Assuming his log was actually written by him, here is my best attempt at using it to answer the obvious questions.

Disclaimer: I never met him, didn't do an evaluation of him, etc.  Basing this entirely on the log.

An unsurprising number of adults don't care either way.

Michael Jackson's father gets interviewed.

You all are not going to believe this-- the answer is not completely narcissism.

I'm sure you've read The Catcher In The Rye.  Why is it called that?

And a few more that came to mind.

Comedian Todd Barry:

The guitarist for Third Eye Blind was on MTV Cribs, showing off his house.  He picks up a guitar and says, "this is my favorite guitar.  With this guitar, the songs just write themselves."  Yeah, sure.  Blame the guitar.

What are you telling me, that I can dodge bullets?

I'm telling you that when you're ready, you won't have to.

Don't worry, the word narcissism does not appear in this post.

Ah, finally, a post about science only, that doesn't offend anyone.

Whoops, sorry, that's my other blog.  In this blog, I write about how the parents cause autism.

The wrong question.

One reason why not having fixed and predetermined identities may be useful to us.

I can no longer find the link, but someone-- Us Magazine?  Entertainment Weekly?-- did a Most Memorable TV Moments, and the season 3 finale of The Hills was one of them.

They were right.

If, as I say, a narcissist is one who thinks of himself as the main character in a movie, then what about those who actually are the main characters in a movie?

Hold on-- not in all college students, and not all in college students, and not in all college students in all times...

Time Magazine's A Frosh New Start describes Vanderbilt University's $150M public works project to create an all/every freshman 10 dorm "Commons" where-- if I read this right-- they "will help first-years get acclimated to college life."

I suppose it occurred to no one that the "college life" these first-years are getting acclimated to is exactly the kind of artificial world of the Commons?

Previously heterosexual Callie becomes involved in a relationship with a female doctor, Erica.  But when they "do it," as Callie later describes to Mark Sloan, she didn't like it.

"It was not good at all.  I choked,  I just couldn't go down there, I tried, but it felt so weird..." 

[Mark gets up and leaves.  Where is he going?]

"Two girls getting nasty and loving it; that's hot.  One girl talking about how much it sucked, it's depressing.  And wrong.  Just wrong."

The article is actually called The Lengthening of Childhood, but somewhere sometime the other phrase caught on, which is a shame, because this phrase is much more accurate.

You know that 17 year old kid who thinks Obama is Muslim and Europe is a country and any girl that doesn't sleep with him is a slut?  I found someone dumber than him.  Wasn't hard, either.

And if you dispute that, I am coming over to your house, pants down and guns blazing.

(Original idea here.)

     Pearson's r = 0.943, that's amazing.
     Maybe CNBC viewers are exhausted.  But they're checking out, and if Professor Pearson has anything to say about this, VIX has to fall very soon.
     FYI, the VIX is at the highest point in 20 years.  Remember 800.  It is inevitable.
I'll write something funny, maybe about narcissism, for you all on Saturday.  You know, to go with the rum.

Updated 12 years later.

Marx was wrong: feudalism doesn't precede capitalism, it follows it.  And after feudalism comes this:



Welcome to 1600.

On the Late, Late Show With Craig Ferguson, a joke about "man-ginas," a few drug/DUI references, a Kristy Ally fat joke ("uses her swimming pool to cook spaghetti") and a homosexual reference.

And I think about how TV has changed, things unimaginable 20 years ago are routine now.   I guess they'll do anything to get the coveted youth demographic.

And then I think, wait a second...

This is what 46 year old Scottish late night TV host Craig Ferguson said Tuesday night:

The Jonas Brothers... I'm sure they're fine young kids, and their music's not for me, it's for young people, I understand that, but my point is-- they're kind of too clean. With the purity rings, symbolizing that you're saving yourself for marriage. Now, I'm thinking-- what kind of a rock star is this? What kind of a rock star is this?...

It makes me a little uncomfortable, it's a little sinister to me, when the teenage rebellion is controlled and sanitized by a big corporation. There has to be some rebellion, or else it's not rock and roll.

TV journalist Tim Russert, from Meet The Press, died yesterday.

Both Obama and McCain delivered a short speech to the press, around the same time of day, and both did it outside at airports.

They used almost the same words.  So what was different?

With authority.

The $253M Vioxx verdict against Merck is overturned.

(It was actually only a reduced $26M verdict, but since the media didn't highlight that fact when Merck lost, I'm following in kind.)

Meanwhile, A New Jersey court removed a $9M punitive damages award in another case, and upheld another Merck verdict in another case.

The court found no evidence that Vioxx caused a fatal cardiac embolus, because-- surprise-- there isn't any evidence.  At best we have an association, not causation, and it may be that the Vioxx itself has nothing at all to do with death.  (Though I realize that the law accepts association as evidence.)

The score is now Merck 11, plaintiff's attorneys 3.

Question: well, what are they supposed to do when there's some evidence that a drug poses a health risk?  Ignore it?

Answer:  who is they?  There isn't supposed to be a they at all.  (There it is again, the steady creep of social democracy, sister of narcissism.)  There's a chemical, it exists, doctors are supposed to know when to use it appropriately.  Not to mention it may later be discovered to have additional value (aspirin, thorazine, thalidomide, etc.) 

When you create a body to decide for doctors whether a drug is worth the risk, then you are saying you do not trust doctors to make this assessment.  Therefore, you do not need doctors at all, you need flowcharts.

Unfortunately, I'll admit, they might be right.

Really?  Was that the reason?

An article written by one of the test subjects in the Milgram experiments, and his explanation for why it happened the way it did.

He's wrong.

On the one hand, you have articles in the Economist saying people are spending less time at work and more at home, on the other hand Time writes about the sex-starved wife.  If they're both home more and at work less, why aren't they naked?

The answer isn't porn.

In which appears the phrase, "the sticky pages of the New England Journal."

The article that has infuriated everyone, that no one will read.

ABC News, and others, report that the NEJM study found that antidepressants "may be duds." 

Climb on the bandwagon, my bolsheviks, no brakes, no driver, let us see where it takes us.

Apparently, yes.

A diagnosis of borderline personality disorder could, theoretically, mean that the psychiatrist made a serious attempt at evaluating defense mechanisms and ego integrity; or at least a matching of symptoms to DSM criteria. It's theoretically possible, yes. Other things that are theoretically possible include alien abduction, peace in our time, dual eigenstates, user friendly Movable Type upgrades, political discussions that don't rely on information from John Stewart, Daleks, recession with low unemployment, Independents, Madonna/whores, a benignly rising Russia.

 

 

The quote, "what hath God wrought" comes from Numbers 23:23, about the Israelites, but it was popularized by Samuel Morse when he sent it as the first message over the telegraph.

