struggle with inner and outer resistances, and do not tolerate in him anything of human weakness or imperfection; they then give us a cold, strange, ideal form instead of the man to whom we could feel distantly related. It is to be regretted that they do this, for they thereby sacrifice the truth to an illusion, and for the sake of their infantile phantasies they let slip the opportunity to penetrate into the most attractive secrets of human nature.

fear of death.” Our study of psychoneurotic disturbances points to a more comprehensive explanation, which includes that of Westermarck. When a wife loses her husband, or a daughter her mother, it not infrequently happens that the survivor is afflicted with tormenting scruples, called ‘obsessive reproaches’ which raises the question whether she herself has not been guilty through carelessness or neglect, of the death of the beloved person. No recalling of the care with which she nursed the invalid, or direct refutation of the asserted guilt can put an end to the torture, which is the pathological expression of mourning and which in time slowly subsides. Psychoanalytic investigation of such cases has made us acquainted with the secret mainsprings of this affliction. We have ascertained that these obsessive reproaches are in a certain sense justified and therefore are immune to refutation or objections. Not that the mourner has really been guilty of the death or that she has really been careless, as the obsessive reproach asserts; but still there was something in her, a wish of which she herself was unaware, which was not displeased with the fact that death came, and which would have brought it about sooner had it been strong enough. The reproach now reacts against this unconscious wish after the death of the beloved person. Such hostility, hidden in the unconscious behind tender love, exists in almost all cases of intensive emotional allegiance to a particular person, indeed it represents the classic case, the prototype of the ambivalence of human emotions. There is always more or less of this ambivalence in everybody’s disposition; normally it is not strong enough to give rise to the obsessive reproaches we have described. But where there is abundant predisposition for it, it manifests itself in the relation to those we love most, precisely where you would least expect it. The disposition to compulsion neurosis which we have so often taken for comparison with taboo problems, is distinguished by a particularly high degree of this original ambivalence of emotions.

The exaggeration of the definiteness and importance of the dividing line between the capitalist class in that sense and the proletariat was surpassed only by the exaggeration of the antagonism between them. To any mind not warped by the habit of fingering the Marxian rosary it should be obvious that their relation is, in normal times, primarily one of cooperation and that any theory to the contrary must draw largely on pathological cases for verification. In social life, antagonism and synagogism are of course both ubiquitous and in fact inseparable except in the rarest of cases. But I am almost tempted to say that there was, if anything, less of absolute nonsense in the old harmonistic view—full of nonsense though that was too—than in the Marxian construction of the impassable gulf between tool owners and tool users. Again, however, he had no choice, not because he wanted to arrive at revolutionary results—these he could have derived just as well from dozens of other possible schemata—but because of the requirements of his own analysis. If class struggle was the subject matter of history and also the means of bringing about the socialist dawn, and if there had to be just those two classes, then their relation had to be antagonistic on principle or else the force in his system of social dynamics would have been lost.

Dr. Gilligan states: “I am suggesting that the only way to explain the causes of violence, so that we can learn how to prevent it, is to approach violence as a problem in public health and preventive medicine, and to think of violence as a symptom of life-threatening pathology, which, like all form of illness, has an etiology or cause, a pathogen.”160 In Dr. Gilligan's diagnosis he makes it very clear that the greatest cause of violent behavior is social inequality, highlighting the influence of shame and humiliation as an emotional characteristic of those who engage in violence.161 Thomas Scheff, a emeritus professor of sociology in California stated that “shame was the social emotion”.162 Shame and humiliation can be equated with the feelings of stupidity, inadequacy, embarrassment, foolishness, feeling exposed, insecurity and the like – all largely social or comparative in their origin. Needless to say, in a global society with not only growing income disparity but inevitably “self-worth” disparity - since status is touted as directly related to our “success” in our jobs, bank account levels and the like - it is no mystery that feelings of inferiority, shame and humiliation are staples of the culture today. The consequence of those feelings have very serious implications for public health, as noted before, including the epidemic of the behavioral violence we now see today in its various complex forms. Terrorism, local school and church shootings, along with other extreme acts that simply did not exist before in the abstractions they find context today, reveals a unique evolution of violence itself. Dr. Gilligan concludes: “If we wish to prevent violence, then, our agenda is political and economic reform.”163

During the second half of the sixties, the center of the crisis shifted to the sprawling ghettos of the North. Here black experience was radically different from that in the South. The stability of institutional relationships was largely absent in Northern ghettos, especially among the poor. Over twenty years ago, the black sociologist E. Franklin Frazier was able to see the brutalizing effect of urbanization upon lower class blacks : ". . . The bonds of sympathy and community of interests that held their parents together in the rural environment have been unable to withstand the disintegrating forces in the city." Southern blacks migrated North in search of work, seeking to become transformed from a peasantry into a working class. But instead of jobs they found only misery, and far from becoming a proletariat, they came to constitute a lumpenproletariat, an underclass of rejected people. Frazier's prophetic words resound today with terrifying precision: ". . . As long as the bankrupt system of Southern agriculture exists, Negro families will continue to seek a living in the towns and cities of the country. They will crowd the slum areas of Southern cities or make their way to Northern cities, where their family life will become disrupted and their poverty will force them to depend upon charity." Out of such conditions, social protest was to emerge in a form peculiar to the ghetto, a form which could never have taken root in the South except in such large cities as Atlanta or Houston. The evils in the North are not easy to understand and fight against, or at least not as easy as Jim Crow, and this has given the protest from the ghetto a special edge of frustration. There are few specific injustices, such as a segregated lunch counter, that offer both a clear object of protest and a good chance of victory. Indeed, the problem in the North is not one of social injustice so much as the results of institutional pathology. Each of the various institutions touching the lives of urban blacks—those relating to education, health, employment, housing, and crime—is in need of drastic reform. One might say that the Northern race problem has in good part become simply the problem of the American city—which is gradually becoming a reservation for the unwanted, most of whom are black.

