Radicalism and Canada

I am not a radical Canadian.  I’m pro Canada.  I was born here. I know Canada intimately. I’ve lived in various provinces and cities in Canada. I’ve lived and worked in wilderness, rural, suburban,  urban and inner urban areas of Canada.  I find more and more Canadians are urbanites whose knowledge of other areas of Canada are less than tourists.  Especially talking to activists and doom sayers I am astonished at their ignorance of the resources and wilderness of Canada.  When people talk of reservations I’m mostly aware that they’ve never been on one let alone the dozens I’ve been to.  When someone from Quebec talks about western Canada commonly their knowledge is less than Germans or Americans.  I’ve been to Quebec often. I’ve not worked there but I’ve spent weeks at a time in their cities and province.  Most Torontonians know nothing of Ontario let alone Manitoba.  Yet we all talk with ‘authority’ as Canadians.
I can honestly say that I don’t know any ‘radical’ Canadians.  The most radical Canadianism I know is the fellow who insists he’s not American.  I’ve lived in America as well as Canada and Britain so I’m not so sure I’d quickly judge these other countries in this way. Usually Canadians who speak like this are referring to the propaganda media representation of other countries. Canada is a country of misinformation and propaganda but I'm not so sure it isn't better than most countries where the governments are even more ignorant than Canada's is arrogant.
An American, in Colorado, on seeing my Harley Davidson license commented, “Canada, that’s north of us. Mexico is south, right?”  I answered yes, knowing that many people in Richmond wouldn’t know where Nanaimo or Squamish were or if Saskatchewan or Manitoba was further than Alberta.  We’re an ignorant people collectively in Canada.  There are always smart and stupid people but education beyond college isn’t rated as important as it is in Europe. I was astonished at travelling in Europe how admired education was for the knowledge not the money. Here a degree is equated in how much it can pay for a job.
I liked that in the US in a lot of places people who weren’t certified for a particular position simply weren’t allowed to do that. Here in British Columbia it’s attractiveness is that it’s the last place for the rise of the generalist.  The handy man can get the top specialist position.  Generalists and specialists are only differentiated by finance.  Standards aren’t that important.  Our construction industry is only better than Quebec's which is considered one of the worst and most corrupt in the world.
 Our education system charges a fortune for degrees but does little politically to ensure that those who don’t have a degree aren’t able to have the position because of what they know sexually or whose son or brother they are. One gets a degree in Canada only to find that the best jobs are already taken by those without degrees who knew someone or had some sexual or financial pull.
Corruption is a universal problem and while I’m critical of corruption here  in Canada ,my immigrant and refugee friends tell me that their countries make Canada look pristine by comparison.  By world standards the corruption of Quebec is probably mediocre.  My political science friend says that Canada as a country has ‘institutionalized baksheesh”.  Baksheesh is a bribe or a personal tax.  Canada is collectively taxed to dying while in other countries there are hands that need to be greased to get from one room to the next till you’re actually at the person who does the matter you have enquired about having done.Business is personal. It's more likely to get you killed in Mexico than it is in Canada for sure.
Increasingly Canada makes rules for companies and individuals behaviour overseas.  I can only believe these people are ‘wanting some of the action’ without actually knowing anything about other countries. Usually they have lived their lives a yuppies in some big Canadian city, usually Toronto or Montreal.
I’ve never been to Newfoundland.  I regret that.  The day I was to go, the ferry was cancelled because of storms so I never got there and travelled south to Boston instead.  One of the cross country road trips I took enjoying visiting the amazing variety that is Canada.  I truly love the geography and vegetation of Canada, the people, despite the homogenization of the people.  While the cities increasingly lack diversity, the land will never lose its appeal.  Tundras of the north, the Atlantic and Pacific, the great lakes, the Laurentians, the Rockies, the beaches of Vancouver, the wheat fields, and all the other cliches of Canada.  I love the land.
