When you live in a city and and your mornings are often spent listening to the sound of rubber on asphalt, your afternoons to the huffing of brakes on the local bus line, and the evenings to the scream of sirens and firetrucks, it is good to sometimes hit the road and explore the quiet hinterlands of California. One of those places is the North Coast and towns like Point Arena three hours north of San Francisco. People are generally friendly survivors of this rugged coast, running a variety of local businesses – cafes, second-hand boutiques, carpenters, handymen, wine laborers, yoga instructors, teachers. and artists. Not a chain store or corporate restaurant in sight.
At the pier in Point Arena I ventured into Point Arena Pizza and was amused at an obviously home-made poster on the industrial refrigerator. In San Francisco such sarcasm with the youth is not very common. In the country, they may be less inclined to refrain from such truths.
If you are tired of being hassled by unreasonable parents
now is the time for action
Leave home and pay your own way while you still know everything.
And indeed, sarcasm is just one of the services that they offer. The quote above is timeless. I am sure it would bring a snicker to parents all over the world.
Thomas Szasz’s The Manufacture of Madness – A Comparative Study of the Inquisition and the Mental Health Movement was published in 1970. The gist of the book is that the Inquisition that persecuted witches, heretics, Jews and homosexuals and a variety of “others” is similar to modern psychiatry and the Mental Health Movement that diagnoses people for their insanity and locks them up, against their will in institutions for safekeeping and treatments.
That was 1970. I am sure there is still the practice of putting people with schizophrenia and other diagnoses against their will into institutions and it may be good to remember that The Manufacture of Madness was written in the time of One Flew Over the Cuckoo’s Nest. Additionally it was a time when homosexuality and masturbation were often considered diseases that needed to be cured. I will refrain from the gory details of the treatments.
Of course, comparing the Mental Health Movement to the Inquisition made Dr. Szasz a very controversial academic and he surely had many enemies. In effect he was declaring that mental illness is a myth and the profession of psychiatry a hoax and the people who practice it immoral and dense – not a good way to make friends. Szasz’s thesis surely has merit and it is odd that people then and today dismiss his theories simply because it makes them uncomfortable and they do not like them. In every era we think we become more noble and advanced but time and time again it turns out that more often than not the same dynamics are in play; it is only the words, players and titles that change.
What one thinks of Rush’s tactics depends, of course , on what one thinks of the ideology of psychiatric imperialism and its attendant quasi-medical sanctions.
The chapter The New Manufacturers – Benjamin Rush, The Father of American Psychiatry is an eye-opening account of how Benjamin Rush thought that criminals had mental diseases that needed to be “cured” and that Black people suffered a “disease” from the color of their skin
More surprising than Rush’s self-proclaimed love for the Negro is his theory of Negritude. Rush does not believe that God created the Negro black; nor that a Negro is black in nature… About 1792, white spots began to appear on the body of a Negro slave named Henry Moss. In three years he was almost entirely white. Moss had the symptoms of an hereditary disease we now know as vitiligo. The condition, characterized by loss of skin pigmentation, occurs in both white and colored people… The gist of Rush’s theory was that the Negro suffered from congenital leprosy which “… appeared so mild a form that excess pigmentation was its only symptom.”
By inventing his theory of Negritude, Rush solved the issue of racial segregation. Whites and Blacks could not have sexual contact and God-forbid marry as it would propagate this dreaded disease of being Black. By conflating race with a disease, he was promoting a concept that humans could be cured of their race – or in more modern terms, they would then be cured by becoming transracial. Race (as gender is today) was considered a preexisting medical condition. In the 18th and 19ths centuries, it is clear that unless you were a white male, you had some sort of disease that needed a medical remedy. Women suffered from hysteria and pregnancy was a disease. Black people had the disease of Negritude. It is a sobering fact that this is the basis of psychiatry in America as conjured up by Benjamin Rush, the preeminent doctor and a man who signed the Declaration of Independence.
All students of psychology and psychiatry would do well to read the work of Thomas Szasz as he was a very influential person, intelligently questioning the status quo and his work goes deep into the history of psychiatry. That he is fading into the background of history is predictable. People in the field of medicine that question the profit sector of the industry will always get pushed aside. That the last forty years has seen huge profits in the mental health pharmaceutical industry speaks to this conundrum.
What is interesting is how much has changed in the Mental Health Movement in the last fifty years. Homosexuality and masturbation are no longer considered diseases. Since President Ronald Reagan helped to defund mental health services in the 1980s we see plenty of people that are mentally imbalanced on the streets. If mental illness is a myth, tell that to the homeless person screaming at the moon at 3 AM in the middle of the night. Their condition may go beyond just the cardboard box they sleep in. Indeed. they may have a “problem with living” and a warm, clean safe bed, a toilet and shower is surely part of the remedy, but years of abuse, living on the edge and poverty has its toll. People are complicated. Simple solutions are often overly simplistic.
But then again, as Szasz pointed out, the Mental Health Movement is always manufacturing new diseases. Here are just some of the the latest disorders that people are diagnosed with.
