Some Psychiatric Quotes

Almost every woman I have ever met has a secret belief that she is just on the edge of madness, that there is some deep, crazy part within her, that she must be on guard constantly against ‘losing control’ — of her temper, of her appetite, of her sexuality, of her feelings, of her ambition, of her secret fantasies, of her mind.

I think you're a terrible person and I hope you get some psychiatric help. Go to hell.

The degree to which the psychiatric community is complicit with abusive parents in drugging non-compliant children is a war crime across the generations, and there will be a Nuremberg at some point in the future

Why do I take a blade and slash my arms? Why do I drink myself into a stupor? Why do I swallow bottles of pills and end up in A&E having my stomach pumped? Am I seeking attention? Showing off? The pain of the cuts releases the mental pain of the memories, but the pain of healing lasts weeks. After every self-harming or overdosing incident I run the risk of being sectioned and returned to a psychiatric institution, a harrowing prospect I would not recommend to anyone. So, why do I do it? I don't. If I had power over the alters, I'd stop them. I don't have that power. When they are out, they're out. I experience blank spells and lose time, consciousness, dignity. If I, Alice Jamieson, wanted attention, I would have completed my PhD and started to climb the academic career ladder. Flaunting the label 'doctor' is more attention-grabbing that lying drained of hope in hospital with steri-strips up your arms and the vile taste of liquid charcoal absorbing the chemicals in your stomach. In most things we do, we anticipate some reward or payment. We study for status and to get better jobs; we work for money; our children are little mirrors of our social standing; the charity donation and trip to Oxfam make us feel good. Every kindness carries the potential gift of a responding kindness: you reap what you sow. There is no advantage in my harming myself; no reason for me to invent delusional memories of incest and ritual abuse. There is nothing to be gained in an A&E department.

Well. There is a psychiatric occurrence we see in men-not often women-where they put all their hopes and dreams onto one person, so intensely that at some point it trips a wire in the brain circuitry, and that causes them to go, in a minute, 180 degrees the other way.

Some psychiatric casualties have always been associated with war, but it was only in the twentieth century that our physical and logistical capability to sustain combat outstripped our psychological capacity to endure it.

Here I want to stress that perception of losing one’s mind is based on culturally derived and socially ingrained stereotypes as to the significance of symptoms such as hearing voices, losing temporal and spatial orientation, and sensing that one is being followed, and that many of the most spectacular and convincing of these symptoms in some instances psychiatrically signify merely a temporary emotional upset in a stressful situation, however terrifying to the person at the time. Similarly, the anxiety consequent upon this perception of oneself, and the strategies devised to reduce this anxiety, are not a product of abnormal psychology, but would be exhibited by any person socialized into our culture who came to conceive of himself as someone losing his mind.

...some patients resist the diagnosis of a post-traumatic disorder. They may feel stigmatized by any psychiatric diagnosis or wish to deny their condition out of a sense of pride. Some people feel that acknowledging psychological harm grants a moral victory to the perpetrator, in a way that acknowledging physical harm does not.

He told us that it was important to eat right, exercise, and treat your body as a temple. But he didn't tell us how to get health care services that people with no money could afford. He didn't tell us how we could quickly obtain birth control and other reproductive health services. He didn't recommend any solutions for behavioral or psychiatric care, and for sure some of those broads needed it. He didn't say what options there might be for people who had struggled with substance abuse, sometimes for decades, when they were confronted by old demons on the outside.

The term 'deinstitutionalization' conceals some simple truths, namely, that old, unwanted persons, formerly housed in state hospitals, are now housed in nursing homes; that young, unwanted persons, formerly also housed in state hospitals, are now housed in prisons or parapsychiatric facilities; and that both groups of inmates are systematically drugged with psychiatric medications.

It is no coincidence then that doctors and patients and the entire Lyme community report—anecdotally, of course, as there is still a frustrating scarcity of good data on anything Lyme-related—that women suffer the most from Lyme. They tend to advance into chronic and late-stage forms of the illness most because often it's checked for last, as doctors often treat them as psychiatric cases first. The nebulous symptoms plus the fracturing of articulacy and cognitive fog can cause any Lyme patient to simply appear mentally ill and mentally ill only. This is why we hear that young women—again, anecdotally—are dying of Lyme the fastest. This is also why we hear that chronic illness is a women's burden. Women simply aren't allowed to be physically sick until they are mentally sick, too, and then it is by some miracle or accident that the two can be separated for proper diagnosis. In the end, every Lyme patient has some psychiatric diagnosis, too, if anything because of the hell it takes getting to a diagnosis.

There was a muchacha who lived near my house. La gente del pueblo talked about her being una de las otras, “of the Others.” They said that for six months she was a woman who had a vagina that bled once a month, and that for the other six months she was a man, had a penis and she peed standing up. they called her half and half, mita’ y mita‘, neither one nor the other but a strange doubling, a deviation of nature that horrified, a work of nature inverted. But there is a magic aspect in abnormality and so-called deformity. Maimed, mad, and sexually different people were believed to posess supernatural powers by primal cultures’ magico-religious thinking. For them, abnormality was the price a person had to pay for her or his inborn extraordinary gift. There is something compelling about being both male and female, about having an entry into both worlds. Contrary to some psychiatric tenets, half and halfs are not suffering from a confusion of sexual identity, or even from a confusion of gender. What we are suffering from is an absolute despot duality that says we are able to be only one or the other. It claims that human nature is limited and cannot evolve into something better. But I, like other queer people, am two in one body, both male and female. I am the embodiment of the heiros gamos: the coming together of opposite qualities within.

Psychiatric diagnoses are getting closer and closer to the boundary of normal,” said Allen Frances. “That boundary is very populous. The most crowded boundary is the boundary with normal.” “Why?” I asked. “There’s a societal push for conformity in all ways,” he said. “There’s less tolerance of difference. And so maybe for some people having a label is better. It can confer a sense of hope and direction. ‘Previously I was laughed at, I was picked on, no one liked me, but now I can talk to fellow bipolar sufferers on the Internet and no longer feel alone.’” He paused. “In the old days some of them may have been given a more stigmatizing label like conduct disorder or personality disorder or oppositional defiant disorder. Childhood bipolar takes the edge of guilt away from parents that maybe they created an oppositional child.

Readers will recall that the little evidence collected seemed to point to the strange and confusing figure of an unidentified Air Force pilot whose body was washed ashore on a beach near Dieppe three months later. Other traces of his ‘mortal remains’ were found in a number of unexpected places: in a footnote to a paper on some unusual aspects of schizophrenia published thirty years earlier in a since defunct psychiatric journal; in the pilot for an unpurchased TV thriller, ‘Lieutenant 70’; and on the record labels of a pop singer known as The Him — to instance only a few. Whether in fact this man was a returning astronaut suffering from amnesia, the figment of an ill-organized advertising campaign, or, as some have suggested, the second coming of Christ, is anyone’s guess.

It has been fashionable in some psychiatric and lay circles to blame the mother for whatever goes wrong in development. [...] If blame must be assessed it should be placed on the human condition which requires such prolonged dependence on one individual for development to take place. This makes the child extraordinarily vulnerable to the idiosyncrasies of that person (the mother). On the other hand, the prolonged dependence on this relationship also provides the potential for the richness of the human personality. It is a mistake, in my judgment, in psychotherapy to encourage or side with the patient's hostility to the mother. The patient has to become aware of and express it in therapy in order to grow but whatever the source of this hostility is in the past -- be it an actual memory or a fantasy to rationalize a feeling state -- the problem is now the patient's responsibility and he must work it out.

Sadly, psychiatric training still includes far too little on the very serious psychiatric sequelae of childhood trauma, especially CSA [child sexual abuse]. There is inadequate recognition within mental health services of the prevalence and importance of Dissociative Disorders, sufferers of which are frequently misdiagnosed as Borderline Personality Disorder (BPD), or, in the cases of DID, schizophrenia. This is to some extent understandable as some of the features of DID appear superficially to mimic those of schizophrenia and/or Borderline Personality Disorder.

Wow," Jake said, his face going blank. "Assface. Is that a technical term? Maybe some kind of psychiatric diagnosis I'm not familiar with?

Most people expect survivors of this type of abuse to be extremely damaged and seriously disturbed individuals. Certainly most people around expect them to be in great need of psychiatric help... No matter what the survivor is in contact with a particular agency for, the assumption is quickly made that, because of the [ritual] abuse, there must be mental health problems of some kind present. Yet, this is not always the case.

Implicit [in the psychiatric literature] is a set of normative assumptions regarding the father's prerogatives and the mother's obligations within the family, The father, like the children, is presumed to be entitled to the mother's love, nurturance, and care. In fact, his dependent needs actually supersede those of the children, for if a mother falls to provide the accustomed intentions, it is taken for granted that some other female must be found to take her place. The oldest daughter is a frequent choice... The father's wish, indeed his right, to continue to receive female nurturance, whatever the circumstances, is accepted without question.

Having DID is, for many people, a very lonely thing. If this book reaches some people whose experiences resonate with mine and gives them a sense that they aren't alone, that there is hope, then I will have achieved one of my goals. A sad fact is that people with DID spend an average of almost seven years in the mental health system before being properly diagnosed and receiving the specific help they need. During that repeatedly misdiagnosed and incorrectly treated, simply because clinicians fail to recognize the symptoms. If this book provides practicing and future clinicians certain insight into DID, then I will have accomplished another goal. Clinicians, and all others whose lives are touched by DID, need to grasp the fundamentally illusive nature of memory, because memory, or the lack of it, is an integral component of this condition. Our minds are stock pots which are continuously fed ingredients from many cooks: parents, siblings, relatives, neighbors, teachers, schoolmates, strangers, acquaintances, radio, television, movies, and books. These are the fixings of learning and memory, which are stirred with a spoon that changes form over time as it is shaped by our experiences. In this incredibly amorphous neurological stew, it is impossible for all memories to be exact. But even as we accept the complex of impressionistic nature of memory, it is equally essential to recognize that people who experience persistent and intrusive memories that disrupt their sense of well-being and ability to function, have some real basis distress, regardless of the degree of clarity or feasibility of their recollections. We must understand that those who experience abuse as children, and particularly those who experience incest, almost invariably suffer from a profound sense of guilt and shame that is not meliorated merely by unearthing memories or focusing on the content of traumatic material. It is not enough to just remember. Nor is achieving a sense of wholeness and peace necessarily accomplished by either placing blame on others or by forgiving those we perceive as having wronged us. It is achieved through understanding, acceptance, and reinvention of the self.

