Primary Care Quotes

I’m a modern man, a man for the millennium. Digital and smoke free. A diversified multi-cultural, post-modern deconstruction that is anatomically and ecologically incorrect. I’ve been up linked and downloaded, I’ve been inputted and outsourced, I know the upside of downsizing, I know the downside of upgrading. I’m a high-tech low-life. A cutting edge, state-of-the-art bi-coastal multi-tasker and I can give you a gigabyte in a nanosecond! I’m new wave, but I’m old school and my inner child is outward bound. I’m a hot-wired, heat seeking, warm-hearted cool customer, voice activated and bio-degradable. I interface with my database, my database is in cyberspace, so I’m interactive, I’m hyperactive and from time to time I’m radioactive. Behind the eight ball, ahead of the curve, ridin the wave, dodgin the bullet and pushin the envelope. I’m on-point, on-task, on-message and off drugs. I’ve got no need for coke and speed. I've got no urge to binge and purge. I’m in-the-moment, on-the-edge, over-the-top and under-the-radar. A high-concept, low-profile, medium-range ballistic missionary. A street-wise smart bomb. A top-gun bottom feeder. I wear power ties, I tell power lies, I take power naps and run victory laps. I’m a totally ongoing big-foot, slam-dunk, rainmaker with a pro-active outreach. A raging workaholic. A working rageaholic. Out of rehab and in denial! I’ve got a personal trainer, a personal shopper, a personal assistant and a personal agenda. You can’t shut me up. You can’t dumb me down because I’m tireless and I’m wireless, I’m an alpha male on beta-blockers. I’m a non-believer and an over-achiever, laid-back but fashion-forward. Up-front, down-home, low-rent, high-maintenance. Super-sized, long-lasting, high-definition, fast-acting, oven-ready and built-to-last! I’m a hands-on, foot-loose, knee-jerk head case pretty maturely post-traumatic and I’ve got a love-child that sends me hate mail. But, I’m feeling, I’m caring, I’m healing, I’m sharing-- a supportive, bonding, nurturing primary care-giver. My output is down, but my income is up. I took a short position on the long bond and my revenue stream has its own cash-flow. I read junk mail, I eat junk food, I buy junk bonds and I watch trash sports! I’m gender specific, capital intensive, user-friendly and lactose intolerant. I like rough sex. I like tough love. I use the “F” word in my emails and the software on my hard-drive is hardcore--no soft porn. I bought a microwave at a mini-mall; I bought a mini-van at a mega-store. I eat fast-food in the slow lane. I’m toll-free, bite-sized, ready-to-wear and I come in all sizes. A fully-equipped, factory-authorized, hospital-tested, clinically-proven, scientifically- formulated medical miracle. I’ve been pre-wash, pre-cooked, pre-heated, pre-screened, pre-approved, pre-packaged, post-dated, freeze-dried, double-wrapped, vacuum-packed and, I have an unlimited broadband capacity. I’m a rude dude, but I’m the real deal. Lean and mean! Cocked, locked and ready-to-rock. Rough, tough and hard to bluff. I take it slow, I go with the flow, I ride with the tide. I’ve got glide in my stride. Drivin and movin, sailin and spinin, jiving and groovin, wailin and winnin. I don’t snooze, so I don’t lose. I keep the pedal to the metal and the rubber on the road. I party hearty and lunch time is crunch time. I’m hangin in, there ain’t no doubt and I’m hangin tough, over and out!

The American Institute of Health estimates that 75–90 percent of all visits to primary care physicians are for stress-related problems.

Our primary health care should begin on the farm and in our hearts, and not in some laboratory of the biotech and pharmaceutical companies.

These drugs were advertised mostly to primary care physicians, who had little pain-management training and were making their money by churning patients through their offices at a thirteen-minute clip.

I believe that the most urgent need of parents today is to instill in our children a moral vision: what does it mean to be a good person, an excellent neighbor, a compassionate heart? What does it mean to say that God exits, that He loves us and He cares for us? What does it mean to love and forgive each other? Parents and caregivers of children must play a primary role in returning our society to a healthy sense of the sacred. We must commit to feeding our children’s souls in the same way we commit to feeding their bodies.

Certainly the primary imperative of a physician is to be skilled in medical science, but if he or she does not probe a patient's soul, then the doctor's care is given without caring, and part of the sacred mission of healing is missing.

The primary thing that people are going to try to take away from you— is the purity of your happiness. Rare is it to find in someone a pure happiness. A happiness so innocent, so spontaneous and so raw... it is the way we are born but it is most often not the way that we die. The world comes in and tries to take that away from you. People come in and try to take that away from you. I have learned not to jump into the pigsty with them. You have to protect the purity of your happiness and the innocence of your joy. People WILL try to take it away. Don't go there, don't let them. Keep what is yours.

Political economy tends to see work in capitalist societies as divided between two spheres: wage labor, for which the paradigm is always factories, and domestic labor – housework, childcare – relegated mainly to women. The first is seen primarily as a matter of creating and maintaining physical objects. The second is probably best seen as a matter of creating and maintaining people and social relations. [...] This makes it easier to see the two as fundamentally different sorts of activity, making it hard for us to recognize interpretive labor, for example, or most of what we usually think of as women’s work, as labor at all. To my mind it would probably be better to recognize it as the primary form of labor. Insofar as a clear distinction can be made here, it’s the care, energy, and labor directed at human beings that should be considered fundamental. The things we care most about – our loves, passions, rivalries, obsessions – are always other people; and in most societies that are not capitalist, it’s taken for granted that the manufacture of material goods is a subordinate moment in a larger process of fashioning people. In fact, I would argue that one of the most alienating aspects of capitalism is the fact that it forces us to pretend that it is the other way around, and that societies exist primarily to increase their output of things.

My primary and most essential goal in life is to remain connected to the world of spirit. Everything else will take care of itself—this I know for sure. And my number-one spiritual practice is trying to live in the present moment … to resist projecting into the future, or lamenting past mistakes … to feel the real power of now. That, my friends, is the secret to a joyful life.

Of course, weakness is strong. It’s the primary impulse. You’d probably prefer to sit in your little room and cry. Live in your finite collection of memories, carefully polishing each one. Half a life set behind glass and pinned to cardboard like a collection of exotic insects. You’d like to live behind that glass, wouldn’t you?

What we experience as children becomes familiar and we are more likely to replicate experiences and attract people who carry similar patterns as our primary care givers.

No,” I start, hesitantly. “Well, we have to end apartheid for one. And slow down the nuclear arms race, stop terrorism and world hunger. Ensure a strong national defense, prevent the spread of communism in Central America, work for a Middle East peace settlement, prevent U.S. military involvement overseas. We have to ensure that America is a respected world power. Now that’s not to belittle our domestic problems, which are equally important, if not more. Better and more affordable long-term care for the elderly, control and find a cure for the AIDS epidemic, clean up environmental damage from toxic waste and pollution, improve the quality of primary and secondary education, strengthen laws to crack down on crime and illegal drugs. We also have to ensure that college education is affordable for the middle class and protect Social Security for senior citizens plus conserve natural resources and wilderness areas and reduce the influence of political action committees.” The table stares at me uncomfortably, even Stash, but I’m on a roll.

The door to the primary power junction was reinforced. A red border was painted around the frame, with warnings in half a dozen languages that all meant Please be careful. There’s a lot of things in here that we’ll have to fix after they finish killing you.

The tent was for Abraham’s living. Abraham did not take care of his living first. That was secondary. With Abraham, the primary matter [560] was to consecrate everything to God, to worship and serve God, and to have fellowship with God. Only then did Abraham pitch a tent for his living.

Evenings and mornings represent “the gates” to your inner universe. Taking care of how you enter and exit these “gates” is your primary responsibility; do not give away this power. Once you master it, life will never be the same again.

Equally worrying, and far less recognized, medicine has been slow to confront the very changes that it has been responsible for—or to apply the knowledge we have about how to make old age better. Although the elderly population is growing rapidly, the number of certified geriatricians the medical profession has put in practice has actually fallen in the United States by 25 percent between 1996 and 2010. Applications to training programs in adult primary care medicine have plummeted, while fields like plastic surgery and radiology receive applications in record numbers. Partly, this has to do with money—incomes in geriatrics and adult primary care are among the lowest in medicine. And partly, whether we admit it or not, a lot of doctors don’t like taking care of the elderly.

With the managed care movement of the 1980s and 1990s, insurance companies cut costs and reduced what services they’d pay for. They required that patients give up their longtime physicians for those on a list of approved providers. They negotiated lower fees with doctors. To make up the difference, primary care docs had to fit more patients into a day. (A Newsweek story claimed that to do a good job a primary care doctor ought to have a roster of eighteen hundred patients. The average load today is twenty-three hundred, with some seeing up to three thousand.)

In the Mars-and-Venus-gendered universe, men want power and women want emotional attachment and connection. On this planet nobody really has the opportunity to know love since it is power and not love that is the order of the day. The privilege of power is at the heart of patriarchal thinking. Girls and boys, men and women who have been taught this way almost always believe love is not important, or if it is, it is never as important as being powerful, dominant, in control, on top-being right. Women who give seemingly selfless adoration and care to the men in their lives appear to be obsessed with 'love,' but in actuality their actions are often a covert way to hold power. Like their male counterparts, they enter relationships speaking the words of love even as their actions indicate that maintaining power and control is their primary agenda.