That’s what so many others want. They want our land and resources. They don’t want our culture. They don’t want our government. They don’t want our history. They’re like the first white men who came to Canada in the 1500’s. They wanted fish and furs.  Now the yellow men come and they want our Vancouver land for their houses.  The brown men want the place for their businesses only because our police have historically kept our businesses safe.  The blacks like to come here to get away from the violence where they were and to get into the trade we have here. No one wants Canadian Culture.
They do want ‘free health care’.
I’m a doctor and I have had ‘wage controls’ on my income for 30 years.  Doctors can't afford to buy houses in Canada because the "creepy" real estate moguls won't accept 'controls' except on doctor income. Everyone knows that health care , with the doctor and nurse wage slaves and rich fact administration, is what makes Canada most desirable.
I do a considerable amount of actual ‘pro bono’ work.  It’s had me condemned in the media, especially the pro dope trade Vancouver Sun yellow journalists,  because I’ve taken on those rejected marginal people who the courts and media  scandalize and shame along with me. I’ve defended these underdogs in my belief in ‘fairness’ and ‘justice’  and  “universal health care’.  I am shocked that in Bahrain doctors are jailed for treated patients.  In Muslim countries doctors are told they are only to treat the ‘right sort of people’.  This is tyranny.  In Canada may be a two tier system of care.  The rich often get what the poor cannot access.  Hence the rich go to Edgewood Treatment Centre like Betty Ford Clinic for addiction whereas the poor are given needle exchange and told to inject in the Insite drug pub where nurse waitresses will ensure they are cut off before they overdose.  Thanks to doctors and nurses accepting low hourly incomes and long hours and poor support the system works despite the increasing burden of interfering administration.
But I’m not a radical Canadian.  I’m just a Canadian.  We don’t really believe in radical anything here except maybe radical hockey, radical ideas, like love and quantum physics, string theory and multiverse.  We have heros who are scientists like Colonel Hadfield and also love our singers like Bruce Coburn and Laura McLaughland.  We give the Order of Canada to Dr. Jack Hildes for his work establishing Circumpolar Health Care as well as to Burton Cummings for his many hit records with the Guess Who.
I’m anxious around radical religion and radical politics and radical feminists and radical abortionist and anyone really who is radical enough to want to kill anyone, especially those who say ‘kill infidels’.  But the fact is I don’t know any radical Canadians.  I am not a radical Canadian and I don’t know radical Canadians.
 I do know the most amazing creative and ingenious Canadians.  I know Canadians who are loving and kind and yet would kill you in a second in self defence. I hate that the courts are so biased to the politically correct and serve primarily the rich and elite but otherwise they're not particularly onerous.  I have so many Canadian friends in the sciences, arts, military, politics, health care, law,  industry and resources and government and I truly admire them all individually in their work and home lives.  There’s incredible diversity in my friendship network and that concerns me because so many of my friends many of whom are elderly , young, Christian, Jewish, anti abortion, LGBT, writers, artists, performers, physicians, lawyers would be persecuted, arrested or killed living in so many of the nations of the world.  Half my friends would likely be arrested in Communist countries though I have several card carrying Communist friends.  Half my sexually diverse friends would be killed in most Muslim countries and almost all of Africa.  My Jewish friends would be persecuted in half the world. My Christian friends would be persecuted in China and countless other countries.  I am certain most of my writer friends, especially the poets would be arrested in most countries. The scientists would be made to work directly for the governments because they’re that good.  My business friends would likely do okay in their work but not be able to share what they think and feel socially. My political friends would generally be in trouble somewhere.
Canada is a land in which I’ve known freedom.  Increasingly I see this government and the policies of the world attempting to harmonize Canada to a reductionist 'world order'.  They want to reduce it to something radically un Canadian, something politically correct and 'safe'. Too few Canadians realize that 'buzz words' get their 'buzz' from the 'spin'.  What they sound like is the opposite of what they are.  Hence 'politically correct '  is truly politically incorrect.  And 'safe places' are the most unsafe places in the world.  At least 'carbon tax' is true since its just one more tax on a mountain of tax.  Sometimes these things concern me.
I’m not a Radical Canadian.  I don’t want to become one.

