Sunday, July 31, 2022

Jim Rogers on the Markets and the Economy

From time to time I present the views of stock market mavens. Consider it a public service. 

Some people know more about the workings of financial markets. More often than not, they are elder statesmen of the world of finance. They are never hotshot young traders.

So, now we turn to the justly renowned Jim Rogers, formerly of the Quantum Fund, now living in Singapore.

In a recent interview, Rogers sounded a number of alarms, first regarding bear markets. As you know, many market watchers today are breathing a sigh of relief. They think that the bear market is over and that stocks are going to resume their upward rise. 

Rogers sees things differently:

I know more bear markets are coming. The next one is going to be the worst in my lifetime.

Many stocks are going to go down 70%, 80%, 90% - that's the way bear markets work. Of course that's going to happen. I just don't know when.

Why does he see a new and nastier bear market?

It's been 13 years since we've had big problems, and that's the longest in American history. It could go for 30 years, who knows, but it's already overdue on a historic basis. We have very high valuations, we have staggering debt, we have a lot of new investors coming in. It's not my first rodeo, I've seen this movie, I know how it works. They're all going to lose a lot of money. I hope I'm not one of them.

Where would he invest now?

When you have inflation, if you own the things that go up in price, you make money. Agricultural goods are going to go higher, energy will go higher before this is over. You can sell short many things, many stocks all over the world, and make a lot of money. If you don't know how to do either of those, put your money in the bank and wait - it's better to earn 1% per year than to lose 20% per year. Bear markets lead to big losses.

I own a lot of US dollars. Not because it's a sound currency - it's a disaster going forward - but in times of turmoil, people look for a safe haven. For historic reasons, many people think the dollar is a safe haven. It's not, but they think it is. US dollars are going to get overpriced, they might even turn into a bubble depending on how bad things get.

As for cryptocurrencies, Rogers is not buying:

There's no level at which I would buy cryptocurrencies, unless something dramatically changes.

Bitcoin is wonderful for people who buy it and sell it and trade it. I know people who are having fun trading it; nothing wrong with that. But if it ever becomes successful as a currency, no government's going to allow that. No government wants to lose its control - they all love their monopoly, they're not going to give up their monopoly.

As for the future state of the economy, Rogers sees an oncoming recession, produced by Federal Reserve monetary tightening:

Because we've made so many mistakes this time around, interest rates will have to go very, very high. We will have a serious recession; many people will go bankrupt, we're going to have a lot of problems. There's no other way to solve the problem other than to have double-digit, Volcker-esque interest-rate hikes.

We need to raise interest rates a lot, and have a lot of pain. Or we let people continue to print money, and have horrible, horrible inflation, and cause even more pain. I don't know how we solve the problem of too much inflation without pain.

As for the chance the events impact the market, Rogers has this to say about the chance that the war in Ukraine will end:

If there were peace, we might make new highs, but still that would not negate the bear market. If something positive happens in Ukraine, there'll be a big rally. Oil will go down, grains will go down, stocks and everything will go up for a while. I hope I'm smart enough to sell that rally, because that's probably the last big rally.

So, consider these views to be well informed. Jim Rogers is not a contrary indicator.

The Baby Formula Shortage Continues

Right now this feels like something of a footnote, but given the news blackout about the story, it is surely worth a post. 

The issue is the now-chronic shortages of baby formula, a vital life-and-death issue for many American infants. Clearly, the Biden administration has completely botched the problem, which is perhaps one of the reasons why senile Joe Biden’s approval ratings are lower than any other American president.

New slogan: Joe Biden-- the Worst Ever.

Or else-- Just When You Thought It Couldn’t Get Any Worse-- Joe Biden.

Anyway, we emphasize, yet again, that the mainstream media and the feminist matriarchy has had nothing to say about the baby formula issue. This tells us that they are all incapable of spinning it against Republicans. It also tells us that the media and feminism has been completely corrupted. If you thought that any of them cared about women, think again.

The Daily Mail, intrepid as always, has the story (via Maggie’s Farm):

The nationwide baby formula shortage has worsened with 70 percent of all brands reported out-of-stock, despite President Joe Biden's efforts to make infant milk more accessible.

Families in Rhode Island and Vermont have been hardest hit by the shortage with out-of-stock rates at 79 percent and 78 percent, respectively.

Biden and the Food and Drug Administration (FDA) have made it easier for foreign manufacturers to get shipments into the country, and appealed to companies such as Nestle and Reckitt to step up production.

Why are New England states hit the hardest? Aren’t they among the most reliable blue states in the nation?

