On Cha: an Asian Literary Journal
http://www.asiancha.com/index.php?option=com_content&task=view&id=193&Itemid=112
Tuesday, June 2, 2009
Sunday, December 7, 2008
New Yorker article of Psychopathy
Psychopathy is not my favorite subject. But I find myself reading a cross section of articles on mental health, and letting the ideas pollinate across the various subjects. In this article I do sense distance between the author John Seabrook and the researchers, Dr. Kiehl and his mentor Dr. Hare. For example when Seabrook was interviewing Dr. Hare, he commented, "Hare was friendly but wary of me." I share that sense of distance with the author. I know the subject is important, but I'm not sure I want to get too close to it.
I've excerpted some quotes below just to give a bit of the background on Hare and Kiehl.
At thirty-eight, Kiehl is one of the world’s leading younger investigators in psychopathy, the condition of moral emptiness that affects between fifteen to twenty-five per cent of the North American prison population, and is believed by some psychologists to exist in one per cent of the general adult male population.In order to distinguish psychopaths from non-psychopaths among the Western volunteers, Kiehl and his students use the revised version of the Psychopathy Checklist, or PCL-R, a twenty-item diagnostic instrument created by Robert Hare, a Canadian psychologist, based on his long experience in working with psychopaths in prisons. Kiehl was taught to use the checklist by Hare himself, under whom he earned his doctorate, at the University of British Columbia.Today, Kiehl and Hare have a complementary but complicated relationship. Kiehl claims Hare as a mentor, and sees his own work as validating Hare’s checklist, by advancing a neurological mechanism for psychopathy. Hare is less gung ho about using fMRI as a diagnostic tool. “Some claim, in a sense, this is the new phrenology,” Hare said, referring to the discredited nineteenth-century practice of reading the bumps on people’s heads, “only this time the bumps are on the inside.” (Hare himself is a “strong proponent” of brain-imaging technology, but he noted that scans in isolation will always be insufficient.) Hare sees himself as a generalist, and Kiehl as “more of a data-driven guy.” Hare added that, while Kiehl’s brashness sometimes puts people off, “that’s why Kent gets things done.
And it was this paragraph below, that made me want to excerpt the article for this blog. It illustrates much of the misinformation out there which we have to deal with regarding mental health awareness. And this misinformation or distortion (I'm searching for the right word ... casualness?) is coming straight from the mouth of Dr. Kiehl, a PHD, doing fundamental research, an expert in the field. 1. The DSM definitions are subjective, cover a broad, continuous range of symptoms, and are mutable. You cannot take a blood test and get a definitive diagnosis. When Dr. Kiehl says "so much" it almost implies too much. 2. He mentions the famous drug companies that fund research, and profit from treatment. Quotes like this make the general public suspicious of what is happening. When you read commentary in the MSM you always run into this. 3. The categorization of the disorder is influenced on whether it treatable or not. (I have added the blue for emphasis.)
If a biological basis for psychopathy could be established and pharmacological treatments developed, the idea that many people have at least a little of the psychopath in them could well become accepted. As Kiehl points out, “It used to be the case that it was very hard to meet clinical criteria for depression in the fifties and sixties. However, the definition of depression has been broadened so much with DSM-IV that nearly every person will meet the criteria at some point in their lives. One reason for this is that drug companies have lobbied to change the criteria—because they have a treatment, a drug, that can help people even with moderate levels of depression. It’s a completely different issue whether this is appropriate.” He added that “even moderate levels of psychopathy may someday be considered a disorder—especially if we can treat it.”
Saturday, November 15, 2008
"Mental Health awareness raised in campaign"
The Bernardsville News posted my letter to the editor Thursday. I’ve made progress this week.
I met today with Pam Mastro, the Somerset County Mental Health Administrator. Pam has an open door policy and will take phone calls from anyone with a question or need about mental health. She is eager to help roll out a education and awareness program in our town. Her email is mastro@co.somerset.nj.us.
Earlier this week I met with Mary Lynn Bradshaw and Barbara Barklay. They are coordinators for the Stephens Ministers program at the Liberty Corner Presbyterian Church. The program is non-denominational, and is open to anyone in the community. The Basking Ridge Presbyterian Church has this program as well. A quote from their brochure:
Our congregation’s Stephen Ministry equips lay people to provide confidential, one-to-one, Christian care to individuals in our congregation and community who are experiencing difficulty in their lives.
One of the things I am focused on is how does someone make that first phone call for help. Because of the many obstacles to seeking care, I think the Stephen Ministers are a good model of lay people, in the community, that are available and can help refer the person to the right place for care. Each volunteer has 50 hours of training. The have a list of doctors and therapists within the community, who are all credentialed, and have been endorsed by the local program.
I see the benefit of a group like this, and am wondering if a more secular version of this could also be created for people perhaps not comfortable with a Christian oriented ministry.
More discussion will be coming.
Monday, August 4, 2008
Against Depression
Dr. Peter Kramer’s 2005 book, Against Depression, blows me away. I have read a lot of books in the last couple of years, but this is a rare one, that has me jotting notes on every page.
His chapter 12, “Magnitude,” answers the question: how bad is depression:
“Depression is the most devastating disease known to human kind.” (Researchers measure this statistically in terms of “good days” lost.)In 1996, the most extensive global-burden-of-disease study, conducted by the WHO, the World Bank, and Harvard, concluded that “depression will be second only to ischemic heart disease–in terms of disability caused.”“Estimates put the annual workplace cost in … America at over forty billion dollars.”“The best studies show that over 16 percent of Americans suffer major depression in the course of a lifetime.”“Depression often begins in adolescence. A recent study looked at children between the ages of twelve and seventeen, a stage of life when illness is rare. In the prior six months, 7 percent of boys and almost 14 percent of girls had met the full criteria for major depression.”Impact on the elderly, “researchers evaluated more than 5000 mean and women age sixty-five and older … over a six year period. Those with high depression scores were over 40 percent more likely to die than those with low depression scores.”In a cardiac study: after controlling for variables like social class, health risk factors (such as smoking), and other concurrent disease, depression still accounted for a 24 percent increase in deaths–from such causes as heart attack and pneumonia. “Think of it: a cardiac study that finds depression as deadly as congestive heart failure.”
These statements all relate to major depression. Earlier in the book, on page 69, Kramer writes:
“Depression is characterized less by acuity than duration. Depression is what settles in to stay.”
In these excerpts, I feel like I’ve done the book a disservice. I’m an engineer. Facts are my friends. So I start with the numbers. But Kramer’s writing is clear, convincing, artful. As I make my way through the book I see myself shifting seamlessly from one role to the next: patient, father, child, husband.
Wednesday, December 12, 2007
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