The DSM-5 (2013) The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard classification of mental disorders used by mental health professionals around the world. The manual is the guide by which mental health professionals base their diagnosis. Below is a list in alphabetical order of the 15 new disorders added to the DSM-5.
I never think delusion is ok. Barbara Ehrenreich in an interview with Jon Stewart
Barbara Ehrenreich died on September 1, 2022 at the age of 81. She was a modern-day muckraker who’s books exposed sexism and rampant capitalism in the health care system, wage inequalities, the latest silly fads in psychology and the challenges of living in our modern capitalist America. Her best selling 2001 book Nickel and Dimed: On (Not) Getting By in America, is a memoir of her three-month experiment surviving on a series of minimum wage jobs. It is an easy read, a bit of a “one hit wonder” and ironically gave her some financial freedom to continue to write on topics of her choosing. You can read the New York Times obit which seems to have been picked up by other papers and is the only obit of Barbara Ehrenreich that I could find.
I have three of Barbara Ehrenreich’s books. It has baffled me how of all her books Nickel and Dimed was so successful. People did not know that living off of a minimum wage job is next to impossible? But then again Nickel and Dimed was written as gonzo journalism and hit right when reality television shows were coming of age. People often read to confirm their beliefs not to challenge them. Many of Ehrenreich’s books were written in this first person, lived confessional style. However, to this reader, if you want to read some of her most interesting and powerful works, read the books she co-wrote with Diedre English, Witches, Midwives, and Nurses: A History of Women Healers (1972). and For Her Own Good: Two Centuries of the Experts’ Advice to Women (1978) were she writes as a researcher and scholar about the disenfranchisement of women and the transformation of healthcare over the last 200 years. This is a story that our present medical model and especially the AMA (American Medical Association) does not want the public to know.
Witches, Midwives, and Nurses: A History of Women Healers ( For Her Own Good: Two Centuries of the Experts’ Advice to Women are both books written in the 1970s at the height of Second-wave feminism. Both books look at the history of medicine and how the role women as healers and experts was usurped by the emergence of a medical “profession.” The overriding theme is how this new male dominated profession dealt with what was called the “Woman Problem.”
For decades into the twentieth century doctors would continue to view menstruation, pregnancy and menopause as physical diseases and intellectual liabilities. Adolescent girls would still be advised to study less, and mature would be treated indiscriminately to hysterectomies, the modern substitution for ovariotomies. The female reproductive organs would continue to be viewed as a kind of frontier for chemical and surgical expansionism, untested drugs, and reckless experimentation. For Her Own Good: Two Centuries of the Experts’ Advice to Women
In many ways this sort of medical arrogance has continued. For years women who went through menopause would be prescribed hormone replacement therapy to deal with their “Woman Problem,” as though nature needed help with the natural process of life and aging. It was later found that hormone replacement therapy created risks including heart disease, stroke, blood clots and breast cancer.
And as of 2014, gender is now considered a pre-existing medical condition where God often seems to makes “mistakes.” In many ways, if you connect the dots, the “Woman Problem” has not ended – it just has been repackaged.
Hopefully, someone will take up the torch of critical thinking that Barbara Ehrenreich lit and continue on with her early style of research and questioning the medical establishment and the powers that be. An interesting study would be how the profession has changed now that women are entering the field of medicine at about the same rate as men.
On March 23, 2022, I submitted the comment below on the NY Times website.
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Gustav | San Francisco The Republican’s obsession with child pornography was odd theater. What they did not realize is that Judge Jackson gave them an answer that they should have been pleased with. Saying that the definition of a woman is done by a biologist is the traditional view. More often today it is an “internal sense of self” and then that “sense of self” is affirmed by a psychologist. They are so caught up on, and terrified that a Black woman could be on the Supreme Court, they have stopped listening.
Judge Kentanji Jackson had to sit and watch and respond while the Senate asked questions mostly to grandstand and score political points. The Lindsey Graham tirade was especially painful. The whole confirmation hearing should have been really dry and boring, to see whether or not she is qualified and understands the law. But politics is now more about division and entertainment. It is like mud wrestling or perhaps a demolition derby.
After reading the New York Times article above I commented on it which you can read above. This was approved for a time but then the next day, wondering if someone had commented on my remarks, I noticed that the comment was taken down. This happens to me with the New York Times – they censor my comments at times and practice a sort of thought police. Good grief! I must be a dangerous thinker.
Issues of gender and identity are the new elephant in the room and both the left and the right are thoroughly confused. Judge Jackson’s response to the definition of a woman should have pleased the Republican senator, but he was unprepared, seemingly dense and probably wanted the answer to be about gender roles and something like “a woman is someone who does the laundry, takes care of the kids and cooks me dinner each night.” Judge Jackson’s response was actually similar to how Judge Neil Gorsuch has responded to issues of gender. In a recent case about discrimination (Bostock vs. Clayton County) Gorsuch wrote. “That’s because it is impossible to discriminate against a person for being homosexual or transgender without discriminating against that individual based on sex.” In the same way that Judge Jackson said that a woman can be defined by a biologist, Gorsuch used the word “sex.” In the end, for legal purposes, it is biology evidently that still defines us.
