Just Push the on Button

By Dr. David Laing Dawson

Image by OpenClipart-Vectors from Pixabay

Some years ago while naively trying to lead a teen girl to the awareness that perhaps she did not yet understand everything there was to understand in this universe, I asked her if she knew how that gadget in her hands wired to buds in her ears turned electronic signals into sound that we experienced as music. She looked at me with that particular teen look of incredulity and answered, “Doh. You just push the on button.” I am sure I heard the word stupid at the end of that sentence, but I think it was implied rather than verbalized.

In those same years to make the same point with a teenage boy I would ask him what keeps an airplane in the air. Occasionally a few surprised with a rudimentary knowledge of air flow, gravity, wing shape and… well, at that point the answer usually faltered.

But now a small glass filament encased in a bit of plastic carries light impulses (photons/waves? modulated how?) to a box in my house that transforms them into electronic signals carried by small copper wires to another box and a screen that transforms these signals into moving images and then by more copper wire to boxes that transform electricity into full vibrant sound. I start this process by sending an infrared signal from a handheld thing that has at least two on buttons. (I do have some idea how that last group of boxes transforms electricity via electromagnets and a flexible cone into sound waves, but that can’t be the way they do it on my Blackberry – there isn’t room)

The garage door opens and closes from an app on my wife’s Apple phone; this same phone tells us when the video (stored God knows where) from our door bell has reached 50% capacity and whether or not this past month we have been good citizens in our use of electricity and gas, though I don’t understand the criteria, for it placed us in the bottom half of our neighbourhood yet congratulated us.

China is ahead of the US in the development of sonic weapons, whatever they are. An “atmospheric river” dumped enough water on BC to flood the Fraser Valley, my phone just pinged a computer generated text to me about my scheduled booster shot tomorrow, which might be Moderna or Pfizer; it seems from studies of past ice ages that a relatively small change in temperature or wobble in orbit can trigger a very large cascade of events, our sun they say is about half-way through its life cycle, we need just the right amount of carbon dioxide in our atmosphere or we turn into an ice ball or a burning caldron, as Carl Sagan explained in 1985; a complete stranger just asked me if a certain brand of hickory smoke works well when curing bacon, Amazon did give me the option of clicking on “I don’t know”, Big Pharma tells me to talk to my doctor about this new wonder drug and carries me visually hand in hand through a flowered meadow, beaming grandchildren and puffy white clouds while muttering that it might also kill me; apparently I am living on land that was never ceded by the (too many consonants to pronounce) nation, Putin is amassing troops on the Ukraine border, Belarus is sending the Iraqis back to Iraq, but wait, where is the news about Ethiopia and Haiti? Weren’t they in big trouble last week?

Netflix and Amazon tell me what to watch. Youtube is confused after I bounced from Steven Colbert and Bill Maher to Rand Paul challenging Dr. Fauci, followed by a few bits from MASH and some TED talks and an incursion into QANON and this rather brilliant street musician.

“God created the Heavens and the Earth” just doesn’t cut it anymore. That “He has a plan” fails all empirical observation. To say nothing of His appointed acolytes proving to be rather dodgy in their ethical and moral behaviour. (I’m talking all religions here, just to be clear)

But as Mark Vonnegut put it once, when writing about his own mental illness, “Would you rather be chased by a pack of wild dogs that were hungry or a pack of dogs that had a master who could, if he wanted to, call them off?”

Where on earth is this going, you ask about now.

Well, my point is that we live in a world that fewer and fewer of us, perhaps none of us, understand, and while the sun may have 4.6 billion more years in which to shine, it looks like we have only 30 or so before fire, flood and pestilence return our human population to small tribes fighting over the remaining arable land and potable water. And with all that in mind it is easy to understand the existence of people who shout “No” when someone asks if we actually landed on the moon, and “Yes” to COVID being a hoax, and the reincarnation of JFK Junior arising from the dead to pronounce Donald Trump president-for-life, and the possibility a bunch of deep state pedophiles are running the whole thing.

I could use an all-explaining delusion for myself about now.

Still, I will get my booster shot tomorrow and remember something else Mark Vonnegut said:

“We are here to help each other get through this thing, whatever it is.”

