Goodbye April

I haven’t had the opportunity to post here, however I hadn’t realized that it was over a month since posting something substantial. I wouldn’t say that there’s anything different going on in my life, so much as that, upon reflection, perhaps I’m spending a bit more time seeking comfort where I need it.

I got back into a martial art that I started before the pandemic, called baguazhang, or simply bagua (pron. bahg-wah). It’s a little idiosyncratic compared to more mainstream forms like karate, taekwondo or BJJ. I’d say it’s somewhere between what we in the West call “kung fu” (external) and tai chi (internal). Let’s just say there’s a lot of walking in circles. That said, I needed something that allowed me to move/train my body in a way that was different than going to the gym or distance running, which can feel static. Bagua is anything but static. Also, crucially, the very place that teaches it is literally across the street from my office in Chinatown. It centres me and its choreography is demanding enough without the more wild kung fu-style kicks etc. It’s also nice to do this with other people — something I was also sorely needing (ie a form of socializing that wasn’t chatting with someone at a pub)

I also started Book Four (I know, I know), which is coming along. I can’t really say much about it because it’s very early, however I’m liking its shape. What’s funny is that my previous long-form entry here was about not wanting to be stuck with Author/Psychotherapist in publicity material…and yet the protagonist of Book Four is exactly that. It’s also nice working on a book where the protagonist is a woman. Radioland had two protagonists — male and female — and The Society of Experience had an intermittent female narrative in the form of Seneca’s diaries, however I’m looking forward to keeping things female this time around. Book Three is in revision-mode now, for the last round I think.

I’m trying to keep myself informed of what’s going on in the world, but the world is too big and there’s too much. I think the curse of social media is that there are so many perspectives on so many things that it can be paralyzing to even log-in some days, so currently I’m not. I’m very thankful that I re-subscribed to the London Review of Books this past summer because their coverage of what’s happening in Gaza is extensive and authoritative, without the self-censorship or bad faith arguments that have poisoned coverage of this conflict in much of the mainstream media. I’m not a prolific magazine subscriber, however I can’t help but think of how lucky I felt when I happened to subscribe to Harper’s just prior to the towers falling on 9/11, the drums beating towards a disastrous war. Reading informed, well-written arguments isn’t going to stop the worst of humanity from manifesting, but at least I can form my opinion from a source that isn’t compromised by a fear of spooking advertisers or an editor casting a dark shadow over someone’s shoulder.

Yes, and reading. Lots of reading. Let’s see…Labyrinths (a collection of Jorge Luis Borges stories and essays), Benjamín Labatut’s When We Cease to Understand the World (which is fabulous), The Rigor of Angels by William Egginton and Audit Culture: How Indicators and Rankings are Reshaping the World by Cris Shore and Susan Wright.

I hope this finds you well.

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Memories of a Virus

I can’t help but think about Toronto in 2003. I had just started working with a well-respected performing arts film company in the autumn of 2002 after having been laid off from my previous job after the bottom fell out of their financing for an ambitious Grimm Brothers-based children’s TV series. Some context is important here. 9/11 had only happened a year before my lay-off. The effect of 9/11 was huge on the film and TV industry. One large factor was advertisers: they weren’t producing new ads — I don’t exactly understand the psychology behind this though I gather many were waiting for what the Bush Jr. administration would do as a response to the attacks. But, as I did start my career working in TV commercials, I can tell you that those 30 second spots pump tonnes of money (and jobs) into many parts of the economy. So, no new ads, no ad money to broadcasters, thus no budgets from broadcasters for new productions, which meant industry jobs were scarce.

Then came SARS.

I wrote about this for the Torontoist ten years after the fact, albeit in a more generally-geared way (not focused on the film industry). It may not be the definitive SARS essay, however it’s topical both as an overview of the what and how, and also as a point of comparison to what we are facing today, nearly 20 years later, in the early days of the coronavirus COVID-19 as it spreads its way across the planet.

As I wrote then, we were caught flat-footed as a result of economic downsizing (or to use more current parlance, austerity measures). And if 9/11 took the legs out of the film and TV production in Toronto, SARS was a squarely landed sucker punch. Even though the job I’d just landed paid much less than my previous one (don’t get me started), I had to be thankful because I ended up avoiding an industry-wide cull that left all but the best (or well-connected) in the industry. For a simplistic explainer, Hollywood movies shoot here in order to take advantage of rebates on labour costs, and thus undergird the infrastructure that the native Canadian industry depends on for their productions. They didn’t want to cross the border for risk of any cast or crew getting ill. Even beyond North America we were affected: the company who hired me was about to start pre-production on a feature shooting in southeast Asia — then like now a hot zone of the virus — when the plug got pulled for insurance reasons.