Correlation and causality. Why is it that throughout the animal kingdom and in every human culture, males account for most aggression and violence? Well, what about testosterone and some related hormones, collectively called androgens, a term that unless otherwise noted, I will use simplistically as synonymous with testosterone. In nearly all species, males have more circulating testosterone than do females, who secrete small amounts of androgens from the adrenal glands. Moreover, male aggression is most prevalent when testosterone levels are highest; adolescence and during mating season in seasonal breeders. Thus, testosterone and aggression are linked. Furthermore, there are particularly high levels of testosterone receptors in the amygdala, in the way station by which it projects to the rest of the brain, the bed nucleus of the stria terminalis, and in its major targets, the hypothalamus, the central gray of the mid-brain, and the frontal cortex. But these are merely correlative data. Showing that testosterone causes aggression requires a subtraction plus a replacement experiment. Subtraction, castrate a male: do levels of aggression decrease? Yes, including in humans. This shows that something coming from the testes causes aggression. Is it testosterone? Replacement: give that castrated individual replacement testosterone. Do pre-castration levels of aggression return? Yes, including in humans, thus testosterone causes aggression. Time to see how wrong that is. The first hint of a complication comes after castration. When average levels of aggression plummet in every species, but crucially, not to zero, well, maybe the castration wasn't perfect, you missed some bits of testes, or maybe enough of the minor adrenal androgens are secreted to maintain the aggression. But no, even when testosterone and androgens are completely eliminated, some aggression remains, thus some male aggression is testosterone independent. This point is driven home by castration of some sexual offenders, a legal procedure in a few states. This is accomplished with chemical castration, administration of drugs that either inhibit testosterone production or block testosterone receptors. Castration decreases sexual urges in the subset of sex offenders with intense, obsessive, and pathological urges. But otherwise, castration doesn't decrease recidivism rates as stated in one meta-analysis. Hostile rapists and those who commit sex crimes motivated by power or anger are not amenable to treatment with the anti-androgenic drugs. This leads to a hugely informative point. The more experience the male had being aggressive prior to castration, the more aggression continues afterward. In otherwise, the less his being aggressive in the future requires testosterone and the more it's a function of social learning.

At the beginning of this study on the conditions of suggestion, we have admitted that suggestion could not develop in sickly minds—that it demanded, in order to attain to its full power, minds relatively sane. We have just now demonstrated that it depended on a lack of synthesis, on a weakening of consciousness. Are not these two affirmations contradictory ? Not at all. A symptom may disappear in certain maladies and still remain a pathological symptom. The crepitant rale does not exist in all stages of pneumonia; it disappears in many serious lung affections; it is none the less a very characteristic sign of the disease.

Even when behaviors are clearly stress-related, they can be difficult to interpret. Mel Richardson was once asked to examine a tree kangaroo at the San Antonio Zoo that the keepers said was acting bizarrely. With the ears of a teddy bear, the rounded chub of a koala, and the tail of a fuzzy monkey, tree kangaroos are very cute. But this female was acting vicious. She was attacking her babies, and the keepers had no idea why. Mel went to check on her. Sure enough, as soon as he approached, the kangaroo ran to her babies and started hitting and clawing at them with her paws. He stepped back, and she stopped. He walked forward, and she ran at the babies again. “I realized,” said Mel, “that she wasn’t viciously attacking her babies at all. She was trying to pick them up off the floor, but her little paws weren’t meant for that. In her native Australia and Papua New Guinea her babies never would have been on the ground. Her whole family would have been up in the trees.” The mother kangaroo wanted to move the babies away from the humans. What looked like abnormal attacks on her young were actually her way of trying to protect them. Her behavior wasn’t mental illness at all but a response to the stress of being a mother in an unnatural environment. After the keepers redesigned the kangaroos’ cage so that more of it was elevated and farther from the door, she relaxed and stopped hitting her babies. Mel explained, “As flippant as it might sound, the truth is that in order to know what’s abnormal, you must first know what’s normal. In this case in order to determine pathology, I had to understand the animal’s psychology. It’s pretty easy for people to get this wrong.

Those with cardiovascular disease not identified with diabetes are simply undiagnosed. Dr. Stout in 1977 identified the origin of the pathology of type 2 diabetes as vascular (arterial), directly related to hyperinsulinemia and not to hypergly-cemia.

There were other important reasons for the growth of American individualism at the expense of community in the second half of the twentieth century besides the nature of capitalism. The first arose as an unintended consequence of a number of liberal reforms of the 1960s and 1970s. Slum clearance uprooted and destroyed many of the social networks that existed in poor neighborhoods, replacing them with an anonymous and increasingly dangerous existence in high-rise public housing units. “Good government” drives eliminated the political machines that at one time governed most large American cities. The old, ethnically based machines were often highly corrupt, but they served as a source of local empowerment and community for their clients. In subsequent years, the most important political action would take place not in the local community but at higher and higher levels of state and federal government. A second factor had to do with the expansion of the welfare state from the New Deal on, which tended to make federal, state, and local governments responsible for many social welfare functions that had previously been under the purview of civil society. The original argument for the expansion of state responsibilities to include social security, welfare, unemployment insurance, training, and the like was that the organic communities of preindustrial society that had previously provided these services were no longer capable of doing so as a result of industrialization, urbanization, decline of extended families, and related phenomena. But it proved to be the case that the growth of the welfare state accelerated the decline of those very communal institutions that it was designed to supplement. Welfare dependency in the United States is only the most prominent example: Aid to Familles with Dependent Children, the depression-era legislation that was designed to help widows and single mothers over the transition as they reestablished their lives and families, became the mechanism that permitted entire inner-city populations to raise children without the benefit of fathers. The rise of the welfare state cannot be more than a partial explanation for the decline of community, however. Many European societies have much more extensive welfare states than the United States; while nuclear families have broken down there as well, there is a much lower level of extreme social pathology. A more serious threat to community has come, it would seem, from the vast expansion in the number and scope of rights to which Americans believe they are entitled, and the “rights culture” this produces. Rights-based individualism is deeply embedded in American political theory and constitutional law. One might argue, in fact, that the fundamental tendency of American institutions is to promote an ever-increasing degree of individualism. We have seen repeatedly that communities tend to be intolerant of outsiders in proportion to their internal cohesiveness, because the very strength of the principles that bind members together exclude those that do not share them. Many of the strong communal structures in the United States at midcentury discriminated in a variety of ways: country clubs that served as networking sites for business executives did not allow Jews, blacks, or women to join; church-run schools that taught strong moral values did not permit children of other denominations to enroll; charitable organizations provided services for only certain groups of people and tried to impose intrusive rules of behavior on their clients. The exclusiveness of these communities conflicted with the principle of equal rights, and the state increasingly took the side of those excluded against these communal organizations.

