The president goes to OA

Hello, my name is George Bush and I am addicted to oil. I spend money on oil when, if I didn't, I could move out of the neighborhood where Hamas is celebrating and shooting off guns and making me feel not included. Well, I am moving out by 2025; so they can stop celebrating NOW! It was bad enough that my daddy moved to Texas. I don't know if you've noticed but I've gone a little native. Luckily enough, I've got enough money left over that our great imagineers can begin working on pie in the sky. And you now the great thing about democracy is that you can have any flavor you want. I know some of you, even in Texas, miss strawberry rhubarb pie. Fresh rhubarb is hard to get in Texas but when pie is delivered from the sky you will be able to get any flavor you want.

Some of you may think that I am not only addicted to oil, but also I am smoking something. Well, that brings up another subject. Many of you are concerned about illegal immigration. As you may not have noticed our policy is changing from one where we forswear, at least publicly, addictions to where we manage them. That is why my friend John McCain is introducing the marijuana and cocaine etc. liberation act. All formerly illegal aliens on bringing in the various wondrous substances and on delivering them to one of our people who freely decides to spend his or her welfare money on it, will get a note from said person and will then go to the federales of their choice and get a temporary residence permit. Voila, we succeed in everything. And whatever you're smoking I'm with you.

Heh, looking good wanna have some fun? I recommend threadbared. Helsinki is a place for clothes and drop dead self commentary. My favorites were in September.

I love this pope, have to get his new encyclical. Blunt is better than Hamas.

Update:
Sister in law, Karen, published it right off from www.vatican.va/holy_father/

Potential Change for the Better

The race for majority whip in the Republican party shows what possibilities there are for the Republicans to be, IMHO, Republicans. My haughty grandfather used to complain that the government was going to have half the country pouring concrete and the other half tearing it up but apparently enjoyed the Chicago Tribune landing on his front lawn in Peoria daily. That's what facing a 91% income tax well do to you. The people with real property in Peoria probably had Caterpillar stock options, taxed as a capital gain, but I digress. Boehher is saying he would bring an end to earmarks. This is where a specific appropriation is slipped into a bill by a lawmaker. Recently the local medical school got $73 million for a 'Gulf War Center,' earmark I assume. Such a proposal would go along way toward budget control and honesty. I dislike 'process reforms' like disallowing lunches or 'campaign finance reform' because it reduces the fun of something, reduces communication while not really changing the opportunities for chicanery or discretion and nobility such as by the little group that supported Reagan's political campaigns. Shadegg is another candidate Instapundit has good things to say about. Among the local Republican congressman, Jeb Hensarling, who has also sponsored an important bill having the FCC keep hands off political free speech on the Internet, supports Shadegg. My congressman, Pete Sessions, along with the little tyrant, Joe Barton, referred to in my blog about antidepressants earlier support Blunt, referred to in some places as part of 'Delay, Inc.'

Thanks for the link ...

from Iraq Now. The most clinically useful biological finding in PTSD is that, in contrast to Major Depression, (the 'stress hormone') cortisol levels are low. Aerni at al. in the American Journal of Psychiatry summer 2004 discuss how low cortisol lends to consolidation of traumatic memories and that 10 mg a day of Cortef for a month may be helpful in halting this. Sometimes, especial early in the course of disease if it is to have a quick effect, lithium has been dramatic in its effect. Lithium use is not in current algorithms though, was first reported on by Bessel van der Kolk in 1983. For diagnosis, using the CAPS, the "clinician ..PTSD scale," in an appropriate way drops you past the patients irritabiity defenses, an aspect of PTSD = personality disorder diagnostically. PTSD is like panic in that if there is suspicion and you deny it you may be more likely to have it.

I like reductio ad absurdum arguments. In such an argument you take a hypothesis and draw it's logically consequences to something absurd, or known to be false, thus disproving the original hypothesis. Something of an example can be made here of the argument that PTSD is a false construct. You may see below in my description of the uses of trauma By general Giap in his war strategy against the US that a soldier involved in hand to hand combat, eventually surviving by stabbing the north Vietnamese in the belly while holding the man's rifle, getting blood all over his hands in the man's death. 20 years later, the sargeant spends years trying to wash the blood off his hands by rubbing them as in Shakespeare's Macbeth. I submit that it is logical that in the pregunpowder days, war would have much more often involved combat with hand held piercing instruments and late intrusive memories of the combat would have involved such incidents. By incorporating such a psychic struggle, memory in a scene in Macbeth, Shakespeare shows that he knew of such in the human condition. He also associated it with a sense of guilt, one potential diagnostic criteria in the PTSD diagnosis. Allow me to say that it is absurd to think that Shakespeare included such a report based on the litigiousness and pseudoscience of American law or payments by VA.
A cautionary note too about 'Stolen Valor.' One of my patients spent a tour as a liaison office for the Air Force but with the Army in Laos. We didn't have a big contingent there. By treaty negotiated by Harriman for JFK, that the north said later convinced them we weren't serious about South VN, neither we nor the north were in Laos, not that that affected there presence there a whit. People next to him in small planes were shot on take-off. When he came back to (?) Arizona to get his next assignment, the clerk there started off by saying, "Well I see you haven't had a foreign assignment in a while..." I haven't read it though.
Something I have read that I note more than others is that the professor disputing the relevance or incidence of PTSD if from the University of South Carolina Medical School. It has a history of nihilism with regards to PTSD. I quoted a paper from there in my publication in Military Medicine in 1991, p 100-101.
I thought there nihilistic view of our medication strategies in PTSD was appropriate. Recently this institution had several articles published in the British Journal of Psychiatry supporting the quote in Dr. Helen. The editor of the journal opined that PTSD was maybe not a real diagnosis like schizophrenia or Major Depression. Part of the discussion was about having the diagnosis and not having been in the war theater. I sent in a case report supporting this possibility. This was turned down as I am sure they turn down a lot of prospective articles. Lisa Oliver, delightful lady and English name, who deals with these things conveyed to me 'that the readership wouldn't have sufficient interest.' The politics of PTSD does not just involve it's advocates.

