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Trump Speak

By Dr David Laing Dawson

The collection of laughable, inane, grossly inaccurate, and stupid things that Donald Trump says grows by the week. They have become the fodder of late night talk shows and the target of journalists’ disdain. Satirists don’t have to satirize; they merely repeat what he says.

On the internet one can also find several collections of odd, funny, nonsensical things that came out of George W. Bush’s mouth. George occasionally mangled syntax; he created the odd neologism, mixing two words to make a third; he put his adjectives in the wrong place; he stumbled over language and grammar. One could make the case that he is a little dyslexic, or simply not gifted in the spoken language department.

He was on the Ellen DeGeneres show recently and he said, “…I’m going to use a big word now – symbiotic…” Ellen said, “Wow, four syllables..” The audience laughed, George smiled. And I rather liked him for a moment.

These days the journalists, the pundits, the comedians, the talk show hosts, pounce on the words of Donald J. Trump and point out their inanity, their inaccuracies, their wrongheadedness, and their untruthfulness. But beyond what he says and tweets, a true revelation of the depth of trouble we are in can be found in the way he says what he says. That is, not so much in the simple meaning to be found in his tweets and statements but the meaning hidden in the structure and form of his sentences (or lack thereof).

Whatever the subject, the reference point is himself. Whatever the subject, no matter the population actually affected, how it affects Donald is supreme. Whatever the subject, his words imply that he is supreme; they always imply that he is supreme.

Below is a list of things Donald J. Trump has tweeted or said. Let me point out what is happening in the first two. These two statements followed briefings by experts on the two subjects at hand. In them Trump indirectly admits that perhaps he didn’t fully understand the complex subject before, but then he quickly points out that “nobody” does. He has to say this to retain the fiction in his own mind that he is brilliant, superior, supreme, that he knows all there is to know, and all that anybody can know.

This is a very dangerous level of narcissism.

“It’s an unbelievably complex subject, nobody knew that health care could be so complicated.” (Health Care Policy)

“It’s a very complex subject. I’m not sure anybody is ever going to really know.” (climate change)

“I know words; I have the best words.”

“I will build a great wall — and nobody builds walls better than me, believe me –and I’ll build them very inexpensively. I will build a great, great wall on our southern border”

“I’ve never had any trouble in bed, but if I’d had affairs with half the starlets and female athletes the newspapers linked me with, I’d have no time to breathe.”

“I love the poorly educated.”

“He was a war hero because he was captured. I like people who weren’t captured.”

“All of the women on The Apprentice flirted with me – consciously or unconsciously. That’s to be expected.”

“I am totally in favor of vaccines. But I want smaller doses over a longer period of time.”

“Sorry losers and haters, but my I.Q. is one of the highest -and you all know it! Please don’t feel so stupid or insecure, it’s not your fault.”

“Cher is somewhat of a loser. She’s lonely. She’s unhappy. She’s very miserable. And her sound-enhanced and computer-enhanced music doesn’t do it for me.”

When was the last time anybody saw us beating, let’s say China, in a trade deal? I beat China all the time. All the time.”

“I think the only difference between me and the other candidates is that I’m more honest and my women are more beautiful.”

“Part of the beauty of me is that I am very rich.”

“I dealt with Qaddafi. I rented him a piece of land. He paid me more for one night than the land was worth for two years, and then I didn’t let him use the land.”

“Number one, I have great respect for women. I was the one that really broke the glass ceiling on behalf of women”

These quotes (and much of what he says and writes in tweets) boldly display:

  1. An appalling lack of understanding of issues/technologies/events/history/the world…
  2. An appalling lack of awareness of his own shortcomings and deficits.
  3. An appalling (and child-like) lack of awareness of a world beyond himself.

He could do great damage to the world within four years if he stays energetic, active, engaged, provocative and disruptive.

But clearly he has a short attention span and he doesn’t particularly like to read, work, study, or listen. So while he is watching cable news, golfing and dining at Mar a Lago, some contemporary Rasputins (Bannon for one) will be able to do great damage to the world.

