Monthly Archives: May 2022

Guns and Teens

By Dr David Laing Dawson

As either a parent or a law maker, a tragic clinical case from some years ago tells you all you need to know about teenagers and guns. I will have to leave out some details to try to keep this anonymous.

The boy had a girlfriend. He and his dad hunted together. The father kept his rifles in a locked cabinet. Some jealousies and betrayals occurred in the girl/boy relationship. Someone posted salacious accusations against the boy on social media.

The boy decided his life was thus ruined, permanently and forever.

He decided he would have to kill himself.

That night he broke into his father’s gun cabinet and took out a rifle. He found the ammunition, loaded the rifle and took it into the back yard. His parents were upstairs asleep.

The boy sat beneath a tree, placed the gun between his legs, the muzzle under his chin. He fired the rifle. The bullet tore through his jaw and mouth and nose and ruined his face. But it missed his brain.

Damaged and bleeding he found his way back to the basement rec room and the gun cabinet. He then replaced the rifle and locked the cabinet because at that moment his worst fear was of his father finding out he had broken into the gun cabinet. He then lay on the floor where his mother, wakened by the gunshot, found him.

He survived.

This otherwise bright successful teenager suffers social embarrassment/shame at school. (bound to happen at some time, though greatly magnified these days by social media)

From this he concludes his life is over. (of course, he has a limited sense of time and perspective as a teenager)

He decides the only path is suicide in dramatic fashion. As a teenager, thinking through or talking through alternatives to direct action is beyond his capabilities, and as a teen he has no real sense of how permanent and devastating to family that action could be and/or he might even, before the age of 20 or so, imagine being around to see the consequences of his actions on the friends who betrayed him. A “They will be sorry” moment.

He doesn’t tell his parents because of his sense of shame, his need to present himself to them as an adult, not a frightened child.

Of course he knows how to get into the gun cabinet. Or his mother’s purse, his father’s wallet, the liquor cabinet, the porn sites on his computer. It is an adolescent prime directive to figure out how to get around the rules.

And then the most telling and yet hopeful bit of all: after shooting himself and ruining his face he is still most concerned about getting caught breaking into the gun cabinet and incurring his father’s wrath.

I wrote this months before the recent mass killings by 18 year old boys. And the teen in the above story was healthy, had friends, was successful and social, attended school, had two healthy parents. Just a teenage brain, a moment of public embarrassment and shame, an available firearm.

Add anger, academic/vocational failure, social isolation, spotty or absent parenting, websites, podcasts, internet forums of violence and conspiracy and blame, developing mental illness, and readily available weapons of war, weapons that symbolize pride, strength and manhood in American culture, and…………….

More Mass Shootings in the U.S. of A

By Dr David Laing Dawson

In the Buffalo killings there certainly are overtones of hatred, fear, racism and white supremacy. The authorities and pundits declare this was a “Hate Crime”, a crime motivated by “hate”, domestic terrorism.

Indeed the 18 year old murderer wrote a manifesto (at least partially cribbed from other manifestos), rife with references to “Replacement”, hatred for blacks, anti-semitism, and he planned his assault at a popular grocery store serving a mostly black community.

But I am writing about this because while the word “hate” or “hatred” is probably an apt description of the feeling state of Peyton Gendron before, during and after the shooting, it does not explain this tragedy in any helpful way.

During a time that seems almost quaint now, the late 1960’s, a friend and colleague pointed out that some of the LSD-driven popular literature of the time could be seen as instruction manuals for psychosis. Tune in, drop out, join a commune or Hare Krishna. And many teenagers and young adults searching for meaning (which really means organizing principles that provide some security and predictability) drifted into communes, communal pads, cults, and that strange Hare Krishna thing.

For most of us going through adolescence and youth our organizing principles, our realities, are formed through our daily interactions with others. For teens many of those interactions are with other teens, which can lead to some temporary extremes of idealism, pessimism, rebellion, and the adoption of some strange notions of identity and community. (Which is why it is so important to have teachers, coaches, bosses, uncles, aunts and parents within that sphere of daily social interactions.)

