Cognition & Reality

Saturday, 30 April 2011

The Dog Whisperer & Biological Determinism

Through his program, “The Dog Whisperer,” Cesar Millan has made himself into the most famous dog trainer in America, if not the world. His approach features his intuitions about dogs’ motivations. In explaining those motivations, he frequently refers to the descendence of domestic dogs from wolves, and only occasionally refers to the relationship between breed characteristics and a dog’s problem behavior. I have never heard him blame bad behavior on a dog’s genetics. In fact, he is a strong defender of pit bulls and other breeds that have been seen as dangerous because they are bred to be aggressive. Because he almost always sees the roots of a problem in confusion about dominance, he trains owners to reinforce positive, submissive behavior by becoming better “pack leaders.” When it comes to dogs, as the success of Millan’s program demonstrates, the public is willing to believe that behavioral pathology is mostly a product of learning.

It is therefore interesting that, in the popular imagination, human psychoemotional difficulties, not so different from the fearfulness and aggressiveness the Dog Whisperer often addresses, represent underlying physiological anomalies. Although people readily accept that dog psychopathology reflects bad “parenting,” they reject the idea that the same can be true of humans. To explain humans’ dysfunction, the public prefers explanations that seem to be at a remove from the direct experience of learning and developing, such as “chemical imbalance” or physical inheritance.

Cesar Millan’s treatments are invariably behavioral. Although I believe he doesn’t explicitly disapprove of using antidepressants with dogs, he never presents chemical or even dietary interventions on his show. Instead, through careful titration, he focuses on changing behavior, replacing dysfunctional behaviors with functional behaviors. He not only employs himself and other humans to do this, but also the dogs in his own pack, particularly his pit bull Daddy and a few other canine co-therapists.

Right now, I’m watching a touching installment of “The Dog Whisperer,” in which Cesar is rehabilitating a fearful Doberman mix named Baby Girl. When he discovers that Baby Girl refuses to eat, Cesar brings in a vet to examine the dog for physiological problems, but there is nothing physically wrong with her. Cesar concludes that Baby Girl’s eating disorder is “psychological.”

Admittedly, the psychological disorders of dogs do not track exactly the psychological disorders of humans. In addition, the cases that make it on to Cesar’s show, more often than not, involve violent dogs. Not only is an aggressive dog likely to drive owners to seek help, but a violent dog also makes better TV. On the other hand, Baby Girl was not violent. She had symptoms more similar to clinical depression or a personality disorder, and Cesar used a mixture of behavioral approaches to treat her. The point here is not so much that Cesar Millan believes in the efficacy of psychological treatment, but that the audience believes in the efficacy of psychological treatment, when the “patient” is a dog.

When the patient is a human, however, the public has been conditioned to accept the use of pharmaceuticals to treat psychoemotional problems, and they have accepted the notion that much psychopathology is “genetic.” Contrast this set of ideas with the way Cesar Millan operates. Although he does, under some circumstances, take into account a dog’s genetics, he almost always attributes behavioral problems to what we would call “upbringing” in the human context: The problem is really with the owners, an attribution most of the owners on the show readily accept.

One can see how much more difficult a similar conclusion about human parenting is to accept . Parents don’t want to believe that they contributed to the psychopathology of a child. In addition, physicians presently enjoy enormous power in treating psychopathology. It is therefore in their interest to promote a relationship between physiology and behavior that Cesar Millan implicitly rejects in the way he treats the psychological problems of canines.

Friday, 1 April 2011

Changing The Past

Filed under: Attachment,Emotion,Film,Psychotherapy — drtone @ 1:50 pm

In previous posts, I have discussed the non-existence of past and future. They are projections consisting of nothing but complex thoughts, and are therefore not real. In its many guises, the past can be particularly problematic. From a “psychotherapeutic” standpoint, the past, as we conceive it to be, is the source of many difficulties in the present. We trace the defensive adaptations that seem to get in our way to the distorted family dynamics of childhood. Our memories of the past, constructed though they are, can appear to us with great clarity. Although they refer to the “past,” our memories happen to us in the present.

You can’t change what doesn’t exist. In movies, sometimes, a character journeys into the past, where he or she has no power and can’t even talk to those he or she sees, perhaps to warn them of an impending disaster. Our experience of the past is much more like those movies than we usually recognize. Memories, especially when they are very clear, seem to be as subject to the rules that govern reality, such as the laws of physics, as are events that actually occur in the present. So we try to solve the problems that come to us from the past as if they were happening now. The problem is that we walk around in our memories much like a character in a movie who wanders wraithlike through scene after scene in which he or she can touch nothing nor be heard.

