Trump Trashes the Veneer of Civilization.

By Dr David Laing Dawson

Just as we humans always overestimate our memories and find ourselves regretting we didn’t commit to paper or snapshot yesterday or last week, we also overestimate the extent to which our actions are guided by thoughtful consideration and choice.

We are easily influenced, especially if the influence is playing to our rat brain, to centuries of old survival coding.

The crowd of ordinary people chant in unison, “Lock her up. Lock her up.” It is, of course, entirely irrational, a bit nasty, and quite contrary to all due processes of judgment and punishment that have developed within western civilization over the past 100 years. I scan the part of the crowd shown on my monitor and I can’t find one person who has chosen not to chant.

But then we already know this about humans within crowds and mobs and humans under the influence of a charismatic authority, even when that authority is self-proclaimed. It is a small percent that can resist at that moment, that can buck the trend, be contrary, who can ask themselves, “Is this right?”

We know this from history. We know this from the Nuremberg Trials, from human behaviour in times of armed conflict and occupation. And we know this from some simple experiments in social psychology.

And we also know that among us are a few who respond eagerly to license and sanction, the go ahead to unleash the beast within, to act on a simmering hatred. Again we know this from history and contemporary observation.

Though the assumption of free will and personal responsibility is a cornerstone of human society, it does not negate the reality of what is written above.

We know these things about human behaviour. All our leaders should know these things.

So, yes, when Donald Trump’s crowds chant “Lock her up.” and “CNN sucks.” and when he tells his people they should fear the caravan of “invaders”, and when he fails to condemn the Alt-right extremists or other tyrants, he is culpable.

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The Culpability of a President

By Dr David Laing Dawson

There are always men around, men from age 18 to 70, who are capable of committing hate crimes. These are boys and men who always blame others for their failures, infirmities, losses, inadequacies, and perceived slights. They harbour resentments. Their thinking is delusional or just this side of delusional. They may fantasize revenge, the settling of scores, the righting of wrongs. This particular disorder of personality will usually preclude successful intimate relationships, long term employment and even good friends – the very antidotes to distorted and paranoid thinking.

Isolated it festers, grows and deepens. “They are to blame.”

But usually such men don’t act on their convictions, their fantasies. At least they don’t act on them without some kind of encouragement, support, and sanction.

Unfortunately such encouragement is now readily available on internet sites. This was probably the source of encouragement that set the man off to driving his van into pedestrians (women) on Yonge street.

But for the man who sent pipe bombs in the mail last week, his move from anger, conspiracy theory and threats to action, the encouragement undoubtedly came from the President of the United States. In fact the word “sanction” fits in this case because the encouragement came from authority.

The call has been to “tone down the rhetoric”. That is too weak. Men and women in power need to know their words can foster peace and cooperation or they can incite violence. There are always some men who are waiting for just such encouragement, just such permission.

Donald Trump is not personally and specifically responsible for those pipe bombs, but he is culpable.

He needn’t “tone down the rhetoric”, he needs to “stop inciting violence”.

As I was writing this another delusional man committed multiple murders in a synagogue. His encouragement to act on his antisemitic delusion seems to have come from a social media site called Gab and alt-right conspiracy theorists, but the caravan of “invaders” moving through Mexico may have been the final trigger, and we all know how much Trump has hyped that fear, and, for that matter, threatened to send in a platoon of men with guns. “Screw the optics,” wrote this killer, “I’m going in.”

Trump’s remedy for this was more guns, armed security within houses of worship, before he was distracted by a baseball game and tweeting out a criticism of the manager for pulling the successful pitcher in the last innings of the game.

Nero came to mind.

 

Fear and Loathing from Washington

By Dr David Laing Dawson

Some years ago driving from New Orleans to Ontario I was cruising through the bucolic landscape of Kentucky when a talk radio show asked callers about guns. The first caller suggested buying many guns before the government undermined the second amendment. The second caller disagreed. It was ammunition they needed to buy before the government controlled the amount one could purchase. That’s what they would control, he asserted, not guns. And he was ready with his multiple guns and his great store of ammunition. He would be armed and ready on his roof top when those “terr’rists come over the hills.”

