Category Archives: Uncategorized

New Zealand – Can These Events be Predicted and Prevented?

By Dr David Laing Dawson

There will always be young men whose sense of unfairness, disappointment, failure, and loss can be shaped into a delusional world view, a fantasy of causation, of blame, of a specific enemy, and of their own fantasized role righting these wrongs.

At what stage in this progression can we act to prevent tragedy? At what stage in this progression do we actually have the tools to prevent tragedy?

1. The asocial, narcissistic, vulnerable young man.

2. Social reinforcement of the delusional solution.

Not long ago this would mean reading pamphlets and joining a group, or a clandestine group, a rebel group. But today such groups are readily available on our computer screens. And my guess is that joining a “rebel group” in real life brings about some reality checks and some socialization, (ISIS excepted), while joining an internet group does not.

3. Avoidance of social groups that could counter the developing delusion.

Perhaps easier to achieve now than 50 years ago, with more and more young people staring at a screen all day, and with the development of silos or bubbles of manufactured reality and personalized news feeds.

4. Finding information to support one’s developing delusion.

In the past this might have entailed reading some history and philosophy, attending talks in basements. Today it is shouted at us in podcasts.

5. Finding “heroes” to emulate or imitate.

Again we no longer need prowl through libraries and read history. The exploits of others are readily available at our fingertips.

6. Being encouraged by the careless words of leaders (Presidents) and opinion leaders.

These words, careless or self-serving, or downright racist, are no longer found on a second page column, but repeated in endless news cycles and social media.

7. Desensitization.

Many serious crimes follow a period of desensitization through the commission of smaller crimes. It is a way of managing anxiety and fear. Again, today, a perfect desensitization process can be found in First Person Shooter video games, with the “targets” becoming more life-like every year.

8. Secrets must be shared.

After each mass killing we find bread crumb clues, shared ideas, internet postings, and full manifestos that hint at what is to come,

9. Acquisition of serious weapons, assault rifles, ammunition.

The weapon available can make the difference between a couple of injuries and 49 deaths.

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Reflections on Child Sex Abuse

By Dr David Laing Dawson

With the child sex abuse scandals of the Catholic Church back in the headlines suggesting that these crimes are wide spread and more common than we thought (surprise, surprise), perhaps it is time, at least in the modern sections of this world, to accept the realities of our species and live within that reality.

To put it succinctly and bluntly, when your 14 year old son’s hockey coach drops by and asks if your son would like to come camping with him this weekend, you slam the door on him and call a parents’ meeting.

There is never a moment when your priest has a legitimate reason to be alone with your son or daughter. If he wants to do this he should be immediately suspect.

If you build it “they will come.” I think a century ago building the residential schools was a forgivable naivety. Who might know then, that not all the priests and sisters put in charge of vulnerable children were motivated only by notions of service and altruism?

Power (status, position, control), Sex (in all forms and some we haven’t even thought of), and Money. The prime motivators of this species. Money being strangely third, and really, just a symbol of power.

Now that is not to say there can’t be other motivators, altruistic, social, helpful, loving, giving, generous motivators, but, let us stop being naive.

This past September I was dragged to some monasteries and churches in Italy by my wife’s brother. In one monastery I lingered, looking upward at the child pornography painted on the vaulted ceiling. They were, of course, cherubs, but lovingly rendered with round bottomed pre-pubescent nakedness in teasing, inviting poses.

The family members look askance when I point this out.

This monastery, like others, was built 500 to 700 years ago, with fortifications, on the top of a hill. It is not difficult to imagine how, a few hundred years ago, the poor peasants would drag their offerings up the hill, a few coins and crops and chattel, to receive those empty promises of health and after-life.

The location and fortification of the monastery provides safety and security, and the likelihood of surviving the various wars that will envelop the countryside from time to time. The peasants provide labour and food. The order of sisters in an outer building provide various services. The landowners in the countryside provide money. A little accommodation is made for the changing mayors, monarchs, dictators, governors of the state.

All in all, a sweet deal.

But let us not be naive. Those cherubs. If I painted those on canvas and displayed them at Gallery on the Bay, the police would be knocking on our door within hours.