I've been telling everyone who will listen to buy Google-- it's up 140 points since I wrote about it a month ago-- because it is more than an investment, it is a paradigm shift.

 

 

 

So I read it.  

What is striking is how little it resembles the book everyone seems to think it is.  

Has anyone actually read this book?  Nine people total, all literary critics?

Enough has been written about the book itself.  A more interesting question is why so many people got it so wrong.  

 

(This is Part 2-- click to read Part 1) 

If you behave badly because you know you'll get away with it, that's being "bad."

A Moral Hazard is different.  If you behave "worse" than you would have otherwise, solely because you know that you won't have to bear the consequences, then you have a Moral Hazard.

I'll emphasize: the key is that your behavior is in itself not necessarily "bad."  It is simply worse than your behavior otherwise would have been, because you know there won't be consequences. 

Here's why it's called a Moral Hazard: if there are no external consequences, the only thing that would prevent you from behaving worse is an internal set of rules.

Where do these internal rules come from? 

 

We meet at our regularly scheduled Monday lunch spot, and my friend says, "did you see the Sopranos finale?"  No.   "It sucked, nothing happened.  It was completely unsatisfying.  It just ended with him sitting in a diner, eating with his wife."

"What did you expect would happen?"

"I don't know, something, some closure.  Maybe he gets whacked or something."

"How did it end?"

"He's just sitting there, eating an onion ring, and Journey's playing, and suddenly it ends. Like the film  broke.  And they go right to the credits."

I had never seen an episode of the Sopranos, but I knew at that moment that Tony Soprano had died.

Before I explain, I'll tell you that last night, drunk at a hotel bar around midnight, there was The Sopranos on the TV above me.   It was the last five minutes, but I recognized it immediately from my friend's description.  Tony sitting in a booth, his wife slides in and he gives her a grunt-greeting reserved only for the most familiar of contacts-- beyond love or friendship-- then another guy comes over and joins them.

Meanwhile, suspicious characters abound-- the Member's Only jacket prominent, a signal of belonging vs. exclusion; his daughter trying to park the car-- figuring things out on her own, she'll get it eventually--  and, of course, Journey's Don't Stop Believing.

And, like my friend said, the show simply stopped.  The bar I was in had been silent-- but a collective groan arose when the credits rolled.  Everyone hated it.

I was right.  He was dead. 

I knew he had died because I knew my friend.  He is a human being living in our times, possessing an element of natural narcissism common to all of us.   Remember, the narcissist believes he is the main character in his movie.  This is why they-- we-- have such trouble with death.  In any movie or show, even when the main character dies, the movie continues (the movie never ends/it goes on and on and on and on). It is still about him-- you see the reactions of other people to his death, you see consequences.  

But in reality, when you die, it ends.  There's no more; you don't get to see the reactions of other people to your death. You don't get to do anything.

I knew Tony Soprano was dead because it was too abrupt, too final, for my friend, and for everyone in that bar.  There was no denouement, there was no winding down, no debriefing, no resolution.  Not even a struggle for survival-- at least let him draw his gun! No death on your terms.  And, most importantly, the death didn't seem to flow logically from the show.   The death made no sense, it was arbitrary.  It was unsatisfying.

In other words, it was too real. 

We all have an element of essential narcissism in us, that's part of having an identity.  But it alters our relationship to death. We want it to flow logically from our lives, and most of the time it does.  But sometimes it doesn't.  Except for heroes and suicides, no one gets to choose the time and place of their death, nor the manner.  Nor can we control people's reactions to our death.  

All we can do is choose the life we leave behind.  Choose.

 

 

 

 

Don't ask me about Iraq.

But I do know something about our collective response to the Iraq war, to the Bush presidency, and to our times, and it says a lot about our cultural psychology.  And it helps predict the future.

It's sometimes easier to evaluate one's personality, and thus make predictions about it, by examining the defense mechanisms the person uses.  In difficult situations, specific people will use a small set of specific defenses over and over; so much so that we often describe people  exclusively by that defense, e.g. "she's passive aggressive."

Taking Iraq and President Bush as starting points, and examining the defense mechanisms we use to cope with both, yields the unsurprising conclusion that we are  a society of narcissists.

While this discovery is familiar to readers of my blog, what might be a surprise is what this heralds for our society politically and economically.  It isn't socialism, or even communism, as I had feared.  It's feudalism.  It's not 2007. It's 1066.

Let's begin. 

 

A reader commented that I was minimizing porn's negative effect on women, that ubiquitous internet porn has damaged womens' psyches irreparably.  That it makes women have to conform to some impossible standard.

Nay.

Porn is not the problem.  I'm not saying it's a tremendous boon to society, but you can't blame porn for failing relationships, the pressure on women to attain impossible standards of appearance and performance; and male disinterest in normal sexual relationships.

Certainly porn puts pressure on women, but the effect is not directly from porn, or even from men.  Here's an example that the reader offered: porn forces the women to shave.  Not exactly-- they want to shave.  Why they want to is a cultural discussion, but it isn't because men are explicitly commanding them to do so.

Certainly, porn has affected men.  Ok, women want to shave; why do men suddenly want to, also?  And, I'd expect that a frequent porn user (whatever that exactly is) might have some difficulty with arousal in normal (or repeat) circumstances.

But there's a greater problem that can't be blamed on porn.   Every comic since Marx (Groucho, not the other nut) has joked about how men want sex and women don't.  But in the past three or four years, I've heard comics make the opposite jokes: women want it, men could just as easily pass it up.  Men are disinterested in sex with their established partners.  As comic Mark Maron put it, "[I prefer masturbation because sex] takes up too much energy and it involves other people."  Men always are ready for new women,  but what happens to sex with your partner over time?  Sure, ordinarily it may decline a little, but this is different: this is male disinterest, "lack of energy," lack of motivation to keep a connection with one's partner alive.  The penis may still go up-- but everything else is gone.

Let's face it, porn may make women feel inadequate, but how the hell adequate can a woman feel if  her boyfriend/husband would rather watch TV than have sex? "But I'm tired."  How tired could you possibly be?

So there are two parts to the problem.  The easy, and smaller, part is media/porn objectification of women, and its effects on women and men.  But the second, more crucial part is male "impotence" (metaphorical) and apathy.   Let me be clear about this: porn might magnify this effect; but it doesn't cause it. 

I know no girl in the world is going to believe this, but it's true: if you ask the average guy over 30 if they'd rather be with a girl they have been with many times before or masturbate, they'll pick masturbate.  You know why?  Because their soul bailed out when they were 15-- because they are  narcissists.  What in life is worth aspiring to?   You don't feel a part of anything bigger, everything seems distant, unreal.  Everyone is waiting for something to happen, for their life to "start"-- they're 40 and they're still waiting.  (As Mike Birbiglia joked, "I'm not going to get married until I'm absolutely certain nothing else good can happen in my life.")  Concepts like loyalty don't even get a token nod, because today they seem outright preposterous. 

