Putting Your Best Foot Forward

The gorillas are my favorite animals at the San Diego Zoo. We may have moved away from counting our toes, but I know people who would greatly benefit from evolving toward the humanity of these wonderful creatures.

Also, check out this footage I shot at the same location two years ago ...

A Lesson in History: The 1960 Presidential Campaign

I recall my father sitting me down and offering this sage advice: "Son," he said, "there is no excuse for dancing like a white man."

Actually, he said no such thing. Rather, he counseled, "Son, there is no excuse for thinking like a Republican."

Okay, he never said that either, but I do recollect my father dragging me out on a bitter cold autumn night in New England fifty years ago. I was 10 going on 11, and an historic Presidential campaign was underway.

JFK was due to address an evening rally in nearby Waterbury, Connecticut. He should have arrived hours before, but no one was leaving. I was standing in the drizzling freezing cold with my father and thousands of others. People were warming their hands around improvised fires they had lit in steel trash drums.

I don't remember much about Kennedy that night, but I vividly recall that crowd. I recall my father, I recall the emotion. History was being made. Theodore White, in his book "The Making of the President," recounted that memorable night and how Kennedy was astounded by the turn-out and the enthusiasm. That reception, others have commented, animated the exhausted candidate, gave him a second wind, imbued him with the strength to squeak out a win in what was then the closest election in history.

Had my father and others voted according to reason rather than emotion, Nixon would have easily won the election. Nixon, after all, had more experience by far, having served as Vice-President under Eisenhower, a true moderate Republican who presided over a decade of unprecedented prosperity.

A continuation of the Eisenhower years under Nixon would have been the sensible choice, but many voters harbored a visceral hatred of the Republican candidate. Part of this had to do with Nixon's early rise to fame. Conservatives saw him as a principled man standing up to home-grown communism. Liberals saw him as a rat bag red-baiter out to ruin innocent people for his own personal gain.

Part of this also had to do with Nixon's unfortunate "Tricky Dicky" image, which JFK exploited to the max. (Would you buy a used car from this man?) By contrast, JFK literally invented charisma. All politicians who came after are mere pale imitations. In their first debate (see the above YouTube clip), most of those who heard the proceedings on radio thought that Nixon had won, but JFK emerged a clear winner to the TV audience.

During the campaign, JFK resorted to a scare tactic involving a fictitious "missile gap" with the Soviet Union. Nixon could not respond without disclosing classified information. There was also the complicating variable of JFK's religion, then a contentious issue. Make no mistake about it, in our Irish-Catholic household it wouldn't have mattered if Kennedy were Forrest Gump - he had the McManamy vote securely locked away.

Conversely, all hell could have frozen over before many Protestants would have voted for a Catholic. Then there was the "solid south," in those days staunchly Democrat, still irrationally nursing a grudge against the party of Lincoln.

Nixon and Kennedy entered Congress the same year, 1946. They became good friends, Kennedy a conservative Democrat, Nixon a moderate and almost liberal Republican. Both were thoughtful men, with sharp intellects. Both were keen students of history. On paper, very little separated the two. On all the intangibles - the things that reason cannot explain - it was an entirely different story.

In the final analysis, the right man won for the wrong reasons. Such is the capricious nature of democracy. Jefferson and our Founding Fathers naively assumed that a well-informed public, making reasoned choices, could be trusted with their own government. According to a recent Pew Research Poll, 34 percent of conservative Republicans think Obama is Muslim.

This time around, capricious democracy - fueled on cynically fanned emotions - is leading us to an inexorably wrong result. God help us all.

Hamlet's Madness

Yesterday, I wrote on the madness of Lear. This inspired me to dig out two pieces on Hamlet I did for HealthCentral back in early 2007. Following is a reworked version:

I have of late - but wherefore I know not - lost all my mirth, forgone all custom of exercises; and indeed it goes so heavily with my disposition that this goodly frame, the earth seems to me a sterile promontory …

The speaker is Hamlet, of course, and he is either severely depressed or doing a damn good job faking it:

What a piece of work is man!
How noble in reason!
how infinite in faculties!
in form and moving, how express and admirable!
in action how like an angel!
in apprehension, how like a god!
the beauty of the world!
the paragon of animals!
And yet, to me,
what is this quintessence of dust?

Somehow, our hero has to get over his grief and harness his anger long enough to elicit the facts, figure out who his enemies are, then lie low and bide his time for the right opportunity to strike, assuming he can summon up the nerve to act against his true nature. 