Now out of these interactions should come a sense of who we are, who we might become, how we fit in – a sense of how the whole thing works, a realistic sense of how the whole thing works, and what my part in this should or could be.

While we like to think of our identities and our realities as growing from some innate destiny, some inner soul, a self that we can find, we are actually social animals and to a great extent our thoughts, opinions, our sense of reality, our sense of what is causing what, derives from the thoughts, actions and opinions of others. We imitate and we oppose.

Some teens and youth cannot or will not avail themselves of the very real social interactions that would help them form a balanced, pro-social, rational system of meaning and identity. This includes some teens developing mental illnesses, and some on the autistic spectrum. But the need for the brain to arrive at some organizing principles persists. So they seek meaning and organizing principles elsewhere.

In the 60’s we might find meaning in cults, religion, pop culture, psychedelic literature, science fiction, counter culture literature, and serious literature, TV, and film.

Today we have the likes of Tucker Carlson, Jordan Peterson, thousands of other guru podcasts, websites and forums hosting a large number of conspiracy theories, the internet, the dark net, social media, video games and more …..

The man who killed people (women) with a van in Toronto was on the Autistic Spectrum and had found organizing principles and meaning in Incel.

Peyton Gendron found his reality in White Supremacist websites, podcasts, the internet published manifestos of other mass killers, and apparently Tucker Carlson and the Replacement Conspiracies. These explained the world to him.

And then he became delusional.

And I say delusional because it is one thing to flirt with, even partially or wholly believe any number of racist conspiracy theories, but another leap of grandiosity to go on a suicidal mission of mass killing with the delusional belief that this will……. Unfortunately only Peyton Gendron would be able to finish that sentence.

Which leads to this summary:

1. It is astonishing that an 18 year old can legally buy assault weapons. We need far reaching and effective gun control in every country.

2. Today, the internet provides a vast number of ways of viewing the world and ourselves, many of them fantastical, some of them dangerous.

3. We will always have some among us, usually socially isolated and/or developing a mental illness, who are susceptible to the worst of these conspiracy theories.

4. And a few of these will become sufficiently delusional and grandiose to take it upon themselves to act.

And these conclusions:

1. Gun control, gun control, gun control.

2. Maybe we can find ways of limiting the reach of dangerous ideas without damaging the principle of free speech.

3. There are warning signs often missed, not acted upon, or lost in our maze of institutions and administrative processes.

4. In some of these situations timely mental health/psychiatric intervention and treatment could be effective.

Last week for our special schizophrenia kindle book sale in honour of Mental Health Month  https://www.prlog.org/12915487.html

The Genius of Bitcoin

By Dr. David Laing Dawson

The classic Ponzi scheme always, eventually, collapses. This is because the fraudsters have promised that something tangible, something solid, underpins, is being purchased by, the invested money. The Ponzi fund is supposedly purchasing land, stocks, oil, diamonds, or financing a development of some sort, with the investors earning a really good return on their money.

Of course the early investors are paid handsome returns from the later investors as long as the fund grows. But, eventually, growth stops, someone discovers there is no underpinning land, development, stocks, bonds, oil or diamonds. There is nothing there. The whole thing collapses, the investors lose their money, lawyers make money.

Now bitcoin does not promise any underlying value, any tangible resource purchased by your investment. There is nothing promised, nothing there. What genius. Nobody can discover there is nothing there because all the purchasers of bitcoin knew that from the start. Unless you count some microscopic computer code composed of zeros and ones as “something”. Or the sad truth that drug cartels and other criminals need crytocurrency to hide their profits.

So instead of promising land purchase and development in Costa Rica, the Bitcoin, the cryptocurrency people tell you that you are buying unique code stored somewhere and everywhere, and the value of that code will continue to rise because people will continue to buy. And no one will discover there is nothing there because we all knew there was nothing there. And it will continue to gain in value because there is a limited quantity of nothing there and an unlimited quantity of buyers.

It is sort of like the early investors in a Ponzi scheme knowing there is nothing there but planning to sell their piece of nothing before everyone else finds out.