This is the only time you can study both of your shadows. If you sit perfectly still and watch your primary shadow as the sun sets you will be able to hold it long enough to see your other shadow fill up when the moon rises like a porcelain basin with clear water. If you turn carefully to face the south you may regard both of them: to understand the nature of silence you must be able to see into this space between your shadows.

If one considers this question carefully, one can see that in a certain sense the East was right to see the immeasurable as the primary reality. For, as has already been indicated, measure is an insight created by man. A reality that is beyond man and prior to him cannot depend on such insight.

The goal of the Deep Southern oligarchy has been consistent for over four centuries: to control and maintain a one-party state with a colonial-style economy based on large-scale agriculture and the extraction of primary resources by a compliant, poorly educated, low-wage workforce with as few labor, workplace safety, health care, and environmental regulations as possible.

A philosophical thought is not supposed to be impervious to all criticism; this is the error Whitehead describes of turning philosophy into geometry, and it is useful primarily as a way of gaining short-term triumphs in personal arguments that no one else cares (or even knows) about anyway. A good philosophical thought will always be subject to criticisms (as Heidegger’s or Whitehead’s best insights all are) but they are of such elegance and depth that they change the terms of debate, and function as a sort of “obligatory passage point” (Latour’s term) in the discussions that follow. Or in other words, the reason Being and Time is still such a classic, with hundreds of thousands or millions of readers almost a century later, is not because Heidegger made “fewer mistakes” than others of his generation. Mistakes need to be cleaned up, but that is not the primary engine of personal or collective intellectual progress.

Not only can we lovingly detach from other people and take care of ourselves, it is our primary responsibility in life to do that. To

It is in your primary relationship that you should be able to feel the most sure of receiving kindness and support, of being carefully listened to, of being seen and understood.

The most common complaint heard by primary care physicians today is fatigue, and the most common cause of fatigue is sleep deprivation.

A study of nearly seven hundred thousand primary care visits, for instance, showed that physicians are significantly more likely to prescribe opioids at the end of a long day.

The libertarian philosophy doesn't explain the best way to grow a vegetable garden!" Why do some people talk as if there should be one concept or principle which is all you'll ever need to know in order to handle everything in life? Right now the PRIMARY threat to humanity--by a factor of a zillion--is the belief in "authority." And the solution--the ONLY solution--is for people to escape that superstition. Questions like, "But how do we care for the poor?" are 100% logically IRRELEVANT to proving that statism is immoral and destructive. "But gee, if I stop sawing off my toes with this steak knife, how will I balance my checkbook?" Why the hell do people imagine that anarchists have some obligation to explain how every aspect of everyone's life will work, just because they say, "Having a ruling class is immoral and irrational"? When someone tells you to stop advocating evil crap (e.g., statism), they don't suddenly acquire an obligation to explain the whole universe to you, or to guarantee that nothing bad will ever happen to anyone ever again.

The Christian answer to this is that no two people are compatible. Duke University ethics professor Stanley Hauerwas has famously made this point:   Destructive to marriage is the self-fulfillment ethic that assumes marriage and the family are primarily institutions of personal fulfillment, necessary for us to become “whole” and happy. The assumption is that there is someone just right for us to marry and that if we look closely enough we will find the right person. This moral assumption overlooks a crucial aspect to marriage. It fails to appreciate the fact that we always marry the wrong person. We never know whom we marry; we just think we do. Or even if we first marry the right person, just give it a while and he or she will change. For marriage, being [the enormous thing it is] means we are not the same person after we have entered it. The primary problem is . . . learning how to love and care for the stranger to whom you find yourself married.40

Love often fails because people instinctively give what they want. Because a woman’s primary love needs are to be cared for, understood, and so forth, she automatically gives her man a lot of caring and understanding. To a man this caring support often feels as though she doesn’t trust him. Being trusted is his primary need, not being cared for. Then, when he doesn’t respond positively to her caring she can’t understand why he doesn’t appreciate her brand of support. He, of course, is giving his own brand of love, which isn’t what she needs. So they are caught in a loop of failing to fulfill each other’s needs.

While a life like Frederick Douglas’s is remarkable, we must remember that not every person who lived through slavery was like Douglas. Most did not learn to read or write. Most did not engage in hand-to-hand combat with white slave brakers. Most did not live close enough to free states in the North to have any hope of escape. No one, enslaved or otherwise, was like Douglas. There were other brilliant, exceptional people who lived under slavery, and many resisted the institution in innumerable ways, but our country’s teachings about slavery, painfully limited, often focus singularly on heroic slave narratives, at the expense of millions of men and women whose stories might be less sensational but are no less worthy of being told. “I thought of my primary and secondary education. I remembered feeling crippling guilt as I silently wondered why every enslaved person couldn’t simply escape like Douglas, Tubman, and Jacobs had. I found myself angered by the stories of those who did not escape. Had they not tried hard enough? Didn’t they care enough to do something? Did they choose to remain enslaved? This, I now realize, is part of the insidiousness of white supremacy. It illuminates the exceptional in order to implicitly blame those who cannot, despite the most brutal circumstances, attain super-human heights. It does this instead of blaming the system, the people who built it, and the people who maintained it.

Men did care enough to struggle with our demands. And some cared enough to convert to feminist thinking and to change. But only a very, very few loved us – loved us all the way. And that meant respecting our sexual rights. To this day I believe that feminist debate about love and sexuality ended precisely because straight women did not want to face the reality that it was highly unlikely in patriarchal society that a majority of men would wholeheartedly embrace women’s right to say no in the bedroom. Since the vast majority of heterosexual women, even those involved in radical feminist movement, were not willing to say no when they did not want to perform sexually for the fear of upsetting or alienating their mate, no significant group of men ever had to rise to the occasion. While it became more acceptable to say no now and then, it was not acceptable to say no for any significant amount of time. An individual woman in a primary relationship with a man could not say no, because she feared there was always another woman in the background who could take her place, a woman who would never say no.

Along with better training, pediatricians need better pay. Paradoxically, physicians involved in the primary care of our children—the doctors on the front lines who receive tens of thousands of visits every day from parents and their children—are among the lowest paid of all physicians in the United States. Something is wrong with our system when the doctor who performs a brief diagnostic procedure—some form of X-ray, for example, or a fifteen-minute operation—is paid many times more than the doctors making crucial decisions about our children’s health.

Poor health was not just the result of random acts, bad luck, bad behavior or unfortunate genetics. Deliberate public policy decision about housing, education, parks and streets were the key drivers of racial differences in mortality. Crime kept people off the streets and limited their ability to exercise. The lack of grocery stores limited dietary choices. The lack of primary care doctors and specialists in these communities made chronic disease care more difficult. The degradation and loss of hospital services in these communities affected hospital-based outcomes. … The chronic underfunding of critical health services at Cook County Hospital and other safety-net providers contributed to these poor outcomes as well. The deleterious impact of social structures such as urban poverty and racism on health has been called 'structural violence.

It's all very well to rail against human rights violations or the absence of democracy, but when there's a need to vaccinate children, supply drinkable water, care for the wounded, you'd better step up. No matter what the host government is like. We're aid workers. Not politicians. We serve human beings, not legal or political causes. If we can make a contribution to a cause, so be it, but not at the expense of our primary mission.

Men justify the women taking care of the kids and the house and holding down a job because, after all, men are the primary breadwinners in the family. But that’s because we fucking pay women less! Men claiming superiority over women because men make more money than they do is like claiming you’re stronger than a lion that you tranquilized and put in a cage. Sure, you’re in a better spot now—but how ’bout you unchain the beast and see what happens?

We began before words, and we will end beyond them. It sometimes seems to me that our days are poisoned with too many words. Words said and not meant. Words said ‘and’ meant. Words divorced from feeling. Wounding words. Words that conceal. Words that reduce. Dead words. If only words were a kind of fluid that collects in the ears, if only they turned into the visible chemical equivalent of their true value, an acid, or something curative – then we might be more careful. Words do collect in us anyway. They collect in the blood, in the soul, and either transform or poison people’s lives. Bitter or thoughtless words poured into the ears of the young have blighted many lives in advance. We all know people whose unhappy lives twist on a set of words uttered to them on a certain unforgotten day at school, in childhood, or at university. We seem to think that words aren’t things. A bump on the head may pass away, but a cutting remark grows with the mind. But then it is possible that we know all too well the awesome power of words – which is why we use them with such deadly and accurate cruelty. We are all wounded inside one way or other. We all carry unhappiness within us for some reason or other. Which is why we need a little gentleness and healing from one another. Healing in words, and healing beyond words. Like gestures. Warm gestures. Like friendship, which will always be a mystery. Like a smile, which someone described as the shortest distance between two people. Yes, the highest things are beyond words. That is probably why all art aspires to the condition of wordlessness. When literature works on you, it does so in silence, in your dreams, in your wordless moments. Good words enter you and become moods, become the quiet fabric of your being. Like music, like painting, literature too wants to transcend its primary condition and become something higher. Art wants to move into silence, into the emotional and spiritual conditions of the world. Statues become melodies, melodies become yearnings, yearnings become actions. When things fall into words they usually descend. Words have an earthly gravity. But the best things in us are those that escape the gravity of our deaths. Art wants to pass into life, to lift it; art wants to enchant, to transform, to make life more meaningful or bearable in its own small and mysterious way. The greatest art was probably born from a profound and terrible silence – a silence out of which the greatest enigmas of our life cry: Why are we here? What is the point of it all? How can we know peace and live in joy? Why be born in order to die? Why this difficult one-way journey between the two mysteries? Out of the wonder and agony of being come these cries and questions and the endless stream of words with which to order human life and quieten the human heart in the midst of our living and our distress. The ages have been inundated with vast oceans of words. We have been virtually drowned in them. Words pour at us from every angle and corner. They have not brought understanding, or peace, or healing, or a sense of self-mastery, nor has the ocean of words given us the feeling that, at least in terms of tranquility, the human spirit is getting better. At best our cry for meaning, for serenity, is answered by a greater silence, the silence that makes us seek higher reconciliation. I think we need more of the wordless in our lives. We need more stillness, more of a sense of wonder, a feeling for the mystery of life. We need more love, more silence, more deep listening, more deep giving.