We are about to find out just how solid and resilient and principled American Democracy really is.

 

 

 

 

Popular TV and Mental Illness Misrepresentation

By Dr David Laing Dawson

Currently two serial TV shows of the thriller/spy genre feature major characters who suffer from bipolar illness. Both usually take their medication and acknowledge that it keeps them stable. So far so good. They are successful likable characters and thus could be seen as antidotes to stigma, to the usual poor representation of mental illness by film and television. But in both story lines the characters go off their medication in order to decipher a complex conspiracy. They become manic, paper the walls of their rooms with clippings, photos, lists, time lines, arrows, connecting lines, question marks.

Voila. The unlikely pattern becomes clear to them. And once again the myth of madness and genius being one and the same is exploited for entertainment.

Our brains are organizing machines. They are always looking for patterns, recognizable and logical patterns. In a state of mania and hypomania, aroused, alert and scanning for such patterns, the brain does indeed find them more readily, that is, the brain invents them. The manic person sees connections and patterns where none exist, and to make this connection the manic brain often invents forces, and powers and conspiracies that are pure fictions. This might result in an interesting piece of art, a fascinating stream of consciousness, or even an entertaining performance, but it is a dysfunctional state and it does not result in valuable insight. The usual result is loss of employment, loss of community, loss of reputation, and eventually loss of freedom.

To portray mania as a form of genius does great disservice to those who actually suffer from this illness.

Of course mental illness does not discriminate so we are as likely to find that it strikes a brilliant mind as often as that of an oaf. And that is not a pattern either. Just statistical probability.

We are Now in Big Trouble

by Dr David Laing Dawson

The other evening Mr. Tapper of CNN came out directly and asked the following question: Does Mr. Trump know the difference between the truth and a lie? Does he say these things as strategic gambits, all the while knowing they are falsehoods, in some cases outrageous falsehoods, or is he incapable of knowing the difference? This dichotomy suggests either he lies nastily and without regard for any semblance of truth as a political strategy, a gimmick, a distraction, or he is incapacitated.

Neither answer is very reassuring. And if this is an incapacity what is the nature of it?

There is a simple and consistent answer to this question. Pathological narcissism.

Trump’s lies are responses to that which his inflated ego cannot accept. All information, evidence, facts that suggest Trump is not supreme, the best, the most popular is unacceptable to him and therefore must be denied or rebuffed with “alternative facts”. Any successes or glory he does achieve must be revisited, replayed, exaggerated over and over again.

The fact Donald Trump’s narcissism is extreme enough to require this level of denial of reality (the size of the crowds, the “3 – 5 million illegal votes”, murder rate, wire taps) means it is incapacitating. He is incapacitated.

His lies, his tweets, are not even bounded by plausibility. They will continue, grow more outrageous, and dissolve in a wild lashing out.

Unfortunately Kim Jong Un and the excited commentary on American television may be providing Mr. Trump a way to lash out and destroy. And then, which I am sure aligns with an image in his head, he can stand akimbo in his great black coat upon the scorched battlefield like a Vulcan God.

Follow Up – Education More Important Than Ever

By Marvin Ross

I’ve been contemplating a personal follow up to David’s blog on the importance of public education but I’ve been procrastinating. I decided to write it after having lunch with someone who was complaining that a grandchild was being sent to a private school at a cost of $25,000. His argument was that the local school the child goes to is quite good and he will have to be driven to the new school where he will lose contact with all his friends in the area.

The ability to play with other kids on the block, walk to and from school with them, and to hang out is an invaluable educational tool. I grew up in a Toronto that was just starting to break free of the grip of the Loyal Orange Order – a Protestant fraternal group that celebrated the defeat of the Catholics at the Battle of the Boyne in 1690. Most important jobs were reserved for Orangemen who proudly marched on Yonge St every July 12 behind someone outfitted on a white steed playing King Billy to celebrate the victory of William of Orange over Catholics.