Note to a Reader

I tend of late to follow developments in blogs in the links left and may comment there. I'd be interested in any reaction you have to those blogs and may see your comments there or let me know in comments here. I'm mulling over a new blog on America's war guilt, something I began to develop in the post immediately below. This would be based on Robert Fliess's book and has been outlined in an earlier post on 'Cindy Sheehan.' In WWII, by personal account reported to me, we fired on, and sank, drifting Japanese evacuees of warships marked with the Red Cross in the Coral Sea. Yes we also shot down our own fighter aircraft when, in clear celebration of recent victory but against regulations, it dropped down to below deck level in flight parallel to one of our ships. A different age and time, a different psychological mind set.

Robert McNamara, defense sec'y for Kennedy and up until late Johnson, served 20 years earlier on Curtis LeMay's staff and did bomb damage assessment work on the bombing of Japanese cites. We were in a different situation in VN, and I think to Mr. McNamara's credit and ours we acted differently. McNamara also acted from a sense of regret over our actions against the Japanese of which he had been a part. In terms of limiting our air targets in North VN, the possibility of restraint went to far, allowing escape for important supply depot transshipment points, I haven't researched if on McNamara's watch, and body count was a metric with ethically dangerous implications. But underlying, our honorable conduct in a tradition of ancient Greece exposed your soldiers, Marines, naval patrol boat personnel, SEALs, aviators to death, casualty, and PTSD. Dulles and Eisenhower may have comitted us and there should have been a 58 election pursuant to the Geneva accords, I see this as a hinge point in our foreign policy, to see if this was truly fated but clearly a democratic VN could have eventually returned the emperor to power or turned to Ho Chi Minh. We were not in a war for national survival and did not act like it. That does not mean we can not be. It is ironic that from VN we have an ignoble feeling for military action while the Pacific War left us care free.

May America not fall victim in Iraq to General Giap's trauma inflicted in VN

Instapundit has looked at the phenomenon of lagging support for Bush and the Iraq War. A part of the answer I think is found in the following. The ancient Chinese warrior Sun Tzu taught his men to "know your enemy" before going into battle. For if "you know your enemy and know yourself," he wrote, "you need not fear the result of a hundred battles." But, Sun Tzu warned, "If you know yourself but not the enemy, for every victory gained you will also suffer a defeat" (quoting Sun Tzu after I am reminded of the centrality of his doctrine by Thuan Q. Vu, M.D. of Bedford, Texas, the quote from Oliver North).

General Giap, the commander in chief of North Vietnamese communist, military forces from the forties through 1973 when his assault on South VN was repulsed, used this lesson it seemed to me from my vantage point as a VA psychiatrist. During the Tet offensive part of the quadrangle of a trench line was overrun and one of the sergeants that I treated faced a large man running at him with a rifle in the trench at port arms, that is carried at a 45 degree angle. He recalled how to fight such an opponent from an exercise in basic training, grappled with him, holding the man's rifle, and attempted to stab him in the belly with his knife. The opposing soldier had a wide web belt and this was difficult. A struggle literally to the death ensued and the sergeant stabbed him in the belly and threw him out of the trench bleeding to death. The next morning, the battle over, our sergeant went to see his opponent, found a picture in his front shirt pocket of a woman and 2 children. He threw the man's rifle as far as he could in expressing his tension as in the beginning of 2001, A Space Odyssey. Years later he would spend days rubbing his hands, rubbing the blood off that he perceived there. Another soldier found himself having investigative talent in VN. After the Tet offensive, when 2 ton trucks carried our casualties out of Hue as Mariness marched in to retake it, though he guarded city gates, he was in a quiet place. Somewhat later during the rainy season he wondered why the ground near him was bubbling during the rain. A mass grave was discovered. The communists executed thousands of civilians they apparently had a list for when they overran the city and buried them in mass graves. He also found out that the communists put pictures of a woman and children in front pockets of North Vietnamese soldiers, particularly those raised in their orphanages who would be most fanatically loyal to the regime. If they were killed in battle, well you already know the story. At Tet, General Giap sadistically to his own forces threw them in all their fury against a foe in another weight class militarily, nearly annihilating his forces in the South but showing to America the potential of hatred. He did not leave all to this battle though in adapting himself to the dictum of Sun Tzu.