Tuesday, 15 March 2011

Pictures, Real & False

Filed under: Emotion,Memory,Radical Constructivism — drtone @ 11:14 am

I had an interview this morning about a contract job I may take. I had spoken on the phone a few daze ago with the person I was meeting. Based on that conversation, I was expecting someone in her early to middle forties, with permed blonde or strawberry blonde hair, pretty but pinched WASPy features, dressed in a prim outfit. The real person was in her early to middle thirties, not a WASP, maybe part Chicano or something, dressed casually in slacks and a striped top. On the phone, I thought she would be a brittle person trying to be overpowering,  Actually, she was easygoing and mild. It’s amazing how one develops pictures in the mind of how someone or something will be. In my experience, the picture and the reality rarely match.

Tuesday, 15 February 2011

If It Ain’t Broke…

Filed under: Emotion,Psychotherapy,Radical Constructivism — drtone @ 9:09 am

Because the process of psychotherapy also depends on a story, one about receiving “treatment” for a “problem,” it consists in a self-contradictory story. In that story, I am damaged and someone else, a “therapist,” comes along and fixes whatever is wrong with me. Not only does such a story depend on a static medical model, with a doctor ministering to a passive recipient, but it also involves the false portrayal of the entire situation as a transit from illness to health. When we renounce attachment to our narrative about repairing the Self, we discover that there was nothing broken in the first place.

“If it ain’t broke, don’t fix it” is a maxim to live by. Once we recognize that the true self manifests constantly, we can begin to examine why that is not apparent to the conscious mind. Suffering does occur. Under no circumstances can arrangements in the world meet every need. Life outside is not like life in the womb. It can be uncomfortable and unsafe, a discovery an infant continues to make from birth onward. In response, we develop defenses against the elements of experience that do not comport with feelings of comfort and safety. Psychotherapy is somehow about reaching behind those defenses without disrespecting them.

A client suggested to me, when we discussed psychotherapy and the question of “fixing,” to consider the meaning of the word “fix,” which is about preserving the status quo. In photography, for example, the “fixer” bath prevents the newly developed photo from changing. Fixing, thought of that way, is against change. Therefore, the client suggested, psychotherapy, at its best, is about “un-fixing.”

Wednesday, 5 January 2011

AIDS Now

Filed under: Emotion,Medical Morality,Propaganda,Urban Myths — drtone @ 2:04 pm

I remember back in 1986 when I realized that the AIDS “epidemic” or “pandemic” was largely a scam, that the danger of infection to an average middle-class American of either sex was vanishingly small. I also remember trying to have rational conversations about the actual threat of AIDS with friends and acquaintances. For example, I would point out that an alarming increase in the percentage of women in LA County diagnosed with AIDS meant that the actual number had gone from, like, six women to nine women (not in a year, but since such statistics had been kept)–a 50% increase, true, but barely a blip on the epidemiological radar. I would point out that, similarly, reports involving percentages of cases were inherently misleading, and that the absolute numbers in the CDC’s Morbidity and Mortality Weekly were far less disturbing than the squawking news media, who almost always reported on percentages, would have one believe. Or I would point out that for no other disease would supposed experts derive their epidemiological models for the industrialized world from conditions in Africa, where the “cofactors” for infection included disastrous public health conditions and where AIDS was diagnosed when a person presented with symptoms of TB.

In return, I would get such looks! Not only would no one listen, but they would either covertly or overtly attempt to shame me for downplaying the seriousness of the disease, by my actions placing untold numbers of people at risk. No one wanted to be confused with the facts, and they despised me for trying. Friends would as much as refuse to discuss the issue with me. It was so humiliating that I stopped talking about it, all the time knowing that time would prove me right, because the millions of expected deaths would never happen. They never did, and AIDS, once a topic of non-stop commentary and speculation, has faded from the public imagination, almost as if the whole thing never occurred. (Note that “terrorism” is meeting the same fate.)

I was reminded of that time, the mid 80s to mid 90s, while reading for an online “law & ethics” course I have to take to renew my psych license. Enshrined in law are detailed regulations regarding the proper procedure if, say, an infected individual threatens to infect others with HIV (the AIDS virus), and regarding the circumstances under which it is permissible to report to others that a person is infected with HIV. People were actually concerned that there would be those who would clandestinely “murder” others by literally fucking them to death. Maybe there were incidents of that sort, but if there were, they were extraordinarily rare, hardly of any more concern than the possibility that an infected individual would “deliberately” spread the flu, which is also potentially fatal. Yet, concerns about the possibility actually made it into the laws of California and other states.