The DSM-V offers a comprehensive set of criteria to define narcissism: A. Significant impairments in personality functioning manifest by: 1. Impairments in self functioning (a or b): a. Identity: Excessive reference to others for self-definition and self-esteem regulation; exaggerated self-appraisal may be inflated or deflated, or vacillate between extremes; emotional regulation mirrors fluctuations in self-esteem. b. Self-direction: Goal-setting is based on gaining approval from others; personal standards are unreasonably high in order to see oneself as exceptional, or too low based on a sense of entitlement; often unaware of own motivations. AND 2. Impairments in interpersonal functioning (a or b): a. Empathy: Impaired ability to recognize or identify with the feelings and needs of others; excessively attuned to reactions of others, but only if perceived as relevant to self; over- or underestimate of own effect on others. b. Intimacy: Relationships largely superficial and exist to serve self-esteem regulation; mutuality constrained by little genuine interest in others experiences and predominance of a need for personal gain. B. Pathological personality traits in the following domain: 1. Antagonism, characterized by: a. Grandiosity: Feelings of entitlement, either overt or covert; self-centeredness; firmly holding to the belief that one is better than others; condescending toward others. b. Attention seeking: Excessive attempts to attract and be the focus of the attention of others; admiration seeking. C. The impairments in personality functioning and the individual’s personality trait expression are relatively stable across time and consistent across situations. D. The impairments in personality functioning and the individual’s personality trait expression are not better understood as normative for the individual’s developmental stage or sociocultural environment. E. The impairments in personality functioning and the individual’s personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).7

Many Cptsd survivors flounder in caustic judgmentalness, shuffling back and forth between pathologizing others [the toxic blame of the outer critic] and pathologizing themselves [the toxic shame of the inner critic]. They get stuck in endless loops of detailing the relational inadequacies of others, and then of themselves.

In many ways, the treatment of animal homosexuality in the scientific discourse has closely parallelled the discussion of human homosexuality in society at large. Homosexuality in both animals and people has been considered, at various times, to be a pathological condition; a social aberration; an "immoral", "sinful", or "criminal" perversion; an artificial product of confinement or the unavailability of the opposite sex; a reversal or "inversion" of heterosexual "roles"; a "phase" that younger animals go through on the path to heterosexuality; an exceptional but unimportant activity; a useless and puzzling curiosity; and a functional behavior that "stimulates" or "contributes to" heterosexuality. In many other respects, however, the outright hostility to animal homosexuality has transcended all historical trends. One need only look at the litany of derogatory terms, which have remained essentially constant from the late 1800s to the present day, used to describe this behavior: words such as strange, bizarre, perverse, aberrant, deviant, abnormal, anomalous, and unnatural have all been used routinely in "objective" scientific descriptions of the phenomenon and continue to be used (one of the most recent examples is from 1997). In addition, heterosexual behavior is consistently defined in numerous scientific accounts as "normal" in contrast to homosexual activity... In a direct carryover from attitudes toward human homosexuality, same-sex activity is routinely described as being "forced" on other animals when there is no evidence that it is, and a whole range of "distressful" emotions are projected onto the individual who experiences such "unwanted advances"... In other cases, zoologists have problematized homosexual activity or imputed an inherent inadequacy, instability, or incompetence to same-sex relations, when the supporting evidence for this is scanty or questionable at best and nonexistent at worst.

But laboratory, radiology, and pathology results were computerized relatively early (many hospitals and clinics did so in the 1990s), and some healthcare systems began experimenting with giving patients access to them.21 While this information was less fraught than doctors’ notes, many in the medical establishment still worried about how patients might handle seeing such results unfiltered.

final problem of cognitive therapy is that it is generally a short-term treatment so it is unable to build a strong enough therapeutic alliance to allow the patient to experience the corrective emotional experience. Deep change does not happen when a patient is consciously reflecting on an emotion. Rather it happens when the patient actively experiences the emotion and when a resonating emotionally present therapist recognizes and regulates that emotion, thereby modeling new ways of being with another while one is under stress. There is no interpersonal space for this repair of attachment ruptures in current models of cognitive therapy, where left brain insight dominates over right brain interactive regulation. Coming to the end, Sieff asked Schore what message he would like people to take home from this interview. Schore answered that the earliest stages of life are critical as they form the foundation of everything that follows. Our early attachment relationships, for better or worse, shape our right brain unconscious system and have lifelong consequences. An attuned early attachment relationship enables us to grow an interconnected, well-developed right brain and sets us up to become secure individuals, open to new social and emotional experiences. A traumatic early attachment relationship impairs the development of a healthy right brain and locks us into an emotionally dysregulated, amygdala-driven emotional world. As a result, our only way to defend against intense unregulated emotions is via the over reliance on repression and/or pathological characterological dissociation. Faced with relational stress, we are cut off from the world, from other people, from our emotions, from our bodies and from our sense of self. Our right brains cannot further develop or grow emotionally from our interactions with other right brains. Too many people suffer alone with their desperate pain due to their early relational trauma. For somebody struggling with such emotional dysregulation, the way to emotional security, and to a more vital, alive, and fulfilling life, does not come from making the unconscious conscious – which is essentially a left brain process

The push-pull of jouissance around signs of self-destruction represented a significant advance over Freud’s thinking about why traumatized people behave the way they do. Whereas Freud understood the traumatized person’s “compulsion to repeat” as a way of metabolizing or exorcising the pain of traumatic events and thoughts, Lacan saw that repetitive symptoms are really an adaptation to a new regime of enjoyment, how a person reorganizes his or her life in such a way as to continue to derive enjoyment from something that, on a conscious level, may be despised and even (in its most extreme and pathological forms) possibly does harm. Lacan was no more interested in literal precognition or prophecy than Freud was, but his revision of the Freudian theory of symptoms and their relation to trauma is highly suggestive for an understanding of precognitive phenomena, and the ways trauma may sometimes become “displaced in time.” For instance, in many cases where disasters and deaths are precognized, even including deaths of loved ones or near-fatal perils in one’s own future, there is an implicit reward, if only in the very primitive—and hard-to-acknowledge—sense of “but I survived.” This can be a very repellant kind of reward, something appealing to a very base, “lizard-brain,” survival-oriented part of us that may be at odds with our conscious, moral, social desires and sense of self. The paradoxical connection between survival and death, which sparked Freud’s thinking but which he could never resolve successfully, in some sense boils down to a matter of semiotics: the fact that the one value (survival) takes on its meaning or value as a signal only contrastively, when paired with its opposite (death/destruction). According to structural linguistics, which was hugely influential on Lacan, all signifiers ultimately derive their meaning from their opposition to other signifiers. In life’s semiotic (or “sign language”), death or disaster befalling others is the foremost signifier of our own being-there, our da-sein. If you find yourself “traumatized” by witnessing something terrible, you have by definition survived. Dreams seem to give people dramatic and often distorted previews of those situations lurking in the foggy waters ahead.