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

Maybe PTSD really is triggered by a single incident, a stressor, as it's known in the psychiatric community, and maybe the attack at Al-Waleed was that stressor for me, but as I have learned in the intervening years, I was not damaged by that moment alone. In fact, while there are specific memories that resurface with some frequency, like the suicide bomber in Sinjar or the order riot at Al-Waleed, I find myself most traumatized by the overall experience of being in a combat zone like Iraq, where you are always surrounded by war but rarely aware of when or how violence will arrive. Like so many of my fellow veterans, I understand now how that it is the daily adrenaline rush of a war without front lines or uniforms, rather than the infrequent bursts of bloody violence, that ultimately damages the modern warrior's mind.

The golden age of cultural theory is long past. The pioneering works of Jacques Lacan, Claude Lévi-Strauss, Louis Althusser, Roland Barthes and Michel Foucault are several decades behind us [ … ] Some of them have since been struck down. Fate pushed Roland Barthes under a Parisian laundry van, and afflicted Michel Foucault with Aids. It dispatched Lacan, Williams and Bourdieu, and banished Louis Althusser to a psychiatric hospital for the murder of his wife. It seemed that God was not a structuralist.

To some, madness can be seductive, a way of getting back, of getting even. The only problem is, you can get lost forever.

DSM-5 is not 'the bible of psychiatry' but a practical manual for everyday work. Psychiatric diagnosis is primarily a way of communicating. That function is essential but pragmatic—categories of illness can be useful without necessarily being 'true.' The DSM system is a rough-and-ready classification that brings some degree of order to chaos. It describes categories of disorder that are poorly understood and that will be replaced with time. Moreover, current diagnoses are syndromes that mask the presence of true diseases. They are symptomatic variants of broader processes or arbitrary cut-off points on a continuum.

Maimed, mad and sexually different people were believed to possess supernatural powers by primal cultures' magico-religious thinking. For them, abnormality was the price a person had to pay for her or his inborn extraordinary gift. There is something compelling about being both male and female, about having an entry into both worlds. Contrary to some psychiatric tenets, half and halfs are not suffering from a confusion of sexual identity, or even from a confusion of gender. What we are suffering from is an absolute despot duality that says we are able to be only one or the other. It claims that human nature is limited and cannot evolve into something better. But I, like pother queer people, am two in one body, both male and female. I am the embodiment of the hieros gamos: the comig together of opposit qualities within.

Case by case, we find that conformity is the easy way, and the path to privilege and prestige; dissidence carries personal costs that may be severe, even in a society that lacks such means of control as death squads, psychiatric prisons, or extermination camps. The very structure of the media is designed to induce conformity to established doctrine. In a three-minute stretch between commercials, or in seven hundred words, it is impossible to present unfamiliar thoughts or surprising conclusions with the argument and evidence required to afford them some credibility. Regurgitation of welcome pieties faces no such problem.

Jill was born into an inner-city home. Her father began having sex with Jill and her sister during their preschool years. Her mother was institutionalized twice because of what used to be termed “nervous breakdowns.” When Jill was 7 years old, her agitated dad called a family meeting in the living room. In front of the whole clan, he put a handgun to his head, said, “You drove me to this,” and then blew his brains out. The mother’s mental condition continued to deteriorate, and she revolved in and out of mental hospitals for years. When Mom was home, she would beat Jill. Beginning in her early teens, Jill was forced to work outside the home to help make ends meet. As Jill got older, we would have expected to see deep psychiatric scars, severe emotional damage, drugs, maybe even a pregnancy or two. Instead, Jill developed into a charming and quite popular young woman at school. She became a talented singer, an honor student, and president of her high-school class. By every measure, she was emotionally well-adjusted and seemingly unscathed by the awful circumstances of her childhood. Her story, published in a leading psychiatric journal, illustrates the unevenness of the human response to stress. Psychiatrists long have observed that some people are more tolerant of stress than others.

Some psychiatric clinicians appear to be so biologically or behaviorally oriented that they do not believe in the unconscious. Others have been so indoctrinated in the Freudian psychoanalytic model that they believe all accounts of incest are fantasy. A few of the older clinicians allow pride to get in their way and refuse to believe that they may have missed the diagnosis [of Dissociative Identity Disorder] in some of their patients.

The anti-psychiatrists held various, sometimes conflicting views but one particular line of reasoning is attributable to all of them—they all pitched their arguments against the power of the psychiatric establishment. They argued that the psychiatric diagnosis is scientifically meaningless. It is a way of labeling undesirable behaviour, under the guise of medical intervention. Those who are diagnosed ill are subjected to treatment which is a violation of human rights and dignity. The situation amounts to psychiatry having a mandate to declare some citizens unfit to live in an ‘ordinary’ community. It claims to cure but the supposed beneficiaries of that cure are often held in hospitals against their will. Within a structure like this it is impossible to understand the real nature of mental suffering and it is just as impossible to develop a coherent system of help.

It’s absolutely retrogressive to suggest [ME] CFS is in the heads of patients. I have seen patients commit suicide, or have been otherwise destroyed, because some professor has diagnosed them as having a psychiatric illness.

[S]ocial order displays not the absolute presence or absence of intolerance to difference but a spectrum of intolerance. Each of us bears responsibility to some degree for maintaining these protocols of intolerance, which could not be kept in place if every single one of us did not play our part. From bringing up children ‘appropriately’, to lovingly correcting or punishing their inappropriate behaviour, to making sure we never breach the protocols ourselves, to staring or sniggering at people who look different, to coercive psychiatric and medical intervention, to emotional blackmail, to physical violence-it’s a range of slippages all the way that we seldom recognize.

The koan is not a conundrum to be solved by a nimble wit. It is not a verbal psychiatric device for shocking the disintegrated ego of a student into some kind of stability. Nor, in my opinion, is it ever a paradoxical statement except to those who view it from outside. When the koan is resolved it is realized to be a simple and clear statement made from the state of consciousness which it has helped to awaken. —from The Zen Koan, by Ruth Fuller Sasaki

It is safe to assume that, no matter how it appears, the attempt probably did not come out of the blue. Look for clues. Some possibilities include a family history of mental illness, a history of abuse, unusual or stressful family dynamics, prior diagnosis or evidence of a psychiatric disorder and/or bizarre behavior long before or in the days or weeks immediately preceding the crisis. Part of your job is to be a detective, assembling the pieces in the puzzle that is depression.

but it’s not the only diagnosis. Other diagnoses include: hormonal birth control with a “high androgen index” some types of psychiatric medications high prolactin hypothyroidism rare pituitary or adrenal diseases congenital adrenal hyperplasia.

My other client, whom I will call Teresa, thought Lorraine had MPD and hoped I could help her. Almost no one recognized this condition in those days. Lorraine was forty years old and had been in and out of psychiatric hospitals since she was thirteen. She had had various diagnoses, mainly severe depression, and she had made quite a few serious suicide attempts before I even met her. She had been given many courses of electric shock therapy, which would confuse her so much that she could not get together a coherent suicide plan for quite a while. Lorraine’s psychiatrist was initially opposed to my seeing her, as her friend Teresa had been stigmatized with the "borderline personality disorder" diagnosis when in hospital, so was seen as a bad influence on her. But after Lorraine spent a couple of months in hospital calling herself Susie and acting consistently like a child, he was humble enough to acknowledge that perhaps he could learn some new things, and someone else’s help might be a good idea.

About 30 percent of all adults have a major psychiatric disorder at any given point in time, about 50 percent will have such a disorder at some point in their lives, and nearly 80 percent of these will have more than one serious psychological problem (Kessler et al. 1994).

Deliberately placed triggers for learned behaviours (programmes) Although all abuse and trauma survivors may be “triggered” into intrusive flashbacks by present-day experiences that remind them of the trauma, the triggers deliberately installed by mind controllers are different, in that they are cues for conditioned behaviours. Some of these are behaviours such as going home, going outside (where someone is waiting), coming to the person who uses the trigger, or switching to a particular insider. Others are psychiatric symptoms such as flashbacks, self-harm, or suicide attempts, which are actually punishments given by insiders for disobedience or disloyalty. For many survivors, every trigger causes a switch to a part programmed to perform a particular behaviour associated with that trigger. For others, the front person remains present in the world but has an irresistible compulsion to perform the behaviour.

Another key feature? Thanks to the commitment and common sense of Dr. Randy Dupont, clinical director of emergency psychiatric services at the University of Tennessee Medical Center and a founding member of the Memphis CIT, if the cops brought someone to the center for an assessment, they were not turned away with some bureaucratic excuse.

He tried to get help from the VA but he couldn’t, as so many other returning soldiers have discovered. He suffered terribly—nightmares, insomnia, flashbacks. He drank too much to mask these symptoms, and unfortunately alcohol only exacerbated the condition. It’s called post-traumatic stress and it is a recognized psychiatric disorder. It was around long before we had such a serious-sounding clinical name for it. In the Civil War, it was called a ‘soldier’s heart,’ which I think is the most accurate of the descriptions; in World War One, it was ‘shell shock,’ and during World War Two, ‘battle fatigue.’ In other words, war changes every soldier, but it has always profoundly damaged some of them.

Four key elements of some mental illnesses—mania and depression—appear to promote crisis leadership: realism, resilience, empathy, and creativity. These aren’t just loosely defined character traits; they have specific psychiatric meanings, and have been extensively studied scientifically. I use these terms in their scientific, not their commonsense, meanings.