In point of fact (because we can now see what the actual risk was), unless you were poor, a prostitute, a needle-using drug addict, or a member of the highly promiscuous “gay subculture,” in this country your risk of contracting AIDS from “unprotected” sex was (and remains) zero. As we know from countless reports, as well, the program to promote use of condoms against AIDS was a dismal failure. Public health measures do not, therefore, explain the failure of AIDS to infect a huge proportion of the population, as was widely predicted for upwards of a decade. Millions of North Americans and Europeans did not die simply because they were never in danger.

Some day histories will be written about the AIDS crisis, explaining the hysteria that captured and captivated America and the rest of the Western World. In part, I suspect a brilliant public relations campaign by gay activists who understood that ordinary Americans would never respond adequately to an epidemic that mostly affected gay men, the most hated and stigmatized group in our culture. By the same token, homophobia undoubtedly played a huge role, and wherever sex of any kind is involved, the public cannot help but follow. The almost endless list of players includes both the World Health Organization, excited about the opportunity to display its chops, and a burgeoning news media, hungry to fill the new 24-hour news cycle. Last but not least, the AIDS “crisis” followed a period of unprecedented sexual license that “infected” the entire society in one way or another.

It all added up to a phenomenon of gigantic proportions, a tempest in a very large, very noisy teapot, as we now know. With hindsight, we can see that society was undergoing a major structural change that is still happening. Possibly, the terror surrounding AIDS became shorthand for the groups at greatest risk, gays and Blacks, who were already perceived as a threat to social equilibrium. Fear of AIDS, then, may have been an expression of  anxieties so deep and so forbidden that to express them openly would have been intolerable. If that is true, the AIDS experience was not about disease or sex, but about the power of repressed emotion.

Thursday, 30 December 2010

Why No Joy?

Filed under: Attachment,Emotion — drtone @ 3:23 pm

Yesterday, I had an appointment with a urologist to receive the results of a prostate cancer biopsy performed last week. The results were resoundingly negative (i.e., good): Of the twelve samples taken, all were benign. As readers of my blog know, my prostate cancer story has been going on for six months, ever since a PSA test I had in June was returned showing a substantial jump over my previous tests.

When I received the news from the urologist, after waiting quite a while in a consulting room, I was glad, but I was not overjoyed. I don’t know what I expected to happen to me. I had been meditating deeply for some time, weeks maybe, developing inner peace, not only for its own sake, but to prepare for receiving this news. I had opened up a big space, or so it seemed to me. I was not particularly afraid of receiving bad news. My main concern was that I might be forced to make another decision.

Although I had already come to the conclusion that I would not pursue radical therapy for prostate cancer, I realized as I sat in the consulting room that it was one thing to have reached that conclusion and another to make a positive decision, in the presence of the urologist, not to have surgery or radiation. I remembered all the times, sitting in restaurants as a kid, being pressured by my father to decide what I wanted to order–experiences that have made me the quickest menu reader and food order-er west of the Pecos. I knew I did not want to decide anything. The urologist’s news meant that I didn’t have to, at least not at this time about this issue.

I was relieved, but not exactly happy, nor did I become appreciably happier on the drive home. When I got home, I sent emails to several people with whom I had spoken about my prostate adventure. Some of them have gotten back to me, most expressing feelings of joy and relief that I have not had myself. It’s partly in contrast to these good wished that I am aware of the lack of joy in my own response.

The PSA result had turned into a Big Deal, complete with many hours of Googling and angry rants, some of which have appeared in this blog. Nevertheless, in the last few weeks, I had already moved on, I realize as I write this. It had already become something of a non-issue before I ever made my drive to Fontana yesterday to get the word from the medical world. Yet I did get the biopsy because I wanted to know what was going on “down there.” Now I know, and I don’t care very much. It’s kind of a letdown.

Thursday, 23 December 2010

Soul Without Shame: Book Recommendation

As background for writing a book on the Inner Bully, I’m reading Soul Without Shame by Byron Brown, written from the perspective of the Diamond Approach of A.H. Almaas, with quotes from Almaas. The format is good, using vignettes to illustrate the different forms the “inner judge” or superego takes, and delving precisely into the origins of self-criticism and self-doubt. The Diamond Approach, although based in Sufism and other mystical traditions, draws heavily on object relations theory, making the book of interest to anyone interested in the relationship of depth psychology and spirituality.