The Biden administration is flying in formula from around the world. Unfortunately, it is not nearly enough:

Biden's solution to the ongoing shortage has been to fly in foreign formula to try to plug the gap, but the 802,446 bottles that arrive per shipment barely line the stomachs of the 3 million babies born every year. 

Danone, who has agreed to supply 1.3 million cans of Aptamil to the U.S., shipped out more than 750,000 this week. The initial shipments are already on shelves and online at Walgreens, Safeway and some other retailers.

Those who are interested can go to the Daily Mail story, which explains what is going on at Abbott Labs, whose shutdown contributed mightily to the problem, and which reports on some of the lawsuits that are beginning to address the problem.

Saturday, July 30, 2022

How Goes Britain's National Health System?

Just a note to awaken us all to the risks in having a national health system-- that is, socialized medicine. The sentences in question come to us from the Financial Times editorial on Friday. It concerns the manifest failure of the National Health System. 

The FT is most definitely not a right wing publication. And it does not get its facts wrong:

The UK’s NHS is in critical condition. A record 6.5mn patients are waiting for planned treatment in England, exacerbated by backlogs caused by the pandemic. More than 24,000 people waited more than 12 hours in emergency departments in English hospitals earlier this year. A parliamentary committee this week concluded that chronic NHS understaffing poses a “serious risk to staff and patient safety”. 

The next time you hear some junior socialist whining about national health care, recall this paragraph.

Does Cognitive Therapy Work?

Once upon a time psychoanalysis ruled the mental health profession. Most of you were not born when such was the case, but, whatever.

Psychoanalysis was everywhere, in the media, in movies, in classrooms. Everyone was studying Freud and Jung.

But then, several decades ago a psychiatric resident named Aaron Beck discovered that psychoanalysis was largely ineffective as treatment. It was especially ineffective in treating clinical depression. So, Beck invented what he called cognitive therapy in order to provide effective treatment for depression. Later he extended it to anxiety.

Of course, it took quite some time for cognitive treatment to take over the mental health field. Even today, when it is ascendant, it is still not practiced by all mental professionals. 

Many therapists continued to practice psychoanalytically inspired treatments, to little avail, especially for their depressed patients. Thus it happened that when Prozac arrived on the scene a few decades ago, the press was filled with stories about patients who had undergone psychoanalytically inspired treatment for decades, without there being any improvement. But then, they started taking Prozac and they improved.

The debate has lately become complicated, and I wrote about it in a previous post.

In short, alternative treatments have been proposed and practiced because psychoanalytically inspired treatments failed clinically. The same applies to the behavioral treatment for phobias. Since these have been significantly more effective than psychoanalytically inspired treatments, they are today the treatment of choice.

Today, Britain’s National Health Service will only allow cognitive treatments for mental health issues. 

Naturally, this has caused large amounts of soul searching for those who persist in practicing psychoanalysis. Among those who pretends to be defending psycho analysis is one Bradley Murray. Dr. Murray has written an article explaining that cognitive treatments are not perfect-- as though you needed a serious article to know that. He also explains that cognitive treatments are based on rational thinking-- which he feels is not sufficiently soulful. It feels especially whiny-- but what were you expecting.

In the meantime, if you read through the article you will discover that he never mentions that psychoanalytic treatment works. Psychoanalysis might help you scavenge through your past memories and recover your prior experiences, but when it comes to treating what ails you effectively, it obviously fails.

But, Murray does present the evidence suggesting that cognitive treatments do work:

… I have seen many patients like her in my practice who have found that CBT doesn’t resonate with them. Yes, research consistently shows that patients who receive this form of therapy are more likely to experience an improvement in symptoms than those receiving no treatment at all (or receiving placebos). And yes, CBT is one of the most widely used, well-researched and well-funded forms of therapy in the world, accessible through mental health clinics, online therapists, or even apps. But it is not perfect.

The fact that it does not work in all cases does not discredit the technique. The studies should factor in the different skill levels of practitioners, along with other human variables. But, working half the time is surely better than working none of the time. 

One recalls that famed French Freudian Jacques Lacan once opined that if anyone got better during a psychoanalysis, it had to have been a fortunate accident, not a consequence of the treatment. Now they tell us. Lacan also declared that psychoanalysis was a scam, but I have discussed that elsewhere.

In any event Murray tends toward vague and meaningless concepts like growth and development. I doubt that he knows it-- Lacan would have recognized it immediately-- but his thinking derives from Church mystics who underwent journeys into their minds in order to find God. Among the best writers in this tradition were Bonaventure and St. Teresa of Avila. Dare I say, it has nothing to do with science.

So, Murray champions soulful emotional states, as though our culture were not wallowing in them:

I believe their concerns can be best understood if we acknowledge that not all adult emotional problems ultimately stem from failures in thinking and reasoning, as CBT maintains.

