It is a historical fact, and an abiding conundrum, that so many organizations dedicated to the slaughter of innocents have numbered Physicians among their most devout and murderous adherents. One can draw a line directly from Dr. Mengele choosing life and death at Auschwitz to Dr. Zawahiri choosing death for thousands at a whim. The Palestinians, the modern day masters of terrorism, have numerous Physicians among their leadership. Dr. George Habash (a Palestinian Christian who embodies the concept of "Identification with the Aggressor") led one of the most vicious and intransigent terrorist groups, the Popular Front for the Liberation of Palestine. Dr. Abdel Aziz al-Rantissi, a Pediatrician, was a co-founder of Hamas. The chinless Ophthalmologist, Bashar Assad, leads a government that routinely tortures and assassinates its political opponents. Now we learn that several, as many as 5 or 6, of the terrorists involved in the car bomb attacks in the UK are Physicians and the questions arise anew: What could transform a Doctor, someone dedicated to saving lives, into a monster dedicated to murdering innocents?
The New York Times, in their ever helpful quest to obfuscate, profess puzzlement over one of the Doctors, yet drop early hints in the article that the British were poor hosts to the immigrant Physician, apparently a Palestinian, born in Saudi Arabia and raised in Jordan:
A Surgeon’s Trajectory Takes an Unlikely Swerve
NEWCASTLE-UNDER-LYME, England, July 2 — Mohammed Asha, the Jordanian-trained doctor who has been arrested, though not charged, in the terrorism plots in the Britain last week, was proud of his career accomplishments but fretful about his welcome in English society, friends and acquaintances in Jordan and Britain said Monday.
In this town in the English Midlands where Dr. Asha settled, Simon Plant, 34, recalled in an interview that when Dr. Asha and his wife were interested in renting a modest red brick three-bedroom house last year on a cul-de-sac named Sunningdale Grove, Dr. Asha had a pressing question on his mind. “He seemed very concerned about racism in the area,” Mr. Plant said.
Mr. Plant said that it soon became apparent to him that Dr. Asha’s wife, who was arrested with him on the nearby M6 highway late on Saturday, had experienced racism in the community where the family had lived in Shrewsbury in Shropshire. “It was weighing on him,” he said.
The very tired trope that racism, or its modern incantation of Islamophobia, somehow explains anything about one's transition to terrorism, is the kind of non-sequitor that increasingly presses our MSM toward irrelevance.
During my Residency in the late 1970s there was a brief flurry of papers and conferences arranged to discuss what some thought was a new diagnostic entity. There was a fair amount of semi-scholarly interest in determining if the new type of patient we were seeing represented Pseudo-Schizophrenic Sociopathy or whether it was more properly understood as Pseudo-Sociopathic Schizophrenia.
At the New York VA Hospital, many of these troubling patients were young Vietnam Vets who were socially marginal, often drug and alcohol addicted, and seeking or maintaining Service-connected disabilities. For many of these benighted young men, their income from their SC-Disability, tax-free, dwarfed what they would have been able to earn from the entry level jobs that were the only things they were suited for. As a result, they had a very powerful interest in maintaining their disability status. At the time, the VA rules were such that the easiest way to maintain one's status as suffering from a SC-Disability was to be hospitalized at least every 6 months. Clearly, anyone who was hospitalized was severely ill and deserving of a disability.
We would typically see these people in the emergency room at the VA, often late at night, suffering from Command Auditory Hallucinations ("Voices") telling them to kill themselves. Coincidentally, these relapses almost always occurred 5 1/2 months after their previous hospitalization for the exact same symptoms. Luckily, the symptoms would resolve within a week or two, the patient would be discharged and we would see them again, (or hear from another VA ER in another county or state) 5 1/2 months later..
During this same time frame, at Bellevue Psychiatric Hospital, it was not uncommon to see severely disturbed people, often plagued by similar command auditory hallucinations, often suffering from drug and alcohol addicted, who suffered exacerbations when their services were cut.
Interestingly enough, whether at the VA or Bellevue, when a doughty Psychiatric Resident decided to resist what felt like obvious manipulation and refused admission, a predictable set of reactions occurred.
The defeat of the Comprehensive Immigration bill is the single most important advance for democracy in recent memory. While most commentators point to opposition tot he amnesty provisions in the bill as the impetus for opposition, in reality, amnesty was a minor part of the problem with the bill.