Toronto was just beginning to see an influx of immigrants from all over the world at that time. Up to then, the main immigrants were Jews and Italians. The elementary schools were becoming mix of ethnicities and we all mingled and played together (with the occasional fights that were settled easily). As English Protestants ruled, classes began with the Lord’s Prayer and the singing of God Save the Queen. Once a week, some kindly minister conducted a class on religion.

Jews could be excused but I stayed as did most of the others as I recall. This invariably led to our existence being recognized by the holy man who talked about religion in general rather than his own denomination. We learned about and from each other. Groups of kids from different backgrounds would share experiences outside of class. I can still remember our comparing what we ate for Christmas dinner (which I didn’t have) and being intrigued because my best friend was Japanese and they ate octopus.

As I progressed through the years, more diverse people began showing up in class. At this time, most Blacks were descendants of those who came via the underground railroad but we were soon joined by people from the Caribbean. In elementary school, I went to a drop in centre across the street from our house run by the African Episcopal Methodist Church. One year, I was one of the three wise men in their Christmas pageant. Of new arrivals at that time, the most exotic was a new Algebra teacher called Mr Gupta. No one had ever seen a South Asian before but what was most remarkable was that his two sons were in his class. They were math whizzes much to our disgust.

I don’t want to give the impression that there was no racism as there was but it was slowly beginning to break down thanks to the children from large groups of people from diverse places. We mingled together in school, played and fought together on the playgrounds in the neighborhood and began to develop understandings of each other. In her book on growing up in Toronto as a child of Holocaust survivors (When Their Memories Became Mine: Moving Beyond My Parents’ Past), Pearl Goodman describes how playing with the neighbourhood kids and dealing with them in the local school, helped her contend with the views and trauma her parents had from their experiences.   The outliers were Jewish kids in the area who were sent to Jewish parochial schools rather than the public schools. They were quite different from us and even talked differently with the sing song accents so familiar to those whose first language was Yiddish.

During that time, there was even a radio program hosted by the Minister of Citizenship, Jack Pickersgill, who gave his audience information about the various immigrant groups (called New Canadians), who were flooding into the country. The Governments attempt to help them gain acceptance

Education was a prime reason that fear and distrust of others began to break down. Aside from the fact that most kids in my high school could swear in Yiddish (as Jews were the largest group), tolerance and understanding was starting to emerge in all areas. A holdover from the War was the fact that high schools in those days all had cadet corps affiliated with various regiments and often our teachers were called by their military rank. My history teacher was a major.

My school was affiliated with the Queen’s Own Rifles, an old and respected regiment that landed at Normandy on D-Day and fought its way north to help in the liberation of Belgium and The Netherlands. We had to go on a Church Parade one Sunday to the regimental church and when we got there, the Sgt had us all lined up. His command was Jews and Catholics, fall out and we did and spent the church service in the basement playing foot hockey while the poor Protestants had to endure a religious service.

Education helped us integrate and learn to understand and tolerate each other and is very crucial today more than ever. And it is this understanding and respect for each other that results in US Muslim Vets offering to stand guard to protect Jewish cemeteries from vandals or Toronto Jews standing guard at Mosques to show solidarity.

It has always been important for us to learn about and accept others as equals and that process flourishes when we all go to school together.

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.

Understanding the Disease Model

By Dr David Laing Dawson

I had a friendly argument with a colleague the other day. He reminded me that we had been arguing about this topic for 40 years. I think our arguments are mostly ways of clarifying our own thoughts about a very complicated question involving concepts of mind, of cognition, and of the brain, that organ who’s function makes us human.

Mental illness, disease, disorder, serious mental illness, continuum, spectrum, problem, affliction – when is it both valid and useful to consider aberrations (or non-typical) variations in behaviour and thought, illnesses? In some ways these words are just words, and few would care if we referred to arthritis in any of these terms. But when it comes to behavior, thought, and communication (rather than joint flexibility and joint pain) our dearly held beliefs about self, autonomy, will, power, consciousness, and mortality come into play. The discussion becomes political.