And men have a distorted view of what it means to be loved.  They want to be loved not for who they are, but who they think they are.  "I'm an actor."  "I'm a major force in WoW."  "I'm a fiscal conservative but a social liberal."  What he wants is his girlfriend to say, "I love him because he is such an intellectual, he knows so much about politics."  What he doesn't want is her to say, "I love him because he's good to me."

"Sure it'd be better to be with a girl, but when are you actually ever with a girl?  They don't want you, they want what you represent-- a good job, security, to be taken care of, a big penis."  It doesn't occur to them that the woman who doesn't want these things in her man might be the one to avoid?

I suspect-- I haven't been able to do the survey-- that even sex is a form of masturbation for these guys. That they see you, but they don't see you.  The arm, the breast, the hip, all these become fetishized and transport him to another world.

Our birth rate is 2.1; France 1.7; Spain 1.3; Russia 1.3.  In two generations, there will be 1/2 as many Spaniards, excluding immigration.  We can't even get it up long enough to procreate.   That's not porn's fault.  It doesn't help, sure, having the internet's tubes tied isn't going to fix that problem.  Men are becoming less interested in establishing meaningful relationships with other people as an ultimate goal than in inventing identities for themselves.

A few weeks ago I had used a Lost storyline to explain  my own view that we pick our own identities, rather than have them given to us through either genetics or the environment.  I made Desmond the Abraham in Kierkegaard's Fear And Trembling.

The crux of the episode and the analogy is that Desmond thinks he can see the future, and see that Charlie will die.    But Desmond then makes a vital moral step: he decides that it is also his responsibility to keep this character alive. (Quoting myself:)

The real question is why Desmond actually believes such a choice exists.  How does he think he knows the future?   Anyone else in his shoes would have come to a very different, more logical, conclusion: this is insane.  What, he can predict the future?  Worse: what, he's the only reason Charlie is alive?  He's so-- necessary?  Isn't that narcissism?

If Desmond knew he could predict the future-- if it was a fact that he could predict the future-- then saving Charlie would have little moral heroism.  Any fool a step up from absolute evil would have tried to prevent a horrible outcome if he knew for certain what was going to happen.

What made Desmond worthy of admiration was, exactly, that he did not know for sure he could predict the future. He took it on faith that he could, and then proceeded to live his entire life based on this single, faith based, assumption.

 

That was Feb. 15.  Strangely, I just saw last week's episode, in which Desmond turns out to have once been a a monk, and he has a discussion about Abraham and Isaac with another monk; the wine they make is named Moriah; and later Desmond explicitly references the test of faith-- straight out of Fear And Trembling. 

I suppose this could be a coincidence. 

Another possibility is the writers read and and love this blog and have gone and reshot future episodes based on my ideas.  HA!

Another possibility is I write for Lost.  HA HA! 

But the final possibility is the most likely, and it has less to do with Lost and more to do with the direction of our fiction.

Pre 9-11, fiction, and especially sci-fi, had a distinctly post-modern flavor.  The main character wasn't really a person, but reality-- that it was wrong, or hidden.  This culminated in the Matrix.  The important concept wasn't altering reality for some purpose; it was that reality itself was a fabrication, the Demiurge hiding real reality behind a fake one.

The story goes that Darren Aranofsky (director of Pi) and Jared Leto walked out of the Matrix and asked, "What kind of science fiction movie can people make now?"  The point was that the  postmodern slant, cyber-realities, etc, were done as well as they could be. So, too, CGI.  From now on anything else would be coattail riding. (Think how Pulp Fiction degenerated into Go and 2 Days In The Valley.)  The genre was finished.

So what's next?  Well, for Aranofsky the answer was the mind (see The Fountain), but I'd suggest an even broader answer: ideas.  The next genre of sci-fi, or fiction- has to be about the conflict of  ideas, identities.  

If I was going to write a novel-- and who says I'm not?-- I'd take advantage of our societal narcissism, our search for identity-- and, more importantly, for excuses why we have certain identities; our fear of death manifesting as age-postponement; and the decline of truly meaningful relationships to write a sci-fi novel about what really keeps us linked to each other.

The operative question would be: if you could be anyone, had unlimited power, what would be the ethical system you use to make choices?  Who lives, who dies, who suffers, who doesn't?  How do you decide?

The first element would be Faith.  So, with a parting wave to postmodernism, the protagonist can see the future or alter reality, except that he's not sure he can do this.  Worse, every time he alters reality by avoiding a future he has supposedly seen, he creates a new future he didn't predict-- but this is, of course, no different than normal life.  In other words, by avoiding the future he predicted, he negates the proof that he saw the future.  So he has to have Faith that he has this power, in the absence of any evidence. The protagonist of my book won't have any objective evidence that he is right or doing the right thing, he simply will have to believe, to decide, that he's right.  It has to be identical to, say, psychosis.

In Lost, Desmond still has objective evidence that he predicted the future, even though it gets altered; he sees an arrow; they did talk about Superman; the parachutist looked the way he foresaw it.  So this isn't exactly a leap of faith.  Similarly, if Abraham really knows God exists, then sacrificing Isaac isn't wrong or even strange-- God wants, God gets.   

Unlike Desmond, who has to decide only if he should save Charlie, my character would have to both decide he can see the future, and also that it is his responsibility to act on it.  This brings us to:

The second element, Duty. In making these decisions and accepting these beliefs-- altering reality along the way-- he'll have to establish a hierarchy of good and bad.  What is he supposed to do?  Does he have any duty towards anything?  For the plot, this will require some symbol, metaphor.  A good one might be a piece of jewelry-- some object which changes depending on the chosen duty. It's a ring, it's a sword, it's a bandage, etc-- it's the same "object" that he carries, but it changes.

The third element is Rage. When you believe something that no one else believes-- especially if you believe you are somehow better, or even different, than others; and if others directly oppose you in this belief, the inevitable consequence is rage.  How to depict this?

The fourth element is Love. The negating force for Rage.  This character will need to identify what he loves, and how-- platonic, romantic, etc; a plot-trick might involve altering reality and therefore altering the character of his love (for example, a woman he loves may later become his sister, etc.)

To make the reader share the magnitude of the protagonist's Faith dilemma-- in order to ensure that the reader does not "suspend disbelief" and automatically buy into the protagonist's powers (the way we have with Desmond,) you'd have to write the book from the perspective of a second character, who describes the story of the protagonist.  You should never actually get to interact directly with the protagonist, you should never actually hear him speak, only this second character.   This way, you're never sure what to make of the protagonist or his adventures. 