We need to be much more vigilant and aware of the risks inherent in touting the importance of family involvement and family care. Too easily, those calls can be reinterpreted to mean that the only care worth supporting is that provided by relatives, inadvertently demonizing and pathologizing the use of paid attendants. This is not to say that family members who provide attendant care for their disabled relatives should not themselves be compensated for their work; indeed, I support consumer-directed attendant services that allow disabled people to hire their own attendants, including family members. But, as Laura Hershey explains, seeing attendant care as something best provided by a family member too easily perpetuates the idea that disability is a private problem concerning the family that has no place in the public sphere. This attitude, in turn, leads to the continued devaluation of caregiving; abysmal wages and working conditions are justified on the basis that family members—almost always women—would be doing this work anyway and therefore any compensation, no matter how meager, is sufficient.

You are the toxic one After looking through the window. Look into the mirror . Look through your cellphone. Is this you ? You have cut all ties with people who spoke bad about you. You know the danger of lies and rumors what it can do to a person. But on social media you follow all the accounts that speak bad of others. You follow and glorify all this toxic social media accounts. Mean, vile , miserable , psychopath , pathological liars . You are the first to laugh, comment and share their content. Its you who is spreading the toxic gospel, you even tagging others. Making remarks of not being judged by liking their content. Asking others if it is only you, who likes their content or there are others like you ? You have condition yourself to get excited every time , you hear bad news or bad things happening to others. Next step will be you opening fake or catfish account if you haven’t already. Bad traits have addiction,. Yours started by loving people secrets and downfall. The reason you follow those accounts is to feed your inner soul. It Is because you can relate. They are you and you are them. You share the same mentality, views, sentiments, resemblance, ideology, and character traits. You are justifying their wrong doings or sayings, because in you . There is nothing wrong they said or done. After looking through the window. Look into the mirror . How toxic you are . Look through your cellphone. How bad you have become. By just adding or following someone who is toxic.

Jack Kornfield: I’d like to see the next Diagnostic and Statistical Manual of Mental Disorders expanded beyond pathology. The upcoming revision should have a whole section on human potential and highly developed well-being. We should expand our vision, both individually and collectively. What is a wise society and what is a wise individual in a wise society? There are possibilities of profound inner peace, joy, creativity, and freedom—remarkable dimensions of mental health that all our collective work is pointing to. Zindel Segal: To follow up on what Jack said, a lot of the way we identify emotional problems is by considering them as episodes. Something starts, you have a difficult time, then it ends, and you’re back to being who you were. But if you look at the actual trajectory over people’s lives, they have many episodes that start and stop. For some people with depression, they never actually pull out of it completely and continue to have difficulties in a low-grade way. We are now starting to consider these not as episodes but as chronic problems that require different treatments from just fixing an episode. We can encourage people to practice lifelong ways of looking after themselves: mental training, even when they are not symptomatic; lifestyle changes such as exercise, even when they don’t necessarily need to lose weight. These are examples of taking responsibility for one’s own care. Meditation training is a very important part of that, along with other approaches that don’t necessarily need the presence of an illness to be of benefit. Jon Kabat-Zinn: That relates to what Alan was saying about an attitudinal shift. Your whole life can change in relationship to exercise or diet, for example. It’s not like “Now I’m on a diet,” but rather “This is simply the way I eat and the things I choose to nourish myself with,” including the diet of what comes in through your eyes and your ears, through television, through the newspaper, and through your relationships.

But then, during the months that I was away from my little colony of apes, I began to see the built-in limitations of empathy. Perhaps because of my relationship with Carol and the rivalry with Zack, and because I am a woman, I came for the first time to believe that even a well-intentioned man, one who truly does empathize with women, is nonetheless incapable of knowing how the relations between men and women feel to a woman. Mainly, he is incapable of knowing how he is perceived by her. And therefore she, despite her likeness to him, remains opaque to him, unknowable. This doesn’t mean that conflict between them is inevitable or inescapable. But there are useful parallels in the relations between men and women, between whites and blacks, between people without disabilities and disabled people, and between human primates and non-human primates. We who have more power in the world, like men with good intentions, try to empathize with those who have less. We try to experience racism as if I who am white were black, to see the world as if I who am sighted were blind, and to reason and communicate as if I who am human were non-human. And thus I dealt with my chimpanzees as if I were one myself. And what was wrong with this? What was ethically and even practically wrong with having empathy towards the other? For a long time, I answered, Nothing. Nothing at all. It’s good politics. I see a blind man about to cross the street and think, He can’t see the whizzing traffic, he needs me to see it for him, to take his arm and escort him over to where he clearly wishes to go. Operating on the assumption that, if I were blind, I’d need me to help me, I grab the man’s arm and pull him panic-stricken into the traffic, terrifying and endangering him. Because I am sighted, I have relied and insisted on using a guidance system that utilizes sight as its main source of data. But the blind man has his own system for crossing the street. The blind man hears what I merely see, isolates bits of information that are lost on me, and coordinates and remembers data that I’ve not even registered. I’m talking here about the difference between empathy and sympathy, between feeling for the other and feeling with the other. The distinction came to matter to me. It still does. When you abandon and betray those with whom you empathize, you’re not abandoning or betraying anyone or anything that’s as real as yourself. Taken to its extreme, perhaps even pathological, form, empathy is narcissism.

High unmitigated communion is associated with poor adjustment, both physically and psychologically, and is linked to heart disease, diabetes, and cancer, perhaps because the focus on others keeps those high on the scale from attending to themselves. Helgeson and Fritz speculate that the gender difference here explains women’s greater propensity to anxiety and depression, a conclusion that meshes with the proposal by Barbara Oakley, who, drawing on work on “pathological altruism,” notes, “It’s surprising how many diseases and syndromes commonly seen in women seem to be related to women’s generally stronger empathy for and focus on others.

leads to the depoliticization of society and the disappearance of solidarity. Each person has to look after his or her own happiness. Happiness becomes a private matter. Suffering is understood to be the result of personal failure. Instead of revolution we thus get depression. Working on our own soul as best we can, we lose sight of the social relations that lead to social malformations. Tortured by fear and anxiety, we blame not society but ourselves. The catalyst for revolution, however, is shared pain. The neoliberal dispositif of happiness nips it in the bud. The palliative society depoliticizes pain by medicalizing and privatizing it. The social dimension of pain is thus suppressed and repressed. Chronic pain, a pathological phenomenon of the burnout society, does not give rise to protest. In the neoliberal society, tiredness is apolitical. It is a tiredness-of-the-I, a symptom of the overstretching of the narcissistic subject of performance. Tiredness isolates us instead of binding us together into a We. I-tiredness must be distinguished from We-tiredness, which is the product of a community. I-tiredness is the best defence against revolution.