Before the medical disease concept evolved in the 18th and 19th century most afflictions were considered very personal and specific, and the causes very personal and specific. An obvious grouping of afflictions might mean God was particularly disappointed in a whole family or tribe. The Miasmists thought that perhaps God did not have that much control over everything and proposed that the causes might be found in the atmosphere, the miasma, physical, spiritual, emotional. An excess or a deficit. The Naturopaths liked this idea but knowing nothing of physiology, metabolism, or nutrition, concocted potions and powders with dozens of ingredients positing that the body might choose from the lot that which it needed. Each of these ideas continues to echo in the pursuit of health today. Especially in the commercial exploitation of our pursuit of health.

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.

In a sense the disease model has picked off all the low hanging fruit, those illnesses with very specific causes and courses and, of course, those for which we have found specific treatments, cures and prevention.

The disease model, and some rudimentary epidemiology, led Dr. John Snow to the source of an outbreak of cholera and then to speculate that the cause, residing in the water supply, “behaved as if it were a living organism”. This before we knew about bacteria, let alone viruses, prions, DNA, and neurohomones.

The same disease model has led to the near eradication of Polio. Drs. Alzheimer and Kraeplin applied the disease model to older people with failing cognitive processes and singled out an illness we now call Alzheimers. Dr. Alzheimer had the advantage of being able to examine the brains of his patients soon after diagnosis. Dr. Kraeplin went on to apply the disease model to a younger group of patients with peculiar cognitive difficulties, some similar to dementia, some not, and singled out a group he called dementia praecox, and another group he called manic depressive. Similarly and more recently the disease model singled out autism from the broader group of mentally handicapped children.

The disease model also allows us to study afflictions and find remedies before, sometimes long before we establish with certainty the causes of the affliction. Who on earth but a cruel idealogue would want us to stop treating and reducing suffering until we find an exact and specific cause of the affliction in question, be it cancer, arthritis, or schizophrenia. Yet that is the cant of the anti-psychiatry folks.

Yet the disease model allows us, sometimes by accident, to find remedies that work, can be proven to work, before we nail down etiology. Now, as mentioned earlier, the disease model has picked off the low hanging fruit, those afflictions caused by single alien organisms, and very specific genetic aberrations. We are left with those that are undoubtedly the product of complex combinations of genetic vulnerability, epigenetic influences in the womb, environmental influences, developmental timing, excesses, and deficits.

But we should no more give up on the disease model for schizophrenia and depression than for heart disease, cancer, arthritis, ALS, and dementia.

Our argument was actually about OCD. Having some Obsessive and Compulsive traits can be an asset of course, and of great help in medical school, while extreme OC traits can be debilitating. The “D” of OCD is the initial for “disorder” of course, but is OCD, in annoying to debilitating form, a disease?

Unfortunately the word “disease” has become freighted with negative association, and for my friend, too much associated with “biological cause”.

Ultimately he may think of OCD as a mind problem, while I may think of it as a mind/brain problem, but it is the discipline of the medical disease concept that allows us to study it and find remedies we can test.

Strategies That Help Us Feel Better

By Dr David Laing Dawson

On Monday morning this week, driving to the clinic in minus 14 degree weather, while I was stopped at a light, a well dressed woman pulling a large suitcase hurried along the edge of the ice-filled gutter toward me. She waved at me. I rolled down the window on the passenger side. She told me in thick Spanish accent she needed a ride to the center of town. I unlocked the door. She clambered in, pulling the suitcase in after her. She talked quickly about many things. I dropped her off near the bus stop in the center of town. She blessed me profusely and I drove on to work.

At the end of the day as I walked to my car in the carport another woman flagged me down and hurried toward me, this time a Chinese woman wearing a dust mask to ward off the cold or viruses. She asked to borrow my cell phone. I dialed for her and watched as she told her husband where she was and that her car battery was dead. The call ended successfully and she smiled and waved at me as I drove away.