Shakespeare wastes no time in introducing his madness theme. In the first scene of the first act, sentinels Barnardo and Marcello assume their night watch with extreme caution. Their conversation reveals that they have had two close encounters with a ghost. Are they hallucinating? Hamlet’s buddy Horatio definitely thinks so, but then …

Enter the Ghost in complete armour, holding a truncheon, with his beaver up.

Suddenly, Horatio is a believer. But Marcello needs confirmation that he is not losing his marbles. “How now,” he implores Horatio. “Is not this something more than fantasy? What think you on’t?”

This is Horatio’s cue to deliver his own prognosis: “This bodes some strange eruption to our state.”

Hamlet has yet to make his entrance, and already mad is the new normal.

Now we learn that no sooner have they buried Hamlet’s father than his uncle (Claudius) has married his mother (Gertrude) and assumed the throne. Perfect sociopaths that the new love couple are, neither parent can fathom why Hamlet is so upset.

“How is it that the clouds still hang on you?” enquires Claudius, apparently noticing that his newly adopted son is not exactly acting like the life of the party.

Gertrude gets straight to the point: “Good Hamlet, cast thy nightly colour off.”

In other words, snap out of it, get over it. What’s the big deal? So what that your mother is shtupping the guy who murdered your father?

Clearly Hamlet is becoming unhinged, but if his new father and all his retainers think he’s crazy (as in resolving to exact his revenge on them) then it's curtains for Hamlet. (Actually it turned out to be curtains for Polonius – yuk-yuk.)

We are talking about a normal reaction to a crazy situation, especially in a culture that gave birth to the terms anger and berserk, not to mention the name of the weapon of choice, the knife. This is what everyone around him is expecting, for Hamlet to act as they would, were they in his shoes. The catch is that they are bound to display their understanding in a preemptory outpouring of unsheathed steel.

One slight misstep for Hamlet, then, one indiscreet glance the wrong way, one blown syllable in one soliloquy, and cue up the grave diggers for the first act.

So - was Hamlet mad or was he just faking it? That is the question. Scholars pose this as an either-or “to be or not to be” riddle when reality (keeping in mind our hero is fictional) suggests a far more nuanced “to be AND not to be.”

Hamlet clearly knows he cannot hide his perfectly logical and dangerous madness. No, his survival depends on showing the Danish court a different kind of crazy, a harmless crazy, a crazy so crazy that even fair Ophelia is confused.

At one point in the play, Ophelia advises her father Polonius of Hamlet's interest in her:

He hath, my lord, of late made many tenders
Of his affection to me.

But later on, our title character abuses the object of his affections:

Get thee to a nunnery: why wouldst thou be a
breeder of sinners?

Ophelia has bought in to Hamlet's madness:

O, what a noble mind is here o'erthrown!

And so has Claudius, who has overheard everything:

Madness in great ones must not unwatch'd go.

Hamlet has bought himself time. He is mad, faking mad, going mad. Then there is the not-so-small matter of his force nine depression, introduced at the beginning of the play. As we know, any decent red-blooded male of Viking descent would have been hell-bent on revenge. But no, Hamlet can barely summon up the motivation to get out of bed, and Prozac is eight hundred or so years from being invented.

Someone needs to pull our melancholy Dane out of it. Enter Horatio and Marcellus and Barnardo with a very strange sighting to report, an apparition armed and with his beaver up – Hamlet’s father!

The life and death battle of wits is on.

The Madness of Lear

On Saturday I attended a superb production of King Lear at the Old Globe in San Diego's Balboa Park. Sample this luscious insult:

OSWALD
What dost thou know me for?

KENT
A knave; a rascal; an eater of broken meats; a base, proud, shallow, beggarly, three-suited,
hundred-pound, filthy, worsted-stocking knave; a
lily-livered, action-taking knave, a whoreson,
glass-gazing, super-serviceable finical rogue;
one-trunk-inheriting slave; one that wouldst be a
bawd, in way of good service, and art nothing but
the composition of a knave, beggar, coward, pandar,
and the son and heir of a mongrel bitch: one whom I
will beat into clamorous whining, if thou deniest
the least syllable of thy addition.

Lear's madness is already the topic of conversation in the first scene of Act I, when our main character retires as king in all but title, leaving him to the tender mercies of his two scheming eldest daughters, Regan and Goneril. Lear compounds his bad judgment by impulsively disowning his youngest and most beloved daughter, Cordelia. When his faithful retainer Kent objects  - "When Lear is mad. What wilt thou do, old man?" - Lear, in a rage, banishes him.