While certain feminists are rejoicing with her response, most on the left are apparently oblivious to the ramifications. People on the left may look at a Black woman and think that she shares all of their progressive beliefs and will do everything to keep them happy. Republicans are so caught up on, and terrified that a Black woman could be on the Supreme Court, they have stopped listening and simply long for the days of the old White boys network. But for now, it doesn’t really matter as Judge Kentanji Jackson is imminently qualified and will be a welcome addition to the court.
On March 23, 2022, I submitted the comment above on the NY Times website. At one point I commented a few times every week. It is so odd that my comment was pulled down. Can someone explain why? The NY Times would not say.
This essay explores different perspectives concerning Section 230 of the Communications Decency Act of 1996. Movies such as The Social Network have finally made obvious to the broader public some of the toxicity of social media and this essay is to point out that Facebook and other social media companies are not like cork message boards at the laundromat but rather a modern, innovative and complicated form of publishing. For some background, read the New York Times article Tech Companies Shift Their Posture on a Legal Shield, Wary of Being Left Behind where in the comments a gentleman from New York commented the following:
– Kenneth, ny
Section 230 is the wrong tool for regulating tech giants; it’s how people can say something on the internet without bringing down the hosting service. Let’s remove it; we’d lose these comment boards because now the Times is liable for its contents. Twitter gets nuked completely (possibly a good outcome in your estimation!) but so too does every place users can place comments. The analogy that impressed me in law school was the idea of a cork message board — if someone comes along and staples a defamatory statement, you go after the person who posted it. You don’t sue the owner of the corkboard. And if the corkboard owner removes the defamatory statement, then the original speaker doesn’t get to sue them in turn. That’s the point and purpose of section 230. If the corkboard owner owns all the corkboards, then okay, that’s why we have antitrust laws. But unless you want to start scrutinizing all online speech via legislation, we should use other means to attack the power of the internet giants.
ACT 1: The Metaphor Trap
Trying to make sense of the new digital world, people conjure up metaphors from the physical world. For many years it was called the Information Superhighway and the internet was something that you surfed. Lately, servers are called the cloud. These are convenient ways we, or probably more accurately, marketing departments, try to give people a reference for this fast moving world. But in actuality you do not surf the internet and it is not a cloud. It seems skepticism is sometimes in short supply these days. The notion that interacting with social media and “posting,” is at its essence, the same voluntary action as posting a notice about your lost cat on the local laundromat cork message board is simply naive. Facebook is not a cork board. It is far more complicated.
ACT 2: Horses and cars
Comparing Facebook with cork bulletin boards is perhaps like comparing horses with cars. Both horses and cars are a means of transportation. Indeed, when the automobile became ubiquitous the motor’s strength was horsepower. This must have been a certain horse in a good mood, and it surely was just an average and not very accurate. Because horses were not cars there were all kinds of regulations about how fast they could go, and how you had to drive with lights on at night and wear seat belts, and eventually it got so bad, you had to have a drivers licence. Cars, as long as they had gas could go for hours on end. Horses need rest. While horses and cars are tools for humans to get from one place to another, they are apples and oranges. Facebook is not a cork board. It is far more complicated.
ACT 3: Geography
A cork board in the laundromat always stays in one place . In reality the only reason the owner of the laundromat put up the freakin’ cork board in the first place was because people kept taping room rentals and lost pet posters on the wall and she was getting tired of cleaning off all the sticky tape. People who see Facebook stuff have it on their phone, on their computer at home, in an internet cafe (they still have those) – basically everywhere they are they can get news and messages from people they do not really even know. They see the social media stuff everywhere. The message board at the laundromat hangs out in the laundromat all night in the dark with the florescent lights off waiting for the morning for the door to be unlocked and someone to poke it witha thumbtack in the morning the next day.
Furthermore, your laundromat bulletin board is not a two way mirror where some creepy white guy in a hoody is behind the glass spying on your every move, changing what you see on the bulletin board by gauging your mood and even where your eyes focus. It does not track whether you were in the laundromat last week, or how many loads you did, or whether you just came from the grocery store. Facebook is not a cork board. It is far more complicated.
ACT 4: Classified Ads
In reality a cork board in a laundromat is perhaps more like a free classified service like craigslist but the cork board in a laundromat is physical.. However, unlike craigslist and for that matter Facebook, when someone posts a notice on the cork board they do not have to give the owner of the cork board their birth date, email, or any other personal information. On the cork board people post their “stuff”and often write their phone number many times on the notice so that people can tear off the phone numbers and easily call them . People are usually pretty anonymous and everyone sees the same stuff. The woman who owns the laundromat (or craigslist for that matter) does not customize the cork board for different laundromat users based on their politics, gender orientation or sport teams affiliation. Facebook is not a cork board. It is far more complicated.
ACT 5: Selling Your Self to the Devil
Unlike Facebook, I would wager that a cork message board in my local laundromat is pretty harmless. It is not a platform associated with radical white extremists that are conspiring to kidnap the governor, or entire governments intent on marginalizing and murdering certain members of society as what happen in Myanmar.
The cork board is probably not a place where strange inaccurate and totally false conspiracy theories propagate. Perhaps Facebook is more often like a toxic dump site, that is oozing falsehoods and devious schemes all night. but appears benign. Facebook is not a cork board. It is far more complicated.