Even though we pulled ourselves out of it, it got bleak. It felt like Toronto was put in a sick ward and someone wrapped it in protective plastic from the rest of the world.

A lot has changed since then. Canada learned its tragic lessons — losing 44 lives and having a hole drilled through the economy will do that. Our medical infrastructure is now among the best prepared in the world. It’s a strange and unsettling deja vu to see other First World countries who weren’t affected by SARS struggling to stave off infection. This includes, coincidentally enough, film productions (as it stands, Toronto has become and remains a boomtown, especially since Netflix has invested in studio space). I am very thankful for the lack of social media (as we know it now) back in 2003. What I witnessed then was only a precursor to the more virulent online racism, xenophobia, and paranoia that we are seeing today.

I wanted to write that Torontoist essay in 2013 because it seemed nobody wanted to acknowledge what happened in 2003 — that somehow, maybe thanks to “SARSstock“, we could wash ourselves of it. The body count. The World Health Organization’s travel advisory. The second SARS wave that hit later that year. The economic downloading that made us so vulnerable.

I’m writing this now because I work in the middle of Chinatown, which has been unfairly punished by the association with COVID-19. Restaurants and businesses are suffering for no reason other than the public’s ignorance. I realize it’s early days for COVID-19, which has the potential of wreaking great havoc. My hope is that, where applicable, medical facilities are upgraded to prevent the spread of infection, people use common sense when travelling and — of personal importance — that populist governments do not use this as an excuse for clamping down on democratic freedoms (i.e. public assembly, elections). We shall see.

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Book Review: Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness, by Anne Harrington

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For the longest time I’ve been looking for an impossible book: an historic exploration of psychiatry and psychology over the last 150+ years that lays the groundwork of how we got to where we are (with the infighting, the arrogant spectacles, the tentacles of private interests), that also isn’t painfully academic or with too little (or too much) of the author’s own perspective of such a unwieldy topic. Well, as I said, it doesn’t exist, but Anne Harrington’s Mind Fixers comes very close.

As the subtitle states, Harrington (a science historian and the Franklin L. Ford Professor of the History of Science at Harvard University) has her lens steadied on the search for the (real, perceived, and ultimately elusive) biological underpinnings of mental health conditions. This is a terribly important topic and if this book has not ignited the debate it might have, it’s no reflection on the scholarship or insights gleaned from Mind Fixers, but perhaps a victim of timing and not being the loudest possible controversy to be found on Twitter. Even then, if you follow psychologists, psychiatrists, and those who specialize in related research on Twitter you’ll soon find yourself inundated with accusations of anti-psychiatry levelled at those who criticize prevailing notions of mental illness being caused by chemical imbalances in the brain, while the replication crisis undermines many of the foundations of Psychology 101.

If there’s a story here, it’s one of shifting hegemonies: from those who were concerned of their patient’s physical wellbeing, to those concerned with their brains, from those concerned about subconscious maternal conflict to those convinced the answer was in our brains, but only chemically. And with each shift in search of a possible answer to mental suffering there are reciprocal shifts in public investment and, eventually, interest from pharmaceutical companies. And at the end of the day what shifts the most are some of the most vulnerable people in our society: from sanitariums to hospitals; from wartime battlefields to community centres…only to be dumped onto the streets. It’s all here in Mind Fixers, and it’s a timely read considering the vested interests currently luring large investments in brain science, or in such promised but potentially dangerous remedies as ketamine, or those convinced of a genetic pathology. And if it sounds as if this book is strictly for history/psychiatry wonks you are dead-wrong.