Not all problems can be solved quickly through what CBT practitioners call ‘cognitive restructuring’. Understanding the limits of this popular form of therapy requires us to ask a difficult question: can CBT ever help us to fully develop psychologically?

And then, Murray follows Aaron Beck in suggesting that cognitive treatments derive from Stoic thinking. This is not really true, and one emphasizes that cognitive treatment has its origins in Aristotle, in the notion that symptoms were bad habits-- one might say, bad mental habits-- and that one could cure bad mental habits by replacing them with good mental habits. Since Freud’s work began when he decided that hysterical symptoms were meaningful expressions of repressed wishes, you can see that finding the meaning and correcting a bad mental habit are not the same thing:

Its philosophical roots go all the way back to ancient Greece, to the age of the Stoics. A faith in the power of reason can be found in most ancient Greek philosophy – and in much philosophy since. When we suffer, the logic goes, it’s because we’re letting our emotions get the better of us, pulling us away from seeing reality. Reason, these early philosophers argued, allows us to learn about things that truly matter, including how to be happy, live a good life, and free ourselves from negative emotions including depression, worry, anger, envy and jealousy.

Beck wrote that the philosophical underpinnings of CBT ‘go back thousands of years, certainly to the time of the Stoics, who considered man’s conceptions (or misconceptions) of events rather than the events themselves as the key to his emotional upsets.’

Of course, cognitive treatment does not involve thought reform as much as it involves reality testing. It involves something that is very like the scientific method-- taking thoughts, especially self-deprecatory thoughts, and making them seem less than totally convincing by testing them against reality. As long as we have evidence that shows these thoughts to be potentially untrue, we can think more clearly.

Learning to think differently about events is what CBT therapists call ‘cognitive restructuring’. Changing thinking patterns is what CBT therapists do when they teach their patients to avoid errors in reasoning and to view reality more accurately.

As I said, this is just the scientific method, empirical reasoning. It comes from Aristotle, for the record.

Even today, according to the CBT model, psychological disorders generally fit this mould: the patient is committing cognitive errors that lead to negative emotional states. Helping the patient reason more accurately is key to helping them feel better.

From the point of view of CBT therapists like Beck, the point of exposure is to teach the patient to think more rationally by giving them direct evidence that shows why their thoughts don’t align with reality.

One understands that in today’s culture more and more people do not believe that reality should have any say in their most cherished beliefs. Consider the transgender movement, for example, as I did yesterday.

The differences between CBT and psychoanalysis are striking. Whereas the structure of CBT sessions is meant to be directed by the therapist – who will assign homework at the end of the session – the structure of a psychoanalytic session is left open-ended by the therapist. The patient is encouraged to gain comfort over time speaking whatever comes to mind. Whereas CBT emphasises using a set of tools to form new habits of thinking and behaving, psychoanalysis involves an ongoing, collaborative and transformative process involving therapist and patient. During this process, the therapist notes ways in which the patient might, in the here-and-now of the therapy itself, unconsciously experience repetitions of situations from the past. These repetitions, known as ‘transference’, can indicate core psychological conflicts from childhood or adolescence – often moments when needs went unmet while growing up. But perhaps the major difference between CBT and psychoanalysis is that psychoanalytic therapy does not view all psychological problems as problems of thinking. There is no expectation that these problems can be resolved merely by helping the patient think more carefully and accurately.

Murray does not say it-- his approach is rather vapid-- but cognitive therapy does not see all problems as problems of thinking. After all, one of the side treatments advanced by cognitivists relies on the patient’s ability to change his behavior, to conduct himself differently in his everyday life. About this aspect of cognitive therapy, Murray has nothing to say.

So, Murray, who does not think very clearly, explains that cognitive treatments are effective, but not for all people at all times. Since these treatments require patients to engage in independent work on their problems-- it is not just about taking a pill-- one would expect as much.

It is true to say that CBT is an evidence-based therapy and that it is effective. But it is also true that many people are not helped by CBT.

So, Murray ends up with an insipid recommendation that patients should really get mired in their past, should try to access their "submerged selves"-- true, it’s an idiotic notion-- and should find themselves. Perhaps we should just give them a fishing pole:

But for patients like Valerie, the approach is too structured and educational to foster the kind of maturation and development they desire. It would be heartbreaking if these patients were made to feel like failures just because their concerns do not fit the CBT model. Not all psychological problems are thinking problems, and not all problems require correcting through cognitive restructuring. Given the chance, people like Valerie can learn to address their submerged selves, forgotten or ignored by therapies that focus on cognitive tools for viewing reality more accurately. Given the chance, these people can learn, instead, to empathise with their earlier selves in nuanced ways. They can begin finding themselves.