In private, Regan and Goneril take note of their father's mental instability, knowing full well they may be his next target, and the scheming begins in earnest.

Later on, the houseguest from Hell (Lear) meets the hostess from Hell (Goneril). In a rage, Lear takes leave, cursing his daughter thusly:

Dry up in her the organs of increase;
And from her derogate body never spring
A babe to honour her!

Meanwhile, his fool counsels:

thou hadst little wit in thy bald crown,
when thou gavest thy golden one away.

Lear, in a moment of clarity, realizes he has wronged his youngest daughter. "O, let me not be mad, not mad, sweet heaven," he pleads. "Keep me in temper: I would not be mad!"

But Regan turns him out (in the company of his fool) into the stormy night, a broken man, raging into the fury:

Your horrible pleasure: here I stand, your slave,
A poor, infirm, weak, and despised old man

Out on the heath, Lear encounters Edgar, a victim of a frame-up and fugitive from his father's wrath, disguised as a mad man. A surreal dialogue ensues, with Lear referring to the fake madman as "philosopher" and "learned Theban," a conversation that continues indoors, with the fool fitting right in. In an aside, Edgar empathizes with Lear, confessing:

My tears begin to take his part so much,
They'll mar my counterfeiting.

Soon after, in an ironic twist of fate, our storm-drenched band encounters Edgar's father and dupe in the frame-up, Gloucester, who has recently had his eyes plucked out and consequently fails to recognize his wronged son. He takes a liking to the youth, and engages him as his guide. In a commentary on the sad state of affairs in the world, he utters: 

'Tis the times' plague, when madmen lead the blind.

The action picks up further afield in Dover, with Lear thoroughly mad and disheveled. Cordelia and her army manage to get to her father before the armies of her scheming sisters. A doctor advises Cordelia, watching over her sleeping father:

Our foster-nurse of nature is repose.

On awakening, a more settled Lear reconciles with his daughter. The doctor advises:

Be comforted, good madam: the great rage,
You see, is kill'd in him: and yet it is danger
To make him even o'er the time he has lost.
Desire him to go in; trouble him no more
Till further settling.

The good old fashioned rest cure, based on the ancient principle that much of mental illness is stress-based. A number of years ago, I came across an article in the very first issue of the American Journal of Psychiatry (then the American Journal of Insanity) from 1844 that noted with approval:

Now we confess, almost with shame, that although near two centuries and a half have passed since Shakespeare thus wrote; we have very little to add to his method of treating the insane. To produce sleep and to quiet the mind by medical and moral treatment, to avoid all unkindness, and when patients begin to convalesce, to guard, as he directs, against everything likely to disturb their minds and to cause a relapse is now considered the best and nearly the only essential treatment.

Alas, tragedy is about to unfold. We were watching the production under a night sky, with the ghostly eucalyptus trees as a backdrop. Lear appeared as if from the trees, carrying his beloved dead daughter. The only sound that could be heard was the sickening thud in our hearts.

No one does literature better than Shakespeare. Ditto for psychology.

My America

Yesterday, a friend took me to a service at the First Unitarian Universalist Church of San Diego. I scanned the printed program. "Recitation from the Holy Koran," I read. Interesting. In walked the minister of the church, Rev Arvid Straube, with Imam Taha Hassane of the San Diego Islamic Center and his two young daughters.

A number of members of the church welcomed the Imam and his daughters. The Imam and the minister went to their places, the daughters sat directly in front of me.

The Imam explained that the Koran is the Word of Allah, and should be recited in one's most beautiful voice. He sounded forth a wonderful aural caligraphy, of all things not unlike that of a Jewish cantor reading from the Torah. Same God, same children of Abraham.

The Imam was moved by the warm welcome he received. He noted that a number of individuals from this church had attended his mosque the day before. His daughters, in the meantime, were taking this all in. They looked this way and that way. The oldest one had a camera. She lined up her shots and began clicking.

I could say a million words. Instead, I will conclude with the complete text of the letter that George Washington, early in his Presidency, sent to the Touro Synagogue in Newport, RI:  

Gentlemen:

While I received with much satisfaction your address replete with expressions of esteem; I rejoice in the opportunity of assuring you that I shall always retain grateful remembrance of the cordial welcome I experienced on my visit to Newport from all classes of citizens.