What Harrington does very well is take reams of historical information and distill it into a narrative that ultimately maps out how those with what is generally called (though I hold some hesitations at times) mental illness were treated and what those in their charge felt was at play inside their bodies. Along the way we see ethical lapses in the form of wholesale human experimentation (i.e. injecting unknowing patients with blood infected with malaria), as well as the overreaching ideal of Freudian psychoanalysis as a Rosetta stone. Along the way we are introduced to ideas and theories which seemed to make sense at the time — narcosynthesis, insulin coma therapy — along with travesties such as deinstitutionalization, basically the dumping of people with mental health issues on the streets as a result of overambitious government policy that was out of sync with the realities of state coffers. Mind Fixers is also blunt about the influence of pharmaceutical companies, who increasingly figure in the narrative; the last quarter of the book is an admonishment of the profiteering that took place from the mid-1980s to the mid-00s as companies such as Eli Lilly were able to advertise directly to Americans and, with the help of an increasingly subjective DSM that allowed two people with completely different symptoms to be diagnosed with the same disease, exponentially increase their profits through prescriptions.

There are some issues. Repeatedly, Harrington refers to the “neo-Freudians” who, in their day (mid-20th century), held the reins of power with respect to diagnosis and how psychiatric trends were approved. There is a lot of confusion (just look at the definition provided on this U of C Berkeley page) about what a neo-Freudian is: those who studied but ultimately disagreed with Freud (however kept his strictly psychodynamic approach) or those who held Freudian views but refused to downgrade the role of biological processes? It may sound semantic, but in lieu of a definition the term’s repeated use without context begs for clarity. In the process it also makes it sound as if all psychoanalysts were in some way Freudian adherents. What about Melanie Klein and the rest of the object-relations movement? How did they differ? Indeed, the role of plain ol’ talk therapy — explicitly Freudian or not — is given short shrift, which might sound understandable in a book looking at biological underpinnings, but as a tool in the arsenal against so-called mental illness its absence feels odd, especially in light of the author’s emphasis on the misdirections of neo-Freudians. I get that Harrington could easily have written a book three times its size on her chosen topic. But if you’re going to talk about the influence of Freud and psychoanalysis in general then I feel you have to unpack and contextualize a bit more than what is on display here.

For the most part, however, Harrington is surprisingly fair-minded, not only unveiling the naked greed (and capricious biological arguments) of psychopharmaceutical manufacturers, but highlighting the testimony of those patients who were — placebo effect or not — helped by their medications, even if it came at a cost of other aspects of their health. She is by no means on a mission to dispel the notion of a biological source of mental illness, as I’m sure some vested interests might think looking at her book from a distance, but rather to show how partisanism, arrogance, and greed have wasted decades of valuable mental health research as we swing from trend to trend.

Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness, is available at an independent bookseller near you, or online.

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Book Review: Casting Light on the Dark Side of Brain Imaging

Whenever a mental health authority is interviewed in the media it’s nearly inevitable that this person is a medical doctor, usually a psychiatrist. This individual typically isn’t a practicing therapist; they may only be able to speak of clinical diagnoses and/or the prescription of psychopharmaceuticals. I mention this because when this authoritative psychiatrist is interviewed in the media I end up listening to a depiction of the massively complex human interrelational landscape I see around me every day, as both a writer and psychotherapist, reduced to a chemical imbalance in someone’s brain. It’s like ascribing a boxer’s loss of a title match solely to the width of their biceps.

book coverThe gold standard for looking at mental health is through what’s called a biopsychosocial lens, a flexible model that allows professionals to consider the biomedical (for example, thyroid issues, dementia), the psychological (traumatic experiences, abusive relationships), and socio-economic factors (unemployment, impoverished environment) that might be at play in the mental health profile of any given individual, even if it ends up a combination of one or more parts. In North America there is unfortunately a sacred primacy around the biomedical approach to mental health, with the psychological and socio-economic as (at best) secondary considerations at the table of funding and education. At this moment there are medical doctors losing sleep wondering how to beat the shame of knowing there is a patient in their care whose condition might be psychogenic (meaning, whose pathology is not, strictly speaking, a biomedical end product). Continue reading “Book Review: Casting Light on the Dark Side of Brain Imaging”

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Hello, world (2019 version)

For all intents and purposes, I abandoned this blog. Not willingly or intentionally. To be honest, I didn’t (and still somewhat don’t) know what to do with it. You see, it contains a lot of crap; this is what happens with any blog over time: you change, the world changes, your knowledge/opinions develop. You end up with a blog where you squint at parts, hoping nobody looks too closely at the early stuff. I’ve been doing this since 2006, so cut me some slack.

I’m here to say that I’m back. I just don’t know what form this is going to take. You see, at some points this blog has been philosophically driven, psychologically driven, artistically driven…and I always feel bad when I change the mandate.

