The Women on the Right

By Dr David Laing Dawson

I am not puzzled by the heavy-set blowhard males who espouse the views of Briebart, Fox News, and the Alt right. I know them. I remember them. They were always loud, obnoxious, dripping with hostility, overcompensating for something: Didn’t make the cut for the football team, passed over for Prom king, snubbed by the prettiest girl in the school, not dumb but certainly not first in the class, never cast in the lead of the school play.

But I have been puzzled by the females espousing the same views. The Ann Coulters of our television. But then I think, maybe I’m being sexist. Maybe I expect women to all be kind, empathetic, generous, inclusive, self-effacing. There is no reason a woman cannot be as selfish and short sighted and loud as a man. After all, their bible was written by a woman, one Ayn Rand.

Okay, adjust your thinking David. A woman has just as much right as a man to be a Roger Ailes, a Sean Hannity, a Glenn Beck, a Bill O’Reilly. Women can be loud, obnoxious, and right wing too.

But my puzzlement has returned, for yet another Fox News commentator has been suspended for “lewd photos sent to female colleagues.”

My puzzlement is not about these men behaving socially and sexually as if their development was arrested at age 14. That goes with the territory. That is where they are.

It is all one and the same. Their sense of white male privilege extends to being lord of the jungle, having ownership of all they survey, and that includes the women folk. And their notion of courtship has always been to display plumage and induce fear.

But why don’t the women recognize this? They are not and will never be equal partners in this right wing endeavor. Hand maids, concubines, and incubators, yes. But not equals.

So I remain puzzled by the women. Unless, of course, they have a plan to get rid of all the blowhard males and take over themselves.

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Neo-nazis, thugs, and little boys.

By Dr David Laing Dawson

In our history psychiatry overplayed its hand. As the theories of Freud, Jung, Adler and others caught on, some psychiatrists and psychologists thought we might have something to offer society as a whole. Perhaps psychological intervention could reduce violence generally, and even prevent war and promote peace.

This was overreach. And we are all aware now, I think, that the tools of psychiatry/psychology are more apt to be misused by the state (The Soviet Union), the CIA, Casinos, and by marketing, or building a better soldier, creating brand loyalty, selling junk food to kids, keeping a scholar or athlete focused.

For the most part the profession of psychiatry retreated to being a medical specialty engaged in the treatment of mental illness.

I was thinking of this while watching neo-nazi Christopher Cantwell on his Youtube video. He was an organizer and marcher in Charlottesville, and then a social media hit when he alternately ranted and sobbed on a self-produced video, after hearing there might be a warrant for his arrest.

Why any young and not-so-young American (or German or Canadian for that matter) might proclaim himself a Nazi today is a puzzle. As has been pointed out, they did not grow up watching their fathers lynch Negros or blame Jews for a recession. Where on earth does this come from?

But watching the performance of Christopher Cantwell it occurred to me that I had seen this many times before.

Troubled boys between age 14 and 17. Some ADHD, some labile emotions, and some developmental/cognitive immaturity. Within a half hour they might talk prison talk full of expletive laden revenge, need for respect, blame, threaten, and then cry, weep, apologize to me and their mothers. There is a frightened little boy inside that would-be thug.

They are trapped developmentally, still children dependent on adults, angry their needs are not immediately satisfied, experimenting with male roles of toughness, power, strength, (often borrowed from gang, drug, and prison cultures), ultimately terrified of adulthood and its demands for skills and responsibility.

Most get through this. Good parenting, time for the brain to develop and mature, some boundaries and structures that promote skill building and confidence, more self-reliance, less blaming of others. Sometimes pills for either ADHD or anxiety or both are required.

That is where Chris Cantwell is. I don’t know how much he truly believes what he says, but he is still, developmentally, 14 to 17, at once angry, blaming, playing a macho role, labile and fearful.

So yes, good parenting, some accessible mental health services, the right school system, opportunities to develop skills and confidence, could reduce the number of young men who become neo-nazis, or terrorists for that matter.