Preliminary thoughts, anyway.  Looking forward to the next Lost and JJ Abrams stealing my ideas.  ;-) 

 

 

 

 

A commenter, who I believe is a physics undergrad (his blog here) emailed me some of his thoughts on narcissism, and wrote:

...those studies where people rank each other in a room for different attributes having never met them... I think what's going on is we assign people personalities based on how they look and force them to become a certain thing, creating a whole custom world for them...

which puts the idea of "profiling" on its head.  Do we actually ever "figure people out," or do we change them into what we think they are by the act of engaging in a relationship (on any level) with them?  It sounds a lot like a psychological version of quantum entanglement:

When two systems, of which we know the states by their respective representatives, enter into temporary physical interaction due to known forces between them, and when after a time of mutual influence the systems separate again, then they can no longer be described in the same way as before, viz. by endowing each of them with a representative of its own... By the interaction the two representatives have become entangled.

Which, unfortunately, sounds a lot like this (p. 236):

The unreflective consciousness does not apprehend the person directly or as its object; the person is presented to consciousness in so far as the person is an object for the Other.  This means that all of a sudden I am conscious of myself escaping myself, not in that I am the foundation of my own nothingness but in that I have my foundation outside myself.  I am for myself only as I am a pure reference for the Other.

You can't know who a person is without relating to them, and once you do that, you irrevocably change them.

Only in relationship to another do you get defined. Sometimes you can do it with your God; but either way, any adjective has to be placed on you by someone else.  Are you brave?  Strong?  funny, stupid, nervous?  All that comes from someone else.  So when someone relates to you, they define you.  You can try to control this-- hence the narcissist preying on the borderline to get her to see him the way he wants to be seen-- but ultimately it's up to the other person.

So we're are, or become, whatever a person thinks we are?  No, it's worse than that-- we want to be what they think we are. That's why we maintain the relationship, otherwise we'd change it.  ("I divorced her because I didn't like who I became.")

We do it because it is easier, and it serves us.   You're kind because he sees you as kind-- which in turn allows him to be seen as someone who can detect kindness.  And you accept that you're kind-- or mean/vulnerable/evil/brilliant-- because it serves you-- there's some gain there.  But a strong person accepts that on the one hand the other person gives you definition, and on the other hand you are completely undefinable, free, at any moment, to redefine yourself.  You can defy him, biology, environment and be anything.

You say: but I can't be a football star just because I want to.  But that's wanting someone else to see you in a certain way.  Do you want to play ball?  Go play ball.  "But I won't get on the team."  Again, that's wanting to change someone else.  Change you first. 

But what about-- identity?  That's the mistake, that's bad faith.  Thinking that our past is us; what we did defines us.  Our past can be judged-- what else is there to judge?- but it can't-- shouldn't--  define us, because at any moment we are free to change into something, anything else.  And so, too, we can be judged for not changing.

Ultimately, you are responsible for everything you do and think.  Not for what happens to you, but for how you choose to react.  Nothing else made you be.  Nothing else made you do.

Trinity said it best: The Matrix cannot tell you who you are. 

Rebecca Riley is the 4 year old who died of psychiatric drug overdose-- she was on 3 of them-- supposedly with a diagnosis of bipolar disorder.  If you want the scoop from a psychiatric perspective, you should read this post from the resident blogger (no pun intended) at intueri.

But I'll add two things.  Let me be very clear: it is not unlikely a 4 year old has bipolar-- it is absolutely impossible.  This is because bipolar disorder is not a specific disease with specific pathology that one can have or not have; it is a description of symptoms that fall together.  We decide to call a group of behaviors bipolar disorder-- and meds can help them, for sure-- but this decision is completely dependent on the context of the symptoms.  Being four necessarily removes you from the appropriate context, in the same way as having bipolar symptoms during, say, a war, also excludes you from the context.  You might still have bipolar, but you can't use those symptoms during the battle as indicative of it.   If I transplant you to Brazil, and you can't read Portugese, does that make you an idiot? 

I don't mean that 4 year olds can't have psychiatric symptoms.  I'm saying  you must be more thorough, more attentive to the environment.  As soon as a person-- a kid-- is given a diagnosis, it automatically opens the flood gates for bad practice that is thought to be evidence based.  That's what makes the diagnosis so dangerous.  Instead of, "should I use Depakote in this kid?" it becomes "It's bipolar, so therefore I can use Depakote."

Secondly, we must all stop saying these drugs are not indicated for kids.  That's meaningless.  We can debate whether they should be used or not in kids, but you can't say they shouldn't be used because they're not indicated.  To quote myself (lo, the narcissism):

Thus, categorizing a medication based on an arbitrary selection of invented indications to pursue—and then restricting its use elsewhere—may not only be bad practice, it may be outright immoral.

I do not make the accusation lightly.  Consider the problem of antipsychotics for children.  It is an indisputable fact that some kids respond to antipsychotics.  They are not indicated in kids.  But don’t think for a minute there will be any new antipsychotics indicated for kids.  Who, exactly, will pursue the two  double blind, placebo controlled studies necessary to get the indication? No drug company would ever assume the massive risk of such a study-- let alone two-- in kids. 

And which parents will permit their child in an experimental protocol of a “toxic” antipsychotic?  Rich parents?  No way. The burden of testing will be undoubtedly born by the poor—and thus will come the social and racial implications of testing on poor minorities. Pharma is loathed by the public and doctors alike, and the market  for the drugs in kids is (let’s face it) is effectively already penetrated.   There will not be any new pediatric indications for psych meds.  Not in this climate.  Think this hurts Pharma?  It's the kids that suffer.

It's funny how psychiatry always tries to appeal to a higher authority (FDA, "studies", clinical guidelines, thought leaders, etc) except when it gets in trouble.  And then it's always the same refrain: "no one can tell me how to practice medicine." 

 

 

I'm no Lost expert, and I doubt the writers were thinking along these lines.  But yesterday's episode got me thinking about how we become who we are.

Once again, I appear to be all alone.

...Because of their disabilities in areas of reasoning, judgment, and control of their impulses, however, [the mentally retarded] do not act with the level of moral culpability that characterizes the most serious adult criminal conduct... [over the past 13 years the] American public, legislators, scholars, and judges have deliberated over the question whether the death penalty should ever be imposed on a mentally retarded criminal. The consensus reflected in those deliberations informs our answer...

So opens  Atkins v. Virginia, as opined by Justice Stevens.

It seems unassailable that the mentally retarded should not be executed.  Justice Stevens spoke of a consensus;  the APA's amicus brief to the Court stated:

(1) there is a clear and unmistakable national consensus against the imposition of the death penalty on persons with mental retardation, and (2) the American people oppose the execution of individuals with mental retardation because the practice offends our shared moral values. (emphasis mine.)

