Why You Can't Reason With Republicans - Part II

Last week I posted why you can’t reason with Republicans. This has to do with the “smart idiot effect,” laid out in Chris Mooney’s illuminating book, “The Republican Brain: The Science of Why They Deny Science and Reality.”

First you start with the proposition that the thinking part of the brain is designed to rationalize our emotions rather than override them. The emotional part of the brain was there first, and - like it or not - it still calls the shots. We have to work with what we’ve got. I’m sure if God decided to start over, He would be outfitting us with Vulcan brains. That’s more or less the evolutionary biology take on it. As to why God doesn’t start over - that’s a theological discussion.

If our brains were truly built for dispassionately sifting through information, making reasoned decisions, and adjusting beliefs in response to new facts, we wouldn’t be exposed to such spectacularly stupid dogma as man coexisting with dinosaurs and humans having nothing to do with global warming.

Amazingly, intelligent people actually support such rubbish, and this leads to the “smart idiot” effect, namely the more informed we are, the more elaborate our rationalizations. According to Mooney, Republicans are particularly adept at this. I can cite Romney’s infamous “47 percent” comment as Exhibit A, but I’m not about to change any minds on this, which is exactly my point.

It’s only likely to get worse. One reason, Mooney explains, is that conservatives (read Republicans) rank low on “openness to experience” (part of standard personality tests).  These are people uncomfortable with change and challenge. Liberals tend to be the opposite. Here, Mooney contrasted two default positions: Conservatives with global warming and liberals with nuclear power. According to research cited by Mooney, conservatives (particularly informed ones) failed to moderate their positions over time while the opposite happened with liberals.

So, liberals, rather than being smart idiots, tend to suffer a surfeit of open-mindedness, which can be a fatal affliction. Whereas conservatives are totally sure of themselves, irrespective of the facts, liberals can’t seem to make up their minds, can’t make decisions.

This is why thinking with our emotions can be good. I have written extensively on this, citing Jonah Lehrer’s eye-opening “How We Decide.” When our thinking and emotions align, the brain tends to make the right call. We need to pay attention to what is going on in the back end of the brain, but - likewise - we also need the wisdom to veto where our emotions want to take us.

It may feel good believing that half the citizens of the US are victims who don’t pay their taxes, but is this any way to run a country? Really, seriously.  

But still, extreme liberals are as looney as extreme conservatives, right? Of course, but if we go with Mooney’s analysis there aren’t as many of them. Liberals - you will recall - are more likely to change or moderate their default positions on particular issues. The ones who don’t get relegated to the fringe. Mainstream liberals may wind up despising them as much as Rush Limbaugh, but for much more intelligent reasons. I ask you, who listens to Helen Caldicott these days?

This is not the case, says Mooney, with conservatives. Another personality trait is at play here - “conscientiousness,” which conservatives score high on. These are people who, among other things, exhibit fervent loyalty to their tribe, which can be a great character strength but also a sign of malignant xenophobia.

The eleventh commandment, said Ronald Reagan: “Thou shalt not speak ill of any fellow Republican.”

Party first - pretty scary stuff, especially if the lunatics have taken over the asylum. This explains why you don’t hear principled conservatives or moderates speaking out against the extremists in their midst. It also explains why - with virtually no outcry from principled conservatives and moderates - the extremists have taken over. Try to imagine Eisenhower - or, for that matter, Reagan - finding a home in today’s Republican Party. 

With liberals, it’s a whole different ball game. Says Mooney:

For these folks, it isn’t about obedience, or group solidarity, or sticking up for those on your side of the aisle - it’s about getting it right, dammit.

Getting it right, of course, is always a work in progress. Which is why we need everyone helping out. Principled conservatives and moderates have a lot to contribute. Too bad they have rolled over and are currently playing dead. Too bad they have dropped out of the conversation.

The Smart Idiot Effect: Why You Can't Reason With Republicans

Two years ago, I posted a piece here, Is Republicanism the New Stupid? The short answer, I concluded, is yes. The long answer is more involved. You can write a book on it. Journalist Chris Mooney has: “The Republican Brain: The Science of Why They Deny Science and Reality.”

It’s not like our genes have predestined us to vote for a specific party or believe in a particular ideology (often in complete defiance of the facts), but it’s something like that, and the topic is now the object of intense research across a wide range of disciplines - from how we think (or don’t think), to heritable personality traits, to how we behave, to environmental factors. But we begin with the fact that the Republican Party has been taken over - occupied - by the lunatic fringe.

It wasn’t always this way. Indeed, poll any Democrat today and you are likely to find he or she (myself included) is very comfortable with Eisenhower Republicanism. Indeed, Ike - a former university President who championed science, who got the troops out of (rather than into) a foreign conflict, who expanded social security, and who worked with Democrats across the aisle - had no place for extremists in his party. To wit:

Should any political party attempt to abolish Social Security, unemployment insurance, and eliminate laws and farm programs, you would not hear of that party again in our political history. There is a tiny splinter group, of course, that believes you can do these things, but their number is negligible and they are stupid.

Those were the days of liberal Republicans and conservative Democrats, which appeared to have a strong moderating influence on the politics of the era. Over the years, that changed. Conservatives gravitated to one party and liberals to the other, with a predictable polarization affect. Fine, dandy. We can still talk, right? May the best ideas prevail, right? Everyone benefits, right?

Wrong. For one, the brain is not wired to rationally sift through the facts and make smart decisions. Any casual reader of this blog knows that the brain science is coming in loud and clear on this. Our “thinking” is emotions-driven. We respond first, think later. Too often, our “thinking” is deployed to rationalize our emotions.

We’re all guilty of this. We buy stuff we don’t need, we fall in love with the wrong person, we put up with awful abuse. Do we learn? Sometimes. The rest of the time - well, that’s a different story.

Basically, we have two brains: a sophisticated processing unit retrofitted atop a primitive responding device. When things work right, our emotions give meaning to the flood of information bombarding us, which helps the “thinking” part of the brain make smart choices. When things go wrong, we do a lot of stupid things. This is why we are human, not Vulcans.

The big mistake our Founding Fathers made was that they, as children of the Enlightenment, assumed that reason would prevail. An educated public, with access to the facts - so they thought - could be entrusted with the reins of government.

Had they only known about the “smart idiot” effect.

Chris Mooney begins his book with the example of Conservapedia (see top image), which bills itself as “The Trustworthy Encyclopedia.” You can trust Conservapedia to inform you that evolution is not real, that global warming is a hoax, that homosexuality is a choice, and that abortions cause breast cancer.

On today's front page of the site, in the news section, reads the heading: 

What lunatic, you might ask, is responsible for such nonsense? The answer will surprise you. He is Andrew Schlafly (son of Phyllis), a Princeton-educated engineer and Harvard Law graduate. 

How can smart people (a lot of this stuff is mainstream Republican dogma) possibly believe such rubbish? We start with the proposition that emotions decide and that emotions are housed inside personalities. Thus, if you are the type of person who feels comfortable in a world of certainties and is threatened by change, your natural tendency is to reconfigure the facts (even making up your own) to sync with your world view, however out of touch with reality it may be.