It wasn’t the American obsession with guns that struck me so much as the fear and insecurity. I tried to imagine a full company of Islamic terrorists crawling through the blue grass and over the rolling hills of Kentucky. Fear, insecurity, and a total lack of perspective.

More recently I watched some white suburban American women being interviewed. I think three were leaning toward the democrats in this coming midterm, while at least one was a Trump supporter. This was shortly after his “Horseface” comment. When asked why she supported Trump and by extension the Republicans, this woman’s answer was simple and heart felt: “He has kept us safe.” She didn’t say safe from what. Islamic terrorists, hordes of illegal immigrants, North Korean missiles, socialism?

Though I have compared Donald Trump’s brain to that of the less-than-average 14 year-old, there is some evil genius in this mix. Fear, insecurity, and a lack of perspective, perspectives of time, history, impact, and size. These are the characteristics of a population ready to give up on democracy and welcome a tyrant, and Donald Trump is feeding these insecurities on a Paleo diet.

A caravan of Hondurans approaches from the south, and Trump hypes them into a plague of biblical proportions and threatens to send troops to close the border. If you stand in the middle of them, he says, and look around you will see “Middle Easterns” and criminals. Asked for proof of this he boldly says, “There is no proof of anything.” – an ironic admission that he can say and proclaim whatever comes to his mind.

And then he says he is withdrawing from the nuclear arms control deal with Russia.

Now he is scaring me.

So the democrats need to develop some effective counter punching, rather than the platitudes I’ve been hearing. Here are a few:

“Only a horse’s ass would call a woman a horseface.”

“A few hundred or even a few thousand women, children and men from Honduras are not a threat to the American Way of Life. But putting troops on the border and children in cages is.”

“For God’s sake, any control over nuclear proliferation is better than none.”

”Stop dismantling the international agreements that have kept the world from total destruction since 1945.”

“Your anxieties are misplaced. It is not a few Hondurans that will destroy the US of A but climate change, income inequality, racism, isolationism, criminalization of the poor and mentally ill, and unwarranted trust in the Plutocracy of Donald Trump.”

See David Laing Dawson’s latest play on the moral dilemma of resistence

 

Interesting Times

By Dr David Laing Dawson

“May you live in interesting times.” is an old Chinese curse that places an interesting twist on the word interesting.

And these be they I think. And not just because the world’s most powerful nation has the world’s dumbest president, not because the digital revolution allows me to write this and send it to your phones, tablets and computers, and not because a space station orbits up above us, and not because we now understand there is really no “up” within our space time continuum and expanding universe.

But because the generations alive today can be consciously aware of both the beginning and end of our existence. And by beginning I mean the enlightenment, the industrial revolution, and the birth of science, public health and medicine, and by “end” I mean the ravages of global warming and nuclear conflagration.

My generation had grandparents who moved from horse drawn buggies to motor cars, and they had grandparents of their own who left the farms and migrated to the cities for jobs in the new factories.

Up until then the human population was rather stable, despite pestilence, tribal and religious wars, famine and hardship. For thousands of years and thousands of migrations the ecosystem sustained, and life went on. Short and brutal though it was for most. And then suddenly (a mere blink in the life of our galaxy) we find we have 7 billion people on earth, insufficient forests to absorb the carbon we emit, all 7 billion gasping for breath on a wee polluted globe with a rising temperature.

I now have grandchildren who will experience the true disasters of global warming and over population, and they may have children and grandchildren who will witness the end of times.

From start to finish a mere 10 generations or so. And we, I think, live within that unique middle space of being able to imagine, experience, hear about and read about the beginning, and being able to see and imagine the inexorable movement toward the end. Interesting times indeed.

Unless we somehow control population growth, ease it back to a sustainable 4 or 5 billion, find a way of reducing and absorbing carbon, and sweep Donald Trump into the dustbin of history.

But, speaking of Donald, I must check out those Cohen tapes about the payoffs to Stormy and that other playmate.

A Theory of Addiction

By Dr David Laing Dawson

My new theory about addictions, at least about the explosive increase in serious opioid addictions in the last few years:

I am well aware of the culpability of Purdue Pharma promoting Oxycodone, Oxycontin as “non-addictive”, coupled with an “academic” push to have doctors pay more attention to chronic pain, and then some sloppy prescription practices after acute injuries. And I am well aware that some addictions begin as self-medicating, usually self-medicating a mood or anxiety disorder.