When the bill was first announced I wrote that I was provisionally in favor of a comprehensive bill but offered the caution that "the devil is in the details." At the same time I was fully aware that there was no way I was going to spend the time and energy to actually read the bill. Legalese is a foreign language that I have no desire to learn. It has always struck me as being unnecessarily arcane; of course, the same can be said of medicalese, so I should be measured in my criticism. In any event, I lack the interest and energy to learn how "sausages and laws" are made.
Two important developments occurred in the debate over the Immigration bill which will forever change the way Laws are made.
First, and most important, primarily because of the internet, people who had the interest were able to actually take the time and spend the energy required to read and understand the bill. They were then able to leverage their understanding via the Blogosphere to allow a multitude of engaged individuals to piggy back on their expertise.
Hugh Hewitt performed such yeoman work and when he pointed out that the fantasy of a comprehensive reform was not matched by the reality in the bill, I withdrew my provisional support for the bill. Nothing that followed caused me to change my mind a second time.
As the Immigration debate continued, with the powerful forces in favor of the bill using all their legislative legerdemain to escape scrutiny, they found themselves being watched and caught every step of the way.
The second key point was the not surprising revelation that not only had no Senator even read the bill but that most of them had no real idea what was in it. Once their ignorance was documented, the bill was finished. It is one thing to know intellectually that most bills are passed with little in the way of real debate or understanding by those poseurs who reside in Congress, but to actually be able to see, hear, and savor their ignorance, all the while they were protesting how much smarter and wiser they are than the hoi polloi, has been truly enlightening. The fact is that the American people, via their unelected representatives int he Blogosphere, understood the bill better than its proponents in the Senate.
Expressing opposition to Universal Health Care is a bit like opposing the Flag, Mom, and Apple Pie; it is generally seen as indicative of a cruel and cramped attitude toward the less fortunate. Furthermore, with the price of health insurance and health care acting as a major factor in the increasing anxiety of the middle class, such opposition is a political loser of the first order. Yet the American public is being sold a bill of goods when it comes to Universal Health Care. If Hillary Clinton gains the Presidency and is blessed with a Democratic Congress, the American Middle class is in for one of the great "bait-and-switch" scams of all time.
It is a useful approximation to consider the American health care system as a 3 tier system as follows:
Tier 1: The highest level of health care, with state of the art technology, pharmacology, and personal care, complete with continuity of care, exists for the wealthy and those who have very good insurance. This gold standard is the level of care afforded to our Senators and Congressmen and is very expensive.
Tier 1A: Available to those with good insurance, Tier 1A offers all but the very newest technology and the most expensive of new drugs. This is the level of care that most middle class Americans have been accustomed to; there are some trade-offs, especially in terms of continuity of care. As Doctors have become squeezed by pressures on reimbursement, they have aggregated into groups which decrease expenses but make it harder to obtain timely appointments with the Physician of choice. Thus far this has been a tolerable trade-off for most Americans. Of special note, when Medicare was initially introduced, it was a Tier 1A system; it no longer can be considered such.
Tier 2: Available to those with merely adequate, lower cost (though still expensive for most people) insurance, including Medicare and most managed care health plans, Tier 2 offers some assurance of timely care, very little continuity of care, increasing limits on cutting edge technology and medication, and features significant rationing via such limitations as well as via the administrative road blocks that effectively deny payments for a significant fraction of all claims.
Psychoanalysts tend to be naive and cynical in equal measures. We are naive in the sense that we always must greet each new patient and enter each new session without expectations. We follow our patient's associations without attempting to confine them with theory or history. At the same time we are cynical, in that we know that a person's conscious thoughts and motivations rarely are congruent with their unconscious desires. Much of our work is helping our patients see how their conscious thoughts and actions, reflect often contradictory unconscious desires.
Nowhere is this more significant than in our understanding of aggression. People typically fear their primitive aggression and defend against their awareness of the intensity and depth of their aggression as well as against the expression of their aggression. Yet it is a truism that unconscious impulses always seek ways to find discharge. It is not uncommon to see parents who are committed pacifists, who commit themselves to having homes which display no evidence of aggressive toys, raise children who are themselves aggressive and problematic; via the magic of unconscious processes which include identification and projective identifications, fantasy formation, primitive parent-child introjection and incorporation, among many others, the child becomes the agent for expressing the parent's disowned and disavowed unconscious aggression.