Istanbul Graffitti, Turkey

The government does an admirable job of keeping the city clean. There’s little graffiti of the normal sordid repetitive north american kind. The sad fact about graffiti is that some of the artist are really talented and because there is so much schlock the best of the best getting painted over by the clean freaks.  That said there was some lovely street art in an area of the city which the locals are trying very hard to save from a shopping mall hotel complex.  Right now the area has that Left Bank Paris flavour that spawns real artistic and intellectual creativity.
The struggle that’s going on in Istanbul today was immortalized by Joni Mitchel’s song that said “they paved paradise and put up a parking lot.”  The struggle over the park with a fight between police and locals at Taksim Square was the same competition of ideology - high rise mentality versus trees. There’s no ’third space’ in Istanbul. The Taksim park which my new Friend, Deborah had been through was also the subject of a very fine art work which we saw at the Istanbul Modern Museum.  One day bulldozers came in and the next students stood before them. This was followed by politicians who couldn’t be arrested taking a stand against the police and bull dozers. Then hundreds of thousands joined in including footballers who were famous.  There was tear gas and the normal cast of suspects and then the police left.  The park remains.  It’s a lovely place.  I love ‘green space’ or ’third spaces’ in these great cities.
Vancouver has its famous Stanley Park, loved and used by all the city. The encroachment there is not by bulldozers since we’ve been fortunate to keep them out. Increasingly addicts and alcoholics who spend their rent cheques on drugs are sleeping rough in the park and threatening to burn the place down with their open fires.  Recently a Downtown Eastside Park was taken over by a tent city, claiming allegiance to Occupy, which in New York was a wholly different phenomena than this tent city.
Urban planning and city dynamics are strained always with the history of riots in Byzantine Constantinople as just evidence of the age old conflicts that arise in cities.  In Montreal the graft and corruption of the city officials these last few years in Canada made the middle east look like choir boys. Millions of dollars were pocketed by city officials to allow all manner of abuse of the French Canadian population and it’s city.  The “enquiry’ , as so many such enquiries are  continues, but is limited and most likely the real kingpins will continue their graft and corruption while their cronies get away to do dirt another day.  In Vancouver the Portland Hotel Society had such a case of gross corruption and abuse of public funding but got off with loss of job and keeping of million dollar homes bought with the noney that was supposed to go to the homeless.
I couldn’t at my age be ‘holier than thou’ with the corruption cases I heard of in Istanbul because we have our own. However our graft isn’t covered up by ‘religious claims’ but just seen as white collar crime.  In Istanbul, probably because so many people among the radical Moslem population are so poorly educated the leadership can claim to be acting for god when indeed they’re just serving their own lust and greed. Apparently some palace is being built with public funds by the outwardly pious.  Istanbul needs a dose of our ‘televangelists’ who were caught literally with their pants down and hands in the cookie jar.  The trouble is the Imans as we seen with the Charlie Hebno killing have convinced the populace that ‘transparency’ isn’t good for Allah, whereas I believe ‘we’re as sick as our secrets’ and can only have good politicians with ‘open society’.  Otherwise psychopaths will continue to masquerade as saints while stealing from the children, the widows, the poor and the old.  Istanbul seems to be having this problem on a larger scale than Vancouver. But Vancouver is young and 2 million whereas Istanbul is 12 million.  The more the merrier when it comes to ‘white collar crime’ .
 

International Education and Training in Addiction Medicine - ISAM 2013 - Kuala Lumpur

(The following are my rough notes from the International Society of Addiction Medicine Conference Kuala Lumpur Symposium. I hope that it will give some idea of the depth and breadth of presentations but apologize if there are any errors and would ask that you go to the sources for the definitive information in the area of specialization-W.Hay)
Greg Bunt, President Elect of ISAM


Gabrielle Welle-Strand, Norway - hosted ISAM conference in Norway 2 years ago - coordinating project to assess training around the world

1) Addiction Psychiatry Training in the US - Merrill Herman

I began wanting to be an orthopedist but a psychiatrist working in addiction at Cornell served as my mentor.  There was a methadone clinic there…. Then at Einstein….I met Greg Bunt…..met Marc….he wanted me to come to NYU to be his first fellow …..somehow Dr. Bunt joined us and we became first two fellows in addiction psychiatry….2 years program….but a lot of the training was on a dual diagnosis unit at Bellevue……not a lot of addiction psychiatry with medicine…..mostly dual diagnosis and that was role of addiction psychiatrist….went to be medical director of adolescent dual diagnosis unit….I'm from the Bronx and got recruited to come back to do the Methadone program…..integrated primary care program….I became first psychiatrist in department of family medicine…..AIDS epidemic hitting full on in New York…worked with Peter Selwin, HIV researcher…I was working and teaching residents….department of psychiatry didn't want anything to do with addiction….all the addiction medicine was coming out of family medicine….then they asked me to become director of addiction psychiatry fellowship - we now have addiction consultation in general medicine service….expose students to HIV, hepatitis, methadone, we have classic methadone, ISAM is interesting because the Bronx is multi cultural and a lot of my fellows came from all over the world…..and they'd tell stories of alcoholism around the world…..one of my residents is a sik and there's a major problem with alcoholism in sik community - crossing cultures, where do they fit in….I went to temple and was honorary sik for day - they couldn't talk about alcoholism - talked about it through the other medical problems, hypertension, diabetes……department of psychiatry began to like us and then they took us over and theres this evolution, full circle back into psychiatry…..there are 46 addiction psychiatrist fellowships and 16 addiction medicine residents - theres now parity between medicine, psychiatry and addiction - there are people who leave our family medicine , psychiatry and go to addiction…we need way to find way - there's a big need - there's not going to be enough addiction psychiatrists or addiction medicine - where are we going to go - where in psychotherapy and psychopharmacology - we need to link our forces together, addiction psychiatry and addiction medicine.  ISAM is bringing the various expertise from around the world
2) Addiction Medicine Training in the US - Dr. Stuart Gitlow - president of American Society of Addiction Medicine