Editorial comment – a write up of our two new compilations but mostly

Hamilton psychiatrist David Dawson puts Donald Trump on the couch

Books Based on Mind You Blog Now Available

By Marvin Ross

We are pleased to report that you can now get Mind You the Realities of Mental Illness: A Compilation of Articles from the Blog Mind You and Two Years of Trump on the Psychiatrist’s Couch in either print, kindle or Kobo versions.

Both print editions are distributed by Ingram which supplies almost all bookstores everywhere. The print editions are listed in Amazon world wide, Barnes and Noble, Books a Million, Chapters/Indigo. Kindle editions are, of course, available in all Amazon websites internationally and Kobo is also sold internationally.

A tip for Canadian purchasers. Amazon is selling the books at the US price of around $17.95 whereas Chapters is charging $23.95 for each of the books.

All reviews welcome.

cover dawson trumpcovermindyou

Taking issue with “issue”, again.

By Dr David Laing Dawson

Poets choose words for their rhythm and sound as well as their meaning. And for a poet, that can be a meaning implied or suggested, with the rhythm, sound, and suggested meaning creating a whole that invokes a new thought and feeling, or an old thought expressed more cogently.

If a poet were to choose the word “issue” she might choose it for its vowels and sibilants and its suggestion of movement or controversy.

But when we are trying to convey information in an essay, a news article or a political statement the actual meaning of the word chosen is paramount. But that word can be chosen not as a poet might, but rather to obscure, to obfuscate, to euphemize, to negate, and even to simply shore up the speaker’s credentials.

Unfortunately words get used this way and somehow creep into our regular lexicon for decades at a time. And when used this way for a decade, by politicians, reporters and editors, we are all protected from the truth, from factual information about ourselves and others.

The word “issue” is just one of those words. I am tired of hearing it used to obscure or soften reality.

Recently,  two senior Canadian politicians resigned from their positions in order to seek treatment for “addiction issues.” It turns out that one of them may actually be addicted to alcohol or drugs, but even this was an obfuscation of the real problem of “inappropriate sexual activity”. Now even this is a silliness. “Inappropriate sexual activity” is the couple making out in the back seat of the bus from Toronto to Hamilton. But sexual harassment, intimidation, or assault are more than “inappropriate”.

The other, it turns out, has been sexting and sharing nude pics of himself over the internet and got caught in a blackmail scam.

In one of these cases the word “issue” obscures what might be alcoholism or drug addiction. In both of these cases “having issues” and “seeking treatment” obscures some stupid immature behaviour and does a disservice to people who “seek treatment” for actual illness.

We can forgive both of these men for acting in a stupid, immature fashion, but neither should ever be elected to office again. For both of these men there is no treatment beyond someone shouting at them, “For God’s sake, what were you thinking?”

And this is the real problem with constant use of the term “mental health issues”, as in “has” or “is seeking treatment for”:

On one hand it manages to endlessly widen the scope of human follies, behaviours and struggles to which we do not assign personal responsibility, while at the same time obscuring and denying the existence of true, serious mental illness, and conversely and perversely assigning people who suffer from these illnesses personal responsibility for their illnesses.

Both Terry Fox and I have leg health issues. Mine are a problem of aging joints and lack of exercise. His was, of course, cancer.

Remembrance Day on the 100th Anniversary of Armistice – From the “War to End All Wars”

single_red_poppy

By Dr David Laing Dawson

WW1 was stupid, stupid, stupid, one of the great follies of humankind. And this is what we need to remember on November 11th while still honoring the soldiers who died in that war, or came home with minds and bodies shattered. And we need to do this without glorifying or even justifying war.
This week a classic FM station has been playing a new musical version of “In Flanders Fields”. The composer talks of noticing the last stanza in this poem and its importance and neglect. That’s the stanza that begins “Take up our quarrel with the foe”. She has added the ominous rhythm of marching boots to her score.
No. That “foe” was comprised of equally frightened boys and young men sent to war by the equally blind, heartless, stupid leaders, kings, emperors, Kaisers and politicians of the day. And when Dr. John McCrae wrote that poem, several million bodies of those “foes” were already strewn in the fields of Europe.