And how do you FEEL after reconfiguring the facts? Much better, thank you very much. You may be in total denial of reality, but - very ironically - the smarter you are, the more proficient you become at deluding yourself. Your arguments become ever more sophisticated, your beliefs grow more rigid. By now you are absolutely certain of yourself. Nothing is going to change your world. Check this out, from a Pew report cited by Mooney:

For Republicans, having a college degree didn’t appear to make one any more open to what scientists have to say. On the contrary, better-educated Republicans were more skeptical of modern climate science than their less educated brethren. Only 19 percent of college-educated Republicans agreed that the planet is warming due to human actions, versus 31 percent of non-college-educated Republicans.

What about liberals? “Are liberals ‘smart idiots’ on nukes?” asks Mooney. According to Mooney, the natural liberal impulse to distrust nuclear energy “puts them at odds with the views of the scientific community on the matter (scientists tend to think nuclear power risks are overblown, especially in light of the dangers of other energy sources, like coal).” Mooney cites study evidence showing that on further reflection, liberals  “moved in the opposite direction from where these initial impulses would have taken them.” 

According to Mooney: “This is not the ‘smart idiot’ effect. It looks a lot more like open-mindedness.”

What gives? No surprise, liberals love facts, they are comfortable with change. On personality tests, they score high on “openness to experience” and low on “conscientiousness.” Loosely translated, liberals have messier houses with more interesting things in them.

Loosely translated again: You can reason with most liberals. But, ironically, because liberals are open to reasoned discussion, they are blind to the fact that others are not. You can’t reason with a Republican. I gave up trying years ago.

Much more to come ...

Rerun: My Good Friend Kevin

In honor of World Suicide Prevention Day ...

Eight years ago, I was facilitating a DBSA support group in Princeton, NJ. In walked Kevin, exuding a goofy charm, baseball cap on backward. But there was something about his presence that indicated he was no mere goofball. The others in the room felt it, too.

Over the weeks, I couldn't help but be impressed by the way Kevin carried himself. He would walk up to newcomers and introduce himself and start up a conversation. In the group, he was a great listener, dispensing the wisdom of a sage, leavened by a keen sense of humor.

It was amazing to observe him with people much older. At once, he was deferential, compassionate, and exuding great authority. You simply forgot you were talking to someone much younger. You simply wanted to be around him, laugh with him, seek advice from him.

He had his setbacks, his dark moments. Yet, over time - in group, over coffee, over sandwiches, hanging out - I watched him blossom. With his extraordinary people skills, the sky was the limit.

In late 2006, my marriage broke up. Kevin was the first to offer me support. He also reached out to my then-wife.

Suddenly, I had my life in seven or eight FedEx cartons and a one-way ticket to San Diego. I popped into the DBSA group one last time. Kevin was facilitating. He gave me a heartfelt tribute. I felt the goodness in the man. Goodness, true goodness. That was the last time I saw him alive.

He had so much to live for, so much to offer. Yet, on a miserable muggy New Jersey morning - almost exactly three years ago today - his brain tricked him into believing otherwise. He was 28. Three years later, all those he left behind are still dealing with it.

I've been suicidal. So have a lot of us. We fully understand, yet - we totally don't understand.

Kevin, you still shine a light on the world. Nothing - nothing - is ever going to extinguish it.

Whitaker, Torrey, and Dopamine Supersensitivity: The Conversation Continues

This is the fifth in our series of pieces dealing with Fuller Torrey’s response to Robert Whitaker’s 2010 “Anatomy of an Epidemic.” I’m sure by now you have all had enough, but bear with me. We are learning - all of us - and there is no better way to shake issues loose than by closely observing and then analyzing the back and forth exchange between two of the most prominent voices in psychiatric treatment.

In my coverage of this debate, I am less concerned by who is right and who is wrong than in what we all stand to learn. Nowhere does this come in more loud and clear than on the topic of dopamine supersensitivity.

Whitaker makes reference to the phenomenon in Chapter Five of “Anatomy of an Epidemic,” where he (thankfully) demolishes the myth of “chemical imbalance of the brain.” Contrary to the impression your doctor may lead you to believe, the brain is not some sort of chemical soup that gets thrown out of whack by too much or too little serotonin or dopamine. Likewise, the brain is hardly restored to balance by tinkering with these chemical levels.

In essence, when it comes to an illness such as schizophrenia or addictions such as to cocaine, we find ourselves less concerned with “how much” dopamine is in the brain than in “how sensitive” the brain is to dopamine. The same applies to depression and serotonin.

The presynaptic neuron (the one you always see to the left or at the top on any given diagram) tends to get all the attention, as this is the neuron that releases neurotransmitters into the synapse - the gap - separating the other (postsynaptic) neuron on the left or the bottom. Below is a screenshot from an old Zoloft TV commercial. Here, you see a depressed brain with a “chemical imbalance,” with hardly any neurotransmitters in the synapse:

Now, thanks to Zoloft, we see neurotransmitters bursting out of “Nerve A” like nauseated passengers frantically disembarking from a Kenny G cruise. The swarm is headed straight toward a presumably receptive “Nerve B.” where we are left to assume a happy ending.

But wait. How truly receptive is Nerve B? Ah, that is the real question.

In chemical imbalance terms, if depression is about “too little” serotonin, schizophrenia is about “too much” dopamine. But how much is too much? We turn our attention to “Nerve B.” Whitaker in “Anatomy” (p 76) picks up on the action:

Having discovered that dopamine levels in never-medicated schizophrenics were normal, researchers turned their attention to a second possibility. Perhaps people with schizophrenia had an over-abundance of dopamine receptors. If so, the postsynapic neurons would be “hypersensitive” to dopamine, and this would cause the dopaminergic pathways to be overstimulated.

Whitaker goes on to say that in 1978, University of Toronto researcher Philip Seeman (pictured above) announced that this was indeed the case. Autopsies revealed that the brains of those with schizophrenia had 70 percent more D2 receptors than normal. Nevertheless, Whitaker notes that Seeman cautioned that the “long-term administration” of first-generation antipsychotics may have been the cause, not the schizophrenia.

Here, Whitaker frustratingly breaks off the natural flow of the narrative. Whitaker is pursuing his own agenda, but Dr Seeman, who has devoted his life to the study of dopamine receptors, has an entirely different story to tell, one we need to hear, in his own words, on his own terms. A 2007 article he wrote in Scholarpedia, “Dopamine and Schizophrenia,” best explains:

The discovery in the 1950s that the sedative drug chlorprozamine had both an antipsychotic effect and Parkinsonian side effects (such as tremors) led in the 1960s to a dopamine hypothesis for schizophrenia. By 1967, researchers were discussing “overstimulation of dopamine receptors” as a possible cause for schizophrenia, but it took until 1975 to identify the dopamine D2 receptor as the binding site of dopamine and antipsychotics.

According to Dr Seeman, citing a number of studies, in first episode patients who have never been treated with antipsychotics the density of D2 in the frontal cortex and striatum is elevated by 10 to 30 percent. These same patients experience decreases in D2 in other areas of the brain, as well as decreases in D1 receptors throughout the brain.

D1 and D2 do not operate in isolation. The decreases in D1 may switch a high-affinity D2 receptor into a low-affinity one (ie one not conducive to binding).

Here is the money quote from Seeman’s piece:

Because antipsychotics, including aripiprazole and bifeprunox, alleviate psychosis by inhibiting D2, it indicates that psychosis is associated with a hyper-dopamine state.