When the Mental Health System Refuses to Listen

By  Maria Lorenzoni With Marvin Ross

Much of my writing on mental illness and the flawed system that we have to endure deals with privacy and the absurdity of keeping family and mostly parents in the dark about their loved ones diagnosis, treatment and progress. Maria Lorenzoni recently  gave this  edited presentation this past August to the Service Coordination Council on Mental Health and Addictions of the Central Ontario Local Health Integration Network (LHIN). The LHINs co-ordinate services in geographic areas.

She describes her families experiences with the secrecy of the treating officials and the impact that had on her family. Here is what she had to say:

Every serious sickness is stressful for family members, but caregivers of people with severe mental illness face challenges that are unique in some ways. Imagine for a moment that someone you love has been stricken with a devastating stroke and is in the hospital and can’t communicate, at least for the moment. Now imagine the doctors treating him or her and not giving you details of the diagnosis, prognosis, the exact information in their reports, or the treatment plan. Or just leaving you out of the picture completely. And then imagine the patient slowly recovering, but still not cognitively able to function properly, and perhaps unhappy that they are in hospital, and then being visited by a patient advocate to be informed that he or she doesn’t have to stay in hospital if they don’t want to.

You would argue that this is absurd.

According to a statement from the College of Physicians and Surgeons of Ontario, physicians can share information with others involved within the patient’s circle of care without asking for the patient’s consent if the doctor has no reason to assume that the patient would object.

Sadly, this does not apply to mental health!

In my case, it was only after three hospitalizations that I was able to press the family doctor to give me the diagnosis of my loved one. We finally got our son  into the Centre for Addiction and Mental Health and we were desperately trying to find the right meds and treatment plan. He doesn’t have insight into his illness, he doesn’t think he needs meds, so it took some hard work to get him to cooperate. And then, this vulnerable person that is in serious need of care is visited by advocates who tell him he doesn’t have to stay there.

Then what?

The onus is entirely on the family to persuade the person to stay in treatment. As a family member, you try to cooperate as best you can, BUT, you are not allowed to have any private discussions with the doctor unless the patient is in the room. Being spontaneous and giving some helpful comments is tricky when the person is right there. The doctors, therefore, make all their decisions based on communication with a patient who’s confused and will not share much because they don’t think they are sick.

He finally went to a Home for Special Care and was put under a team.  While we acknowledge the good work they did, there were a lot of misunderstandings and frustration due to a lack of communication.  No one is perfect, and families need to listen to constructive comments without being made to feel that they are just part of the problem.  In the time that he was there, we had three short meetings with the team , there were serious problems with reactions to meds, but we were not given input.  In fact, when I asked a question, I was told quite clearly…”look, you be the mother and we’ll be the treatment team.”  My family was shunned and made to feel that we were not cooperating, and in fact, we were discouraged from even visiting.

SO, POINT NUMBER ONE – family caregivers need to be able to give and receive information (unless there is a very clear reason not to), be given a diagnosis and prognosis, and consulted on a plan of action for the future.

SECONDLY, we definitely need a media campaign to focus on the obstacles faced by people with “hard core” mental illness. Sadly, the current campaign to destigmatize mentally ill is aimed at the people who have a more socially acceptable emotional problem like depression and who are in a position to ask for help. People are under the mistaken notion that everyone with a mental illness has easy access to good, consistent, hands on care. I’ve spoken to some in the health field who have asked me why my loved one isn’t in one of those residences that provide “professional rehabilitation”, and another health professional who recommended that I access a support group that helps caregivers with the tremendous grieving process that comes with caring for someone with serious mentally ill. They didn’t realize that there are no residences with professional staff, and while some support groups are good, none of them have a counsellor to help caregivers, and actually some of them are nothing more than lectures with information that you’ve read from a book a dozen times.

SO, POINT NUMBER TWO – we need to promote public awareness that people with illnesses like schizophrenia exist – that they are from every walk of life, they are people just like everybody else, they are not the dangerous individuals you imagine them to be and CONTRARY to popular opinion, they do not have easy access to services. Caregivers also need counseling as well to be able to deal with living with their loved ones on a day to day basis

NOW, THE THIRD POINT, and the most difficult, is the problem of housing. There are far too few residences and the ones that are available are overcrowded. A few are decent, others have low standards, and the people who live there are not in a position to stand up for themselves.

