Thursday, September 26, 2013

We have a Jesuit Pope

Oswald Sobrino has a link to Pope Francis' interview in the Jesuit magazine America. His answers have been celebrated; the interviewer and his questions were excellent in their own right.

Monday, September 23, 2013

'Anti-Psychotic' Drugs and Bipolar Disorder

A few words on the odd seeming fact that all of the drugs for schizophrenia, all of the 'anti-psychotic drugs,' have been found useful for bipolar disorder. Schizophrenia is a disorder characterized by loosening of ego boundaries. As a recent cartoon in the New Yorker captioned 'I can't tell if that is an internal thought or something I already said.' Viewed in a topographic sense, these drugs tighten up those boundaries. I can recall walking down the hall of the ward with the Vice Chief of Psychiatry at the VA and a patient walked up to us and indicated some way in which he had been hostilely treated by Dr. Charles. Dr. Charles would respond passively and entering the nurse's station would take the man's chart and write in the orders 'Mellaril 100 mg three times a day.' The patient had indicated a psychotic transference toward Dr. Charles. The Rx would help the man not project on to Dr. Charles his negative feelings about himself.

Now depression can often be seen as a narcissistic problem; you know a problem of self esteem. The standard mythological portrayal of Narcissus is of a young good looking man looking at his reflection in a lake in ancient times. One might speculate he is having trouble holding a positive view of himself internally. The 'anti-psychotic medication' helps pull the feeling of 'I am beautiful' back into the person. So an adolescent who is both angry that others aren't affirming him sufficiently and depressed that he can't see himself as beautiful might be able to pull his self regard back and not have the depression or anger. And it may be that the fact that bipolar spectrum disorder responds in adolescence much more favorably to anti-psychotic drugs than to other drugs used for bipolar in adults may indicate that the disorder at that developmental age is more basically a narcissistic problem.

Sunday, September 22, 2013

This weekend an APA task force released a report saying that 'antipsychotic drugs' are overused*. The comments at USAToday had a delighted group of psychiatry bashers. In reviewing the literature, I find that other adult bipolar drugs are just not found useful in Adolescents. Further, from a criticism standpoint, the spokesman, Joel Yager, MD is from the same Medical School that treated the man found armed to the hilt at the scene of the Aurora Colorado movie shooting. Presumably he has some prominence at the Medical School as well. Are we to be speculatively happy that the shooter wasn't about to develop diabetes from Risperdal? *

Sunday, September 15, 2013

The Mass in the setting of Yom Kippur

After going to Yom Kippur Saturday, I heard Mass differently. The opening prayer, after greetings, in the Mass is:
Brethren (brothers and sisters), let us acknowledge our sins, and so prepare ourselves to celebrate the sacred mysteries. I confess to almighty God and to you, my brothers and sisters, that I have greatly sinned, in my thoughts and in my words, in what I have done and in what I have failed to do, through my fault, through my fault, through my most grievous fault; therefore I ask blessed Mary ever-Virgin, all the Angels and Saints, and you, my brothers and sisters, to pray for me to the Lord our God
In the Jewish Prayers of the Day of Atonement, the Jews admit to sins and are forgiven by Adonai. Now the Mass talks loud in a polemical way at times, most notably in the Nicene Creed, but this struck me as a soft request for the Jewish mother Mary to do what you would expect her to do, to accept us and perhaps even his faults if he has them, and the subsequent beliefs may be part of that, to be loved, even in fault, and made whole by Adonai.

Sunday, September 01, 2013

Gerald Ford said in his taking over the presidency from Nixon, 'Our long national nightmare is over;' rather the reverse happened when James Earl Ray killed Martin Luther King, Jr. As David Brooks said this week*:
The idea was to reduce ugliness in the world by reducing ugliness in yourself. King argued that “unearned suffering is redemptive.” It would uplift people involved in this kind of action. It would impose self-restraint. The strategy of renunciation and the absorbing of suffering was meant to guard against all that. In short, the method relied upon a very sophisticated set of paradoxes. It relied on leaders who had done a lot of deep theological and theoretical work before they took up the cause of public action. Nonviolent protest, King summarized, “rests upon two pillars. One, resistance, continuous military resistance. Second, it projects good will against ill will. In this way nonviolent resistance is a force against apathy in our own ranks.
With the death of King, the things his theological undertaking was meant to guard against developed. Again in David Brooks words:
The leaders understood that even people in the middle of just causes can be corrupted. They can become self-righteous, knowing their cause is right. They can become smug as they move forward, cruel as they organize into groups, simplistic as they rely on propaganda to mobilize the masses.
King's dream was no longer; a nightmare began. *