In between these events, during the day, while walking from the secretary’s desk down the hall to my office, I noticed a large group of people in the boardroom standing in a circle with arms raised above in that position of lordly praise. I turned to the secretary and said, “My God, we have a revivalist meeting going on in there.” She said, “That must be the CBT group.” And I said, “Let me know if they start speaking in tongues.”

All of which got me thinking about what, besides pharmacological tweaking of the neuro- hormones in our brains, makes us troubled humans feel better.

Last time I looked there were literally hundreds of varieties of counseling and therapy, each with its own proponents and economic systems. But might not reality be simpler than that? Much like all that we know about good nutrition can be summed up in one short sentence: “Eat, not too much, mostly plants.”

Here is my short list of things that help us feel better when we are sad or depressed, worried or severely anxious, mildly distressed or in a state of panic.

  1. Help others. I am sure it is simply in our DNA and one of those traits that allowed us to grow our tribes and dominate life on earth. And this is why becoming an addiction counselor is one of the most successful ways of overcoming addiction.
  2. Do something in a group. I suspect it doesn’t matter if it is CBT, RTB, ABC, curling or building an ark together. It is being part of, participating in a group activity that helps us feel better.
  3. Touch. Hand to hand, hand to body, body to body. Within a consensual primary relationship of course. But failing that, perhaps a pet, a friend. And failing that, a massage therapist and even a chiropractor.
  4. Talk to someone who is actually interested in your life. The best counselors, therapists, professional or not, besides being empathic and non-judgmental and possessing some wisdom, have one other important trait. They are very curious about other people’s lives. They listen.
  5. Share a laugh. Laughter is probably not really the “best medicine”, but it is a signaling system unique to our species. (Hyenas and Kookaburras “laugh” for other reasons). For us it is a shared moment lacking in threat, caution and animosity, a moment of letting down the guard. And we always feel better for at least several minutes afterward.
  6. Understand. Have a way of understanding, or organizing, or thinking about, yourself and the world around you. Again I am sure it doesn’t matter a great deal whether it is a profoundly complicated mix of anthropology/neurology/evolution/ and quantum mechanics or the AA 12 step program, or the teachings of Buddha or Jesus or Mohammed, as long as it is not rigid, nasty, nihilistic and exclusionary. But the brain demands organization of its experiences, its sensory input. It need not be true in any absolute sense to be helpful. And this is probably why we have so many theories of psychology, so many forms of therapy and counseling. So if you want to believe in astrology and it gives you a way of understanding your friend’s behaviour, go ahead.
  7. Move. Exercise. Long before we knew anything about the dopamine, the serotonin in our brains, and the manner they are influenced and, in turn, influence our sense of well-being, Hippocrates proclaimed his treatment for depression: “Go for a walk. And if you are still depressed upon returning, go for another walk.”
  8. Quell the Inquisitor in your brain, at least for part of each day. By “inquisitor” I mean that brain mechanism that,  at its best, allows us to plan our day,  govern our behaviour, censor our worst notions, doubt and second guess our poor ideas, and at its worst tortures us obsessively with fears and follies. Find a way of taking a holiday from this. Preferably not with alcohol or marijuana. But rather with real holidays, meditation, yoga, playing a sport, playing music, engaging in an absorbing activity. For me it is painting, art. You will know when you have been there because you have lost track of time.
  9. Get a good night’s sleep. Our biology is probably programmed, for optimal performance, to stay active and outdoors through the daylight hours, and then go to our mats, our caves, our beds shortly after the sun goes down. This leads to two sleeps of about 4 to 5  hours each, with a period of semi-wakefulness in between. But then we discovered fire and telling stories around the fire, and Mr. Tesla and Edison came along and we never really adapted. So, turn off the lights and the electronics, use, within reason, whatever aids you require, and get some sleep. The cleaners can’t come through and remove the debris if everybody is still working in the office.
  10. Make something. A birdhouse, a cake, a sous vide prime rib, a back porch, a fire pit. I suspect again that it doesn’t really matter what we make, but we are undoubtedly programmed to be rewarded (internally at least) by our own productivity.  It is how we survived to become the dominant species. Of course this making of things has included making better and better weapons, which is in part, I think, the source of the current puffery of Kim Jong Un, Donald J. Trump, and Vladmir Putin.  Okay. That last thought means it is time to revisit item 8 on this list.