ACT 6: What if I post stuff that is copyrighted?
A few years after Section 230 of the Communications Decency Act of 1996 was the DMCA (Digital Millennium Copyright Act) which ushered in the 21st century that often marginalized tradition creators of music, art and publishing. The DMCA made it completely legal for hosting companies and most often large monopolies to make money off of the music of the last 100 years and be free of any legal consequences for copyright infringement as the material was posted by users. Sort of like taping your 100 gig drive of all your CDs as MP3’s on that laundromat cork board and telling everyone to just come and make free copies while the laundromat got financial kickbacks.
I have been writing about how the DMCA is unconstitutional for years.
Facebook is not a cork board. It is far more complicated.
ACT 7: Facebook is actually a Publisher with Unpaid Content Providers and is Edited by Algorithms
Imagine if your Facebook feed came to you once a day in print delivered to your doorstep. It is a “book” by the way. Your print version of Facebook would contain the news from some traditional news source, the warm and fuzzy stories and op-eds from your crazy uncle. It even has comics. It is published in billions of editions and every user gets their own custom versions. This siloing of content is one of the reasons why our democracies are breaking into the tribalism of identity politics. Everyone lives in their custom realities and subjective idealism with their own version of truth. (The customization of various editions is not unlike the New York Times that has a “west coast” version. ) On Facebook and the New York Times are ads and classifieds and Facebook makes billions off the advertising in their publishing business. Facebook is not just a platform, it is a modern, complicated form of publishing with vast editorial power. Indeed, if I posted this essay on Facebook it would soon end up at the bottom of everyone’s feed and eventually the trash. How do I know this? It has happened before when I posted on Facebook such critiques. Facebook is not a cork board. It is far more complicated.
ACT 8: Anti-trust and Toxic Waste Dumps
The quote above that started this ramble speaks of anti-trust and breaking up the likes of Facebook as Teddy Roosevelt helped do with the railroads a hundred years ago. Anti-trust laws will surely be the legal path, but I still maintain: Facebook is not a cork board. It is far more complicated. The legal world needs to realize that the internet is not one huge cork message board at the laundromat where no one is accountable.
It is rather odd that there is not more written about the influenza pandemic of 1918 or what came to be known as the “Spanish Flu.” No one really knows the death totals but it is safe to say that over 50 million people died worldwide and over 600,000 people died in the United States of America. Like most bad things that happen in life, humans seem to be better off just forgetting these tragedies, but then again perhaps that is why we keep making the same stupid mistakes over and over again.
What is different about our current 2020 Covid-19 pandemic is that technology has made it so we can connect with other people in ways probably not even thought possible in 1918. In fact, many are living lives that are more in keeping with the technological imaginations of the 1950’s and 1960’s. Like the spaceship Enterprise on Star Trek we have technology to connect to our alien relatives even if we find them irritating and obnoxious. Like Captain Kirk we have our trusty cellphones even more advanced than his silly flip-phone. We can view and speak with aliens like our strange brother-in-laws on large screens as though they are Klingons from another planet. Perhaps like 1918 our times are often full of solitary activities and our “bubbles” are where we practice our daily and weekly rituals, and many people continue on with their lives working over the internet. That the video conferencing application ZOOM finally figured it out just in the nick of time was serendipitous. Like the crew of the Star Trek Enterprise, people are often found living for days on end wearing what look like pajamas. Instead of getting beamed over to the Covid-19 testing area we get in our spaceships with wheels and are tested without leaving our seats.
Just like Star Trek, sometimes the video connection fizzles out or people just leave like a band-aid torn off with a sudden pull. I am not sure if on Star Trek they had video drinking parties and happy hours but those can be great fun. Rarely does the the narrative get aggressive – “Scotty: we will need more tonic Jim. I don’t think the party will survive without it!!”- as during Covid-19 you are so starved for attention, just seeing another face is often a welcome and novel event. And of course, never mentioned in space travel science fiction, and one thing they always seem leave out, is that to get to Mars, let alone another solar system, is going to take a lot of travel time. Surviving the Covid-19 pandemic is perhaps like training for space travel to Mars.
In 1918 we were just coming to the end of The Great War which eventually gave rise to Hitler and fascist Germany. In 2020 we dodged a bullet as Donald Trump was barely defeated at the polls. Fascism is indeed alive and well and humans are just barely intelligent enough (a little over 50%) to choose between burning up the planet or at least attempting to save what is left of this marvelous place we call Earth.
It is a good thing that large newspapers have found a way to keep in business in the digital landscape. For a time, in the world of journalism, it looked like even the big players were not going to make it. I subscribe to the local paper and the N.Y. Times. From time to time I will post comments to various N.Y. Times pieces and enjoy reading the contributions and ideas from the many mysterious contributors – Socrates, CynicalObserver, God on wheels, Great Family and Friends Dish. Pretty much all of my comments are approved and people recommend them and life goes on. About a week ago I wrote a comment about how a certain article seemed to just brush the surface of the topic.