First question I want to ask is what per cent of public is addicted …you might think …somewhere between 10 and 15 % - we have 5000 doctors in states certified - not all active -I'm a young addiction - there are 3000 actively practicing - more than half have only 8 years before they retire.  There are 60 fellowships, about 100 doc produced per year - were losing numbers - at the very time when we passed the affordable care - that will increase demand for addiction docs in the socioeconomic area likely to use -where are they going to go
Who can treat addiction - we dx'ed it as a disease of the brain - the reward system of the brain - in a way different from the substance - we may in future be able to identify a person who will need treatment - what is the difference between sw, counsellor, nurse , peer, psychologist, non addiction doctor, addiction doctor, addiction psychiatrist - they're all important but what is the difference. ---Spectrum of training - we need to be able to readily what a nurse can do that a doctor can't and what a doctor can do and nurse can't - ny times ran series on buprenorphine treatment - many doctors are prescribing buprenorphine inappropriately - we looked at what percentage of prescribes were members of addiction therapy - only 20% were members - so what percentage of nurses, and others were doing wrong - we in ASAM decided to move away from being a guild and letting non doctors in to the organization - we could provide training for the people - if I gave you 20 hours or a 1 year course - would a person with nursing or psychologist would that person differ from the physician.
Not many people go into field of addiction ….we wanted to know what to do to maintain people in their interest - medical students year1 - if we ask them 80 to 90% say yes, but in year 4 - 80 to 90% say no - something we're doing in medical school is wrong - so we took willing students  and placed them in a rehab program for 1 month - they went through as if they were patients - these students wrote book chapters on their experience -thought they were just like them
I encourage that kind of experiential process
 We followed them and everyone who did that was involved in some type of addiction work years later

3) Training in Addiction Medicine Training around the world and ISAM's network of addiction.- Gabrielle Wells-Strand

ISAM -evidence baed education and adequate training
we have ISAM exams
established network of national contacts in as many countries as possible
developped questionnaire
Limitations - some of questions in questionnaire not clear enough, my interpretation may be wrong but it's a start

National contacts

Populations
greater than 100 million
50 to 100
10 to 50
less that 1o million

Organization of drug treatment
primary care - belgium denamark
Secondary care  hungary japan,
Mixed models - australia
Under which speciality is addiction medicine organized
psychiathry - canada, england, indian, japan, sweden
Medicine - australia new sealan
several - france
primary care - belgium

Present training and certification
-advance training and certification - austrailia , NZ
Systematic training and certification - Finland 2 years, Hungary 2 years
Master program - australia, NZ, nethenlands
 National training courses in addiction medicine - canada, denmakr
Part of psychiatry

Future Plans
-full specialty - norway
Subspecialty - sweden, thailand
master - indonesia

Where do we go from here
- ISAM products - feed back on ISAMS rol in promoting Addiction Medicine training in different countries and discussion
Put national contracts and survey on ISAM web page
mobilize more national contacts and evaluation

4) Barriers to Addiction Medicine Training in Australia and New Zealnd  -Dr. Mark Montebello - Chair Chapter of Addiction

Medicine Education Committee -
Population australia 23 million-156 ChAM Fellows
New Zealand 4.5 million - 21 ChAM trainees
There were 4 models and we now can't get people in because of the barriers.  The program is great but has a very high standard.
Problem with aging workforce and shortages
To get into the program you have to have done another specialist

Pre requisites
Registered medical practitioner
and fellow of one of the following
-anaethetics, emergency medicine, general practice, adult medicine, pain medicine, psychiatry, rehabilitation, Rural and remote Medicine, Pediatrics and Child health Division
or completion of RACP General Basic Training - 3 years
To develop a fellow who is competent to provide a specialist level, unsupervised comprehensive medical are in Addiction Medicine
18 months core training
- prescribing, pain meds, public health, psychiatry and co morbidity, general medicine
- non core - working in rural setting, isolated communities, indigenous, specialists in research,
-everyone has to do research program and quality improvement
- all under review - moving towards the canadian model - must demonstrate learning objectives learned in clinics

Clinical assessment, attitude, ethical issues, administration, teamwork, medico-legal, self-education, patient management, communication, cultural competency, clinical decision making, health advocacy