The reflection on the days of difficulty and danger which are past is rendered the more sweet from a consciousness that they are succeeded by days of uncommon prosperity and security.

If we have wisdom to make the best use of the advantages with which we are now favored, we cannot fail, under the just administration of a good government, to become a great and happy people.

The citizens of the United States of America have a right to applaud themselves for having given to mankind examples of an enlarged and liberal policy: a policy worthy of imitation. All possess alike liberty of conscience and immunities of citizenship.

It is now no more that toleration is spoken of as if it were the indulgence of one class of people that another enjoyed the exercise of their inherent natural rights, for, happily, the Government of the United States, which gives to bigotry no sanction, to persecution no assistance, requires only that they who live under its protection should demean themselves as good citizens in giving it on all occasions their effectual support.

It would be inconsistent with the frankness of my character not to avow that I am pleased with your favorable opinion of my administration and fervent wishes for my felicity.

May the children of the stock of Abraham who dwell in this land continue to merit and enjoy the good will of the other inhabitants; while every one shall sit in safety under his own vine and fig tree and there shall be none to make him afraid.

May the father of all mercies scatter light, and not darkness, upon our paths, and make us all in our several vocations useful here, and in His own due time and way everlastingly happy.

G. Washington

Is Happiness Possible?

Over on HealthCentral's BipolarConnect, I recently wrapped up a major series on Happiness. Four of my pieces dealt with the positive psychology of Martin Seligman of the University of Pennsylvania. Addressing the American Psychological Society in 1998, Dr Seligman challenged his colleagues to focus on the things that go right in human nature rather than what goes wrong.

In his 2002 book, "Authentic Happiness," Dr Seligman notes that despite our vastly improved standard of living, depression in the US has increased ten-fold since 1960. Part of the cause, he suggests, may be that our society is good at building shortcuts to pleasure.

Pleasure (which is fleeting), maintains Dr Seligman, is not the same as gratification (which is long-lasting). Typically, gratification involves effort. Settling back in the warmth of our homes with the TV clicker may seem like a rational choice. But the exhausted mountain-climber freezing on an exposed ridge doesn't want to be anywhere else.

Likewise, popping something in the microwave may be quick and easy, but making a meal from scratch is going to be a lot more satisfying (as is inviting people over).

A critical key to making the effort is "flow" - literally when time stops and you find yourself doing exactly what you want to be doing, totally immersed, and never wanting it to end. Of all things, flow involves the absence of emotion.

A study that compared "high-flow" teens (who had hobbies and did their homework) to "low-flow" teens (who hung out in malls) found the high flow kids did better on all measures of psychological well-being but one. The exception? The high-flow kids thought their low-flow peers were having more fun.

But tasks are not necessarily fun, per se. Typically, they involve challenge and hard work. Instant and ephemeral pleasure, such as watching sitcoms, is a sure flow-kill. Better, says, Dr Seligman, to pursue a life of meaning - to connect to something greater than yourself.

Dr Seligman also discusses optimism, which is not to be confused with our popular notion of "positive thinking" (which may involve viewing events in ways that fly in the face of unpleasant reality). Naturally, optimists and pessimists think a lot differently. For instance, optimists tend to internally credit themselves for good things happening and write off their inevitable setbacks as bad luck. Pessimists are just the opposite: If something happened to go right, they were just lucky that day. If something went wrong, it was obviously due to a major fundamental character defect.

Not surprisingly, optimists fare better in all endeavors save law. Lawyers are paid to spot negatives that no one else sees - only pessimists need apply. But lawyers have the highest depression rates of any profession or vocation, as well. (Perhaps they are envious of those wild and wacky undertakers.)

Dr Seligman lays considerable emphasis on strengths and virtues. These are embedded in the old-fashioned concept of "character." With his colleagues, Dr Seligman explored 200 works of literature that dealt with virtue including: Aristotle, Plato, Aquinas, Augustine, the Old Testament and the Talmud, Confucius, Buddha, Lao-Tze, Bushido, The Koran, Ben Franklin, and the Upanishads. Out of this emerged six universal virtues:

• Wisdom and knowledge
• Courage
• Love and humanity
• Justice
• Temperance
• Spirituality and transcendence

From there, Seligman et al identified 24 character strengths, such as curiosity and love of learning to augment wisdom and knowledge. Dr Seligman believes that everyone has 
several signature strengths, which they can deploy in their daily lives to their advantage. (You can test yourself for your signature strengths by going to Dr Seligman's Authentic Happiness site.)

