Dealing with empathy

Humans occur along vast ranges of characteristics and one of those ranges is the scale that has empaths and extreme altruists on one end and probably psychopaths on the other. They all have their pluses and minuses. Nothing is bad or good. Everything is both. There is good in bad and bad in good. Good and bad can’t even exist independently. They are expressed relative to each other, after all.

Do you know where on this spectrum you are? Continue reading

We need to reconsider our view of other species, urgently.

Read this story: https://www.thedodo.com/on-the-farm/starving-pig-shared-food-with-his-friends

Two pigs were rescued, one had piglets and was well and the other one was very thin. Rescuers were puzzled. Turned out that the latter had been giving most of the food he had to the other pig. To help the other pig survive.

We need to reconsider our views regarding other species, urgently.

Personally, I have seen small parrots stand up for cats.

How on earth did we “developed” humans manage to think for so long that other species have no cognitive abilities? No capacity for emotions? Mind-boggling. The more developed we become, the less wisdom we humans seem to have?

Traditional scientists have to stop being so damn pig-headed about this. To see the obvious does not make you stupid, silly or dimwitted.

How seeing problems in the brain makes stigma disappear

 

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A pair of identical twins. The one on the right has OCD, while the one on the left does not.
Brain Imaging Research Division, Wayne State University School of Medicine, CC BY-SA

David Rosenberg, Wayne State University

As a psychiatrist, I find that one of the hardest parts of my job is telling parents and their children that they are not to blame for their illness.

Children with emotional and behavioral problems continue to suffer considerable stigma. Many in the medical community refer to them as “diagnostic and therapeutic orphans.” Unfortunately, for many, access to high-quality mental health care remains elusive.

An accurate diagnosis is the best way to tell whether or not someone will respond well to treatment, though that can be far more complicated than it sounds.

I have written three textbooks about using medication in children and adolescents with emotional and behavioral problems. I know that this is never a decision to take lightly.

But there’s reason for hope. While not medically able to diagnose any psychiatric condition, dramatic advances in brain imaging, genetics and other technologies are helping us objectively identify mental illness.

Knowing the signs of sadness

All of us experience occasional sadness and anxiety, but persistent problems may be a sign of a deeper issue. Ongoing issues with sleeping, eating, weight, school and pathologic self-doubt may be signs of depression, anxiety or obsessive-compulsive disorder.

Separating out normal behavior from problematic behavior can be challenging. Emotional and behavior problems can also vary with age. For example, depression in pre-adolescent children occurs equally in boys and girls. During adolescence, however, depression rates increase much more dramatically in girls than in boys.

It can be very hard for people to accept that they – or their family member – are not to blame for their mental illness. That’s partly because there are no current objective markers of psychiatric illness, making it difficult to pin down. Imagine diagnosing and treating cancer based on history alone. Inconceivable! But that is exactly what mental health professionals do every day. This can make it harder for parents and their children to accept that they don’t have control over the situation.

Fortunately, there are now excellent online tools that can help parents and their children screen for common mental health issues such as depression, anxiety, panic disorder and more.

Most important of all is making sure your child is assessed by a licensed mental health professional experienced in diagnosing and treating children. This is particularly important when medications that affect the child’s brain are being considered.

Seeing the problem

Thanks to recent developments in genetics, neuroimaging and the science of mental health, it’s becoming easier to characterize patients. New technologies may also make it easier to predict who is more likely to respond to a particular treatment or experience side effects from medication.

Our laboratory has used brain MRI studies to help unlock the underlying anatomy, chemistry and physiology underlying OCD. This repetitive, ritualistic illness – while sometimes used among laypeople to describe someone who is uptight – is actually a serious and often devastating behavioral illness that can paralyze children and their families.

In children with OCD, the brain’s arousal center, the anterior cingulate cortex, is ‘hijacked.’ This causes critical brain networks to stop working properly.
Image adapted from Diwadkar VA, Burgess A, Hong E, Rix C, Arnold PD, Hanna GL, Rosenberg DR. Dysfunctional activation and brain network profiles in youth with Obsessive-Compulsive Disorder: A focus on the dorsal anterior cingulate during working memory. Frontiers in Human Neuroscience. 2015; 9: 1-11., CC BY-SA

Through sophisticated, high-field brain imaging techniques – such as fMRI and magnetic resonance spectroscopy – that have become available recently, we can actually measure the child brain to see malfunctioning areas.