23 specialities in college - hard to get consensus
get stigmatized,
Study investing ChAM Training Program Barirs
Aims to examine Junior Medical Officers knowledge about cham
to identify barires.
said things like I don't know, it's okay
JMO's - in medical curriculum - get huge exposure to hematology - very little to addiction medicine - the addiction ward is very old wing, versus the hematology ward
We've become more flexible and offer 3 months
Looking at having a 'masters'  - it's already done in Public Health
Looking at it as another way of getting into the program
Also developing diploma for 6 months and this is already in other specialities

5) Improving Conversational Skills in Addiction Medicine -Cor de Jong - Netherlands

- Residents in Addiction Medicine - have 80 well trained
Master in Addiction Medicine
2 years full time cours, 20 residents per group, accredidtated by Royal Dutxh Society of Medicine
Competencies
Themes
Modules
Academic teaching at University and Clinical teaching
Evidence based medicine and professional medical communication
Relationship - rapper building and relationship management
Motivational interviewing
Shared decision making

General aspects of a conversation - welcome, introduction, agenda setting, time monitoring, involvement , empathy, word choice
Non verbal communication
Retreat, Motivational Interviewing, Bedside , role playing, Moral dilemans, family counselling, aggression management
Personal learning style, Interpersonal behaviour Feelings.
Measuring quality aspects of professional communication
Can we measure this, Instruments and video assessment, rate with 3 or 4 observers.  Cross correlation  - intra class - showed reliable instrument
Means scores given at the end of 2 years
Instrument - successful and then get others who get second chance
We developed focussed training course in professional conversation skills in addiction medicine

6) Norway II - shaping of a full speciality in addiction medicine - Garbrielle Well Strand

- first medical specialty in 15 years
 first medical specialty developed by norwegian directorate of health
at the same time - suggested change in the education across the board
first proposal turned down in 1999 - said existing specialities should take care of these patients
2003 - turned down  - better strategy to increase training in family practice and pscyhiatry
2012 - successful - drug reform of 2004 - specialized health care got the responsibility for drug treatemnt
documented increased and severity of health problems among drug users
increased research and knowledge based medciine

Ministry of Health has commissioned Norwegian Directorate of health to evaluate the present specialty training

Part 1 -18 months - 12 months in hospital(general medicine/surgery/psychiatry) and 6 months in municipal general practice
Part 2 - 0 to 3 years fro groups of specialties that naturally fit together
Part 3 Common platform for groups of speciality

Common compulsory cores

New speciality should take account of user involvement and interdisciplinary cooperation
Cooperation between specialists and municipalities

A specialist in Addiction medicine
should always involve the user
-group level
have non stigmatizing practice
 be competent in cooperating with different parts of health services
Developing plans for course work
Teaching goals
Assessment standard
Specification and accreditation = for teaching hospitals

Addiction medicine specialty - training and placement and course work laid out.

Step 4 and Resentments, Institutions and Community

In 12 step programs we are encouraged to do a step 4 listing all the persons, institutions, and or principles we had a grudge against. Later we look at how grudges develop because we have unrealistic expectations. These persons, institutions or principles get between us and security (and or money), our sexual desires (marriages, mistresses, lovers), our ambitions (where we want to go, who we want to be) and our personal relationships (our friendships, status etc.)
Some of the institutions are as follows:

Government - in the 12 step programs there's the recognition that commonly individuals are emotional immature, fixating in their development at a time of trauma in childhood or at a time when they turned to their addictions to deal with the anxiety that followed the trauma or stress that was occasioned with something as everyday as "growing up". So there's a tremendous amount of anti authoritarianism in the society and this shows up with anger at paying taxes, frustration with the arms of government starting with the world, federal, provincial or state and moving down to city and local strata.

 Religion - it follows if we are antiauthoritarian and verging on anarchist like most 'king babies' are would want to be 'accountable' to a God, or even a 'higher power'. We certainly don't like the idea of accountability and we certainly don't like the idea of 'spiritual laws' since we're not particularly happy with 'speed limits' on the highway that we can be fined for ignoring. We don't even like gravity and would want to fly not that we would want others to have this capacity since that would interfere with our own flights of insanity.

Education - we generally encountered rules in home and then in the first institutions of school and church. The schools were a kind of training ground for adulthood and we often didn't like to do as the teachers or principals said and we didn't like completing assignments as we were told to or when we were supposed to. We didn't like the hierarchy there and we didn't like our inadequacies being made public. It was alright when we were the A student or the winner on the sports team or the soloist in the choir but we weren't particularly happy to have no attention so often got negative attention. Later we'd blame what we'd come to know as 'defects of character' on the organizations that were supposed to be moulding our character.

