Friday, January 16, 2015

So Much New, Yet...

Since I have been seeing fewer patients I have had more time to read and hang around and talk to people.  Now, as before, I am reminded that I am a weird guy, as I do not read much about which celebrity is getting married again, or which teenage star has turned naughty, or even the in-depth coverage of which fanatical group is running wild, raping and killing, and calling it something else-- although I am kind of fascinated at how easily a person's mind can justify anything.

Mostly, I have been learning more about how we humans operate.  Since the start of the new millennium there has been so much progress in so many sciences, due to all the developments in new technologies.  I am constantly reading about new findings about how our brains work, and new genetic-environmental-behavior relationships, and new behavioral tendencies that we still carry that are the result of a million years of evolution.

We can now see that the effects of brain injury spread like pebbles in a pool, sending out waves to far shores.  A soldier comes back from one of our endless wars and is violent and depressed around his family.  How much is this due to his being inside a tank when an IED blew-up and his brain got rattled?  And this may have happened to him five times.

Then his family is frightened, his kids are upset, the community doesn't know what to do and the VA, like Forsythia says about other mental health clinics, is far away.

And the kid doesn't have to be a soldier.  He could be a high school football player.  He could have an alcoholic parent who smacks him around.  He could have gown up with diet of lots of fats and sugars.  He could have grown up next to a toxic waste dump or an oil refinery, or even a coal-fired power plant.

We are getting very clear evidence about how strong these effects can be.  But again, doing anything with this knowledge will be expensive.  It will be expensive to the people who are least affected by these factors.  That's why change is still off in the distance.

If "Personal Responsibility" means that I've gone mine and I'm keeping it, but you're fee to go find yours, then things will get worse before they get better.  But if it means that we are all responsible for the family, the community and the world we live in, then we have the knowledge and the technology to make marvelous lives for almost all of us.

It's not impossible.

Monday, January 12, 2015

Happy New Year, Bang, Bang

It's a new year.  I hope you are all healthy and happy, and that you and all those you love are safe and warm.

I am old and cynical, so take this for what it's worth, but 2015 does not hold much promise for being much better than 2014, except maybe for the Patriots -- that's the football team, not a bunch of Whooped-Up Americans.

For most people 2014 was kind of OK.  If you were rich you got richer.  Everyone else paid a little more and got paid a little less, but for most folks it wasn't too drastic.  If you were poor and struggling last year it looks like you will be poor and struggling this year. If you had psychological and emotional issues last year more of you will be able to get some kind of help, from some kind of somewhat trained helper.  They may give you a supportive place to list your difficulties.  They may offer some advice, the kind of which you knew before you saw them.  They may even help you see that you have some paths to choose that you didn't realize were open to you.  That can be very helpful.

But they won't be able to open any doors that are closed to you, or spend enough time with you so that you can retrain your brain to not be so reactive, or to learn totally new behavioral responses to stressful situations, or to change the stressful situation, or to change the fact that you may have chronic pain or a degenerative disease.

In short, there is still no really effective treatment for all the things we call "mental illness."

The guy who shot the two policeman in NYC, the kid who shot his adoptive mother and a couple of other people in Idaho, the veteran who shot his psychologist in Texas, and of course, the jihadists who killed so many people in Paris were all suffering from some form of discontentment.  I believe that  at sometime in their lives they had either actively sought help, or were at least known in their communities to be people who were "at risk."

Do we know what to do to help people who are "at risk?"  I think that most of the time we could figure out an answer.  Find a way to form a relationship, to not only offer help but to offer some resources so that they are able to use the help -- a place to live, job training, stable support people, food, warmth, trust, encouragement, understanding, new and better options to choose from.

But that is very time consuming and very expensive.  It's much simpler, easier, and cheaper just to wait until they go off the rails, and then shoot them.

there is always a well-known solution to every human problem — neat, plausible, and wrong.
-- H.L. Mencken.