The policies sound good, and perhaps they would be, if not for the malignant intentions that motivate them.

That's right.  The single most best predictor of mental illness-- better than family history, better than genetics, better than symptomatology-- is being a foster child.

Texas data: 2004, 40% of the 32,000 foster kids were on psychotropics. 2005 it was, by age:

• 0-5: 12.4%
• 6-12: 55%
• 13-17: 66.5%

Do you understand the significance of this?  If you tell me every single person in your family, including your identical twin, has schizophrenia, I will not be able to tell you if you have it-- but if you tell me simply that you are a foster child...

I'm sure someone has an explanation that deals with 5HT-2a receptors, or the amygdala, or genes on chromosome 12, but:

"When two-thirds of foster care adolescents receive treatment for emotional and behavioral problems, far in excess of the proportion in the non- foster care population, we should have assurances that the youth are benefiting from such treatment," said Dr. Zito.

Damn right. But as I said in my Esmin Green article that failed to convince anyone, this will never really be explored because society doesn't have any other options.    If you don't call 16,000 Texas kids "early onset bipolar," does the system have a Plan B?  Jail, I guess.

In case you doubted, here is today's front page of USAToday: Economy's stuck, but business is booming at therapists' offices.

If that was the end of the story-- if people had social troubles and turned to psychiatry for help because of those troubles, it would be a good thing.  Get help where you can.

But the larger problem is that in going to psychiatry, their socioeconomic issues get demoted to "factors" and the feelings become pathologized.  Psychiatry doesn't explain, it identifies.  You're not depressed because you lost your house; you have depression, and one of the triggers is losing your house.  See the difference?

You'll say this doesn't happen all the time, maybe not even the majority of the time.  But even if it doesn't happen to a specific individual, it still happens to enough people that it bolsters  psychiatry's role as the necessary player in managing suffering of any kind.

A 20% increase in therapy visits will be interpreted by psychiatry as a 20% increase in depression and anxiety.  It will say depression has a prevalence of X, it will say it is underdiagnosed and undertreated, etc. And it will creep into the social consciousness that these are pre-existing diseases with triggers, not the consequences of external events.

Society needs that illusion, it needs that lie, because it has created unrealistic expectations in people and no way of fulfilling them.   Here's what a society looks like under the similar economic conditions, but without psychiatry:

The absence of hope

Today's popular frustrations over flat-lining living standards have been building for years. The recent boom, felt only by the already well-off, has done little to change that discontent. Labor unrest has been growing for months; violent protests erupted... corporate taxes will be raised and gasoline subsidies cut... The move was designed to take the steam out of boiling anti-government sentiment.

The above article, also from USAToday, has a slightly different title: Egypt's economy soars; so does misery.

Two psychiatrists, believe they have discovered a new, YouTube generation, delusion: believing you are in a secret reality TV show.

The article describes cases of people who believe they are secretly being filmed. 

"I realized that I was and am the centre, the focus of attention by millions and millions of people," explained one patient, an army veteran who came from an upper-middle-class upbringing."My family and everyone I knew were and are actors in a script, a charade whose entire purpose is to make me the focus of the world's attention."

The belief that they are being filmed certainly gives the person a sense of importance, or worth independent of and beyond the mundane life he lives in.  In other words, it allows for an inflation of identity without actually having to do anything.   Call it grandiosity

The patient added that he planned to climb to the top of the Statue of Liberty, and if his true love were waiting for him, the puppeteer strings would be cut. If she failed to show up, he would jump to his death.

Grandiosity is one explanation, but I submit that the important part of this delusion isn't the filming, but the "puppeteer."  The delusion isn't about self-importance, but rather an explanation for powerlessness.  I am being manipulated by the outside.  There's nothing I can do.

Consider that a delusion which enhances your importance might not be one you'd want terminated; but these cases have the termination of the delusion built in.

In "reality" (ha!) such cases are cognitive metaphors for maturity.  Only when you gain sufficient self-awareness and autonomy can you break away from the artificial, manipulated reality of adolescence.

"But these guys are 30 years old!"  Exactly.  Real adolescents don't need a delusion to tell them they're powerless.  But a 30 year old should be dealing with intimacy vs. isolation, but instead they're stuck back at identity vs. role confusion.