Friday, July 29, 2022

Mutilating Children

From time to time we hear that autocrats around the world are afraid of freedom. They fear the will of the people and insist on maintaining all powers in their hands. Surely, they are afraid of a free press where people of one political persuasion are often silenced and where the media parrots the Democratic Party line. They must be afraid of a university system that regularly indoctrinates students in a useless ideology.

By dumbing down the best we imagine that we are improving the self-esteem of the worst. And nations around the world refuse to emulate our example because they reject the notion that a boy can become a girl by changing his mind.

Transgenderism is in the news these days. As you know, the Biden administration, including the Pentagon, is totally in favor of mutilating children and even adults who ask for it.

Considering that a child cannot consent to perform a sex act with an adult, the notion that we should take the child’s word about whether he or she wants to transition is madness run amok. And, of course, we are so free that that civil authorities are allowed to remove a child from her home if his parents refuse to accept that she is a he. 

On the latter score, read this and weep. Kelsey Bolar explained what happened to Jeannette Cooper:

Jeannette Cooper never imagined she’d lose custody of her child. The 44-year-old lifelong educator always considered herself a loving and responsible mother to her daughter Sophia. But when, at age 12, Sophia suddenly claimed to be transgender, Jeannette was skeptical. Sophia had never exhibited signs of gender dysphoria. In fact, Sophia exhibited many more traditionally feminine behaviors and preferences than Jeannette ever had. To Jeannette, it didn’t make sense. 

But Sophia insisted, not only that she was trans, but that she was ‘unsafe’ around Jeannette. What followed was an almost Kafkaesque series of court proceedings and therapy sessions in which Jeannette’s ex-husband, lawyers, therapists and other individuals and institutions supposedly concerned with Sophia’s best interests worked to erode Jeannette’s most basic parenting rights. Nearly three years later, Jeannette can’t even visit with the daughter she loves. She lives less than ten minutes away, but can only communicate with Sophia by U.S. Mail. All because she insists that Sophia is a girl.

Note well, it is not merely about whether or not Sophia can transition-- under no circumstances should this be allowed. More importantly, it is about forcing everyone else to live the lie. Transgender activists want you to do what they tell you to do. They want to control your minds. They will tell you what you can and cannot think. To limit discussion to the impact of these treatment on vulnerable, brainwashed children is to tell only part of the story. Insisting that you must accept the lie is another important aspect of the problem.

And of course, the rationale is simple. The transgendered have a much higher suicide rate. Activists refuse to blame the physicians and the counselors and the bureaucrats who are facilitating transitions. They are happy to blame those who refuse to be lied to, who refuse to accept the transgendered as they want to be accepted. Link here.

In the meantime a controversial gender clinic in Great Britain, at the Tavistock Clinic has been shut down. If you read the story in The Daily Mail (via Maggie’s Farm) or PJ Media you will discover that the reason lay in the fact that authorities decided that the clinic was unsafe and that they needed to do more research into puberty blocking hormones. And they had discovered that autistic children were especially susceptible to the grooming that we are not longer allowed to call grooming.

In addition, the clinic had been inundated with demands for service, given that the new efforts to groom children into becoming transgendered had produced something like a 4400% increase in the number of cases in Great Britain. Some people, like Lisa Littman and Abigail Shrier, have sounded the alarm about this, labeling it a social contagion, but the mainstream media has still gone all-in on child mutilation.

Of course, the propaganda media, represented by the New York Times, reports that they are shutting down the Tavistock because they want to provide better, more holistic care in smaller settings.

The Times also assures us that puberty blocking treatments are perfectly safe and totally reversible. Of course, a girl who takes puberty blockers and who goes into menopause at age 13 is not going to be able to reverse the damage. That is why Abigail Shrier called her book, Irreversible Damage

In the meantime our very own Food and Drug Administration has just come out with warnings about puberty blockers. Read this story from The Daily Signal:

Puberty blockers earned a warning label from the Food and Drug Administration earlier this month after six minors (ages 5-12) experienced severe symptoms. The puberty blockers in question are known scientifically as “gonadotropin-releasing hormone (GnRH) substances.”

The minors, who were all biologically female, suffered from symptoms of “pseudotumor cerebri” (tumor-like masses in the brain), including visual disturbances (seeing bright lights that aren’t there), headache or vomiting, papilledema (swelling of the optic nerve), increased blood pressure, and abducens neuropathy (eye paralysis).