Fanon could never bring himself to endorse the surrealist fantasy of madness as—in Rimbaud’s famous expression—the “disordering of all the senses.” Mental illness, he argued, was not freedom’s extreme edge but rather a “pathology of freedom.” This pulverizing alienation from the self, Fanon believed, presented an almost insurmountable obstacle to normal relations with others. The enforced solitude of the mad, prisoners of their delirium, held no romance for Fanon. That Fanon repudiated the Lacanian defense of madness—that he emphasized the vulnerability, suffering, and loss of freedom experienced by the mentally ill, rather than the “visionary” nature of their perception, or the ecstasy of hallucination—is a reminder of the value that he always placed on self-determination.

How does chronic stress affect this process? First, the hormones of the stress-response cause even more glucose and fatty acids to be mobilized into the bloodstream. For a juvenile diabetic, this increases the likelihood of the now-familiar pathologies of glucose and fatty acids gumming up in the wrong places.

What we don’t use it for is to pathologize our clients. Levels of organization do not define who someone is, and we do not make judgments based on the scores.

Children with PDA are often more intellectually able and verbally articulate than children with more typical autism and also appear to be more socially aware. However, they have major problems in relating to and understanding the subtle social aspects of life, together with the unwritten rules of social interaction. They can be extremely challenging but understanding the nature of their difficulties can really make a difference to their lives.

NARM Clinical Approach Is Not NARM Clinical Approach Is Primarily historically focused Primarily present-moment focused Focused on trauma stories (content-driven) Focused on the adaptations to trauma (process-driven) Regressive (child consciousness focused) Grounded in here and now (adult consciousness focused) Cathartic Containment oriented Pathologically oriented Resource oriented Goal driven Inquiry driven Strategically based Curiosity based Behaviorally focused Internal-state focused Focused on symptom reduction Focused on shifting underlying patterns that are driving the symptoms Practitioner driven, with client following their lead Client driven, with practitioner providing new opportunities for exploration

If mental health has been associated with the ongoing development of resilient and adaptive coping through early positive attachment experiences, psychopathology later in life has been associated with disturbances in attachment, characterized by deficits in coping with novelty and stress (Schore, 2001). For those who go on to develop eating disorders, there have often been pathological failures in early maternal responsivity, as well as maternal impingements. Bruch (1973), one of the first psychoanalysts to theorize about and treat eating disorders, noted that often. these patients have what she calls an interoceptive problem - difficulty distinguishing between inside and outside and between self and other - as the result of having their mothers' needs imposed upon them throughout development. As a result, the potential, or transitional space, never achieved as a space between two people, becomes an embodied, or "in-myself' space (Boris, 1984).

prove his superiority over others: “It’s on the ruins of my entourage that I must build my virility.” The West Indian’s drive to overcome his inferiority complex is aimed not at the French, or even at the békés, but at his own peers of color, whom he seeks to dominate, a bleak reminder of how colonial oppression is internalized and reproduced, after the formal end of colonialism. The Adlerian themes in Mannoni—the colonizer’s fears of inferiority, the psychic pleasure of domination, colonial repression as narcissistic and spectacular exhibitionism—would later find even more powerful expression in The Wretched of the Earth. But Fanon historicized the pathologies of colonial psychology by situating their formation in the structures of racial and economic domination, rather than in parent-child relations.

Autophagy is essential to life. If it shuts down completely, the organism dies. Imagine if you stopped taking out the garbage (or the recycling); your house would soon become uninhabitable. Except instead of trash bags, this cellular cleanup is carried out by specialized organelles called lysosomes, which package up the old proteins and other detritus, including pathogens, and grind them down (via enzymes) for reuse. In addition, the lysosomes also break up and destroy things called aggregates, which are clumps of damaged proteins that accumulate over time. Protein aggregates have been implicated in diseases such as Parkinson’s and Alzheimer’s disease, so getting rid of them is good; impaired autophagy has been linked to Alzheimer’s disease–related pathology and also to amyotrophic lateral sclerosis (ALS), Parkinson’s disease, and other neurodegenerative disorders.

Helgeson and Fritz speculate that the gender difference here explains women’s greater propensity to anxiety and depression, a conclusion that meshes with the proposal by Barbara Oakley, who, drawing on work on “pathological altruism,” notes, “It’s surprising how many diseases and syndromes commonly seen in women seem to be related to women’s generally stronger empathy for and focus on others.” The

Besides robbing us of health and vitality, emotions constitute the greatest obstacle to spiritual cultivation by diverting energy and attention from internal development to external distractions, and by provoking behavior that contradicts our best intentions. Our emotions constitute our own worst enemies, yet not only does Western medicine overlook the severe pathological consequences of emotional imbalance, Western philosophy romanticizes emotions as heroic impulses to be indulged rather than recognizing them as primitive instincts that must be controlled by the higher sentience of human awareness. Herein lies one of the most fundamental differences between Eastern and Western tradition, for Eastern philosophy clearly identifies emotions as obstacles to spiritual development, pollutants to mental clarity, spoilers of human relations, and enemies of intent and reason. When Asians remark that Westerners have 'hot feelings', what they mean is that they overreact emotionally, thereby 'overheating' human relations with unrestrained emotional energy.

Only after the concept of knowledge has been based on an ontological relation [*Seinsverhältnis*] can we work out the particular kind of being from which the principle of immanence-to-consciousness (the starting point of Idealism and Critical Realism) mistakenly proceeds as though from a primary insight. This is the being of "being-conscious" [*Bewusst-Seins*]. All being-conscious must first of all be brought under the higher concept of ideal being, or, at all events, that of irreal being. The mental item which presents itself in the experiences of consciousness may be real; being-conscious itself never is. However, the concept of consciousness is derivative in not only this sense. Consciousness also presupposes the concept of knowledge. Nothing is more misleading than to proceed in the opposite direction and define knowledge itself as simply a particular "content of consciousness," as we see if we oppose, to the particular kind of knowing and having-known which we call consciousness, another kind of knowledge which precedes it and includes no form of being-conscious. We will call this knowledge *ecstatic* [*ekstatische*] knowledge. It is found quite clearly in animals, primitive people, children, and, further, in certain pathological and other abnormal and supra-normal states (e.g., in recovering from the effects of a drug). I have said elsewhere that the animal never relates to its environment as to an object but only *lives in it* [*es lebe nur "in sie hinein*"]. Its conduct with respect to the external world depends upon whether the latter satisfies its instinctive drives or denies them satisfaction. The animal experiences the surrounding world as resistances of various types. Hence, it is absolutely necessary to contest the principle (in Descartes, Franz Brentano, *et al*.) that every mental function and act is accompanied by an immediate knowledge of it. An even more highly contestable principle is that a relation to the self is an essential condition of all processes of knowledge. It is difficult to reproduce purely ecstatic knowledge in mature, civilized men, whether in memory, reverie, perception, thought, or empathetic identification with things, animals, or men; nonetheless, there is no doubt that in every perception and presentation of things and events we think that we grasp *the things-themselves*, not mere "images" of them or representatives of some sort. Knowledge first becomes conscious knowledge [*Bewusst-sein*], that is, comes out of its original ecstatic form of simply "having" things, in which there is no knowledge of the having or of that through which and in which it is had, when the act of being thrown back on the self (probably only possible for men) comes into play. This act grows out of conspicuous resistances, clashes, and oppositions―in sum, out of pronounced suffering. It is the *actus re-flexivus* in which knowledge of the knowledge of things is added to the knowledge of things. Furthermore, in this act we come to know the kind of knowledge we have, for example, memory, ideation, and perception, and finally, beyond even these, we come to have a knowledge of the relation of the act performed to the self, to the knower. With respect to any specific relation to the self, this last knowledge, so-called conscious self-knowledge, comes only after knowledge about the act. Kant's principle that an "I think" must be *able* to accompany all a man's thoughts may be correct. That it in fact always accompanies them is nevertheless undoubtedly false. However, the kind of being (indeed, of ideal being) which contents possess when they are reflexively *had* in their givenness in conscious acts―when, therefore, they become reflexive―is the being of being-consciously-known." from_Idealism and Realism_