So once again I am the sole hold out to national consensus.  Okay.  If I am to grant that such a national consensus does exist-- which it most obviously does not-- it is not in small measure due to misunderstanding what mental retardation is:  it isn't Down's syndrome.  It isn't a guest spot on the Howard Stern Show, it isn't finger paints and a baseball cap at age 30 moaning, "I wanna eat tato chips!"

If it was this, I'd agree a consensus might even be close to unanimous.  Ironically, such a consensus would be irrelevant as such individuals don't commit capital offenses. 

But this is not what mentally retarded is.  Atkins, the above defendant, was determined by the defense expert to be MR because of an IQ of 59.  With this IQ, he was able to get drunk and smoke pot (which, FYI, does not diminish responsibility,) drive a car (which he was licensed to do), kidnap and drag his victim to an ATM to force him to withdraw $200, then drive him to an isolated spot and shoot him 8 times-- not to mention be competent to stand trial, cooperate in court and with his attorney, etc.  He was also able to pull of 16 other felonies in his life.   An IQ of 59 allows reading at a 6th grade level-- comic books are 4th grade and Time Magazine is 9th grade.

But that was Atkins.  A diagnosis of MR is an IQ less than 70. Can someone with an IQ of 70 appreciate that shooting  your kidnapping/robbery victim in the chest 8 times and dumping him in an isolated location is really, really, wrong?  From 1976-2002, 44 people with "mental retardation" have been executed; all but 2 had IQs at least 58.

So a categorical exemption for the mentally retarded might be sensible if someone could tell me exactly what mentally retarded means.  Because the psychiatric definition quite obviously covers individuals well within competency standards.  And that's the point.

Here's an example: if the exemption was for "Down's Syndrome" then this would be plausible, because a) we can reasonably agree how Down's impacts the defendant; b) we can identify it.  But "retardation" means-- what?  Mentally ill, as an exemption, is worse-- does depression count?  Only psychosis?  Does the presence of only a hallucination count, or do you have to have a thought disorder?  "Schizophrenia?"  What's that?  The John Nash type, or the homeless crackhead type?  How about borderline?  Narcissism?  If you can't be sure of what constitutes "mentally ill", how can you make a blanket exemption for it? 

We can take this debate up a level, and observe that with every other psychiatric disorder that impacts on legal matters, the question for psychiatrists is simply, "what's his disorder?" or "how does the disorder impact this case?"-- we have an advisory capacity, leaving the ultimate decision of culpability up to the courts. In this way, we put some distance from the outcome.  That's what expert testimony is all about.  Fair enough.  But now, with MR, the diagnosis automatically gets you out of execution.  As long as the IQ test comes back 59, the sentence changes.  Mental retardation is binary, apparently, and if you are fortunate enough to have it, you live-- regardless of how well you understood the wrongness of your actions, or how egregious were the crimes.

Which is ridiculous.  There are practically no valid measures for any psychiatric illnesses-- everything is up for debate and interpretation.  MR especially is a continuum disorder.  Factors as trivial as which IQ test is used, or when it is taken, can affect the diagnosis.  One study finds a 6 point increase using older tests vs. the newer version of the same test.  

"Our findings imply that some borderline death row inmates or capital murder defendants who were not classified as mentally retarded in childhood because they took an older version of an IQ test might have qualified as retarded if they had taken a more recent test," Ceci says. "That's the difference between being sentenced to life imprisonment versus lethal injection."

But now the law has set an arbitrary and empty, binary cut off for execution.  Psychiatrists now actually choose the sentence.  Not inform the sentence-- choose it.

I'm fairly certain the APA didn't think about this when it filed its amicus brief.  They never think these things through, because they believe they are an instrument of social change.  But, like  forced medication to render competent to be executed, psychiatrists have now boxed themselves into a corner.  It is now solely up to them-- and their "tests"-- to decide who gets executed. 

Consider the ethical dilemma for a forensic psychiatrist asked to evaluate for MR: given that the defendant can fake MR; and given that finding the defendant does not "have" MR--or suspecting that he is faking MR-- is exactly equivalent to sentencing him to death, can there be any other medically ethical outcome than finding they are MR?  Think well.  In other words, an answer is forced, an answer is created, simply by asking the question.  The situation here is identical to the judge leaning over and asking, "Do me a favor and decide for me.  Should I hang him or put him in prison?"  Um, well, gee, it's up to me? um, since you asked...

I know, doctors are going to inwardly smile, pat themselves on the back for their cleverness; after all, the goal is to abolish the death penalty for everyone, one group at a time.    And I am sure there are organizations who will actively, openly, exploit this loophole.

Notwithstanding the laudability of this goal, this isn't about the death penalty, it's about who decides the death penalty. 

Just remember, when society allows psychiatrists to decide who lives or dies, then psychiatrists will also decide who dies or lives.  I want everyone on the planet to take a very deep breath, and think about this.

 

I have another unrelated post coming, but a quick word on insults vs. narcissistic injuries, and why this distinction is so important.

Narcissistic injuries have nothing to do with sadness.  They are always and only about rage. 

The narcissist says, "I exist."  A narcissistic injury is you showing him that he does not exist in your life.  Kicking him in the teeth and telling him he is a jerk is not a narcisstic injury-- because he must therefore exist. 

Let's say I'm a narcissist, and you send me a 10 page letter explaining why I suck, I'm a jerk, I'm an idiot; you attack my credibility, my intelligence; and you even provide evidence for all of this, college transcripts, records from the Peters Institute, you criticize my penis size, using affidavits from past and future girlfriends-- all of this hurts me, but it is not a narcissistic injury.  

A narcissistic injury would be this: I expect you to write such a letter, and you don't bother. 

This is most easily seen in the failing marriage of a narcissist. 

The reason it's important is because the reaction of the narcissist to either "insult" is different.  In the first example, he will be sad and hurt, but he will yell back, insult you, or cry and beg forgiveness or mercy--he will respond-- maintain the relationship.   He'll say and do outrageous things that he knows will cause you to respond again, to prolong your connections, even if they cause him misery.  He doesn't care that it makes you and him miserable-- he cares only that there is a you and him.

But in the latter case where you ignore him, humiliate him-- an actual narcissisitic injury-- he will want to kill you.

 

----

And before everyone flames me, I am not trying to give a scientific explanation of the pathogenesis of narcissism.  This is simply one man's opinion of how we can specify what it is, and what it may predict, past or future.  Nor am I suggesting this isn't "treatable"-- anyone can change.  It may not be easy, but it is always possible.

And I also do not mean to imply that all narcissists will kill everyone who injures them.  The point is rage.  They may never act on it, or they may break a window, or attempt suicide, etc. 

 

Narcissism- what I believe to be the primary disease of our times-- is one side of a coin.  The other side-- the narcissist's enabler-- is the borderline.