In the spring of 1916 my grandfather stood up from a soggy rat infested trench in Belgium at the call to charge. A bullet pierced his left arm and shrapnel from an exploding bomb gashed his face and stuck in the left side of his skull. He was carried to the field hospital for the third time that year and from there transported to a hospital in England and then a rehabilitation center.
A hundred years later I have his service and hospital records on my computer.
The bullet in his left upper arm was a through and through and the wound healed quickly. The Xray of his skull shows particles of shrapnel embedded in his frontal and parietal bones. The surgeons removed what they could but a few metal shards remain. He was then transferred to the rehabilitation center to be prepared to be sent back to the front. But my grandfather kept having dizzy spells and falling down. In the brief medical jargon of the day the doctors wondered if this was caused by concussion, or was it shell shock or might it be “functional”. Today the doctors would have used the words “post-concussion syndrome”, PTSD, and pondered the possibility of conversion reaction and/or malingering. But first they would send him for an MRI.
My grandfather spent the summer and autumn of 1916 in that rehab center and he kept having dizzy spells and falling down. Eventually he was given a medical discharge and sent home to Canada, to Victoria, to arrive there in the winter of 1917.
I have a few scattered memories of my grandfather from the late 40’s into the 50’s when, for the entertainment of his grandchildren, he might tap the metal in his head and imply his whole skull was steel. Otherwise, I know, he never talked of the war. He had enlisted in 1915 with the first Canadian Expeditionary Force, after the rule that wives had to agree was dropped. He trained in England in the summer of that year and then was deployed to the battlefields in the fall, the trenches of France and Belgium.
I had always assumed my grandfather was a veteran of Vimy Ridge and I visited the monument there and wrote in the guest book. But his war and hospital records show he was discharged home before the battle of Vimy Ridge. He was a veteran and survivor of lesser known and less successful battles.
In the language of medicine “functional” implies both “no physical/organic cause” and “the possibility of there being a purpose or goal involved in the loss of function”. “Conversion reaction” and “malingering” are two extremes of interpretation. The first implies that though the behaviour has a goal it is not a conscious goal, the second that it is a fully conscious goal. Of course, for much human behaviour the truth lies somewhere in between.
But there it is. In the hospital and rehabilitation center in England did my Grandfather decide he was not going back to that insane war, to the death trap of those trenches, to the whim of a general ordering a charge against machine guns? Did he decide to fake infirmity and return to his wife and three small children waiting in a farmhouse on Cedar Hill Crossroad?
I’m sure he suffered PTSD, and those dizzy spells may have been caused by concussion, by cerebral bruising.
But I like to think that he realized how stupid, stupid, stupid it was for young men to be sitting in rat infested soggy trenches through the night and day shooting at each other, and that he should go home to care for my grandmother, my uncle, my aunt and my father. (Another aunt arrived after the war).
If he consciously decided to go home on a medical discharge, even while feeling the guilt and humiliation of such a decision, well, here is what I have to say:
“Good on ya, Grandad. I’m proud of you.”

Flu Season is Coming

By Marvin Ross

Recently, a Facebook contact held a poll to determine if they should get a flu shot. Much to my surprise, 30% voted no with reasons like “it is better to build up your own immune system” to “the vaccine is not perfect”.

I was surprised but I guess I should not have been given the amount of anti-vax sentiment around. Building up your own immune system is stupid and it does not work. Polio, smallpox et al were eradicated not by having people build up their immune systems but by vaccinations. And yes, the flu vaccine is not perfect and its efficacy varies based on the best guess of epidemiologists but it does help to varying degrees.

What convinced me about 30 years ago was a study done by the National Hockey League. It may have just been the Toronto Maple Leafs but what they found was that the time off for players was greatly reduced  the year they got flu shots compared to the previous season. I’ve been getting it since and have never contracted the flu.