The delusion is the protection, not the empowerment.  It says, "don't worry, you haven't accomplished anything because the producers haven't put that into the script yet."  Ultimately, this YouTube delusion is the result of a fleeting awareness that you cannot choose your identity unless you back it up with actions-- that actions are identity.

When a narcissist has this awareness, he has two choices.  He can retreat into a protective delusion, such as this one; or he can convince-- read: force-- someone else to accept his identity even in the absence of actions.  "I am a tough cop!  Well, maybe not actually a cop, but if something went down in this mall, I could be like a cop, and that's just as good!"

You do not want to be the person the narcissist tries to convince.

And with good reason.

Making the internet rounds is a post written by Debbie Nathan, (Pornography: A Groundwork Guide and Satan's Silence: Ritual Abuse and the Making of a Modern American Witch Hunt) on what the government is going to do when computer generated child porn becomes indistinguishable from actual photos. 

Other than freak out.

Yes, you read that right.  Drink a big glass of OJ and put away your blotter paper, you won't need 'em in here.

Awesome, just awesome.

An article, over a year old, which must be posted again.

There isn't really an easier way to say this: that cavalier, simplistic attitude towards history; myopic beliefs which bypass logic or reason, supported only by intuition and faith; and a hatred of others who have a radically different perspective on humanity-- that's not Bush, that's us.  I'm not even saying this perspective doesn't have some merit; but know thyself, yo. 

Most of our enemies share a common social philosophy that, at its core, is psychic: don't trust any country where women are regularly more powerful than men; where individuals are more important than a collective; and where personal beliefs and freedoms trump historical identity.  Because that means that its men are weak, its individuals are selfish, and they cannot be trusted to act in the long term interests of their own people.  Rather than responding seriously to worldview, with equal fervor-- and it's so easy to do it-- the country has instead chosen to release this press statement: "Bush lied."

It is, to me, the most important article I have ever written on this blog. 

https://thelastpsychiatrist.com/2007/05/the_wrong_lessons_of_iraq.html

Please, read it, and pass it around.  It's happening now.

In CNS Spectrums, Dr. Rosenheck takes Dr. Marder to task for his suggestions that CATIE results are limited and flawed, and clinical trials may not be better than clinical experience.

The article must be very important, because it is labeled as a Communique, yes, just like the one that called for the normalization of relations with China and decreasing arms sales to Taiwan, which brought us the Beijing Olympics 2008.   Thanks, Mr. Nixon!

To the twenty-somethings out there:

Twenty years from now, when you look back on this year:

you had ideas

And you had youth and energy

you had interest rates so low they were negative relative to inflation-- you could borrow money at literally no cost.

and a ready made excuse in case of failure-- Oh, I was young then

and little responsibility, no family

You had the internet-- global distribution or marketing, for free
    information on anything, for free


And then the time passes.

At least you got your file ready for the promotions committee.  At least you got that summer job that'll look good on your college application.  At least you watched the whole season of Grey's Anatomy and only vomited twice.

I'm sure, in twenty years, it will have been worth it.

Stop trying to figure out what you want to do with your life, and just do something with it.

Parade Magazine asks the Best Of Us What Is Patriotism? and they answer:

McCain: Putting The Country First
Obama: Faith In One Another As Americans

As neutrally as possible, I look at the differences between the answers.

I.

This is the story of a boy, he just turned four, but he couldn't talk yet- nothing more than one or two words at a time, "mik" and "mo Nemo!" and that was it.  The worry was that there was something wrong with him, and everyone who discussed it never said the word Asperger's.

There are a million reasons he could have this speech delay, including but not limited to genetics, increased paternal age, thiomersal, elevated serotonin, or parts of any of those, but for certain it could not possibly be related to being bookended by an cooing pork sausage of a baby brother and a preposterously hyperverbal, parentified 5 year old sister.  and a father who was angry all the time because the junior partner is an idiot.

But at least mommy was for him, she got him, she was tender and strong and consistent and available, a brick wall between him and schizophrenia.

It took me longer to write this then it will to implement the changes.