A common and traditionally masculine marital problem is created by the husband who, once he is married, devotes all his energies to climbing mountains and none to tending to his marriage, or base camp, expecting it to be there in perfect order whenever he chooses to return to it for rest and recreation without his assuming any responsibility for its maintenance. Sooner or later this “capitalist” approach to the problem fails and he returns to find his untended base camp a shambles, his neglected wife having been hospitalized for a nervous breakdown, having run off with another man, or in some other way having renounced her job as camp caretaker. An equally common and traditionally feminine marital problem is created by the wife who, once she is married, feels that the goal of her life has been achieved. To her the base camp is the peak. She cannot understand or empathize with her husband’s need for achievements and experiences beyond the marriage and reacts to them with jealousy and never-ending demands that he devote increasingly more energy to the home. Like other “communist” resolutions of the problem, this one creates a relationship that is suffocating and stultifying, from which the husband, feeling trapped and limited, may likely flee in a moment of “mid-life crisis.” The women’s liberation movement has been helpful in pointing the way to what is obviously the only ideal resolution: marriage as a truly cooperative institution, requiring great mutual contributions and care, time and energy, but existing for the primary purpose of nurturing each of the participants for individual journeys toward his or her own individual peaks of spiritual growth. Male and female both must tend the hearth and both must venture forth. As an adolescent I used to thrill to the words of love the early American poet Ann Bradstreet spoke to her husband: “If ever two were one, then we.”20 As I have grown, however, I have come to realize that it is the separateness of the partners that enriches the union. Great marriages cannot be constructed by individuals

CCA finds ways to minimize its obligation to provide adequate health care. At the out-of-state prisons where California ships some of its inmates, CCA will not accept any prisoners who are over sixty-five years old, have mental health issues, or serious conditions like HIV. The company's Idaho prison contract specified that the 'primary criteria' for screening incoming offenders was 'no chronic mental health or health care issues.' The contracts of some CCA prisons in Tennessee and Hawaii stipulate that the states will bear the cost of HIV treatment. Such exemptions allow CCA to tout its cost efficiency while taxpayers assume the medical expenses for the inmates the company won't take or treat.

Maitri can be translated as "love" or "loving kindness". Some Buddhist teachers prefer "loving kindness" as they find the word "love" too dangerous. But I prefer the word "love". Words sometimes get sick and we have to heal them. We have been using the word "love" to mean appetite or desire, as in "I love hamburgers". We have to use language more carefully. "Love" is a beautiful word; we have to restore its meaning. The word "maitri" has roots in the word mitra which means friend. In Buddhism, the primary meaning of love is friendship.

I'm a good person. I eat pretty well. I work out. I go to bookstores. I save people. For a living. I have better things to do than get hauled in for a medical checkup every week. Have I complained the last few months? Constantly. Was I a good patient? No. What can I say? When your primary care provider is a shadowy government agency, you have to be your own medical advocate.

It was interesting, actually, how everyone’s primary feeling-state at that moment was disguised as a different emotion. Sarah’s repulsion at being reunited with Liam took the form of outrage at Martin. Liam’s passion for Sarah took the form of concern for Karen. And Karen’s unbearable humiliation, which she had always expected and never expected, took the form of emotionlessness and not caring. “I

Story is a trojan horse for truth. It can sneak truth past the gates of our defenses and prepare our hearts to hear things we might have resisted if they had come as mere declaration. Jesus relied on storytelling as his primary method of teaching for just this reason--to persuade Jews to empathize with Samaritans, wealthy people to care for the poor, and religious people to have compassion on society's fringe.

The message carried by all the pioneers of codependency recovery was the same: Not only can we lovingly detach from other people and take care of ourselves, it is our primary responsibility in life to do that.

The primary problem with modern psychiatry is its reduction of mental illness to bodily dysfunction. Objectification of those identified as mentally ill, by insisting on the somatic nature of their illness, may apparently simplify matters and help protect those trying to provide care from the pain experienced by those needing support. But psychiatric assessment too often fails to appreciate personal and social precursors of mental illness by avoiding or not taking account of such psychosocial considerations. Mainstream psychiatry acts on the somatic hypothesis of mental illness to the detriment of understanding people's problems.

Our brainstems take in the rhythmic movements of [our mother/primary attachment] as she attentively follows our bid for play, our drift towards sleep, our signal that it is time to be quietly together. In our midbrain, our SEEKING system finds the waiting eyes and arms of our mother's CARE system in times of PLAY or GRIEF, patterning the expectation that connections will be restored when they are momentarily lost, that ruptures will call forth repairs.

Ecology is beginning to slowly shift focus with tentative explorations of what the world would look like if process, rather than matter were the basis for reality What if we defined a species in terms of its life processes? We might seriously doubt whether the California condor or the tall grass prairie can be 'saved' or even 'restored.' Perhaps we can re-create some local conditions that foster a few nests of condors or a few acres of prairie. But the life process of the condor ended with the urbanization of the California foothills and the living ebb and flow of the tall grass prairies died with the plowing of the Great Plains. What if we suggested that a thing is what it does? In this light, the Rocky Mountain locust was a immense aperiodic energy flow that linked life processes on a continental scale. This notion of life-as-process might seem unusual in a society in which material existence is primary. But such a perception informs our deepest understanding of life. Indeed, life-as-process underlies our notion of euthanasia. When loved ones are simply bodies, devoid of the capacity to care, respond, or relate again a away that we can recognize as being "them," we understand that they are gone even before they are dead.

Tocqueville concluded that “the strength of free peoples resides in the local community. Local institutions are to liberty what primary schools are to science: they put it within the people’s reach; they teach people to appreciate its peaceful enjoyment and accustom them to make use of it.”26 He stressed that it was the nearness and immediacy of the township that made its citizens more likely to care and take an active interest not only in their own fates but in the shared fates of their fellow citizens. By contrast, he noted a striking lack of attentiveness to more distant political centers of power, including both state and an even more distant federal government, where only a few ambitious men might govern but which otherwise was of little concern to the active citizens within the township. Tocqueville would have regarded a citizenry that was oblivious to local self-governance, but which instead directed all its attention and energy to the machinations of a distant national power, not as the culmination of democracy but as its betrayal.

People with an entertaining rigid structure are brought up in environments in which the parents are uncomfortable with expressing feelings. This is not to say that the parents do not care, but they do not express feelings like affection, warmth, and caring or feel comfortable with expressing such feelings (Keleman). The experience within the family is not one of intimacy and true interchange of feeling. To contend with the situation, the child may learn to draw out the parents by being cute, entertaining, or charming. Although being charming is something most children do naturally to some extent, the difference in the case of people with an entertaining rigid structure is that this becomes the primary mode of relating. Furthermore, the entertaining rigid structure pattern is reinforced as the parents respond primarily to the child's charm, rather than to their own feelings. Therefore, such children effectively learn that they will not get the reaction they crave without using that behavior. At the same time, these children are also developing or have developed a discomfort with intimacy that is similar to that of their parents. As a result, people with an entertaining rigid structure as adults act out this pattern in which they are energized or emotionally fed by being able to cause another person to be attracted to them, but they become anxious if the person becomes too close or expresses "real" feeling. Love is what they are really craving, and they think they are getting it, but are not. In other words, they have mistaken the energy of attraction for love.

The first organization for the ministry of mercy is the Christian family. When God sees a person in need, he puts primary responsibility for aid on that person’s family. He who does not care for his own family is worse than an unbeliever (1 Tim. 5:8; cf. Lev. 25:25).

Here was a space with dreams beyond self and ideals that truthfully felt no different from what we’d learned in primary school—be kind, collaborate, take care of the Earth, share—concepts that don’t jibe well with our capitalist system, the ones they push us to forget.

The world is unfair and nature is cruel. This was a primary observation when I first became aware. In a natural world, anything weak is eradicated with pain and prejudice.  All that which deserves sympathy, pity, and love receives none. You may look at a beautiful garden and marvel at nature’s wonder—yet in such a place, nature is nowhere to be found. On the contrary, a garden is a product of loving cultivation and care. With great effort, it is protected from the heartier weeds that nature would use to undermine and choke its splendor.