We have found, for example, that children 8 to 19 years old with OCD never get the “all clear signal” from a part of the brain called the anterior cingulate cortex. This signal is essential to feeling safe and secure. That’s why, for example, people with OCD may continue checking that the door is locked or repeatedly wash their hands. They have striking brain abnormalities that appear to normalize with effective treatment.

We have also begun a pilot study with a pair of identical twins. One has OCD and the other does not. We found brain abnormalities in the affected twin, but not in the unaffected twin. Further study is clearly warranted, but the results fit the pattern we have found in larger studies of children with OCD before and after treatment as compared to children without OCD.

Exciting brain MRI and genetic findings are also being reported in childhood depression, non-OCD anxiety, bipolar disorder, ADHD and schizophrenia, among others.

Meanwhile, the field of psychiatry continues to grow. For example, new techniques may soon be able to identify children at increased genetic risk for psychiatric illnesses such as bipolar disorder and schizophrenia.

New, more sophisticated brain imaging and genetics technology actually allows doctors and scientists to see what is going on in a child’s brain and genes. For example, by using MRI, our laboratory discovered that the brain chemical glutamate, which serves as the brain’s “light switch,” plays a critical role in childhood OCD.

What a scan means

When I show families their child’s MRI brain scans, they often tell me they are relieved and reassured to “be able to see it.”

Children with mental illness continue to face enormous stigma. Often when they are hospitalized, families are frightened that others may find out. They may hesitate to let schools, employers or coaches know about a child’s mental illness. They often fear that other parents will not want to let their children spend too much time with a child who has been labeled mentally ill. Terms like “psycho” or “going mental” remain part of our everyday language.

The example I like to give is epilepsy. Epilepsy once had all the stigma that mental illness today has. In the Middle Ages, one was considered to be possessed by the devil. Then, more advanced thinking said that people with epilepsy were crazy. Who else would shake all over their body or urinate and defecate on themselves but a crazy person? Many patients with epilepsy were locked in lunatic asylums.

Then in 1924, psychiatrist Hans Berger discovered something called the electroencephalogram (EEG). This showed that epilepsy was caused by electrical abnormalities in the brain. The specific location of these abnormalities dictated not only the diagnosis but the appropriate treatment.

The ConversationThat is the goal of modern biological psychiatry: to unlock the mysteries of the brain’s chemistry, physiology and structure. This can help better diagnose and precisely treat childhood onset mental illness. Knowledge heals, informs and defeats ignorance and stigma every time.

David Rosenberg, Professor, Psychiatry and Neuroscience, Wayne State University

This article was originally published on The Conversation. Read the original article.

My latest lesson

I used to be against. Injustice, for example.

Then I decided that it was better to be for things than against things. More positive.

But you can’t be for the safety and well-being of children if you don’t also fight child abuse, which includes that you are against its acceptance in some circles and cultures. (As expressed by for instance a recent decision in Britain that child abuse victims by definition “consented” to their abuse if they were living in the same house as the abuser, and other nasty nonsense like that.)

Similarly, you can’t be for the creation of a better future if you’re not also against its destruction.

You can’t be for human rights for every human being if you’re not also against the taking away or diminishment of human rights of some people by some people (such as in the case of that abused apprentice who had the misfortune of working at a business with an approved abuse culture).

I see that now.

I am redefining myself as fiercely anti-abuse (etc) first and fiercely pro-flourishing (etc) second.

That is probably what I already was when I started out. I don’t like feeling angry, however. So I tend to avoid anger and tend to see it as something negative. But you can’t accomplish a thing in the world without anger. Ultimately, anger is what makes the world go round. Anger for instance makes people fight against (the effects of) abusive people in power, like Donald Trump, and fight for a better world.

Anger pushes people out of complacency and opens their eyes. And then it makes them decide to do something about what caused the anger and fight for what becomes possible without it. Anger makes people start food banks and raise funds for medical treatments in the presence of failing governments and corrupt politicians.

Anger is a tool that you can learn to use. The first step in that learning process is to stop avoiding and suppressing it so that you see how you can actually use it constructively. Anger makes people stop waffling and whining and begin to act instead. Anger is empowering. It is powerful.

Anger can therefore be very destructive (particularly if you suppress it and allow it to fester). That is the risk inherent to anger, and part of the reason why most people try to avoid it (and also why it’s generally seen as done for men but not for women).

That’s why you have to tie it to something else. Compassion, for example. Anchor it.