My guess is that we tend to elude happiness far more than happiness eludes us. Heaven knows, I'm an expert at that, but thankfully I appear to be losing my edge.

My HealthCentral Happiness Posts

Happiness: Life's Greatest Challenge

Happiness: The Compassion Challenge

Happiness: Is Managing Our Misery the Key?

The Happiness Challenge: Keeping it Small

Happiness - Making the Effort is Always Worth It

My Practical (and Gratifying) Experience with Happiness

Happiness, Mental Wellness and Positive Psychology

Learning Optimism

More on Happiness: Using the Flow

Happiness: Capitalizing on Our Strengths and Virtues

Two Suicide Prevention Videos

This week is National Suicide Prevention Week. I produced both these videos more than two years ago. The first, "Brilliant Lives Cut Short," I did with the iMovie program that came with my new iMac. Please forgive the rookie mistakes. The second, "The Road to Nowhere," shows more sophistication, but it was my first or second outdoor shoot and it shows.

On top of that, this was the pre-HD era on YouTube. Despite all that, the message comes in loud and clear.

Systems in Collapse

Instead of conceptualizing the brain as some sort of uniform chemical soup that could use a bit more serotonin or dopamine, we need to see the brain as a highly intricate ecosystem that requires sophisticated nurture and cultivation.

In a guest blog here last year, Cristina Romero had this to report from a talk by Kay Jamison of Johns Hopkins:

The brain is like a pond. It’s like an ecosystem. You want to get the ideal ecosystem and then you don’t want to disturb it very much. ... You want to really create a stable environment.

The brain, like an ecosystem, is highly complex, non-linear, and self-organizing. Both brain scientists and environmentalists describe this self-organizing principle as "homeostasis," where the system maintains its own equilibrium at a particular "set point."

We see this in the cycle of the seasons. But what if a drought or global warming intervenes? That's where "allostasis" kicks in. The system engages in compensatory wobbles to restore its sense of balance, either back to its original set point, or to a new one. That could be going on right now with Mother Earth.

Over the last two decades, southern California has gotten drier. The drought-weakened oaks in San Diego's eastern back country, my home until very recently, have been sitting ducks for certain species of beetles, who lay eggs in the bark crevices. The larvae then bore under the bark, and literally drain the life out of the tree. By the time you see dying leaves, it is too late to save the tree. Literally, a walk in the back country here is a walk along arboreal death row.

It doesn't stop there. The dead and dying trees serve as kindling for wild fires, which the seasonal Santa Ana winds fan like a bellows. In 2004, a once-in-a-century fire raged through the back country and other areas of San Diego, scorching more than a quarter million acres and killing 15 people. In 2007, another once-in-a-century fire struck.

Cycle of nature or planet in crisis? Who knows? The earth will heal one way or the other. It's just that it may no longer look the same or have people in attendance to witness the change. San Diego's Museum of Natural History has a fossilized mastodon skeleton on display, together with a mural depicting the beasts frolicking in the local swamps.
   
Then global warming happened. The swamps became desert. The earth eventually adjusted - found a new set point - but it was a new world order that did not include the mastodon. (Thanks for the memories.)

Then there is allostatic overload, a state of total collapse. As it happened, late last year I was hiking along the arboreal death rows of San Diego's back county - enjoying the sun, sucking in the type of air that city people would happily pay a dollar a bottle for - as I contemplated a person close to me in a psych ward back east. Back in the old days, they simply would have referred to his condition as a nervous break-down. They got that right. His brain was indeed broken. But which part of the brain was broken? That’s what I wanted to know.

Ha! If only life were so simple. In a review article in Psychiatry, Dhwani Shah MD of the University of Pennsylvania et al point out that “psychiatric syndromes cannot be localized in a single, so-called ‘abnormal’ brain region.” Rather, “mood and anxiety disorders involve immensely complex interconnected systems or networks of organization within the brain.”
   
Repeat: The brain is an ecosystem, the brain is an ecosystem, the brain is an ecosystem ...

The causes of depression and other mental illnesses are complex and only partly understood. Nevertheless, a picture is beginning to emerge of interconnecting brain systems in allostatic overload on the brink of collapse.

Tell me about it ...