Dr Seeman goes on to explain the need for focussing on “how sensitive” rather than “how much.” In experiments involving the administration of low doses of stimulants, three-quarters of those with schizophrenia experienced psychosis or worsening psychosis, even when on an antipsychotic, as opposed to zero to a quarter of the control subjects. In Seeman’s words:

The data indicate that dopamine supersensitivity is prevalent in patients with schizophrenia.

Seeman describes a number of animal studies that suggest a variety of causes for schizophrenia and psychosis, including different gene variations, brain lesions, birth hypoxia during Caesarian section, stimulants, and steroids. All these result in dopamine supersensitivity. Rats given high doses of corticosterone, for instance, showed a 210 percent increase in D2 high-affinity receptors.

Dr Seeman also notes, citing studies by Chouinard, that “antipsychotic drugs themselves can occasionally induce an increase in the high-affinity state of dopamine D2 receptors and the associated state of behavioral dopamine supersensitivity.” Withdrawal of the antipsychotic, he explains, can unmask this dopamine supersensitivity and precipitate an episode of “supersensitivity psychosis.”

Chouinard’s findings of supersensitivity psychosis is where Whitaker comes back into the picture, to make his case for the harmful effects of the long-term administration of antipsychotics. But to make that case, Whitaker first needs to acknowledge the general principle of dopamine supersensitivity.

In other words, the best working theory we have for schizophrenia and psychosis at the moment has to do with study findings showing increases in dopamine D2 high-affinity receptors in key parts of the brain in rats and in humans. As Dr Seeman notes, there may be multiple causes and multiple gene variations for schizophrenia and psychosis along multiple neural pathways, but just about all of these have a way of “converging onto a similar set of brain D2High targets.”

Whitaker’s response? Three way out of context quotes (p 77). First:

“The dopaminergic theory of schizophrenia retains little credibility for psychiatrists.” This came out of the blue in a 1990 article by French researcher Pierre Deniker. The article actually acknowledges the “anti-dopaminergic action” of antipsychotics, but cautions against a one-size-fits-all approach to treatment.

Second:

There was “no good evidence for any perturbation of the dopamine function in schizophrenia.” The 1994 article that houses this quote, from John Kane of the Long Island Jewish Medical Center, actually talks up the newer generation atypical antipsychotics, with their putative (and still not proved) action on the serotonin system.

Finally:

“There is no compelling evidence that a lesion in the dopamine system is the primary cause of schizophrenia.” Whitaker’s use of this 2002 quote (Steven Hyman, former NIMH head) is supposed to lend weight to the proposition that chemical imbalance is a myth. But all Hyman is saying is what everyone agrees on: That schizophrenia, like all other mental illnesses, is heterogenous and multifactorial - many shapes and sizes, many different causes.

Hopefully, you see the point: One cannot talk up supersensitivity psychosis while trying (pathetically, at that) to discredit dopamine supersensitivity. To do so invites fierce attack by Fuller Torrey.

Next: Fuller Torrey attacks ...

Whitaker vs Torrey: Crunching Numbers

This is the fourth in our series of pieces dealing with Fuller Torrey’s response to Robert Whitaker’s 2010 “Anatomy of an Epidemic.” In his review, Dr Torrey asserts that on matters of schizophrenia and antipsychotic drugs, “Whitaker got it mostly wrong.” The same day that Torrey published his review, Whitaker in a blog post issued an angry rebuttal and his own counter-attack.

In our most recent installment, we discussed Whitaker’s heavy reliance on a 2007 publication of a Harrow-Jobe 15-year longitudinal study which found that about 40 percent of schizophrenia patients did well when taken off their antipsychotic medication. What the authors of the study found of greater significance, however, was the fact that the patients who did well were those with a “good prognosis” to begin with.

In his book, Whitaker made the barest passing reference to Harrow’s real findings, neither reporting on the primary results of the study nor how this information can be used to help patients with schizophrenia achieve better outcomes. Rather, Whitaker interpreted the study to mean that “that the drugs worsened long-term outcomes” (p 118).

Had this been a long-term trial of antipsychotics as Whitaker would have us believe, the authors would have conducted an entirely different study. There would have been at least two evenly-matched groups of patients, one on antipsychotic meds and one not on antipsychotic meds, if not at the very beginning of the study then at a key stage further along.

The catch is long-term studies of this type are impossible to conduct. The costs are prohibitive and no review board would dare permit such an enterprise. But the real world affords untold opportunities to observe the natural course of schizophrenia without meds. As Torrey scathingly notes:

[Whitaker] fails to focus any attention on the fact that on any given day in the United States half of all individuals with schizophrenia, or about one million people, are not being treated. This is a huge natural experiment to test his thesis. Many of these individuals are found in public shelters, sleeping under bridges, in jails, and in prisons. If Whitaker had spent more time in these settings observing the outcome of this natural experiment, instead of delivering lectures on his vision of the impending antipsychotic apocalypse, he would have written a very different book.

In this regard, Whitaker’s highly selective use and non-use of information becomes a major issue, akin to writing “Gone with the Wind” without noting that there is a Civil War going on.

So, is there any legitimacy to Whitaker interpreting the Harrow study his own way? Yes. It’s called “secondary analysis,” a fairly common practice amongst researchers and journalists. Basically, one mines other people’s data in search of new - and often startling - insights. And Whitaker certainly had more than enough data to work with.

The 2007 Harrow-Jobe article tells us that 12 of 64 patients with schizophrenia (19 percent) experienced a period of recovery over 15 years. Of these: Eight of 12 (40 percent) were no longer on any meds and two of five were on meds but no longer on antipsychotics.

In contrast, only two of 39 patients (5 percent) on antipsychotics experienced a period of recovery. Moreover, 19 of 23 patients (83 percent) with uniformly poor outcomes after 15 years were on antipsychotics. Tellingly, 64 percent of these patients had psychotic activity at the 15-year point vs only 28 percent not on antipsychotics.

Harrow’s numbers back up Whitaker, right? Wrong. Recall, the Harrow study involved an apples-to-oranges comparison - good prognosis patients vs bad prognosis patients. The good prognosis patients, identified at the beginning of the study, were the ones most likely to get better in the first place and therefore were in a position to go off their meds.

For Whitaker’s secondary analysis to work, he would have had to show that the “good prognosis” patients who stayed on antipsychotics did worse than the good prognosis patients who went off antipsychotics. (It would have been useful to compare results in the bad prognosis group, as well, but this finding wouldn’t have had the same significance, as we don’t have high expectations for this group.)

So - we’re looking for an apples-to-apples comparison. Easy to show, right? We just pull up the relevant number and ...

No number. Whitaker doesn’t cite one. No problem. We’ll find the number in the 2007 Harrow-Jobe study that Whitaker refers to. Wait, this is weird. The number isn’t in the study, either. The authors slice and dice the data in a multiplicity of ways, but the closest they come to what we’re looking for is a finding that 17 percent of the good prognosis patients were on antipsychotics after 4.5 years and 13 percent after 15 years.

No mention of how these particular patients actually fared. Why? The answer is simple (okay, complicated for me). Let’s assume one-third of the patients in the study were good prognosis patients. Let’s make the number 20. If only 13 percent of these patients were on antipsychotics at the 15-year mark, we are looking at a study sample of two, at most three, patients.