At the transpersonal level, we begin to love others not because they love us, affirm us, reflect us, or secure us in our illusions, but because they are us. Christ’s primary teaching does not mean, “Love your neighbor as you love yourself,” but “Love your neighbor as your Self.” And not just your neighbor, but your whole environment. You begin to care for your surroundings just as you would your own arms and legs. At this level, remember, your relationship to your environment is the same as your relationship to your very own organism. At

While making money was good, having meaningful work and meaningful relationships was far better. To me, meaningful work is being on a mission I become engrossed in, and meaningful relationships are those I have with people I care deeply about and who care deeply about me. Think about it: It’s senseless to have making money as your goal as money has no intrinsic value—its value comes from what it can buy, and it can’t buy everything. It’s smarter to start with what you really want, which are your real goals, and then work back to what you need to attain them. Money will be one of the things you need, but it’s not the only one and certainly not the most important one once you get past having the amount you need to get what you really want. When thinking about the things you really want, it pays to think of their relative values so you weigh them properly. In my case, I wanted meaningful work and meaningful relationships equally, and I valued money less—as long as I had enough to take care of my basic needs. In thinking about the relative importance of great relationships and money, it was clear that relationships were more important because there is no amount of money I would take in exchange for a meaningful relationship, because there is nothing I could buy with that money that would be more valuable. So, for me, meaningful work and meaningful relationships were and still are my primary goals and everything I did was for them. Making money was an incidental consequence of that. In the late 1970s, I began sending my observations about the markets to clients via telex. The genesis of these Daily Observations (“ Grains and Oilseeds,” “Livestock and Meats,” “Economy and Financial Markets”) was pretty simple: While our primary business was in managing risk exposures, our clients also called to pick my brain about the markets. Taking those calls became time-consuming, so I decided it would be more efficient to write down my thoughts every day so others could understand my logic and help improve it. It was a good discipline since it forced me to research and reflect every day. It also became a key channel of communication for our business. Today, almost forty years and ten thousand publications later, our Daily Observations are read, reflected on, and argued about by clients and policymakers around the world. I’m still writing them, along with others at Bridgewater, and expect to continue to write them until people don’t care to read them or I die.

When self-esteem is at a high level, people are easy to get along with. They are cheerful, generous, tolerant, willing to listen to others’ ideas. They have taken care of their own primary needs—and are able to think about the needs of others. Their own personalities are so strong and secure that they can afford to take a few risks. They can afford to be wrong, occasionally. They can admit to themselves that they have made a mistake. They can even be criticized and slighted, and take it in their stride—for such things only make a small dent in their self-esteem, and they have plenty more left.

A man must think well before he marries. He must be a tender and considerate husband and realize that there is no other human being to whom he owes so much of love and regard and consideration as he does to the woman who with pain bears and with labor rears the children that are his. No words can paint the scorn and contempt which must be felt by all right-thinking men, not only for the brutal husband, but for the husband who fails to show full loyalty and consideration to his wife. Moreover, he must work, he must do his part in the world. On the other hand, the woman must realize that she has no more right to shirk the business of wifehood and motherhood than the man has to shirk his business as breadwinner for the household. Women should have free access to every field of labor which they care to enter, and when their work is as valuable as that of a man it should be paid as highly. Yet normally for the man and the woman whose welfare is more important than the welfare of any other human beings, the woman must remain the housemother, the homekeeper, and the man must remain the breadwinner, the provider for the wife who bears his children and for the children she brings into the world. No other work is as valuable or as exacting for either man or woman; it must always, in every healthy society, be for both man and woman the prime work, the most important work; normally all other work is of secondary importance, and must come as an addition to, not a substitute for, this primary work. The partnership should be one of equal rights, one of love, of self-respect, and unselfishness, above all a partnership for the performance of the most vitally important of all duties. The performance of duty, and not an indulgence in vapid ease and vapid pleasure, is all that makes life worth while.

When creating a Hook, focus on the primary benefit or value your offer provides. Emphasize what’s uniquely valuable about your offer and why the prospect should care. Brainstorm a list of words and phrases related to your primary benefit, then experiment with different ways to connect them in a short phrase.

When I read Muller’s biography I was shocked to learn why he started the orphanage. His primary purpose was not to care for orphans. Instead, he wrote in his journal: If I, a poor man, simply by prayer and faith, obtained without asking any individual, the means for establishing and carrying on an Orphan-House, there would be something which, with the Lord’s blessing, might be instrumental in strengthening the faith of the children of God, besides being a testimony to the consciences of the unconverted, of the reality of the things of God. This, then, was the primary reason for establishing the Orphan-House.… The first and primary object of the work was (and still is:) that God might be magnified by the fact, that the orphans under my care are provided with all they need, only by prayer and faith without anyone being asked by me or my fellow-laborers whereby it may be seen, that God is faithful still, and hears prayer still.8 Muller decided that he wanted to live in such a way that it would be evident to all who looked at his life—Christian and non-Christian alike—that God is indeed faithful to provide for his people. He risked his life trusting in the greatness of God, and in the end his life made much of the glory of God.

The primary fantasy of connection leads to a posture of pseudo-independence in the developing child—“I don’t need anyone, I can take care of myself”—yet the irony is that the more the person relies on fantasy, the more helpless he or she becomes in the real world and the more he or she demands to be taken care of.

The pastor by definition is a shepherd, the under-shepherd of the flock of God. His primary task is to feed the flock by leading them to green pastures. He also has to care for them when they are sick or hurt, and seek them when they go astray. The importance of the pastor depends on the value of the sheep. Pursue the pastoral metaphor a little further: Israel's sheep were reared, fed, tended, retrieved, healed and restored – for sacrifice on the altar of God. This end of all pastoral work must never be forgotten – that its ultimate aim is to lead God's people to offer themselves up to Him in total devotion of worship and service.

Indeed, language, thought, and discourse are not what is most basic and determinative about human life as social and interpersonal. To say that ethics is more primary than philosophy is also to say that praxis is more primary than theory and that acting on behalf of the needs of other persons is more important, more basic, and more the point of being human than thinking about them or even following rules aimed at them or their well-being. Caring for you is the most human thing I can do, and a world in which I act toward you by acknowledging, accepting, and aiding you is best, enriched by my act and the acts of everyone who acts similarly.

Fresh drinking water is an issue of primary importance, since it is indispensable for human life and for supporting terrestrial and aquatic ecosystems. Sources of fresh water are necessary for health care, agriculture and industry. Water supplies used to be relatively constant, but now in many places demand exceeds the sustainable

Secure attachment reflects the deep emotional bond that forms in the first months of life between an infant and the primary caregiver when the child feels consistently loved and cared for. The caregiver conveys in many ways that the child is safe, protected, and valued: by holding, skin-to-skin touching, kissing, and hugging; by loving gazes and facial expressions; by safe, rhythmic gestures and vocal sounds; by timely attention to the infant’s needs; and by smiling, laughing, and having fun with the child. Through repeated encounters that are sensitive to the child’s needs, the child learns that the caregiver is available and responsive, and will not abandon her.

Separating from Family Issues: January 4 We can draw a healthy line, a healthy boundary, between ourselves and our nuclear family. We can separate ourselves from their issues. Some of us may have family members who are addicted to alcohol and other drugs and who are not in recovery from their addiction. Some of us may have family members who have unresolved codependency issues. Family members may be addicted to misery, pain, suffering, martyrdom, and victimization. We may have family members who have unresolved abuse issues or unresolved family of origin issues. We may have family members who are addicted to work, eating, or sex. Our family may be completely enmeshed, or we may have a disconnected family in which the members have little contact. We may be like our family. We may love our family. But we are separate human beings with individual rights and issues. One of our primary rights is to begin feeling better and recovering, whether or not others in the family choose to do the same. We do not have to feel guilty about finding happiness and a life that works. And we do not have to take on our family’s issues as our own to be loyal and to show we love them. Often when we begin taking care of ourselves, family members will reverberate with overt and covert attempts to pull us back into the old system and roles. We do not have to go. Their attempts to pull us back are their issues. Taking care of ourselves and becoming healthy and happy does not mean we do not love them. It means we’re addressing our issues. We do not have to judge them because they have issues; nor do we have to allow them to do anything they would like to us just because they are family. We are free now, free to take care of ourselves with family members. Our freedom starts when we stop denying their issues, and politely, but assertively, hand their stuff back to them—where it belongs—and deal with our own issues. Today, I will separate myself from family members. I am a separate human being, even though I belong to a unit called a family. I have a right to my own issues and growth; my family members have a right to their issues and a right to choose where and when they will deal with these issues. I can learn to detach in love from my family members and their issues. I am willing to work through all necessary feelings in order to accomplish this.

By now, I hope you recognize this as one more example of the reductionist paradigm at work, even when it's couched in natural and alternative terms. As we saw in chapter ten, one of the major problems with modern medicine is its reliance on isolated, unnatural chemical pharmaceuticals as the primary tool in the war against disease. But the medical profession isn't the only player in the health-care system that has embraced this element of reductionism. The natural health community has also fallen prey to the ideology that chemicals ripped from their natural context are as good as or better than whole foods. Instead of synthesizing the presumed "active ingredients" from medicinal herbs, as done for prescription drugs, supplement manufacturers seek to extract and bottle the active ingredients from foods known or believed to promote good health and healing. And just like prescription drugs, the active agents function imperfectly, incompletely, and unpredictably when divorced from the whole plant food from which they're derived or synthesized.

Nietsche once observed that the primary purpose of marriage was conversation. The purpose of a committed relationship, of which marriage is but one example, is not to take care of each other, to reinforce the parent-child complexes, but to grow through and with each other. Relationship is meant to be dialectical—soulful encounters that temper and enlarge.