Money - The institution of money and how some people had more and we had less and how families and tribes got more and others got less all upset us to no end. So often we'd focus on these 'entitlements' rather than consider our own 'benders' and 'wastes' and how we'd alienated the institutions that might help us get more money.

Work- the need to contribute to society and have a job and participate really peeves the addict who would rather be out playing hooky and pursuing pleasure so since work often delays gratefication with the primary pleasure pursuits of the addicts it's soon forgoten that work is a means to an end and increasing work becomes anathema.

 Family - this is an institution that gets a lot of flak from the addict because of the unrealistic expectations that addicts and alcoholics have placed on family members. If they can blame their parents or siblings for their losses or lack of achievements then they don't have to look at themselves and god forbid their 'addiction'. Addiction works like a virus in a computer hiding itself by every means possible and yet taking over all programs and making them work poorly, like a cancer really. Alcoholism and addiction have been called 'cancer of the brain' and the 'great chameleon' since they appears as everything but addiction. The Addict or alcoholic then ascribes the 'problems' whatever they are to 'family' or 'work' or 'school' or some individual or institution.

The Banks - we didn't like the banks if they didn't loan us money and if they loaned us money and then they wanted it back with interest. We didn't like the paying back part. Anything that interfered with our personal pleasure was something we developed a grudge against.

The Courts - we came to realize that while the government was a problem if we'd ever dealt with the courts directly they were even more of a problem because the judge might well not agree with our view on the way things happened in an event that got into his court room. We might object to only lawyers being judges, only educated people being judges, judges having so many powers, the way the courts worked, lawyers, the way lawyers were recompensed, the history of the courts, any number of aspects of the courts that we could bitch about if we somehow got an unfavourable judgement.

The Prison System -if we found ourselves in the institution of the jails we had a lot to be resentful about.

The Medical System - we could have a grudge against this. Sometimes alcoholics blame their liver failure and gut bleeds and all the other failures of the body to deal with self poisoning, on the care of the doctors, nurses and hospitals, rather than consider who caused the problem and who can stop the drinking and drugging.

The Psychiatrists and Asylum - if we found ourselves in the psychiatric system we could develop real resentments against the whole deck of cards that makes up what people insist is 'reality'.

There are the 'mind police' we have resentments against, the 'feeling police', the 'gender police', the 'sex police' and increasingly all these police and punishments of the courts and jails and psychiatrists and asylums were overlapping.

We didn't like anyone who interfered in our freedom. Society - so what it came down to was we wanted to be alone with our addiction what ever our pleasure lever was that we, (like the monkeys who have a brain operation to their pleasure centre and will spend all day pressing the lever until they die if they're not physically disconnected) didn't like anything that got between us and our 'pleasure lever'.

So others, humans in general were a curse to others unless they were somehow helping us, building levers and putting electrodes in our monkey brains, otherwise, be gone. So it's not surprising that so many people with addictions are in the end very unhappy unless they are actively drinking or using or have the electrodes in their brain hooked up and they're pressing that lever 24/7. Wow!

So addiction tends to break down relationships reducing their reciprocity, decreasing their depth, and increasing their shallowness. People may pull away from long term friends and claim new using friends are just the same as family and friends known for years. Suddenly the person met last week, usually a buddy who shares the addiction is as important as a person who knew the person for decades and stood by them through thick or thin.

In Jaggerts curve of the decline of alcoholism there is a movement away from others to the source of addiction, anything that takes time from being 'available' for the 'call' of the addiction or to respond to the 'craving' for alcohol gets put aside. Increasingly a person stops belonging to community, going to work, attending church, being a member of a club or organization. They become solely 'on call' to their new God, whatever is the addiction, what ever lever they've got their brain's pleasure centre electrically hooked up to. So they're distracted and not really present for anything but their addiction where they worship at the alter like the greatest zealot.

Having rejected all the community institutions as a result of addiction which ultimately aims to have them alone with their addiction when they stop their addiction it's not just stopping the drug or alcohol that is 'recovery'. In medicine setting a fracture isn't the cure if the patient stays in bed where the broken leg took them. Rehabilitation is walking again.