If the analogy for narcissism is "being the main character in their own movie," then the analogy for borderline is being an actress.

 

 

 

I know it looks like one, but it's not.  And why it's not makes every difference in predicting what will happen next. 

My previous post described the modern narcissist, which is slightly different than the kind described by Kohut and others.  In short, the narcissist is the main character in his own movie.  Not necessarily the best, or strongest, but the main character.  A narcissistic injury occurs when the narcissist is confronted with the reality that he is not the main character in his movie; the movie isn't his, and he's just one of 6 billion characters.

The worst thing that could happen to a narcissist is not that his wife cheats on him and leaves him for another man. He'll get angry, scream, stalk, etc, but this doesn't qualify as a narcissist injury because the narcissist still maintains a relationship with the woman.  That it is a bad relationship is besides the point-- the point is that he and she are still linked: they are linked through arguing,  restraining orders, and lawyers, but linked they are.  He's still the main character in his movie; it was a romantic comedy but now it's a break-up film.  But all that matters to the narcissist is that he is still the main character.

No, that's not the worst thing that can happen.  The worst thing that could happen to a narcissist is that his wife cheats on him secretly and never tells him, and she doesn't act any differently towards him, so that  he couldn't even tell.  If she can do all that, that means she exists independently of him.  He is not the main character in the movie.  She has her own movie and he's not even in it. That's a narcissistic injury.  That is the worst calamity that can befall the narcissist. 

Any other kind of injury can produce different emotions; maybe sadness, or pain, or anger, or even apathy.   But all narcissistic injuries lead to rage.  The two aren't just linked; the two are the same.  The reaction may look like sadness, but it isn't: it is rage, only rage.

With every narcissistic injury is a reflexive urge towards violence.  I'll say it again in case the meaning was not clear: a reflexive urge towards violence.  It could be homicide, or suicide, or fire, or breaking a table-- but it is immediate and inevitable.  It may be mitigated, or controlled, but the impulse is there.   The violence serves two necessary psychological functions: first, it's the natural byproduct of rage.  Second, the violence perpetuates the link, the relationship, keeps him in the lead role.   "That slut may have had a whole life outside me, but I will make her forever afraid of me."  Or he kills himself-- not because he can't live without her, but because from now on she won't be able to live without thinking about him.  See? Now it's a drama, but the movie goes on.

So if you cause a narcissist to have a narcissistic injury, get ready for a fight. 

Saddam is not experiencing a narcissistic injury: he is still the main character in the movie.  If he was sentenced to life in prison, to languish, forgotten, no longer relevant, no longer thought about, that would be a narcissistic injury-- then his rage would be intense, his urge towards violence massive.  But who cares?  There's nothing he could  do.

But remaining the main character, he has accomplished the inevitable outcome of such a movie: he has become a martyr.  Even in death, he is still the main character.  That's why the narcissist doesn't fear death.  He continues to live in the minds of others.  That's narcissism.

I'm not saying executing Saddam wasn't the right thing to do, and I'm not sure I have much to add to theoretical discussions about judgment, and punishment, and the sentence of death.  It doesn't matter what your political leanings are,  what matters is we look at a situation that has occurred, and use whatever are our personal talents to try and predict the future.

I understand human nature, and I understand narcissism.   And I understand vengeance.  Saddam was a narcissist, but this wasn't a narcissistic injury. 

This was a call to arms. 

We should all probably get ready.

 

 

 

 

A quick primer on the new Narcissism.

I don't mean the traditional Kernberg, Kohut, or even Freudian descriptions.  In the modern times, I think narcissism has evolved.

A narcissist isn't necessarily an egotist, someone who thinks they are the best.  A quick screen is an inability to appreciate that other people exist, and have thoughts, feelings, and actions unrelated to the narcissist.  These thoughts don't have to be good ones, but they have to be linked to the narcissist. ("I'm going to get some gas-- because that jerk never fills the car.")

The narcissist believes he is the main character in his own movie.  Everyone else has a supporting role-- everyone around him becomes a "type."  You know how in every romantic comedy, there's always the funny friend who helpes the main character figure out her relationship?  In the movie, her whole existence is to be there fore the main character.  But in real life, that funny friend has her own life; she might even be the main character in her own movie, right?  Well the narcissist wouldn't be able to grasp that.  Her friends are always supporting characters, that can be called at any hour of the night, that will always be interested in what she is wearing, or what she did.  That funny friend isn't just being kind, she doesn't just want to help-- she's personally interested in the narcissist's life.  Of course she is.

A comedian I can't remember made a joke about actors in LA, but it's applicable to narcissists: when two narcissists go out, they just wait for the other person's mouth to stop moving so they can talk about themselves.

So on the one hand, the narcissist reduces everyone else to a type, as it relates to himself; on the other hand, the narcissist, as the main character in his movie, has an identity that he wants (i.e. he made it up) and requires all others to supplement that identity.

A narcissist looks the same every day; he has a "look" with a defining characteristic: a certain haircut; a mustache; a type of clothing, a tatoo.  He used these to create an identity in his mind that he will spend a lot of energy keeping up.

Consider the narcissist who wants his wife to wear only white, high heeled pumps.  The narcissist wants this not because he himself likes white high heel pumps-- which he might-- but because the type of person he thinks he is would only be with the type of woman who wears white high heeled pumps.  Or, in other terms, other people would expect someone like himself to be with a woman who wears those shoes.  What he likes isn't the relevant factor, and certainly what she likes is irrelevant.  What matters is that she (and her shoes) are accessories to him.

Never mind that the woman is obese, or 65, or the shoes out of style, or impractical-- the shoes represent something to him, and he is trying to reinforce his identity through that object.

Narcissists typically focus on specific things as proxies for their identity.  As in the example above, that the woman might be obese or a paraplegic could be ignored if the footwear was the proxy for identity.  These proxies are also easy to describe but loaded with implication: "I'm married to a blonde."  Saying "blonde" implies something-- e.g.  she's hot-- that might not be true.  But the narcissist has so fetishized "blondeness" that it is disconnected from reality.  The connotations, not the reality, are what matters (especially if other people can't check.)

This explains why narcissists feel personally sleighted when the fetishized object disappears.  "My wife stopped dying her hair blonde; but when she used to date her other boyfriends, she was in the salon every month.  Bitch."  He doesn't see the obvious passage of time, what he sees is part of his identity being taken from him, on purpose.  Here's the final insult: "she obviously doesn't care about me as much as her old boyfriends."