Paris Syndrome” affects roughly a dozen Japanese tourists every year, who arrive in Paris bearing romantic expectations of the French capital, but end up hospitalized “when they discover that Parisians can be rude, or the city does not meet their expectations,” adding, “The experience can apparently be too stressful for some and they suffer a psychiatric breakdown.

Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning.

As bad as were the physical consequences of captivity, the emotional injuries were much more insidious, widespread, and enduring. In the first six postwar years, one of the most common diagnoses given to hospitalized former Pacific POWs was psychoneurosis. Nearly forty years after the war, more than 85 percent of former Pacific POWs in one study suffered from post-traumatic stress disorder (PTSD), characterized in part by flashbacks, anxiety, and nightmares. And in a 1987 study, eight in ten former Pacific POWs had "psychiatric impairment," six in ten had anxiety disorders, more than one in four had PTSD, and nearly one in five was depressed. For some, there was only one way out: a 1970 study reported that former Pacific POWs committed suicide 30 percent more often than controls.

Since we choose our bodies and the lessons that come with living that life, those with crippling imperfections--a physical handicap, maybe, or a psychiatric struggle related to depression or OCD--have done so to grow their souls in some way. I wish my body were a lot of things it’s not--relaxed instead of anxious, five foot seven and a hundred twenty pounds instead of five foot one and…never mind.

And yet after thirty years and millions upon millions of dollars’ worth of research, we have failed to find consistent genetic patterns for schizophrenia—or for any other psychiatric illness, for that matter.2 Some of my colleagues have also worked hard to discover genetic factors that predispose people to develop traumatic stress.3 That quest continues, but so far it has failed to yield any solid answers.4

000-x02 Dissociative reaction This reaction represents a type of gross personality disorganization, the basis of which is a neurotic disturbance, although the diffuse dissociation seen in some casts may occasionally appear psychotic. The personality disorganization may result in aimless running or "freezing." The repressed impulse giving rise to the anxiety may be discharged by, or deflected into, various symptomatic expressions, such as depersonalization, dissociated personality, stupor, fugue, amnesia, dream state, somnambulism, etc. The diagnosis will specify symptomatic manifestations. These reactions must be differentiated from schizoid personality, from schizophrenic reaction, and from analogous symptoms in some other types of neurotic reactions. Formerly, this reaction has been classified as a type of "conversion hysteria.

And then, after years of being dismissed as a soft science, talk therapy, too, has seen a reconsideration as studies have shown that for some people, therapy creates profound changes in the brain—as pronounced, in some cases, as psychiatric medication. “Psychotherapy is a biological treatment, a brain therapy,” said Nobel Prize–winning psychiatrist and neuroscientist Eric Kandel in 2013. “It produces lasting, detectable physical changes

adolescent who expresses dissident opinion more or less vocally can end up in a place like that. Some of the children arrive there from orphanages. If a child tries to run away from an orphanage, it is considered normal in our country to commit him to a psychiatric facility and treat him with the strongest of sedatives, such as aminazine, used to suppress Soviet dissidents back in the 1970s. This is particularly shocking considering these institutions’ general punitive trend and the absence of psychological help as such. All communication there is based on fear and the children’s forced subjugation. They become exponentially more cruel as a result. Many of the children are illiterate, but no one makes an effort to do anything about that. On the contrary, they do everything to quash the last remnants of any motivation to grow. The children shut down and stop trusting words. I

You’ve—it seems—no other psychiatric history, Mr. McMurry?” “McMurphy, Doc.” “Oh? But I thought—the nurse was saying—” He opens the folder again, fishes out those glasses, looks the record over for another minute before he closes it, and puts his glasses back in his pocket. “Yes. McMurphy. That is correct. I beg your pardon.” “It’s okay, Doc. It was the lady there that started it, made the mistake. I’ve known some people inclined to do that.

reality is this: All of us, to some degree, are mentally ill. We get paranoid, anxious, depressed, and insomniac. We alternate between delusions of grandeur and crippling self-doubt, we suffer from paralyzing fears and embarrassing neuroses. We all have compulsions to do things we know we shouldn’t, and there are millions of us with addictions, whether to gambling, drinking, dieting, or playing Second Life. Every one of us has psychiatric symptoms, many of them

Controversy has always existed among psychiatrists and psychologists about the validity of personality diagnosis. Some believe in the merits of the enterprise and devote their careers to ever greater nosological precision. Others, and among them I include myself, marvel that anyone can take diagnosis seriously, that it can ever be considered more than a simple cluster of symptoms and behavioral traits. Nonetheless, we find ourselves under ever-increasing pressure (from hospitals, insurance companies, governmental agencies) to sum up a person with a diagnostic phrase and a numerical category. Even the most liberal system of psychiatric nomenclature does violence to the being of another. If we relate to people believing we can categorize them, we will neither identify nor nurture the parts, the vital parts, of the other that transcend category. The enabling relationship always assumes that the other is never fully knowable.

For nearly a hundred years, psychiatry has been striving to apply medical model thinking to psychiatric disorders. In this model, the symptoms besieging patients are sorted into specific disease entities and the causes then identified and removed. For doctors of internal medicine, this works. In the case of diabetes mellitus, for example, the symptoms of urinary frequency, fatigue, and confusion often lead to suspicion of the underlying cause, which is confirmed by blood sugar monitoring and then treated by insulin replacement. But psychiatric symptoms are much harder to sort into diagnoses. People with depression sometimes become paranoid. People with schizophrenia sometimes become depressed. Some people who hear voices have no other symptoms whatsoever, and others who hear voices also fall victim to terrible mood swings. Thus far, the hope that psychiatry would be able to identify homogeneous disease states, uncover the biological underpinnings, and remedy them has been largely a barren one. Kappler's symptoms, however, evolved when the hope for psychiatry's becoming a true medical specialty was bright to the point of being blinding. Over the years he would collect over a dozen diagnoses and cavalierly take a myriad of medicines, but no one would be able to bring him close to confronting the past he had disowned, to stand a chance of making peace with it and, ultimately, overcoming it. (46)

As far back as 1563 the courageous Dutch physician Johannes Wier published his masterwork, De Praestigiis Daemonum (On the Delusions About Demons) in which he states that the collective and voluntary self-accusation of older women through which they exposed themselves to torture and death by their inquisitors was in itself an act inspired by the devil, a trick of demons, whose aim it was to doom not only the innocent women but also their reckless judges. Wier was the first medical man to introduce what became the psychiatric concept of DELUSION and mental blindness. Wherever his book had influence, the persecution of witches ceased, in some countries more than one hundred and fifty years before it was finally brought to an end throughout the civilized world. His work and his insights became one of the main instruments for fighting the witch delusion and physical torture (Baschwitz). Wier realized even then that witches were scapegoats for the inner confusion and desperation of their judges and of the “Zeitgeist” in general.

Something in every person objects to acknowledging the fact that he is not even "master in his own house". The unconscious is un-conscious, and there's no bargaining on that score. The whole analytic therapy is based on the principle of making the unconscious conscious through an emotional therapeutic process, thus changing the unfavorable inner structure. All the misconceptions current about "self-analysis" via book knowledge are empty talk; self-analysis is a fancy word for arriving at wrong conclusions about one's own wonderful self. A psychiatric guide is needed for the descent into one's "inner hell". Psychoanalysis has always had the distinction of presenting unpalatable ideas. This fact is not based on some peculiar predilection of analysts but is inherent in analytic discoveries. Since our science deals with psychic material typically repressed (expelled from consciousness because too painful and shameful to remain conscious) the reaction of the conscious ego is an indignant "no". Facts, however, do not change by simple denial of them.

The implication that the change in nomenclature from “Multiple Personality Disorder” to “Dissociative Identity Disorder” means the condition has been repudiated and “dropped” from the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association is false and misleading. Many if not most diagnostic entities have been renamed or have had their names modified as psychiatry changes in its conceptualizations and classifications of mental illnesses. When the DSM decided to go with “Dissociative Identity Disorder” it put “(formerly multiple personality disorder)” right after the new name to signify that it was the same condition. It’s right there on page 526 of DSM-IV-R. There have been four different names for this condition in the DSMs over the course of my career. I was part of the group that developed and wrote successive descriptions and diagnostic criteria for this condition for DSM-III-R, DSM–IV, and DSM-IV-TR. While some patients have been hurt by the impact of material that proves to be inaccurate, there is no evidence that scientifically demonstrates the prevalence of such events. Most material alleged to be false has been disputed by someone, but has not been proven false. Finally, however intriguing the idea of encouraging forgetting troubling material may seem, there is no evidence that it is either effective or safe as a general approach to treatment. There is considerable belief that when such material is put out of mind, it creates symptoms indirectly, from “behind the scenes.” Ironically, such efforts purport to cure some dissociative phenomena by encouraging others, such as Dissociative Amnesia.

After they broke up, Redse helped found OpenMind, a mental health resource network in California. She happened to read in a psychiatric manual about Narcissistic Personality Disorder and decided that Jobs perfectly met the criteria. “It fits so well and explained so much of what we had struggled with, that I realized expecting him to be nicer or less self-centered was like expecting a blind man to see,” she said. “It also explained some of the choices he’d made about his daughter Lisa at that time. I think the issue is empathy—the capacity for empathy is lacking.

Gretel dreamed quite a Druhástranian dream. I mean, the absence of inclination to pass commentary, a reluctance to subscribe to any ideology in case the compromise proves catastrophic; those aren’t the only clues as to the Druhástranian nature of this dream. What about the fear that not having a point of view is in some way a crime? If this dream had been dreamed by a non-Druhástranian perhaps it would have had moral or spiritual overtones, or nationalist ones, or Gretel would have dreamed we were in a psychiatric hospital being treated for this chronic lack of a point of view.