Kitty Dukakis on ECT

Following is an edited excerpt from a much longer piece on ECT, from mcmanweb:

In 2006, Kitty Dukakis (with journalist Larry Tye) published "Shock: The Healing Power of Electroconvulsive Therapy." Ms Dukakis is the wife of 1988 Democratic Presidential candidate Michael Dukakis. From the time she was old enough to worry about her body image, diet pills were a constant in her life. Ms Dukakis describes her quarter-century love affair with amphetamines as an addiction, though these pills almost certainly did more for her depression than the antidepressants she later took (readers, please don’t get any ideas).

The cure turned out to be worse than her addiction. Once she was off the pills, her depression manifested in full measure, together with a new dependency on the bottle. A steady round of rehabs followed, plus failed trials on antidepressants and mood stabilizers. In a state of emotional unraveling and desperate for a solution, in 2001 Ms Dukakis turned to ECT.

The very fact that Ms Dukakis had the option to choose electroconvulsive therapy is something of a miracle. As she and Larry Tye describe in their book, had events played out according to expectations, the plug would have been pulled from ECT years before.

Ironically, ECT's worst enemy has been the psychiatric profession. The over-use of the treatment during the forties and fifties and sixties, often against the patient’s will, under primitive conditions, and on populations upon whom the procedure conferred no benefit, gave rise to strong opposition. Part of the backlash came from the new antipsychiatry movement which got its start from patients who had been abused by ECT and inhumane institution-based practices. The movement found ready allies in other sixties-era groups pressing for political and social reform.

At around the same time, new psychiatric meds, with marketing campaigns heavily bankrolled by the drug industry, promised a new day. The death knell was the release of the 1975 movie, "One Flew Over the Cuckoo’s Nest," that portrayed head nurse Ratchett as Torquemada and ECT as a torture rack with voltage.

According to the authors of "Shock," Max Fink MD of New York State University, Stonybrook, helped save ECT from extinction. Essentially, he led with the facts – that for depression the response rates were exceptionally high (even in treatment-resistant populations) and offered immediate relief. For most depressed patients, the treatment worked better than antidepressants, and without their troubling side effects. The treatment also worked for mania and for depressive symptoms in schizophrenia.

But there was still the persistent problem of memory loss to contend with. Psychiatry did not help its own cause by repeatedly down-playing and even denying this disturbing invasion to the brain’s hard drive. Ludicrously, psychiatrists picked fights with patients who uncooperatively reported they could no longer remember their own kids’ birthdays. Clinical evidence, anecdotal or otherwise, was difficult to come by, as few clinicians even bothered to follow up on their patients.

Ironically, the authors report, during ECT’s golden era, its champions cited memory loss as an advantage of the treatment. (Economists would call this creative destruction.)

If Dr Fink saved ECT, it was Harold Sackeim who restored its credibility. To the horror of Dr Fink and others, Dr Sackeim freely acknowledged the memory loss. What the old guard saw as giving aid and comfort to the enemy, Dr Sackeim saw as a chance to improve upon technology and technique. Thanks in large part to his efforts, a more sophisticated generation of machines has been introduced and "unilateral" placement (to only one side of the brain) is replacing bilateral placement (though there still may be scope for the latter).

The authors cite Dr Sackeim for the observation that new generation ECT can target specific regions of the brain, thus reducing side effects and memory loss. By contrast, clinicians lack control for how meds are diffused throughout the brain.

During the early nineties, the media began observing that ECT was making a quiet comeback. Lately, the psychiatric profession has been more vocal in advocating ECT as an early treatment option, a development that may frighten some people otherwise prepared to accept the procedure as a last ditch or desperation measure.

The debate is by no means settled, and moderates tend to get assailed on all fronts by psychiatry and antipsychiatry zealots alike, who unfortunately tend to dominate the discussion (such as it is). As Kitty Dukakis and Larry Tye freely acknowledge, memory loss is still a legitimate concern and needs to be weighed against the promised benefits of treatment. Indeed, Ms Dukakis confesses to not being able to remember important events in her life and to having difficulty recalling names and other details. But she also writes, in relation to her first treatment:

Next thing I know I am waking up. I am back on the upper floor of Massachusetts General Hospital, in the unit where I slept last night … I am not sure I got the treatment. One clue is a slight headache … Another is the goo on my hair, where they must have attached the electrodes. There is one more sign that I did have my first session of seizure therapy: I feel good – I feel alive.

Yes, Ms Dukakis acknowledges, "I still can’t remember Paris," and that ECT may not be for everyone, but, "as my counselor Corky says, the choice is simple: Would I rather be depressed or be forgetful?"

Is Republicanism the New Stupid?

"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.

More to come ...