And I will continue to push the on button.

Musings of a Newly Retired Psychiatrist

By Dr David Laing Dawson

Ontario Advisory Covid-19 Science Table

In my retirement I have come to realize that one of the privileges bestowed upon a psychiatrist is the opportunity to sit in comfort many many times with people who hold irrational beliefs. In this role I assume a posture of empathy and acceptance, of non-judgement, and listen, and try to understand these beliefs and where they are coming from; how they came to be and to what they might be leading. And in this role I can always emerge wiser and sometimes kinder.

How interesting, I might say to myself.

But now, in retirement, I read of a man found dead in his apartment, a man very active in the flat earth society, and an outspoken anti-COVID, anti-vaxxer. And apparently only two days before his death he posted on Twitch that he was feeling ill and that he had taken Ivermectin.

And I click on the link.

It is a video a half hour long recorded from the dashboard of his truck as he drives along what looks like a British Columbia Highway, while recounting his trials and tribulations, his advice, thoughts, and symptoms, to his followers whom he addresses as “Guys.” Some respond in brief texts that stream on the right of the screen.

“It is definitely not CONVID” as he calls it, “Which is a hoax.” He has taken much Advil and Tylenol to no avail. It seems he is headed for a pool or a sauna in which to “sweat out the toxins.” He goes on for a bit about toxins and how we expunge them from our bodies through “sweat, pee, poo, and breath”.

His dog is ill as well, and he tells us about this in some pungent detail. First he tried “natural” remedies and then he took his dog to the vet.

He has some grievances he shares, and he offers health advice, and repeats quite often that “CONVID” is a hoax.

I try to understand him but I can’t read his eyes through the video and I can’t ask him questions. It is clear his physiology education is very limited and for a moment I ponder the fact that (a la Gwyneth Paltrow), in this year 2021, we have a surfeit of people providing 18th century health advice. He uses the metaphor of a sponge to demonstrate (with both hands while driving), how the muscles and tendons can squeeze out the toxins.

I suspect his only close relationship is with his dog, and he refers to his condo which he shares with his dog. But he has found a community on Twitch, and among the flat-earthers, and somehow he has been able to assume a role of teacher or influencer.

I want to see him in person, though apparently it is too late for that, so that I might satisfy my own brain’s need to understand how and why he came to be.

At the same time it is apparent how social media has allowed the growth of fraudulent communities of pseudo intimacy and delusional beliefs, and the rise of truly ignorant “influencers”.

Guns and More Guns

By Dr David Laing Dawson

The Kyle Rittenhouse trial has been something of a circus, but as I read and listen I can’t help but wonder how it is we remain stuck with Old Testament concepts of human behaviour, of right and wrong, of guilt and innocence, and of righteousness and punishment.

It is interesting to ponder why this particular kid decided to anoint himself the protector of property in a town in another state in the midst of a protest and riot. His background may explain it. But he was 17, and so his quest just as easily might have taken him to a white supremacist gathering, an anti-vaccine protest, a save the whales demonstration, or free the dolphins, or stop the inhumane treatment of edible mammals, or anti-nuclear, anti-pipeline, anti-coal, save the planet, stop dress codes in High School… – any number of chances to express some righteous idealism. So off he goes, to do something that is good and righteous, maybe a little thrilling, and, I suspect, in his mind, heroic.

As we all know he took an AR 15 rifle along with him and shot and killed two people and wounded another. This then leads to a court case in which the prosecution argues that he committed murder, and the defense argues that he acted in self-defense. And just as I write this the jury has returned a verdict of not guilty.

The case, the arguments, the outcome all hinged on the actions, re-actions, and probable thoughts of this 17 year old boy and of the victims in the chaos of a few minutes of high excitement, threat and hostility. Did he shoot these three men in self-defense? The jury concluded the answer was “yes”.

But really, a loaded semi-automatic weapon in the hands of a 17 year old, at night, in a milling crowd and an atmosphere of threat and danger? Of course some people will die.