I understand how hooked they are. How, once addicted, consciousness is reduced to getting that fix. Empathy is lost along with any ability to think beyond the fix and the avoidance of withdrawal. By that point there are brain changes and it is a disease.

And pockets of addiction can be found alongside unemployment, poverty and despair.

But this is 2018. Not 1932. There really is no shortage of easily acquired food, and despite the cries for more affordable housing for families, there really is no shortage of basic shelter for single men.

So why now are so many men sleeping on benches and on the hustle for drugs around the Sally Ann in my neighbourhood? And why is the otherwise fit looking man with his German Shepard dog willing to stand for hours in a cold drizzle at a busy intersection collecting coins from every tenth car that stops? And why on earth does anyone ever inject a substance into his vein that has a ?10, ?20 percent chance of killing him?

I have also had many clinical experiences of addicts, vague, unhappy, scattered in thought, pathetic in actions, but laser focused and energetic when it comes down to the moment of trying to persuade me to write a prescription. Tenacious, persistent, with far more stamina than I.

And here are two more seemingly unrelated bits of information: When we go on holiday our sense of well being peaks on day 8. It is downhill after that. Time to go back to work, we say, by day 12. And some zoos have learned that making the carnivorous animals hunt for their food, rather than just giving it to them, makes them happier and healthier. And the retired couple, free now of children, mortgage and job, free to roam in an RV. What do they always do? They get a dog, or two dogs to fuss over, look after.

We humans were not made for leisure. Our DNA tells us we need to hustle. We need to hunt for food, check the barricades, repair the roof, fashion the spear, dig the trenches, work for ten hours in the mine, or kitchen. We are programmed to be busy. And our busy-ness rewards us with food, safety, or some small achievement. (I am quite amazed how delighted I am when I manage to complete a New York Times Crossword puzzle and then cast it aside to look for a new one.)

Challenge, occupation, risk, reward, repeat. (note that this is the same sequence video games provide)

Our focus has been on the reward, the drug, swallowed, snorted or injected. We can make that safer with safe injection sites. We can eliminate the need for the hustle if we provide the drug. But what of the challenge, the occupation, the risk and the repeat? What of the need for the hustle?

My new theory is that these last few decades have removed the natural life challenges and occupations for more and more men, and that drug addiction provides just that. That is, it provides not just the reward (the drug) but also the challenge and occupation, the risk and repeat.

As do video games for the young man in his parents’ basement.

We can “treat” addiction, try to eliminate drugs, or provide the drugs legally, but how do we replace challenge, occupation, risk, reward, repeat as the robots take over all the work?

The Art of Psychiatry

By Dr David Laing Dawson

The Eyes, ahh, the Eyes.

Some years ago a psychiatrist asked me to see one of his patients on the ward of the mental hospital. She had been admitted in a state of psychosis; he had prescribed appropriate medication, and then later increased that medication, and now she sat alone all day, communicating with no one. Was the dose too high? Had he made her toxic? Should he stop the medication?

In her room the woman sat fully clothed on the side of her bed staring straight ahead. I introduced myself and talked with her. I sat beside her on the bed and talked to her. I received no answer, verbal or non-verbal. I looked closely at her eyes.

I left her room and talked with her doctor. Increase her medication I told him. He raised his eyebrows. No, I said, I’m sure.

He did so and the patient recovered, first in small ways, acknowledging the presence of others, and then talking, engaging, and plans for discharge were made.

Her eyes told me she was in a state of high arousal, not drugged at all, but rather in turmoil, flooded by fears and anxieties to the point of immobility. Her eyes were alive but focused internally.

It is easier to be a poet than a scientist when it comes to eyes. A nurse might say to me about a patient, “The lights are on but nobody’s home.” It is an apt phrase, so accurately describing a state of dementia. In early dementia the right image, phrase or music might bring that person back home for a while, but then she will leave home again, and, eventually, not return.

And then there is the stare of the true believer, aroused and focused, all knowing, all seeing. They are the same eyes one sees in delusional states. Perhaps they are daring one to challenge them. They send no signal of welcome, no invitation for discourse, no flicker of doubt. They are the easiest to imitate.