When our oldest was ~5, he often played with a neighboring child whose parents were ideological liberals and aggressively anti-aggression. This child owned no guns and wasn't allowed to play with toy soldiers, watch violent cartoons, etc; there were many other rules governing his play too numerous to enumerate. His parents were what one might refer to as "controlling" people (which is why we did not maintain a long term friendship.) We would carefully place our son's militaristic weapons/toys out of sight when this child came to visit. On one of his last visits, in his mother's presence, he quite cleverly took bites out of his grilled cheese sandwich in just such a fashion as to create a gun which fit quite nicely in his tiny hand; he proceeded to shoot everyone and everything in sight. His mother was quite apologetic, though I suspect managed in her own mind to blame us for her son's behavior. You will not be surprised to find that he was having some "issues" in kindergarten with aggression.
I have wondered for quite some time if this kind of projective identification is an aspect of the Left's fascination with, and (denied) support for, anti-civilization violence.
In 1931, the New York Times correspondent Walter Duranty wrote a series of stories about Stalin's Soviet Union which extolled the virtues of the young communist state. He neglected to mention the millions of Ukrainian citizens who died because of a state engineered famine or the litany of atrocities that Stalin has rightly become famous for in the eyes of history. Nonetheless, in a fitting tribute to the nation which gave us the Potemkin village, Duranty was awarded the Pulitzer Prize in 1932. Several years ago the Times missed an opportunity to redress their perfidy and decided to stand by Duranty's "reporting" and keep the Pulitzer Prize.
In the spirit of Walter Duranty, our the Times appears to be laying the groundwork for a celebration of the state of governance in some unexpected places.
The Modern MSM. at least minimally cognizant of the army of fact checkers in the Blogosphere, and certainly more sophisticated that their forefathers, create their Potemkin Villages in a more nuanced manner.
Seth Sherwood penned a lyrical paean, a verbal postcard, to Syria in the Sunday Times:
As I discreetly tried to photograph a Damascus sidewalk stand of militant Islamic religious posters — including the Hezbollah leader Sheik Hassan Nasrallah and his Kalashnikov-toting guerrillas — I looked around and realized that the young, rough-shaven salesman had spotted my camera.
“Where you from?” he said, in English, as women in headscarves battled for plastic shoes from an adjacent sidewalk dealer.
“New York,” I answered, lowering my lens and awaiting a tirade against my country — or worse. Instead, he broke into a smile.
“New York, great city!” he said. “Ahlan wa sahlan bi Sham.”
Ahlan wa sahlan bi Sham: Welcome to Damascus.
How delightful; they like us, they really like us!
Next week we will celebrate the birth of an idea that has sustained us for 231 years:
We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.
Our ancestors treated these precious rights as of the most profound importance, worth risking all for:
We, therefore, the Representatives of the united States of America, in General Congress, Assembled, appealing to the Supreme Judge of the world for the rectitude of our intentions, do, in the Name, and by Authority of the good People of these Colonies, solemnly publish and declare, That these United Colonies are, and of Right ought to be Free and Independent States; that they are Absolved from all Allegiance to the British Crown, and that all political connection between them and the State of Great Britain, is and ought to be totally dissolved; and that as Free and Independent States, they have full Power to levy War, conclude Peace, contract Alliances, establish Commerce, and to do all other Acts and Things which Independent States may of right do. And for the support of this Declaration, with a firm reliance on the protection of divine Providence, we mutually pledge to each other our Lives, our Fortunes and our sacred Honor.
Can anyone imagine any of the moral and intellectual pygmies in our government pledging "our Lives, our Fortunes and our sacred Honor" for anything?
Our cultural elites are only too ready to sell out our most precious rights in order to press their own agenda. Free speech, that is, the freedom to offend any and all, is under attack from the most primitive and vicious of troglodytes. Sadly they are all too often joined by the cowardly and frightened among the intelligentsia.