The questions of thought, of intent, of perception at that precise moment are, well, silly. He was a kid with a gun, his arousal system at peak, surrounded by noise, shouting, flashing lights, milling people, other guns. Of course some people died.

The only question of importance here is “Why on earth do we allow a 17 year old kid to acquire a gun of any kind, let alone an AR 15?”

More on the Hijacking of A Family Mental Illness Advocacy Organization

By Marvin Ross

In May, I wrote about the demise of the formerly highly respected and effective Schizophrenia Society of Ontario (SSO) organization into what sounds like a consumer survivor group called the Institute for the Advancement of Mental Health – IAM. For mental health week, they were planning a virtual event dubbed as “mental health is everyday health” including such activities as “virtual yoga, guided meditations, live music, maintaining a home garden, and workshops on anxiety & stress”.

SSO is the same group founded by families of those with schizophrenia and originally called Friends of Schizophrenics. As SSO they fought successfully for changes in the Mental Health Act to have community treatment orders included despite opposition from many quarters. SSO was the face of advocacy for families and provided tremendous education and support. Now they fight for yoga as a solution.

In his keynote address at the 10^th anniversary of Home on the Hill Supportive Housing recently, psychiatrist Richard O’Reilly asked his audience if any had heard of IAM. The vast majority had not and he went on to describe the new organization as “a disaster”. One of their big goals is to explore how public space design can influence well being. See his description starting just before the 47 minute mark in his lecture below.

Bad as all that is, it gets worse. On November 10, they sent out a survey which seems to question the validity of the cornerstone of treatment for schizophrenia – anti-psychotics. Without a doubt, every responsible medical expert agrees that the basis of successful treatment of schizophrenia begins with this class of drugs.

Not so IAM. Their rationale for the survey states:

“We are looking for your feedback on the impact of antipsychotic medications and other treatments and supports on your lifestyle and quality of life; what you see as the most important things you would like addressed by treatments; and how you think treatments can be improved.”

The reason for their survey is for them to give input to the Canadian Agency for Drugs and Technologies in Health (CADTH) who are presently conducting a review of a new anti-psychotic called Cariprazine, so they can determine if this medication should be paid for by the government for people on social assistance and others who use public drug plans. It is my understanding that this drug has already been approved for use because the efficacy outweighs the side effects. It is one of many anti-psychotics available for doctors to prescribe and the more the better. Often, finding a good anti-psychotic with minimal side effects can be difficult.

Why IAM would try to get involved is a bit of a mystery until you read the survey questions. It would appear that they want to discredit the use of anti-psychotics. I did ask the contact person for the survey but they have ignored my e-mail query. This is the link to the survey but the deadline is November 17 so it may not still be there https://www.surveymonkey.com/r/ZD5X2L3

Nonetheless, question 4 makes the assumption that people have stopped taking the medication. The question is how long before you stopped? It is taken for granted that everyone quits which may or not be the case. They should have asked, did you ever stop, why did you stop and what was the outcome. They then ask if the person gets pills or injections and which they prefer. That is legitimate but I’m not sure how relevant it is for them to tell that to the agency deciding on government reimbursement only.

Next, they want to know the advantages and disadvantages the person finds with taking anti-psychotics followed by how well they managed the positive and negative symptoms both without medications and with them. No idea why they would ask this and it is well established that medications do help with positive symptoms. This is followed by questions on other medications that are not anti-psychotics the subject may be taking to control their symptoms.

They then explore other non pharmacological treatments and ask if they compare to anti-psychotics. It is known and well established that other treatment modalities can add to the improvements of the individual so what does this have to do with this particular new agent?

What is IAM trying to accomplish? I cannot figure that out and they will not respond to my request. The cost of doing this and the resources required seem to be a waste when we do not have enough beds for those who are seriously ill, limited assistive housing and inadequate programs in the community to help those who are ill and their families.

As my colleague, Dr David Laing Dawson said, “whatever the motive for the survey it could not possibly provide worthwhile data about anything”.

He then looked at the toolkit on their website and added:

“It is the most outrageous pile of meaningless ten dollar words and graphs I have seen in a
while. Looks to me like SSO got highjacked by professional grant receivers with the goal being continuous employment through grants (I mean for the IAM staff, not the sufferers).”