My comment was approved and garnered a fair amount of recommendations and then was taken down. When I asked the N.Y. Times about why it was taken down, I got this for an answer: “While most comments will be posted if they are on-topic and not abusive, moderation decisions are subjective.” I find it odd that they censored this comment as it is not off-topic and abusive only if you think the truth is intolerable. What I was simply saying is that this topic is complicated – “a complicated story with many players needing more than 3000 words.”
But in the end the N.Y. Times has every right to not publish my comments. It is a private company and can do what they want, just as Jack Dorsey should have kicked Donald Trump off of Twitter years ago for violating their terms. However, I feel that my comment below is certainly not off-topic, not abusive and perhaps even insightful. For posterity, the comment that was taken down and the N.Y. Times response is below.
What do you think? Did I cross the line?
Wed, Nov 11, 8:33 AM
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Thank you for sharing your thoughts with The New York Times community.
Gustav | San Francisco
I think it is important to look at the rapidly changing landscape of identity among young people with a more nuanced eye. A big change in the last five years is that the medical community has become very aggressive in intervening in the bodies of youth who declare that they are transgender. Hormones and surgery are used as early interventions and “treatments.” A story not told on the NYT is how the rise of social media and the ubiquitous smart phone has stressed out many kids. Today identity is everything and many have gotten lost in transgender echo-chambers. The ignorant medical community just gets out the needles and scalpels – a complicated story with many players needing more than 3000 words.
And the N.Y. Times response to why they removed my comment.
Michelle (The New York Times Customer Care)
Nov 20, 2020, 8:00 PM EST
Thank you for contacting us here at the Customer Care Center here at The New York Times. Let me first personally thank you for your ongoing support and readership of The New York Times. I appreciate your loyalty.
While most comments will be posted if they are on-topic and not abusive, moderation decisions are subjective. Our Community desk will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
If you have any questions or require any other assistance, please feel free to reply to this email. You can also call us at 800-698-4637, or chat with us.
Thank you again for contacting The New York Times. Enjoy your day and be safe!
In the March 2020 edition of Wired Magazine is an article written by Steven Levy entitled Mark Zuckerberg’s Lost Notebooks. Steven Levy has known Zuckerberg for many years so had a fair amount of access. These notebooks are where Zuckerberg plotted to rule the world and the notion of physical evidence like notebooks surely adds to the intrigue and mystique of one of the powerful players on the world stage.
Of all the internet billionaires, Mark Zuckerberg is perhaps the most controversial. Starting with your date of birth and your high school, Facebook’s creepy form of surveillance capitalism built the Facebook empire. The Facebook empire influences all things in our modern society – journalism, marketing, advertising, commerce, education, politics and personal lives to name the obvious. It is a platform build on modern humans’ natural addictive tendencies, narcissism and social insecurities and is nothing about the justice and equality that seemed possible in the early days of the internet. That people are so gullible to the deviousness of Facebook is surprising.
The secret sauce of Facebook is outlined below:
“Zuckerberg envisioned a three-tier hierarchy of what made stories compelling, imagining that people are driven chiefly by a blend of curiosity and narcissism. His top tier was “stories about you.” The second involved stories “centered around your social circle.” In the notebook, he provided examples of the kinds of things this might include: changes in your friends’ relationships, life events, “friendship trends (people moving in and out of social circles),” and “people you’ve forgotten about resurfacing.”
“The least important tier on the hierarchy was a category he called “stories about things you care about and other interesting things.” Those might include “events that might be interesting,” “external content,” “paid content,” and “bubbled up content.”
This secret sauce reaffirms my disgust with Facebook and social media as a whole. Web 2.0 and Facebook in particular has perpetuated our present era of what I call the era of “Digital Narcissism.”
“He was an avid Latin student, developing a fanboy affinity for the emperor Augustus Caesar, an empathetic ruler who also had an unseemly lust for power and conquest.”
There is this tendency in the United States of adulation of the rich. The notion that Zuckerberg was an “avid Latin student” attempts to affirm a notion that Zuckerberg was some sort of child genius who studied the classics. Whenever I have heard Mark Zuckerberg speak in public he does not seem worldly, well educated or secure in the least. Memorizing a few Latin phrases when you were eighteen to help you conquer a video game does not a Latin scholar make. In reality, Zuckerberg was mostly writing php “for loops” and working on “membership data models. ” Latin scholar… yeah right.
Zuckerberg’s initial reaction to criticism was most often defensive. But when misinformation could not be denied and Congress came calling, he clicked back into apologize-and-move-on mode.
And then near the end of the article there is this completely strange and obtuse sentence that would make even George Orwell snicker. “When misinformation could not be denied” means when written in plain and clear English – “when the truth came out. “ Indeed, truth is in short supply and Facebook is in the business of often perpetuating lies.
Mark Zuckerberg’s Lost Notebooks is an interesting and insightful piece but as with most articles in Wired, barely questions the digital powers that be and instead holds them up in reverence. Reverence is not journalism – it is cheer-leading. There is no mention of Facebook’s tax avoidance, the millions of accounts where passwords were in plain text and hacked, the perpetuation of false advertising and political smears and lies that are ubiquitous on the platform. A quote not mentioned that was literally Facebook’s mantra for years is “move fast and break things.” Now that Facebook has broken lots of things, why cheer on Goliath?