Anxiety and stress-related mental dysfunction is the plague of modern-day society. Millions of people are tormented by anxious thinking and the consequent distress this brings, irrespective of whether they live in a mansion or a bed-sit or whether they earn millions or are living on the breadline. This would indicate that external circumstances cannot prevent or cause pathological anxiety or free people from negative emotions.

Near-Psychotic Symptoms in Obsessive-Compulsive Disorder Despite clear-cut differences in psychopathology between schizophrenia and OCD, there is a substantial overlap, a “gray zone,” between the two disorders. Thus, unusual and “bizarre” obsessive themes exhibited by a subgroup of otherwise typical OCD patients might complicate the distinction between the obsessions and delusions. The difference between OCD-related pathologic slowness and the restrictive motor output associated with negative symptoms of schizophrenia or with catatonic motor disturbances is not straightforward. The differential diagnosis between OCD-related indecisiveness and pathologic doubt and schizophrenic ambivalence is also challenging. Patient insight into the senseless nature of OC symptoms is one of the hallmarks of the disorder. According to the DSM-5, at some point in the course of the illness, the patients must recognize that their obsessive beliefs are “definitely or probably not true.” Indeed, in typical OCD cases, patients readily acknowledge that their OC symptoms are illogical and pathologic. On the other hand, a significant majority of schizophrenia patients either do not believe that they are ill, or even if they do acknowledge symptoms, they misattribute them to other causes.6 Nevertheless, a significant subset of OCD patients can sometimes present without insight, or with conviction that their obsessions are true, thus complicating the differential diagnosis of obsessions from delusions. Overall, from the psychopathologic perspective, schizophrenia and OCD are distinct, despite their partially overlapping characteristics. Some symptoms, such as delusions and obsessions, pathologic doubt and ambivalence, rituals and motor stereotypy, may represent a continuum of OCD impairments, while others, such as negative and disorganized symptoms, are more schizophrenia-specific (Fig 3.1).

Whether analyzing news coverage in some of the nation’s most respected newspapers and magazines, or depictions of Blacks in film and on television, my students find that African Americans are too often relegated to narratives related to crime, sports, and pathology. For far too many Americans, these depictions are more authentic renderings of African American life than are the daily strivings of the actual people who evade detection: the ordinary and extraordinary fathers, brothers, mothers, and sisters who languish on the margins. It’s unlikely that the average African American is cognizant of the extent to which these portrayals shape and misshape the contours of their own lives: how the preponderance of stereotypes in film, crime shows, news stories, and music videos reduces them to specters whose walking, driving, or standing can result in a store clerk’s surveillance or a fatal encounter with police. And these images have gone far to sustain a rigid racial caste system resulting in the overpolicing and the mass incarceration of Black and Brown men, as well as a culture of exclusion in many of the most influential fields.

Central to the existence of racism is the politics of its denial. It is in the best interests of the right to assert the nonexistence of racism except as a manifestation of individual pathology—a matter simply of individuals with bad attitudes. But it is the shame of liberals who think of themselves as guardians and witnesses of corrective concern and conscience that they too have elected to treat racism as a problem of individual social relations and not the systematic operation of power at work throughout our political economy. These essays call into question and to account a liberal majority that trivializes racism by turning its attention to individual remedies, to attitude adjustment, to “color-blind” legal adjudication.

While these racial differentials in mortality have provoked a certain amount of discussion, public health expert Vicente Navarro recently pointed to the "deafening silence" on the topic of class differentials in mortality in the United States, where "race is used as a substitute for class." But in 1986, on "one of the few occasions that the U.S. government collected information on mortality rates (for heart and cerebrovascular disease) by class, the results showed that, by whatever indicators of class one might choose (level of education, income, or occupation), morality rates are related to social class.

although those who exhibit structural division of the personality commonly exhibit altered states of consciousness, only relatively few individuals who experience altered states of consciousness also exhibit structural divisions of the personality. To clarify the distinction, Steele and colleagues preferred to reserve the terms dissociation and dissociative for instances of structural division of the personality, with altered states of consciousness instead referred to simply as such (see also Nijenhuis & van der Hart, 2011). Steel and colleagues called for further investigation of the psychological and neurobiological underpinnings of both pathological alterations in consciousness and structural division of the personality. Trauma-Related

In our secular world, we no longer see eternal paradise as a carrot at the end of the stick of life, but try to cram as much as possible into our relatively short time on the planet instead. This is, of course, a futile endeavour, doomed to failure. It is tempting to interpret the modern epidemics of depression and burnout as the individual's response to the unbearable nature of constant acceleration. The decelerating individual - who slows down instead of speeding up, and maybe even stops completely - seems out of place in a culture characterised by manic development, and may be interpreted pathologically (i.e. diagnosed as clinically depressed).

We are quite ready to accuse others of ‘narcissism' in particular those whom we desire, with the aim of reassuring ourselves and relating their indifference, not to the very minor interest that we hold in their eyes or even perhaps in absolute terms […] but to a kind of weakness that afflicts others. When we do this, we credit them with an excessive and pathological concentration on themselves— with a kind of illness that makes them more sick than we are and consequently incapable of breaking out of their over-protected ego and meeting us half-way as they should.