A three-patient sample? Okay, let’s be generous and double it. A six-patient sample?

In his blog, Whitaker insists that “in every subgroup of patients (by prognostic type), those off medication had better long-term outcomes (in the aggregate).” In making his claim, Whitaker relies upon this paragraph from Harrow-Jobe:

In addition, global outcome for the group of patients with schizophrenia who were on antipsychotics was compared with that for the off-medication schizophrenia patients with similar prognostic status. Starting with the 4.5-year follow-ups and extending to the 15-year follow-ups the off medication subgroup tended to show better global outcomes at each follow-up.

Had Whitaker actually asked, “how much? how many?” he would have realized the absurdity of his assertion.

Conclusion: Whitaker’s secondary analysis fails. Totally, absolutely, completely. Case closed, right? Not so fast:

When the dust settles, we still have two key pieces of data that simply will not go away: Eight in 12 patients not on meds (plus two of five on meds but no antipsychotics) experiencing periods of recovery vs only two of 39 on antipsychotics.

Still a very small sample size. Still apples-to-oranges. Still other factors in play such as the type of life experience and personal make-up that separates good prognosis from bad prognosis patients.

But when all is said and done, Whitaker is perfectly justified in saying: “Hey, hold on a minute, have a look at these figures.” And we need to be listening.

Likewise, Torrey is perfectly correct in insisting that Whitaker got it wrong. Again, we need to be listening.

More to come ...

Previous Whitaker vs Torrey pieces:

At Last, a Conversation

Collision Course

Digging Deeper

Whitaker vs Torrey: Digging Deeper

This is the third in our series of pieces dealing with Fuller Torrey’s response to Robert Whitaker’s 2010 “Anatomy of an Epidemic.” In his review, Dr Torrey asserts that on matters of schizophrenia and antipsychotic drugs, “Whitaker got it mostly wrong.” The same day that Torrey published his review, Whitaker in a blog post issued an angry rebuttal and his own counter-attack.

Previously, we examined Whitaker’s use of two studies he cited in support of his thesis that mental illness is on the rise because of psychiatric medications rather than despite them.

In the first instance, Torrey busted Whitaker for blatantly misrepresenting one study’s findings. The study involved a mere passing reference, but was illustrative of the highly selective cherry-picking that Whitaker employs throughout his book. Whitaker counter-attacked, accusing Torrey of “dishonesty,” but failed to answer the charge.

In the second instance, Torrey dismissed two WHO studies that Whitaker heavily relied upon, characterizing them as “discredited.” Essentially, Torrey (citing various researchers) interprets these studies as an apples-to-oranges comparison. The studies (which found better outcomes among the third-world patients surveyed) - serve as a textbook example of why no finding can be taken at face value. Basically, both Torrey and Whitaker were justified in interpreting these studies the way they did. It would have been helpful, however, had Whitaker addressed Torrey’s apples-to-oranges issue. Instead, he issued another gratuitous “dishonesty” charge.

Let’s move on ...

The Harrow-Jobe Study

Whitaker’s Position

This 15 (later 20)-year longitudinal study, published in 2007, served as Exhibit A in Whitaker’s case against antipsychotic medications. In his book, Whitaker interprets the study results to advance his claim that patients with schizophrenia fare worse on meds over the long-term than those not on meds. According to Whitaker (p 115):

...The off-med group began to improve significantly, and by the end of 4.5 years, 39 percent were “in recovery” and more than 60 percent were working. In contrast, outcomes for the medication group worsened during this thirty-month period. ...

Whitaker in his book did note that Harrow in an interview attributed better outcomes to “stronger sense of self” and “better personhood,” but Whitaker did not elaborate why these factors were significant. Instead, he kept his focus exclusively on meds vs non-meds.

Later in his book (p 311), Whitaker accuses both the NIMH and NAMI of failing to promote (and by implication suppressing) the study’s optimistic finding:

... I also searched the NMIH and NAMI websites for some mention of the studies listed above and I found zilch. ... Forty percent of those off medications recovered over the long term! But that finding directly contradicted the message that NAMI has promoted to the public for decades ...

Torrey’s Response

In his review, Dr Torrey points out that the Harrow-Jobe study is not exactly the hot news that Whitaker makes it out to be. Since at least as far back as 1938, Torrey reports, numerous schizophrenia outcome studies have found that “on average one-quarter of the patients recovered completely, one-quarter had a continuous illness, and the other half had intermediate outcomes between these two extremes.”

Of critical importance, citing one researcher: “There are relatively benign and malignant forms of illnesses generally diagnosed as schizophrenia.” This leads to what the study was really all about, with Torrey noting that “Harrow et al. even explicitly state that their study provides no evidence on whether very long-term use of antipsychotic medication produces undesirable effects for some SZ [individuals with schizophrenia].”

Once again, we have an apples-to-oranges issue. As I observed in a number of previous blog posts, rather than comparing a meds group to a non-meds group as we are used to seeing in clinical trials, the study actually compared a “good prognosis” group to a “bad prognosis” group. These patients were identified at the beginning of the study, then followed over 15, then 20 years.

Predictably, the good prognosis group had better results, with more of them in a position to go off their antipsychotics and to function well. But, according to Torrey, Whitaker twisted these findings to serve his own purposes:

Using tortured logic, he asserts that the Harrow et al. study proves that long-term antipsychotic use causes brain damage and is responsible for many of the symptoms of schizophrenia, when in fact the study does nothing of the kind.

Whitaker’s Comeback

In his blog post, Whitaker breaks down those parts of the Harrow-Jobe study that showed how all the subgroups of non-medicated patients fared better without antipsychotic medications. This includes both “good prognosis” patients and “bad prognosis” patients. Says Whitaker:

Although [Harrow] didn’t provide the global data for these two subtypes, he did report this finding: “In addition, global outcome for the group of patients with schizophrenia who were on antipsychotics were compared with the off-medication schizophrenia patients with similar prognostic status. Starting with the 4.5-year followup and extending to the 15-year follow-up, the off-medication subgroup tended to show better global outcomes at each follow-up.”


In other words, in every subgroup of patients (by prognostic type), those off medication had better long-term outcomes (in the aggregate).

Whitaker (predictably) assigns another “dishonesty moment” to Torrey. This is based on the fact that Whitaker did not cite the Harrow-Jobe study for the proposition “that long-term antipsychotic use causes brain damage and is responsible for many of the symptoms of schizophrenia,” as Torrey claimed. Rather, Whitaker kept his interpretation to outcomes.

Nevertheless, Whitaker in his book (p 118-119,) linked the Harrow-Jobe study to a study that did suggest that “drugs made patients more vulnerable to psychosis over the long-term,” and (p 120) he noted that “we can also see how this drug-induced chronicity has  contributed to the rise in the number of disabled mentally ill."

What Harrow et al Actually Say

From a 2005 article (free on PubMed):

More recent data of ours suggest that some of the schizophrenia patients who go off antipsychotics are a different type of patient. They have better premorbid developmental achievements, have more favorable prognostic characteristics, and are more resilient and less vulnerable to psychopathology (or “healthier”), leading to their better functioning.

And from the 2007 article Whitaker refers to (you have to pay $50 for this, the abstract is free):

The results suggest that the subgroup of schizophrenia patients not on medications was different in terms of being a self-selected group having better earlier prognostic and developmental potential.