Reflections on Democracy in the Age of Trump

By Dr David Laing Dawson

Some very smart people have been pessimistic about the staying power of democracy.

“When the people find that they can vote themselves money that will herald the end of the republic.” – attributed to several American Statesmen and Politicians.

“The best argument against democracy is a five-minute conversation with the average voter.” – Winston Churchill

“Democracy cannot succeed unless those who express their choice are prepared to choose wisely. The real safeguard of democracy, therefore, is education.” – Franklin D. Roosevelt

“Democracy… while it lasts is more bloody than either aristocracy or monarchy. Remember, democracy never lasts long. It soon wastes, exhausts, and murders itself. There is never a democracy that did not commit suicide.” – John Adams

“Democracy substitutes election by the incompetent many for appointment by the corrupt few.” – George Bernard Shaw

Yet those of us born into, growing up and spending our adult lives within a democracy, assume that with every passing year it will grow stronger, more resilient, and less easy to corrupt. And that would be, I think, the consensus of academics, philosophers, political scientists: that with many safeguards in place, a separation of governance and religion, civilian control of the military, an independent judiciary, a functioning economy, literacy and education, voting rights for all, transparency and openness, a decent and wise constitution – that with these in place democracy can but flourish.

But.

A friend of mine, a fellow medical student at the time, was the son of the first minister of the crown in the British Commonwealth to be convicted of fraud. It was purported to be a $5,000 bribe he accepted from a major corporation. I remember being puzzled by the smallness of the bribe. It seemed a paltry amount upon which to risk one’s career, family, reputation, livelihood. Some have whispered in that time-honoured conspiratorial manner that the $5000 was only the tip of the iceberg and what they could “get him on”. But I have come to understand that our individual sense of entitlement is so strong, so close to the surface, that it can be easily manipulated by the unscrupulous, or simply by our own grandiosity and narcissism. How else can one explain our vaunted Canadian senators hedging their expense accounts? Let’s face it. All it takes is a $50 gift and a letter extolling your brilliance and goodness. Just sign here.

So democracies are fragile. And not just those nascent democracies of Chile, Argentina, Brazil, Venezuela, Turkey. The old, established ones as well.

The foreboding elements are now in place: seriously unequal wealth distribution, increasing tribalism triggered by migration, mass media mechanisms for the dissemination of fake news, and, in the USA, a floundering public education system, competing religious extremes, the inevitable failure of the American Dream for the majority of Americans, a festering and historic racial divide, a warrior culture, a culture that celebrates celebrity above all else, a culture that is skeptical of experts, where many think the facts derived from science are simply opinions, a culture with rather simple notions of “good guys” and “bad guys”, a manipulated information system, and the election of Donald Trump.

Americans are at risk of losing their democracy. We are all at risk of war and economic collapse. I have no idea exactly how these events might unfold but I am sure they have moved from the impossible column to the quite possible column.

As well, it seems, surveys of the populations in several democracies find a growing percentage of people who think an alternative to democracy would be okay. Close to 50 percent say they could live without it. This laissez-faire attitude is especially prevalent among the generations who have only known democracy.

There have been a few moments since the election when it seemed that maybe this will be all right, we will somehow muddle through, when Donald is reported to have said something sensible, conciliatory, inclusive. But, for the most part he remains Donald Trump, and my fears are growing.

I won’t go over all that he has said and tweeted, the inordinate amount of time he has spent focused on petty grievances, watching SNL, celebrating his victory – or on his sketchy appointments, his lack of attendance at briefing sessions, his poking a stick at China and at the findings of his own CIA. But I would like to point out a few things he has said, and the way he has said them. For they are more telling. They are more telling about his level of narcissism, his tone-deafness, his lack of knowledge, and his grandiosity.