Rehabiliation in terms of the disease of addiction and alcoholism is termed 'recovery'. The 12 step program was developed to assist people in recovery and understanding. Hence the person who sarcastically in a meeting says "a thermometer has degrees and you know where we stick them" is likely to have left school and formal learning and avoided education and formal learning, to their own detriment, despite no longer being a drunk or a drug addict. In this regard they need to address their own unresolved anxieties with the education system and let go of the long seated resentment at perhaps leaving school or failing, or perhaps return to school to make the achievements they want in recovery. Similiarly a person who 'jokes' 'sarcastically' that they are a 'recovered catholic' might well need to look at their own leaving the church and return to change the church or start a new church, join a different church or at very least let go of the resentment against an 'institution' that has served billions. Institutions are generally simply organizations that individuals have solidified to enhance the good of some activity.

Even the military is an organization that improved on the original need of a small group to defend against another small group. If I had resentments against the military I might perhaps become involved in the peace movement. But the idea of the 'critic' and 'righteous anger' is beyond the alcoholic and addict because part of the disease of addiction and alcoholism was the mental process whereby we became the most adept 'critics'.

Dr. Paul O. a famous writer in recovery said he could find fault with a blank wall and if you didn't see the problem that made the problem even worse.

Today whenever I hear others or find myself 'criticizing' an institution I ask what would I replace it with and how much time am I willing to put into this alternative. If I'm not going to run for government and sit in parliament and listen to old fat cats belly ache and complain and argue, then maybe I should just accept that politics is never about the best but rather the picking of the least bad. In the case of the alcoholic or addict I have to stop thinking with the 'idealism' of a child and 'participate' to see how getting anything done in this world is like herding cats.

Institutions have developed often over hundreds to thousands of years to deal with the the principal problem of the alcoholism or addict, talking alot but not getting anything done, criticizing a lot but creating little. Recovery is about creativity. It's said that a 'meeting' of a 12 step group only needs a 'coffee pot and a resentment'. A person in addiction will leave the meeting and go off alone to be available for the call of their addiction whereas a person in recovery might well leave a meeting and go off and set up another meeting more to their liking. The world is such that if I don't like a school I can create my own, and the same goes with churches, laws and governments, if I wish to invest the time and energy that those whose names are associated with the major institutions did.

Personally I'm more often than not thankful that others will take on the leadership and invest the time and energy that makes for the olympic champions of society no different that those olympic champion athletes. I also know that recovery means I'll participate in community and contribute creatively. As Dr. Phillip Ney, a spiritual psychiatrist liked to day, the world doesn't need another bitter critic especially if they're an old man or old woman.

Sandy Hook, Guns, Asparagus and Social Terrorism

It's like Columbine all over again. The same occurred in Montreal. A tragedy occurs and those who have an ax to grind, or a gun to load or unload, derail the story with utter disrespect for the principal players, the victims and victimizer. These cabal of hyenas then put their brand all over the thing to sell their idea of a new world order or peace on earth stealing the Sandy Hook tragedy from those who forever live with the reality of the 'thing'.

What concerns me most about these random acts of violence, truly far rarer than the common random acts of human kindness that routinely go unreported, is that they overlook the most obvious facts of the critical drama played out by victims and victimizer.

 First and foremost the person who is accountable is the killer yet ever so very quickly we are distracted from the individual and individual responsibility to somehow feeling perhaps that his eating or not eating asparagus was as important as President Obama and the National Firearms Association.  The thing suddenly becomes about asparagus rather than about murder.

Frankly I'd think the Rifle Manufacturers wouldn't want to be drawn into this any more than a Toyota executive would wants to have his company's name mentioned when there's a car accident involving the deaths of dozens of 'victims'.   Rarely do I hear what 'brand of car' was involved in a drunken mass murder on the highways but  I actually learned what bullet types were used in this killing.  This is odd as  I can't recall anyone telling me the nature of the steel, domestic or foreign,  used in the recent slashing and stabbing that occurred down the street in my own city.

The critical factor to is that this man was part of a family and raised in a particular way in a particular community and went to a particular school. Somehow even our highly offensive media and this culture of irrelevance and  fatuousness have less influence on a person than the presence or lack of presence of a person's family. There is first and foremost accountability in the family and immediate community, followed by school and teachers and perhaps church, mosque synagogue and religion and lastly political party affiliation.   Did this kids' family vote democrat or republican in the last election?

For years we've been denying any relationship between children and their primary caregivers. This way when a child becomes a nobel prize winner we can't thank his parents for a job well done. Because simply, no praise, no blame. So some inanimate object, a tool, is held accountable for an intentional action rather than the people who gave birth and raised this child to manhood or increasingly in the case of violence these days womanhood. And I've known a mother who raised her son to jihad and spent every waking day of her time with him encouraging him to kill with revenge the infidels. But today I'd think Einstein wasn't responsible for relativity theory it must have been the pen or pencil he used that created that marvellous wonder of science.