Jennifer Bauwens, of the Family Research Council added this:

“We already have studies showing the negative effects of both puberty blockers and cross-sex hormones,” but “any time we see more evidence and more publicity on the damage that these drugs do to kids, it’s helpful.” She added, “Good science is on our side. Truth is on our side. Those things always prevail when given the opportunity.”

In truth, we have reported on this very blog that cross sex hormones, the kind that transitioners are obliged to take for a lifetime, are poison. And dare we mention that what is dishonestly called gender affirming care cannot create a penis out of a vagina or a vagina out of a penis. The presumption that it can is terrifying.

Considering the extent of the gaslighting that is required to pass this off as medical science, and you might understand why America is not setting a standard that very many countries around the world are tempted to emulate.

Thursday, July 28, 2022

The Politics We Deserve

America continues its long slide from meritocracy to idiotocracy. In a nation where public education renders people stupid and uniformed, we end up with the politics we deserve. 

And that means, a politics that involve perpetual drama, constant conflict, raw entertainment, or, as the Romans had it, bread and circuses. Assuming that any of it is still affordable.

It is a politics led by drama queens, by shrill ranters who think that each issue spells the end of the world, who imagine that each court decision and each election brings the end that much closer.

Evidently, entertainment politics appeals to the dumbest among us. It appeals to those who do not really know how to think, but who are expert at the art of emoting. Better yet, our political circus is now conducted and performed by the dumbest among us. 

We no longer deliberate. We no longer debate the issues. We slander and defame; we attack reputations in a flurry of ad hominem assaults. One would think, upon looking at the spectacle, that we have lost our collective minds. That is, that we have lost the ability to join together to engage in some consequential political action.

When America’s competitors around the world look at the spectacle, at a great country being ruled by a band of clowns and buffoons, they know that they need but await the climax, when it all falls down.

Keep in mind, we are about to spend ourselves into inflationary oblivion in order to fight a war against the weather and in order to watch Russia destroy Ukraine. As though to prove the point, yesterday we saw the president and first lady of Ukraine in Vogue. Nothing like a spot of glamour while you are allowing your country to be destroyed.

But, Lance Morrow, author of the thesis that American politics has descended into entertainment for the uneducated masses, believes that citizens still have one foot in reality. In their private lives, when they go to the supermarket or the gas station, when they see what is going on in public schools, they see more clearly.

Let’s hope that Morrow is right, because politics as entertainment is a sign of cultural self-deconstruction.

So, bread and circuses, constant psychodrama, visions of the pending apocalypse, predictions of the end of democracy as we know it, Morrow sums it up well in the Wall Street Journal:

If it’s beasts of the jungle you want—the savageries of nature, red in tooth and claw—politics and media offer an ongoing and spectacular show replete with raging ideology, riots, race hate, store looting, police-car burning, pageant plays, Proud Boys, deadly pandemics, mass shootings, cops caught on video doing dastardly things, the Capitol assaulted by mobs. Politics and media are co-producers of the immense 21st-century moral circus. It offers Americans such grand and enraging constitutional spectacles as Roe and Dobbs, such extravaganzas as the Transgender Follies and White Supremacy vs. Black Lives Matter. Held over (though not necessarily by popular demand): The Orange Man and the Dotard.

And Morrow points out that entertainment politics appeals most readily to those who know the least. By avoiding the complexity of issues, by collapsing the distinction between two opposing points of view into a battle of absolute good versus absolute evil, we have gotten to the point where more and more people are more and more stupid. By reducing the American mind to terminal stupidity you manage to render the stupid people less embarrassed about their intellectual deficiencies. In the academic world that is the point:

The ways of performative politics and media prey on unformed minds. The danger is that, in time, those ways will supplant what we used to recognize as reality and, in its place, install their theatrical and sinister and essentially cartoonish ideas. What were Uvalde or Highland Park but instances of the (very sick) private mind enacting grotesque public performances.

For all that, it may be that the extreme divisions in America are now tending toward the sort of exhausted resolution that is suggested at the final curtain of “King Lear.” The house lights come up; it’s time to move on.

Americans are troubled, but they aren’t crazy.

We would like to think so. And yet, we also know, from a number of studies, beginning with that of the former head of the National Institutes of Mental Health, one Thomas Insel, that the mental health profession has not done very well at curing people of crazy.

So, beyond the entertainment that has invaded our homes and our minds, we find what Morrow calls a base-line sanity, where people see through the bread and circuses, where they refuse to be distracted by the show and where they go about conducting their lives:

But the private mind is still committed to the sanity and realism that are necessities of survival. What Americans worry about is inflation. Reality is an insistent thing. Grown-ups know that they are being imposed on by the big show. They understand that a circus is a circus. The sane American mind—mens sana in corpore morbido—is the best hope now, I suspect.