What you describe is parasitism, not love. When you require another individual for your survival, you are a parasite on that individual. There is no choice, no freedom involved in your relationship. It is a matter of necessity rather than love. Love is the free exercise of choice. Two people love each other only when they are quite capable of living without each other but choose to live with each other. We all-each and every one of us-even if we try to pretend to others and to ourselves that we don't have dependency needs and feelings, all of us have desires to be babied, to be nurtured without effort on our parts, to be cared for by persons stronger than us who have our interests truly at heart. No matter how strong we are, no matter how caring and responsible and adult, if we look clearly into ourselves we will find the wish to be taken care of for a change. Each one of us, no matter how old and mature, looks for and would like to have in his or her life a satisfying mother figure and father figure. But for most of us these desires or feelings do not rule our lives; they are not the predominant theme of our existence. When they do rule our lives and dictate the quality of our existence, then we have something more than just dependency needs or feelings; we are dependent. Specifically, one whose life is ruled and dictated by dependency needs suffers from a psychiatric disorder to which we ascribe the diagnostic name "passive dependent personality disorder." It is perhaps the most common of all psychiatric disorders. People with this disorder, passive dependent people, are so busy seeking to be loved that they have no energy left to love…..This rapid changeability is characteristic of passive dependent individuals. It is as if it does not matter whom they are dependent upon as long as there is just someone. It does not matter what their identity is as long as there is someone to give it to them. Consequently their relationships, although seemingly dramatic in their intensity, are actually extremely shallow. Because of the strength of their sense of inner emptiness and the hunger to fill it, passive dependent people will brook no delay in gratifying their need for others. If being loved is your goal, you will fail to achieve it. The only way to be assured of being loved is to be a person worthy of love, and you cannot be a person worthy of love when your primary goal in life is to passively be loved. Passive dependency has its genesis in lack of love. The inner feeling of emptiness from which passive dependent people suffer is the direct result of their parents' failure to fulfill their needs for affection, attention and care during their childhood. It was mentioned in the first section that children who are loved and cared for with relative consistency throughout childhood enter adulthood with a deep seated feeling that they are lovable and valuable and therefore will be loved and cared for as long as they remain true to themselves. Children growing up in an atmosphere in which love and care are lacking or given with gross inconsistency enter adulthood with no such sense of inner security. Rather, they have an inner sense of insecurity, a feeling of "I don't have enough" and a sense that the world is unpredictable and ungiving, as well as a sense of themselves as being questionably lovable and valuable. It is no wonder, then, that they feel the need to scramble for love, care and attention wherever they can find it, and once having found it, cling to it with a desperation that leads them to unloving, manipulative, Machiavellian behavior that destroys the very relationships they seek to preserve. In summary, dependency may appear to be love because it is a force that causes people to fiercely attach themselves to one another. But in actuality it is not love; it is a form of antilove. Ultimately it destroys rather than builds relationships, and it destroys rather than builds people.

we have equal legal rights to spend real time with our families, where there really is equal pay, where the pressures of the long-hours culture are removed, where pay in the caring professions was made so rewarding that it did not invariably fall to women to look after the elderly, the disabled or children in nurseries, nor that teaching in primary schools was a female role.

Sorry I’m late, dear. I was snatching babies and children from the jaws of death.” I thought that as a pediatrician I would be taken care of and protected, that if people knew I was a pediatrician they wouldn’t break into my house or mug me, that I wouldn’t have to stop and chat after minor car accidents, that my way would be smoothed. I wanted to be someone no one could take exception to. When I told a professor at Harvard that I wanted to go into primary care, he said that it would be a waste of a Harvard education. He had done primary care. It was easy. With a Harvard education we could cure generations rather than individuals. So it wasn’t enough that I was in medical school. I was supposed to be lining up to cure generations. And I’d thought I was crazy.

The first and most basic evolutionary point is that the primary targets and beneficiaries of sociality are the offspring. Why? Because mammalian babies are immature at birth and will certainly die without care. Baby turtles, after hatching from their eggs, immediately dig their way up out of the sand, scuttle down to the water, and begin to look for food. No parents are anywhere close by, nor are any needed.

Newspeak occurs whenever the primary purpose of language – which is to describe reality – is replaced by the rival purpose of asserting power over it. The fundamental speech-act is only superficially represented by the assertoric grammar. Newspeak sentences sound like assertions, but their underlying logic is that of the spell. They conjure the triumph of words over things, the futility of rational argument, and also the danger of resistance. As a result Newspeak developed its own special syntax, which – while closely related to the syntax deployed in ordinary descriptions – carefully avoids any encounter with reality or any exposure to the logic of rational argument. Françoise Thom has argued this in her brilliant study La langue de bois.5 The purpose of communist Newspeak, in Thom’s ironical words, has been ‘to protect ideology from the malicious attacks of real things’.

What, then, would it mean to imagine a system in which punishment is not allowed to become the source of corporate profit? How can we imagine a society in which race and class are not primary determinants of punishment? Or one in which punishment itself is no longer the central concern in the making of justice? An abolitionist approach that seeks to answer questions such as these would require us to imagine a constellation of alternative strategies and institutions, with the ultimate aim of removing the prison from the social and ideological landscapes of our society. In other words, we would not be looking for prisonlike substitutes for the prison, such as house arrest safeguarded by electronic surveillance bracelets. Rather, positing decarceration as our overarching strategy, we would try to envision a continuum of alternatives to imprisonment—demilitarization of schools, revitalization of education at all levels, a health system that provides free physical and mental care to all, and a justice system based on reparation and reconciliation rather than retribution and vengeance. The creation of new institutions that lay claim to the space now occupied by the prison can eventually start to crowd out the prison so that it would inhabit increasingly smaller areas of our social and psychic landscape. Schools can therefore be seen as the most powerful alternative to jails and prisons. Unless the current structures of violence are eliminated from schools in impoverished communities of color—including the presence of armed security guards and police—and unless schools become places that encourage the joy of learning, these schools will remain the major conduits to prisons. The alternative would be to transform schools into vehicles for decarceration.

Those Americans who have the power to end racism as we know it, to become tough on racism, and to build the postracial society that the postracialists actually don’t want to see—these people have known the facts throughout the storied lifetime of Angela Davis. Powerful Americans also knew the facts during the lifetimes of Cotton Mather, Thomas Jefferson, William Lloyd Garrison, and W. E. B. Du Bois. It is the primary job of the powerful to know the facts of America. So trying to educate knowledgeable people does not make much sense. Trying to educate these powerful producers or defenders or ignorers of American racism about its harmful effects is like trying to educate a group of business executives about how harmful their products are. They already know, and they don’t care enough to end the harm. History is clear. Sacrifice, uplift, persuasion, and education have not eradicated, are not eradicating, and will not eradicate racist ideas, let alone racist policies. Power will never self-sacrifice away from its self-interest. Power cannot be persuaded away from its self-interest. Power cannot be educated away from its self-interest. Those who have the power to abolish racial discrimination have not done so thus far, and they will never be persuaded or educated to do so as long as racism benefits them in some way.

I felt arrows of rage rising in me, fraught images spreading like bloodstains. There’s no point, I told myself. I reached for the ordinary decoys. It won’t get you anywhere. Think of the outcome you want and make sure you are moving towards it. Got to be practical. That’s what I always told the girls at school. There is so much in life that doesn’t matter, so many things that hold you back, hem you in and throw you off the scent of what’s important. Don’t get too bogged down in things that don’t count or things you cannot influence, and specifically don’t worry too much about making sure others know you’re in the right, because it so easily gets in the way of what you want and need. Become an expert at shrugging most of life off and free yourself for what really interests you. Hone your focus. Don’t bother with cleaning or tidiness beyond basic hygiene. Don’t make your appearance your primary concern. It will zap all your creativity. Be as self-sufficient as you dare. Sometimes you hold more strength when people don’t know what you think or feel, so be very careful whom you confide in. People can run with your difficulties when you least expect it, distort them, relish them even, and before you know it they’re not yours any more. Respect your privacy. And earn you own money or you’ll lack power. Take good care of your friendships, nurture them and they’ll strengthen you. Don’t turn frowning at the defects of other people into a hobby, delicious though it may be; it poisons you. Read every day—it is a practice that dignifies humans. Become a great reader of books and it will help you with reality, you’ll more easily grasp the truth of things and that will set you up for life. And don’t expose your brain to low-quality art forms because there will be a certain measure of pollution.

While a life like Frederick Douglas’s is remarkable, we must remember that not every person who lived through slavery was like Douglas. Most did not learn to read or write. Most did not engage in hand-to-hand combat with white slave brakers. Most did not live close enough to free states in the North to have any hope of escape. No one, enslaved or otherwise, was like Douglas. There were other brilliant, exceptional people who lived under slavery, and many resisted the institution in innumerable ways, but our country’s teachings about slavery, painfully limited, often focus singularly on heroic slave narratives, at the expense of millions of men and women whose stories might be less sensational but are no less worthy of being told. I thought of my primary and secondary education. I remembered feeling crippling guilt as I silently wondered why every enslaved person couldn’t simply escape like Douglas, Tubman, and Jacobs had. I found myself angered by the stories of those who did not escape. Had they not tried hard enough? Didn’t they care enough to do something? Did they choose to remain enslaved? This, I now realize, is part of the insidiousness of white supremacy. It illuminates the exceptional in order to implicitly blame those who cannot, despite the most brutal circumstances, attain super-human heights. It does this instead of blaming the system, the people who built it, and the people who maintained it.

Some seem to forget that I’ve worked with those on movies and television. I warn you. Television may be exciting, but always take what you watch or read with a grain of salt. The more extreme these people act, the more money they make. They don’t care about us. You should always do your own research using verified primary sources. Editorials or articles published can be exciting, but they are seldom the truth. This country will eventually be destroyed for the sake of a paycheck.