People with very serious mentally ill are most in need of supportive housing, yet they are the least likely to obtain it. They DO NOT GET MEDIA ATTENTION, AND DO NOT HAVE A VOICE. There is no easy solution, but with SOME BRAINSTORMING AND SOME PROPER REDIRECTING OF FUNDS, some pilot projects can begin to appear. Families would be delighted to help in any way they could, and IN FACT, THEY NEED TO BE PART OF THE PROCESS, so that a proper support system could be implemented.

I know so well that parents of adult children with serious mental illness are very concerned about the future of their kids and want to see them living in a place where there is hope, dignity and support.

If the public becomes more aware, and less afraid of mental illness, if there is more communication with families on the part of health professionals, more guidance and support for families and the hope for proper supportive housing, the future can be much more promising.

 

Trump’s Great Service to Americans – But Time To Go

By Dr David Laing Dawson

The unraveling of Donald Trump is nigh. And if it happens soon, and if the reaction he has provoked has staying power, then, surprisingly, Donald Trump will have performed a great service for America. Perhaps the reaction to Donald will bring about a better America.

Donald has brought to light the simmering racism, the unholy divide, and the hypocrisy that is America. It has always been there of course, addressed politely from time to time, but recently not so overtly, so publicly that it could not be ignored by others.

To be fair though, the credit probably goes equally to Barack Obama, for it may be this unusual sequence of a first black president, and a very good one, followed by a Donald Trump that so ignited the fires of white supremacists and then lifted the fog of denial from the eyes of liberals.

All of them, the KKK, the Nazis and neo-nazis, the white supremacists, they all quietly nursed their wounds and hatred during Obama’s eight years. Now Donald has set them free.

On Tuesday, August 15, off the teleprompter, peppered with questions, Donald Trump revealed Donald. He was of course full of himself, referring back to his successes, even to his riches, boasting of his holdings, taking credit for an improved economy, defending his first statement after the events in Charlottesville, even taking it from his pocket and reading it again, even shamelessly claiming he received praise from the mother of the woman killed.

He became combative with the press, calling them fake news, stating he is more attentive and truthful than they are.

But most of all this exchange revealed his brittle narcissism and the extent to which he cannot tolerate any criticism, any possibility that he may not be the smartest, the best, the most successful person in the room, that he may have been imperfect this one time. And it revealed how his ego overshadows any concept of country, democracy, history. Asked if he would visit Charlottesville he told us he owns a house and a golf course there, the biggest, thus demonstrating his confusion between being president of a democracy and the emperor of all he surveys.

And it gave us a hint of how mad (this word meant to be read both ways) he will become when he is finally cornered and dethroned.

Do it soon. Do it carefully. Do it with a safety net in place.

On Democracy

By Dr David Laing Dawson

In my childhood I took my birth certificate with me to sign up for a summer soccer league. Of course I lost it. There is a good chance I did not tell this to my parents. But three nights later we all responded to a knock on the door. Standing on the porch was a stocky man who proved to have a thick middle European accent and my birth certificate, a little grass stained.

I remember all this because he gave me a stern lecture about my birthright as a citizen in this democracy while I blushed under my father’s gaze. Although, in my defense it was either my father or my mother who allowed me to take this precious piece of paper on my bike ride to the soccer field in the first place.

Among many others I have been writing about the threat to democracy Donald Trump and his colleagues pose as they systematically undermine the Fourth Estate, the judiciary, instill unease in the citizens, point their fingers at immigrants, and undermine the people’s confidence in the electoral process.

But I did not think it would be so easy. Surely the very idea of free, regular, unfettered elections is sacrosanct in this American Democracy of which they are so proud.

Apparently not. A new poll finds that over 50 percent of Republicans would be quite happy to have the 2020 elections postponed if either Trump or the Republican Party suggested or requested this.

Wow. Should not their instinctive response be, “No way!”

So the groundwork has been laid. And apparently few Americans received the awakening I received in my childhood, a stern lecture from a man who escaped a tyranny, and who knew shortsightedness, indifference, and stupidity can lose a democracy but only bloodshed can regain it.