As a paradigm, the narcissist is the first born (or only) child, aged 2-3.  Everything is about him, and everything is binary.  His, or not his.  Satisfied, or not satisfied.  Hungry, or not hungry.  Mom and Dad are talking to each other and not me?  "Hello!  Focus on me!"  Youngest children don't typicaly become narcissists because from the moment of their birth, they know there are other characters in the movie.  (Youngest more easily becomes borderline.) Control, of course, is important to a narcissist. If you can imagine a 40 year old man with the ego of a 2 year old, you've got a narcissist.

Obviously, not all first borns go on to be narcissists.  Part of their development comes from not learning that there is a right and wrong that exists outside them.  This may come from inconsistent parenting:

 

Dad says, "you stupid kid, don't watch TV, TV is bad, it'll make you stupid!"  Ok.  Lesson learned.  But then one day Dad has to do some work: "stop making so much noise!  Here, sit down and watch TV."  What's the learned message?  It isn't that TV is sometimes good and sometimes bad.  It's that good and bad are decided by the person with the most power. 

 

So the goal in development is to become the one with the most power.  Hence, narcissists can be dogmatic ("adultery is immoral!") and hypocrites ("well, she came on to me, and you were ignoring me at home")  at the same time.  There is no right and wrong-- only right and wrong for them.  He's an exaggerated example: if they have to kill someone to get what they want, then so be it.  But when they murder, they don't actually think what they're doing is wrong--they're saying, "I know it's illegal, but if you understood the whole situation, you'd understand..."

Narcissists never feel guilt.  Only shame.

 

 

Continuing my week long celebration of narcissism, let me jump on the wagon:  I got an email informing me I was selected as one of the "Best Doctors in America." (5% of doctors, selected by  peers; and no, I didn't pay them.)  Yay!!  Me!!  Now...

 

I know, I said I was going on Christmas break.  But what better time than the holidays to focus on narcissism?

After thinking about how marketers target our narcissistic leanings, I wondered if other groups did the same.  Stand up comedy seems also to have followed this path.  Most of today's main comics do what I call meta-comedy; they tell jokes, but then also deconstruct the process of joke telling, right there, during the act.  They comment on the act.  Here are some examples:

A tremendous example of the societal narcissism I wrote about in my Time article with the funny cover.    If there was any one organization that I would have thought was in direct opposition to narcissism it would be the military, yet here it is, being specifically promoted.

I understand the practical necessity of this approach, of course; trying to tap into a listless and apathetic populace who get their current events from clips of the Colbert Report on YouTube-- they can't even be bothered to find Iraq or Afghanistan on a map, let alone enlist.  But mark my words, when a military cannot effectively appeal to any higher beliefs at all, and must resort to patronizing illusions of self-fulfillment only, then this society cannot last.

Look at the evolution of the slogans, and tell me I am exaggerating (from Army Times:)

“Today’s Army wants to join you”: 1971-73.

“Join the people who’ve joined the Army”: 1973-1979.

“This is the Army”: 1979-1981.

“Be all you can be”: 1981-2001.

“An Army of one”: 2001-2006.

Look at the grammar, the semiotic connotations.  A question for the historians would be whether or not a civilization in decline was aware that it was declining; and if not, what did they think was going on?

But perhaps all is not lost.  The Army just announced their new recruiting motto, which has apparently tested quite well:  "Army Strong."

----- 

As an aside, the "Army Strong" campaign was created by the Army's new advertising firm, McCann Erikson.   They're responsible for the MasterCard "priceless/there are some things money can't buy" campaign. Of course, this cost the Army one billion dollars. 

I'll go back to psychiatry now. 

I'm off for two weeks, taking the opportunity to upgrade the computers/monitors and plan my next move.  I will also be starting another blog under another alias.  I'll reveal it as mine if it takes off.

Also, to all those who emailed me about the Time Person of the Year post: thanks; it wasn't Photoshop but MS Paint; I have nothing against Grossman at all, I loved his King piece, the piece wasn't about Grossman, it was about us, society, our purposeful alienation from each other; I changed the screen to blue to reference the Blue Screen of Death; no, "Go Fuck Yourself" wasn't supposed to be (only) mean, it was a double entendre: narcissism--> self love--> "Go Fuck Yourself." 

That would be you.

 

 

The short version of the Time article is that we as individuals have formed a community on the internet (YouTube, MySpace, Wikipedia, etc), and this community is starting to "build a new kind of international understanding, not politician to politician... but person to person."

Ok, no.  Wrong, wrong, wrong all over the place.

The author of this piece is Lev Grossman.  Grossman is fairly famous book critic, one of the better ones.   He also wrote a novel that's a nod to Borges.  This isn't bad, it's just context.

The entire problem with Grossman's premise is exemplified by his first paragraph:

The "Great Man" theory of history is usually attributed to the Scottish philosopher Thomas Carlyle, who wrote that "the history of the world is but the biography of great men." He believed that it is the few, the powerful and the famous who shape our collective destiny as a species. That theory took a serious beating this year.

Well, not exactly. Grossman's thesis is that we matter, we can shape our destinies; he puts that in contrast to Carlyle's premise that great men help shape destiny.  But that's not what Carlyle actually says.  Here's the actual quote:

In all epochs of the world's history, we shall find the Great Man to have been the indispensable savior of his epoch;--the lightning, without which the fuel would never have burnt. The History of the world, I said already, was the biography of Great Men.

Carlyle doesn't say great men shape destiny; he says great men, and only great men, cause history. These great men should be given power to run society because only they can be trusted to do it.  Great men actually drive history, not shape it.

Democracy can't be trusted.  Paternalistic socialism, or at least a non-hereditary, anti-capitalist, aristocracy is all that can keep us from the dark of ochlocracy.  Individuals trump ideology-- which sounds like a good motto, except when individuals means Stalin and ideology means liberalism.  Oh, and the last book Hitler read was Carlyle's History of Friedrich of Prussia. 

So Grossman is not really paraphrasing Carlyle correctly.  This is important because Grossman is a book critic with a PhD from Harvard in comparative literature.  Either he simply did not know this about Carlyle, which I have to assume is impossible, or it didn't matter: he commandeered the quote, stripped it of the meaning Carlyle intended and used it the way he needed to use it.  And that exactly describes the problem:  truth and reality aren't important, what's important is you.

Because "You" as Person of the Year is actually quite portentuous.  It's is both representative and symptomatic of the problem of our times: narcissism.  Nowadays we are so alienated and matter so very little to larger society that the only thing that inflames any passion is to be reminded of this.   Consider Bush and Cheney.  Put aside politics for a moment, it is clear that their single-mindedness of purpose ignores each of us as individuals.  Give them the benefit of the doubt, that they are doing what they think is best.  But it's best for society, for America: what we hate is that it isn't for us, for you, for me.  That's what people hate about them, the seeming indifference to our individual worth, to our sense of importance.  Our votes don't count; everything is about religion; "Global War On Terror."  Where in all that is the individual?  We are tools to their "higher cause."  I know people say that they are angry at the cause; but I think it's really anger that we're being used for anything.

