Category Archives: Media

The Perils of Data Mining

By Dr David Laing Dawson

Allowing computers to search through large medical data bases may one day discover a link, an association of great importance and one that stands up as actually a causal link. It is really the headlines associated with the reporting of these studies with which I have a problem.

These headlines appear on Google searches, Google news, newspapers, and trade epublications such as Psychiatry Times. I suppose the purpose of a headline or lead is to make the reader want to read the article, or in these cases, the research findings and the methodology.

If I read that eating bacon is going to double my chance of a heart attack I am compelled to read the actual study. In that case (an example from a few years ago) I concluded, after reading the actual study and juggling statistics with reality, that I would have to increase my bacon consumption from occasional to every day to increase my chance of dying from cardiovascular disease within the next ten years from 14 percent to 16 percent.

You can’t make good carbonara without bacon or prosciutto.

Butter is good, butter is bad, and now butter is good again.

These data mining exercises can never account for all variables, and they certainly don’t prove cause. In fact they are quite dumb in the sense of ignoring the obvious, and they seem often to be initiated with a prejudice, with the prejudice informing the headline but belied by the actual results of the study.

Others have pointed out that there is a very strong correlation between the presence of an ambulance and a road side accident. My satire on the subject would compare the rate of death from cancer in people who have taken anti cancer drugs with people who never have.

But I am writing this because of a Psychiatric Times headline that implied a causal relationship in the elderly between antidepressant treatment and hip fractures. Forcing me to read at least the synopsis of the study.

Comparing the elderly population (mean age 80) who were not taking antidepressants with those that were found that more of those taking antidepressants had suffered hip fractures. In the details of the study they found peak incidences of hip fracture 30 and 90 days before the initiation of antidepressants. Yes, before the initiation of antidepressants.

This throws the notion of antidepressants causing hip fractures out the window and hints at a much more complicated relationship between hip fractures, falls, osteoporosis, and depression. Depression is, after all, an illness that affects the body as well as the mind: (diet, life style, exercise, concentration, isolation, sleep, carelessness, memory, awareness, along with low mood).

Of course with the elderly all drugs need to be prescribed with added caution, often lower doses, and closely monitored. But if not newspaper editors at least the medical and science writers should refrain from writing headlines that are actually not supported by these data mining exercises.

But more often today all the other interpretations of the data, the cautions, the caveats, the list of missing variables, and the call for more research is added at the end. But few readers today, as we know, read more than the headlines and first paragraph.

Ignorance and Depravity Goes to Washington

By Marvin Ross

Every week I think it can’t get any worse and it does. I’m talking about our southern neighbours of course. Just how low can it go? Well, it seems that there is no bottom to the ignorance and depravity of the Trump administration.

First, we have the attacks against the transgender community. If people are law abiding and civil, what they are or what they do is their business. And do normal, sensible people really care where others pee? I remember being in a hotel in the 1960’s in some small community in Guatemala. Down the hall were two doors – one marked damas and the other caballeros. They both lead into the same large room with cubicles and basins lining either side of the room. That would likely cause a stroke in South (or is it North) Carolina in 2017.

But then, to top off that bit of idiocy, we have the new communications director for the White House who has no idea how to communicate suggesting that another official is a fu@@@ paranoid schizophrenic. Words fail me at this total display of ignorance, indecency and lack of civility.

I’ve just finished reading White Trash The 400 Year Untold History of Class in America and I have to say that the author got it wrong. White trash extends into the White House.

Like most Canadians, I have friends and relatives in the US and they are intelligent decent people with whom, mostly, I share similar values. But those sensible, decent, civil people need to stand up and do whatever they can to get their country back and to help it move into the 21st Century. And lest we forget, that includes health care for your citizens. No one in civilized society anywhere can fathom how you can argue about the need to provide citizens with health.

Before you suggest that no one should throw stones, let me explain that other countries have grown. Racism and incivility exists everywhere and probably always will but most countries have gone beyond that being the norm and deal with it when it occurs. Canada’s record with Indigenous people is not very impressive but efforts are being made. The overt racism towards others and homophobia is no longer the norm. Just look at the minorities in the current Canadian cabinet or the Sikh with a full beard and turban running for the leadership of a national political party.

In Hamilton,  posters promoting Fringe Festival plays  about feminist and LGBQT topics were defaced with biblical anti-feminist and anti-gay graffiti. That was denounced in social media and by civic officials and festival officials have put rainbow coloured stickers over the graffiti saying “All for love. And love for all”.

