Monthly Archives: November 2017

Trying to Understand The Harvey Weinsteins of this World

By Dr David Laing Dawson

Harvey Weinstein. We can call his behaviour evil, reprehensible, outrageous, nasty, illegal, criminal, or sick, but is there a way to understand it? Such behaviour does require a degree of sociopathy, the absence of empathy, of guilt or remorse. It does require a degree of self-importance, of narcissism. It does not bother him much that he hurts people.

But the cloying, nasty, crude, pleading, begging, and disgusting aspects of his behaviour, combined with the physical reality of the man speak to a different impulse. The same with most of the others who have been recently exposed, with the exception of George H. W. Bush, whose fixation on a single play of words that provides him the excuse for a fanny squeeze suggests a little frontal lobe dementia is at work.

But the others, what of the others? What strikes me is that they are physically repulsive men living in a world that values youth and beauty.

To some extent we all live in that world. Beautiful young, and beautiful not-so-young women are paraded before us on our screens, on our billboards, at the office, on the campus, in our newspapers and magazines. Every man notices. Every man enjoys this visual treat. Every man is attracted to this spectacle. And if drag queens are anything to go by, the attraction is not limited to the heterosexual male. Even gay men are fascinated by the adornment, the display, the theatricality, the vigour, the exhibitionism – youth and beauty.

If the Harvey Weinsteins of this world took advantage of their positions to court, seduce, and then maintain as mistresses a couple of beautiful young women, it would be understandable as the fulfillment of a natural biological yearning experienced by an Alpha Male. Common around the world, with humans and other primates.

But that is not what they do. They display their own disgusting selves, their bodies, and then force these young women to degrade themselves, to experience the disgust they must feel for themselves.

So Harvey looks in the mirror and finds himself physically repulsive, unhealthy, weighted with an excess of mortal flesh. His successes in film making do not remove this repulsion, this self-disgust. Especially when he is reminded every day that some others, most notably young female actors, glow with health and beauty, and command the eyes of everyone else in the room.

He will make them suffer too, and suffer with the same sense of self-disgust he feels. And then make them flee from him as they must, but now reduced and no longer threatening.

………………..

There is a cartoon circulating now with a father explaining to his son that, regarding sexual abuse, “We hold our movie stars to a higher standard than our presidents.”

But is there a real link here? I mean between the presidency of Donald Trump and so many women now blowing the whistle on abusive male behaviour?

It is not surprising that Donald Trump has provoked a backlash of Democrats being elected. Maybe a little surprising that one of those Democrats is a transsexual. But has the election of Donald Trump and his band of privileged rich white males caused a reactionary wave of female empowerment? Maybe.

That would be a treat. Perhaps Trumpism will ultimately produce, by reaction, a universal health care system, some environmental protection, some concern about global warming, a more equitable distribution of wealth, some actual gun control, less racism rather than more, a rational, thoughtful and more realistic assessment of America’s place and role within an interdependent world.

It is the silver lining to this mess. His two steps backward may cause a mighty leap forward.

But I am surprised and troubled by just how many rich privileged males have been behaving as if they were 16 year old brain damaged boys living in a group home.

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Addictions and Mental Illness – Continued

By Dr David Laing Dawson

Folk wisdom tells us that with alcoholism and addiction, at several points in the spectrum of these afflictions, there lies choice. Free will is at play. The law generally agrees. Drunkenness is not grounds for “not responsible due to mental illness.” Even science and rehab experience agree. All treatment and rehabilitation programs for addiction and alcoholism are founded on a principle of choice and free will.

No doubt alcoholics and addicts develop a sort of tunnel vision. The big picture is lost to them. The effect they are having on others is lost to them. The ability to plan beyond the next few hours is lost to them. Reality for the addict becomes a set of shadings and lies he tells himself and others.

Scholars and philosophers can debate the myth, reality or limitations of free will, but the concept is in itself a foundation of community, of organized society. To function communally we must assume that individuals generally have free will and are responsible for their actions. We are careful and strict when we allow exceptions to this rule, as we must be. Science and compassion inform these decisions.

Our courts debate these decisions every day. The age at which one can be tried in court as an adult rather than a child has been changing and varies from state to state. At what level of mental development should we assume a mentally handicapped person is fully responsible for his crime? Harvey Weinstein will claim he is a sex addict and couldn’t help himself; the prosecutor will point out he is a serial predator who chose to debase women over and over because he could get away with it.

Within our long history we have only recently absolved people of personal, moral responsibility for falling ill with recognizable physical diseases. Though not totally, for we still expect them to assume some responsibility for working to get better, take their medicines, and do the things that prevent illness in the first place. e.g stop smoking, get vaccinations, use condoms.

It is only more recently, within two hundred years, that we began to include severe mental illnesses in the body of afflictions for which people should not be held morally responsible. Nobody chooses at any point in their lives to become schizophrenic, bipolar, depressed, have regular panic attacks. These are illnesses. Nobody chooses for these illnesses to continue.

Folk wisdom regarding who with mental illness should be absolved of moral and personal responsibility (and therefore not punished if a crime is committed) remains fluid. The question is often decided, in the public’s mind, by our visceral reaction to the crime itself.

But at least without horrendous crimes occurring, folk wisdom generally, today, accepts that severe mental illnesses are indeed illnesses and no personal decision making is involved.

But this is always a tenuous belief.

Which is why it was such a setback for the public’s attitude toward mental illness when our institutions for addictions and for psychiatric illnesses were merged, and many of the philosophies for “treating” addictions slipped over to mental illness. I could argue that this merger has set us back a hundred years and allowed us to believe (or by inaction accept) that many with mental illness choose to live on the street or cycle in and out of our jails. (I put treatment for addictions here in quotation marks because there is no treatment as such. All programs for addictions are forms of organized browbeating to quit, and then to stay abstinent. Whereas we actually have effective medical treatments for severe mental illness.)