Why can’t you be more consistent? Does that question sound familiar? For those of us who are outliers (not by choice but by design), there is a great deal of downward pressure on us by society to fit the fuck in. Because if you’re not consistent then you’re difficult, and difficult means people have to spend more time than they anticipated trying to figure you out. People who are difficult or inconsistent typically find themselves struggling to figure themselves out — why the hell am I taking a path that only makes things harder for me socially?

Often, there’s no choice. Because being consistent typically means disregarding complexity, and if you have an innate appreciation for complexity then this is going to be a problem. And so, getting back to this blog, I’m not going to sweat the inconsistencies. I’m not going to pretend to stand by everything I wrote in 2012 or 2009 — this is why most posthumous memoirs shouldn’t be published: if the author had an opportunity, they would probably throw them into a fireplace for fear of looking like an asshole/monster. Thankfully, I don’t think I come across that badly.

Kerry Clare has some interesting points to make about returning to blogging. For me, I can relate to wanting to shift away from the disposability of social media. Particularly as I’m wrapping up work on my next novel, I think I have time for this.

I hope you’ll stick around.

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The Brain & Science – The Problem With Wanting It All

As a psychotherapist, I have taken an interest in the rise of neurobiological research being applied to my field. At first, particularly upon hearing about “interpersonal neurobiology” (or IPNB), I was excited — I was seeing the intrapsychic and biological converge into what appeared to be a fascinating model of understanding human behaviour. But here’s the thing: while I have a deep reverence for the subjective life of the individual, I’m also interested in looking at things empirically, where applicable. Without this latter aspect, I feel we fall prey to magical thinking.

The more I looked into some of the new ideas permeating my field, I became aware of a few things. While certain concepts, such as the idea of neuroplasticity, were taken from science, the more I looked at who was writing about this, the more I noticed that the people applying these complicated concepts to psychotherapy weren’t neurologists or geneticists. One of the oft-referenced authors in the field of IPNB is Allan N. Schore, who is a psychologist and researcher. His books are popular with those looking to harmonize neurology and psychotherapy. And while I respect his multidisciplinary work, I have difficulty with binary conceptions of how the left and right brains work (whereas, supposedly, the right brain is responsible for emotional attunement, the left brain for insight and analysis). Why do I have difficulty with this? Because many neuroscientists would contend that this is too simplistic a way to look at the brain.

This is a blog post and not a long-form essay. I could go on. I suppose what irks me is the amount of material being written about a myriad of complex neurobiological research findings that skip over the necessary cautions that are the hallmarks of science. Correlation is not causation. How big was the sample size? Continue reading “The Brain & Science – The Problem With Wanting It All”

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Keep Moving / Being Wrong / Keep Moving

Sometimes I feel that I stand in-between too many things. Un-firm. Undecided. This is in part due to my fond appreciation for not only a lot of disparate topics but also disparate approaches. I believe in the vigour of an approach which involves good research. I also believe that we can lace “good research” with wishful thinking so that the evidence it produces is wishful thinking presented as fact. I believe that there are charlatans who willingly or naively provide a distraction that slows us down. I also believe that we dismiss many things as charlatanism not because they pose a danger but because they conflict with the politics of our personal or professional lives. I believe in intuition. I also believe intuition alone brings us too close to a raw reflexiveness which doesn’t serve long term needs.

So when someone asks me What do you think about x? I sometimes find myself considering a number of things and contexts to understand the question. The drawback is we’ve created a world where this sort of complexity is undesired. Certainly, in some industries and roles, complexity is unnecessary — a prime example would be assembly line work where the task is to simply crank out carbon copy iterations of something already conceived-of and revised to an acceptable standard. If you want to know what roles robots and AI are going to swallow up in the future, it’s those things. Complexity, on the other hand, keeps us guessing, reminds us that there are no set answers, or if there are they are kludges we developed until the next discovery forces us to revise our notions, our presumptions.

In an essay in this weekend’s New York Times Magazine, Ferris Jabr profiles someone turning to exotic flora in order to stave off our imminent depletion of effective antibiotics. The researcher in question turns to the lore of sometimes ancient civilizations, the extracts and tinctures from nature that one might rightly think come from fantasy, or from a presumably primitive culture. From some pharmaceutical industry perspectives, this is quackery. And yet, in one example, Continue reading “Keep Moving / Being Wrong / Keep Moving”

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Book Review: The Trouble With Physics, by Lee Smolin

I posted about this book earlier, noting that it was surprisingly hard to get into, particularly for someone such as myself who, while not majoring in physics in high school, has always been curious about science and particularly interested (since a young age) in the concepts surrounding quantum physics. Boy, what a difference the last half of a book can make.