Boys on the ASD spectrum avoid eye contact, and when they are coaxed into making such “contact”, the eyes quickly touch and then slip away, as we do when we glance at the sun.

The girls, the ASD girls sometimes stare fixedly, unblinking. They make “good” eye contact we notice, but the dance is wrong, the movement static, the intent unreadable; my smile goes unanswered by her eyes.

The eyes of the man with schizophrenia are similar, but often flit from certainty to perplexity and back again, as if they are trying to decipher a very difficult passage in an ancient text.

Depression is always present in the eyes. The light is dimmed, the person home, but slow to answer the door. Sometimes they are hooded and dull, but other times, in agitated depression, fearful and searching.

And then mania. If it is an angry mania I sit low in my chair and make only fleeting eye contact, for fear of adding fuel to the blazing fire within my patient’s eyes. If it is a grandiose mania, I watch the eyes of delusion and true belief and wait for a moment of doubt, a shadow to cross those eyes, before I offer a comforting smile and some medication.

Smart Phones and Mental Health

By Marvin Ross

Can your smartphone usage predict your mental health? Silicon Valley seems to think so and millions are pouring into a start up called Mindstrong. The concept is that its “app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage — how quickly they type or scroll, for instance.”

The app has generated tens of millions of dollars in investments from people like Jeff Bezos of Amazon and one of the company’s executives in Dr Tom Insell the former head of the National Institute on Mental Health. He acknowledged that the app isn’t perfect but the CEO told STAT that it “could provide unprecedented insight into conditions like depression”. They also told STAT that it “can even predict how a person will feel next week, or at least how a person will perform on the Hamilton Rating Scale for depression — kind of like a weather app for your mood.”

There is one little problem with the hype for this company. The program has never been validated by independent scientists and none of the results from 5 clinical trials have been released. They did publish a pilot study of 27 subjects and presented a poster of that which states that this is feasible.

This project came to my attention while I was reading Bad Blood Secrets and Lies in a Silicon Valley Startup by John Carreyrou of the Wall Street Journal. The book deals with a long standing health startup begun by a 19 year old Stanford dropout. Elizabeth Holmes was afraid of needles and decided that it would be possible to perform all blood testing with just a small finger stick as is done with blood sugar levels. Her idea was that the testing could be done instantaneously and people could even have these units in their homes.

She patented the idea, set up a company and managed to raise sufficient funds to value her company at $9 billion. Members of her board included former US Secretaries of State George Schultz and Henry Kissinger as well as General Mad Dog Mattis who went on to become Secretary of Defence under the Trumpster and Rupert Murdoch. Along the way, she managed to get testing done with the US Military and two pharmaceutical companies but those efforts failed. She also had arrangements with Safeway and Walgreens Pharmacy chain.

Investors have lost over $600 million in the venture including over $100 million by US Secretary of Education, Betsy Devos, and the heirs to the Walmart fortune. The founder was recently charged with criminal fraud.

So, if I’m a tad skeptical about using smartphones to measure mental illness, there is a reason. First, let’s have the data subjected to peer review in reputable journals.

Conrad Black and Donald Trump

By David Laing Dawson

I made the mistake of reading an article by Conrad Black. I usually avoid reading Lord Black of Crossharbour (“on leave”) for I find his over-use of penultimate, supercilious, pretentious, swank, grandiloquent, Miltonian, show-offy adjectives very annoying.

But I did read his paean to Donald Trump, and then went for a bicycle ride to clear my head. But what should one expect from a man who gave up his Canadian citizenship for a Peerage in the UK, and once flew across the Atlantic to attend a costume party dressed as Cardinal Richelieu?

He refers to all immigrants entering the US through the border with Mexico as illiterate peasants and he thinks Donald Trump is the leader America needs. He does find Trump “grating” and that he takes “liberties with the truth”, but he thinks that Trump can make America Great Again, and by that I think he is referring to a degree of respect we all must show for the man holding the true weapons of mass destruction in his hand. And by “respect” I think he means fear. Donald does seem to be on track for making America a country we soon will all fear.

Of course, Conrad Black, as a man barred from entering the United States, may simply be, like so many others, currying favour with the one man who could and might pardon him.

And then I read another by Lord Black along the same lines but more of a dissection of the geopolitical game afoot. And I was reminded of an experience from 1964. Bear with me for a moment.