Being on YouTube, having a blog, having an iPod, being on MySpace-- all of these things are self-validating, they allow that illusion that is so important to narcissists: that we are the main characters in a movie.  Not that we're the best, or the good guys, but the main characters. That everyone around us is supporting cast; the funny friend, the crazy ex, the neurotic mother, the egotistical date, etc.  That makes reminders of our insignificance even more infuriating.

Take a look at the photos in the Time article: a DJ, a punk rocker, a guy in dredlocks, a kid dancing with headphones, a guy singing into a mic, a hot chick taking a photo of herself-- none of these people could ever be "Person of the Year."  They barely have identities outside of their image.  (And observe how so many are defined through music they listen to.)  They must be defined by something from without, like a tattoo.  But they deserve everything anyone else can have.  It's their right.

I'm not saying each of us as individuals is insignificant. We should, could, matter. But to protect ourselves from an existential implosion,  we decide to define ourselves through images and signs, rather than behaviors; lacking an identity founded in anything real makes us vulnerable to anger, resentment.  But no guilt, ever.  The narcissist never feels guilt.  He feels shame.

It can't last.  If society chooses to make narcissism the default, it's going to have to deal with society-wide narcissistic injuries-- when we suddenly realize that it isn't solely our movie and we're really not the main character.  And no one wants to see this stupid movie anyway.  This inevitably leads to violence: the school shooting, inexplicable knifing over Play Station 3, Andrea Yates, beating the wife because she wore the wrong shoes type of violence.  Oh, they weren't white high heeled pumps?  That bitch! She used to wear them for her old boyfriend.

I'm not sure anyone in psychiatry sees this-- they are too busy documenting Pharma excesses and Lamictal outcomes-- but it is the problem of our times.  The only ones who seem to notice are advertisers, marketers-- they see it.  They don't judge it, they simply profit from it. 

Grossman could morph Carlyle into what he wanted because Carlyle doesn't matter, what matters is what Grossman wanted, what Grossman needed.  Carlyle doesn't exist, or he only exists as we need to use him.  He becomes a tool, another supporting character.  Anyone actually read anything by Carlyle anymore?  Why bother?  We only need a few soundbites for our own use.  Grossman is a clearly a good writer and hardly the problem here. But picking "You" as Person of the Year only reinforces the collective delusion that our individual selves matter more than other person, or a collective good, an ideology, truth, or right and wrong.  It's relativism with a cherry twist.

It won't last.  It absolutely can't.

 

 

 

from Pharmagossip, but also Dr. Peter Rost's site, edrugsearch (which actually has several rep-models), etc, etc.  She's a rep from Miami (where else) who won Miss FHM 2006.  

Meanwhile, Sunderland at the NIH plead guilty to "conflict of interest" charges-- he had received about $300k over 5 years from Pfizer while he was a director at NIH, but never disclosed the money. 

All of medicine has rules about disclosing financial relationships.  Any academic center, for example, requires you to list all financial entaglements that could be perceived as conflicts of interest, including grants, honoraria, stock holdings, etc.  The idea, of course, is that money can exert undue influence, and at the very least the people around you should be aware of any potential conflicts of interest.

This includes conflicts of family members.   If you are giving a Grand Rounds about how Zoloft is better than Lexapro, but your wife is a Zoloft rep, you could be benefiting financially by getting people to write more Zoloft which gets her bigger bonuses, so you have to disclose this relationship. 

But if you are dating a Zoloft rep, you don't have to.  There would be no way you could be profiting financially from her increased sales, and thus no need to disclose that relationship.

But there's the cryptosocialist hypocrisy.  If it was really about protecting the public from conflicts of interest, we'd have to disclose dating reps as well.  History is full of examples of people behaving unethically for the sole purpose of bedding a woman.  Want examples?  They all come from politics.  Still want examples?

So why aren't we worried that I'm praising Zoloft because my rep is hot?  Perhaps we should mandate all reps be ugly?  You know, to protect society?

This sounds silly not because hot reps don't have influence, but because we're lying: it's not the influence that actually bothers us.  It is specifically the money.  "It's not fair that a doctor gets all that money from..." 

So let's stop kidding ourselves, it's not about protecting the public after all; it's really about resentment that the doctor makes so much money off the people; that they get sent on trips first class while others can't afford healthcare; about the rich getting richer at the expense of the poor.  &c., &c.  Pick up any copy of the New York Review Of Books for further examples.

Taking the convenient moral high ground just because it has better soundbites ("the public has the right to know!") and saves us from having to perform any critical thought is lazy and unproductive.  If you want to argue that doctors make too much money or Pharma's profits are excessive, we can go down that road and try for an honest and productive debate.  But let's stop pretending these disclosure rules have anything to do with protecting the public from bias.  They have everything to do with the current zeitgeist of income redistribution and class warfare.
 

---

As an cultural observation, look for the drug rep to become the next fetishized job, like cheerleader and nurse.   A profession becomes sexualized not because the members are themselves hypersexual, but because they represent a particular balance of the "unattainable slut:" "sleeps with everyone but me."  "e.g. the only reason that bitch (nurse or rep) isn't sleeping with me is that I'm not a doctor."  In this way suppressed misogyny is given a cover story to make it acceptable.  It's narcissism protected by an "if only" delusion.  Violence is never far behind.

 

--- And there's your free association bringing me back to what I was really thinking when I saw Diana Chiafair's photo: marxism and healthcare reform.  Hot rep--> fetishized--> commodity fetishism.  Because we never see the labor that went into the objects, we never see that social relation; the laborer disappears, all that is left is the commodity to which we ascribe value-- fetishize it. 

 

 

Just thought you should know:

There are about 1200 murder-suicides per year (i.e. 500-600 suicides by the person who just killed someone else).

75% involve the boyfriend/girlfriend or spouse; 96% of the murderers are males (duh)

92% involve guns 

92% occur in the house of the victim

There is an average 6 year age difference between the murderer and his victim.  Risk increases with widening age difference.

23% of murder-suicides (say, about 130), the murderer is 55 or older.  Contrast this with the general homicide rate by 55 year olds: 5% 

Contrast this with the suicide statistics in the general population,  and I think you'll agree that there are an amazingly high number of people dying at the hands of their idiot boyfriends/husbands.     "You don't understand, I loved her, I'd do anything for her, and she lied, slept around-- all that time meant nothing to her-- she wouldn't listen!  How can she just take what we had and just throw it away?  It doesn't make any sense!" 

The societal question is what has happened to many men that they are unable to define themselves, or affirm their value, except through another person.  And "love"-- or its distortion-- and aggression are closely linked in such people.  But that's narcissism, and it's the disease of our times.