See, when you get angry, you have a choice. That choice is whether to let the anger make you act for good or act for bad. Whether to make a cake to throw into a politician’s face or to make soup to hand out to strangers on a cold street. Whether to start a mud-slinging campaign on Twitter against some public figure or start a fund-raising campaign for someone’s medical treatment, or heck, sponsor the pill for an American woman.

An example of fighting for justice and against child abuse:

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(“Wow, the Guardian and the Times not calling me a fantasist anymore after Conifer report”). For more, see for example:
https://www.johnglen.org.uk/news/my-statement-operation-conifer-report
https://jersey.police.uk/news-appeals/2017/october/operation-conifer-report-published/

However, “Even when people are unhappy with a state of affairs, they are usually disinclined to change it. In my area of research, the cognitive and behavioral sciences, this is known as the “default effect.” wrote Musa al-Gharbi in May in the US News on the likely reelection of Donald Trump. Today, the same prediction was made by a different medium.

People generally dislike taking responsibility. They don’t like stepping up. This is often connected to risk aversion. So they are angry, but don’t do anything with their anger. That causes stress.

Stepping up does not have to mean getting your face into the newspapers because of something you did or proclaiming that you want to rule the world. It does not have to involve huge risks. Stepping up can be as simple as driving your neighbor to the supermarket and back.

So to use anger, you have to look at your possibilities. If you don’t have a car, you can’t drive someone else to the supermarket. And I, for example, don’t have the power to vote against Trump or against Theresa May. So what can I do? And what can you do? Looking into that can force you to take other steps. Empowering steps. Steps that enable you to do something instead of nothing.

Here is another example of how you can use anger for good. (Don’t worry, there are five or so comments in Dutch but everything else is in English.) It’s an MTV video on Facebook that a Dutch cop showed a young woman who’d been using her phone while driving. He didn’t ticket her.
https://video-lhr3-1.xx.fbcdn.net/v/t42.1790-2/21718690_118651268834762_4211678555756560384_n.mp4?efg=eyJ2ZW5jb2RlX3RhZyI6InN2ZV9zZCJ9&oh=8055066e6214239bed7073acbedb51d9&oe=59D92C8D

 

Narcissistic personality disorder explained – very good!

The “very good” refers to the videos below.

I talked about this disorder in relation to Donald Trump, before. Please, do remember that persons with narcissistic personality disorder DID NOT CHOOSE to have this disorder. In most cases, something happened in early childhood while the person’s personality was being formed. (There is a video below about that.)

It’s my interest in bioethics in combination with a zen tinge of acceptance, among other things (including two personal situations), that is causing me to look deeper into particularly these personality disorders.

Bioethicist Julian Savulescu, for instance, advocates for removing essentially all disorders and diseases from the human gene pool, even when we can do a lot to prevent certain conditions or keep them under control (think asthma and air quality). A lot of what he wants is like demolishing homes to prevent that they ever burn down. He also is highly critical with regard to various personality disorders.

If you are able to be compassionate and keep in mind that the line between compassion and stupidity is very thin, you may find that dealing with a narcissist becomes much easier. Also, not everyone with narcissistic personality disorder has the affliction to the same degree or in the same way.

It is, for instance, possible to be friends with someone with narcissistic personality disorder. You have to be very steady on your feet and recognize every instance you’re being played so that you can stop each manipulative game before it starts (such as being told that you’re wrong, that red is black and then when you agree it’s black, being told it’s red).

Recognize the toddler part in narcissists when they behave like toddlers. Respond the way you would respond to a toddler. (Calmly.)

You also have to be aware of what may be happening behind your back (lies that are being told about you) and realize that if you try to talk to third parties about the disorder or about what is going on, YOU will sound like the “crazy” and “jealous” one. Can you handle that?

I am not recommending that we all become friends with narcissists, but they are a part of human diversity so we run into them whether we like it or not. Being able to deal with them well is better for everyone.

You can often choose how you respond emotionally to all sorts of occurrences and being able to choose how you respond can make a great difference. Often, you can either choose to get upset and feel victimized or shrug, smile and calmly carry on with whatever you were doing (or walk away). Understanding more about narcissistic personality disorder can facilitate this ability to choose your own responses.

The upside? Narcissists may all have a great sense of humor and no one can ever accuse them of being boring. Sometimes, you can actually learn from them, or from having encountered them.

The downside? They may have ruined you (your life) completely before you even know what hit you. Taking the zen approach of mentally letting go of what you lost and acceptance can help you deal with it and enable you to stay “whole” (but that is hard to explain without sounding shallow or even flippant or, worse, as an encouragement for accepting abuse).