Bryukhanov and Fomin, as the highest ranking men at the plant, were each sentenced to ten years in prison, Dyatlov received five, Kovalenko and Rogozhkin: three, and Laushkin: two. Bryukhanov and Dyatlov - who wrote a book telling his side of the story some years afterwards, in which he placed the blame almost squarely on the designers - were released from prison early due to poor health brought on by radiation exposure. Chief Engineer Nikolai Fomin was declared insane in 1990 and transferred to a psychiatric hospital. Astonishingly, after he recovered he was allowed to return to work at the Kalinin Nuclear Power Plant near Moscow.

ME/CFS is not synonymous with depression or other psychiatric illnesses. The belief by some that they are the same has caused much con- fusion in the past, and inappropriate treatment. Nonpsychotic depression (major depression and dysthymia), anxiety disorders and somatization disorders are not diagnostically exclusionary, but may cause significant symptom overlap. Careful attention to the timing and correlation of symptoms, and a search for those characteristics of the symptoms that help to differentiate between diagnoses may be informative, e.g., exercise will tend to ameliorate depression whereas excessive exercise tends to have an adverse effect on ME/CFS patients.

Panksepp is emphatic on this point, arguing that his neural studies as well as those of his colleagues show that the prime, fundamental emotions of humans and all mammals do not emerge from the cerebral cortex, as was commonly believed in the twentieth century and as some leading neuroscientists still claim, but come from deep, ancient brain structures, including the hypothalamus and amygdala. It is why, he notes, that “drugs used to treat emotional and psychiatric disorders in humans were first developed and found effective in animals—rats and mice. This kind of research would obviously have no value if animals were incapable of experiencing these emotional states, or if we did not share them.

God bless her, but the child is wild. It’s not her fault. But she’ll never be normal. At least let her enjoy her childhood. You read the report, didn’t you? There was rotten food in the fridge, clothes all over the floor. She came here wearing one of her father’s T-shirts and his baseball cap. You just wanted to throw out all the things that she had in her suitcase and give her a chance to start all over again. And the child’s fingernails were long. Who ever heard of long fingernails on a twelve-year-old? And she smelled!’ ‘Is she worse than Rodney?’ ‘Rodney? No, God no. She doesn’t need psychiatric help. I’m just saying that she needs a couple extra things like a sweater or some new toys of her own.’ Later that afternoon, Isabelle came into my room with a box filled with girls’ toys. I pulled out a blue pony with long yellow hair and pink seashells on its butt. ‘Who was Rodney?’ I asked her. A little boy who lived here and used to wear swimming goggles all the time. Who’s been talking to you about Rodney?’ ‘You mentioned him to the social worker.’ ‘Lord! Don’t worry what I say to the social worker. I have to make you sound like a real sorrowful case to be able to get you more things. See, I got you a pretty pony, didn’t I?’ I guess it was worth having your self-esteem destroyed if there was a free toy involved. Isabelle told me that she was trying to get us a subscription to Ranger Rick magazine. I didn’t want to hear what she was going to say about me to get it.

Because DID requires the presence of amnesia, DID patients are, by DSM-5 definition (American Psychiatric Association, 2013), unaware of some of their behavior in different states. Progress in treatment includes helping patients become more aware of, and in better control of, their behavior across all states. To those who have not had training in treating DID, this increased awareness may make it seem as if patients are creating new self-states, and “getting worse,” when in fact they are becoming aware of aspects of themselves for which they previously had limited or no awareness or control. Although some DID patients create new self-states in adulthood, clinicians strongly advise patients against so doing (Fine, 1989; ISSTD, 2011; Kluft, 1989).

Equally serious is the complaint that psychoanalysis as a medical practice is a form of oppressive social control, labelling individuals and forcing them to conform to arbitrary definitions of ‘normality’. This charge is in fact more usually aimed against psychiatric medicine as a whole: as far as Freud’s own views on ‘normality’ are concerned, the accusation is largely misdirected. Freud’s work showed, scandalously, just how ‘plastic’ and variable in its choice of objects libido really is, how so-called sexual perversions form part of what passes as normal sexuality, and how heterosexuality is by no means a natural or self-evident fact. It is true that Freudian psychoanalysis does usually work with some concept of a sexual ‘norm’; but this is in no sense given by Nature.

Among DID individuals, the sharing of conscious awareness between alters exists in varying degrees. I have seen cases where there has appeared to be no amnestic barriers between individual alters, where the host and alters appeared to be fully cognizant of each other. On the other hand, I have seen cases where the host was absolutely unaware of any alters despite clear evidence of their presence. In those cases, while the host was not aware of the alters, there were alters with an awareness of the host as well as having some limited awareness of at least a few other alters. So, according to my experience, there is a spectrum of shared consciousness in DID patients. From a therapeutic point of view, while treatment of patients without amnestic barriers differs in some ways from treatment of those with such barriers, the fundamental goal of therapy is the same: to support the healing of the early childhood trauma that gave rise to the dissociation and its attendant alters. Good DID therapy involves promoting co­-consciousness. With co-­consciousness, it is possible to begin teaching the patient’s system the value of cooperation among the alters. Enjoin them to emulate the spirit of a champion football team, with each member utilizing their full potential and working together to achieve a common goal. Returning to the patients that seemed to lack amnestic barriers, it is important to understand that such co-consciousness did not mean that the host and alters were well-­coordinated or living in harmony. If they were all in harmony, there would be no “dis­ease.” There would be little likelihood of a need or even desire for psychiatric intervention. It is when there is conflict between the host and/or among alters that treatment is needed.

In attunement, it is the infant who leads and the mother who follows. “Where their roles differ is in the timing of their responses,” writes John Bowlby, one of the century’s great psychiatric researchers. The infant initiates the interaction or withdraws from it according to his own rhythms, Bowlby found, while the “mother regulates her behaviour so that it meshes with his... Thus she lets him call the tune and by a skillful interweaving of her own responses with his creates a dialogue.” The tense or depressed mothering adult will not be able to accompany the infant into relaxed, happy spaces. He may also not fully pick up signs of the infant’s emotional distress, or may not be able to respond to them as effectively as he would wish. The ADD child’s difficulty reading social cues likely originates from her relationship cues not being read by the nurturing adult, who was distracted by stress. In the attunement interaction, not only does the mother follow the child, but she also permits the child to temporarily interrupt contact. When the interaction reaches a certain stage of intensity for the infant, he will look away to avoid an uncomfortably high level of arousal. Another interaction will then begin. A mother who is anxious may react with alarm when the infant breaks off contact, may try to stimulate him, to draw him back into the interaction. Then the infant’s nervous system is not allowed to “cool down,” and the attunement relationship is hampered. Infants whose caregivers were too stressed, for whatever reason, to give them the necessary attunement contact will grow up with a chronic tendency to feel alone with their emotions, to have a sense — rightly or wrongly — that no one can share how they feel, that no one can “understand.” Attunement is the quintessential component of a larger process, called attachment. Attachment is simply our need to be close to somebody. It represents the absolute need of the utterly and helplessly vulnerable human infant for secure closeness with at least one nourishing, protective and constantly available parenting figure. Essential for survival, the drive for attachment is part of the very nature of warm-blooded animals in infancy, especially. of mammals. In human beings, attachment is a driving force of behavior for longer than in any other animal. For most of us it is present throughout our lives, although we may transfer our attachment need from one person — our parent — to another — say, a spouse or even a child. We may also attempt to satisfy the lack of the human contact we crave by various other means, such as addictions, for example, or perhaps fanatical religiosity or the virtual reality of the Internet. Much of popular culture, from novels to movies to rock or country music, expresses nothing but the joys or the sorrows flowing from satisfactions or disappointments in our attachment relationships. Most parents extend to their children some mixture of loving and hurtful behavior, of wise parenting and unskillful, clumsy parenting. The proportions vary from family to family, from parent to parent. Those ADD children whose needs for warm parental contact are most frustrated grow up to be adults with the most severe cases of ADD. Already at only a few months of age, an infant will register by facial expression his dejection at the mother’s unconscious emotional withdrawal, despite the mother’s continued physical presence. “(The infant) takes delight in Mommy’s attention,” writes Stanley Greenspan, “and knows when that source of delight is missing. If Mom becomes preoccupied or distracted while playing with the baby, sadness or dismay settles in on the little face.

Some judicial officials began to notice the unusual frequency of deaths among the inmates of institutions and some prosecutors even considered asking the Gestapo to investigate the killings. However, none went so far as Lothar Kreyssig, a judge in Brandenburg who specialized in matters of wardship and adoption. A war veteran and a member of the Confessing Church, Kreyssig became suspicious when psychiatric patients who were wards of the court and therefore fell within his area of responsibility began to be transferred from their institutions and were shortly afterwards reported to have died suddenly. Kreyssig wrote Justice Minister Gortner to protest against what he described as an illegal and immoral programme of mass murder. The Justice Minister's response to this and other, similar, queries from local law officers was to try once more to draft a law giving effective immunity to the murderers, only to have it vetoed by Hitler on the grounds that the publicity would give dangerous ammunition to Allied propaganda. Late in April 1941 the Justice Ministry organized a briefing of senior judges and prosecutors by Brack and Heyde, to try to set their minds at rest. In the meantime, Kreyssig was summoned to an interview with the Ministry's top official, State Secretary Roland Freisler, who informed him that the killings were being carried out on Hitler's orders. Refusing to accept this explanation, Kreyssig wrote to the directors of psychiatric hospitals in his district informing them that transfers to killing centres were illegal, and threatening legal action should they transport any of their patients who came within his jurisdiction. It was his legal duty, he proclaimed, to protect the interests and indeed the lives of his charges. A further interview with Gortner failed to persuade him that he was wrong to do this, and he was compulsorily retired in December 1941.