And the NFT’s. Not quite as genius, because even though the fraudsters are also just selling “unique” code, or at least the password that will unlock that unique code, the buyers are given the feeling there is something tangible, or at least visible, they are purchasing. I mean, at least they could look at it occasionally. “It” being a uniquely arranged assortment of coloured pixels on a monitor generated by a code, for which someone else may want to give you a lot of money so he can then say that now he is the only one on earth who can change that bit of code into a specific array of pixels on a monitor.

So the NFT market will probably collapse or fade away. But the cryptocurrency market will probably continue, inflating and deflating like a horny toad. But (pay attention Mr. Poilievre) God help the government that buys into this Genius Ponzi scheme.

We are such a shallow, greedy, gullible, clever species.

Holistic Medicine

By Dr David Laing Dawson

“Holistic medicine is the art and science of healing that addresses the whole person – body, mind, and spirit. The practice of holistic medicine integrates conventional and alternative therapies to prevent and treat disease, and most importantly, to promote optimal health.”

I never gave much thought to the word “holistic” before. I mean, who could object to such a nice all-encompassing word, and a word that implies we medical practitioners should be considering mind and body when we see our, well, patients, if you will pardon that word. And “spirit” too, whatever that means. I do suspect it means a little more than a story I have from my first month of interning years ago:

I was thrown onto a large internal medicine ward and one of my first tasks was to write the discharge orders for a man of age scheduled to go home, a cardiac patient. I dutifully copied the drugs and diet on which he had been stabilized into his discharge prescription, including “no meat” in his diet.

A couple of days later the Chief Resident reamed me out. I think his words were, “You asshole. The man is not a vegetarian. He’s Jewish, and we just don’t have kosher in the hospital.”

But I digress. Holistic. What a bunch of hooey. “Holistic Medical Practitioner”. Now apart from the futile practice of recommending healthy diets, regular exercise, a balance between work and play, and a loving relationship, it does seem to emphasize one thing otherwise often neglected. Massage. And massage does feel good.

The other thing these holistic centres seem to do is offer both evidence based scientifically demonstrated-to-work medicines (which they call conventional medicine) along with “alternative” medicine. Curiously what they call “conventional medicine” is actually the result of scientific progress in the last century and what they call “alternative medicine” are mostly unproved and/or scientifically disproved quackery that has been around for a millennium or more.

Retired now I have a little more time to explore some of these ancient practices. And I discovered that the big toe has a direct connection (Chakras? Or “reflex” areas?) to the brain and if I regularly rub and massage my big toe I can ward off Alzheimers. I did get my wife to do it for me one evening but then she broke out laughing and poured me a drink instead.

But I understand why we have this resurgence in pre-scientific approaches to healing, wellness, and treatment of ailments. Our (scientific, evidence based) modern medicine practices have become perfunctory, cold, flat, solid, stolid, and overwhelmed with numbers, percentages, probabilities and paper work. The magic is gone. What a bore it is to visit my family doctor’s office and have her recite probabilities regarding my elevated systolic pressure and prescribe a “calcium channel blocker” for me.

No magical incantation, no sweet smelling candles, no little needles in my foot, no big toe massage, no promises to live forever, no rejuvenating potions, no toxin cleansers, no spinal adjustments.

No magic at all. What a terrifying world we now live in.

And now I think I understand what they mean by the word “spirit” in their “body, mind and spirit” promo.

And, as this is mental health month, please take a look at our  Discount on All Our Top Rated Kindle Schizophrenia Books. See https://www.prlog.org/12915487.html

The Pitfalls of Supportive Housing – Part Two

By Dr. David Laing Dawson

David Ross moved out of Parkdale into an Indwell building next door because he didn’t feel safe in Parkdale.  BARRY GRAY / THE HAMILTON SPECTATOR

To quote David Ross, “Lumping Addiction and Mental illness together is just stupid. It doesn’t work.”

Over the past 25 years or so, organizationally, institutionally, and in journalistic and common lexicon, we have been coalescing the problem of Drug Addiction and that of Mental Illness.