Il n'y a pas de trouble pathologique en soi, l'anormal ne peut être apprécié que dans une relation.

Empirical logic achieved a signal triumph in the Old Testament, where survivals from the early proto-logical stage are very few and far between. With it man reached a point where his best judgments about his relation to God, his fellow men and the world, were in most respects not appreciably inferior to ours. In fundamental ethical and spiritual matters we have not progressed at all beyond the empirico-logical world of the Old Testament or the unrivalled fusion of proto-logical intuition, 64 [see Coomaraswamy, Review of Religion, 1942, p. 138, paragraph 3] empirico-logical wisdom and logical deduction which we find in the New Testament. In fact a very large section of modern religion, literature and art actually represents a pronounced retrogression when compared with the Old Testament. For example, astrology, spiritism and kindred divagations, which have become religion to tens of millions of Europeans and Americans, are only the outgrowth of proto-logical interpretation of nature, fed by empirico-logical data and covered with a spurious shell of Aristotelian logic and scientific induction. Plastic and graphic art has swung violently away from logical perspective and perceptual accuracy, and has plunged into primordial depths of conceptual drawing and intuitive imagery. While it cannot be denied that this swing from classical art to conceptual and impressionistic art has yielded some valuable results, it is also true that it represents a very extreme retrogression into the proto-logical past. Much of the poetry, drama and fiction which has been written during the past half-century is also a reversion from classical and logical standards of morality and beauty into primitive savagery or pathological abnormality. Some of it has reached such paralogical levels of sophistication that it has lost all power to furnish any standards at all to a generation which has deliberately tried to abandon its entire heritage from the past. All systematic attempts to discredit inherited sexual morality, to substitute dream-states for reflection, and to replace logical writing by jargon, are retreats into the jungle from which man emerged through long and painful millennia of disillusionment. With the same brains and affective reactions as those which our ancestors possessed two thousand years ago, increasing sophistication has not been able to teach us any sounder fundamental principles of life than were known at that time. . . . Unless we can continue along the pathway of personal morality and spiritual growth which was marked out for civilized man by the founders of the Judaeo-Christian tradition, more than two thousand years ago, our superior skill in modifying and even in transforming the material world about us can lead only to repeated disasters, each more terrible than its predecessor. (Archaeology and the Religion of Israel, 5th Ed. New York: Doubleday Anchor, 31-33.)

We need to be able to differentiate for a moment fear, anxiety and angst. Angst is existential anxiety, it comes with the condition: we are born, we are consious, we are aware of our fragility and mortality and that contributes to the sense of the peril in which daily life occurs. That’s existantial anxiety, it’s not pathological...it’s part of the suffering, of the human condition. Fear is something specific, something related to a specific threat, real or perceived, to our wellbeing. Anxiety is a free floating anticipatory emotion, anxiety is always in some way bound to the future, like something could happen here, something might happen. Paradoxicallly guilt binds us to the past and we always stuck in the past with guilt. And anxiety binds us to a possible future, a so improbable one, but a possible one. So in differentiating for a moment between fear and anxiety we realize that there can be therapeutic move from anxiety to fear, and you could say: oh, yea, i feel so much better already! I am not anxious anymore, i am just fearfiul. In many cases our fears are non existents or manageable, in many cases our fears are based on powerless past...most of our fears.. if you look at them as an adult, they are not going to happen, but if they were to happen, we can bear them, because we’ve also become adults, we have most of all we have psychological tensil strength, we have resiliance that child did not have, we have modes of behavious and other choices available to us, we have a capacity for toleration, we have a capacity for freedom of motion, that we didn’t have as a child... And so many times the effort to define a fear is to say it’s not going to happen, but if it were to happen, i can handle it, i can manage that. Fear in a sense is specific always, anxiety is like a fog that blows across the highway.,i t can keep us from driving as we can’t see clearly what is happening, but underneath all that we know that anxiety has power to cripple life.

In 2010, a cognitive neuroscientist named Reza Habib asked twenty-two people to lie inside an MRI and watch a slot machine spin around and around. Half of the participants were “pathological gamblers”—people who had lied to their families about their gambling, missed work to gamble, or had bounced checks at a casino— while the other half were people who gambled socially but didn’t exhibit any problematic behaviors. Everyone was placed on their backs inside a narrow tube and told to watch wheels of lucky 7s, apples, and gold bars spin across a video screen. The slot machine was programmed to deliver three outcomes: a win, a loss, and a “near miss,” in which the slots almost matched up but, at the last moment, failed to align. None of the participants won or lost any money. All they had to do was watch the screen as the MRI recorded their neurological activity. “We were particularly interested in looking at the brain systems involved in habits and addictions,” Habib told me. “What we found was that, neurologically speaking, pathological gamblers got more excited about winning. When the symbols lined up, even though they didn’t actually win any money, the areas in their brains related to emotion and reward were much more active than in non-pathological gamblers. “But what was really interesting were the near misses. To pathological gamblers, near misses looked like wins. Their brains reacted almost the same way. But to a nonpathological gambler, a near miss was like a loss. People without a gambling problem were better at recognizing that a near miss means you still lose.” Two groups saw the exact same event, but from a neurological perspective, they viewed it differently. People with gambling problems got a mental high from the near misses—which, Habib hypothesizes, is probably why they gamble for so much longer than everyone else: because the near miss triggers those habits that prompt them to put down another bet. The nonproblem gamblers, when they saw a near miss, got a dose of apprehension that triggered a different habit, the one that says I should quit before it gets worse.

Enforced love is not love. All it can lead to is a “sham” relationship without any genuine communication, a pretense of warmth and cordiality that does not really exist, a false avowal of affection designed to mask resentment or possibly even hatred. It can never lead to a genuine encounter. One of Mishima’s works is called Confessions of a Mask. How can a mask genuinely relate what the person behind it has experienced? It cannot. The story it tells in Mishima’s work is purely intellectual. All Mishima could do was to relate the consequences of the facts, but both these facts and the emotions that went with them remained inaccessible to his conscious mind. The consequences manifested themselves in pathological, perverted fantasies, what we might call an “abstract death wish.” The actual feelings of a little child imprisoned in his grandmother’s room year after year were beyond the reach of the adult he finally became.

Dissociative disorders (DDs) were first recognized as official psychiatric disorders in 1980 with the publication of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM III) in 1980. Prior to this, the related symptoms were listed under ‘hysterical neuroses’ in the second edition of the DSM.[1,2] Interestingly, all of the current DDs that have been described were discovered prior to 1900 but decades passed with little study or research of this spectrum of psychiatric pathology.