It’s Treatment Based on Symptoms, Not Income Billboard in San Francisco – Sutter Health
That healthcare can be a lucrative line of work has been a feature of the healthcare system in the United States for over 150 years. The American Medical Association (AMA) has been doing all it can to elevate doctors and dismiss community traditions like midwives and alternative medicine. Of course when there is money involved all sorts of shady people come out of the woodwork, trying to make a buck. Think of the wallpaper that you sometime see on folksy restaurant bathroom walls of reproductions of late 18th century newspapers. Ads for tonics and elixirs, perhaps often disguised liquor, that cure everything from heart conditions, digestion issues and even your sex life.
This sort of commercialization of healthcare, even when they are “not for profit” institutions is so ubiquitous that people rarely think twice. So when I saw the Sutter Health slogan “It’s Treatment Based on Symptoms, Not Income” I was struck with the thought of whether this was created by the Sutter Health marketing department, the Sutter Health finance department or the Sutter Health doctors. It all sounds so altruistic and noble but give me a break; the CEO of Sutter Health a few years back made over 7 million dollars a year; the CEO of Kaiser Permanente made 16 million a year. Even though these institutions go under the moniker of “non-profit” in the end it is really about money and just like the petrol-chemical and banking industries, the main message of most marketing is often not about the actual product but about the political spin and supposed benevolence of the organization. I would wager that there are people today dealing with the Sutter Health billing department.
A larger question would be what does “treating the symptoms” actually mean? If you were a roofer, treating the symptoms would mean that your leaking roof would never actually get fixed. Instead of treating the cause, that perhaps your roof is twenty years old and needs to be replaced, roofing companies would simply charge you for expensive plastics buckets indefinitely to capture the symptom – the water dripping through the ceiling. If you were a glass shop, you would indeed treat the symptom, the broken window but never get to the cause – perhaps the golf driving range next door.
If our healthcare is now simply about “treating symptoms,” our healthcare system will over time become more expensive and never become single-payer. There are simply trillions of dollars, whole economies, insurance companies, medical technology companies, a cultural ethos and entire small cities built around our current healthcare system. That the pharmaceutical industry is also built around treating symptoms simply closes the loop.
A better slogan, but one where there is a lot less money to be made would be,
“Identify the cause, the symptoms may go away.”
But that would would take some actual work and people always want a quick fix – give me a pill, make it go away.
While taking the BART back from a show in Oakland, I was struck by the fact that every single billboard in the 19th Street Station was bought out by Kaiser Permanente. All fifty or so billboards had doctors looking directly at you. With the slogans “There When You Need Us”, “Care at the Center”. This must have cost a lot of money. Every billboard was rented which meant perhaps fifty units in one of the most expensive markets in the United States. Meanwhile, every few minutes a somewhat desperate looking person would approach you panhandling and looking for a few bucks. The irony was a bit hard to take.
Modern medicine, especially the technological advances when it comes to intricate surgeries, are amazing. If you get in a car accident, the tools available to doctors today are much more powerful than just ten years ago, but that is just part of the story of our current state of Western medicine.
The “Medical Industrial Complex” is upon us. Dwight Eisenhower who’s final speech as president gave us the term, “Military Industrial Complex” is probably just shaking his head. It is probably dangerous for healthcare slogans to be made by marketing departments and in the end not good medicine.
“The challenge of absorbing this new technology into the values and practices of the existing culture has no precedent. The most comparable event was the transition from the medieval to the modern period. In the medieval period, people interpreted the universe as a creation of the divine and all its manifestations as emanations of divine will. When the unity of the Christian Church was broken, the question of what unifying concept could replace it arose. The answer finally emerged in what we now call the Age of Enlightenment; great philosophers replaced divine inspiration with reason, experimentation, and a pragmatic approach. “
The Metamorphosis is a very interesting article in The Atlantic. Co-written by three very influential people it muses over the impacts of artificial intelligence which is all the rage now. Some of the three writers end with forecasts that are optimistic. Others are more skeptical. It is easy to figure out who wrote what in the article. The quote above is surely Henry Kissinger reminding the kids of some of the fundamentals of history in the West. It is rather peculiar that Kissinger jumps from the medieval period to the modern in one fell swoop but so be it. I highly doubt that most kids graduate from college these days with even the faintest understanding of the Age of Enlightenment or any notion of this concept of history and humanity.
The other unifying concept was of course the creation and notion of the “self” but that is far too complex for most people to comprehend in our current age of narcissism and selfies. You can get a better understanding how this is relevant in the field of psychology by reading The Invention of the Self: The Hinge of Consciousness in the Eighteenth Century by John O. Lyons, my dear old dad who’s ashes are floating around somewhere in lake Michigan. Rest his soul.
It took until I went to college in the early 1980’s that I learned that geography was not only about maps, states, countries and continents. I took a class by Yi Fu Tuan where I learned about spaces and places. That besides physical geography there was also the whole world of human geography. Inside of human geography there were many sub types, cultural and political to name but two.