And the key finding from the wider dataset (including patients with other diagnoses), in a 2009 article (available free on PubMed):

A more external locus of control is related to fewer periods of recovery, to both depressed mood and psychosis, and to various aspects of personality.

Locus of control (LOC) “refers to the extent to which an individual perceives events in his or her life as being a consequence of his or her actions, and thus under his or her perceived control.” Internal LOC is good. External LOC is bad.

Of the schizophrenia patients in recovery over 15 years, according to the 2009 article, 67 percent had internal LOC. In the overall sample, 75 percent had internal LOC.

Basically, Harrow et al are telling us that an individual’s personal make-up is a key predictor to recovery, perhaps THE key. In their study, these were the patients more likely to go off their meds and do well off their meds. In the authors’ own words (2007):

Patients who are internally orientated and have better self-esteem are the types of patients who are more likely, if their functioning improves, to urge that they try functioning without medications ...

This is worth restating: According to Harrow et al, based on their study findings, doctors should be encouraged to consider taking a good prognosis patient who is doing well off his or her meds. This is an entirely different proposition than what Whitaker would have us believe - namely, get EVERYONE off their meds as soon as possible.

Whitaker doesn’t say this in so many words, but the thrust of his interpretation of the study  - namely “that the drugs worsened long-term outcomes” (p 118) - leaves himself open to Torrey’s charge of using “tortured logic.”

What Whitaker is doing is making a “secondary analysis,” a common and legitimate practice that can often yield far more interesting insights than the primary analysis. The catch is that you have to read Whitaker’s book microscopically to know he is making this of kind analysis. He certainly does not trumpet Harrow et al’s real findings, much less explain them, and this is disturbing, to say the least.

This brings us to the crucial question, does Whitaker’s secondary analysis hold up?

To be continued ... 

Collision Course: Whitaker vs Torrey

This is the second in a series of pieces dealing with Fuller Torrey’s response to Robert Whitaker’s 2010 “Anatomy of an Epidemic.” In his review, Dr Torrey asserts that on matters of schizophrenia and antipsychotic drugs, “Whitaker got it mostly wrong.”

My first piece laid out the background to the controversy, namely my view (spread across numerous pieces throughout 2010 and 2011) that Whitaker had not made his case that psychiatric meds have caused a mental illness epidemic. Nevertheless, he made a very strong “case to answer,” one that demands a considered point-by-point response, preferably from a leading psychiatrist. More then two years went by since the publication of “Anatomy,” with no signs of intelligent life from psychiatry. Last week, Torrey broke the silence. Better late than never.

The same day that Torrey published his review, Whitaker in a blog post issued an angry rebuttal that cited Torrey for at least four instances of “dishonesty,” as well as using the occasion to attack Torrey and the Treatment Advocacy Center for its aggressive stance on assisted outpatient treatment (which a good many of us - myself included - also have serious issues with).

Lost in the noise was that on key points Whitaker has failed to respond to Torrey’s criticisms. Let’s get started:

The 1994 Outcome Study

Whitaker’s Position:

In the foreword to his book, Whitaker says that he “encountered two research findings that didn’t make sense.” One of these was a 1994 study conducted by researchers at Harvard, which found that “outcomes for schizophrenia patients in the United States had worsened during the past two decades ...”

He says no more about the study and makes no further mention of it in the rest of his book.

Torrey’s Response:

In his review, Dr Torrey notes that what the study actually said was “quite different,” namely that when a broad definition of schizophrenia was in vogue, outcomes were a lot better. Moreover, “the data showed a clear improvement in outcomes during the 1960s and 1970s following the introduction of antipsychotic drugs.” Outcomes worsened during the 1980s and 1990s, “which the authors attributed to the introduction of a narrow definition of schizophrenia.”

The broad and narrow definitions are no mere diagnostic quibbling. The narrow (DSM) version (introduced in 1980) mandates six months of symptoms.

Torrey also noted that Whitaker “later added that the worsened outcomes were due to the use of antipsychotic drugs.”

Whitaker’s Comeback:

In his blog post, Whitaker claims that he only mentioned the study in passing in the foreword to his book, as something that “piqued my curiosity,” thus implying that his use of the study was not worthy of Torrey’s attention. Surprisingly, in his defense, Whitaker acknowledges that the study authors said exactly what Torrey said they said, namely:

... the researchers reasoned that improved outcomes in the middle part of the century were due to both a change in diagnostic criteria that broadened the definition to include patients who were less ill at disease onset and then to the introduction of neuroleptics.

Then Whitaker served up his own theory of why maybe - sort of - the study supports his thesis anyway. (We won’t get into that here.)

Torrey’s big mistake? Whitaker made no specific reference to this study when he talked about worsened outcomes on antipsychotic medications, as Torrey stated in his review. This brought down Whitaker’s wrath in the form of “dishonesty moment number one" for Torrey.

Actually, though, on page 118 of his book, Whitaker says, “We have followed the trail of documents to a surprising end ...” Why wouldn’t we assume the Harvard study was part of that paper trail?

Verdict:

Dishonesty moment to Whitaker, big time. This is an egregious example of a journalist misciting a study to serve his own ends, then conveniently forgetting about it when the actual facts failed to support his thesis. This is hardly the only example of Whitaker’s highly selective cherry-picking in his book. Torrey was perfectly correct to call out Whitaker.

As for Torrey’s “dishonesty moment,” using a flimsy pretext to brand a critic as dishonest violates all the basic principles of playing well with others.

Finally, Whitaker totally failed to address Torrey’s extremely relevant point concerning broad and narrow diagnostic criteria. More about that, coming right up ...

The WHO Outcome Study

Whitaker’s Position:

Whitaker devotes considerable attention in his book to two World Health Organization studies that found that those with schizophrenia in developing countries had much better outcomes than those in developed nations. As Whitaker reported in his book (p 111):

... the bottom line is clear: In countries where patients hadn’t been regularly maintained on antipsychotics earlier in their illness, the majority had recovered and were doing well fifteen years later.

Whitaker then goes on (p 119) to link this study to other studies to conclude that “evidence for long-term recovery rates are higher for nonmedicated patients appears in studies and investigations of many different types.”

Torrey’s Response:

Dr Torrey in his review evinces far less enthusiasm, noting that the WHO study claim “has continued to be criticized over the years and has now been largely discredited.” At issue, once again, is broad and narrow diagnostic criteria. Citing various sources, Torrey notes that many of those enrolled in the third world centers probably did not have true schizophrenia (some of the patients were referred by religious and traditional healers). More likely, the researchers were dealing with a good number of those suffering from “acute reactive psychosis,” which have much better outcomes than schizophrenia.

Torrey also cites a five-year 2011 study on a cohort of Ethiopian patients with findings that contradict the WHO studies. Finally:

Faced with such criticisms, the authors of the WHO studies have recently modified their claims, stating that “we do not argue that the prognosis of schizophrenia in developing countries is groupwise uniformly milder” and acknowledging that “the proportions of continuous unremitting illness…did not differ significantly across the two types [developed and developing] of setting.”