Having a TV—which gives you the ability to receive information—fails to establish any capacity for sending information in the opposite direction. And the odd one-way nature of the primary connection Americans now have to our national conversation has a profound impact on their basic attitude toward democracy itself. If you can receive but not send, what does that do to your basic feelings about the nature of your connection to American self-government? “Attachment theory” is an interesting new branch of developmental psychology that sheds light on the importance of consistent, appropriate, and responsive two-way communication—and why it is essential for an individual’s feeling empowered. First developed by John Bowlby, a British psychiatrist, in 1958, attachment theory was further developed by his protégée Mary Ainsworth and other experts studying the psychological development of infants. Although it applies to individuals, attachment theory is, in my view, a metaphor that illuminates the significance of authentic free-flowing communication in any relationship that requires trust. By using this new approach, psychologists were able to discover that every infant learns a crucial and existential lesson during the first year of life about his or her fundamental relationship to the rest of the world. An infant develops an attachment pathway based on different patterns of care and, according to this theory, learns to adopt one of three basic postures toward the universe: In the best case, the infant learns that he or she has the inherent ability to exert a powerful influence on the world and evoke consistent, appropriate responses by communicating signals of hunger or discomfort, happiness or distress. If the caregiver—more often than not the mother—responds to most signals from the infant consistently and appropriately, the infant begins to assume that he or she has inherent power to affect the world. If the primary caregiver responds inappropriately and/or inconsistently, the infant learns to assume that he or she is powerless to affect the larger world and that his or her signals have no intrinsic significance where the universe is concerned. A child who receives really erratic and inconsistent responses from a primary caregiver, even if those responses are occasionally warm and sensitive, develops “anxious resistant attachment.” This pathway creates children who feature anxiety, dependence, and easy victimization. They are easily manipulated and exploited later in life. In the worst case, infants who receive no emotional response from the person or persons responsible for them are at high risk of learning a deep existential rage that makes them prone to violence and antisocial behavior as they grow up. Chronic unresponsiveness leads to what is called “anxious avoidance attachment,” a life pattern that features unquenchable anger, frustration, and aggressive, violent behavior.

I thought of my primary and secondary education. I remembered feeling crippling guilt as I silently wondered why every enslaved person couldn’t simply escape like [Frederick] Douglass, [Harriet] Tubman, and [Harriet] Jacobs had. I found myself angered by the stories of those who did not escape. Had they not tried hard enough? Didn’t they care enough to do something? Did they choose to remain enslaved? This, I now realize, is part of the insidiousness of white supremacy; it illuminates the exceptional in order to implicitly blame those who cannot, in the most brutal circumstances, attain superhuman heights. It does this instead of blaming the system, the people who built it, the people who maintained it. In overly mythologizing our ancestors, we forget an all-too-important reality: the vast majority were ordinary people, which is to say they were people just like everyone else. This ordinariness is only shameful when used to legitimate oppression. This is its own quiet violence.

Now the hurt, angry and scared little boy was easy to spot behind the mawkish facade. Carol and I made calls and got Raleigh admitted to a halfway house where he could stay temporarily. I called Fred Goodson and had him come see Raleigh and bring him into their newly formed support group. Though we had given Raleigh information about TAP and the support group, it had probably been too much to expect him to follow up on his own. In putting Raleigh under Fred’s care, I had as secure a feeling as if I had put him in professional therapy. Joyce, my secretary at the VA, explored a job-training possibility for Raleigh. What had happened to Raleigh was a forceful reminder to me that there was a lot I could do, a lot I had to do, for our patients even if we had no therapy for HIV. I could no longer sit and be the consultant and pontificate over the progression (or lack thereof) of the disease; I was providing primary care, total care for this group of patients, whether I liked it or not.

Oh, all right,” she said. “But be careful, those tiles are rotten.” The stranger’s face had a pained expression of stupor and he seemed to be battling silently against his primary instincts so as not to break up the mirage. Remedios the Beauty thought that he was suffering from the fear that the tiles would break and she bathed herself more quickly than usual so that the man would not be in danger. While she was pouring water from the cistern she told him that the roof was in that state because

In accepting as two primary texts, Singer's Animal Liberation and Regan's The Case for Animal Rights--texts that valorize rationality--the animal defense movement reiterates a patriarchal disavowal of emotions as having a legitimate role in theory making. The problem is that while on the one hand it articulates positions against animal suffering, on the other hand animal rights theory dispenses with the idea that caring about and emotionally responding to this suffering can be appropriate sources of knowledge. Emotions and theory are related. One does not have to eviscerate theory of emotional content and reflection to present legitimate theory. Nor does the presence of emotional content and reflection eradicate or militate against thinking theoretically. By disavowing emotional responses, two major texts of animal defense close off the intellectual space for recognizing the role of emotions in knowledge and therefore theory making. As the issue of caring about suffering is problematized, difficulties with animal rights per se become apparent. Without a gender analysis, several important issues that accompany a focus on suffering are neglected, to the detriment of the movement. Animal rights theory offers a legitimating language for animal defense without acknowledging the indebtedness of the rights-holder to caring relationships. Nor does it provide models for theoretically engaging with our own emotional responses, since emotions are seen as untrustworthy. Because the animal advocacy movement has failed to incorporate an understanding of caring as a motivation for so many animal defense activists, and because it has not addressed the gendered nature of caring--that it is woman's duty to provide service to others, while it is men's choice--it has not addressed adequately the implications that a disproportionate number of activists are women motivated because they care about animal suffering. Animal rights theory that disowns or ignores emotions mirrors on the theoretical level the gendered emotional responses inherent in a patriarchal society. In this culture, women are supposed to do the emotional work for heterosexual intimate relationships: 'a man will come to expect that a woman's role in his life is to take care of his feelings and alleviate the discomfort involved in feeling.' At the cultural level, this may mean that women are doing the emotional work for the animal defense movement. And this emotional work takes place in the context of our own oppression.

There is an alternative approach to being wrong as fast as you can. It is the notion that if you carefully think everything through, if you are meticulous and plan well and consider all possible outcomes, you are more likely to create a lasting product. But I should caution that if you seek to plot out all your moves before you make them—if you put your faith in slow, deliberative planning in the hopes it will spare you failure down the line—well, you’re deluding yourself. For one thing, it’s easier to plan derivative work—things that copy or repeat something already out there. So if your primary goal is to have a fully worked out, set-in-stone plan, you are only upping your chances of being unoriginal. Moreover, you cannot plan your way out of problems. While planning is very important, and we do a lot of it, there is only so much you can control in a creative environment. In general, I have found that people who pour their energy into thinking about an approach and insisting that it is too early to act are wrong just as often as people who dive in and work quickly. The overplanners just take longer to be wrong (and, when things inevitably go awry, are more crushed by the feeling that they have failed). There’s a corollary to this, as well: The more time you spend mapping out an approach, the more likely you are to get attached to it. The nonworking idea gets worn into your brain, like a rut in the mud. It can be difficult to get free of it and head in a different direction. Which, more often than not, is exactly what you must do.

...we must be careful to avoid the error of reductionism, as if the whole of the Spirit’s ministry can be reduced to Christology, as if the Spirit does nothing but glorify Christ. It’s the mistake of arguing that the primary purpose of the Spirit’s coming is the sole purpose of his coming. The principal aim of the Spirit in what he does is to awaken us to the glory, splendor, and centrality of the work of Christ Jesus. But this does not mean that it is less than the Spirit at work when he awakens us also to his own glory and power and abiding presence.

For too long we’ve closed ourselves to the participatory life of our senses, inured ourselves to the felt intelligence of our muscled flesh and its manifold solidarities. We’ve taken our primary truths from technologies that hold the world at a distance. Such tools can be mighty useful, and beneficial as well, as long as the insights that they yield are carried carefully back to the lived world, and placed in service to the more-than-human matrix of corporeal encounter and experience. But technology can also, and easily, be used as a way to avoid direct encounter, as a shield—etched

That’s a conscious decision to presume the primary goodness of Being. That’s an act of courage. Aim high, like Pinocchio’s Geppetto. Wish upon a star, and then act properly, in accordance with that aim. Once you are aligned with the heavens, you can concentrate on the day. Be careful. Put the things you can control in order. Repair what is in disorder, and make what is already good better. It is possible that you can manage, if you are careful. People are very tough. People can survive through much pain and loss. But to persevere they must see the good in Being. If they lose that, they are truly lost.

Indeed, Newton confessed, “an evil heart of unbelief fills my sky with many clouds.”73 This lack of trust in God “is the primary cause of all our inquietude.”74 Newton prayed hard against the unbelief in his heart: “For this I sigh and long, and cry to the Lord to rend the veil of unbelief, scatter the clouds of ignorance, and break down the walls which sin is daily building up to hide him from my eyes.”75 Yet in our pride we hold tightly to our cares and open ourselves to spiritual attack (1 Pet. 5:6–8). We pull anxiety close like a blanket, so close that we cover our faces and cloud our souls from the victory and sovereign reign of Christ in the heavens. Even worse, unbelief makes us despondent. By faith we see our sin more clearly, and we see the sufficiency of Christ, which brings daily opportunities for joy in Christ. In turn, joy in Christ brings spiritual fortitude. “The joy of the Lord is the strength of his people: whereas unbelief makes our hands hang down, and our knees feeble, dispirits ourselves, and discourages others; and though it steals upon us under a semblance of humility, it is indeed the very essence of pride.”76 Pride exchanges joy in Christ for a cloud of spiritual despondency. Unbelief also brings insecurity about our salvation, and insecurity in Christ carries compounded anxieties and doubts to snuff out joy in Christ.