Drug addiction is now often referred to as “Addiction Issues” along with statements that conclude that addiction is an “illness”. “Mental Illness” is now commonly expanded and euphemized into “Mental Health Issues.”

Crazily, addiction has become an “illness”, and mental illness has become an “issue”.

Programs and Institutions have now been renamed “Program for” or “Centre for” “Addiction and Mental Health”.

The motivation for doing this, the goals imagined, were probably mostly good. Though I am sure, at a governmental and budget level, much of the motivation was economic.

(In the US some of the motivation has been to transfer the cost of looking after the mentally ill from State to Federal coffers – State Hospital to Federal Programs and Federal Prison. In Canada some of the motivation has been to transfer cost and political headache from the Provincial to the Municipal level of government – Provincial Psychiatric Hospital to local General Hospital Mental Health and Addictions Program.)

But, whatever societal, economic, and philosophical intentions we had, as grandmother would often say: “The road to hell is paved with good intentions.”

This merging of the two problems has not helped those who suffer from severe mental illness, specifically schizophrenia, bipolar disorder, and depression. And when I write schizophrenia I mean schizophrenia, or as Kraeplin called it, “Dementia Praecox”. And when I say bipolar disorder I mean Manic Depressive Disorder, not moodiness. And when I write depression I mean serious depression, clinical depression, biological depression. These are illnesses, brain diseases, and, as the concept “disease” implies, not something one can recover from using will power, hard work, and abstinence alone. And not something caused by any action or inaction taken by the sufferer.

The merging of the two problems has harmed those who suffer from severe mental illness by adding stigma, tacitly implying some sort of social personal causality, and by taking funding away. While we do not have a specific and effective treatment for addiction we do have (since the middle of the last century) specific and effective treatments for the three mental illnesses mentioned above. This too is confused by the merger of the two.

This has also contributed to the North American phenomenon of the locus of care of a large population of seriously mentally ill people being moved from our mental hospitals to our jails and prisons.

As the Indwell experience highlights, people suffering from severe mental illness, whether treated or not, are vulnerable. They are easily victimized by unscrupulous addicts and dealers.

The old mental hospitals had the means, usually, to keep the drug dealers away from the mentally ill. A place like Indwell does not.

And this conceptual and institutional merger of Drug Addiction with Mental Illness has not helped the problem of Drug Addiction either. Not in the slightest. The statistics bear this out.

I recognize this is associative and not necessarily causal but ever since we decided to think of drug addiction as an illness, to work at de-stigmatizing it, to lump it together with the euphemized “Mental Health Issues”, and, by the way, to open safe injection sites and distribute naloxone kits, the rate of addiction in our communities has gone up and up, along with addiction related crime, homelessness, and, of course, death by overdose.

The latter, death by overdose of illicit drugs, has reached astonishing numbers. In British Columbia, in 2021, that figure was 43 per 100,000 population, 2224 for the Province, followed by over 200 overdose deaths in January 2022.

to be continued.

And, as this is mental health month, please take a look at our  Discount on All Our Top Rated Kindle Schizophrenia Books. See https://www.prlog.org/12915487.html

The Pitfalls of Supportive Housing – Part One

Marvin Ross

Parkdale Landing CATHIE COWARD/HAMILTON SPECTATOR FILE PHOTO

Operating supportive housing is not easy as my family has learned the hard way. As the headline in a recent Hamilton Spectator expose stated:

“Hamilton’s Parkdale Landing was to provide safer supportive housing — but then a murder happened”.

The subhead said “A look inside Indwell’s Parkdale Landing, where drug-dealing visitors have posed such challenges the non-profit says it will never build another home like it.”

This is the link to the story which is behind a paywall but if you have a Toronto Star account, you should be able to read it.

Indwell is a Christian charity that buys up properties and renovates them into very nice residences for the homeless and/or those needing a place to live because of disabilities. The acquisition and renovation they do well but from my own personal experiences, that is all they do well with the $14 million in grants that they get from all three levels of government.