Our first year medical school class went on a weekend retreat with faculty. This entailed a 90 minute bus ride to a resort north of Vancouver. By chance I sat next to our Professor of Physiology. The Vietnam war raged and was about to expand. My companion on that trip had fled McCarthy era USA rather than testify against his colleagues, who might or might not have attended a communist party meeting. So we talked Vietnam.

I was 24 at the time, but worldly and cynical. I argued geopolitics along the lines that it was better for the two major superpowers, the two competing ideologies, to be squaring off in the jungles of Vietnam rather than in the skies over Moscow and New York. He disagreed. It was simpler than that for my professor, who must have been in his 40’s or 50’s at the time. For him it was simply immoral. It was immoral for Americans to take their guns, their napalm, their warships and their helicopters to Vietnam and kill people. It was simply wrong.

By the end of that trip I had concluded that if he could remain idealistic in his 50’s, surely cynicism in my 20’s was, at least, premature. It wasn’t long after that I found myself in a placard carrying crowd in front of the American Consulate chanting: “Hey, Hey, LBJ, how many kids did you kill today?”

But why I was reminded of this was because Conrad Black was writing with his usual elegance and erudition about the geopolitics of recent years, the new balance of power, the symbolic chess game played by nation states, and prognosticating about the geopolitics of the future. And it is this examination of geopolitics that I can hear from other politicians, commentators, advisors, other writers. And it reminds me of my self, age 24, arguing, albeit more naively, about these world events and shifts and movements and power struggles as if they are being played on large chessboards by giants, with the pawns and rooks representing a few million to a billion people. And talking about it and playing the game as if they experience, think about, Joseph Stalin’s famous observation as advice, rather than the cynical observation of a sociopath. “One man’s death is a tragedy; the death of millions is a statistic”.

My medical school professor could see beyond the geopolitics and the million death statistic to the terrified little girl fleeing the sticky horror of napalm.

The Bannons, Boltons, Millers, Trumps and Conrad Blacks of this world do not, cannot.

I do not want them to have any influence over myself or the lives of my children and grandchildren. We need to stop listening to them and focus instead on the little girl fleeing the napalm and the kid from Honduras locked in an American cage.

Trump, Dr Ford, and A Warning to Americans

By Dr David Laing Dawson

I wrote a blog before the 2016 election of Donald Trump titled “the mental and emotional age of Donald Trump”. I looked at a range of his behaviours and his speech patterns and considered the age at which such a behaviour would be typical for a boy or man, though not exemplary, not necessarily good, maybe even requiring some parental admonition, just typical. I arrived at an average of 14. Though some Trump statements required a pre-teen brain and some rose at least to 18 year-old jock talk.

A comment someone left on that blog was that I was being generous; it would have to be a particularly entitled and narcissistic 14 year-old.

More recently I listened to Trump mock the testimony of Dr. Ford and then go on about the threat the #MeToo movement poses for fine young men. He took on the voice of a boy talking to his mother about all the hard work he’s done, about being offered a great job, but all this is over because some woman he’s never even met is accusing him of things he’s never done. How terrible this is for men and boys.

I might run across a small group of 14 year old boys with one of them going on in this vein, and two might be laughing, though more at the outrageous display of disregard for propriety than the content itself; another two would be cringing, but unable to break the code of teenage boys to never be a “pussy”.

So the comment was fair. Only a nasty, narcissistic, and probably guilty 14 year-old could talk the way Trump so often talks.

Donald may be but a symptom of some other struggle in your country, my American friends, and I know you have some wide divides that need major bridgework, but he is doing damage to your country, more and more damage each day he has a voice.

They were laughing at him at the U.N. Much of the world is appalled by him and all he represents. He throws oil on your fires; he cozies up to nasty dictators; he is stripping the USA of any moral high ground it ever might have had; he is creating fizzures in your country it may take decades to repair. He has reduced political discourse to a schoolyard brawl and international relations to flea market bartering.

He represents you, my friends, and how we see him we will begin to view you. We don’t care how you see us, you may say, we are better than that. But there is a bit of psychology here you might not like. For gradually, whatever traits we assign to you, you will absorb, you will become.

This midterm you can show the world you are not all Trumpets; you can clip his wings and put him in a tail spin. Please do so.