Political geography is defined as:
“Political geography is concerned with the study of both the spatially uneven outcomes of political processes and the ways in which political processes are themselves affected by spatial structures. Conventionally, for the purposes of analysis, political geography adopts a three-scale structure with the study of the state at the centre, the study of international relations (or geopolitics) above it, and the study of localities below it. The primary concerns of the subdiscipline can be summarized as the inter-relationships between people, state, and territory.” – Wikipedia
I find it interesting that I have been unable to find any writings on how technology has affected human geography over time. Imagine with every technological change how our understanding of the earth, other spaces, places and cultures have been influenced. For instance, starting with the invention of the wheel the world has become a smaller place. People are always devising new ways to get around more efficiently, faster or easier. Fast-forward to 1450, in the West, the printing press made it so descriptions of faraway places were mass-produced and then could be consumed by many people. Notions of that world were given a perspective always from the cultural point of view of the observer. The telegraph made it so people continents apart could send messages instantly. Later the telephone, radio and then television perpetuated this phenomenon of space taking on new meaning. As time goes on, these technological advances have had profound effects on human psychology and geography. The world is no longer your family and farm, local community or village. It is seven continents and you can visit any one digitally and by pushing a few buttons. In our current world, this notion of space and presence has been invaded by the internet, but more significantly the cellphone and specifically, the “smartphone.”
From a human experience perspective, all of the modern communications technologies of the last 150 years have to do with changing this sense of space. A telegraph over the wire was like an arm reaching across an ocean. Radio had the effect of making it so someone hundreds of miles away was seemingly sitting in your living room. Television. simply added a visual component. At the beginnings of each of these technological advancement was a time of readjustment and decentralization of society and political power. Eventually, overtime, the power became monopolized by few powerful players. In television, in the United States it was the three major broadcasting networks. Now on the internet it is Google, Facebook and Amazon.
In 2019 the cellphone makes it so many people for most of the day are mentally not even in the physical location that they preside. I noticed this phenomenon when at the beach. It was a hot day and people went out to the ocean to cool off. I noticed a woman wading in the water while at the same time having a video chat with someone on her cellphone. Was the woman at the beach or was she with the person on the cellphone? Where was the woman? Is human geography simply where we occupy the planet or where we preside in our minds? The digital era makes it so geography no longer is a place at all but spaces that are digital and psychological.
The ramifications of this effect are many. We see it in the way the political systems around the world are in upheaval. No longer do you simply build walls and moats to keep away intruders as in the end the digital landscape has no borders. We see it in how political systems have become more reactionary and full of jingoism.
Furthermore, while people have this notion that they are in control, nothing could be further from the truth. The large internet companies are tracking everyone’s digital landscape and using techniques from behavioral psychology to reward or punish certain behaviors with the motivation of both political and economic influence. This has been dubbed the “surveillance economy.” George Orwell is surely snickering in his grave but probably not, as humour was not his strong suit. He is probably screaming – “I told you so!”
Where this will end up is unknown but for those who think that the digital era is a time of liberation and some sort of political and economic equalization are wrong. The same centralization of power that happened in previous technological eras has happened again. Monopolies have emerged as the powerful players. There are dangerous silos of digital communities that are like echo chambers reaffirming racist and cult-like manifestos based on ignorance and flawed science. This is happening in all spaces, both on the political right and left
What is the one constant is that the undesirable qualities of humans that have existed over centuries are unchanged – greed, vengeance, vanity, violence to name a few are still prevalent. In some ways, with the internet they simply are amplified.
Recently the American Psychological Association (A.P.A.) published their new guidelines entitled the American Psychological Association’s guidelines for practice with men and boys . Writing and publishing something like the guidelines for practice with men and boys is a strange and ill-advised project. Creating guidelines for protologists on the use of the FOS-425 for colonoscopies on men over fifty seems like a good idea, but men are far too varied and complex to create generalizations and guidelines.
Before you read further, I highly recommend that you read the actual paper. It is rather odd that like Moses’ 10 Commandments there are 10 A.P.A. guidelines for practice with boys and men. But perhaps it is more like an A.P.A. awards document as I am sure that of all the researchers and contributors who’s studies are cited celebrated this career triumph with a lot of wine and champagne to fortify their narcissistic egos. I believe the guidelines will be viewed as a curious historic document, similar to writings and guidelines for women during the late 19th and early 20th centuries when doctors and the medical scientists viewed woman as having the “woman problem.” This is clearly outlined in For Her Own Good: Two Centuries of the Experts Advice to Women by Barbara Ehrenreich.
Now that Western medicine has terrorized woman for over 200 years, for some reason they now have moved on to men. In fifty years, the American Psychological Association’s guidelines for practice with men and boys will be embarrassing evidence on just how absolutely naive, cult-like, dangerous and ignorant the A.P.A. is to history, philosophy, language and actual science.