Smolin’s approach to the organization of information in his book might make sense to him, and – if I had an undergraduate in physics – it would to me also. He begins by stating five fundamental unsolved problems with our understanding of the universe, not already explained by Einstein’s theory of relativity (governing big stuff) and quantum physics (governing small stuff). He then goes on to discuss the idea of string theory and how it was posited as a candidate for a unifying theory which might possibly go to explain these unresolved problems (along with the effects of gravity). After laying out the details, he then discusses the Continue reading “Book Review: The Trouble With Physics, by Lee Smolin”

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The Trouble With The Trouble With Physics

I’m on my second attempt reading Lee Smolin’s 2006 book The Trouble With Physics. I am reminded of a similar situation with another book, Joyce’s Ulysses. And, similarly, my second attempt with The Trouble With Physics is not a reappraisal but a confirmation: this is hard to read.

Smolin’s book is making a case for the fact that string theory is a failure; a spectacular failure that its adherents defend with a most byzantine theoretical web; that, because string theory is de rigueur in so many of the top schools, with so many reputations at stake, no one wants to recognize the fact that string theory — an attempt to harmonize the ideas of quantum theory and relativity so that we might understand the foundation of the universe more clearly — is a dead end.

The problem I’m (still) having with the book is that Smolin is writing to an audience that is willing to take a steep (try 90 degrees upward) climb in order to understand the various concepts and theories which not only formed the foundation of string theory, but the issues that weren’t resolved through the original work of Newton, Einstein, etc. Smolin lays out in the beginning various fundamental aspects of how things work that we simply don’t know — instilling early that scientific inquiry is, if anything, about the need for curiosity. However, given Smolin’s densely described approach to get us ready to understand his arguments, and while I don’t doubt the necessity, I think he would need to double the length of his book to do so effectively for interested readers who are not physicists.

What is more successful, and the reason I continue to read it, is how Continue reading “The Trouble With The Trouble With Physics”

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The Importance of Self Care

I was reading this article in the National Post, about a psychiatrist whose trained specialty is analyzing and working with violent sexual predators, who recently experienced a breakdown as a result of what is believed to be symptoms of PTSD (post-traumatic stress disorder). He has worked on cases involving Paul Bernardo, Robert Pickton, and most recently Russell Williams: all of them so-called sexual sadists, all of them convicted murderers.

To put this into context for those reading from outside Canada, each of these convicted – by virtue of the severity and depravity of their crimes – is a poster boy for reinstating capital punishment (which, for the record, I do not support). They have individually terrorized regions of the country when they were active. It’s important to understand all of this due to the nature of being a mental health professional – someone trained to see people as people no matter who they might be or what they might have done – working with people of this description.

The article describes how Dr. John Bradford simply lost his ability to keep the burden of content (and ostensibly the affect of said content) from seeping into his consciousness, whereas before he was able to separate the explicitly graphic information he worked with from getting to him. What stood out in the article for me was the following:

What he wouldn’t realize until he went into therapy was that the videos from his many cases had been gradually taking their toll and they rushed back to haunt him on that long drive home.”

 

In particular, the phrase “until he went into therapy”, which implies that he wasn’t seeing a therapist until this point. Assuming this conjunction isn’t sloppiness on behalf of the writer, I find it appalling that Dr. Bradford could have such a role and somehow not be mandated by his employer (or his governing professional society) to be in some form of regular personal therapy. It boggles my mind, actually.

We live in an odd time when the general public are being told (rightfully) the importance of mental health and not allowing toxic environments to fester within them and yet someone tasked with watching videos of killers’ victims doesn’t walk into a therapist’s office until he is exhibiting signs of PTSD and is forced to take a month off work?

Let me be clear: to my knowledge there is no explicit mandate for said procedure. I am not implying that Dr. Bradford was in any way professionally negligent. I am however suggesting that the past and current culture of psychiatry, with its “detached” experts, should reconsider its standards for those tasked with a specialty like Dr. Bradford. Self care goes both ways: it allows patients/clients/non-professionals to seek help and understanding for their issues; it also allows professionals an opportunity to explore how their work impacts their lives.

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