I lived in England for a year during the Enoch Powell era when racism and anti-immigrant sentiment was very strong. Today, I marvel at the English cultural mosaic that is reflected in British TV mysteries and the BBC News. The vote for Brexit may have been a bit of a setback but gone are the days when BBC newsreaders and journalists had to be white and all talked with that upper class Oxbridge accent. Not anymore.

Countries evolve and also regress as liberal Germany did in the rise of Hitler. It is time for the decent Americans I know to actively work to take back their country and to evolve. I’m waiting for US organizations like NAMI, Mental Health America and others to speak up and and denounce the obscene insult to people with mental illness and  hopefully, they will by the time this gets released on Monday. I am writing it on Friday.

Trump’s grandiosity.

by Dr. David Laing Dawson

I have been watching too much CNN. I must control this new addiction. It is bad enough to find oneself compelled to watch a train wreck or a car accident, to have to slow down and gawk, but now I’m following the ambulances into the ER and waiting to hear the pronouncements of the doctors and nurses and next of kin.

Each evening several panels comprised of both political persuasions dissect the president’s tweets and statements, seeking substance, direction, and meaning, seeking precedent for his personal attacks, sometimes deftly skipping past his actual words to re-frame and reword the proclamation in question. They are often concerned about the political advantage or disadvantage his words might have. As George Orwell and Mark Twain and others have told us, when the outrageous lie becomes commonplace it loses its ability to outrage us. It becomes “strong opinion”. It may even become “alternative fact”.

But none of these panelists seem to pay attention to a part of Donald Trump’s speech that I think they should. Perhaps they need a linguist on one of their panels. Like a child
Trump calls the judge a “so-called judge”; like an envious teenager he revels in the low ratings of Arnold Schwartzenegger; he demonstrates every day he has no boundaries, personal, professional, or ethical.

But this is the kind of sentence I find most frightening:

“I comprehend very well, better than I think almost anybody.”

Without irony or a wink he begins to tell us that he comprehends better than anybody, that he is smarter than everybody else. Then as he is forming the words he catches a glimpse of how this will sound to others, and he squeezes in the phrase, “I think almost”.

He did the same when he said, “I am very smart.” He squeezed in the word “like” to soften the statement a tad, even if it ended up sounding adolescent.

I can analyze this as a grandiosity that is really an over-compensation for insecurity, but it is, nonetheless, grandiosity: A belief in his own powers, in this case his intellectual powers, that far exceeds reality.

As President Kirkman said last season: “There is nothing more dangerous than a pawn that thinks it’s a queen.”

It is this grandiosity that will bring down the house, or some day implode in rage.

Reflections on Donald Trump and Reality TV

By Dr David Laing Dawson

I apologize for writing again about Donald Trump, but what is happening in that country south of our border may be very important for all of us. Many pundits have been sharing their views, but when you are living at the time of a tipping point in human affairs it is very hard to see what is coming.

I previously commented on Trump’s off-the-cuff speech pattern being akin to that of a teenager with ADD. (my apologies to all bright articulate teenagers). Well, there are two possibilities: that is his natural speech pattern and it reflects his pattern of thought or… or he is faking it. Which means he is masterfully engaging his audience in this manner because he understands the brain of those raised on Talk Radio and Duck Dynasty. I don’t mean to make light of this. It is a much worse alternative to thinking he simply suffers from some ADD, both for what it says about him, and what it says about our Reality TV and Celebrity Culture.

I remember the moment Television changed democracy. Nixon vs Kennedy. Nixon did not look good on camera. At the time people speculated that FDR would not have been elected had every household owned a television. As we know either Nixon looked better on color television or his consultants taught him how to look better next time around.

Over fifty years have passed since the Nixon Kennedy debate, and since that time the makers of film, television, and other commercial interests have become much more sophisticated in the manipulation of the human mind/brain. Which boils down to tapping into our arousal systems, our reward systems, our primitive fears, anxieties, frustrations, anger, our primitive responses, our seeking of certainty and security. The digital revolution has given them amazing tools to do this. The very tools that can make information and wisdom available to all can be used to make us play video games for days on end, binge watch a cable series, and tune in for another episode of “Reality Television”. We get hooked, we say. Well, yes, that is the point. A bit of fun, then mystery, then anxiety, threat, struggle, fear (albeit vicariously) then resolution and reward, repeat. Our brains love this stuff.

(McLuhan’s famous dictum “the medium is the message” sounds rather quaint now.)

Donald Trump knows this. Or he is a phenomenon created by this “Reality” TV culture.

Perhaps he is a one-off, an accidental politician, a throw-back, the subject of many future dissertations subtitled, “How and why did this happen?”