Indeed, after the American Psychological Association’s guidelines for practice with men and boys were released it created a bit of a firestorm. People on the conservative right and academics of all walks often criticized the paper as either being an attack on men and traditional morals or simply inaccurate and absolute intellectual self-deception. The New York Times ran an opinion piece that basically side-stepped the issue and did a report of how various people and authorities on the subject responded to the “guidelines.” However, the critique I found most perceptive was by Jacob Falkovich and his essay Curing the World of Men
This is, after all, the same organization that classified homosexuality as a mental disorder until the seventies, and whose members were not discouraged from recommending conversion therapy until 2009. You’d think being wrong about gays for a century may teach the APA some humility. –Jacob Falkovich
What I find alarming about the A.P.A. is the fabric of the organization. To me it has characteristics more in keeping with a cult or a religious organization than a scientific organization. If you simply start with the “definitions” at the beginning (gender, cisgender, gender bias, gender role strain, etc.) you can see right away they are laying the ground work for current fashionable cultural assumptions and not science. For example, the term “gender non-conforming,” which is so in fashion in psychology these days, rarely gets scrutinized. “Gender non-conforming” – based on what? Is the A.P.A. now determining the “style” of a certain gender. Is a gender “style” for some reason now an important part of psychotherapy and also a subject of science? From the very introduction, the paper begins with some pretty shallow assumptions.
Boys and men are diverse with respect to their race, ethnicity, culture, migration status, age, socioeconomic status, ability status, sexual orientation, gender identity, and religious affiliation.
Seeing as men make up about half of the 7.5 billion humans on the planet, this statement seems accurate. However, how can boys and men be diverse with regards to gender identity? They are both male. Last time I bought airline tickets I had to choose between either male or female in the gender dropdown. If the A.P.A. has discovered additional genders they perhaps should inform United Airlines. I do hear of non-binary as being another gender and there is of course intersex or hermaphrodite people but this paper and guidelines are for men. Then the next sentence gets to the core of how the A.P.A. defines gender.
Each of these social identities contributes uniquely and in intersecting ways to shape how men experience and perform their masculinities – Introduction to A.P.A. guidelines
“… how men experience and perform their masculinities.” What a strange notion that a man simply performs “masculinities” as though a gender has no biological basis and is simply a “performance.” This notion perhaps comes from the psychologist Judith Butler and her notion that gender is defined by “gender performativity.” That the A.P.A. adopts this theory as being a scientific fact is rather odd. This is why the A.P.A. is more akin to say the Catholic Church. Indeed if you create a study that is peer reviewed and published that challenges another prominent researchers’ work, you immediately get called out for not towing the accepted line. This is exactly what happened to Lisa Littman when her paper Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports when data challenged the assumptions of other scientists currently in fashion. That people like Diane Ehrensaf, PhD from UCSF dismissed the study outright just shows how political and cult-like is the field of psychology and the APA. As a scientist, you would think Ehrensaf would be curious. “Interesting. You are taking a different angle than I did and found that kids with Rapid Onset Gender Dysphoria seemed to be due to environmental factors and a common feature was an addiction to the internet.” Instead, Ehrensaf dismissed the findings outright even though her work is often based on studies that have yet to be replicated. This is but one example of how the APA is not really interested in science but ideological conformity. Often, in the end they become the unknowing henchmen of the pharmaceutical industry.
Not related to men specifically, Drug Dealer, MD is an insightful look how the medicine in the United States is the cause of the opiod crisis. That “pain” is now considered a vital sign has profound influence on the prescribing of narcotics and other prescription drugs.
While reading the comments from the New York Times article it was interesting to read that the guidelines use of the word “stoic” is actually inaccurate, shallow and lacking of historical perspective. It is almost as though the modern psychologist notions of the topic of men was informed only by time spent reading the latest studies, watching beer and truck commercials, John Wayne movies and never bothered to learn some of the fundamentals. Three times in the paper it discusses how stoicism in men is a bad thing, that “not showing vulnerability, self-reliance, and competitiveness might deter them from forming close relationships with male peers.” A rather odd statement for anyone who has ever participated in athletics and formed bonds with teammates and opponents. Online, in the comments, someone pointed out that “Stoicism” as a ancient philosophy of life is very different than what perhaps how the APA defines stoicism. Recommended reading was the book A Guide to the Good Life: The Ancient Art of Stoic Joy Irvine, William B.
It is good read and what you learn is that Stoicism as an ancient philosophy of life has more in common with Zen Buddhism than emotional repression and asceticism. I am certain learning about Stoicism is much more worthwhile than reading the APA guidelines. For when after the APA psychologist, who is having therapy session with your anxiety-prone child, decides “maybe its time to start medication or hormones” and suggests Prozac or Ritalin, you will need to consult some of the practical advice from the ancient philosophy of Stoicism in order to come to terms with your life’s turn of events. But now I am going to stop writing, and as my father did before me, a very stoic creature,perform one of my many “masculinities” and do the dishes and clean the house.
Although there are differences in masculinity ideologies, there is a particular constellation of standards that have held sway over large segments of the population,
including: anti-femininity, achievement, eschewal of the appearance of weakness, and adventure, risk, and violence. These have been collectively referred to as traditional masculinity ideology
– From American Psychological Association’s guidelines for practice with men and boys.
What a strange definition of something the APA calls “traditional masculinities.” Of all the thousands upon thousands of men I have known, I have yet to know any who embrace that list. To stereotype people is a sign of a shallow intellect and for health care providers a dangerous path.