Indwell had been highly recommended to us and so my son applied, waited 3 or 4 years, was interviewed after a visit by us and his caseworker from St Joseph’s Hospital Schizophrenia Outpatient Clinic. He was accepted and moved into a very nice brand new bachelor apartment when Parkdale Landing first opened in September 2018. In November, he woke up, exited his apartment and was met by a hall full of police and forensics personnel as his neighbour across the hall had been found murdered and hog-tied in his bathroom.

OK. Stuff happens wherever you live but this turned out to be the start of a horrendous living experience. Drug use, prostitution, drug dealing, violence, threats, were all regular occurrences and staff were helpless. My son had break ins, stuff stolen, threats and little was done by staff. I have a chronology of much of my correspondence with staff in a PDF file including my snarky comment that I hope the person who stole my son’s medication blister pack gets some use out of his Abilify (an antipsychotic).

Staff admitted there were problems and they were working on them while the police told me that Indwell did not do enough to make the building safe. Indwell said it was all a police matter and one desk sergeant wondered why anyone would live there. One cop offered to take my son to a safe place for the night on one occasion.

At one point, residents circulated a petition asking that a security guard be employed but they were turned down. There is one there now.

When the Spectator reported on the trial in November, 2021, all that my son had reported was verified and staff at the Schizophrenia Outpatient Clinic told me they were stunned. This is the link to that article which may still be behind a paywall. Here is some of what was testified to in court:

Nearly all residents and visitors who have testified admitted to being drug users and, in some cases, dealers.

Security video from the hallway in the 28 hours leading to Michel being found shows people going between units at all hours.

Suzanne Maye knocked on Michel’s door asking for a morphine pill.

He didn’t give it to me because he only had one left,” she testified. “There was a homeless guy there. I think, George.”

Maye told the jury she was high that night and her memory is hazy.

Crystal meth. I was up for two or three days … I don’t remember yesterday, never mind three years ago.”

Early on the 30th, David Herak — a drug dealer then — knocked on Michel’s door while Beverly Staines watched. Opassinis let him in.

Staines, high on crack and owed $20 by Michel, wanted in too.

I tried to squeeze in, but I got shoved out.”

Herak came out barely a minute later. He had seen Michel and knew he was dead.

I had mentioned the Indwell problems to the editors I’ve worked with at the Hamilton Spectator and then contacted the reporter who covered the trial. After the guilty verdict, she told me she wanted to write an article about Indwell once the person was sentenced. She mentioned that she always thought Indwell did good work and was now shocked to learn what was really going on.

Meanwhile, Indwell put up a new building next door for people who were more independent and my son moved there into a one bedroom. The problems are not as bad but they are not great. I did request police statistics for both buildings under freedom of information which were used in the Spectator article and are shocking.

In Parkdale Landing from Sept 2018 to February 24, 2022, there were 1,261 emergency calls to the building or one per day. The most frequent was ambulance. 103 criminal charges were laid mostly for fail to comply with a probation order and there were seven deaths – one murder, two suicides, two overdoses, one natural causes and one undetermined but likely an overdose.

In the new building from December 2020 to February 24, 2022, there were 302 emergency calls, 21 criminal charges mostly fail to comply and no deaths.

My son, David, is quoted in the article and said:

I wanted a place where people with drug addiction problems and mental illness can live happy and more productive lives,” he says. “There was a murder. There were overdose deaths from heroin. There were fights. There was a suicide.”

I wanted to keep things quiet. Low key.”

People were always going door to door, knocking on the door and shouting about drugs. There were some really bad times there.”

He says visitors caused problems at Parkdale. “They’re homeless and they’re crashing at their friend’s house.”

Go out at the wrong time of day and you’d be assaulted for $5 in your pocket. If I went outside for a cigarette, I wouldn’t feel safe.”

He felt that way despite police being at Parkdale on an almost daily basis, he says.

Ross didn’t witness anything the night of Michel’s murder. When he opened his door the next morning, there were police officers in the hall. When he learned what happened, he says he felt “disturbed, not safe.”

Ross never really knew Michel, but he was friends with another tenant who died of a drug overdose at Parkdale.