Chaos et âge d'or sont les termes mythiques de la relation normative fondamentale, termes en relation telle qu'aucun des deux ne peut s'empêcher de virer à l'autre. Le chaos a pour rôle d'appeler, de provoquer son interruption et de devenir un ordre. Inversement, l'ordre de l'âge d'or ne peut durer, car la régularité sauvage est médiocrité ; les satisfactions y sont modestes – aurea mediocritas – parce qu'elles ne sont pas une victoire remportée sur l'obstacle de la mesure.

The real pathology is in the way family members relate to each other. Who actually becomes symptomatic and shows up as the “patient” is somewhat arbitrary, and she may even be the healthiest one in the family

Article F: Alternobaric Vertigo and Eustachian Tube Dysfunction. Charles D. Bluestone, MD; J. Douglas Swarts, PhD; Joseph M. Furman, MD, PhD; Robert F. Yellon, MD. Case Report: Persistent Alternobaric Vertigo at Ground Level due to Chronic Toynbee phenomenon. Laryngoscope 2012;122(4):868–72. The term “alternobaric vertigo” was coined by Lundgren in 1965 to describe vertigo in deep-sea divers, but also referred to aircraft pilots in 1966. It occurs during ascent and rarely descent and is a result of asymmetrical middle-ear pressures. Classically the vertigo due to this pathogenesis is transient but may last for several minutes. It is frequently associated with nausea and vomiting. It has been reproduced in pressure chamber experiments with some divers and fliers, but has not been reported spontaneously at ground level (Figure F–1). FIGURE F–1. Alternobaric vertigo can occur during ascent in an airplane or when scuba diving. We encountered a 15-year-old female with bilateral tympanostomy tubes who manifested persistent severe vertigo, at ground level, secondary to a unilateral middle-ear pressure of +200 mm H2O elicited by an obstructed tympanostomy tube in the presence of chronic nasal obstruction. She had had long-term tubes placed due to recurrent and chronic otitis media. Physical examination revealed achondroplasia, which is an autosomal dominate disorder characterized by abnormal bone growth, short arms and legs, short stature and a large head, which is associated with otitis media. The pathogenesis of otitis media in these individuals may be related to abnormal anatomy causing Eustachian tube dysfunction. Balance testing was abnormal, Eustachian tube function tests revealed dysfunction of tube. Surgery was performed to replace the obstructed tube with a patent one, and an adenoidectomy and bilateral inferior turbinate reduction to relieve the chronic nasal obstruction. Postoperatively balance testing was normal, Eustachian tube function remained dysfunctional, but she had complete resolution of her vertigo following the surgery. FIGURE F–2. Pathogenesis of alternobaric vertigo due to the “Toynbee phenomenon” One tympanostomy was obstructed and when swallowing, she developed high positive pressure in the middle ear, but in the ear with a patent tube, the pressure did not remain in the middle ear. We believed this was a previously unreported scenario in which closed-nose swallowing insufflated air into her middle ears, resulting in sustained positive middle-ear pressure in the ear with the obstructed tube. Swallowing, when the nose is obstructed, can result in abnormal negative or positive pressures in the middle ear, which has been termed the “Toynbee phenomenon.” We concluded that in patients who have vertigo, consideration should be given to the possibility that nasal obstruction and the “Toynbee phenomenon” are involved (Figure F–2). CHAPTER 7 PATHOLOGY The pathology of the ET may or may not be involved in the pathogenesis of otitis media, whereas the

In reflecting on these conflicts in the Balkans, political philosopher Michael Ignatieff observes that closely related (often inter-related) group identities became segregated along rigid collective boundaries that illustrate Sigmund Freud's psychoanalytical concept of the "narcissism of minor differences" (Ifnatieff, 1997, 34-71). According to Freud, small differences between people become magnified and classified manipulatively and destructively, especially when those people are actually quite similar or live in close proximity to one another. In fact, according to Freud, the more similar or closely related people or groups are, the more likely they will be to amplify their small differences (Freud, 1985, 131, 305) This tendency is liable to assume the form of pathological self-love (narcissism) in which loving oneself (and one's people) becomes indistinguishable from loathing "the other" (i.e., those who are different from oneself and the members of one's group) Such self-love perceives the very existence of the other as a source of anxiety; it is perceived as harmful to - in some way, a judgment against - oneself and one's group. Typically, this narcissism results in explicit violence against the other who is perceived as perversely different but is, in the vast majority of ways, actually quite similar.

From this perspective of cancer as a metabolic disease, insulin and IGF promote the cancer process through a series of steps. First, insulin resistance and elevated levels of insulin trigger an increased uptake of blood sugar (glucose) as fuel for precancerous cells. These cells then begin producing energy through a mechanism known as aerobic glycolysis that is similar to what bacteria do in oxygen-poor environments. (This phenomenon is known as the Warburg effect and was discovered in the 1920s by the German biochemist and later Nobel Laureate Otto Warburg, although its importance in the cancer process was not embraced until recently.) Once cancer cells make this conversion, they burn enormous amounts of glucose as fuel, providing them, apparently, with the necessary raw materials to proliferate. By metabolizing glucose at such a rapid rate, as Thompson suggests, these cancer cells generate relatively enormous amounts of compounds known technically as “reactive oxygen species” and less technically as “free radicals,” and these, in turn, have the ability to mutate the DNA in the cell nucleus. The more glucose a cell metabolizes and the faster it does so, the more free radicals are generated to damage DNA, explains Thompson. And the more DNA damage, the more mutations are generated, and the more likely it is that one of those mutations will bestow on the cells the ability to proliferate without being held in check by the cellular processes that work to prevent this pathological process in healthy cells. The result is a feed-forward acceleration of tumor growth. While this is happening, the insulin and IGF in the circulation both work to signal the cell to keep proliferating, and to inhibit the mechanism (technically known as apoptosis, or cell suicide) that would otherwise kick in to shut it down.

From mind control to programming Foa and Kozak (1986) note that pathological fear structures, including unrealistic elements that may become associated with states of absorption and heightened arousal often attendant with extreme stress, are extremely resistant to modification. Hence, the power of all statements made during and immediately after abusive episodes while the victim is in an altered state will be enhanced by the absence of an operative critical consciousness (Conway, 1994), and by the indelible connection with intolerable terror or dread. Psychologically sophisticated abusers who have mastered the methods of mind control know how to induce psychobiological state changes, how to elaborate and encapsulate them, how to provide the cues to trigger them, how to tap into and alter the victim's motivational and belief systems, and how to layer amnesias within a personality. In this way a polyfragmented dissociative individual can appear to lead the life of a normal hardworking citizen, yet can function undetected (by himself or by others) as a mind-controlled operative and remain available for service to individual perpetrators or groups.