Delusions and Delusions

By Dr. David Laing Dawson

The human brain is an organizing machine. It constantly seeks to organize data in linear, cause and effect paradigms. And the goal of this is to create some certainty in our lives, some predictability. We seek patterns. We seek to filter and organize the data flowing to us to create mental maps that guide our behaviour. Highest among the vectors our brains must grasp are threat and danger. And after that, power, control, social position, sex, love and self-worth.

Although the butterfly effect and chaos theory are comforting to a few intellects, most of our brains seek simpler explanations. “Ah, of course, he’s a Taurus.” I read the morning astrological chart. I know it is hooey, and my frontal lobes ponder the manner these charts are written to suit any life or circumstance. And yet, and yet…

But I am writing about this again because of new forms of mass delusions appearing in our age.

I have spent much of my professional life contemplating the delusions of people suffering from schizophrenia, mania, and psychotic depression. And they, the delusions, turn out to be the organizing principals and conclusions created by brains, in the case of schizophrenia, that can no longer read, receive, filter and sort corrective social, interpersonal information, and in the case of mania and depression, brains that must develop explanations for profound, overwhelming, persistent emotional states. (If I am feeling this good, this exalted, I must have special powers; if I am feeling this bad there must be something rotten in my core)

The primacy or power of this process is experienced every day by mental health workers trying (and almost always failing) to convince a person suffering bipolar mania that he is really not invincible and a messenger of God and that he only thinks this because he is experiencing so much high, inflated good energy, and he should go back on his meds.

Unfortunately the rational cognitive processes of our human brains take a back seat to the imperatives of power, control, social status, sex and self-worth.

We also know that complete sensory deprivation leads quickly to delusional thinking, as does full and complete social isolation, slowly but surely, as does social isolation plus membership in a cult with a charismatic leader. And true to form these delusions always organize the paradigms and mechanisms of control, power, sex and worth.

And now we have a new and potentially very dangerous pathway to delusional thinking. And these are the silos of social isolation and singular information sources created by the internet and social media. And again, just as in specific mental illnesses, the human brains subjected to this general social isolation plus an ever narrowing stream of information complete with ready-made conclusions, must find patterns to satisfy the need for control, power, social status, self-worth and sex, the need to know threat, the need to know our enemies, the need to blame someone for our failures.

And hence, QANON, which before social media might have grown to a 200 person cult until the FBI arrived (Branch Davidians) or the Kool-Aid was dispensed (Jonestown), has now reached beyond the borders of the USA. And while some reporters played down the size of the crowd gathered recently in Dallas, the videos showed hundreds of otherwise normal looking folk lining the streets to witness JFK junior rising from the dead and restoring Donald Trump to power. (A delusion does not have to make any actual rational sense.)

So this is the question with a preface: During the so-called Arab Spring (which mostly backfired) we thought we were witnessing the good that can come from a world wide information highway and the unbridled communications of social media. Here might spread the grand ideas of freedom and democracy, of equality and fraternity.

But it can also spread, thanks to those notorious algorithms, an intensifying, ever narrowing deluge of delusional ideas, patterns and conclusions.

How do we control the latter without forfeiting the former?

A Nostrum for Marvin’s Hurting Brain

By Dr. David Laing Dawson

Image by HitaJast from Pixabay

In response to Marvin’s Two Things That Make My Brain Hurt – Anti-Vax and Income Inequality The other day, a crowd of over 1000 gathered in Kelowna to protest the vaccine mandate. “The crowd was organized by a group of concerned allied health care professionals made up of dentists, chiropractors, naturopathic doctors, RMTs, and many more,” according to a spokesperson.

Today I made my online appointment for a booster shot of Pfizer.

When COVID first arrived I assumed the development of a vaccine would take several years, but science and technology had advanced faster than I imagined it could, complete with an mRNA vaccine that bypasses a complicated step in our immunity development.

Wow. This bodes so well for our future, a future in which there undoubtedly will be new pandemics every few years as our population continues to swell and encroach on the ecology of other life forms. In theory, at least, a cooperative world can catch these quickly and have a vaccine ready in months.