There is also an interesting difference between Canada and the US over flu shots. For many years, the flu shot in Ontario was only free to people with chronic diseases who were immune compromised. Then, it became available for free to everyone. In fact, only three provinces in Canada do not provide free vaccinations universally but they all do provide it for those with chronic illnesses. A few years ago, Ontario made it available in all pharmacies so people did not have to make a doctor’s appointment but could go into a pharmacy and get it from the pharmacist.

From what I gather, the flu vaccine in the US is only free to people who can satisfy certain conditions and who must apply for it. Otherwise, you pay. Now I don’t have stats on what percentages in each county do get the shot but the death statistics are telling. The World Health Organization says that up to 650,000 people die from influenza each year. In Canada, deaths from flu are about 3500 a year. As the US is about 10 times the Canadian population, that translates into 35,000 Americans. The actual death toll in the US in 2017/18 according to the CDC was 80,000. More that double the Canadian rate. This is an example of what the Spanish flu of 1918 to one city

An interesting commentary on the failure of the US to adopt universal health care was mentioned by the anthropologist, David Graeber. In his book Bull Shit Jobs, he quotes Obama who said:

“Everybody who supports single-payer health care says ‘look at all this money we would be saving from insurance and paperwork’. That represents one million, two million three million jobs (filled by) people who are working at Blue Cross Blue Shield or Kaiser or other places. What are we going to do with them? Where are we employing them?”

That quote came from an article in Nation, June 26, 2006 by David Sirota called “Mr Obama goes to Washington”.

When you don’t get a flu shot, you not only endanger yourself but those around you with compromised immune systems like the chronically ill and the elderly.

Go get a flu shot!

Madness Can Be Contagious

By Dr David Laing Dawson

Some years ago, working within psychiatric clinics and mental hospitals, I used to advise staff, students, counselors, therapists, psychiatrists, that the most important thing they should strive for at all times, was “to remain sane.” At all times, remain sane. Your job, as a mental health professional, is first and foremost, to remain sane.

Sane meant, of course, keeping calm, ethical, sensible, compassionate, and not reacting or over-reacting to the insanity that surrounded them. That insanity coming from both the patients and the human systems we all worked within.
Sane also meant not assuming responsibility for that which was not yours to assume, and not trying to change the unchangeable. It was also wise to bring perspectives of time and relative importance to all events.

Of course none of us were always able to achieve this.

But I am thinking of this as Maxime Bernier angrily leaves the Conservative party to start one of his own, presumably along even more conservative lines, and Doug Ford sets up a hotline for parents to rat on teachers if they step past 1950 in their sex ed teachings. And from James Cagney mouthing the words, “You dirty rat.” to the 15 year old boys I see who don’t “rat” on their friends, to Donald Trump calling John Dean a “rat” and then offering that maybe “flipping” should almost be illegal.

It is hard to remain sane.

It is hard to remain sane living next door to the USA as they fall into a deeply conflicted madness. But that is our Canadian task. Remain sane.

Americans are currently struggling over dichotomous extremes, polarizing issues that should have been settled long ago, now requiring mere tweaking with each new generation.

In Canada, all our systems can be improved, carefully, gradually. None of them need be abandoned, or drastically and dramatically changed. Our problems are not either/or. We do not need to choose capitalism or socialism, abortion or no abortion, accepting refugees or not accepting refugees, being multicultural or not multicultural, of having social programs, guaranteed income, health care for all, or not having these things.

We just need to tweak them and improve them from time to time, occasionally shifting the balance of private enterprise and government, reacting sanely and generously to crises, tweaking our laws and services to deal with the new realities, all the while pursuing the goal of a healthy, equitable, and happy society.

I am not downplaying the problems we face around housing, adequate income for all, employment and health care, not to mention saving the planet, but we must not fall into the contagion of vitriol south of our border.


On Youtube: A new play by Dawson premiered at the Artword Artbar, Hamilton.

 

How Science Tries to Understand Mental Processes

By Dr David Laing Dawson

When science tries to understand human behaviour it can develop methodologies to look at multiple levels of our organization. These levels could range from subatomic particles to the behaviour of tribes, nations, the population of the entire world.