So, Morrow is an optimist:

The private mind can spot the public con. It used to, anyway. Private citizens know that many decisions in life—most, perhaps—are difficult and may involve 48/52 calls, even 49/51. It’s true in choosing a mate and other important matters.

Morrow says that public politicians have now become drama queens. And he suggests, tellingly, that the constant manipulation of emotion, the constant shrieking public hysteria, is addicting, about as addicting as social media is to our children:

Such is the dramaturgy of American public culture, of a performative public mind that is addicted to its sensations and categories. The American ideologue is a drama queen. I’m perhaps kidding myself, but I suspect that Americans in the privacy of their own minds, in conversation among friends and family, remain in touch with reality. On the subject of abortion, for example, or on race, guns and transgenderism, the private mind remains fairly sensible and humane. It remains capable, among other things, of tolerating contradiction. There is such a thing as intelligent ambivalence. People in the privacy of their thoughts don’t have to be consistent. They aren’t burdened or corrupted by the demands of performance. That is true even in the clamor of social media.

Agree or disagree, the educated mind can tolerate contradictions. The educated mind can engage arguments that tend to dispute its most cherished beliefs. The educated mind can accept the results of democratic elections without taking to the streets and shouting about how the world is about to end.

If that were not bad enough, surely democracy is, by the meager dim lights of our pseudo-intelligentsia, about to be swallowed up by the forces of evil. This means that the products of our deficient educational system, the thought leaders who conduct public debate are basically frauds and imposters. First among their goals, to ensure that no one figures out that they do not know what they are talking about. 

Let’s hope that Morrow is right, that the private American mind is more sane, more grounded and more pragmatic than is the public spectacle that our politics has become.

Wednesday, July 27, 2022

Is Depression Caused by a Chemical Imbalance?

Doubtless you have been puzzled. Recently, the media, and that means all the media, breathlessly reported that some researchers had discovered that depression is not caused by a serotonin deficiency, that is, by a chemical imbalance in the brain. 

Cue the outrage. Apparently, all of those selective serotonin reuptake inhibitors were not as powerful as claimed. And all those hundreds of millions of prescriptions should not have been written. 

Naturally, to be especially clear, I know nothing about medical treatments for depression. So I have hesitated to comment on the new findings.

And yet, I have now found a column, written by a psychiatrist named Max Pemberton, which explains what the research does and does not show. Pemberton writes for The Daily Mail and we are happy to see that one of our favorite newspapers has offered some sage commentary on the study-- what it does and does not demonstrate:

Last week, the debate was reignited with the publication of research into the 'serotonin theory of depression': the idea that low mood is caused by low levels of the brain chemical serotonin.

The new research claimed to have debunked this theory and, because the most commonly prescribed antidepressants work by boosting serotonin levels in the brain, this led to much discussion about whether antidepressants are effective.

And yet, Pemberton continues, the research did not study the effectiveness of anti-depressants.

It is important to say from the outset that this research didn't actually look at antidepressants at all, just whether low serotonin was the cause of depression.

And besides, the chemical imbalance theory is a simplification, not a scientific fact. In truth, physicians do not believe it.

But really this is irrelevant. The idea that depression is simply a chemical imbalance in the brain is clearly a gross over-simplification and I don't know a single doctor who believes it.

Now, for some useful information. First, that there is no single thing called depression. The condition is associated with a number of conditions, and its causes are complex.

Considering that depression might be associated with psychosis, which seems to be a brain disease and with bipolar illness which seems to be a metabolic disturbance, this is a high useful qualification.

Besides, as we have often remarked, and as we discovered during the pandemic lockdowns, reducing the amount of social interaction we have produces something like depression. And no serious psychiatrist thinks that anyone can solve the problem by taking a pill.

The reality is that depression is an umbrella term — it's a symptom rather than a medical condition on its own — and there are many, many different causes. It seems likely that it's caused by a complex interaction of biological, psychological and social factors.

It would make sense, therefore, that rather than one treatment, you would need a number of different treatment options depending on the individual. In the fight against depression you need an arsenal of weapons — and antidepressants are a useful part of that.

Needless to say, drug companies have been touting the virtues of Prozac and the other SSRIs. Their marketing has been sustained by the wild-eyed claims of psychiatrists like Peter Kramer who argued that Prozac could change your personality-- for the better or the worse, he was not very clear.

And yet, as a psychiatrist who has prescribed antidepressants, Pemberton affirms that in many cases they really do work. 

I am no fan of the pharmaceutical industry or the way it attempts to manipulate its data to make drugs appear more effective. I also think antidepressants are too readily prescribed and access to psychotherapy is far too limited.