It did not occur to me that there would be thousands of supposedly educated human beings who would refuse the vaccine.

But I guess it makes sense. Three groups I think: 1. Those whose primary sources of information have been narrowing silos of social media misinformation. (most of which can be traced back to con-men and women making money by selling fraudulent alternatives). 2. Those who still respond with a knee jerk adolescent opposition to any authority, (a very large group in the USA it seems) and 3. Health care professionals (nurses, dentists) and purveyors of a very iffy form of health care (chiropractors, homeopaths, naturopaths) who have always nursed a resentment toward doctors. And a few actual MD doctors who have been caught up in an exaggerated sense of their own importance and healing powers, and/or are part of that first group making money with alternatives.

Unfortunately it is further proof that with respect to human behaviour, the amygdala and subcortex trump the frontal lobes. The maintenance of social status, the maintenance of feelings of worth, of specialness, of autonomy, and of superiority, override common sense, reason, logic and empathy.

Ah well. I am sure it is better to be living in a society where we must contend with, persuade, convince, peacefully and thoughtfully, 10 to 20 percent hold outs, than within an authoritarian country (United Arab Emirates) which found it quite easy to get 99% compliance.

Two Things That Make My Brain Hurt – Anti-Vax and Income Inequality

By Marvin Ross

The first is anti-vax sentiment. When the flu shots first became available years ago, I looked at the evidence on efficacy. The one bit of research that I found compelling was done on the Toronto Maple Leaf hockey team. Every year, players miss games because of the flu and that served as the baseline. Before the start of the next season, all the players got a flu shot and the researchers compared the games missed because of the flu that year with the previous unvaccinated year.

There was a significant reduction in games missed and so I got a shot and have been getting one every year since. I rarely get a flu and, if I do, it is pretty mild.

Those of us who are older, remember polio. Outbreaks were common, our mothers would not let us go to the beach or to gatherings of large crowds and we would find kids missing from school when we went back in September. Some were dead, others learning to walk again and others in iron lungs so they could breathe. Then came the vaccine and no one heard of polio again.

Now, let’s look at Covid. Worldwide, there have been over 245 million cases of Covid and over 5 million deaths. At the moment, over 80% of Canadians are fully vaccinated but the hospitals (and particularly the ICU’s) are filled with the unvaccinated. Is that not sufficient evidence that they work? According to a study conducted in the US, in the first six months after the vaccines were approved for use, they prevented 140,000 deaths.

More recently, a study conducted by the Kaiser Health Foundation in the US suggests that 90,000 people could have lived if only they had taken the vaccines. A hell of a lot of people died who did not have to die if only they got vaccinated.

As for adverse events associated with the vaccine, they are minimal and not severe. One large US study reported that adverse events accounted for 0.4%, 0.6% and 0.35% for Pfizer, Moderna and Johnson vaccines. The most common adverse events were chills, headache and fever. Severe reactions were rare and mostly found in those over 80 with co-morbidities.

So, what is the reason for the opposition? It is stupid and makes no sense.

Second is income inequality. Despite years of refutation, trickle down economics does not work but governments show little to no interest in ensuring that people have an adequate income. One of the 2021 winners for the Nobel prize in economics won that prestigious award for his research on minimum wage. The wealthy argue that if the minimum wage is raised, they will go out of business but this economist proved the opposite. Ontario born, David Card, an economist at Berkeley, demonstrated that when the minimum wage is increased, there are no job losses.

Demands for a guaranteed minimum income are growing but falling on mostly deaf ears in government even though they make perfect humanitarian and economic sense. There are people in society who cannot work because of disabilities – both physical and mental. Disability payments in most, if not all, jurisdictions give them the barest of bare resources and force them to make difficult decisions – rent or food.

Conservative governments in Ontario have not once raised disability allowances over the past 40 years when they were in office. Other governments have but not by enough. The Ontario Conservative government just showed its compassion and raised the minimum wage by a full dime. Yes, you read that right, 10 cents! With an election coming in less than a year, they just raised the minimum wage again to $15 an hour – an amount they cancelled when they took office 3 years ago. However, a study in Hamilton, Ontario found that the minimum wage needed for people to make ends meet is $17.20 an hour. In Toronto, it is $22.00 an hour.