Within the medical sciences we are interested in the behaviour of cells, of neurochemistry, and, at the other end of this chain, the experiences and behaviour of individual humans.

Behaviour can be observed, and observed within different contexts, and under specified situations. Internal experiences require self reporting within a social context, and self reporting is notoriously unreliable. (Imagine asking Donald Trump what he is thinking and feeling, and why he is having these thoughts and feelings, and whether he has written many books.)

Until quite recently the behaviour of brain cells, of neurochemistry, could only be studied by measuring the rise and fall of various metabolites in blood and urine.

And between these extremes (human behaviour and the rise and fall of metabolites in blood and urine) there existed an enormous black box containing the interaction of chemistry, cells, neurons, organs within the brain, systems of arousal and perception, systems of neural organization, complex biochemical and electrical feedback systems….

With EEGs, CT Scans, MRI’s, Pet scans, molecular biology, genome mapping, our new ability to at least see which parts of the brain are active (metabolizing, using glucose and oxygen) and which are dormant when we talk, listen to music and/or hallucinate, that Black Box has shrunk. But it is still there.

Behaviour is a visible product of a long complex chain of events from cell activity, neurohormone production, arousal and filtering systems, inhibiting and stimulating feedback loops.

Ritalin is a stimulant. Yet when given to a boy with ADHD it usually slows him down. So my best guess here is that with ADHD our stimulant is stimulating an inhibitory mechanism.

Like many medications, the power of Chlorpromazine (Largactil) to quell psychosis was discovered by accident. This time in France. Heinz Lehmann brought it to Canada to use in a trial at The Douglas Hospital. It worked dramatically, but why and how it worked is another question. Following the methodologies mentioned above it was first determined that chlorpromazine and drugs developed within the same family affected the neurochemical, neurotransmitter, dopamine. From this arose the dopamine hypothesis of schizophrenia.

But we have since learned that each mental illness is the product of long, complicated pathways from neuron to dendrite to neuron to behaviour (sometimes through long chains and multiple pathways), and that different medications can affect the final behavioural outcome by affecting different parts of that chain, sometimes by stimulating production of a neurohormone, sometimes by emulating a neurohormone, sometimes by inhibiting a neurohormone, sometimes by blocking the transmission of a neurohormone, and sometimes by inhibiting the degradation of a neurohormone (hence the SSRI’s – Selective Serotonin Reuptake Inhibitors)

With the modern technologies we can describe with accuracy what exactly each drug does at a neuronal, biochemical level. But there remains a black box between that level and the actual observed behaviour. Though it is getting smaller and smaller and easily bridged with hypotheses.

But psychosis is not simply too much dopamine, nor depression inadequate serotonin. Although medically altering those two neurochemicals (neurotransmitters) does affect (usually) the chain of electrical/molecular events that leads to psychosis and depression.

What We Need to do to Survive

By Dr David Laing Dawson

The DNA imperatives that propelled our species this far are someday going to kill us all. We seek patterns, linkages, cause and effect. Our brains organize our multiple visual and auditory experiences. Our brains are, as others have said, organizing machines.

Most other creatures have built in templates seeking a match: the pathway to food, to shelter, to procreation, to touch and comfort. Our dominance has been upheld by our brains’ ability to organize information into new patterns, unique patterns, new cause and effect linkages, new explanations of cause and effect.

Galileo muttered, “And yet it moves” as he left the inquisition. Elon Musk says we need to colonize Mars. The Flat Earth Society is meeting in Saskatchewan (which is a good choice it occurs to me). Each brain is responding to the same imperative. The first has organized new information to arrive at a conclusion the church is not ready to accept. The second imagines a future from his own larger-than-life experiences and resources. The third clings to an old explanation by ignoring a wealth of other information.

A friend says, “They are both Leos; that explains it.” He smiles, letting me know he is not wholly committed to that (demonstrably silly) template of understanding.

The delusional man tells me a song on the radio is about him, for him, a message only to him, written for him, played for him. His penetrating gaze tells me this is how he organizes information. He is a believer. He is psychotic.

Today my Google list of top news topics includes Xi Jinping, Doug Ford, Donald Trump, and Steve Bannon.