A soldier in illustrating to me that the Vietnamese did not control sadism by internal guilt in contrast to a Western position offered this example. The Vietnamese would beat a dog to tenderize the meat before killing the dog to eat it. Nor in VN was there a protected period for childhood. General Giap appeared to use these differences to affect Americans. A soldier was in his first day in country and walking in a city. Something in the distress of a mother and child on a bridge led him to hustle over to her. Another US soldier, happening there, ran to her first and threw the baby off the bridge. The baby exploded just before it hit the water. In another example a young boy was running toward a patrol boat. A sailor saw a bulge in his shirt and fired; the boy exploded being wrapped in explosives. The sailor, partially African American, perhaps better able than most of us to pick up the syncopated overtone in a presentation, said, "I'd like to talk to the commanders about the way they treated their children." For many Americans, it was not so easy to resolve the double bind of wanting to be tender to children and being affronted with their death and the implication of some responsibility. Such incidents I heard again and again. The way the communists induced guilt and psychological isolation in Americans was taken to an art form, and I am afraid you would tire of the gallery but interestingly and in seeming contradiction in such a hardened enemy, such seemed a priority military objective . Americans did commit, occasionally, war crimes and/or the appearance of them in defending themselves against their feelings of guilt or in the liberty of sadism both taught in the school above or in frightened isolation. This was just the icing on a devil's food cake prepared mostly by the North Vietnamese communists and as America ate it, particularly the public, it became nauseated. Even though President Johnson's choice for Commander in Chief VN, Creighton Abrahms, led his forces in new directions with the South Vietnamese toward true liberty, Pavlov's American dog wanted none of it, just wanted, desperately, out of the bakery. Wanted nothing of the military. And thus we come to Iraq. In a detail left out of the riveting Street Without Joy, some at least of those French forces who fell shortly before Dien Bien Phu in the magnificent Ashau Valley and surrounding mountains, were not recovered by the French and were buried by their Vietnamese foes standing up in the ground on the mountain pass where they fell, facing France with a bright domed stone on the ground above their heads. Similalry, the ABC program This Week buries our dead facing toward America. May they rest in honor and in peace.

The Double Bind, Liberal Chicks, and Holden Caulfield

The Liberal Chicks inspire me to recollect issues of the 'double bind.' This is noted in a medical students first textbook in psychiatry, The Person. 'The child's trust in verbal communication depends on whether the words of the person who are essential to him help solve problems or confuse... Difficulty can arise when parents' words contradict their nonverbal signals, as, for example, when the mother's words of affection are accompanied by irritable and hostile handling... The value of words is also negated when erroneous solutions are habitually imposed, as when the child who cries because he wants attention is told he is hungry and is fed... Persistent denial of the correctness of the child's perceptions and understanding of what transpires about him or her can have a particularly malignant influence in promoting distrust of language and fostering distortions of meanings. The child is repeatedly placed in a "bind" because the obvious is negated, and he is threatened with loss of approval or love if he does not see things the way his parents need to have him or her see them. A mother keeps telling a little boy that he must love his Father as she does, that Father is very good to them; but Father comes home drunk, beats his wife and gives his son a whack.'

The vignettes of The Liberal Chicks are dissections in serious and humorous veins of what is presented as a true identity complicated by subsequent actions which 'bind' the observer who is left to seem to be expected to respond to the original (true) identity but faced now with really a different one.

Holden Caulfield in The Catcher in the Rye found himself overwhelmed in a similar situation. Psychoanalytically, he was unable to accept the flags of convenience that people flew under. He took an aspect of their 'good' presentation as a given identity and was overwhelmed when he 'bound' to that and was sheared, as it were, by finding in them a different reality. Thus, hypothetically, he was overwhelmed by the struggle over childhood double binds being too much the template for present relationships. In his first experiences, he had to find himself a person, in Lidz' phrase, but was, in those experiences, not finding himself an entity, having thus too strongly to have to recapitulate the attempt as a young adult. He solved this in reverie, in part, imagining a role as the catcher in the rye, saving lost children and turning his passive wish into an active role.

The Laws of War and White Phosphorous in Fallujah

The Economist reports that white phosphorus was used as a weapon of war during last years struggle for Fallujah. Let us stipulate that it is true. Is this a war crime? The The laws of War are that if one side breaks a law, the other side may break it similarly in a demonstration that there is a penalty for breaking the law. The British endured, for a while the bombing of Coventry in part to conceal their possession of German code. The bombing of Dresden was to demonstrate to the German people that there would be a penalty for breaking laws against bombing civilian targets. We all know that, in a subterfuge, former US soldiers acting on a humanitarian mission were drawn into the center of Fallujah and hacked and burned to death, with body parts strung on a bridge. This was to the delight of the multitude including children. The author of the above book on the laws of War was a US prosecutor at Nuremberg, and it would be on his moral authority that white phosphorous could be used in Fallujah on one occasion.