Video 1: How to understand people who irritate or upset you

Video 2: Understanding the mind of a narcissist

Video 3: The emotion at the heart of narcissism

Video 4: The childhood origins of narcissism

Video 5: 5 key strategies for dealing with narcissists

Video 6: How the narcissist destroys your physical health

Video 7: 5 destructive fantasies empaths have after the narcissist has left.
(This is a video about lingering beliefs or ideas some people have after the breakup of a relationship with a narcissist.)

Video 8: The hidden emotion that makes empaths vulnerable to narcissists

Video 9: 7 traits of Narcissistic Abuse Victim Syndrome

Also, this happens when you ignore a narcissist, apparently:

Knowing how manipulation works is helpful too.

Below is an example of a behavior that narcissistic personality disorder can also result in, apparently. (Notice that no one seems to have realized yet that hackers can also have narcissistic personality disorder.) I am not sure yet how that comes about. Perhaps from the realization that in real life, relationships are too hard for someone with such a personality disorder?

I post the following from the work of Dr Lorraine Sheridan.

Typology 4: Sadistic stalking (12.9%)

Characteristics

· victim is an obsessive target of the offender, and who’s life is seen as quarry and prey (incremental orientation)
· victim selection criteria is primarily rooted in the victim being:

(i) someone worthy of spoiling, i.e. someone who is perceived by the stalker at the commencement as being: – happy – ‘good’ – stable – content and
(ii) lacking in the victim’s perception any just rationale as to why she was targeted

· initial low level acquaintance

· apparently benign initially but unlike infatuation harassment the means of intervention tend to have negative orientation designed to disconcert, unnerve, and ergo take power away from the victim

– notes left in victim’s locked car in order to unsettle target (cf. billet-doux of infatuated harassment)
– subtle evidence being left of having been in contact with the victim’s personal items e.g. rifled underwear drawer, re-ordering/removal of private papers, cigarette ends left in ash trays, toilet having been used etc.
– ‘helping’ mend victims car that stalker had previously disabled · thereafter progressive escalation of control over all aspects (i.e. social, historical, professional, financial, physical) of the victim’s life

· offender gratification is rooted in the desire to extract evidence of the victim’s powerlessness with inverse implications for his power => sadism
· additional implication => self-perpetuating in desire to hone down relentlessly on individual victim(s)
· emotional coldness, deliberateness and psychopathy (cf. the heated nature of ex-partner harassment)
· tended to have a history of stalking behaviour and the controlling of others · stalker tended to broaden out targets to family and friends in a bid to isolate the victim and further enhance his control
· communications tended to be a blend of loving and threatening (not hate) designed to de-stabilise and confuse the victim
· threats were either overt (“We’re going to die together”) or subtle (delivery of dead roses)
· stalker could be highly dangerous

– in particular with psychological violence geared to the controlling of the victim with fear, loss of privacy and the curtailment of her social world

· physical violence was also entirely possible

– especially by means which undermine the victim’s confidence in matters normally taken for granted e.g. disabling brake cables, disarming safety equipment, cutting power off

· sexual content of communications was aimed primarily to intimidate through the victim’s humiliation, disgust and general undermining of self-esteem
· the older the offender, the more likely he would have enacted sadistic stalking before and would not be likely to offend after 40 years of age if not engaged in such stalking before
· victim was likely to be re-visited after a seeming hiatus

Case management implications

· should be taken very seriously
· acknowledge from outset that the stalker activity will be very difficult to eradicate
· acknowledge that there is no point whatsoever in appealing to the offender – indeed will exacerbate the problem
· never believe any assurances, alternative versions of events etc. which are given by the offender
· however, record them for use in legal action later
· the victim should be given as much understanding and support as can be made available
· the victim should not be given false or unrealistic assurance or guarantees that s/he will be protected
· the victim should carefully consider relocation. Geographical emphasis being less on distance per se, and more on where the offender is least able to find the victim
· the police should have in mind that the sadistic stalker will be likely to:

(i) carefully construct and calculate their activity to simultaneously minimise the risk of intervention by authorities while retaining maximum impact on victim,
(ii) be almost impervious to intervention since the overcoming of obstacles provides
(iii) new and potent means of demonstrating the victim’s powerlessness (ergo self-perpetuating) and,
(iiii) if jailed will continue both personally and vicariously with the use of a network.

http://www.le.ac.uk/press/ebulletin/archive/speaker_sheridan.html

http://www.le.ac.uk/ebulletin-archive/ebulletin/features/2000-2009/2007/07/nparticle.2007-07-17.html

http://news.bbc.co.uk/1/hi/uk/6300291.stm

http://www.le.ac.uk/press/stalkingsurvey.htm

Charlie Gard finally at peace

Initially, it felt wrong to say much more about it than that. So I didn’t.