At a rally after congratulating himself on being named person of the year by Time Magazine, he commented to the crowd that maybe the title should be returned to “Man of the Year”. Eh? Eh? Apparently the crowd cheered.

When asked why he didn’t attend intelligence briefings, he answered, “I am, like, a very smart person.”

When being asked about answering the call from Taiwan, and then questioning why we have a one China policy, he said, “I won’t let China push me around.”

His ignorance is palpable even when he remembers a few catch phrases from a briefing by his people. But in theory he could learn. What is more frightening is the level of his narcissism and grandiosity revealed in those three quotations. This is a Shakespearean level of grandiosity and narcissism, the kind that leads a man to listen only to sycophants, to govern according to his own pleasure, according to his own ego gratification, and to bring the temple crashing down, to lay waste to his nation before accepting any slight, any blow to his over-inflated but fragile sense of self.

I’m afraid I only see three possibilities. The electoral college votes against Trump, precipitates a constitutional crisis, and stokes the American divide, or he is inaugurated, and then impeached, precipitating a constitutional crisis and stoking the American divide, or we all spend the next four years on the brink of nuclear war while watching regressive policies being put in place.

Dangers of Chiropractic Neck Manipulations

By Dr David Laing Dawson

Some years ago my father, then in his 80’s, suffered dizziness and syncope following a visit to his chiropractor. Now, I didn’t know he went to a chiropractor, or I would have been all over him before this. But this time, he had a neck adjustment and I found out because of the symptoms it caused afterward.

I made him promise to never visit a chiropractor again. I explained the anatomy of the neck to him, and the fragility of his arteries, cartilage and bones at his age.

When patients tell me they go to chiropractors I tell them, okay, but do not let them “adjust” you. Go for the massage, the muscle stretching. No adjustments. Especially the neck. Do not let them go near your neck. There are rather important things running up and down your neck.

Had my father died from his neck adjustment it would not have made the news. Because of his age we may never have known the cause. He lived till the age of 95 and died of cancer surrounded by his children and grandchildren.

But I see in the news a beautiful woman and mother (Katie May)  just died from a neck adjustment. She developed what she called a “pinched nerve” in her neck on a photo shoot and went to see her chiropractor who “adjusted” her neck. The adjustment tore an artery and she died.

Do not let chiropractors go near your neck.

Adjustments are nonsense procedures of course. And when it involves the neck, also dangerous.

What chiropractors tell you they are doing when they “adjust” your spine, they are not doing. In fact, they cannot do it. Or to put it another way, if they actually had the strength to force a shift in the alignment of your vertebrae, this procedure would be even more dangerous. It would risk the integrity of the spinal cord. But they don’t have  the strength to do that, except when the cartilage is brittle, the ligaments are old and infirm, the muscle wasted, and the bone is porous – as in aging. (Although I must admit there is a moment in many violent thrillers when one character breaks the neck of another in what looks suspiciously like a “cervical spine adjustment”.)

Those “pinched nerves” we talk about are seldom pinched nerves. They are inflamed ligaments and muscles from acute or chronic stress. The muscle may be in spasm. An acute muscle spasm can be stretched out as I do with my calf when I awaken in the night with a cramp, and trainers do on the football field. Other than that the inflamed, sore muscle or ligament responds to heat and rest, and, when persistent, anti-inflammatories.

That crick in the neck we get from sleeping awkwardly? Same thing. And left alone it will heal. There is no need for serious intervention. Especially interventions that are

1. Entirely bogus and 2. Very dangerous.

Charter Challenge To B.C. Mental Health Act Is Misguided

By Marvin Ross

Two B.C. patients have just launched a Charter challenge to the province’s Mental Health Act. The last challenge to a Mental Health Act that I am aware of was in Ontario where expanded civil commitment rules and the provisions of Community Treatment Orders (CTOs) were challenged. That was unsuccessful. A CTO is an order mandating treatment in the community.