Ideally, work is consecrated. It is something that happens within the present moment . . . Ideally, work is just another beautiful form of joining the cosmic sparkle. But this is an ideal. . . . I worked as a psychiatrist in public institutions . . . for nearly 20 years. During the last 12 of those years, I was consciously trying to be mindful of love, to practice the presence of God. It was the most frustrating thing I ever tried to do. . . . as soon as I entered the ward everything changed. I was immediately kidnapped. I was gone: away from the present, away from any sense of love or its source, away from even appreciating my own being. . . Looking back, it seems clear that I went into my sense of responsibility for the diagnosis and care of the patients. . . . And there was so much paperwork! Most days I would remain forgetful until my work was done and I was driving home. Then I would remember, and such sadness would fill me. Where had I been? How could I have allowed myself to be so captured? I can remember driving home one day after I had spent a long time feeling helpless with a very disturbed patient. I actually slapped myself in the face when I realized I could have been praying for her and praying for myself instead of just worrying about what to do. I tried everything . . . and still it did not “work”. . . . It stopped only when I left the psychiatric institutions and started working full-time with Shalem. . . . I go into this detail because what I am saying does not apply only to psychiatric institutions. It applies, to some extent, to almost every institution we have. It applies to education and social work, to government and business, and to religious institutions as well. People are stuck in all these places, and they can neither get out of them nor find a loving quality of presence within them. Love demands defenselessness, and in many if not most of our workplaces that is just too high a price.

Although there are no set methods to test for psychiatric disorders like psychopathy, we can determine some facets of a patient’s mental state by studying his brain with imaging techniques like PET (positron emission tomography) and fMRI (functional magnetic resonance imaging) scanning, as well as genetics, behavioral and psychometric testing, and other pieces of information gathered from a full medical and psychiatric workup. Taken together, these tests can reveal symptoms that might indicate a psychiatric disorder. Since psychiatric disorders are often characterized by more than one symptom, a patient will be diagnosed based on the number and severity of various symptoms. For most disorders, a diagnosis is also classified on a sliding scale—more often called a spectrum—that indicates whether the patient’s case is mild, moderate, or severe. The most common spectrum associated with such disorders is the autism spectrum. At the low end are delayed language learning and narrow interests, and at the high end are strongly repetitive behaviors and an inability to communicate.

In studies of first-episode bipolar patients, investigators at McLean Hospital, the University of Pittsburgh, and the University of Cincinnati Hospital found that at least one-third had used marijuana or some other illegal drug prior to their first manic or psychotic episode.10 This substance abuse, the University of Cincinnati investigators concluded, may “initiate progressively more severe affective responses, culminating in manic or depressive episodes, that then become self-perpetuating.”11 Even the one-third figure may be low; in 2008, researchers at Mt. Sinai Medical School reported that nearly two-thirds of the bipolar patients hospitalized at Silver Hill Hospital in Connecticut in 2005 and 2006 experienced their first bout of “mood instability” after they had abused illicit drugs.12 Stimulants, cocaine, marijuana, and hallucinogens were common culprits. In 2007, Dutch investigators reported that marijuana use “is associated with a fivefold increase in the risk of a first diagnosis of bipolar disorder” and that one-third of new bipolar cases in the Netherlands resulted from it.13

Contrary to popular belief, the psychiatric concept of clinical depression is different from ordinary sadness. Depression adds to sadness a constellation of physical symptoms that produce a general slowing and deadening of bodily functions. A depressive person sleeps less, and the nighttime becomes a dreaded chore that one can never achieve properly. Or one never gets out of bed; better sleep, if one can, since one can’t do anything else. Interest in life and activities declines. Thinking itself is difficult; concentration is shot; it’s hard enough to focus on three consecutive thoughts, much less read an entire book. Energy is low; constant fatigue, inexplicable and unyielding, wears one down. Food loses its taste. Or to feel better, one might eat more, perhaps to stave off boredom. The body moves slowly, falling to the declining rhythm of one’s thoughts. Or one paces anxiously, unable to relax. One feels that everything is one’s own fault; guilty, remorseful thoughts recur over and over. For some depressives, suicide can seem like the only way out of this morass; about 10 percent take their own lives.

Shortly after I returned home from the Ukraine, I became severely ill with what doctors believed was a parasite. I couldn’t hold my food down and lost a lot of weight. Different doctors kept prescribing me antibiotics, but none of them seemed to help. For a couple of months, I was poked and tested in a variety of ways, only to have more questions surface than answers. Then I was sent to an ear, nose, and throat doctor for an evaluation. I was sitting in a waiting room with a bunch of toddlers, when my name was called. By the time I got into the examination room I knew I’d had enough. “Hey, I’m outta here,” I told the doctor. “I’ll take my chance with the resurrection.” Well, a couple of weeks later, my insurance agent called me. He was one of my lifelong friends and sounded concerned. “Hey, Jase,” he said. “Your insurance company wants you to see a psychiatrist.” Apparently, the ear, nose, and throat doctor recommended I undergo a full psychiatric evaluation based on my refusal to be examined, along with my speech on the resurrection! Apparently, he thought I was crazy. I convinced my buddy that I didn’t need a psychiatrist and eventually got over my illness. I would later read a passage of scripture in the Bible that caused me to smile in reflection on the entire ordeal. Second Corinthians 5:13 says: “If we are out of our mind, as some say, it is for God; if we are in our right mind, it is for you.

The story begins with the revelation Alicia murdered her husband. Why do you think the author made this admission at the very start?   2.  Alicia’s diary plays a key role in the book. What purpose do you think it serves? And does your perception of Alicia change the more you read?   3.  Alicia’s silence is related to the Greek myth of Alcestis. How do you feel about the story of the myth? Why do you think Alicia is silent?   4.  Theo’s motives to work with Alicia are complicated. Do you think he wanted to help her?   5.  Both Alicia and Theo had difficult childhoods. Early on, Theo says no one is born evil. That who we become depends on the environment into which we are born. By the end of the novel he appears to change his mind, saying that perhaps some of us are born evil, and, despite therapy, we remain that way. Which do you think is true?   6.  Weather plays a large role in the book, such as the heat wave during the summer. What purpose do you think the description of the weather serves in the novel?   7.  Do you think the world of a psychiatric unit was convincingly portrayed? How do you feel about Diomedes and the other psychiatrists?   8.  We never enter Kathy’s mind in the book. Do you have any sympathy for her?   9.  What do you think happens at the end of the book? The last line is ambiguous. 10.  It’s a psychological thriller with a twist. The author has said he was influenced by Agatha Christie. Did you feel this was simply a detective story or are there any other influences you can spot?

To suggest, as Shine does, that my father was in some way mean-spirited is totally unfair. Holding back David’s career was not in the least my father’s aim. He was extremely proud of his son and nurtured his talent in every way. He was David’s strongest advocate. But allowing any boy who had just turned fourteen to live by himself so far away without proper provisions being made for him would have been irresponsible, to say the least. In David’s case, it would have been particularly inappropriate. He had never been abroad before; he was completely hopeless in practical matters; and he needed to be looked after, cooked for, and cared for. He was also by that time behaving rather erratically, although of course we did not know then that these may have been the first signs of a serious mental illness. My father’s attitude was proved correct: when David did go to London of his own volition four years later, he fell ill and ended up receiving psychiatric care. In any case there simply wasn’t enough money available to finance the trip to America. Contrary to what is related in Shine, where my father and Mr. Rosen decide that David should have a bar mitzvah as a method of raising money for this trip, David had already had his bar mitzvah almost a year earlier, when he turned thirteen, the usual age for this ceremony. His bar mitzvah had nothing to do with “digging for gold,” as Mr. Rosen puts it in Shine, in one of several offensive references in the film to Jews or Judaism. My father may not have been an Orthodox Jew himself, but he still had a strong desire to hold onto the basic tenets of Jewish tradition and to pass them on to his children.

Beauty Junkies is the title of a recent book by New York Times writer Alex Kuczynski, “a self-confessed recovering addict of cosmetic surgery.” And, withour technological prowess, we succeed in creating fresh addictions. Some psychologists now describe a new clinical pathology — Internet sex addiction disorder. Physicians and psychologists may not be all that effective in treating addictions, but we’re expert at coming up with fresh names and categories. A recent study at Stanford University School of Medicine found that about 5.5 per cent of men and 6 per cent of women appear to be addicted shoppers. The lead researcher, Dr. Lorrin Koran, suggested that compulsive buying be recognized as a unique illness listed under its own heading in the Diagnostic and Statistical Manual of Mental Disorders, the official psychiatric catalogue. Sufferers of this “new” disorder are afflicted by “an irresistible, intrusive and senseless impulse” to purchase objects they do not need. I don’t scoff at the harm done by shopping addiction — I’m in no position to do that — and I agree that Dr. Koran accurately describes the potential consequences of compulsive buying: “serious psychological, financial and family problems, including depression, overwhelming debt and the breakup of relationships.” But it’s clearly not a distinct entity — only another manifestation of addiction tendencies that run through our culture, and of the fundamental addiction process that varies only in its targets, not its basic characteristics. In his 2006 State of the Union address, President George W. Bush identified another item of addiction. “Here we have a serious problem,” he said. “America is addicted to oil.” Coming from a man who throughout his financial and political career has had the closest possible ties to the oil industry. The long-term ill effects of our society’s addiction, if not to oil then to the amenities and luxuries that oil makes possible, are obvious. They range from environmental destruction, climate change and the toxic effects of pollution on human health to the many wars that the need for oil, or the attachment to oil wealth, has triggered. Consider how much greater a price has been exacted by this socially sanctioned addiction than by the drug addiction for which Ralph and his peers have been declared outcasts. And oil is only one example among many: consider soul-, body-or Nature-destroying addictions to consumer goods, fast food, sugar cereals, television programs and glossy publications devoted to celebrity gossip—only a few examples of what American writer Kevin Baker calls “the growth industries that have grown out of gambling and hedonism.