A day has passed.

Many lessons are being learned, and Charlie Gard’s life and death have not been in vain. I too will be doing a write-up. For the sake of future Charlies and future babies’ parents, but also for the sake – I hope – of all the people who were touched by Charlie Gard’s short life. Towards greater understanding, I hope. Towards more compassion, too.

(Personally, I primarily do it to learn from it and because I enjoy the analytical process and the reasoning. But all the people who write about these issues help pave the way to a future in which we deal with such situations much more elegantly.)

I too felt torn the way everybody else seemed to be torn, and I too generally responded more emotionally rather than rationally to what I read here and there, and I too, like almost everybody else, didn’t have many facts.

Charlie Gard’s condition fell within my definition – not my feelings! – of what constitutes a life not worth living. We need objective definitions to prevent inequality and injustice, and, more importantly, to prevent harm.

I also seem to have managed to define harm for situations like these a while back, and having let Charlie Gard try the nucleoside therapy does not appear to qualify as such within my definition (which I need to write up properly). Whether or not Michio Hirano had a financial interest in the matter is immaterial.

So I have a lot of thinking – and writing – ahead of me, but it looks like my definitions continue to hold up. That comes as a surprise. It makes me conclude that I may be doing something good and useful, something worthwhile exploring.

That’s scary – for several reasons – and powerful – empowering – at the same time.

I will soon post something about my own experiences with this kind of pain and suffering – the medical kinds of pain of suffering – in view of the fact that I say so many things about other people’s pain and suffering in such situations, in what may occasionally come across as a cold and calculated manner to some.

Solidarity and compassion

There are two kinds of solidarity. Exclusive solidarity is essentially protectionism. Groups rally to stand up for their own kind and do each other favors such as recommend each other and give each other jobs. It exists on the basis of what divides us, what makes us different from others.

Birds do this too. If you are observant and like being outdoors, for instance go for walks, you may on occasion have seen crows appearing from all sides and forming a circle around a crow attacked by someone’s dog. You can also occasionally hear a lot of loud cackling, look up and see a group of magpies around a cat that has climbed into a tree.

Inclusive solidarity, on the other hand, is much closer to compassion. It does not ask many questions and exists on the basis of what we have in common.

Birds do this as well. If for example you happen to have lived with certain parrots, you may be quite familiar with this. I adopted two quaker parrots in 1994 and they both stood up for my cats if they thought some harm might be happening to one of my cats, for example if I had to stuff a pill into a cat’s mouth and make sure the cat swallowed it, for a very good reason. This happened regardless of whether the cat in question was kind to birds or not.

Birds are capable of compassion because they appear to have something called “theory of mind” just like humans do.

I have seen one of my little parrots quickly step forward and snatch a bit of feces off the other bird. It was stuck to a feather. That other bird never even noticed what happened. This was an act of selfless compassion based on the first bird’s reasoning that she would not want to have feces stuck to her own butt and therefore the other bird probably wouldn’t like it either.

I have two kinds of confirmation for this.

In the past, I have seen that particular bird come running down a series of perches (in a huge cage) and then stop short to avoid stepping into fresh feces.

This particular bird was a pretty intelligent rascal who went through phases of pranks involving feces. For a while, she took great delight in pressing her butt against the bars of the open cage to help her aim and then pelt poop at my shoes whenever I sat reading in a chair near the cage, for example. Poopball. Goal! This means that the bird assumed that I would not like getting feces on me and also that she knew that getting feces on my shoes wasn’t so bad.

This bird has forever changed the way I look at birds. I used to see birds as completely devoid of anything resembling human intelligence. Birds flew, hopped and tweeted. That was it. Oh, and they laid eggs, too. Particularly the flying made me experience them as distant, I presume. Removed. Different.

I couldn’t have been more wrong about that.

I still remember the look that parrot – the longest-living of the two – gave me when I apologized to her for it having taken me so long to realize how intelligent she was. How stupid the two of them must have thought we humans were and how desperate they must have felt at times. “Is she ever going to get it?” She was a very wise one, that one. (She started showing me, by anticipating my moves and wishes and acting on them, all by herself. The first time that happened I was stunned.)

We’d all do ourselves a favor if we could focus more on inclusive solidarity and less on protectionism. I believe we’re slowly getting there.