The world is unfair and nature is cruel. This was a primary observation when I first became aware. In a natural world, anything weak is eradicated with pain and prejudice. All that which deserves sympathy, pity, and love receives none. You may look at a beautiful garden and marvel at nature’s wonder – yet in such a place, nature is nowhere to be found. On the contrary, a garden is a product of loving cultivation and care. With great effort, it is protected from the heartier weeds that nature would use to undermine and choke its splendor. Nature is the sum of all selfishness, forcing each and every species to viciously claw its way to survival by snuffing others in the suffocating mire of history.

Divorce is distressing. One does need moral support. Divorce lawyers are professionally adept at persuasively taking your side. A good divorce lawyer will have no trouble agreeing that an errant husband’s adultery killed the marriage and that he is, consequently, tyrannical for holding against his wife her own tiny indiscretion, which was a mere meaningless one-time fling with a friend. Divorce lawyers are the professional adepts at proxying for the kind of emotional support often given by best friends. Attorneys are ready and able to provide you with emotional alliance. But let me ask you: are you ready to pay a divorce lawyer’s hourly rate for emotional support? Why not use lawyers for legal work and reach for emotional support elsewhere? Many people are much better suited to comfort you. Most of them work cheaper or even free: therapists, clergy, primary care physicians. Your mother is often a good choice, and always free. Your best friend may be a good choice—unless your spouse is sleeping with your best friend. Facebook is full of “supporting each other in divorce” groups. Talk to your mother. Talk to your friends. Talk to the fellow-sufferers on Facebook (but do be careful not to give out too many personal details). These resources might not heal all of your emotional scars, but unlike your divorce layers, they are cheap or even free. They will cost less even if you become quite a successful practitioner in the art of stiffing an attorney for his fees.

A comprehensive ancient African world view based on the values of intense humanness, caring, sharing, respect, compassion, and associated values, ensuring a happy and qualitative human community life in the spirit of family. Broodryk anticipates our next question: “It may be asked whether this notion is unique,” he writes, “since all cultures ascribe basically to these positive values.” He’s right, of course—if we think of ubuntu as, say, “human interconnectedness,” there are parallels in Buddhism, or the Hindu concept of dharma. The difference, he says, is that in Africa “these values are practiced on a much deeper level. It is about a real passionate living of humanity, as if humanity is the primary reason for living above all other concerns.

The individualized narcissism of our society translates into our church life in not only our self-absorbed worship and our longing for sermons that speak to us or bless us personally but even in how we live out our church community life. A therapeutic culture translates into the context of the local church with an individualized and personalized approach to counseling and self-care. Community is lost in the process of a highly individualized approach. Even small group ministry, which is supposed to be the primary expression of community life in the American evangelical church, often yields a narcissistic, individualistic focus. Small groups become a place of support and counsel rather than a place where Scripture challenges the participants toward kingdom living.

Consider the fact that we care deeply about what happens to the world after we die. If self-interests were the primary source of meaning in life, then it wouldn’t matter to people if an hour after their death everyone they know were to be wiped from the face of the earth. Yet, it matters greatly to most people. We feel that such an occurrence would make our lives meaningless. The only way death is not meaningless is to see yourself as part of something greater; a family, a community, a society. If you don’t, mortality is only a horror, but if you do, it is not. Loyalty, said Royce, solves the paradox of our ordinary existence, by showing us outside of ourselves the cause which is to be served, and inside of ourselves, the will which delights to do this service, and is not thwarted, but enriched and expressed in such service… Above the level of self-actualization in Maslow’s hierarchy of needs, they suggest the existence in people of a transcendent desire to see and help other beings achieve their potential. As our time winds down, we all seek comfort in simple pleasures; companionship, everyday routines, the taste of good food, the warmth of sunlight on our faces. We become less interested in the awards of achieving and accumulating and more interested in the rewards of simply being. Yet, while we may feel less ambitious, we also have become concerned for our legacy, and we have a deep need to identify purposes outside ourselves that make living feel meaningful and worthwhile. In the end, people don’t view their life as merely the average of all of its moments, which after all is mostly nothing much, plus some sleep. For human beings, life is meaningful because it is a story. A story has a sense of a whole, and its arc is determined by the significant moments; the ones where something happens. Measurements of people’s minute by minute levels of pleasure and pain miss this fundamental aspect of human existence. A seemingly happy life may be empty. A seemingly difficult life may be devoted to a great cause. We have purposes larger than ourselves. Unlike your experiencing self, which is absorbed in the moment, your remembering self is attempting to recognize not only the peaks of joy and valleys of misery, but also how the story works out as a whole. That is profoundly affected by how things ultimately turn out.

1. What do you want more than anything? For yourself. 2. What do you want more than anything? For the world. 3. What do you want more than anything? For your children. 4. What do other people do that hurts you? 5. What do you fear? 6. What makes you mad? 7. What makes you cry? 8. If you could go back in your childhood and change your mother (or primary female care-taker), what would you change? 9. If you could go back in your childhood and change your father (or primary male care-taker), what would you change? 10. What didn’t you get as a child? 11. If you could make something in your childhood better, what would it be? 12. If you could make something in your childhood go away, what would it be? 13. What do you need to feel safe? 14. What do you need to feel loved? 15. What do you need to feel happy? 16. What kind of community do you want?

Situated in the center of family values debates is an imagined traditional family ideal. Formed through a combination of marital and blood ties, "normal" families should consist of heterosexual, racially homogeneous couples who produce their own biological children. Such families should have a specific authority structure, namely, a father-head earning an adequate family wage, a stay-at-home wife and mother, and children. Idealizing the traditional family as a private haven from a public world, family is seen as being held together through primary emotional bonds of love and caring. assuming a relatively fixed sexual division of labor, wherein women's roles are defined as primarily in the home with men's in the public world of work, the traditional family ideal also assumes the separation of work and family. Defined as a natural or biological arrangement based on heterosexual attraction, instead this monolithic family type is actually supported by government policy. It is organized not around a biological core, but a state-sanctioned, heterosexual marriage that confers legitimacy not only on the family structure itself but on children born in this family. In general, everything the imagined traditional family ideal is thought to be, African-American families are not. Two elements of the traditional family ideal are especially problematic for African-American women. First, the assumed split between the "public" sphere of paid employment and the "private" sphere of unpaid family responsibilities has never worked for U.S. Black women. Under slavery, U.S. Black women worked without pay in the allegedly public sphere of Southern agriculture and had their family privacy routinely violated. Second, the public/private binary separating the family households from the paid labor market is fundamental in explaining U.S. gender ideology. If one assumes that real men work and real women take care of families, then African-Americans suffer from deficient ideas concerning gender. in particular, Black women become less "feminine," because they work outside the home, work for pay and thus compete with men, and their work takes them away from their children. Framed through this prism of an imagined traditional family ideal, U.S. Black women's experiences and those of other women of color are typically deemed deficient. Rather than trying to explain why Black women's work and family patterns deviate from the seeming normality of the traditional family ideal, a more fruitful approach lies in challenging the very constructs of work and family themselves. Understandings of work, like understandings of family, vary greatly depending on who controls the definitions.

Our failure to keep our children attached to us and to the other adults responsible for them has not only taken away their shields but put a sword in the hands of their peers. When peers replace parents, children lose their vital protection against the thoughtlessness of others. The vulnerability of a child in such circumstances can easily be overwhelmed. The resulting pain is more than many children can bear. Studies have been unequivocal in their findings that the best protection for a child, even through adolescence, is a strong attachment with an adult. The most impressive of these studies involved ninety thousand adolescents from eighty different communities chosen to make the sample as representative of the United States as possible. The primary finding was that teenagers with strong emotional ties to their parents were much less likely to exhibit drug and alcohol problems, attempt suicide, or engage in violent behavior and early sexual activity. Such adolescents, in other words, were at greatly reduced risk for the problems that stem from being defended against vulnerability. Shielding them from stress and protecting their emotional health and functioning were strong attachments with their parents. This was also the conclusion of the noted American psychologist Julius Segal, a brilliant pioneer of research into what makes young people resilient. Summarizing studies from around the world, he concluded that the most important factor keeping children from being overwhelmed by stress was “the presence in their lives of a charismatic adult — a person with whom they identify and from whom they gather strength.” As Dr. Segal has also said, “Nothing will work in the absence of an indestructible link of caring between parent and child.” Peers should never have come to matter that much — certainly not more than parents or teachers or other adult attachment figures. Taunts and rejection by peers sting, of course, but they shouldn't cut to the quick, should not be so devastating. The profound dejection of an excluded child reveals a much more serious attachment problem than it does a peer-rejection problem.