The case in B.C. is a bit unusual in that it opposes provisions in the B.C. Act that are unique in Canada. The two plaintiffs are opposed to the rules that allow a detained individual to receive treatment without consent. The concept of the Act is that if you need to be detained because you pose a danger to yourself and/or others yet lack the capacity to seek voluntary treatment, then you should also be treated as soon as you are detained. That provision is one that makes the Act in B.C., in my opinion, superior to other jurisdictions.

The claim suggests that this forced treatment violates a person’s rights and that the person being committed should be able to help decide on the treatment they wish to have. However, involuntary committal only occurs when someone with a mental illness poses a danger and refuses to accept treatment according to the guide to the Act. (P11). If they recognized they needed treatment and accepted it, they would not be detained.

The plaintiffs argue that with physical illnesses, patients are allowed to make bad health care decisions, which are denied to psychiatric patients. But — and they acknowledge this — if someone is taken to the emergency injured and unconscious, it is appropriate that they be treated. When someone’s brain is so injured and incapacitated by their mental illness, they can be considered to be in the same situation as someone unconscious from a physical trauma. It may take them longer through treatment to reach a level of consciousness where they can participate in their treatment options but providing that treatment is analogous to treating the unconscious victim.

Many will likely disagree with my statement above but B.C. civil libertarian, Herschel Hardin, writing in the Vancouver Sun in 1993, gave an excellent explanation of that when he said, “Here is the Kafkaesque irony: Far from respecting civil liberties, legal obstacles to treatment limit or destroy the liberty of the person.”

He went on to say:

The opposition to involuntary committal and treatment betrays a profound misunderstanding of the principle of civil liberties. Medication can free victims from their illness – free them from the Bastille of their psychoses – and restore their dignity, their free will and the meaningful exercise of their liberties.

Ontario is a good example of the downside of committing someone involuntarily because they pose a risk of danger to themselves and then allowing them to refuse the treatment that is deemed necessary. This issue was discussed in a 2008 article in the Canadian Bar Review called Treatment Delayed – Liberty Denied . The authors demonstrate that attempts to safeguard autonomy by allowing involuntary patients to then refuse treatment has the opposite effect. It: “often results in subjecting them to prolonged detention, mental anguish, physical and chemical restraint, and solitary confinement.”

The most famous Ontario case is that of Professor Starson as he called himself as he believed he was a son of the stars (starson) and a professor. In 2003, the Supreme Court of Canada upheld his right to refuse treatment that had been proposed in 1998 (P 680 in Bar Review Article). After that decision, Starson’s delusion led him to refuse to either eat or drink for fear that his imaginary son would be tortured. By 2005, his health had deteriorated to such an extent that, fearing death, his doctors appealed to the Consent and Capacity Board who ruled that he could be treated. He began on the anti-psychotic medication that he was offered in 1998 and he improved dramatically. He lost seven years of his life as the result of his refusal to accept treatment [P 680-681 in article].

Three other patients like Starson were incarcerated from 5 1/2 years to over 10 with long stretches in solitary until they became so ill without treatment that they had to be treated to prevent death [P 713]. As with Starson, the three of them improved dramatically once they began treatment. One person who continued to refuse, Paul Conway, has been locked up for 25 years and, without treatment, he is unlikely to ever be discharged P 714].

The choice is agreeing to treatment when voluntary or putting up with it when involuntary and getting better in both instances versus being locked up indefinitely. I think the rational decision is treatment.

And, it should also be pointed out that there are protections for the involuntary patient at every step of the procedure. Those opposed to involuntary treatment imply by omission that once someone is locked up they remain so and lose all their rights. That is not the case in any jurisdiction.

Section 7.1 of the B.C. Guide lays out all the rights that the involuntary patient has upon being hospitalized. These range from the right to consult with a lawyer or advocate, the right to a second medical opinion, to a hearing by a review board, regular reviews of the committal orders and the right to apply for habeus corpus.

Involuntary committal and treatment is not something that is taken lightly by anyone or used frivolously but is only done in extreme circumstances in the best interests of the patient.