But that doesn't mean drugs don't work when they are prescribed properly. For many people they undoubtedly do work.

And yet, while we are questioning motives we should recognize, as Pemberton explains, that the researchers who seem to have debunked a theory that no one believes are what used to be called anti-psychiatrists:

It's important to note that several of the academics involved in this latest research are so-called 'critical- psychiatrists'.

In other words, they are academics who disagree with the idea of prescribing medication for mental illness, so their conclusions are, perhaps, unsurprising.

So, they have a vested interest in the research. One is somewhat surprised to hear that anyone still believes that mentally ill patients should not be treated with medication. The theory had some followers, like R. D. Laing and David Cooper, during the 60s and 70s. It produced calamities, so no real psychiatrists were ever willing to apply it. In truth, psychiatrists who were practicing before the advent of neuroleptics and different classes of antidepressants categorically believe that these drugs have helped their patients.

As it also happens, SSRIs have been overprescribed, especially since many of the prescriptions have been written by general practitioners:

The answer is complicated. It is true that, in some situations, antidepressants may be given out too readily by harassed GPs who have just ten minutes to help patients with complex social problems.

Unfortunately, the mania about drugs obscures the fact that you can make considerable progress in overcoming your depression by improving your relationships. And, dare we add, aerobic conditioning exercises also have a demonstrably positive impact on depression:

However, there is no pill or potion on this planet that is going to make your bullying boss change their ways, or your bored wife love you, or remove the stress of looking after your ailing elderly parents.

That is not to say these situations aren't awful but, actually, feeling down about these sorts of things is normal, not pathological. It's not an illness, it's what medics call 'c**p-life syndrome'.

Sometimes it is right to feel bad about a situation. Feeling depressed or anxious are not necessarily signs of illness:

Certainly, social situations can trigger a depressive illness, but all too often people who are just responding to unpleasant, stressful and awful situations in a perfectly normal way are given a prescription and pushed out the door.

And then, in Great Britain, thanks no doubt to the wonders of the National Health Service, much severe depression goes untreated:

The flip side of this is that while antidepressants are being overprescribed in some quarters, in others, depression is woefully under-diagnosed and under-treated.

A horrifying study by the London School of Economics a few years ago showed that while mental illness accounts for nearly half of all ill health in the under-65s, only a quarter of people in need of treatment actually get it.

Further research conducted by Aberdeen University showed that GPs failed to diagnose major depression in half their patients, with the result that they went untreated.

There are large swathes of the population who are suffering in silence. Some of the highest rates of under-diagnosis occurred in older men — who also have the highest rates of suicide.

A confidential inquiry into suicide showed that fewer than 10 per cent of people who killed themselves had been referred to mental health services in the previous 12 months. How appalling.

For people who are struck down with depression, whether low serotonin is or is not the cause doesn't really matter.

People who are depressed need treatment. It might include medication, but it is better prescribed by people who are qualified in psychopharmacology. And treatment should involve more than just pills:

Such people need quick, individually-tailored, expert help, whether that's in the form of antidepressants, psychotherapy, social support or a combination of these things.

The fact that the evidence clearly shows this doesn't happen for the majority of people with depression is the real scandal and that is what warrants our attention.

Now, you have a better sense of what is involved in the so-called research.

Tuesday, July 26, 2022

Rasexism and Kamala Harris

Even by New York Times standards, this article is amazingly stupid. Written by an historian of some note, one Jeffrey Frank, it attempts to revive the flagging reputation of our very own vice president, one Kamala Harris. 

As it happens, it fails at the task, because it ignores the real reason that the nation is suffering acute anxiety over the fact that Kamala is a heartbeat from the presidency. It has nothing to do with Joe Biden’s ability-- that is, his inability-- to manage his vice president, but because Kamala suffers from that toxic mixture of incompetence and stupidity.

Amazingly, in the world of performatives, since Frank, presumably not an idiot, tries to revive the flagging reputation of a moron like Kamala Harris, he finds himself falling into stupidity himself. Amazing, don’t you think? So, we can ask the important philosophical issue-- can you defend an idiot without sounding like an idiot yourself?

Has Kamala ever done anything more than embarrass herself or the administration? Has she ever shown the least smidgeon of competence in the jobs that were accorded her? Not a whit.

And yet, Frank fails to take account of her incapacities, tending, like a good little wokester, to write them off as a manifestation of racism and sexism. Or, should we save ourselves a few keystrokes and write it--rasexism?

And besides, when has Joe Biden shown any competence or any intelligence in any aspect of his job?