If the curtain is indeed about to drop on Sapiens history, we members of one of its final generations should devote some time to answering one last question: what do we want to become? This question, sometimes known as the Human Enhancement question, dwarfs the debates that currently preoccupy politicians, philosophers, scholars and ordinary people. After all, today's debate between today's religions, ideologies, nations and classes will in all likelihood disappear along with Homo sapiens. If our successors indeed function on a different level of consciousness (or perhaps possess something beyond consciousness that we cannot even conceive), it seems doubtful that Christianity or Islam will be of interest to them, that their social organizations could be Communist or capitalist or that their genders could be male or female. And yet the great debates of history are more important because at least the first generation of these gods would be shaped by the cultural ideas of their human designers. Would they be created in the image of capitalism, of Islam, or of feminism? The answer to this question might send them careening in entirely different directions. Most people prefer not to think about it. Even the field of bioethics prefers to address another question: 'What is it forbidden to do?' Is it acceptable to carry out genetic experiments on living human beings? On aborted fetuses? On stem cells? Is it ethical to clone sheep? And chimpanzees? And what about humans? All of these are important questions, but it is naive to imagine that we might simply hit the brakes and stop the scientific projects that are upgrading Homo sapiens into a different kind of being. For these projects are inextricably meshed together with the Gilgamesh Project. Ask scientists why they study the genome, or try to connect a brain to a computer, or try to create a mind inside a computer. Nine out of ten times you'll get the same standard answer: we are doing it to cure diseases and save human lives. Even though the implications of creating a mind inside a computer are far more dramatic than curing psychiatric illnesses, this is the standard justification given, because nobody can argue with it. This is why the Gilgamesh Project is the flagship of science. It serves to justify everything science does. Dr Frankenstein piggybacks on the shoulders of Gilgamesh. Since it is impossible to stop Gilgamesh, it is also impossible to stop Dr Frankenstein. The only thing we can try to do is to influence the direction scientists are taking. But since we might soon be able to engineer our desires too, the real question facing us is not 'What do we want to become?, but 'What do we want to want?' Those who are not spooked by this question probably haven't given it enough thought.

Almost no one—not even the police officers who deal with it every day, not even most psychiatrists—publicly connects marijuana and crime. We all know alcohol causes violence, but somehow, we have grown to believe that marijuana does not, that centuries of experience were a myth. As a pediatrician wrote in a 2015 piece for the New York Times in which he argued that marijuana was safer for his teenage children than alcohol: “People who are high are not committing violence.” But they are. Almost unnoticed, the studies have piled up. On murderers in Pittsburgh, on psychiatric patients in Italy, on tourists in Spain, on emergency room patients in Michigan. Most weren’t even designed to look for a connection between marijuana and violence, because no one thought one existed. Yet they found it. In many cases, they have even found marijuana’s tendency to cause violence is greater than that of alcohol. A 2018 study of people with psychosis in Switzerland found that almost half of cannabis users became violent over a three-year period; their risk of violence was four times that of psychotic people who didn’t use. (Alcohol didn’t seem to increase violence in this group at all.) The effect is not confined to people with preexisting psychosis. A 2012 study of 12,000 high school students across the United States showed that those who used cannabis were more than three times as likely to become violent as those who didn’t, surpassing the risk of alcohol use. Even worse, studies of children who have died from abuse and neglect consistently show that the adults responsible for their deaths use marijuana far more frequently than alcohol or other drugs—and far, far more than the general population. Marijuana does not necessarily cause all those crimes, but the link is striking and large. We shouldn’t be surprised. The violence that drinking causes is largely predictable. Alcohol intoxicates. It disinhibits users. It escalates conflict. It turns arguments into fights, fights into assaults, assaults into murders. Marijuana is an intoxicant that can disinhibit users, too. And though it sends many people into a relaxed haze, it also frequently causes paranoia and psychosis. Sometimes those are short-term episodes in healthy people. Sometimes they are months-long spirals in people with schizophrenia or bipolar disorder. And paranoia and psychosis cause violence. The psychiatrists who treated Raina Thaiday spoke of the terror she suffered, and they weren’t exaggerating. Imagine voices no one else can hear screaming at you. Imagine fearing your food is poisoned or aliens have put a chip in your brain. When that terror becomes too much, some people with psychosis snap. But when they break, they don’t escalate in predictable ways. They take hammers to their families. They decide their friends are devils and shoot them. They push strangers in front of trains. The homeless man mumbling about God frightens us because we don’t have to be experts on mental illness and violence to know instinctively that untreated psychosis is dangerous. And finding violence and homicides connected to marijuana is all too easy.

Treating Abuse Today (Tat), 3(4), pp. 26-33 Freyd: You were also looking for some operational criteria for false memory syndrome: what a clinician could look for or test for, and so on. I spoke with several of our scientific advisory board members and I have some information for you that isn't really in writing at this point but I think it's a direction you want us to go in. So if I can read some of these notes . . . TAT: Please do. Freyd: One would look for false memory syndrome: 1. If a patient reports having been sexually abused by a parent, relative or someone in very early childhood, but then claims that she or he had complete amnesia about it for a decade or more; 2. If the patient attributes his or her current reason for being in therapy to delayed-memories. And this is where one would want to look for evidence suggesting that the abuse did not occur as demonstrated by a list of things, including firm, confident denials by the alleged perpetrators; 3. If there is denial by the entire family; 4. In the absence of evidence of familial disturbances or psychiatric illnesses. For example, if there's no evidence that the perpetrator had alcohol dependency or bipolar disorder or tendencies to pedophilia; 5. If some of the accusations are preposterous or impossible or they contain impossible or implausible elements such as a person being made pregnant prior to menarche, being forced to engage in sex with animals, or participating in the ritual killing of animals, and; 6. In the absence of evidence of distress surrounding the putative abuse. That is, despite alleged abuse going from age two to 27 or from three to 16, the child displayed normal social and academic functioning and that there was no evidence of any kind of psychopathology. Are these the kind of things you were asking for? TAT: Yeah, it's a little bit more specific. I take issue with several, but at least it gives us more of a sense of what you all mean when you say "false memory syndrome." Freyd: Right. Well, you know I think that things are moving in that direction since that seems to be what people are requesting. Nobody's denying that people are abused and there's no one denying that someone who was abused a decade ago or two decades ago probably would not have talked about it to anybody. I think I mentioned to you that somebody who works in this office had that very experience of having been abused when she was a young teenager-not extremely abused, but made very uncomfortable by an uncle who was older-and she dealt with it for about three days at the time and then it got pushed to the back of her mind and she completely forgot about it until she was in therapy. TAT: There you go. That's how dissociation works! Freyd: That's how it worked. And after this came up and she had discussed and dealt with it in therapy, she could again put it to one side and go on with her life. Certainly confronting her uncle and doing all these other things was not a part of what she had to do. Interestingly, though, at the same time, she has a daughter who went into therapy and came up with memories of having been abused by her parents. This daughter ran away and is cutoff from the family-hasn't spoken to anyone for three years. And there has never been any meeting between the therapist and the whole family to try to find out what was involved. TAT: If we take the first example -- that of her own abuse -- and follow the criteria you gave, we would have a very strong disbelief in the truth of what she told.

ever. Amen. Thank God for self-help books. No wonder the business is booming. It reminds me of junior high school, where everybody was afraid of the really cool kids because they knew the latest, most potent putdowns, and were not afraid to use them. Dah! But there must be another reason that one of the best-selling books in the history of the world is Men Are From Mars, Women Are From Venus by John Gray. Could it be that our culture is oh so eager for a quick fix? What a relief it must be for some people to think “Oh, that’s why we fight like cats and dogs, it is because he’s from Mars and I am from Venus. I thought it was just because we’re messed up in the head.” Can you imagine Calvin Consumer’s excitement and relief to get the video on “The Secret to her Sexual Satisfaction” with Dr. GraySpot, a picture chart, a big pointer, and an X marking the spot. Could that “G” be for “giggle” rather than Dr. “Graffenberg?” Perhaps we are always looking for the secret, the gold mine, the G-spot because we are afraid of the real G-word: Growth—and the energy it requires of us. I am worried that just becoming more educated or well-read is chopping at the leaves of ignorance but is not cutting at the roots. Take my own example: I used to be a lowly busboy at 12 East Restaurant in Florida. One Christmas Eve the manager fired me for eating on the job. As I slunk away I muttered under my breath, “Scrooge!” Years later, after obtaining a Masters Degree in Psychology and getting a California license to practice psychotherapy, I was fired by the clinical director of a psychiatric institute for being unorthodox. This time I knew just what to say. This time I was much more assertive and articulate. As I left I told the director “You obviously have a narcissistic pseudo-neurotic paranoia of anything that does not fit your myopic Procrustean paradigm.” Thank God for higher education. No wonder colleges are packed. What if there was a language designed not to put down or control each other, but nurture and release each other to grow? What if you could develop a consciousness of expressing your feelings and needs fully and completely without having any intention of blaming, attacking, intimidating, begging, punishing, coercing or disrespecting the other person? What if there was a language that kept us focused in the present, and prevented us from speaking like moralistic mini-gods? There is: The name of one such language is Nonviolent Communication. Marshall Rosenberg’s Nonviolent Communication provides a wealth of simple principles and effective techniques to maintain a laser focus on the human heart and innocent child within the other person, even when they have lost contact with that part of themselves. You know how it is when you are hurt or scared: suddenly you become cold and critical, or aloof and analytical. Would it not be wonderful if someone could see through the mask, and warmly meet your need for understanding or reassurance? What I am presenting are some tools for staying locked onto the other person’s humanness, even when they have become an alien monster. Remember that episode of Star Trek where Captain Kirk was turned into a Klingon, and Bones was freaking out? (I felt sorry for Bones because I’ve had friends turn into Cling-ons too.) But then Spock, in his cool, Vulcan way, performed a mind meld to determine that James T. Kirk was trapped inside the alien form. And finally Scotty was able to put some dilithium crystals into his phaser and destroy the alien cloaking device, freeing the captain from his Klingon form. Oh, how I wish that, in my youth or childhood,