I might even argue (with the exception of it providing more resources for addictions) this merging of the services was also a disfavor for society, addicts, and alcoholics. For when we absolve people of responsibility for their behaviour, we give it wings.

Hence the astounding human behaviour we see today in all our communities in which a person is offered in a back alley or a house party a substance that promises to alleviate any suffering (emotional or physical) for a few hours, maybe cause the experience of a little euphoria, but which has a 30% chance of being lethal – and still that substance is greedily taken and snorted or injected.

Conflating mental illness and addictions has caused a paradoxical shift. It has allowed us to absolve addicts of personal responsibility for their addictions and, at least tacitly, blame the mentally ill for their illnesses.

Though I am in favour of suing, for billions of dollars, the pharmaceutical company that lied about and promoted oxycontin/oxycocet/oxycodone  and then pouring that money into “treatment” and prevention of drug addiction.

Addictions and Mental Illness Do Not Belong Together

By Marvin Ross

For some inexplicable reason addictions is lumped in with mental illness or, to be politically correct, mental health. Combining the two is, in my opinion, like putting orthopaedic surgery together with chiropractic. Addictions are quite separate from mental illness and combining them does a disservice to the mentally ill.

I do no want to demean the seriousness of addictions but there is a fundamental difference. Addictions at some point involve choice. You made a decision to go into a bar and start drinking or to snort coke, take opioids or inject heroin. No one has a choice to become schizophrenic, bipolar, depressed or any other serious mental illness. There is no choice involved whatsoever.

Before you jump all over me, take a look at a court case before the Massachusetts supreme court called Commonwealth v. Eldred . Ms Eldred admitted to stealing in order to support her drug habit and was sentenced to probation with the term that she not use drugs and submit to regular drug testing. Ms Eldred tested positive for drugs in one of her tests and her probation was revoked and she was put in jail pending the availability of a treatment bed.

She appealed using the argument that the sentence of abstinence was cruel and unusual punishment as she has no choice but to take drugs as she is an addict. Addiction psychiatrist, Dr Sally Satel, co-wrote a brief with others arguing against the grounds for this appeal. Those grounds are that addicts are involuntary drug users who cannot be held responsible for their drug use. If that is upheld then it would “affect the future of successful treatment programs that are based on the verified principle that addicts can and often do say no to drugs” and “it would hobble successful judicial interventions that help addicts stay out of jail by making probation and parole contingent on testing clean for drugs”.

Dr Satel argues that this position runs counter to accepted science in her blog Addiction, she says, is not a chronic and relapsing brain disease. Addicts can and do learn to say no to drugs and recover in large numbers without intervention. Three epidemiological studies done in the US found that “among those who ever met the criteria for addiction to controlled substances, 76% to 83% were at the time of the surveys ex-addicts. They no longer used drugs at levels that met the criteria for substance dependence.”

Dr Satel also points out that the argument that is often used is that the drugs or alcohol change the structure of the brain so that the addiction continues and cannot be controlled. However, as she points out, all actions, including reading an article, change the brain and thus brain changes are not a valid marker for loss of self control.

One analogy that comes to my mind is smoking. It is generally recognized that nicotine is a very strong addicting substance and it is not easy to quit. My generation smoked a great deal as it was socially acceptable and allowed just about everywhere. One brand even advertised that 4 out of 5 doctors smoked whatever. Then, we were given more and more evidence of how harmful it was and it became socially unacceptable. The vast majority of us were able to quit and I don’t recall anyone ever arguing that we suffered from an illness and that we had a brain disease. Once we determined to stop, we did using a variety of methods. What was key in each and every case was a true desire to do so.

During the Vietnam War, it was discovered that 40% of US servicemen had used heroin and that nearly 20% were addicted. Government officials were stunned and worried and Richard Nixon set up a new office called The Special Action Office of Drug Abuse Prevention. Its goal was to prevent and rehabilitate as well as to track troops returning from Vietnam. What they found shocked them. Nearly 95% of the addicted servicemen gave up heroin voluntarily upon return to the US.

They stopped, it was hypothesized because they found themselves in a totally different environment from that of a hostile war zone. In contrast are drug users who go into rehab who relapse at a rate of about 90% once they return to their regular environment. That is an environment and life situation that caused them to become addicted in the first place.

The solution to addiction is not to treat it like it is a brain disease where the addict has no control but to try to change the life circumstances of those who do become addicted.

As Dr Satel said, addiction is not a conventional brain disease like Alzheimer’s. “Addiction is self-destructive drug use, and those who are destroying their lives with drugs deserve our help and sympathy, but they are not helpless victims” like those with serious mental illnesses.

Trick or Trump

By Dr David Laing Dawson

I had in my office yesterday an 11 year old who was in a bit of trouble at school. His defense was “Kevin did worse than me and he didn’t get in trouble.”

I laughed and then explained to the parents that I had just read a Donald Trump tweet along the same lines, “What about Crooked Hillary and the Dems.”

The parents smiled warily, but the boy took offense. He did not like being compared to Donald Trump. I tried to explain that deflecting the blame, or trying to do that from an immature sense of playground fairness, was quite appropriate at his age. He was still unhappy that I had compared him to Donald Trump.

Then I saw a 12 year boy, a little fire-plug of a kid who happens to have a mop of blonde hair, a square face, and a passable rendition of a Donald Trump pout. I asked if he was going to go out Halloween as Donald Trump. No way he told me. There are too many Donald Trumps. He was dressing as a robber. Besides, Donald Trump is stupid.

So, at least, I concluded, the fear that Donald Trump might be a role model for our children, at least our Canadian children, is unfounded.