It's amazing what can be given with mother's milk but we can't look there can we. We can't ask where was the father either.  Why wasn't  the father teaching his son the proper use and handling of guns. We can't ask either what gun safety programs were available in that community or what requirements specifically were in place around the purchase of guns if the guns were 'legitimate'. Somehow when teenagers are driving without a license and crash stolen cars we all register that there's something intrinsically wrong about the issues of possession, legitimacy and education in this case yet somehow those critical areas of concerns have been lost in competing agendas that have no respect for the victims or victimizers in this case and more concern with collecting funding for non profits and lobby group CEO's.

Not in a generalized consideration of a irrelevancies, but specifically what salesperson sold a gun to a man wearing a cap that said "I"m going to kill children first opportunity I have."? We ask bar tenders to assess the drunkeness of patrons before they are served so what occurred in this specific case? I don't know. I heard this whole important story immediatly hijacked by these dirty people with dirty agendas who simply love to pounce on these kinds of stories for their own promotion.  The causes and agencies with a dog in a wholly different fight were all over this story from the get go.  They lust for these kinds of the stories.

I never did hear the important parts of the very specific 'crime'. I don't know the name of the man who sold the gun to this man who was wearing a look "I want to kill my mother."  I want to know about that individual more than I want to know about asparagus.  I don't think what he ate was as important as what music he listened to or what magazines he read.

I want to know about this specific school and whether there were any courses on morality which I suspect were absent since God has been banned from the schools. I didn't hear any one saying 'perhaps we should return to having prayer in the school' since it seems these kinds of events have occurred in America since America dropped prayer from the curriculum. But I'm just a social scientist and I'd say that there have been guns around forever but this mass murder at the school seems to have taken an increase since we allowed the  courts rather than elected make decisions for society.

Now wouldn't that be interesting to hear from the media which frankly I would love to say caused these tragedies if only because there's often better news coverage these days from the late night comedians than the supposedly learned 'talking heads'. I do think that the whole exercise is about denying the individuals their personal tragedies and not letting the police do their work realistically, not politically and not as an 'entertainment' which this 'circus'  certainly became rapidly.

 It's not about guns as much as it's about accountability and responsibility and whether individuals, families, communities, business men or inanimate objects or whether he did or didn't eat asparagus is the problem. Next thing I'll be hearing is that this bad little monster kid ate at  Macdonalds and Big Macs cause mass killings so Macdonalds should go strictly vegetarian.

At least these events do wonders for reassuring us about the collective stupidity and herd mentality that will guarantee that more of these will occur. As we learned from teenage suicide epidemics, we can learn from Columbine and Sandy Hook , there's a whole lot of irrelevant inadequate needy individuals who will now know their way to fame is to shoot up their neighbourhood. That's why we put a muzzle order on the media reporting of terrorist acts back in the day of Carlos so that terrorists couldn't use violence as a means to get a stupid sideline view to the maximum number of people without going through American Idol like the rest of us.  As a result terrorism was then controlled better by the authorities. This kid was a social terrorist by any definition and these acts of apparently random violence are 'terrorism'.  As a result we should learn from the terrorist experts and take that learning into the schools.

When we advertise a teen suicide a dozen copy cats occur.   I'd like the media to be held accountable for it's celebration of death and to take some of the responsibility for this act of mass destruction. I'd point out to that the use of armed air marshals on planes and metal detectors are the best bet that multimillion dollar air industry has arrived at. When I enter a court room I have my bag scanned and empty my pockets.  I think kids would be safer in schools if the entrance had a metal detector and there was an armed security guard not unlike any government office. If anything perhaps we could learn from the death of the marines overseas and from these kids and ask what we can do to really make our schools safer because terrorism isn't going to go away just because we all collectively keened on face book.

While we're getting real we can also consider that this is the best evidence that removing God from the school has failed and perhaps suggest that a post constructionist study of morality and ethics in light of the learning spirituality should be as important to a school curriculum as art.  All the collective moaning and keening and angst isn't going to do much to stop the next attack. It's  being planned right now by some little nobody  needing serious psychiatric help in a society that would rather spend more money on public relations lawyers to do 'damage control' than on mental health resources to prevent the problem.

Let's get real. This isn't about inanamate objects, it's all about people. And personally I'm a little tired of those folk who get paid to hijack the news to their own ends. And yes we should also out law bombs, oops we did that, didn't we? And by golly gee, the president still has a security detail and the borders still have armed guards. Now why is that?  Don't you think we should care for our children, seriously.