Our patients predict the culture by living out consciously what the masses of people are able to keep unconscious for the time being. The neurotic is cast by destiny into a Cassandra role. In vain does Cassandra, sitting on the steps of the palace at Mycenae when Agamemnon brings her back from Troy, cry, “Oh for the nightingale’s pure song and a fate like hers!” She knows, in her ill-starred life, that “the pain flooding the song of sorrow is [hers] alone,” and that she must predict the doom she sees will occur there. The Mycenaeans speak of her as mad, but they also believe she does speak the truth, and that she has a special power to anticipate events. Today, the person with psychological problems bears the burdens of the conflicts of the times in his blood, and is fated to predict in his actions and struggles the issues which will later erupt on all sides in the society. The first and clearest demonstration of this thesis is seen in the sexual problems which Freud found in his Victorian patients in the two decades before World War I. These sexual topics‒even down to the words‒were entirely denied and repressed by the accepted society at the time. But the problems burst violently forth into endemic form two decades later after World War II. In the 1920's, everybody was preoccupied with sex and its functions. Not by the furthest stretch of the imagination can anyone argue that Freud "caused" this emergence. He rather reflected and interpreted, through the data revealed by his patients, the underlying conflicts of the society, which the “normal” members could and did succeed in repressing for the time being. Neurotic problems are the language of the unconscious emerging into social awareness. A second, more minor example is seen in the great amount of hostility which was found in patients in the 1930's. This was written about by Horney, among others, and it emerged more broadly and openly as a conscious phenomenon in our society a decade later. A third major example may be seen in the problem of anxiety. In the late 1930's and early 1940's, some therapists, including myself, were impressed by the fact that in many of our patients anxiety was appearing not merely as a symptom of repression or pathology, but as a generalized character state. My research on anxiety, and that of Hobart Mowrer and others, began in the early 1940's. In those days very little concern had been shown in this country for anxiety other than as a symptom of pathology. I recall arguing in the late 1940's, in my doctoral orals, for the concept of normal anxiety, and my professors heard me with respectful silence but with considerable frowning. Predictive as the artists are, the poet W. H. Auden published his Age of Anxiety in 1947, and just after that Bernstein wrote his symphony on that theme. Camus was then writing (1947) about this “century of fear,” and Kafka already had created powerful vignettes of the coming age of anxiety in his novels, most of them as yet untranslated. The formulations of the scientific establishment, as is normal, lagged behind what our patients were trying to tell us. Thus, at the annual convention of the American Psychopathological Association in 1949 on the theme “Anxiety,” the concept of normal anxiety, presented in a paper by me, was still denied by most of the psychiatrists and psychologists present. But in the 1950's a radical change became evident; everyone was talking about anxiety and there were conferences on the problem on every hand. Now the concept of "normal" anxiety gradually became accepted in the psychiatric literature. Everybody, normal as well as neurotic, seemed aware that he was living in the “age of anxiety.” What had been presented by the artists and had appeared in our patients in the late 30's and 40's was now endemic in the land.

A wide variety of dissociative disorders including DID occur in the psychiatric population and may be misdiagnosed or underdiagnosed for a variety of reasons. Some psychiatrists believe these disorders are extremely rare and some believe that they do not exist. More research is needed, but these disorders may be more common than previously thought.

On the other hand, I can tell you, both from extensive research and from firsthand experience, that as convincing as the case made by Lane and his fellow Antipharma critics can be, the distress felt by some social phonics is real and intense. Are there some 'normally' shy people, not mentally ill or in need of psychiatric attention, who get swept up in the broad diagnostic category of social anxiety disorder, which has been swollen by the profit-seeking imperatives of the drug companies? Surely. But are there also socially anxious people who can legitimately benefit from medication and other forms of psychiatric treatment- who in some cases are saved by medication from alcoholism, despair, and suicide? I think there are.

An early portent was provided when patients in psychiatric hospitals in Gdynia, Stettin, and Swinemünde were murdered under the Nazi “T-4” euthanasia program to enable the facilities to be used as temporary accommodation for some of the incoming Deutschbalten.

The beauty of poker is that while luck is always involved, luck doesn’t dictate the long-term results of the game. A person can get dealt terrible cards and beat someone who was dealt great cards. Sure, the person who gets dealt great cards has a higher likelihood of winning the hand, but ultimately the winner is determined by—yup, you guessed it—the choices each player makes throughout play. I see life in the same terms. We all get dealt cards. Some of us get better cards than others. And while it’s easy to get hung up on our cards, and feel we got screwed over, the real game lies in the choices we make with those cards, the risks we decide to take, and the consequences we choose to live with. People who consistently make the best choices in the situations they’re given are the ones who eventually come out ahead in poker, just as in life. And it’s not necessarily the people with the best cards. There are those who suffer psychologically and emotionally from neurological and/or genetic deficiencies. But this changes nothing. Sure, they inherited a bad hand and are not to blame. No more than the short guy wanting to get a date is to blame for being short. Or the person who got robbed is to blame for being robbed. But it’s still their responsibility. Whether they choose to seek psychiatric treatment, undergo therapy, or do nothing, the choice is ultimately theirs to make. There are those who suffer through bad childhoods. There are those who are abused and violated and screwed over, physically, emotionally, financially. They are not to blame for their problems and their hindrances, but they are still responsible—always responsible—to move on despite their problems and to make the best choices they can, given their circumstances.

Neuro-psychiatric cases, termed combat exhaustion, rose to nearly a quarter of all hospital admissions. The German army, which refused to recognize the condition, apparently suffered far fewer cases. Combat exhaustion produced recognizable symptoms: ‘nausea, crying, extreme nervousness and gastric conditions’. Some

But if Hubbard really did cure himself of his mythical injuries by 1947, why was he still claiming a part disability pension? Why did he write to Veterans Administration in October of the same year saying he’d been ‘trying and failing for two years to regain my equilibrium in civil life’ and asking for help paying for psychiatric treatment? Why did he continue to lobby for an increase to his pension over this period of time? And why was it the case that he claimed a disability pension for decades afterwards?46 Some

Until fairly recently, there has been precious little research on expectant fathers’ emotional and psychological experiences during pregnancy. The very title of one of the first articles to appear on the subject should give you some idea of the medical and psychiatric communities’ attitude toward the impact of pregnancy on men. Written by William H. Wainwright, M.D., and published in the July 1966 issue of the American Journal of Psychiatry, it was called “Fatherhood as a Precipitant of Mental Illness.” (Another wonderful title that came out at about the same time was: “Psychoses in Males in Relation to Their Wives’ Pregnancy and Childbirth.”)

Unfortunately, some real autistics who have real problems that cannot be helped by military schools or boot camps, find themselves in military academies and boot camps anyway. They may need psychological or psychiatric care, and never receive it. It is these people who autistic advocacy organizations talk about when speaking against the idea of military schools and boot camps, but ironically, some people in some of these autistic advocacy organizations are manipulators themselves, and might benefit from a

Our immune system does not exist in isolation from daily experience. For example, the immune defences that normally function in healthy young people have been shown to be suppressed in medical students under the pressure of final examinations. Of even greater implication for their future health and well-being, the loneliest students suffered the greatest negative impact on their immune systems. Loneliness has been similarly associated with diminished immune activity in a group of psychiatric inpatients. Even if no further research evidence existed—though there is plenty—one would have to consider the long-term effects of chronic stress. The pressure of examinations is obvious and short term, but many people unwittingly spend their entire lives as if under the gaze of a powerful and judgmental examiner whom they must please at all costs. Many of us live, if not alone, then in emotionally inadequate relationships that do not recognize or honour our deepest needs. Isolation and stress affect many who may believe their lives are quite satisfactory. How may stress be transmuted into illness? Stress is a complicated cascade of physical and biochemical responses to powerful emotional stimuli. Physiologically, emotions are themselves electrical, chemical and hormonal discharges of the human nervous system. Emotions influence—and are influenced by—the functioning of our major organs, the integrity of our immune defences and the workings of the many circulating biological substances that help govern the body’s physical states. When emotions are repressed, this inhibition disarms the body’s defences against illness. Repression—dissociating emotions from awareness and relegating them to the unconscious realm—disorganizes and confuses our physiological defences so that in some people these defences go awry, becoming the destroyers of health rather than its protectors.

Words speak, "A Cure For Wellness" "Volmer: Do you know what the cure for the human condition is? Disease. Because that's the only way one could hope for a cure." "Voice: There is a sickness inside us rising, like the bile that leaves that bitter taste at the back of our throats. It’s there in every one of you seated around the table. Only when we know what ails us can we hope to find cure. [after reading letter from their company’s CEO]" "Volmer: [to Lockhart] Think of it as a cleansing of the mind as much as the body. Some patients experience visions, but rest assured it’s just the toxins leaving the system." "He was in a psychiatric before reaching us. The others follow the current ... but Mr. Lockhart disease makes it susceptible to their plots. I know what they intend to do. All of you. They want to make me think I'm crazy. I've seen this. It is fairly common. Childhood trauma ingrained comes to the surface ... something that the patient has fled his entire life. It is the case ... I would say it is a wrong feeling of guilt ... by the death of his father.

When I started school, I began to see less of her. More and more, I noticed my father encouraging me to spend time with the Hudsons, old family friends. Then when I was nine, he finally sent Camilla away. I don’t even remember saying goodbye to her, and I never visited her. My father thought it best that I didn’t. She’d cracked and lost her mind, he’d said. But he’d reassured me that the doctors at her psychiatric hospital were some of the best in the world. Truth be told, I didn’t ever feel the urge to track her down. After she moved out, I thought

Despite my medical and psychiatric training, I struggled to understand the intensity of my desire to meet this man. What could possibly explain it? Perhaps it is simply human connection—the thing I have been thinking and writing about for decades now. As humans, we are capable of unimaginable violence and deep kindnesses, as well as the capacity to feel one another, and in that feeling we are enlarged and improved, even in the deepest pain. In feeling another person, we are invited to become whole. Maybe in some cosmic, karmic way, a connection with Isaac would buffer the agony of losing the primal connection with my father.