Monday, 6 December 2010

Terminal Entertainment

Filed under: Emotion — drtone @ 5:13 pm

I recently contacted an old friend, someone with whom I went to grad school and whom I liked a lot. At one of his weddings (he’s another serial marry-er) someone  thought we were brothers, although we look nothing alike and he’s nearly a foot taller than me. I had not seen him in years, and the last thing I heard from him was  through his former girlfriend, who told me that he had left the city they lived in and his university post, having fallen in love with a grad student who had two kids. This was strange, considering that he had never wanted kids, and it was disturbing because it was hard to understand why he had left his beautiful girlfriend and beautiful job.

Anyway, I found his name in a book I’ve mentioned here, The New Phrenology, in which his work is cited often. I remembered some discussions I had with him on the topic and many discussions that had nothing to do with the topic. In fact, we had a blast once upon a time. I subsequently looked him up on the web and found a video of a talk he gave. The talk was too technical for me, but he was the same charming fellow I had known years earlier, and I realized how much I missed him, so I sent him an email. A couple of weeks later, I received a long, long reply that included various details about his life.

There was a passage in his email about his current illness and treatments he was receiving, including a mention of his diagnosis: pancreatic cance . I already had experience with someone from that part of my life and pancreatic cancer. That person, Liz Bates, perhaps the single most important influence on my intellectual growth other than my mother, had died while I dithered about driving down to La Jolla to visit her. She died in a matter of months. In connection with her and her illness, I had googled pancreatic cancer and discovered that it’s among the worst, both painful and deadly.

I had replied to my friend’s email with a long email of my own. That email contained news of my current life and bitter complaints about the way my ex-wife exited our marriage. It mentioned my friend’s illness only in passing. It not until I was with my therapist later in that day, and mentioned to him that my friend “seems to have pancreatic cancer” that I realized what was afoot. I had been clueless for a few hours, and had almost entirely skipped over the seriousness of my friend’s condition, thus demonstrating the power of denial.

In reply to a second email from me, in which I expressed deep concern about his condition, and reported that it had dawned on me later how sick he is, he referred to his conditions as his “terminal entertainment.” He reported that his response to it is varied, that it hits him, and then he reacts well or maybe not so well. I still don’t want to look at it squarely. It’s just so weird.

Saturday, 13 November 2010

Scientific Authoritarianism

A genuine grasp of current genetics research would take years to acquire and involve the rigors of a postgraduate education. The same is true of any branch of physiology. An ordinary citizen, even one who is otherwise well-educated, cannot hope to bring any level of technical expertise to evaluating claims about the genetics of mental disorders. As I explained in yesterday’s post, even doctors are at sea when it comes to this topic, although they may not realize it. Therefore, belief in those claims depends, at least in part, on faith and obedience.

That is why, rather than supporting explanations of psychoemotional difficulties based on individual experience, which would ostensibly be more consistent with an American emphasis on individual responsibility, our society has gravitated toward explaining aberrant behavior with reference to physiological, “disease” processes beyond a person’s control.

Thursday, 11 November 2010

DSM-IV & Reality

I found the following paragraph in the course of my reading about “chemical imbalances.” I couldn’t have said it better: The diagnostic enterprise in psychiatry has transformed from nosological exploration into reifying patterns of psychoemotional distress, as if patients’ symptoms represent “real” diseases underneath. It is similar to the “computer metaphor” in cognitive psychology, which went by barely perceptible steps from cute heuristic into actively characterizing the mind as a computer, until ostensibly intelligent people were talking seriously about “storage,’ “retrieval,” “programming,” etc., as if they are authentic features of cognition.

On a still more fundamental level the use being made of the DSM-III and IV model of illness is at issue. DSM-II, perhaps out of respect for the underlying psychodynamics believed to be behind patient’s symptoms, tended to be loose about how to label patients. What was going on inside was more important. Beginning with DSM-III the decision to cluster symptoms into operational definitions that were consensually agreed upon was a proper step in trying to use scientific models. We were asked to buy into the principle, that regardless of theories about causality, there would be an agreed upon name for the collection of observed symptoms. But it has all too often deteriorated into a Platonic essence model, that is, a belief that there is a “real” version of the illness and actual illnesses are imperfect derivatives. If we truly understood etiology and pathogenesis this approach would be wonderful. It would mean we had arrived at the promised land. But short of this, DSM-IV can actually hinder therapeutic perspectives and treatment approaches. From “A Reevaluation of the Relationship between Psychiatric Diagnosis and Chemical Imbalances,” by Simon Sobo, M.D.

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