Fire and Fury

By Dr David Laing Dawson

Some years ago the person who oversaw both the men’s and women’s shelters in this city expressed his surprise that far more actual physical fights broke out in the women’s shelter than in the men’s.

But it did make perfect sense after we discussed it.

Some irritation would occur, expected when living on top of one another, and a man would verbally insult another man. Then a pattern of behaviour would unfold that was learned on the playgrounds of every public school, playing field and back alley, one that probably has genetic roots we can observe with our cousins, the apes and chimpanzees.

“Yeah, and who’s gonna make me?”

“You and who’s army?”

Chin thrust forward, the baring of teeth, the snarl, the threatened encroachment on the other’s space, insulting the other’s sexuality, his courage, his birth, his mother, name calling, dire threats for the future, the unfurling of plumage.

Other men (boys) would intervene pulling the two apart as they hurled their last insults at one another. Their assuaging words were always of the order of, “He ain’t worth it.”

This last part is important, for it is face saving for both antagonists. And an actual fight is averted. Life goes on.

In the women’s shelter, one would insult the other, and the recipient of the insult would hurl herself at the antagonist. They had not experienced the same playground socialization.

I am thinking about this because of Kim Jong Un and Donald Trump and the way war begins, and even those words of Tillerson and others, “It’s the only language Kim Jong Un understands.”

No. No. No.

Tillerson, your job is to put your arm around Donald Trump, pull him aside and say, “He ain’t worth it.”

Maybe no one can do that with Kim.

It doesn’t matter. All that matters is that one of the protagonists, these blustering would-be alpha males, especially the stronger of the two, gets pulled back.

“Donald, he ain’t worth it.”

Now if American leadership really was smart and confident, it could offer Kim some face saving device. “But we will look weak,” American leadership will scream. This despite the fact they have the capacity to destroy the world and we all know it.

Tillerson, you appear mostly sane to me, and a man who understands a few things. It is your job to pull Trump aside and tell him, “He ain’t worth it. You could take him easy, but it ain’t worth it.”

And would it kill you to promise Kim that you will stop flying B 52’s over North Korea and stop practicing war in South Korea if he stops testing A bombs?

“I Think Anthony Will Do Amazing.”

By Dr David Laing Dawson

In his brief sojourn in public life Anthony Scaramucci managed to provide hours of material for the late night shows and many columns of commentary by serious pundits.

It is all so troubling and disturbing. A man so obviously unqualified to be a Communications Director quickly drops the tenor of the office to the level of teen boy locker room talk in an under founded school system.

He has come and gone.

But within all the inaccuracies, lies, egoism, and stupidity of Donald Trump’s statements in an interview with the Wall Street Journal on July 25, this particular use of language stood out for me:

“I think Anthony will do amazing.”

There is a time in one’s development of intellectual and linguistic abilities when nouns and adverbs and adjectives get all mixed up, when the brain cannot yet formulate explanatory secondary clauses, and when the brain does not yet notice the misuse of words, catch this, and then explain further.

That age is about 13, 14, 15. (and younger than this of course)

13, 14, 15 is the age at which I hear kids use the phrase, “will do amazing.”

By 17, if they say “will do amazing” they catch themselves and explain further in a second clause, such as, “I mean, like, I think he will get really high marks.”

By university level they realize that the quality of being amazed belongs to the observer, not the doer, and the whole thing is phrased differently.

And all through the transcripts of recent interviews and off-the-teleprompter speeches it is clear Donald Trump does not catch his own absurdities, his own unfinished thoughts, his own deviations from logic, and his own outrageous boasting.

I hear the same from 14-year-olds in my clinical practice. By 17 or so, most have the ability to hear what they have just said, to notice when it veers from truth or logic.

My American friends, your president is a very narcissistic entitled 14 year old.

Though, I must admit, as damaging as he is to the reputation of America in the rest of the world, he may be less dangerous than many Republican alternatives.

Might I suggest a strategy to keep us all safe: Every other leader in this fragile world of ours should send Donald Trump an effusive Valentine card four times a year, at least.