Or he is a sign of the times, a man of these times, a man who understands the way entertainment can tap into the human brain and destroy the boundary between truth and fiction, the manner repetition creates reality, the manner in which simple phrases can instill anxiety, the manner in which bluster can convince, and our brains’ desire to repeat that anxiety, fear, struggle, resolution, reward cycle as often and as quickly as possible.

Like the despots who managed to corrupt nascent democracies in the past Trump stirs up primitive anxiety, fear and anger and then offers us fentanyl, the quick fix. And he does this with a mastery of the new media and an accidental or calculated understanding of the brains of the fans of Reality TV.

Well, for the sake of my grandchildren I hope this is a one-off, and less to do with the impact of absorbing reality TV, entertainment, and video games with faster and faster editing taking us through that anxiety/arousal/reward cycle over and over again for many hours each day – I hope it has less to do with that and more to do with the residual racism and sexism in the American culture. The latter can be improved over time. I don’t know what we do with the former.

Read Media Reports on Mental Illness With a Critical Eye

By Marvin Ross

Despite the best of intentions of most reputable papers and their editors, nonsense still gets published. Much of that nonsense pertains to theories of mental illness.

A perfect example of that was in my own local paper, the Hamilton Spectator on September 21. The Op Ed by a social worker was headed “Bad Behaviour is Bad Behaviour. Period.” The author, Alexander T. Polgar PhD, RSW, is a forensic social worker and public safety consultant. His PhD is in social work and RSW means that he is a registered social worker.

Dr Polgar was objecting to a recent report by the John Howard Society of Ontario which pointed out that many in prison in Ontario have untreated mental illness and that people often have to commit crimes in order to get mental health treatment. One of the authors of that report said that “Ontario must stop punishing people for their mental health issues and take ‘bold and immediate action’ to decriminalize mental illness.”

Now Dr Polgar objects to the fact that the primary premise of that report is that “mental illness is a medical problem” and he comments that this speaks “to the success with which bad behaviour has been and continues to be medicalized”. He goes on to say that “throughout history, those who behaved badly or strangely were considered to be possessed by demon spirits and the solution was to ‘beat the devil out of them’”.

He says, we no longer beat them in Western cultures but we do punish them in a variety of ways including incarceration. He then adds that the medical model of madness continues to compete with the demon-possessed causes of bad behaviour. Freud, he said began to change that with a focus on family dynamics, social conditions and various relational issues. That gave rise to psychotherapy, counselling, behaviour modification and family therapy. Not surprisingly, he cites Thomas Szasz and RD Laing.

But, the resistance to Freud, Szasz and Laing are the result of two problems – the human proclivity to abdicate familial and social responsibility for troubled children who become dysfunctional adults and a profit driven pharmaceutical industry who can provide a solution that justifies the abdication of reponsibility.

He concludes his piece by saying that “we cannot and should not tolerate from anyone bad behaviour. This includes bad behaviour from those we currently label as the mentally ill.”

And, finally “the best place to modify these socially unacceptable behaviours contrary to the views of the above cited report, is in correctional institutions and in community based correctional programs provided by behaviourally trained personnel far better resourced and equipped than they are now.”

Unfortunately I can’t give you the link to the article so you can read it for yourself as it is one of the very few articles that the paper did not put online. They may have read my letter to the editor with copies to the senior editors which they did not publish.

But, who is Dr Polgar? Well, interestingly enough, he has been prosecuted by the College of Psychologists of Ontario (CPO) for the unauthorized practice of psychology. In 2006, the CPO applied to the Ontario Superior Court of Justice for an order to desist. It was alleged that “he held himself out as a person who is qualified to practice in Ontario as a psychologist or in a specialty of psychology. The Application also related to allegations that he performed the controlled act of communication of a diagnosis in the circumstances described in the Regulated Health Professions Act, without being a member authorized by a health profession act to perform the controlled act.”

The case did not get to court as Dr Polgar agreed that “Without any admission that he has done so in the past, Polgar agrees that he will refrain from communicating in any report to any client or other person, any diagnosis, meaning any statement identifying, as the cause of a person’s symptoms, a neuropsychological disorder or a psychologically-based psychotic, neurotic, or personality disorder. It shall not be considered a violation of this agreement for Polgar to make and communicate social work diagnoses as that expression is defined by the OCSWSSW.” (the College of Social Workers)

The second link downloads the CPO Bulletin and details of his unauthorized practice can be found on P 10.

The moral of the story is to read with a very critical eye. Fact checking does not always catch everything.