Whitaker’s Comeback:

Predictably, Whitaker assigns Torrey another “dishonesty moment.” This is based on the fact that far from “modifying their claims,” the authors of the WHO studies in the same paper Torrey cited actually vigorously defended their findings. Says Whitaker:

Dr. Torrey, in his review, was intent on discrediting the findings from this WHO study, which reported superior outcomes in poor countries where only a small percentage of patients were regularly maintained on antipsychotics. To do so, he implied that the WHO investigators now agreed with the critics of the study, when that is not true.

Verdict:

We have a big wet loogie on the table, which Whitaker fails to address, namely: The authors of the WHO studies have explicitly acknowledged that the patients in the third-world countries had a milder prognosis than those in the developed countries. Why is this important? If we are comparing apples to oranges, then the findings of the WHO study are totally meaningless.

More likely, the “apples to oranges” controversy merely raises questions about the study rather than discredits it, as Torrey maintains. If anything, the WHO study is a textbook example of why no finding can be taken at face value. Certainly, we all know this when it comes to clinical trials sponsored by drug companies.

What is particularly disturbing is that Whitaker would have been aware of the “apples to oranges” controversy when he wrote "Anatomy of an Epidemic." Yet he makes only a fleeting reference to it in his book, and only in the context of vindicating the first WHO study (as if there were no reason to question the second study). A straightforward and thorough stating of the controversy would hardly have undermined both studies' findings or Whitaker’s thesis. If anything, preemptively dealing with this concern would have greatly strengthened Whitaker’s argument, along with his credibility.

Instead, we are left with the feeling that Whitaker is hiding something.

Keep in Mind ...

In past blog posts, I have been supportive of Whitaker, but I have also not hesitated to point out numerous examples of where he played fast and loose with the facts, or where - quite frankly - he failed to turn in his homework. I continue to be supportive of Whitaker, but I also support any critic of Whitaker acting in good faith. In my 13 years researching and writing on mental illness, one vital lesson stands out loud and clear: Never - never-ever-ever - take anyone (and I include myself here) at face value. Always maintain a healthy skepticism, even if the party involved claims to be speaking for you - especially if the party involved claims to be speaking for you.

To act otherwise is to place your life on the line. Our illness takes no prisoners.

Much more to come ...  

Torrey Responds to Whitaker: At Last, a Conversation

I have devoted considerable space on this blog to Robert Whitaker’s 2010 “Anatomy of a of an Epidemic,” which posits that mental illness is on the rise because of psychiatric medications, rather than in spite of them. In reviewing Whitaker, I read the same studies he cited in his book and came to the conclusion that Whitaker had not made his case.

Nevertheless, I pointed out that Whitaker had made a very strong “case to answer.” In other words, until someone (presumably a psychiatrist with weighty credentials) made a convincing counter-argument (preferably in a point-by-by rebuttal), Whitaker’s thesis - whatever one’s misgivings - stood as the authority.

I also stated that Whitaker had initiated a conversation that we badly need to have. Whitaker was also very clear that he wanted to have this kind of discussion.  

To my dismay - and to the shame of psychiatry - that conversation never eventuated. Daniel Carlat of Tufts University in two blogs issued what was essentially a collegial light dusting, taking issue with Whitaker’s presentation of the evidence in a friendly sort of way, but hardly knocking any holes in his main arguments.

Andrew Nierenberg of Harvard purported to “rebut” and “refute” Anatomy of an Epidemic in response to a grand rounds Whitaker delivered at Mass General. The so-called rebuttal amounted to an irrational and high-volume hissy fit (one punctuated by totally unprofessional ad hominem attacks) that I could only characterize as “sick, very sick.”

A few commentators quibbled about Whitaker’s interpretation of the term, “Epidemic,” tossing in an ad hominem attack or two for good measure, but otherwise avoiding engagement.

That all changed last week with an article posted on the website of the Treatment Advocacy Center. Anatomy of a Non-Epidemic - A Review by DrTorrey, read the heading. “How Whitaker Got it Wrong,” read the subheading.

E Fuller Torrey (pictured above) has a way of getting a rise out of certain mental health advocates. Dr Torrey is the founder of the Treatment Advocacy Center (TAC), which pushes for aggressive outpatient treatment laws for those with severe mental illness. The issue is a hot-button one, and TAC and Torrey have come under considerable criticism for their position and their tactics (including from this writer).

But Torrey has paid Whitaker the ultimate compliment of intelligently and thoughtfully responding to Whitaker. Too often, in our focus on personalities, we lose sight of the issues. Advocates who should know better have elevated Whitaker to the status of cult hero who can do no wrong. This is a grave disservice to both Whitaker and the people we purport to serve.

Torrey, too, enjoys a certain cult following, particularly among first-generation NAMI parents, as well as villain status from a host of mental health advocates. We will discuss these matters in a future blog. But, for right now, let’s focus on the issues. Essentially, Torrey has shifted the whole discussion. He has convincingly answered Whitaker’s “case to answer.” This hardly means that Torrey is right and Whitaker is wrong. Indeed, a constructive synthesis would move the discussion to a new level, one that Whitaker and Torrey could easily agree upon - the need for some serious research.

In other words, if the scientific evidence is insufficient to either support Whitaker’s case or to rebut it, then let’s put some serious money into unearthing the evidence.

In future blog posts, we will explore point-by-point Dr Torrey’s responses to Whitaker. In the meantime, this disclosure: Dr Torrey wrote a very glowing back-cover blurb for my 2006 book, “Living Well with Depression and Bipolar Disorder.”  The blurb states: “Very helpful for those affected by bipolar disorder and their families ... I recommend this book enthusiastically.”

I have had no other involvement with Dr Torrey and none with the Treatment Advocacy Center.

Stay tuned ... 

Living with Someone Who Has Bipolar; Living With Someone Who Has Normal

Now Available as a Paperback

From Therese Borchard, author of Beyond Blue:

I kept saying to myself, "Did he just write that?" "Did he really just write that?" until I got to the third chapter and expected the pages ahead to be full of the same playful, entertaining .... um .... original prose that preceded it.

Anyone can jot down the bizarre thought patterns that are floating between their brain lobes. I guess what makes McManamy different is that he has taken a tour of Dante's Inferno and, while there, jotted down some funny notes that people who had been to Dante's Purgatory--or maybe even the first layer of hell--might appreciate, read in the bathroom, or digest like their favorite comics because the stories simply make them feel better. They are written by an intelligent man who has suffered and has been able to translate that suffering into hysterical laughter.

Funny is good. And this man's outrageous stories make me laugh. Sometimes they even make me forget about my day's trauma. Now that's a miracle.

Purchase paperback edition ($9.95)

Or download directly to your Kindle or Kindle app ($4.99):

Bipolar Relationships

A quick note: On Thursday, I will be addressing the International Bipolar Foundation on Relationships. Details:

Living with Someone who has Bipolar; Living with Someone who has "Normal"

Thursday, April 12, 2012

Speaker: John McManamy

5:30-6:00- SOCIAL 6:00-6:45-LECTURE 6:45-7:00- Q and A  

Location: Sanford Children's Research Center, Building 12 Address: 10905 Road to Cure, San Diego 92121

Public welcome. See you there!

Some Interesting Facts About Raccoons Respect My Piss (Plus a Few You Wish You Didn't Know)

I'm still nose down-ass up in the post-production phase of my new Kindle book, RACCOONS RESPECT MY PISS BUT WATCH OUT FOR SKUNKS. Scout's honor: I will return to blogging as usual once I come up for air. In the meantime, a few interesting tidbits regarding the book:

No animals were harmed in the making of RACCOONS. Pity about the human.