In Hamilton, $17.20 an hour works out to an annual income of $35,776 per year. The disability amount, using the same formula, comes to an hourly rate of $6.75 for a 40 hour week. The difference is down right obscene.

The disabled, however, are not the only ones who cannot work and the number of those who cannot work is growing. Automation is making many jobs obsolete or reducing the work force significantly.

• No one is needed to pump gas anymore or to work in automated car washes.
• ATMs and online banking have reduced the number of bank tellers needed
• automated check outs in supermarkets are reducing the number of cashiers needed
• industrial plants and warehouses are moving towards robotics and automation faster than ever before
• Drive through fast food places will soon be using robots to take your orders as one has already done.

How will the people displaced from those jobs make a living? Many probably will not as many thus far have not. The humanitarian and economic solution is a guaranteed minimum income. People without sufficient income and opportunities will often turn to drugs to escape their miserable lives. In order to pay for them, they resort to petty crime, drug dealing and prostitution. Others simply commit crimes to get what they need. All of this leads to growing civil unrest and possible insurrection thus the need for more police to keep them in place.

Health and life expectancy is impacted – a condition first called social murder way back in 1845 by Marx’s buddy Engels. While that concept has been dormant for many years, according to three academics in the School of Health Policy and Management at York University in Toronto, it is making a comeback. The idea of social murder was used in the UK after the 2018 UK documentary Grenfell Tower and Social Murder and the effect of austerity imposed in that country by various Conservative governments.

Providing people with a livable income is a win-win for everyone. The poor get to live a reasonably decent life and the economy benefits. If people have more money, they spend it. That benefits the people they buy from, the suppliers, manufacturers and importers of those goods and tax is paid giving the government more revenue.

The time has come to implement a basic income but will our politicians do that?

What is a Disease – Advice for Anti-Psychiatry and Anti-Science Luddites

By Marvin Ross

Ancient treatment for mental illness and migraines

Schizophrenia and mental illnesses do not exist say the anti folks because we cannot see it, measure it, test it and whatever. To answer that, one of my favourite psychiatric writers, Dr. Ronald W Pies wrote a tongue in cheek article in Psychiatric Times entitled “Why Thomas Szasz Did Not Write the Myth of Migraine?

Dr Pies began his article with:

The next time one of psychiatry’s detractors tells you that psychiatrists do not treat real diseases because we have not identified the precise pathophysiology of schizophrenia, bipolar disorder, or other psychiatric illnesses, try this: Ask the skeptic to explain the precise pathophysiology of migraine or cluster headaches. Follow up by asking what laboratory test or neuroimaging study neurologists use to diagnose these devastating conditions. At that point, the critic should be either blushing or blanching.

I really doubt if they will blush or blanch as the good doc is being kind. They will probably sputter more nonsense or refer to a psychologist or chiropractor or an alternative medicine guru. The fact is that despite all the research done into migraines (like serious mental illnesses), the exact pathophysiology of migraine is not known. There are also no medical tests or neuroimaging that will identify a migraine in someone. Migraines are diagnosed based on the reports of the patient and the elimination of other causes. Just like serious mental illnesses.

Despite our lack of knowledge on the causes of migraines, there actually are some very good treatments for them although far from perfect ones. And the same goes for schizophrenia, bipolar and severe depressions.

What the anti crowd fail to understand is how scientists come to determine if something is a disease. My colleague, Dr David Laing Dawson, covered this in a blog from a few years ago called Understanding the Disease Model. He stated that:

The disease model is founded on the idea that if a number of people suffer the same symptoms and signs, and if their affliction follows the same course with the same outcome then perhaps these people suffer from the same “thing”. This in turn raises the possibility that the cause is the same in all cases and that a treatment that works for one will work for the others. To study this we need to name (diagnose) the thing and describe it’s symptoms, signs, and natural course. Given that we are biological beings it is reasonable to think that some of the signs of these diseases will be biological, and that the causes might be as well. But first the chore is to observe, study, collate, find groupings and test this hypothesis.