If you poll people in the church, you will find a spectrum of opinions on psychiatric medication. Some will say it is from the Devil, some will say it is the answer, and some don't care. A more moderate opinion is that, although it is not wrong to take these medications, they are rarely our first line of attack against personal suffering. Instead, we should first consider that God can bless us through our suffering, and we might also weigh the possibility that psychiatric medications could numb us to the refining benefits of suffering. There is a worthwhile point here. Although it may sound strange or evening unloving to those who don't share a biblical position, there can be real benefits from having our faith testing a strengthened through trials. Consider it pure joy, my brothers, whenever you face trials of many kinds, because you know that the testing of your faith develops perseverance. Perseverance must finish its work so that you may be mature and complete, not lacking anything. (James 1:2-4) Suffering is not always something that must be escaped. In contrast to the growing American sentiment that we have a right to a pain-free existence, most everyone has personal examples of how suffering and difficulties have been essential to Christian maturity. Conversely, most everyone has witnessed the sad consequences of lives that have been artificially shielded from suffering by overprotective parents or illegal, mind-altering drugs. Given these common observations, suffering is not always the enemy that we think it is, and medication should not be considered the ultimate answer.

If you poll people in the church, you will find a spectrum of opinions on psychiatric medication. Some will say it is from the Devil, some will say it is the answer, and some don't care. A more moderate opinion is that, although it is not wrong to take these medications, they are rarely our first line of attack against personal suffering. Instead, we should first consider that God can bless us through our suffering, and we might also weigh the possibility that psychiatric medications could numb us to the refining benefits of suffering. There is a worthwhile point here. Although it may sound strange or even unloving to those who don't share a biblical position, there can be real benefits from having our faith testing a strengthened through trials. Consider it pure joy, my brothers, whenever you face trials of many kinds, because you know that the testing of your faith develops perseverance. Perseverance must finish its work so that you may be mature and complete, not lacking anything. (James 1:2-4) Suffering is not always something that must be escaped. In contrast to the growing American sentiment that we have a right to a pain-free existence, most everyone has personal examples of how suffering and difficulties have been essential to Christian maturity. Conversely, most everyone has witnessed the sad consequences of lives that have been artificially shielded from suffering by overprotective parents or illegal, mind-altering drugs. Given these common observations, suffering is not always the enemy that we think it is, and medication should not be considered the ultimate answer.

When it comes to an internal sense of truth, what develops for some Positive Precogs could be called faith, and for others a sense of awe and humility in the beauty of the universe. Regardless, this internal sense of truth is not at odds with actual reality. It is just a very personal way of understanding and being in relationship with the universe. But wait, weren’t we talking about health and wellbeing? Yes! So why all this talk of self-transcendence? Well, that’s because the two are intricately linked. Having experiences of self-transcendence are directly related to your health and wellbeing. People who more regularly work toward something beyond themselves, who connect authentically with others, and who have an internal sense of truth – in other words, people who score higher on a scale of self-transcendence – have better physical health and more positive moods.c In fact, psychiatrists feel that self-transcendence is so important for wellbeing that the World Psychiatric Association released a statement in September 2015 asking all psychiatrists and psychological professionals to discuss spiritual, religious and self-transcendent ideas and experiences with their patients.d This recommendation has thus far been slow to catch on, as is any major change in protocol. Yet it is clear that many people would be better off with mental health professionals who were aware of the benefits that self-transcendence can bring to wellbeing.

biomedical view, for its part, increasingly recognizes the power of things like meditation and traditional talk therapy to render concrete structural changes in brain physiology that are every bit as “real” as the changes wrought by pills or electroshock therapy. A study published by researchers at Massachusetts General Hospital in 2011 found that subjects who practiced meditation for an average of just twenty-seven minutes a day over a period of eight weeks produced visible changes in brain structure. Meditation led to decreased density of the amygdala, a physical change that was correlated with subjects’ self-reported stress levels—as their amygdalae got less dense, the subjects felt less stressed. Other studies have found that Buddhist monks who are especially good at meditating show much greater activity in their frontal cortices, and much less in their amygdalae, than normal people.n Meditation and deep-breathing exercises work for similar reasons as psychiatric medications do, exerting their effects not just on some abstract concept of mind but concretely on our bodies, on the somatic correlates of our feelings. Recent research has shown that even old-fashioned talk therapy can have tangible, physical effects on the shape of our brains. Perhaps Kierkegaard was wrong to say that the man who has learned to be in anxiety has learned the most important, or the most existentially meaningful, thing—perhaps the man has only learned the right techniques for controlling his hyperactive amygdala.o

One of his first steps was to invite Fredric Wertham to his office for an interview that lasted from 5:00 p.m. until midnight. It wasn’t long before Leibowitz—imagining himself as a jury member listening to “the erudite doctor”—concluded that twelve ordinary men would be utterly “bewildered by the technical terminology of the psychiatrist” and view the concept of “catathymic crisis” as “nothing but psychiatric double talk.” Indeed, just a few years earlier, Wertham’s testimony as an expert witness had failed to save the life of Albert Fish, a man so extravagantly deranged that even some jurors who voted for his conviction believed he was insane. By the time their lengthy conference was over, Leibowitz, despite his high regard for “the sincere and capable doctor,” had eliminated him as a possible defense witness.2

When Bouchard’s twin-processing operation was in full swing, he amassed a staff of eighteen—psychologists, psychiatrists, ophthalmologists, cardiologists, pathologists, geneticists, even dentists. Several of his collaborators were highly distinguished: David Lykken was a widely recognized expert on personality, and Auke Tellegen, a Dutch psychologist on the Minnesota faculty, was an expert on personality measuring. In scheduling his twin-evaluations, Bouchard tried limiting the testing to one pair of twins at a time so that he and his colleagues could devote the entire week—with a grueling fifty hours of tests—to two genetically identical individuals. Because it is not a simple matter to determine zygosity—that is, whether twins are identical or fraternal—this was always the first item of business. It was done primarily by comparing blood samples, fingerprint ridge counts, electrocardiograms, and brain waves. As much background information as possible was collected from oral histories and, when possible, from interviews with relatives and spouses. I.Q. was tested with three different instruments: the Wechsler Adult Intelligence Scale, a Raven, Mill-Hill composite test, and the first principal components of two multiple abilities batteries. The Minnesota team also administered four personality inventories (lengthy questionnaires aimed at characterizing and measuring personality traits) and three tests of occupational interests. In all the many personality facets so laboriously measured, the Minnesota team was looking for degrees of concordance and degrees of difference between the separated twins. If there was no connection between the mean scores of all twins sets on a series of related tests—I.Q. tests, for instance—the concordance figure would be zero percent. If the scores of every twin matched his or her twin exactly, the concordance figure would be 100 percent. Statistically, any concordance above 30 percent was considered significant, or rather indicated the presence of some degree of genetic influence. As the week of testing progressed, the twins were wired with electrodes, X-rayed, run on treadmills, hooked up for twenty-four hours with monitoring devices. They were videotaped and a series of questionnaires and interviews elicited their family backgrounds, educations, sexual histories, major life events, and they were assessed for psychiatric problems such as phobias and anxieties. An effort was made to avoid adding questions to the tests once the program was under way because that meant tampering with someone else’s test; it also would necessitate returning to the twins already tested with more questions. But the researchers were tempted. In interviews, a few traits not on the tests appeared similar in enough twin pairs to raise suspicions of a genetic component. One of these was religiosity. The twins might follow different faiths, but if one was religious, his or her twin more often than not was religious as well. Conversely, when one was a nonbeliever, the other generally was too. Because this discovery was considered too intriguing to pass by, an entire additional test was added, an existing instrument that included questions relating to spiritual beliefs. Bouchard would later insist that while he and his colleagues had fully expected to find traits with a high degree of heritability, they also expected to find traits that had no genetic component. He was certain, he says, that they would find some traits that proved to be purely environmental. They were astonished when they did not. While the degree of heritability varied widely—from the low thirties to the high seventies— every trait they measured showed at least some degree of genetic influence. Many showed a lot.

Foster children are much more likely than other children with similar problems to be prescribed multiple medications that will have no impact on their symptoms. These medications, particularly the so-called atypical antipsychotics (medications like Risperdal, Abilify, and Seroquel) can shorten life and have severe side effects, like weight gain great enough to increase risk for diabetes. The over prescribing and inappropriate prescribing of such medications to children in foster care has been so dramatic that the Government Accountability Office has issued a special report condemning it. Both the federal government and several states have sued Big Pharma for targeting foster care children, resulting in multi-million-dollar settlements. In the last few years, attention to these issues by legal groups, such as the National Center for Youth Law in Oakland, the press (an excellent example can be seen in the online series from the Mercury News by Karen de Sa), and advocacy groups such as Foster Youth in Action, has increased awareness of this problem. These investigations and advocacy are leading to some positive changes. For example, California passed legislation to monitor prescribing to children in foster care. But sadly, rather than joining in or even leading efforts to improve the quality of care for foster and adopted youth, most medical and psychiatric groups have resisted or even openly opposed these efforts. Change is hard, and it is hardest for those with the most to lose. As Annette Jackson and I wrote in 2014, “the academic or interest group most threatened by the innovations which challenge their existing frame of reference or perspective, will be the most vocal and hostile to the new ideas.

As you can see, you can actually change the way you feel merely by changing your body posture or facial expression. It is what some people call “fake it until you make it.” For instance, you can put a smile on your face to make you feel happier. Conversely, you can negatively affect your mood and even create a depression by changing your body posture. David K. Reynolds, in his book Constructive Living, explained how he changed his identity for his alter ego, David Kent, and created a depressed, suicidal patient. The goal was to be accepted as an anonymous patient into various psychiatric facilities to assess them from the inside. Note that he wasn’t simulating depression, he was actually depressed. Psychological tests proved it. Here is how he created depression: Depression can be created by sitting slouched in a chair, shoulders hunched, head hanging down. Repeat these words over and over: ‘There’s nothing anybody can do. No one can help. It’s hopeless. I’m helpless. I give up.’ Shake your head, sigh, cry. In general, act depressed and the genuine feeling will follow in time. ​— ​DAVID K. REYNOLDS, CONSTRUCTIVE LIVING.