I refrained from gratuitous use of the word, "quotidian."

I insisted that the book be printed on environment-friendly paper only. Then I found out that Kindle books don't use paper.

The official peanut butter employed in the Raccoons Project is Laura Scudder "Nutty." (How appropriate.)

The Lamborghini Murcielago was chosen as the official car of the Raccoons Project. Unfortunately, Lamborghini never got back to me.

The word "bipolar" appears 10 times in the book. The word "crazy" 28 times. This is intentional.

In the movie version of the book, I save the world and get the girl, or get slowly eaten by a well-mannered orange land whale - I can't remember which.

The skunks still laugh at me.

***

You can start reading my book right now by clicking on the link below, which will take you to Amazon.com. Because I am cutting out the middleman, I am offering RACCOONS at the very low price of $4.99.



If you don't have a Kindle, you can download your free Kindle app for your iPad, phone, desktop, or laptop by clicking the link below.

Download your free Kindle app.

Happy reading!

At Long Last! Raccoons Respect My Piss But Watch Out For Skunks ...

When you're both depressed and crazy, life has a way of becoming hilarious. I always sort of knew this, but it wasn't till my friend Therese Borchard (author of Beyond Blue) urged me to emphasize my funny and personal side that the message came in loud and clear.

Soon, I was writing about some of my comic misadventures in dealing with life on a planet seemingly built for other people. We are outsiders, all of us, all of humanity. A lot of us simply don't know it. I soon discovered that I was rewriting my favorite piece of literature, Homer's Odyssey, the story of a battle-weary man, living by his wits, longing to return home.

Except that I was dealing with things such as skunks walking in through the cat flap. I was also pondering life's impenetrable mysteries, such as the purpose of Ramen noodles. What was the connection?

It wasn't long before I figured out that our purpose here on earth is to make God laugh. Trust me, every day we do something to make Him snort milk out of His nose. But I also came to this important realization: Every time we make God laugh we have the opportunity to learn an important life lesson.

I have had plenty of opportunities to learn. This is my story - an outsider, cast up on a strange shore, seeking a place I can call home. In many ways, it's your story, too. We all face similar challenges, deal with similar issues. We may stumble in the dark, gritting our teeth through the pain, but we learn along the way, and that's a start.

Whether contending with mental illness or contending with normal, RACCOONS validates your worth as a human being, a band of light, a soul with neurons. Let the healing begin.

A quick sampling:

From Chapter One:

I perform my own stunts. Trust me, through large parts of my life I would have loved to employ a stunt double and perhaps someday I will. Take my depressions—please. It was around the time I was in seventh grade that I had a profound sense that I wanted to return to the planet that I was born on, any planet but this one. I was small and skinny with glasses and had a nerdy personality.

A nerd is an individual not smart enough to be a geek.

From Chapter Eight:

Life, unfortunately, doesn't come with a manual, and the tech support is a joke. Seriously, when has God—or St Aloysius, even—ever gotten back to you? Is it too much for God to stop what He is doing for just one second and tell me that the vital piece of hardware I dropped on the floor—the one I desperately need to assemble my counter extender from IKEA—rolled under the refrigerator?

It's not like I am asking God to move the refrigerator for me. Or, for that matter, to assemble my IKEA furniture, though that would be a very nice gesture. IKEA, by the way, is Sweden's revenge for not being allowed to be Vikings, anymore.

Hannibal's elephants, in battle formation, about to unleash a deadly volley.

From Chapter Eleven:

Thursday morning, I got hold of a cab driver and we negotiated a flat rate to go shopping for used cars. "They say it's best to buy a Japanese car," I opened. (Who said I didn't do my research?)

The cab driver (who was driving a Lexus) enthusiastically concurred.

We pulled into the first car lot on my list. Five VWs with silver paint were lined up in a row. "Get the car with the silver paint!" the two-year-old part of my brain screamed at me. But I'm way too sophisticated for that.

"Uh, German is kind of like Japanese," I said tentatively to the cab driver. Yes, he agreed. Good enough for me. After all, they both lost World War II.

From Chapter Eighteen:

And when it comes to a loving relationship, it's not just one person we're talking about. For starters, there's her family to deal with. Every time, the same sense of deja vu. "Weren't you 'Patient X' I was reading about in the New England Journal of Abnormal Psychology?" I am tempted to inquire of the scheming sister of the clan.

From Chapter Twenty:

Bipolar is the "crazy" diagnosis. Call me crazy. We do things that attract unwanted attention to ourselves, you know, like discovering America, painting the Sistine Chapel, founding the US, figuring out gravity, coming up with alternating current, and inventing rock 'n roll.

As I like to say to people: "We give you the gift of civilization and how do you treat us? You marginalize us."

From Chapter Twenty-Seven:

1. If you think you are experiencing God—it's probably dopamine.
2. If you think you are experiencing love—it's probably dopamine.
3. That doesn't mean God or love is not real ...
4. ... but we know dopamine is.

My idea of hell.

You can start reading my book right now by clicking on the link below, which will take you to Amazon.com. Because I am cutting out the middleman, I am offering RACCOONS at the very low price of $4.99.



If you don't have a Kindle, you can download your free Kindle app for your iPad, phone, desktop, or laptop by clicking the link below.

Download your free Kindle app.

Happy reading!

My New Kindle Book!!

Here is why I haven't been posting recently: I just completed the Kindle Book I promised, and it's now up on Amazon:

Raccoons Respect My Piss But Watch Out For Skunks: My Funny Life on a Planet Not of My Choosing That I Now - Sort of, Maybe, Well Okay - Call Home

Here is the product description from the site:

When you’re both depressed and crazy, life has a way of becoming hilarious. In his new book, highly regarded mental health author and advocate John McManamy displays his wickedly dark and equally exuberant funny side.


RACCOONS RESPECT MY PISS BUT WATCH OUT FOR SKUNKS recounts the author’s comically absurd misadventures in dealing with life on a planet seemingly built for other people. Childhood, relationships, nature’s furry psychopaths, falling in love, neurons, God, UFOs, Hannibal’s elephants - it’s all there. Each chapter tells a story, the stories bind into a narrative. The narrative builds into profound realizations.


And you are laughing all the way.


John McManamy’s deep humanity and ability to connect to others is unmistakable. RACCOONS is a timeless story, one to which we can all relate, of one individual’s long and painful and ultimately heartening journey to find home.


Whether contending with mental illness or contending with normal, RACCOONS validates your worth as a human being, a band of light, a soul with neurons. Let the healing begin.


PRICE: $4.99 (Cheap)




The book is available on Kindle or any device or computer that has a Kindle App. These include your desktop or laptop, iPAD, and smart phone. To download your FREE Kindle App, go to this page on Amazon.

Huichol VW

If you guessed this photo has something to do with your VW on acid circa 1967 you're pretty close. Classic Beetles have been manufactured in Mexico till fairly recently. In 2010, underwritten by various sponsors, eight members of the Huichol people, living in the mountains of central-western Mexico, began customizing their own Beetle.