I didn’t belong at Parkdale,” Ross says. “They lump mental illness and drug and alcohol addiction together. That’s just stupid. It’s not working.”

Since the article appeared, he has had some residents thank him for what he said and one person told him that he would like to move but he has nowhere to go.

Indwell has been trying to evict some tenants but has difficulty doing so I’m told but, given that they screen potential residents, they should be doing a better job of it. Since that article appeared, there was a stabbing at the back door of the building. One person was arrested but the badly injured victim ran off and the police are looking for him.

This is not the way to run supportive housing and, as a taxpayer, I resent the amount of money given to an agency that cannot get it right. One lawyer I consulted wondered why residences like this are not inspected by some level of government who fund them and that is a very good question. Do our ill relatives not require the assurance of safe, proper housing to live in?

Indwell promotes its housing as harm reduction but from what I’ve seen, that means lectures on the safe use of drugs and the supply of naloxone kits. Since all their bad publicity, they are now saying that their homes provides enhanced programs that wrap tightly around the tenant. I’m not sure what that means and there are no examples on their website but it is something they should have been doing from the outset.

The one thing that they should not have been doing is mixing residents with different problems and needs in one place. People with serious mental illnesses with no illicit drug use (like my son) are quite different from those with addictions.

Stay tuned for Dr David Laing Dawson’s comments on this and similar situations coming shortly.

And, as this is mental health month, please take a look at our  Discount on All Our Top Rated Kindle Schizophrenia Books. See https://www.prlog.org/12915487.html

Nature/Nurture Biology/Environment

By Dr David Laing Dawson

Why do these dichotomous abstractions continue to cause so much dissension?

That’s a rhetorical question actually. For the answers clearly lie within the realms of power, economic interests, professional prestige and influence, as well, I think, within our adherence to a notion of there being a soul, a homunculus, a perfect ethereal ‘I’ somewhere inside our poor bodies. They do not lie within genuine, scientific, unbiased intellectual investigation.

The disease TB flourishes and spreads in overcrowded conditions, poverty, poor ventilation and poor nutrition. It also requires the presence of a certain bacilli. We could prevent TB by correcting overcrowded conditions, poverty, poor ventilation and poor nutrition, or by finding a substance that kills the bacilli. Or both.

Many years ago a 30 year-old woman was admitted to the Riverview Mental Hospital. She was flown there from a small town two hundred miles away. She was mute, and we had little information, except that she had been talking until a month before. She sat by herself in the dayroom, staring blankly into space. She clung to the walls as she walked the corridors. She stared at me but would not say a word. With her tacit permission one afternoon, I sat across from her and slowly injected a small amount of sodium amytal into the vein in her arm.

She spat her first words at me: “You bastard.” And then she unleashed a torrent of rage aimed at me, men in general, but more specifically, her husband, who, she told us, had forced her, made her, terminate a pregnancy some weeks before.

So, clearly, in this case, a specific environmental insult was the ultimate and necessary cause of her distress and her silence, and she recovered without anti-psychotic medication. But, there was a biological mechanism at play here, some blockage cleared by my IV drug. An electrical switch, a biochemical switch, some neurons working in excess to prevent speech, perhaps to prevent rage and its consequences.

There are many questions you could ask about that case, and they might range from the status of women, societal and medical attitudes regarding abortion, the family history, the husband/wife relationship, her “allowing” him to order her to have an abortion, her relationship with her father, the interplay of fear, anger, rage, and the biological mechanisms that facilitate speech and selective mutism, post-partum depression, hormonal changes……..

Biology/environment. When I leave that story and she flies back home, she is speaking again, grieving, and faced with many difficult decisions. I may have prescribed anti-depressants for her – I don’t remember. I would have if I had thought they would help her.

Which is the point, isn’t it? We are biological beings impacted by, interacting with our environment. Sometimes the original insult is biological, sometimes it comes from our environment, sometimes it is the particular interplay of the two: a biological vulnerability, a specific set of experiences.

But the important question remains, “What tools do we have that could alleviate suffering?”