Anyway, Frank opens by explaining how Dwight Eisenhower, someone who had manifested superior executive abilities, helped prepare his vice president, Richard Nixon, for the eventuality that he might have to step in and take over for an ailing Ike:

Just months after being sworn in as president in 1953, Dwight D. Eisenhower gave an unusual task to his vice president, Richard Nixon.

Years earlier, when Eisenhower was the supreme commander of the Allied forces in World War II, he was distressed over the unpreparedness of Vice President Harry Truman upon President Franklin Roosevelt’s sudden death. Now president at 62, a former four-pack-a-day smoker with what would become a serious heart condition, Eisenhower understood the importance of training a vice president for the presidency; Nixon had just six years’ experience as a congressman and senator from California before becoming Eisenhower’s running mate.

The president had no great liking for Nixon, whom he barely knew, but he gave him a lot to do — including dispatching the vice president and his wife, Pat, on what would become a 68-day trip through Asia and the Middle East. In the fall of 1953, the Nixons visited Japan, Korea, the Philippines, Thailand, India, Pakistan, Iran and Libya — the first of many chances for the vice president to establish personal ties with foreign leaders.

It was a deep education in diplomacy and statesmanship that served Nixon well. And the reviews were good; an enthusiastic story in Life magazine said that Nixon had established himself as “a mover and shaker of national and world affairs.”

Of course, and I hope it is not heresy to say so, but no matter what you think of Richard Nixon, he was very intelligent. One cannot say the same about Kamala.

Frank ignores the most salient point about Kamala, perhaps hoping that most of the dumb readers who spend time on his column, will join him in ignorance:

Vice President Kamala Harris, who was a first-term senator from California before entering the White House, hasn’t been given the sort of immersive experiences or sustained, high-profile tasks that would deepen and broaden her expertise in ways Americans could see and appreciate. 

Frank knows that Harris has been given a number of tasks by the Biden administration. He chooses to cover up her manifest failures by declaring the issues intractable. You see, if you want to overcome your rasexism you can start by rationalizing all of Kamala’s failings:

 But over the past 18 months, her on-the-job training in governing has largely involved intractable issues like migration and voting rights where she has not shown demonstrable growth in leadership and hit-or-miss trips overseas like the troubled foray in Central America a year ago and the more successful delegation to meet with the United Arab Emirates’ new president, leading a team that included Secretary of State Antony Blinken and Defense Secretary Lloyd Austin.

But, Frank also neglects to mention that the Biden administration sent Kamala to deliver an address to the Munich Security conference last February. Less than a week after her stirring speech, the Russian army invaded Ukraine. Not what I would call a rousing success.

In any event, Frank ignores Kamala’s manifest insufficiencies, and blames the Biden administration for doing nothing to prepare her for her eventual takeover of the presidency. 

Mr. Biden’s announcement last week that he tested positive for the coronavirus underscores the clear and present need for the 79-year-old leader, his aides and Ms. Harris to find ways for her to become a true governing partner rather than just a political partner who helped him get elected. This isn’t simply about being fair to Ms. Harris or elevating her as some other vice presidents have been elevated; Americans deserve to know and see that they have a vice president who is trusted by White House and administration officials to take over, should anything happen to the president.

And yet, despite the empty protestations of Jeffrey Frank, the Biden people know better than he does. They know that she cannot be trusted, and that her primary role today is to ensure that Biden remain in office-- recall the 25th amendment controversy.

Ms. Harris is not to blame for her relative paucity of national and international experience. She had been in the Senate less than four years when Mr. Biden selected her, and he did so knowing that she had never served in an executive role. But since he tapped her as his running mate in August 2020, we’ve learned that her bonds with him and key administration officials are relatively thin.

Of course, Frank is agitated, to the roots of his wokeness, by the negative stories about Kamala. He fails to recognize that many of the negative reports are mere clips of her uttering incoherent sentences. In any case, he dismisses them all as rasexism.

Ms. Harris has been a regular target of negative stories — about staff disarray and departures or her annoyance that White House staff members didn’t stand when she entered a room or even her discomfort in some media interviews. She has also faced double standards in how she is seen and judged, as many women and people of color are, including when they are firsts in jobs.

And then, Frank treats us to an especially vapid closing. He suggests that the reason people are refusing to work for Kamala and the reason why the Biden people are not wasting their time consulting with her, is not that she is a fool, but that they have somehow been derelict in their duties.

With the government itself under siege from a new class of enemies within and with more than two years to go until the next presidential election, Mr. Biden must not only find a way to infuse his party with enthusiasm and fresh purpose but also fulfill an urgent obligation — to his party and the nation — to hasten and advance the education and authority of his vice president.