More than anything, we have lost the cultural customs and traditions that bring extended families together, linking adults and children in caring relationships, that give the adult friends of parents a place in their children's lives. It is the role of culture to cultivate connections between the dependent and the dependable and to prevent attachment voids from occurring. Among the many reasons that culture is failing us, two bear mentioning. The first is the jarringly rapid rate of change in twentieth-century industrial societies. It requires time to develop customs and traditions that serve attachment needs, hundreds of years to create a working culture that serves a particular social and geographical environment. Our society has been changing much too rapidly for culture to evolve accordingly. There is now more change in a decade than previously in a century. When circumstances change more quickly than our culture can adapt to, customs and traditions disintegrate. It is not surprising that today's culture is failing its traditional function of supporting adult-child attachments. Part of the rapid change has been the electronic transmission of culture, allowing commercially blended and packaged culture to be broadcast into our homes and into the very minds of our children. Instant culture has replaced what used to be passed down through custom and tradition and from one generation to another. “Almost every day I find myself fighting the bubble-gum culture my children are exposed to,” said a frustrated father interviewed for this book. Not only is the content often alien to the culture of the parents but the process of transmission has taken grandparents out of the loop and made them seem sadly out of touch. Games, too, have become electronic. They have always been an instrument of culture to connect people to people, especially children to adults. Now games have become a solitary activity, watched in parallel on television sports-casts or engaged in in isolation on the computer. The most significant change in recent times has been the technology of communication — first the phone and then the Internet through e-mail and instant messaging. We are enamored of communication technology without being aware that one of its primary functions is to facilitate attachments. We have unwittingly put it into the hands of children who, of course, are using it to connect with their peers. Because of their strong attachment needs, the contact is highly addictive, often becoming a major preoccupation. Our culture has not been able to evolve the customs and traditions to contain this development, and so again we are all left to our own devices. This wonderful new technology would be a powerfully positive instrument if used to facilitate child-adult connections — as it does, for example, when it enables easy communication between students living away from home, and their parents. Left unchecked, it promotes peer orientation.

While making money was good, having meaningful work and meaningful relationships was far better. To me, meaningful work is being on a mission I become engrossed in, and meaningful relationships are those I have with people I care deeply about and who care deeply about me. Think about it: It’s senseless to have making money as your goal as money has no intrinsic value—its value comes from what it can buy, and it can’t buy everything. It’s smarter to start with what you really want, which are your real goals, and then work back to what you need to attain them. Money will be one of the things you need, but it’s not the only one and certainly not the most important one once you get past having the amount you need to get what you really want. When thinking about the things you really want, it pays to think of their relative values so you weigh them properly. In my case, I wanted meaningful work and meaningful relationships equally, and I valued money less—as long as I had enough to take care of my basic needs. In thinking about the relative importance of great relationships and money, it was clear that relationships were more important because there is no amount of money I would take in exchange for a meaningful relationship, because there is nothing I could buy with that money that would be more valuable. So, for me, meaningful work and meaningful relationships were and still are my primary goals and everything I did was for them. Making money was an incidental consequence of that.

When you finally meet someone who loves you and respects you in words and actions, relationships take on a whole new meaning. Your life becomes bigger because the things you discovered about yourself in your alone time are still being honored and cared for and you have a partner to share your life with. Love accommodates you and all your interests and obligations. You’re not being asked to give anything up for love and someone is helping to support you while you support him or her. Real love, functional love, doesn’t cause you to lose people, places, things, health, sleep, or appetite. Real love does not demand, either actively or passively, that you give up your friends, hobbies, or interests. In fact, it encourages independence and being fulfilled by other people, places, and things. When you are a healthy and functional person, your healthy and functional mate trusts and supports you. Your partner does not purposefully or unwittingly engulf you. If you’re losing your friends, your family, or your children due to a relationship you’re in, you need to think about what is going on in this relationship. Don’t automatically blame your friends, family, and children. If your partner always wants you to choose him or her over others in your life, even if it’s not an explicit demand but always turns out that way, there is something wrong. Real love does not strip you of the things you love or the people you love, and real love does not make you choose. Real love encourages quality time alone with friends, family, and children. Being nurtured and loved by others makes a person fulfilled and, in turn, adds to the primary relationship.

Marriages in the bourgeois sense of the word, and I mean in the most respectable sense of the word 'marriage', haven't the least to do with love no kind of institution can be made from love - and just as little with money; but rather with the social permission given to two people to satisfy their sexual desires with each other, of course under certain conditions, but such conditions as have the interests of society in view. It's clear that the prerequisites for such a contract must include some degree of liking between the parties concerned and very much goodwill - the will to be patient, conciliatory, to care for one another - but the word love should not be misused to describe it! For two lovers in the whole and strong sense of the word, sexual satisfaction is not the essential thing and really just a symbol: for one party, as has been said, a symbol of unconditional submission, for the other a symbol of assent to this, a sign of taking possession.- Marriage in the aristocratic sense, the old nobility's sense of the word, is about breeding a race (is there still a nobility today?) Quaeritur, in other words about maintaining a fixed, particular type of ruling men: man and woman were sacrificed to this viewpoint. Obviously, the primary requirement here was not love, on the contrary! - and not even that measure of mutual goodwill on which the good bourgeois marriage is based. The decisive thing was first the interest of the dynasty, and above that the class. Faced with the coldness, severity and calculating clarity of this noble concept of marriage, which has ruled in every healthy aristocracy, in ancient Athens as in eighteenth-century Europe, we would shiver a little, we warm-blooded animals with our ticklish hearts, we 'moderns'! And this is precisely why love as passion, in the grand understanding of the word, was invented for the aristocratic world and within it―where coercion and privation were greatest...

1. Commit to take the lead in the godliness of your relationship. Read the Bible's passages about how men and women and all Christians should treat one another. Especially take the lead in establishing boundaries that will keep you from sexual sin. Assume that this woman is going to be your wife or the wife of some other Christian brother (who might be currently dating your future wife). Treat her as the precious sister in Christ that she is. 2. Decide in advance whether or not you are willing to love a woman in the self-sacrificing, nurturing way the Bible describes. Until you are ready to faithfully hold a woman's heart in your hand, do not enter into a dating relationship. 3. Realizing that God wants you to learn to put her interests ahead of your own, ask her the kinds of things she likes to do and be eager to spend time doing them. 4. Be willing to talk about the relationship. Initiate honest dialogue about how you feel. Do not resent her desire to have the relationship defined, but protect her heart by making your level of commitment clear and thereby making clear the appropriate kind of intimacy to go along with that commitment. 5. Pay attention to her heart. Ask her about her burdens and cares. Seek ways to minister to her and to make her cares your own. Instead of being critical of her, speak words of encouragement and support. 6. Do not be shy in ministering the Word of God to her. Do not preach, but exhort her and call to mind God's promises and God's love for her in Jesus Christ. Make it a primary goal that she will be spiritually stronger by having been in a relationship with you. 7. If something about her bothers you, think about how you can encourage her in that area. Realize that none of us is without flaws. Pray for her weakness and try to strengthen her in that area. If your concerns are enough to deter you from wanting to marry her, let her know in a forthright manner while being as considerate as possible.

The other important aspect of the “interoceptive inference” view is that the purpose of perceiving the body from within has little to do with figuring out what’s there. My brain couldn’t care less that my internal organs are objects with particular locations within my body. The only thing that’s important about my internal physiology is that it works, that it keeps me alive. The brain cares primarily about control and regulation of the body’s internal state. So perceptual predictions for the body’s interior are of a very different kind: they’re instrumental, they’re control-oriented, they’re not epistemic, they’re not to do with “finding out.” For me, this is suggestive of why our experiences of being a body have this nonobject-based phenomenological character, compared to our experiences of the outside world. More speculatively, there is the idea that all forms of perception, conscious and unconscious, derive from this fundamental imperative for physiological regulation. If we understand that the original (evolutionary) purpose of predictive perception was to control and regulate the internal state of the body, and that all the other kinds of perceptual prediction are built on that evolutionary imperative, then ultimately the way we perceive the outside world is predicated on these mechanisms that have their primary objective in the regulation of an internal bodily state. This idea is really important for me, because it gets away from pretheoretical associations of consciousness and perception with cognition, with language, and maybe also with social interaction—all “higher order” properties of cognition. Instead, it grounds consciousness and perception much more strongly in the basic mechanisms of life. It might not just be that life provides a nice analogy with consciousness in terms of hard problems and mysteries, but that there are actually deep obligate connections between mechanisms of life and the way we perceive, consciously and unconsciously, ourselves and the world.

what makes life worth living when we are old and frail and unable to care for ourselves? In 1943, the psychologist Abraham Maslow published his hugely influential paper “A Theory of Human Motivation,” which famously described people as having a hierarchy of needs. It is often depicted as a pyramid. At the bottom are our basic needs—the essentials of physiological survival (such as food, water, and air) and of safety (such as law, order, and stability). Up one level are the need for love and for belonging. Above that is our desire for growth—the opportunity to attain personal goals, to master knowledge and skills, and to be recognized and rewarded for our achievements. Finally, at the top is the desire for what Maslow termed “self-actualization”—self-fulfillment through pursuit of moral ideals and creativity for their own sake. Maslow argued that safety and survival remain our primary and foundational goals in life, not least when our options and capacities become limited. If true, the fact that public policy and concern about old age homes focus on health and safety is just a recognition and manifestation of those goals. They are assumed to be everyone’s first priorities. Reality is more complex, though. People readily demonstrate a willingness to sacrifice their safety and survival for the sake of something beyond themselves, such as family, country, or justice. And this is regardless of age. What’s more, our driving motivations in life, instead of remaining constant, change hugely over time and in ways that don’t quite fit Maslow’s classic hierarchy. In young adulthood, people seek a life of growth and self-fulfillment, just as Maslow suggested. Growing up involves opening outward. We search out new experiences, wider social connections, and ways of putting our stamp on the world. When people reach the latter half of adulthood, however, their priorities change markedly. Most reduce the amount of time and effort they spend pursuing achievement and social networks. They narrow in. Given the choice, young people prefer meeting new people to spending time with, say, a sibling; old people prefer the opposite. Studies find that as people grow older they interact with fewer people and concentrate more on spending time with family and established friends. They focus on being rather than doing and on the present more than the future.