In recent years, with the application of new materials, Huichol art has exploded onto the world scene. One aspect of this is "yarn-painting," using modern fine yarns with bright colors. The other makes use of very tiny beads. The designs are traditional, the effects are very modern and spectacular. I have four framed reproductions of Huichol beadwork "paintings" hanging in my living room.

Yesterday, while strolling in Balboa Park, I stumbled upon the mother of all Huichol art - the "Vochol," a combination of the popular term for VWs in Mexico and Huichol. The artists, led by Francisco Bautista Carrillo and his daughter Kena, labored 4,760 hours, and applied 2,277,000 beads with a special resin.

As to the 60's on-acid appearance - the Huichol beat the hippies by at least a millennium. The peyote is a sacred plant.

San Diego is the first stop in a world tour. The Vochol will be auctioned off to rise money for the Huichol people

Coming Soon to A Kindle Near You

Personal Note

I'm head down, ass up, putting together an ebook I plan to self-publish as a Kindle edition. I'm aiming to get the book out in two weeks. The book is based on a number of my pieces here at Knowledge is Necessity. It will be a humorous memoir with the title, "Raccoons Respect My Piss (But Watch Out For Skunks): My Funny Life on a Planet Not of My Choosing That I Eventually Came to Call Home."

I know - I need to make the title longer.

I will be posting reruns this week, and - of course - updates on my forthcoming book. Thanks for bearing with me, and stay tuned ...

Rerun: McMan's Dispensable Rules and Observations for Right Living

I've been tied up with a lot of volunteer work and work on new projects. Looking forward to returning to live posting fairly soon. In the meantime, this from April last year ...

My grandson’s birth in Sept 2009 inspired me to come up with two posts along the lines of the clan elder (me) offering his sage advice to the newest member of the tribe. The piece below represents a reshuffle of my original two lists, plus some new stuff. I make no claim to originality (one of my aphorisms is a shameless rehash of Diogenes). My status as a dispenser of wisdom derives from an unparalleled lifetime streak of doing everything wrong. Enjoy ... 

Four Rules for Living with Perspective

1. Remember, Hannibal never won a battle with his elephants.
2. Caviar is fine, but peanut butter will always be your friend.
3. We elude happiness far more than happiness eludes us.
4. God has a sense of humor. Trust me, every day you will do something to make Him snort milk out His nose.

Four Rules for Making Wise Decisions

1. The Wise Man knows when to quit while he’s behind.
2. If you challenge Tiger Woods to a game - make sure it’s not golf.
3. Ration your hate. Don’t indulge.
4. When you reach into your pocket searching for a one dollar bill and all you can come up with is twenties - try not to express your disappointment.

Four Rules for Right Conduct

1. There is no excuse for dancing like a white man.
2. You are a book responsible for your own cover. Expect people to judge.
3. We are who we pretend to be. You can’t go wrong pretending to be JFK or Martin Luther King.
4. If you suck up to the rich and powerful, you won’t have to do your own laundry. If you do your own laundry, you won’t have to suck up to the rich and powerful.

Four Observations About Meaning

1. Friends are a way better investment than money.
2. A good poop is way better than mediocre sex.
3. Our purpose here on earth is to laugh at farts.
4. There is one constant in life: Ursula Andress will always be the all-time number one Bond Girl.

Four Observations About the Mysteries of Life

1. Thoreau danced to a different drummer, but he also died a virgin.
2. Napoleon lost an entire army in north Africa and an entire army in Russia. Still, he had no trouble recruiting volunteers for Waterloo. Go figure.
3. God has a funny way of treating people He loves most. Just ask Joan of Arc.
4. The oldest known redwood is 2,200 years old. An idiot with a chainsaw only needs one day.

Four Observations on Reality

1. If you think you are experiencing God - it’s probably dopamine.
2. If you think you are experiencing love - it’s probably dopamine.
3. That doesn’t mean God or love is not real ...
4. ... but we know dopamine is.

Rerun: Is Republicanism the New Stupid?

From Sept, 2010, still relevant ...

"Republicanism isn't a party. It's a diagnosis." A friend of mine happened to relate that to me in a conversation about a year ago, and I have no reason to dispute it. In fact, we actually have the brain science to lend credence to his statement. The same findings also indict Democrats, though I would contend there are mitigating circumstances. It breaks down like this:

It appears that nearly all of us are wired to register moral outrage, but we have very different on and off buttons. The same event can turn us all into avenging angels of God, but for entirely different reasons. A conservative, for instance, might want to kick a beggar. A liberal would kick the person who kicked the beggar.

Yes, environmental factors loom large, but a 2005 NY Times article brought attention to a Virginia Commonwealth University survey of a large sample of identical and fraternal twins on such divisive issues as taxes, labor unions, and x-rated movies. It turned out the identical twin pairs showed much greater concordance on political and social issues than did their more fractious (and apparently less) fraternal counterparts.

We have decades of research to back the proposition that our genetic makeup contributes mightily to our gut-level reactions to all manner of things that go off in the world around us. That same body of research also indicates that our pretenses at reasoned discourse are little more than elaborate justifications for our thoughtless emotional reactions.

In his excellent book, "How We Decide," science writer Jonah Lehrer cites an analysis that found that only 16 percent of voters with "strong party allegiances" during the 1976 US Presidential campaign were persuaded to vote for the other party. In a more recent study, political partisans had their brains scanned as they were read out the on-the-record inconsistencies of George W Bush and John Kerry. Predictably, the prefrontal cortices - the seat of reason - were recruited, which should have been a good sign.

For instance, if exposed to the fact that while on the same day George Bush promised "to provide the best care for all veterans" his administration cut medical benefits to 164,000 veterans, you might expect a Republican to seriously question his or her cherished beliefs. Or at least register some level of primal disgust.

Instead, the Republicans (and Democrats, too, when exposed to stupid Kerry tricks) felt a rush of pleasurable emotion. What seemed to be happening was that the thinking regions of the brain were activated - not to dispassionately weigh the facts and formulate some kind of rational response - but to fabricate a favorable interpretation of the facts, no matter how unpleasant those facts happened to be.

Thus, when the thinking brain had successfully arrived at "mission accomplished" - that is, a palpably absurd conclusion - the lower regions of the brain slobbered like a dog gorging on red meat.

As Lehrer contends, these and many more studies force us to rethink the long-held notion that reason, judiciously applied, overcomes ignorance and blind instinct. Adolph Hitler proved us all wrong on that count.

Now I know why I regard engaging in any kind of dialogue with a Republican as a total waste of time. I came to this unfortunate conclusion back in the nineties, but it wasn't always this way. Before that, I actually cultivated conservative friends. I also worked in a field (financial journalism) which involved total immersion in conservative opinion.

These individuals had a strong influence in my moderating many of my core beliefs and turning me around completely on my more flaky ones. Likewise, I like to think that I exercised a similarly beneficial influence. But in today's highly divisive political climate - the worst in my estimation since the Vietnam era - that simply is not possible. Heaven help if I were to point out to a Republican that Clinton actually turned federal deficits into federal surpluses.

I'm sure Republicans can make similar complaints, but how can I take them seriously when they cite Sarah Palin or Glenn Beck with approval? Hopefully, we can eventually restore reason to the dialogue. In the meantime - forgive me for my attitude - I have to go along with my friend: Republicanism is a diagnosis.

***

I've been very busy with other projects and volunteer work, so beg your indulgence in going with reruns for the next little while.