I know why Xi Jinping and Doug Ford are there. I will resist using the juxtaposition of those four names to draw any organizational conclusions about the world and it’s future.

But Steve Bannon? Why is Steve Bannon back on the list?

And it turns out he is busy. Busy in Europe, especially Italy, meeting with numerous Populist Leaders, Far Right politicians, giving speeches, promoting…. I’m not sure what he’s promoting actually. “History is with us,” he says. He seems to be promoting the kinds of xenophobic, racist, exclusive, fascist, isolated enclaves that brought us both the First and the Second World War. He gathers information through his own filters and sees an apocalypse in our near future, a Fourth turning, a war of civilizations. The elitists can’t win this war for us, he says. He promotes a populist movement fueled by Social Media, by reinventions of Briebart News. He seems to relish an age of warring tribes, this time with modern weaponry.

But where does he picture himself in this? Surely not as a robed and besieged emperor. Not as a Mussolini. Perhaps as the Consigliere who can escape to Argentina after the conflagration?

Bannon’s grandiosity would not be important if he didn’t have an audience. And that is the puzzle. Why are these people including Steve Bannon as a source of information to help them formulate their understanding of the world? Though I suppose they are simply selecting those who come with ideas that support the self-serving conclusions they already share.

To survive the ant must organize a pattern, a trail, that will lead him from the nest and back in search of food. And then the ant will stick with it. If I plant my shoe in that track the ant will ignore the bodies and simply go over that shoe.

To survive now we humans must, somehow, quell the need for simple, absolute patterns, the need that opens the door to the veneration of Imams and Popes and Kings and Presidents-for-life, and the Trumps, Bannons, and Fords of this world. And we need to overcome that genetic impulse calling us back to small, exclusive, warring tribes.

We humans have the gift of imagining new patterns; though, like the ant, we cling to the old. To survive, contrary to the impulses of Trump, Bannon, Miller, and many others, we need to imagine our tribes as more and more inclusive, less and less competitive, more and more cooperative.

Steps in the Unraveling of a President

By Dr David Laing Dawson

Some wondered if Donald Trump’s latest tweet storm heralded an unraveling. This time he bounced back with a somewhat adult response to gun control, in so far as raising the the age of legal purchase and banning “bump stocks” is at least a beginning. ( He later returned to the NRA talking points of “hardening schools” and arming teachers)

So he didn’t unravel completely but he certainly gave us intimations of things to come.

As the Mueller investigation grinds on with more and more indictments and guilty pleas what can we expect from Donald J. Trump?

A supreme narcissist, like a child when cornered or caught stealing or reprimanded will fall back on an ever regressive series of deflections and denials:

  • It starts with straight denial. (never happened, wasn’t me, fake news, hoax, didn’t say that, I’m the most honest person you’ll ever meet)
  • Boasting about other things is added to this to distract and shore up his sense of omnipotence. “Popularity, security, number of bills passed, military budget.” This is compared to the failing of sibs or, in this case, all previous presidents.
  • It moves quickly to blaming someone else for the current problem, usually a brother or sister when a child. In this case Obama and Crooked Hillary, the Dems, the previous administration.
  • Next comes a statement of unfairness or injustice. “You never get after my sister and she does worse things.” “Obama was worse, how come he doesn’t get in trouble? Look at what Hillary got away with? You should be looking into the Uranium deal?”
  • And then accusations of unfairness, prejudice on the part of parents (FBI, Justice Department). “You never liked me. You always liked Obama more than me. You gave Hillary a pass.” You are terrible parents (Congress, FBI, Justice Department). I hate you.
  • Then perhaps a string of unrelated accusations against a sister or brother or friend or teacher. In this case the Dems, various Senators, Obama, the Justice Department.
  • And then the temper tantrum. The weeping, yelling, pounding of fists on the floor, stomping of feet. In this case a flow of whiny, semi-coherent profanities and mutterings. A mix of self-aggrandizement and self-pity.
  • And then some lashing out.

And this is when more than the reputation and solvency of the USA is at risk. This is when we are all at risk.