Ignorance and Depravity Goes to Washington

By Marvin Ross

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

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

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

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

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

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

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

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

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

The Ministry of Silly Walks

By Dr David Laing Dawson

We are living within a Monty Python skit. I must try returning my dead parrot to a Pet store and see what happens.

The American Congress has just granted Charlie Gard and his parents resident status in the U.S. so that Charlie can “receive the first rate American Medical care that he needs”.

This is the same Congress trying to repeal and replace Obamacare with a plan that would eventually deny health care for 30 million Americans, many of them children.

Polio is making a comeback. Measles is making a comeback, thanks to the antivaxers. Cholera is sweeping through Yemen.

Today, a child with cystic fibrosis in Canada will live, on average, ten more years than the same child in the United States.

A doctor from the U.S. flew to England to examine Charlie. The money spent to fly him there and back could feed 10 starving children in the Sudan for a year if he flew economy, perhaps 5 years if he flew first class. Or bottles of clean salty water and a dose or two of tetracycline for thousands of cholera victims.

This doctor, who has been experimenting on rats, would like to try his therapy on a human. He guesses at a 10% chance of “some improvement”.

With the goal being “some improvement” and the odds only 10%, most placebos do better. And I am not sure what “some improvement” looks like with an infant who cannot breathe or eat on his own, has brain damage at the structural and cellular level, and is dying from an incurable progressive genetic disease involving the mitochondria, one of those essential bits in every cell.

As with much of American culture and politics, I guess this isn’t about health care, saving and improving lives, treating illness, preventing disability. It is about money, self-aggrandizement, career, and celebrity.

In another real life skit NASA has had to officially deny that it is running a child slave camp on Mars. Or was that a child sex slave camp?

And in an open hearing a Republican Congressman asks “if Mars was different thousands of years ago, could there have been a civilization on Mars?” The scientist on the panel tells him Mars was different billions of years ago, but there is no evidence of any civilization ever existing on Mars.

The chairman thanks the congressman and says, “Looking forward to finding what’s up there, for sure.”

This last statement is interesting. Besides the notion that Mars is “up there”, this chairman doesn’t seem to know that with probes, orbiting satellites, and rovers, we have been receiving information about Mars for over 40 years.

Donald Trump thinks the “biggest crowd that ever gathered around the Eiffel Tower” came to see him dine, shortly after he made the “best speech any president has ever made on foreign soil.”

Ground Control to Major Tom.

More on Families, Privacy And Suicide

By Dr David Laing Dawson

Much of psychiatry is about convincing people to do things that will improve their mood, their health, and their lives. Exercise, better diet, overcoming fears, taking necessary medication, stop taking harmful substances, go to bed earlier, turn off electronics, find balance in your life, join something to overcome loneliness, stop procrastinating, call a relative, tell your husband, plan your day, stop worrying about things you cannot control, take baby steps, take medication regularly as prescribed, go for blood tests, enjoy small pleasures, scream at someone rather than cut yourself….

It is not in the DSM V (I think) but we know “no man is an island”. We are social beings. Maybe not to the extent of bees and ants, but no less than chimpanzees. We are never fully independent life forms. Even a hermit has a relationship (albeit a distorted and contrary one) with the community and family he or she is rejecting.

We also know that the quick impulse to say to the doctor, “Don’t tell my family.” or “I don’t want my family involved.” is often derived from shame, guilt, a sense of failure, and sometimes the opposite, a genuine wish to not burden the other. This is further complicated in the teen and youth years by an ongoing negotiation with respect to power, control, individuation, responsibility. We also know in these years the adolescent often says, in the same breath, “I hate you. Give me a hug.” “Get out of my life. Drive me to the mall.” “Don’t tell my dad. Please tell my dad so he can protect me.”

And we also know that persons suffering from severe anxiety and depression develop a sort of tunnel vision that excludes broad levels of social awareness and understanding. “Leave me alone.” And people suffering from a psychotic illness often harbour delusions about family members. “She’s controlling me.”

So, absolutely, when the young person says, “Don’t involve my family.” professionals should explore this, and then convince the patient otherwise unless there is good evidence that keeping the family (parents, sibs) away will be ultimately better for this patient.