Senator Feinstein was on Fox News Sunday with Chris Wallace and her understanding of our constitutional rights are so susceptible to her fear of people hearing objectionable ideas that she is considering looking into corrective measures:
Continue reading "What Part of the Meaning of Free Speech Do They Not Understand?" »
It is a well known aspect of Psychoanalysis and Psychoanalytic Psychotherapy that assisting a patient to make fundamental change is an arduous task. You must first spend considerable time identifying and interpreting the various defensive maneuvers the person uses to avoid knowing those things they don't wish to know. Then, once the defenses have been interpreted, the hidden wishes must be revealed and explored, with all the conflicted feelings and thoughts that surround the unhappy desires. How the wishes and defenses are expressed toward the therapist must also be carefully explored, with attention to innumerable details and careful monitoring of the interaction between therapist and patient to avoid enactments within the therapy which can derail progress. With all that is required to create the conditions under which deep seated character traits can be altered, it is no mystery why the process can take a very long time; Psychoanalysts require a fair amount of patience as well as patients.
In almost every Psychoanalysis, there comes a time when progress stalls. For both patient and Analyst, these periods of time are crucial. Sometimes the patient/analyst dyad becomes trapped in a mutually frustrating enactment; once the stall can be understood as emerging from the patient's past relationships and the Analyst is able to extricate himself from his own contribution (counter-transference) it is very common to find significant and rapid progress follows. Unfortunately, there are also times when the lack of progress becomes extended. Days and weeks go by with little progress. Interpretations fall flat; the patient seems stuck in a patterned, predictable narrative. Often, the Analyst finds his attention wandering, searching for an entree into the constricted world of the patient. It becomes a frustrating time for both Analyst and Patient.
How do we come to the determination that the therapy has gone as far as it can? What determines that the plateau is merely a workable obstruction, worse in duration but not in kind from the usual impediments of any treatment, rather than a more definitive break down in the process?
These are very difficult questions and months can go by before an adequate answer emerges.
Each of us bring our own working models, paradigms, to our interactions; this includes our experience of the conversation of the Blogosphere. My paradigm is informed by Psychotherapy and Psychoanalysis. While I write primarily for myself, I also write with the hope of finding surprises and engaging in productive discourse.
What happens when the Blogosphere produces little in the way of surprise and minimal productive discourse? Are we in a plateau? Or are we running up against something fundamental in human interactions?
Amid all of the turmoil and tumultuous events of the last few years, what continues to be most amazing is what hasn't happened.
Following 9/11 almost all of us expected more terrorist attacks in America. While there have been incidents, they have been minor or have been discovered and stopped before they could come to fruition. Al Qaeda and its affiliates have conducted terrible attacks elsewhere, but none in America.
The other event that hasn't happened relates to the economy. For at least the last two years we have been bombarded with stories about the collapse of the housing market. Maxed Out Mama, one of the sharpest bloggers out there when it comes to discussions of the economy, has been worried for a very long time that we are overdue for a recession. Her latest take on conditions is disquieting:
The paper wealth in this economy is slowly getting eroded. Unfortunately, the response has been to package this stuff up in more and more complex vehicles, which allows everyone to pretend that they are holding paper that is worth considerably more than it really is. If you imagine what the impact on the economy would be if stocks dropped 20% in six months, you can get a handle on the scope of what is being discussed here. You cannot hide this stuff forever, and the cost of hiding it is mounting, scaring the street.
Yet, the recession which should have occurred hasn't yet. As MOM points out in her post, gas prices are a huge drag on the economy, though have not yet reached a tipping point. If the Middle East becomes embroiled in greater instability and war, how will the world react to $100 oil?
We are winning the battles in Iraq, but have a major party threatening to surrender anyway. Iran seems to be gaining in confidence as its allies advance in Gaza and Lebanon. Our government seems weak and vacillating, Israel's government appears even weaker, Europe is pre-occupied with their internal problems, and the West gives the impression that there will be no new strategic thinking done until after November of 2008; meanwhile the world is not planning on sitting still until we can overcome our passivity.
There is a sense that our Democracy is not functioning. Congress is held in the lowest esteem ever measured and yet our legislators continue to posture and preen rather than address crucial issues. The divide, however, is not merely rhetorical; both parties have incompatible world views, between them and within them. As a result, without a program that a majority of either party can rally around, our politicians are left with little option but to posture and preen. There seems little coherence in Washington these days.
Cognitive dissonance results from the conflicting feeling that we are on the cusp of traumatic change and a competing sense of hyper-normalcy.
Continue reading "Still Waiting For the Other Shoe(s) to Drop" »
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